Wednesday, September 5, 2018

On Nike.



Nike.

This is the same company that created a dri-fit hijab for Muslim women athletes. “Seeing” people is not a new thing for them.



Nope.



For those feeling conflicted about the “Just Do It” campaign? Know this: People REALLY like to matter. And if you and your loved ones get to live your lives every single day as the ones who consistently get to matter in this country by historical default? Or if you’re down with Kap and Nike but are among those who have the luxury of being able to voluntarily remain silent or indifferent on a whim because of your outward appearance? Thank your lucky stars.

For real.




After that, take a moment to wonder what it’s like to breathe an involuntary sigh of relief every single time your black husband or son makes it home after dark. Or to regard the millions of families like ours who have to regularly run through “the police drill” with their middle school sons at the dinner table—because it could literally be life or death someday if you don't.

So you have to start early.




Sigh. 



It’s so much deeper than shoes, man.






Oh—and for the record? I’m the proud wife of a Ranger-qualified United States Army Veteran who approves of this message.

Don’t have a full appreciation for what a U.S. Army Ranger is? I'd suggest you Google it.

Seriously. You should.

That's all.

***
Happy Wednesday.

Sunday, September 2, 2018

Some type of way.



When I saw you on rounds today you were quiet. Your eyes looked in my direction but were otherwise vacant. This was a change.

Me: "You okay?"
You: "I'm okay."

I asked you to sit up in bed and carefully untied the back of your gown. Gently, I searched your back with my stethoscope, listening to see if you were improving.

Me: "Can you take a deep breath?"
You: *deep breath*
Me: "And let it out."
You: *let it out*

We repeating that exchange for a few more beats. The sounds emitted from your lungs confirmed what I'd been told. Things were improving.

I'd attempt to lift the mood.

Me: "You sound so much better!"
You: *head nod and shrug*

No such luck.

You'd been so upbeat the day before. So animated and full of light. Out of breath, yes. But still with eyes that twinkled. And so loquacious that I pulled up a chair to sit down and just let you talk. Today? None of that. Just quiet cooperation and a cloak of melancholy that didn't make sense.

Me: "What's wrong?"
You: "I'm okay."
Me: "Really? You seem sad today. Like you're not okay."
You: *silence*

Another shrug.

I slowed my movements and looked for a chair. Perhaps if you didn't feel like I was too busy to listen, you'd share. Something was wrong. And I didn't like the idea of you holding on to that something all by yourself while laying in a hospital bed. And so. I told you just that.

Me: "I don't like you in here by yourself with something heavy on your soul. If you feel like sharing, I want to hear. If you don't feel up to it, I can respect that."

A tear squeezed out of your eye and rolled under your chin. You sighed.

You: "Somebody came to talk to me about all this. Told me that if I don't do better I'm not gon' be here this time next year."
Me: *listening*
You: "Saying 'You need to lose weight and take your medicines! And stop missing appointments! And why you don't exercise and why you keep eating the wrong stuff and smoking cigarettes? You keep this up and you gon' die!' That's what they said to me."
Me: "Hmm."
You: "They kept on saying it was 'tough love.' Like every few words it was 'tough love' this and 'tough love' that. But to me? It wasn't no love in it."

Another tear slipped over your nose and disappeared into your nostril.

You: "I wanted to say, 'Do you know my life? Do you live where I live? Like, do you even know? I want to be healthy, too!' But all I did was just wait for it to be over. I just said, 'Okay' and acted like it was cool." *shaking your head*
Me: "Man. I'm sorry."
You: "That hurt my feelings, Miss Manning. For real. I know that doctor meant well but I felt some type of way about that."
Me: *silence*
You: "Like, I think when a doctor speak to you they should look you in your eye and see where you at. And if your face say this ain't okay? They need to do something else. Or just stop talking."
Me: "That's good advice for anyone."
You: "Know what? You right."

After that, we talked more about what makes it hard for you to get your medicines and make appointments and eat healthier and move your body and move toward being a non-smoker. You told me about where you live and who you live with and what it's like and how you get the things you need and what makes your nerves bad. Then we talked about a few strategies to help you make steps in the right direction. And the whole time I watched your face to see where you were.

Or if I needed to just stop talking.

The doctor who gave you what was believed to be "tough love" is a good one who, I have to believe, was looking to motivate you not be unkind to you. And I told you that, too. That we are all works in progress with blind spots and ball drops. All of us.

This seemed to resonate with you.

We didn't fix all your problems. But you were smiling when I left. Which, to me, was a start.

Yeah.

***
Happy Sunday.

Saturday, September 1, 2018

Ms. Doctor.



I was walking near the hospital entrance today and saw three young brothers standing out front talking and laughing in the sunshine. One was slender with long locs rolled into an afrocentric hipster man-bun. He was animated and talking with his hands. Another was short and stout with flawless espresso skin and a close cut fade haircut. His mouth was gleaming with gold teeth. The third fellow was leaning on the wall chuckling in response to his comrades. His dancing eyes were a beautiful shade of amber and his nose was dusted with freckles.

They were beautiful. Seriously, they were. They greeted me in deference as I passed by.

Manbun: "Hey Ms. Doctor."
Me: "Hey gentlemen. You guys doing alright?"
All: "Yes, ma'am."
Me: "That's great. Have a good day, gents."
They smiled and all said it again: "Yes, ma'am."

I liked the way they all called me ma'am. Even though hearing it always jolts me out of this frozen-in-time idea in my head that I'm forever thirty years old, something about hearing it said in my direction feels maternal and special. I always return the favor, greeting the young men I see around Grady as "gentlemen"-- no matter who they are. Just like I do my own sons.

Yep.

I could immediately tell they weren't being fresh. Just pleasant and respectful toward a woman that they saw as--dare I say it? An elder.

Gasp. An elder.

Ha.

As I walked by, I admired the vast variations in blackness that each of them represented. All so different yet clearly unified in this cultural thread that weaved them all together.

And me with them.

Manbun reached for the door when I got to it and held it open. Just then I noticed that all three of them had their pants hanging nearly to their mid thighs. At first I was going to ignore it but then I decided to use my elder license instead.

Sure did.

Me: "Now you know I don't like seeing my three handsome little brothers standing out here with their pants falling down. Pull up those britches, gentlemen."

And yes. I said "britches."

You know what happened next? All three of them immediately pulled up their low slung jeans up over their hips. And all of them mumbled apologies and words like "my bad" and such.

Me: "Who y'all here to see?"
Manbun: "Our homeboy."
Me: "Is his mama there, too? Did she have to see what I just saw?"

*laughter*

Me: "If she is there, I know she don't want to see your whole behind hanging out of your jeans."
And yes. I said "whole behind."
Manbun: "Ha ha ha we hear you, Auntie."
Me: "Okay, but for real--what's the deal with your entire butt and drawers hanging out of your pants?"
Them: *looking at each other with amusement*
Me: "I'm serious, y'all!"
Frackle face: "It's just the style, I guess."
Me: *old lady scowl* "A style that make it where you walking like a penguin?" *shaking my head*

*laughter*

Me: "Let me go in here and do my job."
*laughter as I walked through the door*
Manbun: "Hey Ms. Doctor!"

I turned around from the door and looked back. All three of them were standing in a row with their pants pulled all the way up and holding them at the waist. They all had these goofy, exaggerated smiles that reminded me of my own sons. Then we all burst out laughing.

I waved my hand at them and walked away shaking my head and smiling.

I told my team on rounds today: "If you stay with someone long enough, you'll always find a place where you intersect. Always."

No-- I don't like the sight of sagging jeans. At. All. And honestly? I'm not a huge fan of gold fronts either.

But I also don't like that video game Fortnite.
Or the random YouTube gamers I have to hear about nonstop.
Or dinner table discussions about skins and virtual outfits for video games.

Nope.

But what I DO have is a soft spot in my heart for goofy sons with silly smiles. And beautiful brown manchildren with knotty hair and easy slang who hold doors and also poke fun at me and each other. Just like the ones that stood outside of that hospital entrance today.
And just like the ones that came from my own body.

Yeah.

***

Pollyanna.



Her: "Do you think we should do any more testing?"
Me: "I think we should check another round of cardiac enzymes, don't you?"
Her: "I don't know, Dr. M. The timing aligns with the crack use."
Me: "That's true."

*silence*

Me: "Cocaine accelerates coronary heart disease. So, like, even if you use, it adds risk both short term and long term."
Her: "I get it. I guess I'm just trying to think through what we would do next, you know? If the cardiac enzymes are positive. Would we suggest cardiology come do a cardiac catheterization?"
Me: "If they are suggestive of an acute coronary syndrome? Yes."
Her: "Hmmmm. But let's think this through. So then we do the cath and it calls for an intervention. And then the intervention calls for the patient to take anti-platelet medicines that must be taken."
Me: "And that if they don't take them they'd be worse off."
Her: "Exactly. So I am torn. This isn't because I don't want to advocate for the patient. It's actually because I do."

*silence*

Her: "So what do you think?"
Me: "The same thing. Check them."
Her: "Really?"
Me: "Yeah."
Her: "And if the cardiac enzymes are positive?"
Me: "Consult Cardiology."
Her: "For a cath? And intervention?"
Me: "Yeah."
Her: "You wouldn't be scared of doing harm?"
Me: "I'm always scared of doing harm."

*silence*

Me: "Listen. I should tell you. I'm a total Pollyanna. . an eternal optimist--often to fault. So I want you to know that I truly get what you are saying. But I always have this little idea in my head that I can encourage the patient to quit. Like, if your heart depends upon it? And I believe right along with you that this isn't your lot in life and that you can recover? Yeah. I tell myself that this might be the day. The discussion that turned the ship around."

*silence*

Me: "But I get it."
Her: "I get what you're saying, too."
Me: "You make great points."
Her: "Let's check one more set. And if they are abnormal, we will cross that bridge when we get to it."
Me: "I like that plan."

*silence*

Her: "Hey Dr. M? What's a Pollyanna?"
Me: "You don't know what a Pollyanna is?"
Her: "I'm a millenial."
Me: "Then Google it."
Her: *smile*
Me: *smiles back*

Let's be clear: My resident is sensitive and empathic. And this discussion is as old as crack cocaine itself when it comes to ethical dilemmas at Grady. But regardless of that and all that I see, I can't shake my optimism. Some piece of me always believes that this might be the day.

Yeah.

I love this job.
****

#amazinggrady #eternaloptimist #igetburntalot #butsometimespeoplewin #blindspot #rooterfortheunderdog #alwaysalwaysalways #thismightbetheday

Friday, August 31, 2018

Fear is a liar.




Me: "So wait. I'm making sure I hear you correctly. You said this first started when?"
Her: "Like two and a half years ago."

*silence*

Her: "I know. I know I should've come before now. I know. "
Me: *silence*
Her: "You are probably thinking I'm crazy."
Me: "I didn't say that."
Her: "You didn't have to."

*silence*

Her: "I was just . . .I was just so, so. . . ." *starts crying*
Me: "Afraid?"
Her: *crying and nodding*
Me: "It's okay. You're here now."
Her: "I've been scared every day. And I would want to come but then I would just get too scared of some bad news."
Me: "I get it. I'm serious. I do."
Her: "You do?"
Me: "We all scared of something."

*silence*

Her: "What are you scared of?"
Me: "The same things you scared of, I think. Something bad. Something taking me from my family. Something that make it where I can't do what I want to do in my life."
Her: *staring*
Me: "Or rather what I feel like I'm supposed to do."

*silence*

Her: "Can I ask you a question?"
Me: "Sure."
Her: "Do you think I'm gonna be okay?"
Me: "I think anything is better than living every day in fear. So yeah. I think today you are more okay than yesterday. And that's a good thing."
Her: *starts crying again*

*silence*

Her: "I'm so relieved. To tell somebody. To get this weight off my chest."
Me: "And I'm happy that you are here and that we are sitting here together."
Her: *smiles*
Me: *smiles back*

I remember a few years ago when I had a health scare. I had something happening in my body that didn't seem right. I worried for two full weeks. When I finally told Harry I was crying before I could even explain. Man. I was so scared when I finally went to get it checked out.

Whew.

And no--I didn't wait two and a half years but even in those two and a half minutes that passed between the doctor looking at my results and telling me what could have been life-altering information, I fully understood how she felt.

Damn, I did.

Look, man. Fear can present itself in all kinds of ways. Sometimes it marches in like a King Kong with big muscles and gnashing teeth. Other times it's a smooth operator and completely in disguise. And the only things to take it down are love and truth. And today they both showed up like a badass tag team.

Sure did.

I love it when fear loses. And today it did.

Hell yeah.

***
#amazinggrady #fearisaliar #getitchecked #maketheappt #knowingisbetterthanworrying #loveisthewhat #andfearisapunkassbeeyotch

Thursday, August 30, 2018

Squeaks and Squawks.



Him: "Them shoes you wearing is some a your favorite shoes?"
Me: *looking down* "My shoes?"
Him: "Yeah. Your shoes. They your favorites?"
Me: *squinting eyes and thinking* "Ummm. . . I guess I like them. They're good work shoes for the most part. And this color goes with a lot of stuff."
Him: "You mean it's a good work shoe for YOU."
Me: "Huh?"

*silence*

Him: "Look here. If them ain't your favorite shoes--hell, your ONLY shoes, then you need to go on and retire 'em."
Me: *looking down at my shoes again*
Him: "Miss Manning you woke me up two different times this week with that damn squeaky shoe. And today it was both of 'em squawking? Lord Jesus! Unh uh!"
Me: *laughing*
Him: "Them shoes got to GO. Or you gon' need to kick 'em off for you get on my hall so folk can get some rest."
Me: *still laughing*
Nurse: "Tell her how you really feel."
Me: "I was in denial."
Him: "Well you need to get out of denial. Or out my room in that shoe."

*laughter*

He's right. I do love the shoes. And I have no idea why or when they started squeaking like this and how to fix it. Wait--I take that back. It was after getting caught in the rain last week. I guess I just hoped it wasn't as bad as I knew it was.



Ha.

That got me thinking about all of the things that we totally notice but that we act like people don't see. Like the skirt that used to fit but is now too tight. Or that stomach or thigh you bared that reeeeally wasn't ready for sunshine or for going un-Spanxed. Or that very odd weave or hairdo that leaves people speechless (to your face.) Or the reeeally wrinkled shirt that you know you should have taken a moment to iron. Or even the funny smelling shirt that you hope only you've noticed. Man. . .If you noticed? Oh, someone else noticed.

Totally.

And this? This is just one more thing to love about Grady. You'll immediately know if you've gained weight, if your decision to go grey is questionable and even if you need some gum since your breath smells like garlic and onions after lunch. Folk will tell you, do you hear me?
By the way--that same patient told me that I shouldn't button too many buttons on my white coat because it makes me look like I'm. . . wait for it. . . ."with child."

Bwah.

***

Wednesday, August 29, 2018

L-O-V-E.



I took care of you in the hospital for fifteen days straight. I was there when you first came in with those symptoms. And I held your hand when you found out why.
“I am not afraid,” you said. “I’m just really, really glad you’re here.”

And you said that every single one of those days after. You also said the same thing to me each day before I left your room:

“I love you.”

Which isn’t something we never hear as doctors but is something out of the ordinary. But you—you said it each and every time.

I love you.

Not “I’ve got love for you.” Not “I love all that you’ve done.” But those three simple words spoken with clear intention every time.

I love you.

When your body got sicker and you were in pain, I held your hand again. And you looked into my eyes and told me once more, “I am not afraid. I’m just really, really glad you’re here.”

And then, “I love you.”

You had a big fight ahead of you. The kind of big that comes in like a playground bully, stealing lunches and terrorizing the innocent and weak. You were brave and fought back. You did. But that bully wouldn’t leave you be.

No it would not.

Someone called me the other day to tell me you’d been readmitted. This time sicker and requiring intensive care. I was grateful to have been told and made a plan to go see you first thing in the morning the next day.

You transitioned before I could.

Damn.

Today I am thinking of you. Letting your memory remind me of the great privilege of caring for you and every one of my patients at Grady. I am remembering our time together and speaking back the words you gave to me:

I am not afraid. I’m just really, really glad you’re here.

and

I love you.

Yeah.
***


Tuesday, August 28, 2018

Open doors.




You weren’t nice to me. Your words were scathing and mean—the kind designed to cut straight down to the bloodless white meat. Though I’d told myself over and over again that it wasn’t really about me, how could I be sure? You weren’t an angry patient pounding a fist on the tray table when denied Percocet. You were a learner.

A learner.

We had things in common. Undeniable things. That made this blow land harder on my jaw. And, what’s worse, is that I didn’t even see it coming so it came like a ruthless sucker punch.

Ooph.

I told myself that I’d tried my best. That your approval doesn’t matter. Me trying is what mattered. But on that day I was forced to admit it. It does. Of course it does. Especially from the ones like you.

Like us.

I told a colleague friend about what you said. I was honest about how it felt and admitted that it hurt. Together we unpacked it all and I looked inward for what, if any of it, was true.

“Even if a person isn’t happy, there is a way to express it,” my friend said. “This isn’t it. This feels like something else.”

“Yeah.” That was all I could say.

“No matter what, I say keep the door open. Don’t lash out. You can only control you. Make it known that you are always a phone call away. Even after all that, you are. You have to be.”

“Do I?”

“I think so.”

After that, I sent a message your way keeping the door open like she said. I chose kindness. And you? You chose radio silence.

Yep.

That was a while ago. Time has passed. New learners have come along and both of us have moved on. Fortunately, we won’t have to interact again. So given that, mostly I pushed the memory away. And I suspect from the indifference I perceived that you never even had to push it anywhere.

Nope.

But funny how life is with our paths. Just when you think something is behind you, Life LOLs and shows you otherwise. And the older I get, the more I wonder if anything is really ever behind anyone.

Hmm.

Today a silhouette was coming my way and, from a distance, I couldn’t tell it was you. But by the way you slowed your feet, I could see you knew it was me. As you got closer, you stopped and just sort of stared.

“Hey you.” I broke the ice with something neutral. “You doing okay?” I smiled. And it wasn’t even forced.

At first your face appeared pensive. But then it softened with relief.

“Hey, Dr. M,” you replied quietly. And then you let out this tired sigh. Your shoulders sagged..
We talked a bit. I gave you a hug. You hugged me back. And it was good. It was.

See, we have things in common. Undeniable things. And because of those things, i know how hard it can be to navigate all of this as who you are. As who we are. So very hard sometimes.

I know.

“Call me, okay?” That’s what I said.
“I will,” you say back. “For real, I will.”

This time you hug me. I hug you back.

Control you, she said. I’m so glad I did.

This time especially.

Yeah. 

Snitches and stitches.



If a tree falls in the woods and nobody is there to hear it, does it make a sound?

________________________________

On rounds at Grady

Him: "I just wanted to say sorry for how acted yesterday. I shouldn't have cussed at you and called you out your name like that."
Me: *silence*
Him: "I was just in pain. But I know you was just trying to look out for me. I shouldn'ta said all that to you, though."

*silence*

Me: "Um. Are you sure I'm the one you cursed out? I appreciate your apology but I'm not sure I'm the one who should be getting it."
Him: "Damn. Am I going crazy? I was sure it was you."

*silence*

Neighbor on other side of the curtain starts laughing. Loud and hard. We both swing our heads in the direction of that loud cackle.
Neighbor: "Yeah it was you."
Me: "Sir?"
Neighbor: "Bruh, you did have some words for her but it was after she left. You was talking to ME not HER, remember?"
Him: *eyes widened*
Neighbor: "Be glad you didn't hear it, doc. It was . . .whooo." *starts laughing super hard again* "Mane! That lady ain't even know you said nothing!"
Him: *now laughing too* "Damn! I snitched on myself!"
Neighbor: "Yeah bruh. Where they do that at?"

*laughter*

Neighbor: "Want me to tell you what he said?"
Me: "Nah, I'm good."

*laughter*

Him: "At least I said I was sorry."
Me: "True that."
Neighbor: "Hey. . . .do snitches REALLY get stitches in the hospital?"
*howling with laughter*
A Grady elder once told me:
"Some shit said 'bout you ain't meant for you to be hearing. Don't go dissecting some little bitty shit you overheard on Tuesday that don't mean nothing on Wednesday."

Bwah.

This was in reference to her niece whose feelings were hurt because she was earhustling and overheard her auntie talking about her. That elder said she didn't answer the phone when her niece called because she talks too much. When confronted, that elder said:
"Well. You do."

Ha.

Here's what I now know for sure: People say all kinds of things. And sometimes? Some things said about us just AREN'T meant for our ears. Nope. Does it mean the person wants to ruin your life or see you go bankrupt? Nah. And in a perfect world would everyone be saying only nice things? Sure. But you know? It's not that heavy, man.

You know? I'm convinced that my angry-about-oxycodone patient who cursed me out to his neighbor isn't the only person saying something unflattering about me away from my ears.

And I'm cool with that. Supercool, in fact.

So. . .if a tree falls in the woods and nobody is there to hear it, does it make a sound?
Well. That depends on if the tree is a snitch.

(Or in the room with one.)

OMG. I love this place.

***
Happy Humpday.

Monday, August 27, 2018

Aretha.




Any and every resident or medical student who has ever worked with me at Grady has heard me say these words:

"Rock steady, baby."

It is what I say when a patient is doing better. It is what I say when everything is going well. It is the response I give to someone telling me they got several interviews for jobs or fellowships. Or even just the thing I offer someone who asks how things are going with me.

"Rock steady, baby."

It is the song that lifted my spirits after losing my sister. The one that lulled me out of bed and outside to learn to run to combat grief. The beat that thumped in my chest when I spoke to millions of people on CNN as the Chilean miners were rescued. The velvety voice that crooned over my shoulder when stepping up to a podium to give a lecture. And the jam that helped me cross finish lines for those 13.1 mile races I never believed I could run.

Rock steady, baby.

See, I believe that everyone should have a soundtrack playing in their head every single day. Those who know me and have read my blog know that I have a mental iPod playing 24-7. I kid you not--if my life were a movie and it had to have a musical soundtrack? Right at the top of the playlist would be this song.

Rock steady, baby.

Sometimes I put my earjacks in and strut straight into Grady to the beat of this song playing in my ear--literally. But most times? I don't even need it. I can hear it clear as a bell no matter what other ambient noises are around me.

Yup.

Something about the bass. The horns. Her voice. Her voice. . . and the background singers, too. All of it seems to swirl in my spirit and speak to my mood. It says, "You are good. You will be fine. Things are good. And if they aren't, they will be or they can be."

Rock steady, baby.

It makes me want to high five people, do the bump with somebody in the elevator, and put some pep in my step. It makes me want to convince a patient they can make it, shake the hand of a security guard, and raise my hand in the back of the teaching conference. It lifts my spirits and puts my feet on a positive path. Yes. That.

Rock steady, baby.

Such a perfect song. Nothing too fancy. Not too many complicated lyrics. Just good, clean soul. I mean, let's call this song exactly what it is.

Mmmm hmmmm.

So if you see me around Grady or anywhere for that matter. . . .and you wonder why I look like I hear music in my head? It's because I do. And thanks to the Queen of Soul, it is probably this very song.

Rock steady, baby.

Aretha will forever be playing on my mental iPod as a reminder to feel the rhythm of each day and step into it with gratitude. And then? Just call this life exactly what it is: One I'm glad to be living.

Rock steady, baby.



Rest in power, Soror Aretha. Your talent and legacy will live on forever. May you forever move rock steady, baby.

***