Sunday, March 1, 2015

High Achiever Inertia.

(Rambling, idea sorting and unpacking ahead. Consider yourselves warned. )



"Keep on movin'. Don't stop like the hands of time."

~ Soul II Soul

____________________________________________________


I remember logging into the protected residency website that houses all of the call schedules a few years back. Waiting for the page to open has always felt like spinning a wheel on Wheel of Fortune--nearly every possible wedge upon which the wheel can land is mostly good with only the very rare BANKRUPT tab. That said, even rarer is the $5000 mark that happens about as frequently as a lunar eclipse. The resident and intern assignment odds are fortunately better than game show ones. The chances of hitting it big are much greater and, even better, the BANKRUPT tab is nearly nonexistent.

(reference photo for folks to young to get the reference.)


Yup.

So this particular month, Vanna White was on my side. I scanned the list and did the slow Tiger Woods fist pump.

No, seriously. Almost exactly like this:




Yes. I'd hit it BIG on the scheduling game show this time. Matter of fact, this was right up there with somebody yelling out, "A NEW CAR!"

Oh yeah, baby.



Interns: solid. Medical students: Not familiar with them but likely solid, too. But the Tiger Woods celebratory gesture? Oh that was for the person designated to lighten my load--the resident assigned as my right hand woman. The scheduling gods blessed me with a RISING CHIEF RESIDENT. Did you get that? Let me explain. See, this senior resident assigned to me had already been asked to be a chief resident--which in a land of smart people is a big deal. So suffice it to say, she was as smart as five whips cracking all at the same time on the same behind. Now that? That's smart, baby.

Mmm hmmm.

So yeah. I did the happy dance and bragged to a few of my colleagues when queried about my resident for the coming month. It was the summer time and let me tell you--the living was about to be easy. For me, at least.



Now. Sure, I went through those fleeting thoughts of terror with regard to working with someone so smart and highly competent. And yeah, I shuddered a few times imagining some clinical curve ball being hit directly to me and, instead of knocking it out of the park, completely striking out. . . only to have the uber-genius future chief resident come right behind me and smash a grand slam into the rafters. Off of the same pitch.

Yeah. I thought those things but honestly, this resident was not only smart and a future chief resident--she was someone that I knew fairly well already. We'd had a good working relationship from the clinic so I knew that this would be a piece of cake.

Oh yeah, baby.



Now. Let me just discuss for a bit on just WHY I was so happy about this assignment. The truth is that it wasn't just about the fact that she was bright and pleasant and considered one of our best. If I am honest--and I try hard to be on this blog--it was more an opportunity to put my brain on ice for a little while. No--not from the patient care standpoint so much. More from the stressors of looking over my shoulder and under every little nook and cranny for something wrong.

And.

No sort of remediation would be needed. What. So. Ever. Hallelujah, man.



And so. I was going to show up with a plan to simply let this superstar resident do her thing. Because the word was not only out on her level of competence--I'd seen it first hand. Moreover, she was in her final year of residency so what was the point of me coming up with some sort of hair brained scheme to transform her in any kind of way?

And this? This is what I am reflecting on today. This thing that I have discovered that happens with a lot of high performing individuals after a while. This point where, instead of us pushing hard and finding ways to help them excel in new ways, we simply shut off all of our faculties and put it all into cruise control. And you know what? Even though it doesn't feel that way, it's like giving up.

Yeah. I said it. Giving up.

It's so pervasive, too. Even though it doesn't create a mutiny and even though for the most part the learners themselves don't even know it's happening--it is. A lot. Even with the really, really great educators it is.

It is.





Sure, at the beginning we push them and applaud their every milestone but there is this threshold that gets crossed where, as I mentioned before, the word is out. He or she is uber-exceptional and has already been given some sort of metaphorical gold star to prove it. So what do we do? We throw our hands behind our heads, lean back in our chairs, and snooze for a little while.

And okay, okay. If you don't like me saying "we" I will just go ahead and raise my own hand and say "me." Because not only have I been guilty of it, now that I am thinking about it and dissecting this idea, I recognize it as something that happened to me at several different points in my training and beyond.

Let me explain.

Usually it starts with some person planting a seed about just WHO this person you're working with is and just how awesome-great-amazing-the best-superstarish-thebombdotcom that they are. And sometimes you've seen it for yourself but a lot of times, you haven't. You just roll with it. Then the person shows up and what you see is through that lens. Which is mostly fine. And often accurate.

But.

What happens next is the thing that since that month with Tiffany (the rising chief resident assigned to me that year) that I've been trying to fight. It's a sort of inertia. I like to call it "high achiever inertia." This point where everyone sort of gives up on trying to do anything special to bring out an even better version of the person who everyone is telling you is already the best.

Did that even make sense? Stay with me. I'm going somewhere,

So check it. Usually there are heaps and heaps of flattery involved. From the start whether warranted or not, the person is lauded as fantastic and a star before they've even done one thing. As time marches on, the sweet words prove to be as empty as sweet foods--delicious to hear but of no real nutritional value. Feedback sessions morph into these nondescript proclamations of excellence without examples. And the person on the receiving in--who is human--eats it all up without even realizing that it was not a balanced meal at all. Or worse--that for the last several months, they've been fed the same, exact plate of food.

Yup.



I know how this feels. I lived through the "hey, you're going to be chief resident!" announcement and experienced the stealthy downshift in meaningful nudging toward new potentials that came from those who worked with me. And I didn't even know it was happening for the most part. I didn't.

Then, during my chief year, my Internal Medicine chairman, Dr. Blinkhorn, started having these weekly meetings with me. He'd give me specific feedback on my teaching and would ask me provocative questions about how I was running my ward teams. He wanted to know about the feedback I gave to learners, what I did at the bedside, and more. The points I made on the chalkboard--though often salient--he challenged. Questions like, "Who are your learners?" and "Do you think that was as effective as it could have been?" were common. He'd even say to me, "You look exhilarated. I can tell that session felt good and like you were in the zone up there today. Let's talk about why."



And that? That was awesome. Just freaking awesome.

Two or three days into working with Tiffany, things were going fine. It was as I had anticipated: She was exceptional in a myriad of ways and I was enjoying the welcomed diastole that came with along with it. But then something happened with a patient. Nothing wrong at all. Just a situation where I watched this excellent resident physician navigate one aspect of patient care into which my personal experience afforded me insight. And so. I took a moment to chat with her about it.

Yep.



Something about that conversation triggered an onslaught of memories. Specifically, I was transported back to those Tuesdays with Blinkhorn and just how pivotal they'd been for me. I put that on a post-it note in my head and vowed to come back to it later that day.

And I did.





That lead to a gigantic ah hah moment. Dr. Blinkhorn did something that very few people had done for me. He fought against the downhill momentum of "high achiever inertia." This was more than someone choosing to push a learner from good to great. This was something that was, in my opinion, even more profound. He approached his chief residents--the ones he'd personally selected--as if he could move them from what many perceived as great to even greater. And instilled in me this idea that we are never ever there. The destination is always moving higher and higher, forcing us all into a zone of development that we deserve.

Yes. That. This zone of development--not some high achiever comfort zone where everything morphs into the predictable and straightforward and hence the default of flattery takes the place of real, true strategy.  That.



So that got my wheels turning. And so. I asked myself:

What if. . . like. . . what if I actually set out to do something transformative with this learner? This one. This known-to-be-already-excellent learner? What if, in spite of everyone saying "oh me, oh my, your resident is awesome". . . what if I actually had the audacity to think that I could still do something to push her deeper into the zone of development? What if? What would that even look like? What would that even feel like? And. . . what would that take? What would that mean to a learner like Tiffany who, by everyone's standards, is at the top of the pack for her current level? Hell, what would it mean to me?

Well. I'll tell you. It would mean planning on my part. It would involve thinking and preparing in ways that I hadn't before. It would call for a boldness and a confidence that I'd not yet fully challenged myself with and a trust in my own ability to actually do something meaningful with someone like her. That was uncharted territory for me. So was I insecure about it? You bet I was.



Let me tell you what happened. It was transformative indeed. But not just for Tiffany. It pushed me into a zone of development and called for something more from me. I tapped into creativity and honesty that had previously lay dormant in such situations and the outcome? Man. It was awesome. 

Yeah.

So I guess that's what I've been thinking about. How to not give up on the high achievers or the proficient performers. And you know? This isn't just in the work place, either. This can be applied in other aspects of life, too. Kind of like the way your child who calls for more academic or personal attention from you somehow seems to get all of it, while (hallelujah) the other one just plugs away independently. In between moments with the needier one, you do what just might be the minimum--checking always finished and correct homework, giving high fives, and feeling grateful as all get out. Which is fine sometimes but when sustained is really no different that that same idea of coasting along in the cruise control of high achiever inertia.

Or in this case, easy kid inertia. 

Whoops. My bad. If your toes hurt from that last part, just know that the person who stepped on them has just had hers crushed as well.

Ummm yeah.


But I digress. So let me get back to a professional context before some toes get amputated.



I guess the thing is. . . . .these guys will usually be fine, you know? These high achievers--they will. And some piece of you knows it which is why we don't fully freak out  about or even think about this--as the giver-upper or the giver-uppee. But imagine--just imagine--what it would be like if they, too, got the level of thought and preparation as everyone? Or better yet, more than just back slaps and applause to fuel their independent development?

I think those greats would be even greater. And, even better, they'd pay it forward first chance they got.  You'd better believe they would. At some point, at least.



When Tiffany finished her chief residency, during her parting words she said one of the kindest, most memorable and most encouraging things I've ever heard any learner or colleague say about me to date. And, at the risk of sounding self important, I will share it--not because I need to puff out my chest--but more because what she said serves as a tangible affirmation of something I was really trying to do. As lofty as it sounds, I was trying to be transformative. I should also note that Tiffany was known for being stoic which made her words just that much more meaningful.

She said:

"No attending had more influence on me during my training than her. Doing a month on wards with Kim Manning as your attending should be a required part of our curriculum for all residents."

Yes. That is what this high achiever who'd already been asked to be chief resident, who'd arrived on my team as "one of those residents that everyone knows is awesome," and who just maybe knew more medical facts than me said in my earshot to a roomful of people.

Uhhh, yeah.

This simple statement will always be high on the list of the proudest moments of my career to date. Because I knew how hard I'd tried. And you know what else? It moved me so greatly that I quickly typed it nearly verbatim into my the my phone for posterity.

Okay maybe posterity is a strong word. But I at least wanted to have those words to revisit and unpack for later.

Sigh.



Here's the thing: No award was given with it. And nope, no plaque, publication, or confetti either. But that? What she said that day? Man. That's what I hear in my head on my shittiest days. It's what pumps me up when I feel myself giving up or falling into a lazy pattern that isn't unique to THAT learner.

Is it exhausting? Hell yes. But the reward is insurmountable. And freaking awesome.

Look. I can't say that every strong learner that I've encountered before Tiffany W. got some watered down, lazy educational experience from me. But I think the difference is that the level of intention I have when working with those performing at that level changed. And thanks to her, I actually believed I could make a difference. Even with the less junior trainees, I started to believe I could.

Yep.

So that's what happened. And that's what I challenge myself to do every single chance I get. For the known superstars, yes. But also for the ones who are superstars in disguise.

Which reminds me: I wish I had time to talk to y'all about how a lot of superstars get mistaken for average.

Mmmm hmmmm.

But that's another subject from another post. Oh. It's in this one, actually.

Ha.

Okay. This has been long enough so let me just wrap it up with this final thought:

If you keep trying at this and being intentional about what you do with every single learner, after a while perhaps a different word will get out. Yeah, man. Not that you're just nice or competent or full of random facts.  Maybe an expectation will get handed around that this person--you--just might be bold enough to try to transform those working with you. Even if they're not a problem child or someone super junior or someone who's been dubbed "just okay." Yes. Even if that person is known to be a star, the rumor might be that you'll still try to make them shine even brighter or in ways they hadn't before. So then no one will show up expecting an experience with you to be super-comfy and vanilla.

Nope.

They'll arrive with a nervous disposition expecting to be a little uncomfortable. Not too uncomfortable. Just kind of. I mean, maybe this could happen, you know? This could be the new word on the street when it comes to you. Even amongst the superstars.

with Tiffany at her Chief Resident farewell program

Then guess what? YOU'LL get forced into a zone of development right along with them. . . . . .the same one that we're all hungry to inhabit but that we don't realize we craved until we're there.

Yeah.

Jen S. and Lucas G. -- two that challenge me constantly. And I love it.

****

Okay. Here's the challenge for everyone reading this who works with someone excellent: Don't give up on them. Don't just float on your back in the pool basking in the sunshine without moving. Because when that happens on your watch, they stagnate. And when they stagnate you do, too. But guess what? When you push them into the zone of development, you go there, too.

Every. Single. Time.

*Based on Vygotsky's Zone of Proximal development--a concept that I like.


***
Happy Sunday.

Whew. That was a lot. I know. And maybe it made zero sense to you. And maybe it set off alarms for you instead. But either way, I appreciate you letting me unpack, okay? I really do. Keep on moving, y'all.

Now playing on my mental iPod. . . . a song that blasted in my dorm room many a day and many a night circa 1990. Soul II Soul singing "Keep on movin'."

Thursday, February 26, 2015

Random thoughts on a fake snow day in Atlanta.




"Due to inclement weather, your kids' school will be closed for the second day in a row."




Maaaaan, I'm calling the automated message line back and leaving a message that says, "Due to the fact that I am very impatient and also have a whole bunch of stuff to do, I'm bringing my kids up there whether y'all like it or not."

Snow-day, shmoe-day.



Something tells me that this wouldn't go over so well. Ha.

Feeling sort of random so if you have anything remotely important to do, please stop reading here. I'm serious. This will do nothing to enhance your brain. But then again, sometimes things like that are welcomed aren't they? Yes indeed.

So let's see. Where to start? Oh, this:



Why is it that I am so, so annoyed with The Duggars family -- you know, the ones with the 19 children -- but paradoxically intrigued by the happenings of their family when shared in People magazine? So now the little Duggars are having babies and getting married. On the cover of my very important literature (People) is the one who just got married and the whole story is about her and her new husband.

Mmmm hmmm.

Yeah, so they didn't even kiss before they got married. And when they did kiss, they went and did it in private. So yeah, that was interesting. Man. That's kind of impressive to hold out on kissing. Being a bad kisser is SUCH a deal breaker, man. I'm glad it worked out for them. Or that it at least appears to be.



What next? Got to see one of my favorite former students a few weeks ago. It was so awesome. It never gets old to me when folks come back to town and call me to meet up. Kevin will always be one of my absolute favorites. He made me a better teacher and physician for sure.





Ha ha ha . . . I posted this on Facebook. . . this super romantic looking picture of the BHE and me from Valentine's day.



Followed by this next snap of our kids who were ON OUR DATE with us.



Funny how romantically perfect social media can make things and people look, right?

Yawn. What else? Oh yeah. Speaking of people not even being perfect. . .  I got what I deserved yesterday. Have I told you guys about my tendency to silently judge peoples' grocery baskets? OMG. I do it. I try to  keep my face all straight as they put stuff on the belt but deep inside I'm all like, "GIRRRRRRL!!! CUP O'NOODLES???" or "Do you have any idea how fattening prime rib is? Sir? Do you?"

Especially if they're in work out clothes. Which for some reason they usually are.

Now. This is completely independent of my own Cap'n Crunch, Hebrew National hot dogs, Eggo waffles and lemonade. I told you already--I judge THEIR baskets. There are perfectly good excuses for every bit of high fructose corn syrup and refined sugar in MY basket.

Mmmm hmmm.

So yeah. Yesterday I'm standing in line behind this lady who had on, of course, work out gear. Now me, I'm getting fake snow day staples like bread, milk and Reddi Whip whip cream. This woman starts pulling all kinds of stuff out of her buggy. Extra buttery microwave popcorn, Oreo double stuff cookies, fish sticks, a thousand different frozen meals, some Digiorno's pizza, a Graeter's ice cream, and like three or four packages of Jimmy Dean sausage biscuits.

Mmmm hmmm.

So I squint my eyes and try not to give a "chile please" smirk. And I secretly think she caught me doing the side eye so I tried to look all happy and sweet which, I think, worked for like two minutes.

Mmmm hmmm.

So she pays for her stuff and keeps it pushing. And I start checking out while watching her leave thinking, "That microwave popcorn is the devil." That is the devil in who will make you not be able to fit your Prada.

Mmmm hmmm.

So the person behind me starts putting their stuff up there. And this person was all UBER granola. Like every single thing was terrifyingly organic. Oh, did I tell you? My buggy judgement is on both sides of the pendulum. I hate on the unhealthy shoppers and equally hate on the super-duper healthy ones. Ha ha ha.

So yeah. This couple had a little kid in the front seat and she looked to be about four or five. And I am just looking and thinking, "That poor child. She is thinking, 'Can a kid just get a bag of damn Cheetos up in here?'" And OMG they even had some of those fake meat hot dogs and burgers.

Ick.

So yeah. In the midst of me sizing up everybody in Kroger and their pantry selections, the time comes for me to pay.

"Debit or credit?" the kind lady asks me.

"Either is fine!" I chirp back.

But then I discover that my wallet is in my other purse. And that I have no cash.

Mmm hmmmm.

So guess who had to be THAT CHICK who pushes her buggy to the side and vehemently apologizes? Uhhh, that would be me. And when I said, "Can you leave this right here while I run home to get my wallet?" I am 100% that little girl in the cart behind me curled her lips and gave me this expression.



Which was really what I sort of deserved.

Sort of, not fully.

Hmmmph. That's why all she gets for snacks is celery and she doesn't know what a Pop Tart even IS. See? Aren't I mature?

Heh.

What else? Oh. I remembered more slang when I was in the hair salon yesterday. The first is this: "In a bad way." This is when somebody wants to do something but it isn't going to work out. The person who says this is usually making it clear that they can't help nor will they with whatever said situation is.

Ha.



For example. Just yesterday while my hairstylist was on the phone speaking with a client who was talking so loud that I could hear everything from the chair:

"Sakinah! I got stuck at work. Can I still come?"

"Oh, boo, I'm getting ready to go after Kim. You were supposed to be here two hours ago."

"I know! Please, please, please!"

"You in a bad way. I can take you Friday but not today."

And that was that.



Here's another: "You tripped." 

That means you made the wrong decision and now you are regretting it. Or someone else made a bad decision and you are talking about them making the wrong decision. Ha ha ha.

"Jessica Simpson blew up after she got divorced from Nick Lachey. Her shoe and clothing business makes millions, man."

"Yeah. He tripped."

Whoops. That reminds me. "Blew up" does not refer to her weight. It refers to somebody succeeding financially or professionally.

"Girl, I start my new job next week. I'm 'bout to blow up."

"That's what's up, girl!"

Ha ha ha. Did y'all know those?



Here's one more which is so ridiculous but a regular piece of the vernacular: "Smelling yourself."

This describes when a person gets cocky either because they've grown a bit older or maybe that they've recently blown up. Ha. Maybe it has to do with hormones? Hmmm. Hell if I know. Here's an example.

"My son has lost his mind. He had the nerve to talk back to me last night."

"Really girl? What's that about?"

"I guess since he's a senior in high school he's smelling himself or something. I sure took those car keys though."

"Ha ha ha, he tripped!"

"Yeah and when he started looking all sad since he had a date planned I told him, 'Bruh, you in a bad way. You should've thought about that before you started talking crazy.'"

*High five*

Ha ha.

That reminds me. I may or may not have schlepped my children with me to the hair salon on fake snow day #1. And there may or may not have been at least three other children there with their moms on their fake snow days, too.

Mmmm hmmmm.



Ummm let's see. What else? Have you guys ever tried flavored balsamic vinegars and olive oils? I'm obsessed with them right now. So delicious. And low in sugar. The oils make your whole house smell amazing. Just ran out of my garlic flavored olive oil from Atlanta Olive Oil Company.

Must. Get. More.

Speaking of which: My grandmother on my mom's side once told me that if I wanted to be a good wife and have my husband come home to delicious smells in the home here's the trick: Just sauté some onions in a little oil. No matter what leftovers you're serving, the house smells like you are wife of the year. Hand over heart she told me that.

"So you just sauté onions no matter what you're cooking?"

"Yep. Especially when it's just leftovers."

"What if he sees the onions?"

"Oh, you put those up. Or dump them in the leftovers."

Yes. This was what my grandma told me and quietly, it is genius advice. That woman had a college degree in Home Economics and knew all the tricks of the trade. She was also married for longer than I've been alive.

So get you some onions at your local Kroger when you go. And some Reddi Whip.

Ha.



OH and last but not least. SPEAKING OF KROGER. . .  Y'all. Y'ALL!!! Did you know that in Atlanta they name all the in-town Kroger stores with nicknames? OMG. So funny. Okay, so check it. I'm talking to one of my residents who is trying to tell me where he was the day before on his off day. And as he is describing the restaurant he then says, "You know, right by Murder Kroger."

And me, I'm like WHAAAAT???

So it turns out that everyone knew this but me. Soooo. . .there's Murder Kroger in Fourth Ward/Downtown, Disco Kroger in Buckhead, Kosher Kroger in Toco Hills, Baby Kroger in Downtown Decatur and Hipster Kroger in East Atlanta. How funny is that?

Yep.



Yawn. I think that's all I've got for today. That and just a little more Stefon who is, in my opinion, SNL's funniest characters of all time.




Okay. That's it really. Thanks for wasting good time with me.

***
Happy Fake Snow Day to all. I hope you don't get hit by a fake snowball.

Wednesday, February 25, 2015

Game face ON.



"Enthusiasm creates opportunities for learning."  

~ Daniel Wang, MD
EUSOM '13,  Small Group Beta


_________________________________________



Small Group Delta (and all of the other medical students in their class) are starting their clinical clerkships this week. Isn't that exciting? I sure think so. Anyways. I met up with them yesterday evening after their orientation session--partly to just lay my eyes on them but also to get their minds right for this next step. I'm a big fan of the "game face."



Ha.

That reminds me. When I was in residency, I used to pretend as if I was literally strapping on a mask when taking call or starting some particularly challenging rotation. My classmates knew about that little practice and would always get a chuckle when they saw me fastening my imaginary buckles behind my head. "GAME FACE ON!" I'd yell out. "BRING IT, BABY!"

Yup.



What that really was was me being intentional about whatever it was I was going to do next. Like, here was this line I was drawing in the sand that said over here is what I was doing before and over there is what I'm about to do. And something about taking a moment to clarify that has always been good for me. I still do that, actually. At the start of wards when riding the elevator up to meet my team on the first day, I put on my metaphorical game face. Sure do.

(A selfie of me at Grady with my game face strapped on.)


I think it makes a difference.




So yeah. That's what I wanted for my small group advisees. I needed them to get their game faces strapped on tight. And so. We met up and had our pleasantries. Then I launched into what I thought were some clutch things for them to know and do before jumping into this part of medical training. And most of them weren't that much different than this, which is pretty much the advice I had a couple of years back when SG Gamma started the wards.

But.



This time tapped into a great resource. This group is the fourth of my small groups to date. Two groups have since graduated on and one more is in their final year. I asked them for a few words of advice for "how to bring your A game" on the wards and clinical clerkships. And by "bring your A game" that means what are the ways to get the most out of the rotation and just maybe get an A while doing so. Oh, and I also told them to "keep it around the length of a tweet."

Ha.



I reached out to the whole Team Manning SG Fam--Small Groups Alpha, Beta, and Gamma. I got quite a few responses. Even if you aren't a member of the Manning SG Family Tree, that's okay. This advice is good no matter who you are. As a matter of fact, it's good advice for me, too.




I bring you:


SHORT SWEET ADVICE FROM THOSE WHO'VE BEEN IN THE MEDICAL STUDENT TRENCHES (AS MEDICAL STUDENTS) FAR MORE RECENTLY THAN YOURS TRULY.

(Oh, and the photos are all members of my small groups through the years. My, how the time flies.)


Like to hear it? Here it go!


______________________________________________

Words of wisdom to put on your mental post it notes. . . . 





"It's a marathon not a sprint. You've gotten this far. Don't let anything get in your way--ANYTHING."




"Go hard. This is a critical time. Don't drop the ball. Run hard and strong on every single play."




"Enthusiasm creates opportunities for learning." 




"Focus on what matters on wards: the patients, the care, the science. Be likable, but don't waste energy thinking about how to be likable." 




"Know things (about both history and pathology) for your patients."




"Don't be late."



"Always do your best. Even if you feel tired."



"Stay engaged and look happy to be there. Sometimes this means that you get to be super involved but sometimes this just means listening attentively during rounds...you never know when a question will be thrown your way."



"Develop a good understanding that it's not about you (or your attending), it's about the patient. This will get you far on the wards, and get you through some of the tougher days."





"Keep the patient and their well-being as your focus and all else will fall into place. Even if it's a rotation you aren't interested in as a career, there's something you can gain from it, appreciate the opportunity."




"Show up on time and have a question to ask (after reading up on the question first.)




"Never stop thinking. And remember: Happy spouse, happy house. And remember that it's all about expectations."




"Work hard. Seriously just work hard for your patients and always ask questions! If you act interested and clearly will do whatever it takes to give good patient care, automatic good eval and a great experience."





"Be nice. And don't ever lie."




"Don't let your midriff show!"





"Appearance matters. No matter how scruffy or gross you are in real life, tighten it up. No cell phones in view of anyone you work with.  Always think of the next step beyond what is asked of you."



"Be useful! Anticipate needs and attempt to formulate plans, even if you're wrong. Ask questions and study for the shelf exam."





"Hear Dr. Manning's motto in your head at all times: 'Don't embarrass me.'"





"Leave it all on the field. Every single time."






"Remember the 'my mama rule' and the 'It's not about you rule.'"





"Never stop caring."


***

Is there any question why I love my job so much? I get to receive text messages that say things like that. From people like this. 



Oh, and before I forget--couldn't miss a chance to add these last couple of snaps with my newest colleague at Grady. . . .


With Dr. Alanna Stone of SG Alpha EUSOM '11



Yep. In a few months I'll say good bye to Small Group Gamma . . and welcome Small Group Epsilon. . . . at the same time that Alanna from Small Group Alpha returns to the nest. Yes. We will be shoulder to shoulder at Grady Hospital. . . but this time as fellow FACULTY.

How cool is THAT?




Game face. . .ON!

***
Happy Wednesday--and hey! Don't embarrass me.

Oh and in case it got missed, here is my first day quick advice that I gave these guys.

And since I'm feeling mushy. . .here are my videos of SG Alpha and SG Beta. Le sigh. Along with the Beatles songs that are playing now on my mental iPod. . . .yes, I am a mush ball.

SG Alpha. . . 

Small Group Alpha - EUSOM Class of 2011 from Kimberly Manning on Vimeo.

and SG Beta's graduation day (for Mark who couldn't come to commencement.)

Commencement 2013 from Kimberly Manning on Vimeo.


. . . and, okay,  this isn't the Beatles, but is also from Small Group Beta. . . "Beautiful Stranger" by Madonna.  Watched this, too and got choked up with the other ones. Yes, my advisees have the most sentimental advisor of them all. :)

Small Group Beta from Kimberly Manning on Vimeo.