Wednesday, September 6, 2017

Twenty for twenty: Number 5.



Please remain standing.

Back in the 80's at my Southern California high school, every single day we started the morning the same way: By standing and reciting the pledge of allegiance. First in English and then in Spanish. Every. Single. Day.

Yep.

After we finished the English version, the person on the PA system would say in this booming voice, "PLEASE REMAIN STANDING." After that, came a chorus of Spanish--from everyone. The nerds. The jocks. The gangsters. The mean girls. The popular kids. The weirdos. The new wavers. Even the teachers. It was actually pretty cool. Back then we thought nothing of it but now I realize the symbolism in those three words:

PLEASE REMAIN STANDING.

It was so unifying and was an act of inclusion. Every single kid in our school recited those words together. And whether you are a fan of the pledge of allegiance or not--somethng about a few hundred (unilingual) kids speaking Spanish in unison with their bilingual sisters and brothers is kind of powerful. I bet you every kid who went to Morningside High while I was there STILL remembers saying this every day:

"PLEASE REMAIN STANDING. . . .

Juro fidelidad a la bandera de Los Estados Unidos de América
Y a la república que representa
una sola nación bajo de Dios 
indivisible con libertád
y justicia para todos."

I stand with the DREAMERS, man. Indivisible con libertád y justicia para todos.

Para TODOS.

Yeah.

***

Twenty for twenty: Number 4.



Overdrive.

If I won the lottery--like the big, bad, super-inflated, multimillion dollar PowerBall? Let me tell you exactly what I'd do:

1. Get some sheets in the highest count attainable.
2. Get my currently periodic housekeeper to make my home her main and only gig.
3. Get a driver.
4. Make sure the driver is down for driving 24-7-365-52.
5. Get one of those cars with internet access so that I can do stuff like blog while riding.
6. Philanthropize like a BOSS.
7. Have a cook.
8. Pay off my house and my student loans (yes, I still have some.)
9. Keep my minivan

Oh, and of course, keep working at Grady.

I need to emphasize numbers 3 through 5. I really, really, really don't like driving. Outside of that? My life is rich enough, man. Like, I'm pretty sure I wouldn't do too much different if I suddenly hit a windfall of moolah on a random Wednesday. But the thing you could bet your life upon is that somebody other than me would be driving.

Everywhere.

So, this is on my mind because in the past few days I've driven WAY more than I want to. I mean, I really don't want to ever at all. But when I do, I'd like it to be as limited as possible.

Anywho.

Yesterday, I was rounding and my patient kicked me out as soon as I walked in. He said, "I'm not happy. Y'all are making me leave and I don't even have no shoes, man. This is some bullshit."

And so. I tried to tell him that we'd go find him some shoes in the social work office but he announced that he had to pee and that I needed to get out. And that was that. But before I left, I did ask him what size he wore. Which was a twelve.

Yep.

Well. Turns out that the BHE is a size twelve and since he is from the midwest where sneakers get retired after just one speck of dirt gets on them, I knew EXACTLY where to get this man a fresh pair of kicks.

Yep.

It was Labor Day so I knew the BHE was off. I tried to get him to bring the shoes but he was hanging out with the kids and the dog away from home.

Grrr.

So you know what I did. At lunch time I drove my butt home. To get the shoes for the man who kicked me out of his room. And can I just say this? Bringing those shoes back to that brother made it worth driving across town, man. It was.

"Got you some shoes."

"Who shoes is those?"

"Yours."

"Them shoes look like new."

"Yeah. They come from a dude from Cleveland."

"Awww shit. Them cats from Cleveland, Detroit and Chicago? They crazy 'bout some shoes getting dirty."

"You know it."

"Damn. This is a good look, doc. What size they is?"

"Twelve."

"No shit?"

"Nope."

"And they mine?"

"All yours."

"Damn."

"Can I examine you now?"

"Lady, you can make me do jumping jacks for all I care. Man. These shoes is great."

"I brought a pair of socks, too."

He just stared at me on that one. And looked almost like he wanted to cry. I've learned that socks are a big deal when you don't have stable housing. For reals.

So yeah. I drove for that.

Then there was today. I was at Grady in the morning rounding. And I had seen all but one patient but that patient belonged to the med student. It was noon and the students and residents were supposed to go to Grand Rounds. I didn't want to delay them going but I also had this one more patient. There was an easy solution: See the patient while the team went to Grand Rounds.

Oh, did I mention? Today I had to be at Emory at 1PM to teach my first year med students. So I'd need to either see the patient alone and not give the student a chance to present his patient to me (a big deal when you're a student) or go to Emory and come back explicitly to let the student have the chance to present his patient.

Sigh.

Yeah. So you already know what I did. I went to Emory. Came back to hear the student discuss the patient. And then? Did I mention? I had to go back toward Emory to meet my third year students. Oh, and I had to get Isaiah from school, too.

Now.

That student knew that I valued him when he saw me walking back into Grady to hear his presentation. That was worth a lot to me. But dude. That was a lot of driving. A lot, man. I really need a driver. For reals.

Yeah. So I've been in overdrive this week, man. But all of it is give and take, I guess. And if I could do it all over again, I'd do it the same.

That's it. Oh, that and the fact that I have nightmares about someone forcing me to drive Uber for the rest of my life. Like, full on nightmares.

I think that's it. Yeah.

****


Tuesday, September 5, 2017

Twenty for twenty: Number 3.




Mother and son.


When I walked in and tried to shake his hand, he took one step back. He clasped both hands together and nodded in my direction. His expression was warm, though. Kind even.

But, still. He didn't shake my hand.

The center of his forehead had this slight hint of hyperpigmentation. Because his skin was already a velvety confluent espresso shade, most wouldn't have noticed it. But coupled with him not wishing to touch my hand and his somewhat exotic facial features it came together for me.

This wasn't personal. No, it was not.

The conversation about his mother was serious. His face was cloaked in pain and his eyes were glistening with tears that he dared to counter his stoic persona. "Please, doctor. Do everything. Everything you can possibly do," he said. The words came out staccato and firm, blended with his unmistakable mother tongue. I understood him, though.

I did.

But his mom. She was sick. The kind of sick that doctors can't simply put back together. The kind that, in an elder with other serious health conditions, often leads to everyone agreeing to step out of the way of the inevitable. "Let go and let God" the Grady elders call it. A concept that, in this situation, almost always resonates.

And you know? Even for the ones who don't hold fast to Jesus Christ--they, too, are usually on board with the letting go piece. At least, in my experience, they are.

So I realized that these two scenarios are where I am most comfortable. The bible thumping, hallelujah shouting families who have Jesus on the mainline at all times and the pragmatic ones who either don't subscribe to or are unsure of higher powers but who are just steadfast in their belief in love. The approach is the same really. It focuses on reducing suffering and achieving death with dignity. You tow the line of faith and pragmatism the best you can.

"We want everything," he kept saying. "Everything you can do to help."

I swallowed hard and glanced at my feet. I explained about how sick his loved one is. And I spoke more about how her body is nearing the end of life.

"We can focus on her comfort," I said. "Helping can often mean doing the things that make her not feel so bad. Sometimes when we do things we stand in the way as a person tries to rest. Like, the feeding tube we talked about. It could help her live longer but it could also cause suffering. And, like I said, stand in the way." I was grasping. I felt my voice trailing off.

"Stand in the way? That is not possible," he replied. Now his thick accent had a ripple of something indignant.

"I'm not sure I know what you mean," I said. I could tell he seemed offended.

He sat up straight and stared at me intently. "In my faith, we don't believe this is possible. To stand in the way of His will. You are a part of the will of Allah. The doctors and the things you can do to keep her alive. No person can stand in the way if she is to die."

I just stayed quiet. It was super uncomfortable. Still, he let me writhe in it. Finally I spoke. "When you say everything, tell me what you mean."

"I mean all that can be done to keep her alive. If her heart stops, you help it come back. Whatever things you have that can be tried. We want her to stay alive."

"But--" When I said that one word his eyes trained onto mine and away from his mother. "You want this. . . even if it could mean her suffering?"

"We do not look at it in this way." He swallowed hard and sighed. I could tell he wanted to cry. "We do not. . " his voice cracked and he cleared it hard and went on. "We do not say do nothing. We do not do that. What you do to try to help is okay. We want it all. If Allah is ready for her, she will go."

After he said that part he stood up from his bedside chair. That was his way of letting me know this discussion was over.  "Okay," I said. Then my voice grew softer. "Okay."

"Thank you."

"Thank you for talking to me," I responded.

We both just stood there for a few beats staring at his mother. Her comatose body lay limp and peaceful. Her chest rose rhythmically with each breath. And that was it.

"Okay, sir.  Remember, my name is Dr. Manning, okay? Let me know if there is anything that you need or if you have more you'd like to discuss later." And just like that I reached my hand for his, immediately wanting to kick myself for forgetting that he wouldn't shake my hand. "Oh, yes. I'm sorry."

I turned toward the door and slipped through the partial opening. As I pulled it closed, I could see him placing a cover over his mother's shoulders and pressing his lips to her head. Then he dropped his forehead to her chest and held it there. At that point I turned away since watching felt like a violation of his privacy.

What I am learning is that the expression of love looks so many ways. But no matter what, there is always something universal about the tenderness between a mother and her child. Regardless of what I thought about the decisions he made, there was no denying that every single thing he did was rooted in love. In that sliver of a moment, I made up my mind not to ask him about this again.

I would respect their wishes. I would respect their faith. I would respect their love.

Yeah.

***




Monday, September 4, 2017

Twenty for Twenty: Number 2.





The Alley Oop.


I imagine what life is supposed to be like in the sixth and seventh decades. I see grandkids screaming through houses, knowing full well not to stomp too hard in certain areas because something precious to grandmama will fall and shatter. Those kids have it down to an art. They hop and leap in the other areas. And the grandmama is cool with it.

And if, by chance, grandmama is not well enough to sweep her own floors and make her own bed and scramble her own eggs due to some unfortunate health detours, I see the same family responsible for making those rambunctious grandchildren stepping in to see about her. Coming to get grandmama to her doctor's appointment or going to the store to pick something up for her if she needs it. Lightening her load because that's what family does.

Yeah.

But that isn't what is going on here. You are a sixty-something grandmama. Wait. I take that back. I am not fully sure if you are a grandmama but, still, in those far away eyes I see the love and tenderness of one. So, in my mind, that counts. And you are here in front of me in this hospital bed staring into far away places. Your body is sick. But it is sick with the kinds of things that could be managed with some support. I mean, mostly managed. With support, that is.

But you don't have that.

Mental illness is what robbed you in broad daylight. Held you up at gunpoint one day and then came back for more. And nobody jumped in the way to stop the crime so you eventually lost all the things that people need to just be. Especially as you get up in age.

"Where are your people?" I ask.

You don't fully get it. It's like I threw a basketball for you to catch and shoot and instead you grabbed a bat to swat it like a baseball. Our conversations don't align; they don't match. "We were eating peach cobbler. And I said, 'Do you think this cobbler need some ice cream on it? Or some heavy whipping cream on it?' But everybody just kept on eating it."

My brow furrowed. "Who made the cobbler?"

"I just eat it. But not without any kind of cream."

"Who gave you the cobbler?" I wanted to know. There is love in peach cobbler. And just maybe that meant there was someone somewhere loving you. "Who served you peach cobbler?"

"Somebody said it feel like the autumn coming. To me, it feel mostly like summer time still. The mosquitoes still here. But they don't like me."

This time she kicked the basketball like a soccer ball.

"Where do you live?"

"There was the bench where we had the cobbler but I had to move from there. I had a daughter. She died from sickle cell."

My breath hitched. You lost a child?

"Jesus." I covered my mouth because I didn't mean to say that out loud.

"They came and cleaned up out there so you can't lay on the bench over there."

I swallowed hard and just kept gazing at you. Your hair matted down to your head in one confluent dreadlock. Your teeth fractured and denuded down to tiny browning chiclets. Your eyes super wild and industrious, oblivious to all of this. And your hands, unusually soft-looking in their appearance with a tapestry of bulging veins that look just right for grandmothering.

Sigh.

Oh, and the other thing about those hands? No burns or callouses on them suggestive of holding glass pipes or flicking lighters. Your labs also told the same story--this was all just unruly mental illness with low resources and no support. This was something I've seen and I see.

I hate it. Perhaps more than or as much as the things I see that I hate the most in this work.

And so. I will treat your illness. At least, the medical one that I can handle. I will call the social worker and try as hard as I can to advocate for you just like the doctor did the last time you were here. I will attempt to grasp the names that fly out of your mouth into word clouds above you, hoping to attach them to phone numbers and peach cobbler. This is what I will do.

And, even when it feels futile, I will keep passing you ball after ball. Praying with all of my might that, just maybe, this will be the time that you lean your body back, press your palm to the back of it and shoot it straight into the air and into the basket.


And it that doesn't work? That someone, somewhere will run to your rescue to tip it in on the alley oop.


Yeah.

***
Happy Monday.


Sunday, September 3, 2017

Twenty for Twenty: Number 1.



I will set a timer for twenty minutes. Then I will write. 
When the timer goes off, I will stop. 
That's it. That's all.


_____________________________

Magical places.


"Where you from?" I asked as I unfastened his gown to place my stethoscope on his chest.

"Opelika," he replied. "You probably ain't never even heard of it."

"Opelika, Alabama. Lee County."

His eyes widened when I said that. You could tell it was the last thing he expected me to say. "You don't even sound like you from Alabama."

"I'm not. I'm from California but I went to school in Tuskegee."

"Macon County," he responded. We both chuckled.

I pressed the diaphragm of my scope into his chest and instinctively he knew it was a drill to be quiet. As soon as I lifted it off of him, he spoke again. "What made you come all the way out to Alabama for school?"

"Oh, my whole family went to Tuskegee. And I knew I'd have to leave California. I'd always wanted to attend a historically black college so knew I'd have to at least go to Texas."

He squinted one eye and gave one nod. Then he pressed his hands down and sat up in the bed to lean forward. I listened to his lungs as he took big, deep breaths.

"I got a question," he said when I finished listening. "What makes somebody pick a historically black college anyway? Like, maybe me being a white guy and all, you know, that might sound like a dumb question. But I always wondered what the appeal was."

I paused for a moment to see if he was serious. He was. I pursed my lips and gave the question some thought. "I knew it was like a magical world. And that it was different than the real world."

He looked confused. I decided to go on.

"Like. . . . I had visited colleges back home. And I had also been with my parents to historically black colleges. And . .  . I don't know. It was just this special little slice of the world where you could be exactly yourself and then all of this culture surrounding you, too. It's hard to explain."

"A place to be comfortable?"

"Kind of. I mean. . .I guess the thing is. . . . a place where you get very comfortable in your own skin. While growing up, too. I knew that's what happens at an HBCU. I knew because of my parents and my friends' parents. Oh, and Spike Lee."

"Spike Lee?"

"Yeah. He'd just put out the movie 'School Daze' when I was a junior in high school. I was sold after that."

"I never saw that movie. Maybe I would've gone to one if I had seen it."

"Ha. Maybe you would have." We both smiled.

"I did like the TV show about the black college. The one with Will Smith's wife. Or Lenny Kravitz' wife, I think. Which one of them was it?"

"It was both of them."

"Oh."


I got to the end of his examination and sat on the end of his bedside chair. He asked a few questions about his hospitalization and I did my best to answer them. And that was that.  I shook his hand and prepared to leave.

"Hey doc? One last question--how far is Tuskegee from Opelika?"

"Maybe 30 minutes?"

"Hmmm. I think I'm on go there and see it next time I'm home."

"You really should."

"Can't believe I lived so close to a magical place and never went to see it."

That made my face light up. "You know? It's never too late."

And he gave me a bright grin with a thumbs up. I returned the gesture and left the room.

And that was it.


Not sure what made me think so much about this exchange. I guess he made me think about how we are often right next to people and places where there is magic happening. . . . but because of our cultural differences or believing our comfort zones don't align, we miss it all. By allowing just a few glimpses of ourselves to one another, the magic is shared.

Yeah.

***






Sunday, July 23, 2017

Heavy on my soul.



"I don't know no love songs
and I can't sing the blues any more
but I can sing this song 
and you can sing this song
when I'm gone."

- James Taylor



"You okay?"

I pointed at my chest. "Who me?" 

"Yeah, you. Look like something heavy on your soul."

That's what my patient said to me on rounds the other day. It was late in the afternoon and visiting him was the last thing on my to-do list before heading out of Grady. He'd had some tests and I'd come back to check in on him and explain results. He'd need a minor procedure the following day and I wanted to be sure he was okay with it all. He was. After we'd gone through all of the business parts, I realized I had some time. Instead of walking out to chat with friends or my team, I pulled up the bedside chair and made up my mind to spend that window chatting with him. And honestly? Nothing about it was heavy. If anything, it was light.

Quite light.

A woman was on the television talking about a myriad of unimportant things and repeatedly kept using the word "slay" to describe any and everything. Her outfit. Her friend's hair. Michelle Obama's entire time in the White House. And even the person interviewing her. It was "slay" this and "slay" that.

Yeah, man. So, really, we were talking about whether or not the word "slay" had been officially beat to death or not. Me with my arm leaning on the bed rail and him narrowing his eyes and tapping his chin to give this topic far more thought than both of us knew it deserved.

It was perfect.

See, it had been a bit of a rough week. And with all the sandpaper rubbing against my heart over those last few days, this mundane chat with my young (but sick) patient was like a balm for my emotionally  weary soul. Plus, I really liked this patient. His energy spoke to my own from the moment I first shook his hand on rounds a few days before.  So, on this day in particular, I was really thankful to sit with him.

Yeah.

"I blame Beyoncé," I said.

"The Queen Bey? Honey, she is never at fault." He let out a moist cough into his fist and then slapped his chest a few times. I started to stand up to check on him and he stopped me. "I'm okay. Stay put."

I nodded and sat back down. Then went back to our conversation. "But you have to admit the word has been beat to death."

"Slay? Beat to death? Hmm. I don't think so. But it can't be the only thing you say, you know? Like, you have to mix it up. Everybody and everything can't slay." Right when he said that, the lady said it again. We both laughed.

We sat in silence for a few beats. And then I spoke. "Confession: I still say 'legit.' And 'epic.'"

"Whoa. You legit say legit still? And epic?" He widened his eyes playfully and raised his eyebrows. "And you seemed so cool at first."

"My niece asked me if I knew that wasn't really a thing people say any more. She legit said that to me." That made me snort out loud because it was so funny to me. He laughed, too. Followed by another cough.



After that the room fell silent again. The TV kept going and, other than my patient clearing his throat or coughing here and there, we weren't moving or talking. So there I sat. Chin in my palm and mostly just enjoying that moment. Which was good.

Really good.

A few more seconds passed and that's when he said it. Swung his head  in my direction and rested his brown eyes on me. Even though I was facing the television, I could still tell he we was looking at me.

"You okay, doc?" he said.

"Who me?" I pointed at my chest.

"Yeah, you."

I turned my head away from the television and back toward him. I poked out my lip and furrowed my brow.

"Look like you got something heavy on your soul."

Heavy on my soul.




I didn't say anything. Instead I just stared at him, surprised at how warm my face was becoming and embarrassed at how my eyes were stinging with tears.

"I'm okay," I finally said, speaking quietly. "But yes. That's a good way to put it. Something is heavy on my soul these days. But I'm okay."

"I hate hearing that. And here you are having to see about everybody else."

"No, it's okay. In fact, it's more than okay. Really."

I didn't talk because I didn't want to start crying, you know? But really, he was right. Something was heavy on my soul.

I wanted to tell him, too. I wanted to tell my patient--this patient who embodied every single thing I love about patient care and patient caring -- all about what was weighing me down. I wanted to talk about it with someone less connected to it, someone who didn't really know me. This way I could just hear the words or see the expressions in response unfiltered. Or, just maybe, I could wrinkle my nose like a little child and cry into balled up fists without any expectations or pressure. Empathy uncut.

But I didn't when he asked. I was his doctor. Though my sitting in his room that afternoon dissecting the social relevance of slang terms didn't exactly fall into the physician playbook I'd been shown in medical school or residency, I knew for sure that flipping the script in this way wasn't even in the same library.

So when he asked, I just stayed silent.

Yeah.



Just about 24 hours before that moment in his room, I was down in the emergency department seeing newly admitted patients with my team. My phone had buzzed twice in my pocket with text messages followed by two or three sustained vibrations from incoming calls. A few seconds later, I felt it happen again and that time, I fished into my white coat to see who it was.

Call me when you can. Alanna is not well. She wanted me to update you.

That was what the text read. It was from my colleague Danielle J. in reference to our friend and colleague Alanna. I walked straight out of that patient room and called immediately. That's when I learned that Alanna, who'd been fighting a ruthless cancer, was now intubated and in intensive care.

Wait, what?

The wind was knocked so hard out of my chest that I had to get out of the ER and away from my team immediately to catch my breath. This wasn't supposed to be happening.



As soon as I got out of there I felt the tears filling up my eyes. Once they began falling, I abruptly stopped. Then I turned my forehead into the nearest wall and let myself cry. And I could feel the people looking at me as they walked by, their feet slowing down and wondering what could be going on with this doctor and the muffled, guttural sounds she was making. No one said anything though. They, too, must have read the doctor-patient playbook and decided not ask.

Maybe.

Maybe my actions spoke enough. I mean, whatever it was had to be awful. A doctor facing a wall with shoulders shaking and body heaving in a stiff white coat said plenty. I guess it did.

Here's the backstory:

I met this remarkable woman named Alanna in July of 2007. I met her on her very first day of medical school when she came and sat in a room with several other medical students. And then, I really, truly met her when that big group was whittled down to just seven individuals--the seven that would go on to become my first small group.



Yeah.

I would get to watch her evolve into a doctor--literally bookending the experience from that very first day with placing a doctoral hood over her shoulders at commencement on her very last. I jumped for joy with her on residency match day and again jumped for joy when, after her residency training, she took a job back at Grady Memorial Hospital and Emory where we first met. This time, though, it would be different. Now we would be colleagues--both of us Grady doctor attendings.

Yeah.

One year into coming back to Grady, she was diagnosed with breast cancer. It was aggressive, but they caught it early. And that Alanna. That tough girl slugged it out. She came to work and taught the residents and rallied on. Finally that final treatment day came and our whole division celebrated by wearing pink in honor of Alanna and every person affected by breast cancer. It was super awesome.

Things seemed to be getting back to normal. Alanna was getting on great as a Grady doctor and showing everyone the very things I got to see as early as July 2007. The accolades poured in and so did the opportunities. And she was over the moon. She was.

Last April she wasn't feeling good. I remember sitting outside having lunch with her between lectures at a medical conference we were both attending in Washington D.C. "I'm feeling a little under the weather," she said. And that was about it.

A week later, she would find out why. Acute leukemia. Yes, after licking breast cancer, she now had a new cross to bear.

"Are they sure?" I asked her.

"They are," she replied.

"I'm so sorry." My voice was a whisper.

"Me, too."



Up until the moment Danielle called me during my rounds that day, it never occurred to me that she wouldn't get through this. Our last chat on the phone was upbeat, hopeful even about the bone marrow donor match that she'd located and the road ahead. "I'm nervous but I'm ready," she told me. "Just ready to get on with my life."



"That's great," I told her. "So great." And then, like usual, I started crying. Crying these complicated tears about how much I hated knowing that her dreams were having these horrific speed breakers thrown before them. I'd think about her adoring husband and their precious son with his head of blonde curls. I could hear her telling me that she wanted more children and how she'd chuckle and refer to the timing of her breast cancer as "super annoying." All of that would make me cry when trying to talk to her. I guess it was because of the nature of how our relationship began. As her formal small group advisor, even when she joined the faculty, my role always felt more familial, maternal-ish and big-sisterly than anything else. And in that role I'd always prided myself in protecting my students. From any and everything I could.

Yeah, so not being able to do that made me cry.

Yeah.

She was super kind with my crying. Patient and super kind like she was with everyone. Because of that, even though we talked sometimes, mostly, we texted. And I'm grateful to this day that she permitted me to do that. So very grateful.

Just a few hours after I got that call about her being in the intensive care unit, another call came in. It was Danielle. And as soon as I saw the phone ringing, I knew.



"She's gone." That's all Danielle could eke out. I slumped to my kitchen floor and dropped the phone. And then we both erupted into tears. And the same thing happened a few more times that same evening.

It sucked.

I was on the hospital service when all of this happened. And, since I'd spent the entire night crying in the fetal position on my bed, I knew that next day would be hard. The faces of some people made me cry even more. Then the text messages from that first small group amplified how out of order this all was. This wasn't supposed to be happening.

So all of this is what was going on that late afternoon when I came to sit with my patient. And he was right--all of this was weighing heavy on my soul. So heavy that I couldn't lift it.

Even still, I wasn't forthcoming when my patient asked. I just stayed silent. Even though the heavy was palpable and suffocating to more than just me.

"I'm okay," I said.

"Okay." That was all my patient said. Except for a few moments later when he repeated it. "Okay."

I tried to take things back to where they were. Light, airy and easy. But it didn't work. That heaviness on my soul was now out of hiding and cloaking the room. It was about time for me to go anyway so I arose from my seat and told him so.

"I'll see you tomorrow, okay?" I said. I tried my best not to sound as somber as I felt. "Don't forget--nothing to eat after midnight, okay?"

"Okey dokey." He held up a thumbs up. I returned the gesture.

I stepped toward the door and stopped short to pump some hand sanitizer foam into my hand. Just as I grabbed the door, he spoke one more time.

"Hey, Dr. Manning? I hope it gets better. Whatever is heavy on your soul, okay?"

I forced a smile and nodded. I pulled the handle of the door and then stopped. But then something clicked in me like a light switch. I spun on my heel and faced his bed from the door.

"Um. One of the doctors I work with here at Grady? Um. Well, she passed away yesterday. And she was young. And I knew her since, like, her first day of medical school." I cleared my throat and pressed my back against the door to keep from crying. "So, today was hard. Because she was really great. Really, really great."



"Was she nice?" he asked.

I smiled at the simplicity of that question. "Nice? She was more than nice. She was the kind of nice that you don't see all the time. Like . . . epic nice. . . genuine and for real, you know?"

"Yeah. I think I do know. What was her name?"

"Her name was Dr. Alanna Stone."

He mouthed out her name and squinted one eye as if he was trying to determine if he knew her. Realizing he didn't, he first shook his head then switched to a nod instead. "Well. Something tell me Dr. Alanna Stone would be happy you was in here spending time with a patient like me on a day like this. It seem like she would like that. Plus sometimes y'all need people to see about y'all, too."

He was right. That thought made the corner of my mouth turn upward on one side. I thought of how someone had told me about how, even in her ICU bed, she checked on the well-being of the physicians involved in her care. She even graciously told them that she trusted and appreciated them--even in her last moments.

"You know what? I think she would." Then something came to me so I went on. "Now that Dr. Alanna Stone? She slayed, man. At everything she did. As a doctor and as a person she did. She really slayed."

My patient gave me a playful smirk. "She legit did?"

"She legit did!"

We both chuckled at that and pretended to give a high five through the air since I was nearly out the door. And just that quick the heavy returned. Pressing upon the room once again and sliding around my chest like a boa constrictor.

"Okay then, sir."

"Hey--Dr. Manning? Thanks for telling me that, okay?"

"Thanks for asking. For real."

We stood there looking at each other. Me at the door, him in his bed.

"I wish I'd met her."

"I wish you had, too."

I think he could feel the emotion mounting again and wanted to let me off the hook. He smiled the warmest, dearest smile ever and waved. "See you tomorrow, Dr. Manning."

"See you tomorrow, sir."



I slipped out of the door and let it quietly close behind me. And then I walked out of the unit as fast as I could. . .through the automatic doors, down the hall. . . and then into the quietest Grady stairwell I could find so that I could lean my head into a wall once more to cry and cry.

Crying because I would miss seeing the life of this beautiful woman continuing to unfold. Crying because thirty four is too young to die. Crying because a little boy had lost his mother and a husband had lost his wife. Crying because one of the most legit epic students-turned-doctors that I have ever witnessed has had her career cut short and that patients like the one I'd just left would never get to meet her. Crying because she slayed which was ironic because that's not a word she would have ever used to describe herself or anything else. But also crying because of that moment with that man and how Alanna herself understood more than anyone that patients take care of doctors, too. That patients save their doctors' lives every single day.

I will miss Dr. Alanna Stone.

Yeah.

***

Now playing on my mental iPod. . . . one of my favorite songs of all time.









Sunday, July 9, 2017

The Mandolin.

Me and Isaiah this morning


That's me in the corner. 
That's me in the spotlight.


- R.E.M. , Losing My Religion


Today I was sitting in church by myself. Isaiah had joined me this morning but he'd gone on to his middle school service and I to the adult one.

Which was fine with me.

Summer is weird for schedules. At least it is in my family. So a lot of our regular routine relaxes a bit. Harry had a late evening so was breathing heavily and not stirring even though I was moving all around the room. I decided to let sleeping husbands lie. Zachary was as still as a statue--not even the fake, smirking one that appears on most school days--when I tried to rouse him from sleep. I left him be as well. Isaiah was up and said he wanted to come with. "Wait for me," he said quickly pulling on his sneakers. "I'm gonna come, too."

Which was also fine with me.

He's getting older. Twelve now. Full of his own ideas, some of which are still adolescent half-baked, but still very good ones. Views and attitudes. Somewhere along the way he has decided that he likes attending church. Which feels really good since it's of his own volition. The fact that we can wear whatever we want, bring a cup of coffee or a water bottle right into the sanctuary, or even chew a stick of gum without admonishment doesn't hurt either.

Anyway.

I was sitting in church this morning. I'd chosen a corner seat, the first on the aisle. The kind of seat that makes you swing your legs to the side or stand up every time someone comes up. And probably, it's one of those things that, if you really, truly were to ponder it, is kind of selfish. But I just kind of felt like sitting on the end this morning. Which, as it turns out, was fine, too. Summer-schedule weirdness apparently isn't just limited to the Manning family. The church services are generally less full this time of year so no smiling usher-person came over to wave gently in my direction asking that I slide down.

I was glad.

So, I guess all of that had me in a peaceful place. The week had been full. I wanted a peaceful moment of fellowship. And, while I know that not everyone is a believer in God or a follower of any organized religion, I do think we can all agree to knowing that feeling of just wanting a peaceful moment. One not tainted by someone moving you from the place where you want to sit or forcing you awake and guilting you into doing something that, just maybe, you kind of aren't in the mood to do. So yeah. That's where I was.

Peaceful.

That's when I heard it. Hauntingly beautiful. Painstakingly tender. Like a rub on the shoulder when you feel sad or a very, very tight hug when you feel super happy. The room had fallen quiet, as often churches do when lights go down and doors close. But instead of someone talking or singing, it was just this sound, this melody.

I looked up from my corner seat. And there was this light falling upon this one man, head down and eyes closed, playing a mandolin. His head was waving rhythmically, almost choreiform and trancelike. Lost in the sound of his instrument.

Yeah.

I could see the other musicians on the stage, too, but that soft, bluish spotlight was on him. Eventually the rest of the lights filled in to reveal the rest of the band and they began singing. But for some reason, I couldn't hear them. All I could hear was him. And that mandolin.

Hauntingly beautiful. Painstakingly tender.

Like the flash of lightning, my eyes filled with gigantic pools of tears. They spilled over my lashes and onto my cheeks. It all caught me off guard. It did.

But that mandolin. So tender, so beautiful . . . it reached straight into my chest and clutched at my heart. Squeezing it tight and bursting from it every single moment of my week, of my life. And let me be clear: Life is good, it is. But it is, like always, full and complex. It is.

The more he played that mandolin, the more I cried. Tear after tear. Eventually, I just stopped wiping them away and just surrendered to it. All of it.

I'm taking care some very sick people at Grady right now. Sick in ways that I cannot really fix. And all of that feels so dark, you know? But then, right in the middle of all of that, are these enormous bursts of light that shine like sunbeams. People saying and doing unexpectedly amazing things. Some of them patients. Some of them not patients at all but just a part of the teams who signed up to care for them.

This one lady on my team was so sick that she could barely catch her breath when we came to see her. We were seeing her as a team and I felt guilty asking her to answer my questions or even sit up with such short wind and pain. But she did and I was able to assess what was happening with her from that. So I talked to her about the plans and answered our questions. And that was that.

Then, just as we prepared to go, she pointed at my medical student Joav and said to him, "Hey, you're the only guy on this team. How's it feel being surrounded by all of these ladies?" And we all just sort of chuckled as Joav made a small talk comment back. So we left the room and that was that.

But that wasn't really just that. See, on this team, I am working with a med student who is a transgender woman. She, along with all of us, is navigating a territory that is, to put it mildly, new to a lot of people around her. And with new or unknown things, people say and do things that catch you off guard. Some of them extremely hurtful. But some hauntingly beautiful. Painstakingly tender.

Kind of like that man randomly playing a mandolin in my church today.

Or like a lady gasping for air who points out the obvious. The obvious being that there was only one man on our team.

Yeah, that.

So I saw my student Holly's eyes when listening to that mandolin. That flicker that went across them when that patient spoke those words. And, to quote Holly, a lot of trans women will never look like Laverne Cox. They won't have the "pretty" advantage or mysterious ambiguity that some others enjoy. But still. That woman--that woman who pulled her oxygen mask to the side to say what she said--didn't seem to care about all of that. Yeah, so that was part of what made me cry.

And then there was my patient who, while fighting for her life, shared on rounds with me that her biggest concern was getting some diapers to her auntie's house for her baby. That was her big, big worry. She said her baby probably has a washcloth on her. And then she started crying because, honestly, there just wasn't any sort of solution.

To get diapers, that is.

And me, I was just thinking about her medical problems, you know? How serious and life threatening they were and just how totally first world, in comparison, that getting a box of pampers was.

Except that it wasn't first world to her. It wasn't. To her, it was just her world.

So I thought of that, too. With each cord of that mandolin wailing into the heavens, I did. That brought more tears.

This week, at least three different nights, I woke up and felt something right in front of me in my bed. It was my youngest son, Zachary--ten and a half years old and up to my shoulder, no less. But somehow finding himself under his mama's bosom just like when he was a little toddler. So savvy that he even figured out how to do it without even waking me up.

Yeah.

And so I asked him, "What's up with you coming into my bed, son? Big ol' boy in my bed!" And mostly I laugh about it since it was as unusual as it was funny.

"I don't know, Mom," he replied. "Something just told me that you needed to feel my love this week. Plus I just sort of wanted my mom. So I got in your bed."

And he was right. So very right. Which was also something I thought about as that mandolin played.

Hauntingly beautiful. Painstakingly tender. My growing, athletic and outwardly tough baby boy. Who somehow hasn't lost that inner compass to his mama's heart.

When he was about five or six, he tried to get in bed with me late one night. It had been a long time since that had happened so it startled me. I lifted up my blanket for him, and he started crying when I let him under the comforter next to me. I asked him why he was weeping and he said, "I'm getting big so I thought you'd say no. But sometimes I just want my mom."

To which I replied, "Remember this: Your mom always wants you, too."

Sigh.

I decided right then and there that I love the mandolin. Which probably I should have already known since one of my favorite songs of all time is "Losing My Religion" by R.E.M.  The irony of that song, to me, is that listening to it is always a bit of a religious experience for me.

Yeah.

The rest of the service was amazing. I learned some stuff and was given some good ideas to reflect upon from the sermon. Nobody sat directly beside me or coughed or smacked gum or kicked the back of my seat. They didn't try hugging me when I was crying or intrude upon my mandolin-induced emotional outburst with words of consolation or inquiry. And I'm super glad, too, because I wanted none of that. I just wanted peace on the corner seat. Which was exactly what I got.

On the way out of church, I chatted with Isaiah about a whole bunch of nothing. He told me about what they did in middle school church and I did my best to explain the mandolin making me cry. "I love the sound of the mandolin," I told him. "It makes my heart fill up when I hear it." And since Isaiah said he didn't know what a mandolin was, when we got into the car, I immediately played R.E.M. for him from my iPhone and pointed out the mandolin parts.

He just sort of shrugged and said, "Uh, okay, Mom." Then looked at his phone.

Which was also fine with me.

So yeah. Today, that was me in the corner. Not necessarily in the spotlight. But  as filled with emotion as that man in the spotlight playing that mandolin.

Hauntingly beautiful. Painstakingly tender. Like darkness and light existing together. The light always wins.

"Hey, Isaiah, get that paper and that empty bag off of the back seat for me," I said as we got out of car at home. He did as I asked of him and then walked toward the garbage can to toss the stuff in the trash.

"What'd you get from Target yesterday?"

"Some diapers," I replied. "And some wipes."

The garage door went up and Isaiah just sort of scowled at me. Then he just shook his head, deciding not to bite. "Diapers and wipes. . . . Uh, okay, Mom."

That was all he said before trotting up the stairs two by two and out of sight.

And you know what? That was fine with me, too.

Yeah.

***
Happy Sunday.

Now playing on my mental iPod. . . . the song that me and my friend Mary Moon have connected over and that, just maybe, had something to do with her own baby playing a mandolin. (That might be in my own head, though.)








Friday, July 7, 2017

These three.




3 things I witnessed today on rounds at Grady

1. Faith 

Him: "I was scared at first. But I prayed and now I feel a lot better."

Me: "That's awesome."

Him: "I prayed for YOU, too. Asked God to give me a doctor who was patient and with kind eyes. When I met you and your team, I knew He heard me."

Wow.


2. Hope 

Me: "How are you today?"

Him: "Thankful for another chance!"

Me: *high five*

Him: "You know what, Miss Manning? I feel like going on."

Me: "That's what's up."

Him: *looks serious* "I think this time I'm gon' get it right, too."

Me: "You can and you will."

And then we hugged it out.


3. Love

Me: "You look like you want to cry. Are you okay? Do you need anything?"

Her: "I need him to be better. Because I just love him so much."

Him: *words in Spanish*

Her: *full on crying*

Interpreter: "She is my world and I am hers. Every day this is what is in my mind. From morning until I sleep. God knitted our hearts together."

Then he grabbed his wife's hand and squeezed it tight. So tight that those hands looked knitted together, too.


Today at Grady I saw faith, hope and love in action.
These three--but the greatest of these was love.

Yeah.

***
Happy Thursday.

Monday, July 3, 2017

Sixteen years.




We wear the mask that grins and lies, 
It hides our cheeks and shades our eyes,— 
This debt we pay to human guile; 
With torn and bleeding hearts we smile, 
And mouth with myriad subtleties. 

Why should the world be over-wise, 
In counting all our tears and sighs? 
Nay, let them only see us, while 
       We wear the mask. 

We smile, but, O great Christ, our cries 
To thee from tortured souls arise. 
We sing, but oh the clay is vile 
Beneath our feet, and long the mile; 
But let the world dream otherwise, 
       We wear the mask!

- Paul Laurence Dunbar




We are drawn to Grady for its complexity. The people riding along in the struggle bus just hoping and praying to be seen. Seen by someone who cares for real and not just because caring seems like the cool thing to do this year. We want to be that person. We want to be the one who swoops in and helps. 

Because this is what we do at Grady, right?

July 1 marked my 16th year as a Grady doctor. And in 16 years I've seen a lot. I've grown a lot, too. There are stories that I've heard that would break your heart into a million tiny pieces. Laughter garnered from my patients that would split your side in two and make you vow to cover your ears at all funny things for the rest of your days. 

But. 

Here is what I have especially learned: Those drawn into the doors of this place know not fully what she will offer to them. She changes you. Makes you believe in humanity again and recognize the similarities we share instead of the polarizing differences. Without asking for it, she gives you that. Freely. And those who are most eager for her lessons get the most frequent and most heaping helpings of them. 

They do.

I saw something beautiful today. A patient felt broken. Sad and like their world had not really, truly been worth living. And no, not suicidal but more in this downward spiral. Life looked bleak. And, when I listened, it reminded me of the man who once told me that he felt like bugs were crawling all over his body. Once I leaned in and looked closer to him? He was right. There were bugs crawling all over his body. So sometimes? A bleak outlook on life is exactly what it is. 

Bleak.

But here is the thing about Grady. From some of the hardest, coldest concrete lives, there is still life. And from it, if you stay long enough, you see a leaf shoots out of it. And then a tiny bud. It blooms into a rose. Fragrant, beautiful. And something about seeing that restores hope in the person who watered it, not believing for sure that it would ever become the flower it was designed to be. 

Yeah.

So that? That is what I saw today. A patient was going through it. And that patient was honest about it. Said, "It is what it is--messed up." Family who mostly isn't fully supportive. And the person who was supportive not living long enough to stay in your corner, pat your back and send you back into the ring when you get your mouth piece knocked out. 

That is where we thought we came in. Us. The Grady doctors. With our listening ears and our hearts on our sleeves and our hearts that have just a little extra space inside for the least of these. Because, you know, that's what we do. Thinking all along that it's them who need us. 

Except when you do this you learn. Especially after sixteen years. You learn that, really, people are all a little bit broken somewhere. Us included. And that kindness is kindness and empathy is empathy and that all of it is therapeutic whether you have several letters after your name and student loans on your credit report or not. Every one of us could use that balm for our weary souls in the form of another human being looking in your direction and offering affirmation. Especially when it's genuine. 

I saw that happen today. At Grady, I did.

The patient was seen by a medical student on my team. And under that student's care that patient felt connected and safe. So, to this student, that patient shared a truth that had never been shared. A scary truth that doesn't perfectly fit into the box of "how to be" in the bible belt. And that student sat on a chair and held that patient's hand. 

She sure did.

She listened and nodded and created a safer space than the patient had ever known. A student did this. Yes, a medical student. And it made this tremendous difference that will, I'm sure, lead to better outcome for this patient. I believe that it will.

So I come back in with the team to see the patient. And I do the things an attending physician is supposed to do,  you know? I ask a few questions. I repeat a few parts of the story. I hold the patient's hand and let them know I am an extension of the care they've already received. And if the care hasn't been good? I am the place where that ends. Except, in this instance, it had been good. It had. 

Yeah.

So I go over everything and it is good. This person who'd felt broken was feeling better. Motivated to fight hard as hell to get to the other side of complicated. And a lot of it had to do with this medical student who'd quietly slipped into that room with a tiny pad of paper and a very big heart. Peeled off the mask that the patient had worn for over half of a century. And it was as a amazing as it sounds. 

It was.

But then something happened. That patient turned toward that student. Looked into her eyes and spoke words stronger than any healing salve in your grandmama's medicine cabinet. Trained those big brown eyes on hers and spoke of gratitude. But that isn't all that happened. 

No, it is not.

See, this student also knew of the pain of wearing masks. That patient let it be known that this student and her transparency had provided the wings this patient would need to fly. And it was stated concretely, too. In front of that whole team. Me, the resident, the others on the team. And that patient said that because it was exactly what was deep down inside of their heart. 

Sure was.

"Thank you for giving me the courage to speak the truth. I don't have to pretend I'm a mistake or the wrong person. I'm so proud of you," the patient said to that student. "You are so brave. And I admire you so much for that. Seeing you be so strong makes me feel stronger, too."

That is what that patient said. That. 

Let me tell you--this? This was a magical moment. And another perfect reminder that we think we sign up to do the healing. Here we come in with our little bag of medicine tricks, believing that we have the panacea to whatever ails you. Or at least the brains to talk about it all. 

But.

Like I said before we, too, are broken. We come to Grady for one thing. But we stay or keep coming back for something altogether different. Healing. Our healing. Opportunities to remove our own masks and walk upright. Souls being soothed by humankind and reminded of the very best of who we can be. 

Grady gives that a thousandfold. Maybe even more 'fold than that.

I know I'm totally rambling. I know. 

Anyways.

Today was the very best of Grady Hospital personified. Underscoring yet again that the most important things we can give to our patients are never learned in medical school. We don't come needing to learn that critical piece--humanism. Instead, it is simply our job to fight to keep it intact. I think that what our patients most need from us are exactly the same things we need from other human beings, too. And when we both agree to remove those masks and share freely? It is a beautiful thing, man. It so very is. 

That is what I saw today at Grady. And what I've witnessed for the last sixteen years. 

And I'm thankful for that. Super, duper thankful.

Yeah.

***
Happy Monday. And here's to sixteen more. 

Thank you, Grady for giving me sixteen fantastic years and for saving a piece of my life every day, too. And thank you to that brave medical student for being you. You know who you are.



Wednesday, June 28, 2017

The lady in the street.



Street life there's a thousand parts to play
Street life until you play your life away

- Joe Sample


I was driving down Dekalb Avenue yesterday. Headed away from Grady in an effort to make it to Grand Rounds on the Emory campus across town. It was the lunch hour so there wasn't much traffic which was good. And on this day I was in a mostly good mood and didn't have anything heavy on my mind.

NPR was on. Someone was talking about the 45th President and something he said or did. Or both. And I just listened quietly, doing what I always do when hearing these radio segments. And what do I always do? I try to imagine the looks on the faces of the people speaking. Like, I imagine it to be like people are when they're in a room together on the phone and the person on the line is the butt of a joke. Except they don't fully realize that they are since it's the phone and not face to face. Yeah. So, I wonder if Kai Ryssdal and Steve Inskeep are snickering next to their microphones or if there's some sister producer making the kinds of faces that I make when hearing crazy stuff.

Anyways.

That's what I was thinking about and not much else. Unless you count the fact that I hadn't eaten lunch and was wondering if I would at all. I read a book recently about listening to the body and eating when you're actually hungry instead of just eating at the programmed times. So yeah. I thought about that, too.

The sun was out and the sky was blue. Which was very much a welcomed thing given the sheets of rain that we'd had the week before. Downpour after downpour, man. The kind that keeps kids indoors and ruins plans to do stuff.

So yeah. I guess I was thinking about that, too.

Along I drove . . . telling myself I wasn't hungry, giggling at the imaginary facial expressions I'd assigned to the NPR people and being glad that I wouldn't need an umbrella. And all of it was fine.

That's when I saw it. This blur of brown and blue. Spinning around like a real-life Tasmanian devil in the center of traffic.

"What the hell?"

I said that out loud. Because seriously, I had no idea what it was I was looking at. But then I got a bit closer and saw that it was a person. A woman, actually. Wearing this denim dress versus shirt that appeared both tattered and several sizes too big. And at first, it was hard to tell what she had on since she was moving so quickly and erratically.

Her arms were swinging at the air. She was screaming and punching and fighting some imaginary opponent, cursing them with such deep hatred that spit was flying from her mouth. Her feet were kicking in the air, too. I slowed my car down, partly because I didn't want to hit her but also because I was just kind of worry-wondering about what would happen next.

Then her wild eyes met mine. She lit over toward my driver side window--fast, too. So fast that I couldn't hide my startled expression or quell the wave of fear that washed over me. She ran right up to my window but then stopped. Her eyes were still pointed in my direction but I realized then that she didn't see me. Those eyes were looking through me, into some world far, far away.

"I WILL PISS RIGHT HERE ON THIS SIDEWALK! RIGHT HERE IN THIS STREET! CAN'T NOBODY TELL ME WHAT THE FUCK TO DO. NOBODY!"

And all of this was aimed into my car which was now at a near complete stop. I wasn't scared anymore though. Well, I take that back. I wasn't scared of her. But I was scared for her. Short term scared and long term scared.

Suddenly, it was like a switch flipped. She turned away from me and toward the oncoming traffic. Her bottom fell to the sidewalk while her knees went into a deep bend. Placing a hand on the ground in front of her, she began doing a sexually suggestive dance of some sort. Laughing the entire time, her brown and fractured teeth gleaming in the high noon sunshine. She was still talking, but I now I couldn't hear her.

I could see that she wasn't wearing underwear. Or much of anything beneath her clothes. They were falling off of her, now one deflated breast exposed. That made her throw her head back and laugh more.

HONK!

A car was behind me. Dekalb Avenue has only a single lane in that direction during that hour. People needed to go. And since I was at a complete stop in a place where there wasn't a light or a stop sign, that honk was for me.

And so. I lifted my foot off of the brake and slowly eased forward. My pulse quickening because I felt like there was something I should do for her. Like, something you know? Even something little like buttoning her up and getting her out of the street. Covering up her body so that no one could see it on Dekalb Avenue or escorting her over to the Grady Psychiatry ER.

Something.

But I didn't. I moved my car up and eventually went back to driving to where I needed to go. I kept my eyes on her through my rear view and was relieved to at least see her get out of the middle of the street.

And that was that.

I wish I could say that this moment was something totally unusual. I mean, the half dressed dancing part was kind of odd, but not that sinking feeling I felt. This horrible mixture of guilt and fear and sadness and helplessness. That? That is something I feel a lot.


So those empty thoughts I'd had before were replaced. I sifted through what could have been happening with that woman and what would happen next. Like, was she mentally ill and in need of medication? Was she sick from drug dependence and under the influence of some mood altering substance? Was she a kid who'd been neglected and abused? Was she somebody's mama or somebody's sister? Did she have a grandmother somewhere who was praying nonstop for the Lord to take all of this away from her baby? Or was she none of those things?

Or maybe she was all of those things at the same time.

I don't know. Yeah, man. I don't know and it bothers me that I probably won't know.


I looked for her when driving to work today. Slowed down and really, truly looked for her all up and down Dekalb Avenue as I rolled up the street. I'd tossed a pair of pants and a shirt in the back seat just in case. At minimum, I told myself that I'd give her something to wear. And if her mind was in a better place, maybe I'd even ask her if she was okay.

Maybe.

I never saw her though. Not then or on the way home either.

Nope.


Not even sure why I wrote about this. I guess I just wanted to honor her as a person. Putting even that tiny sliver of time into words to let her know I saw her. I saw her and in that moment wished I could apologize for whatever in her world had let her down.

Yeah.

***