Sunday, October 31, 2010

Cover me.

I remember this one time when I was talking to one of my Grady patients who was dying of AIDS:

"What can I do for you today?" I asked him.

"You can pray for me. By name."

"Ummm. . .okay." That was all I could eke out.

"Will you really?" he pressed. I still remember his gaunt face and hauntingly sad eyes. He was serious.

"I will, sir. I . . I will." I was serious, too.

Later on that afternoon when I was sitting in my office, I replayed that encounter. I thought about his request for me and my promise to do what he'd asked. Right then and there, I closed my eyes, clasped my hands and did just that. Prayed for him. By name. When I opened my eyes again, I felt good. Like I'd offered my patient something much more than a prescription or a diagnosis.

Here's the thing: That particular day, I'd felt so frustrated. I felt helpless in that patient's overall prognosis and like nothing we were doing for him was working. Every day, it seemed like there wasn't anything I could do for him. So this time, I admit that I was slightly relieved that he actually had a suggestion for me that I could at least consider: "You can pray for me." Whew. I think I can do that. But heal you? Cure you? That would be much harder. . . .

For the rest of the hospitalization, I kept it simple, just like his question. Every morning on rounds, I would try my best to not be distracted by anything. Then I'd just hold his delicate hand and ask, "How are you, my friend?"


I also remembered to pray for him. Not in just the "God bless all my patients at Grady" way that I had habitually done before. This time I prayed for him by name. Just as he'd asked. Now that I think of it, I kind of liked the added nudge to be specific.

Today I'm reflecting on all of the things we can do for people that go beyond prescriptions or medical knowledge or material objects. Sometimes our therapeutic alliances (and relationships in general) are strengthened by our authentic presence, be that physical, emotional or even spiritual.

There's this song I like called "Cover me." It's about asking a person to pray for you. It immediately came to mind when my patient made his request. I like to think that "covering" each other goes far beyond prayer. . . . .


Regardless of what you believe, here is something I'm pondering today that I hope you will, too:
 Oftentimes when people ask to be kept in your thoughts and prayers, they mean it. I know this patient did.

Remember to cover me
That I might go in peace
Remember to keep me lifted
That I might go in spirit
Keep my name on your lips
When you pray remember this:
I need you to cover me.

Remember to cover me
That I might go in peace
Remember to keep me lifted
That I might go in spirit
Keep my face on your mind
When you go to God next time
I need you to cover me.

from "Cover Me" by 21:03 (hear it here.)

~ to my dear friend and fellow Grady doctor. . . .you know who you are. Your face is on my mind, my friend. Know that I am covering you. I am.

Saturday, October 30, 2010

Love actually.

*details, specifics changed to protect anonymity. . . .you know the deal.

A friend called me one day in tears. "I'm never going to get married," she moaned. "Ever. I'm so unlucky in love."

"Trust me," I responded, "There is somebody for everyone. Really. Just be patient. Trust me, I mean it."

"But I think some people just have crappy luck when it comes to love. I am a loser magnet."

"Stop speaking it, man. You have to stop speaking it or the universe will hear you."

"Okay," she whimpered, "Okay."

And that ended our conversation. I bet you think I was drawing upon my wonderful epic saga of when Harry met Kimberly when offering up those encouraging words, don't you?

Well, I wasn't. I was thinking of Grady Hospital.

How I know that love is out there for everyone:

This one time at the Gradys, I was seeing a Grady elder with one of the residents. And what a patient he was! The first thing I noticed about him was his infectiously positive attitude. This was remarkable, considering some of his other features.

He had exactly one tooth remaining of the thirty-two that he'd started out with, and that sole survivor was riddled with decay. Oh that lonely incisor. . . it was buried on each side by a heap of inflamed pink gingiva, yet had somehow migrated exactly to the center of his upper gumline. His face was covered with pasted on "moles"-slash-flat warts, and his lips kept a constant supply of white, frothy saliva tucked in each of their corners.

Aaahh, but it didn't stop him from smiling.

He had a poorly controlled case of diabetes which left him with one below the knee amputation, and because of his limited workout schedule, his stout midsection looked like a spare tire, literally. And just to give you a better sense (pun intended) of this particular patient, let me add that he wreaked of some dank odor that was possibly urine or something else.

Now, y'all know by now: I love me some Grady Hospital. But even more than I love me some Grady Hospital, I love me some Grady patients. And even MORE than I love me some Grady patients, I love, love, love me some Grady elders. So please. . . .know that when I say this next statement, it is with nothing but endearment:

This dude was no chick magnet.

(But somehow, he never got that memo.)

"Haa-haaaaaaahhhh!!!" he'd cackle and slap his knee during the encounter. It was this awesome-front porch-in-a-rocking-chair-happy-grandmama-or-granddaddy type laugh. Unabashedly loud and boisterous. No hand in front of his mouth. No embarrassed, slumped shoulders. No skittish eyes. Not this dude. He was cool with himself.

And as it turns out, he wasn't the only one. I learned that when I returned to discuss his treatment plan with the resident physician who'd been seeing him that day. We'd painstakingly made adjustments to his insulin to account for sky-high blood sugars, his blood pressure medicines to account for failing kidneys, his pain medicine to account for horrible neuropathy, and his cholesterol medication to account for his soaring lipids. The patient had only completed 4th grade, and, though motivated, had very limited health literacy.

We carefully explained the entire plan step by step. We drew pictures, we asked questions, we had him repeat what had been said to be sure he understood. After he understood the medical aspects of his visit, we explored aspects of his home life to be sure he wasn't getting overwhelmed. Fortunately, he had plenty of support from his adult children and friends. He'd been widowed for several years, so I feared that he was isolated and perhaps at risk for depression. A few quick screening questions confirmed that this was absolutely not the case. He was fine. And especially fine with himself.

So, that was that. We prepared to wrap up the visit with this moderately obese, virtually toothless, diabetic, and amputated gentleman in a room that seemed made for containing this urine-ish odor in its every crevice. But somehow his pleasant attitude and outlook on life overshadowed all of that. We helped him back into his motorized wheelchair and prepared to bid him adieu. I decided that he'd be my F.P. (favorite patient) for the day.

"Doctor?" he asked as I put my hand on the doorknob to leave.


"I almost forgot to ask y'all--I wonted to see if I could get me some them Viagras. I ran out of the ones I had got from a friend."

Say wha-wha-whaaaat? (Imagine me on a turntable scratching a record like a very surprised deejay.)

The resident and I exchanged glances. I spoke first. "Errr. . . .sir, are you. . .umm. . . .do you. . .have a lady friend?"

Great Manning. You're the attending, remember? That's officially the lamest way ever to ask a patient if he was sexually active. Decided to try to fix it. "I mean, sir, are you currently having sex with someone?" Great. Even dumber.

"Well yeah! Or else'n why would I be askin' for the Viagras?" He let out that giddy laugh again. "Me and my lady-friend been friends for years, and got close a while back after both our spouses passed on. We old, but we ain't dead!" And this time winked.

Ummm. Yeah.

I looked at his chart and noted that he wasn't on any nitroglycerin containing medications (which would make medications like Viagra a no-no.) The resident explained that his erectile dysfunction issues (or "nature" as he referred to it) could be from his diabetes and possibly something that might not respond to medications like. . .uhh. . Viagras.

"Nawww, it work for me jest fine," he countered and winked again. He still had that big gummy smile when he added, "My lady-friend out in the waiting area, and I know she gon' be glad I remembered to ask."



This morning, I'm reflecting on a few simple yet poignant lessons that this patient had to offer:
  1. Attitude is everything.
  2. What matters most is how you see yourself.
  3. Never assume that a patient doesn't have the kind of sex life that warrants Viagra. (Or Viagras.) And most important?
  4. There is a lid to every pot--even if it's buried so far in the back of the cabinet that you think it's nonexistent. Even when you lose your first lid, another can await who lost its pot.

See? Now surely my morose girlfriend's prince charming is out there somewhere. And who knows? Maybe he's a frog sitting in a waiting area somewhere just waiting to be kissed.

Thursday, October 28, 2010


Good news:  

Grady Hospital is "going live" on our new electronic medical record (EMR) in less than one week. 

Bad news:

Well, actually. . . there's no real bad news per se. But there are some aspects of overhauling the medical record system of a ginormous hospital system that qualify as annoying, to say the least.

The main one?  The training sessions! And it's not because we don't have a wonderful team of trainers who are eagerly walking us through this electronic system. It's not them at all. It's us. The doctors. Getting us scheduled, making sure we "get it", and much, much more. There are several four to six hour training sessions that we must complete prior to the "live" date--some of which are even on weekends. It's a necessary evil for an overall positive endpoint, I know.

But Sunday at 7am? Really?

Now. .  .let me give you the visual. . . .a six hour session with twelve doctors sitting in front of twelve computers.  A very efficient teacher praising us for "getting it" so fast and agreeing to shave off an extra fifteen minutes of the session with every "good job!" compliment.  And, most importantly, a new found knowledge of our massively upgraded, generation Y charting system -- all ending nearly two hours before the intended end time of the scheduled session. That doesn't sound too horrible, right? Right.


You get in a session with one of the following types of people:

  1. The "excuse me, I didn't get that, so can you back up and repeat the last five trillion things you said over the last five trillion hours?" doctor.
  2. The "I don't know my home keys on the typewriter so I keep getting behind so then I turn into #1" doctor.
  3. The "jump ahead because I am too impatient to wait and learn and listen so then I get locked on some weird page that requires the instructor to stop and deal with me" doctor.
  4. The "I'm so OCD that I can't get past the inaccuracies of the medical problems in your practice patient examples so I will continually correct the non-doctor instructor to insure that every example is evidence-based" doctor.
  5. The "I'm going to keep checking my Blackberry/iPhone/Droid because there is no way I can go two minutes without texting an emoticon-laden message to someone sitting in this training session with me" doctor.
  6. The "what? I've been in the wrong room for the last two hours?" doctor.
  7. The "sorry I'm late, but I was in the wrong room for the last two hours" doctor.
  8. The "I scheduled all my trainings out of order so, even though this is '102' I'm going to keep asking five trillion annoying questions because I actually haven't even done '101'" doctor.
  9. The "even though all eleven other want us to keep plowing through the training so that we can get out early, I do want the offered breaks even if it means not leaving until the full six hours is up" doctor.   And last but not least,
  10. The "all I want you to do is give me credit for being here so will ask an alarmingly off-based question that suggests that I have not paid attention to a single thing you've said for the last five trillion hours" doctor.
(Feel free to offer suggestions for any I may have missed. . . )

So this is what I (and all of my fellow Grady doctors) have been going through for the past several weeks. Is there a deep point to this?  Uhhh, probably not. But today, I am reflecting on how hard change can be.  It's interesting to see how set in our ways we can all be (me included.)  Change throws everything into a tailspin. Even when it's necessary.

Funny thing is when it's all over, you sit there scratching your head and trying to imagine life before/without the big change you kicked and screamed about just a few months/years before.  This will surely be no different. Oh, and for the (electronic medical) record, I refuse to admit which of the ten EMR training personalities I fit. On second thought, I've been a perfect angel, so clearly none of those apply to me. Heh.

Bottom line: This change is a good thing.

But still. I will still periodically let out my war cry:


Wednesday, October 27, 2010

Outward appearances.

Isaiah and I were sitting "criss-cross-applesauce" on the asphalt waiting for the school bus this morning. We were playing a word game of some sort, and also talking whether or not it would rain today. As the bus pulled up, we leaped to our feet to meet the bus.

"Make it a great day, son!"

"Mommy, I hope you have the best day ever!"

::big hug/big kiss::

"What do you say, son?"

Looks at the bus driver as he lumbers up the steps of the bus with his over-sized backpack. "Good morning, sir!" he says, knowing that I was referring to the importance of greeting people courteously.

"Hey there, Master Isaiah!" replies the bus driver. Glances down at me and smiles wide and genuine.

"You really enjoy those sons of yours, don't you?"

"Yes, sir, I do. I really do," I answer him.

"I can tell. I can really tell."

And with that, he closed the door and drove off.

Love as a verb. Love you can see.


Thanks for making my day, Mr. Busdriver.

Monday, October 25, 2010

Off day.

Ferris Bueller: The master of the good kind of "off day"

Do you ever have a day where you just feel kind of "off?" Like for every sentence someone speaks to you, you say, "huh?" or "beg pardon?" because you're zoning in and out? You do? Yeah me, too.

I call them "off days."

Here's what I have discovered about such days: I can feel them coming like the aura before a migraine. I try to pack too much into one small suitcase of time and the end result? Nothing is exactly right. It ends up being an off day.

And so, yesterday I felt all of the trimmings and trappings of an off day coming together. The preceding week had been bananas, and right on the heels of it was Zachary's birthday on Saturday. Soccer for both kids that same Saturday morning, necessary special-ness for our newly minted 4-year-old to make up for the no birthday party, and then a Halloween costume party that afternoon. We ripped. We ran. We finally got home at nearly 8 PM and had even more excitement when my mentor-slash-friend-slash-fellow Grady doctor, Neil W., came over with his family to wish Zachary a happy birthday. (This was great considering Zachary ADORES Neil and Tamara W.'s ten-month-old, Matthew, who Zach has renamed "Baby Mackey.")

Anyways, soccer + special-ness-for-birthday-boy + costumes + careful-balance-of-special-ness-for-nonbirthday-brother + "Heeeeeyy! It's Baby Mackey!" = One tired mommy. When the kids finally closed their eyes at 10:30 p.m., I was spent. Sho' nuff spent.

When I awoke on Sunday, it already felt like it could be an off day in the making. It started when I couldn't get my act together enough to get the family out the door to church. (And believe it or not, my church has a way to watch the service online, which I couldn't get my act together enough to do either.) Realized that I'd forgotten creamer for the coffee when I went to the grocery store earlier. And. The kids seemed to have forgotten every last one of the things we'd done the day before:

"Hey, Mom! What are gonna do that's fun today?"

"I thought we had fun yesterday."

"But I'm talking about today-fun not yesterday-fun, Mom."

Fake enthusiasm: "How 'bout we go out back and play?" Big smile with jazz hands.

"Out back? That's not fun."

"How 'bout we do nothing and have zero privileges?" Even bigger and very much sarcastic smile, now with wiggling jazz hands.

"Okay, out back, Mom." Smart kid.

Out back we went. Not their first choice, but better than nothing and zero privileges.

As I sat on the steps watching the kids play in the yard, I took in the beautiful day despite my feelings of blah. I'll admit--it was lovely. I'm talking autumn in high definition, and air with just the right amount of crisp in it. Way too nice for a sourpuss attitude. But I was tired, for real. Harry was going to the Falcons vs. Bengals game, and despite his sweet-yet-rhetorical question: "Do you want me to just stay here?" -- I knew that this off-day-in-evolution was going to be all mine.


Such a pretty day. A shame to waste it on blah-ness. I should be driving an hour somewhere to pick apples or frolic in pumpkin patches like my friends are doing with their kids. But I was spent.

After getting good and dirty (and good and tired/hungry) the kids came inside for lunch. Zachy announced that he was going to have "quiet time." (Yes, my 4-year-old announced his own nap.) It was definitely an ultra-twilight zone moment when Isaiah cosigned, saying, "Yeah, and then we can wake up and so something really fun." This had to be God telling me that He was giving me a few moments to get my sourpuss-blah-bleccchhhh act together.


And so they napped. I knew I should be napping, too, but I kept thinking, "I'm tired, but not sleepy-tired." Anyways, I started to blog but then fell asleep after all. Guess I needed an equally solid hard-drive reboot of my own. I woke up before the kids, took a nice hot shower, and then got myself dressed. (Yes, at 1pm.) I shadow-boxed in the mirror and told myself to get it together.

"Kids shouldn't be affected by your off days, lady," I said to my reflection. (Yes, I talk to my reflection quite regularly.) Then came the affirmations.

First a text message from Harry that read: "I'm really happy you made me get my tickets. Thank you for being so thoughtful. It makes me really happy." Harry considered not getting his Falcon's tickets this year and I'd urged him otherwise. Hmm, that was sweet.

I shadowboxed some more, and made up my mind that this would no longer be an off day. No way. No how would I waste this glorious day on negative energy. Despite how tired I told myself I was feeling.

It worked. When the kids woke up, we read a few books and then headed out to do "something fun." On the way to an indoor play center that the kids requested, Isaiah pointed out a festival going on right in our very neighborhood.

"That looks like something fun!" he announced.

Interestingly, my Grady doctor-friend, Lesley M. called shortly after and was on her way to the same festival with her own 5-year-old son. Aaaah. It was meant to be. I made a U-turn and headed over.

And I am so glad I did. We had an absolute blast. Cotton candy. A rock-climbing wall. A jumpy castle. Right in our very neighborhood. Good times, man.

Who knew?

Here's what I am reflecting on right now: Good days and bad days are totally up to us. Deciding that it's an off day is a self-fulfilled prophecy, so I've decided that I'm going to avoid declaring my days as such. Making it a great day is the same way. If you keep saying it's a great day, eventually the heavens open up and get in cahoots with you.

I'm also reflecting on how critical it is to save a little of ourselves for ourselves. Otherwise, you get so spent that you have nothing to give the ones who love you and need you. At least, that's my take on it.

And. You never know what blessings await you. Turns out that two months ago, I feared that I would be tired after Zachy's birthday weekend. I had asked to have Monday off -- so I didn't even have to work today. (I didn't even realize it until around 10 last night!) Go figure.

See what I meant about the heavens being in cahoots?

The off day that I fought off made way for a real off day I needed. From now on, that's my kind of off day. :)

Knowing better.

Still on the Zachary's birthday high. . . . .

October 22, 2006

"Pregnancy turns your bladder into the most useless organ ever."

Harry looked over at me and my very pregnant self sitting in the passenger seat of his car and laughed. "What's that supposed to mean?"

"Exactly what I said!" I replied with a chuckle, "It can't hold much of anything, and if you do so much as sneeze you wish you'd wore a Depends."

Harry kept driving while shaking his head. "Not the Depends, babe!" He glanced over at me and we both laughed out loud. "Not a sexy image to give your husband. At all."

"Don't make me laugh!" I playfully scolded him and then looked down. "Aww man!"

We both cackled again, and then instinctively looked over our shoulders to be sure we hadn't awoken 16-month-old Isaiah who was fast asleep in his car seat behind us.

I thought for a moment as the wheels turned beneath the car. "Hey, babe?" Harry raised is eyebrows in response. "What if I don't just have a faulty bladder? Like, what if this is amniotic fluid? You know. . like my water is slowly breaking."

"I thought when your water broke it was like a water balloon?" he countered while hitting the blinker. Then, for emphasis, he slapped his hands on the steering wheel and said, "SPLASH!" After which he looked over in my direction. "Like that."

"No, I'm for real, you goofball! And it isn't necessarily like a water balloon. Although, I don't really know first hand since they broke my water for me last time."

"See? Don't call me a goofball! Why don't you just call Tracey? I'm not your OB."

"I know I'm probably tripping, but you're right. I'm no OB either," I said as I pulled out my cell phone. "Dang. And it's Sunday. But I guess when you catch babies for a living, this is your thing."

We were on our way home from a lovely dinner with Lesley M., her husband and three other Grady doctor friends/fams that evening when this whole conversation transpired. I was two days shy of my due date with Zachary and, other than feeling like my bladder would explode 24-7, I felt pretty darn great for the entire pregnancy. Even still, I know that I have a tendency to undercall things when it comes to my own health. I went ahead and called Tracey L., my OB-slash-med school classmate-slash-very good friend, to discuss my questions. She promptly instructed me to go to the labor and delivery to get checked out.


I threw my stuff in a bag (nope on baby #2, you don't already have it packed) and headed to the hospital. By 10 PM, I was checked in and by 10:45 I was being checked by the nurse.

"Chile, you don't have nothin' goin' on in there!" the nurse teased. "That cervix is as tight as a drum. We'll see you back in like two weeks." She laughed at her own joke which was, in my opinion--one point five days before my due date--only a '2' on a funniness scale of 1 to 10.

"Hey, do you think you could draw my blood just in case I do go into labor? Like my CBC and platelets so that I can get an epidural right away if something happens in the next 48 hours?" I knew that the anesthesia guys needed to be sure you had normal clotting before harpooning your spine.

Let's just be clear here. I'm not one of those super-bad moms who toughed it out sans analgesia. Well, I take that back. For the first 12 hours of labor with Isaiah I thought I was going to be one of those "Yeah, girl, I did it natural!" moms, but 12 seconds after entering otherworldly pain-free bliss, I wondered what I was thinking and changed my tune big time. This time, I didn't want any delays in pain relief, just in case things didn't happen as Nurse Know-it-all predicted.

"Chile please! You ain't goin' into no labor no time soon. That wasn't amniotic fluid and your cervix could not be more closed. That baby boy wants to float a little longer." She laughed one more time. I know she didn't mean to be annoying. But she was. Very.

Then, as obnoxious as it sounds, I decided to pull the faculty card, since I was at one of our teaching hospitals. "I'm actually on the Emory faculty," I said (eeewww, name-droppy and lame, I know!)"Would it be okay if--"

She didn't even let me finish. "Then you should know better, Dr. Manning. Go home and get some rest. And enjoy these next two weeks before he gets here. You know, they're a lot easier to care for in there than on the outside." Seeing as she was about twenty years older than me, there wasn't much more I could say.

And so, that was that. I was discharged at 11:30 PM, overnight bag and all. No blood draw. No "baby on the way!" phone calls to my parents. No amniotic fluid leak. Just a bladder that didn't enjoy having 8 pounds of baby pouncing on top of it every five seconds. Good night, Dr. Manning. See you in two weeks (when you have to get induced.) Ha. Ha.


By now, y'all have to know how Seinfeld-ish my life is. So clearly you know what happened next, right? Claro que si!

1:45 AM. Awaken suddenly with intense need to bear down, as in the feeling immediately preceding #2. (I worked hard to find a non-disgusting way to say that on this blog. I hope this was acceptable.) Left the bathroom after nothing happened and got back in bed. Exactly eleven minutes later, it happened again.


And again. And again. Eleven minutes on the dot. I woke Harry up and told him flatly, "Dude, I think I'm in labor." Just like that. Then I added, "But my cervix was 'tight as a drum' less than 3 hours ago according to the L and D nurse, so no need in waking up. I'm going to just hang out downstairs and watch TV. I'll call Tracey, and then we can go to the hospital after we take Isaiah to daycare."

After one obligatory, "Are you sure?" my sleep-loving husband turned over and zonked out. (Can't you tell this wasn't our first baby?)

And so. I watched two DVR'd episodes of Entourage. Another of America's Next Top Model. I cleaned and cut up some collard greens. Did a load of laundry. And even made a turkey meat loaf. All while timing these intermittent episodes of feeling the need to do #2 without it actually being because of #2. (My description of contractions.)

7AM the bear-downs have evolved to uncomfortable. We quickly get Isaiah dressed and fed. Then get ourselves dressed and fed. (Can you believe that I was vain enough to shave my legs that morning? Ha ha ha!) Finally, by 8 AM, we are in the car and on the way to drop Isaiah at daycare and then to the hospital. Bear-downs officially hurt.

8:25 AM, Isaiah nearly thrown into daycare like a 16-month-old football (terrible, I know.) Bear-downs getting slightly un-bear-able. Oooh weee. Oooh wee.

8:45 completely at standstill in Atlanta Monday morning rush-hour traffic. Officially miserable.What. Were. We. Thinking? Harry did his best to make things better. He spent half the time trying to make me laugh and the other half rubbing my leg and saying the kinds of things that sweet husbands are supposed to say while you're in labor.

"Sssssh! Shssssshh! Sssshhhhssshh!" (That's me trying to breath through the contractions in the passenger seat.)

"What in the world are you doing?" Harry asked me with a chuckle.

"Breathing . . . .sshshh! shhssshhh! sshhhhh!" I replied. I was unable to hide my amusement with the situation so burst out laughing, too.

With both pregnancies, we never got our act together enough to go to any kind of birthing classes. All I could remember was what I once heard my grandmother say-- "Whether you get lessons or not, that baby is coming out of you." This became my mantra (read:excuse) for not giving up an evening or weekend to learn the proper way to breath/manage pain/etc.

Instead, I resorted to what I'd seen those women do with the doulas on "A Baby Story." It was a pretty darn hilariously awkward thing to see.

By the time we reached Emory Crawford Long Hospital at 9 AM, the bear-downs were every 5 minutes. The pain was mind-numbing, and I intensely wished I hadn't turned to Bravo during the parts on TLC's Baby Story when some very granola, yet knowledgeable midwife explained how to redirect one's mind away from the excruciating pain of an 8 pound human being forcing his way out of a very small, yet allegedly expandable trap door.

"Wait! What if I see one of our residents?" I asked Harry in terror. This was totally possible since it was the 9 o'clock hour at one of the Emory teaching hospitals. I looked at myself. Feet slid into sneakers that were unlaced. Nonmaternity Seven jeans unzipped halfway. Nonmaternity t-shirt with high rise in the front and low rise in the back (kind of like the t-shirt equivalent of a mullet.) Fortunately, I had my hair in braids, which was the only thing that looked even half-way presentable.

"Please don't let me see any residents. . . .Please don't let me see any med students," I muttered under my breath in between contractions, giggles and goofy breaths. The whole sight was pretty ridiculous, I'm sure. Harry and I could not stop laughing.

"Heeeeey Dr. M!"


It was a pack of residents and medical students. Walking in my direction. Waving. All jovial and chatty. Just as they approached, I felt a bear-down coming on. Lawd, lawd, lawd.

"Ummm, hey guys," I said with a wince. "Umm. . turns out, I'm in labor. Sooo. . .yeah. . . I'd better go before I have a baby in this hallway."

And before they could reply, I was around the corner. Mullet shirt and all.

When I get to the L and D, the nurse checks me and asks, "Aren't you a doctor? Honey, you're almost 8 centimeters! Now you know you should know better."

That was the second time I'd heard those words in 24 hours.

"Listen," I cut to the chase, "I need you to draw my blood right away so that I can get an epidural."

She laughed out loud. At me. So not with me. "Oh, honey, it's too late for that. You're there already."

This was the moment where I suddenly understood every single patient who went off on a health care professional when their agenda did not line up with that of the caregiver. Every drop of "professional" flew out of the window. All I could think of was the fact that Isaiah A. Manning was weighed just two seconds after I pushed him out, and that scale read "9 pounds and 2 ounces." This kid could be a ten pounder for all I knew.

"Oh, hells no!" I firmly declared. Harry looked at me sternly. I didn't care, so repeated myself. "Oh hells no, I'm getting something!"

She laughed again. Then she slapped my arm a few times and commenced to try to insert an IV in my arm. 3 times. Unsuccessfully. Oh hells no.

"Please, let me just put it in so you can draw my blood," I said. "I can do it. Give me the catheter."

Wait. Really? Yeah. That's what I said. I'm not proud of it.

"I can't let you place your own IV," the nurse responded.

"That doesn't make sense. Let me just do it because I'm about to jump off this table if nobody gives me something for this pain."

Harry leaned in to my ear and whisper, "Wow, you are being SO obnoxious."

The nurse knew she was in control of this. Despite my foul behavior. After what felt like 100 years, I finally received my IV, along with some kind of narcotic that made me start hallucinating. But not enough to stop demanding an epidural. Now I was just high and demanding.

Once Tracey L. arrived, I launched into begging. "Please, please, please call anesthesia. Please, Tracey. Remember? Isaiah was a 9-pounder. I'm scared. Please, please call them." I was on the verge of obnoxious, hallucinatory tears. "And tell them I'm faculty." Ugggh. There it was again.

The nurse rolled her eyes very obviously. I knew I deserved it, so I didn't get mad. When anesthesia arrived, I realized that I knew the anesthesiologist. Yes!

"Give me something! Anything!" I pleaded. "My first child was almost ten pounds!" I felt the need to exaggerate to make things move along. Plus I was hallucinating, remember?

A few moments later, I received what definitely wasn't an epidural, but what I'd like to call an "epidural-lite." And I am the first to admit--I should have just sucked it up considering literally one minute after they taped it in place, I rolled on my back to push.

Three pushes later, Zachary was here.

The main thing I remember is being so spaced out from Demerol that all I could say was (through trippy tears), "Awwwww, I love him! He's such a little pooda!! But I feel like I'm loopy so take him!" (Which my mom was very happy to do.)

7 pounds and 14.5 ounces. Not quite a ten-pounder, but definitely a respectable size to request an epidural-lite.


Okay, so today, I'm reflecting on how frustrating it can be for patients when the caregivers have one agenda and they have another. This experience made me realize how important it is to keep this in mind with every patient I encounter. Like, for some people, their agenda is as simple as "I'm a healthy person who took off work because I think this is strep throat and I need antibiotics" while as the doctor you think it's a straight forward case of allergic rhinitis with sore throat secondary to post nasal drip. If you don't reflect on the patient's agenda, you write them off as "demanding" or "antibiotic-seeking" or "annoying" or all of the above.

I'm not saying the nurse who saw me that Sunday was wrong to say no to a blood draw. But maybe a little more discussion would have been good. And even though I was able to get the epidural-lite, as a patient, I could have done a better job at recognizing the nurse's agenda to follow protocol. And I'm sure that my behavior didn't exactly help her IV placement skills too much.

In the end, it all comes down to listening, doesn't it? Just respecting each other enough to get where the other person is coming from. That's important for doctors, yes. But probably just as important for everyone else, too.

As for the birthing classes, while they do seem like a good idea for most folks, the fact that I didn't take any makes the story even more Seinfeld-esque, which I dig. And. My grandmother was sho'nuff right:
"Whether you get lessons or not, that baby's coming out of you."

And I'm so glad he did.

Sunday, October 24, 2010

Reflections of an 18th Year Medical Student: Bananarama.

For me, being a medical student was bananas. Some of my richest memories are from that time. . .and some of my funniest. I just remembered something from back then while making coffee this morning and had to laugh out loud. (Loud enough for my kids to ask me to tell them the joke, too . . .or show them the YouTube video, too.) Anyways. . .it's funny to imagine how much we learn and grow throughout our medical training and experience. . . . .sigh. . . .

Labor and Delivery Wards
circa 1994 at the start of our Obstetrics and Gynecology clerkship:

True story:

This is a note that was in the chart, written by a well-meaning medical student/classmate who shall remain nameless, considering that this person is more than likely a fully licensed practitioner of the healing arts in some part of the world right about now. . . . .

Background: As medical students, we couldn't sign our own orders, which meant our plans had to involve either the immediate input and signature of the (very busy) attending physician or the (even busier and often annoyed by pesky medical student) resident physician. . .

. . . .unless, of course, the therapy didn't require a medical license.  . . . .(rubbing hands together) . .Bwaaah Haaah Haaaaaaaaahh!

Progress Note, MS III (med student, third year)

Subjective:  Active labor, progressing well. Pain 0/10 2/10 with epidural in place. Complains of leg cramps.

Objective:  Vital signs within normal limits. Temperature 37 celsius. Blood pressure 108/75. Pulse 100. Lungs: clear Cardiovascular: normal heart sounds, regular rate and rhythm. Abdomen: gravid, nontender. GU: 6cm dilated?, 70% effaced, position ? (will discuss with attending) Extremities: 2+ swelling edema.

Labs:  Potassium: 2.3 !!!  (VERY LOW)

Assessment:  1. 27 year old female G1P0 in active labor. Going to have her baby today (probably.)    2.  Really Low potassium  Profound hypokalemia.

Plan:   Give her some potassium.  A banana, stat. 
            Order given to nurse.

Uuuumm, yeah. For the record, we have excellent alternative therapies to profound potassium depletion than emergent fruit consumption. (If only I had been a fly on the wall when the nurse received that "stat" order. . . . .)


All I'm saying is this: Lawd have mercy!! Thank heavens for medical education.

Um yeah.

Saturday, October 23, 2010

Reflections on my son's birthday: All that I can and can't say.

Classic Zachary move:

Grandma:  "Put Zachy on the phone."
Me: "Okay, Mom. . .Zachy! It's Ma-Ma!"
Zachary: "Hi Ma-Ma."
Grandma: "Hi Zachy! Happy Birthday! Did you have a great day?"
Zachary: "Ma-Ma, I'm four!"
Grandma: "I know! How's it feel to be four? Tell MaMa all about what you did toda--"


Drops phone and walks away to go play with his new toys.

Love it. And him. :)

"Loving you is wonderful
Something like a miracle
Rest assured I feel the same way you do. . .

Needing you it isn't hard
With you I can let down my guard
Stay secure that's all I'm asking of you . . .

I wish I had words to tell
This feeling that I know so well
But I don't, I don't. . . .

All that I can say. . . .

All that I can say. . . .

. . is knowing him, loving him
showing him that I'm all in
living and forgiving him
I would do it all again. . .

. . .genuine seraphim
sweeter than cinnamon
heaven-sent gentleman

Synonyms for loving him. . .

 I love you, I love you
Oh I don't wanna live without you
You're all that I can say. . . ."

~ Mary J. Blige's "All That I Can Say" (written by Lauryn Hill!)*

Dear Zachary,

All that I can say is that being your mom makes me want to wake up in the morning. All that I can say is that my answer to Toni Morrison's question is YES. Yes, son, my eyes light up when you come into the room.  All that I can say is that your laughter sounds like music to my ears, and that I love your scratchy-baby-baritone voice. I can say that, even though when I was pregnant with you I terribly feared that I could never love any child as much as I did your brother, that I was wrong. So wrong. I can say that the day God saw fit to let me be your mom was the day He created a new space in my heart just for you. A space that is every bit as special and cozy and perfect and open for more growth as Isaiah's space or Daddy's space. And that I'm so glad that He did.

All that I can say is that my life is indescribably better with you in it.  That you make me desire to be a better human being. And that every day, even if it makes me cry a little bit, I make myself realize that seeing your face and touching your cheek and smelling your skin is not a guarantee. . . but a privilege that I should never take for granted.

All that I can say is that I love you, son. And that I promise to make my love for you a verb every single day so that you grow up feeling and knowing and believing and internalizing the love in my eyes that sometimes has to speak for all that I cannot say. 

Happy 4th Birthday, son. . . .
*(Hear Mary J. Blige singing this lovely song here.)

Friday, October 22, 2010

One breath.

You do the math. . . . .

1 mommy-doctor-friend-teacher-wife

divided by:

1 lecture at regional Hospital Medicine professional meeting on Thursday completed just in the nick of time
1 manuscript revision due "as soon as you can turn it around to us" (read: Monday)
1 lecture scheduled to be given on Friday (today) on a topic I've never presented on before today, worked on nearly all night because night before was working on other Thursday lecture
1 self-professed procrastinator and refuse-er to do such work while kids are awake and wanting my attention
1 public hospital with 1 million things awaiting me to do once there. . . .
1 superhero costume preschool class party (today) for Zachary who turns 4 on Saturday (yay)
1 mom who would be in poor form not to be there at superhero costume preschool class party despite fact that she has lecture scheduled that she is not 100% ready to give
1 very-best-friend who's baby shower is right around the corner and still with things on to-do list remaining
1 baby-in-best-friend's tummy who deserves a sweet welcome
1 alarm clock that almost got smashed to bits
1 school bus to catch after restricted sleep
1 5-year-old who made 1 request for us to sit "criss-cross apple sauce" on the (cold) ground while waiting for bus
1 kitchen in desperate need of grocery shopping
1 early-morning class to teach to 8 eager medical students
1 head that desperately needs a haircut. (3 if you count my sons.)
1 3 and 364-day-old who refuses to stay in his bed or use inside voice in middle of the night
1 pushover mom (me) who fusses at 1 husband for fussing at 1 3 and 364-day-old 1 day before his birthday
1 3 and 364-day-old ruining my sleep due to teeth-grinding and placing his feet on my face
1 medical resident, 1 medical student, 1 + 1 new faculty that I need to schedule meetings with
1 soccer team expecting me to bring the snacks for the game on Saturday
1 5-year-old who keeps losing his library book that's due today
1 soccer cleat (that is less than 1 month old) that has now been missing nearly 1 week
1 husband who fed kids Mickey-Dees on yesterday for dinner, but with apple wedges instead of fries (go Harry.)
1 tired wife who did not object. . . . .


1 busy, frazzled, tired mommy-slash-doctor-slash-wife-friend who is thankful for two ends of one candle in which to burn. . . . .and even more thankful for

1 life that I would not trade for anything.

Wednesday, October 20, 2010

Holding Out and Pickin' Switches

SkippyJon Jones
 we heart SkippyJon at our house

  • Isaiah had a "good listening" day. Yaaay!
  • Zachary had a "not-so-good listening" day. Booo!
  • Isaiah earned a special treat today for staying on task and getting a good report.
  • Zachary lost privileges like: "playing on your i-Patch" or "watching 'lectric company."
  • They live in the same house.
 (child using an i-Patch: quite the coveted pre-school activity these days)

  • The exact opposite of that took place.
  • Privileges for Zachary, loss of privileges for Isaiah.
  • Ugggh
  • My dad, who put the "old" in "old school", is reading this saying, "I got yo' LOSS of PRIVILEGES ALRIGHT!" 
  • (If you are interpreting this to mean that Pa Pa believes in a good ol' fashioned "butt-whoopin'" you are 100% accurate in that assumption.)
  • Dad and I recently concluded that "butt-whoopins" are only effective when one fully commits to the activity. (Canoodling or falling onto the floor giggling and playing tickle-torture mid-spanking do not count. Nor is this approach recommended.)
  • I do not commit well to the aforementioned because of the canoodling/tickle-torture reason, so must resort to other forms of punishment.
  • This just in: Pa Pa now has eyebrows raised and is saying, "Since when does a KID get any privileges? Yo' privilege is to do what I say." (Love that my kids have an old school granddad.)

Questions (to which I do welcome answers):
  • How do you allow a five-year old to have fun in the same house/room/space as a 3-year-and-363-day old who is supposed to have lost privileges?
  • Why does it feel like I'm being punished when I have to restrict either of them from the kinds of fun activities that give me two minutes to breathe? Uggghh.
What ended up happening:
  • Nobody watched any TV either night. (Too hard to allow one and not the other.)
  • Nobody played on the i-Patch. (They had run the battery down anyway.)
  • I needed to figure out a consequence.
  • Ah hah! I pulled out the heavy artillery:
    • "Where the Sidewalk Ends" by Shel Silverstein. Yeah baby. Zachy went to bed while we read poems of Isaiah's choice. OMG. Mayhem, I tell you.
    • The night before: Isaiah had to go to bed and missed out on Zachary and I reading two "SkippyJon Jones" books.  Two.
  • Okay. I'm slightly ashamed that I have resorted to holding out on books as a punishment. But.
  • I do think (if she just allowed me the chance to explain it) that Oprah would be proud, that I have created such book lovers that witholding books could invoke ear-piercing shrieks heard all over the bible belt. (Even worse than pulling a switch off of the tree in your grandmama's backyard. If you know nothing about "pickin' switches" then you are likely a.) not from the south b.) not black,  c.) not related to anyone who is a. or b., or c.) all of the above.)
  • FYI for city-dwellers: Growing up with urban parents who know how to remove a belt in one fell swoop is equivalent to "pickin' switches."
  • If you were unlucky, you had grandparents who had you "pick a switch" and parents who could do the Zorro belt removal. (No problems committing to either back in the day, it seems.)
  • That said, I've decided that book withholding, when fully committed to, can be a solid consequence for naughty behavior. Solid.*
  • *But only if your kids dig books.

Yes. This is what I go through when I leave Grady Hospital.

Oh. And if you don't have any SkippyJon Jones books in your house and you have a child under the age of 5. You need to be on Amazon. Now. Because SkippyJon Jones = good times.

And if you don't have any Shel Silverstein books in your house then. . . .well. . . I. . uhh. . .wait.  I refuse to finish that statement. Surely you have Shel Silverstein in your house. Surely.

 from Silverstein's "Where the Sidewalk Ends."
(Dude, read this to your kids and everyone wins, man.)

Tuesday, October 19, 2010

Tangential Tales and Teachable Moments.

 My dad as an Omega Psi Phi fraternity pledge marching on "the yard" at Tuskegee University, Fall 1962
(He's the one at the end of the line!)


"Don't assume anything in medicine. Just because something or someone looks a certain way, doesn't mean it is or they are. Sometimes the reality can amaze you. 
Trust me. You have to dig a little deeper."

This is what I told a group of our medical students recently at Grady.


That's what the look they gave me conveyed. They either weren't getting my point, weren't feeling my point, or both. The context was about how patients might appear disheveled or put together but they totally aren't what you thought. Or how they might look like they speak another language or will relate to something, but they don't. (Like when one of my fellow Grady doctor friends was in the Clinica Internacional and began hablas-ing in espanol to a woman with a latin surname--who spoke ingles solamente. Yeah.)  Don't assume anything, I told them. You have to dig deeper.

Eh again.

Tell y'all what. I'll provide an example. An example of how something seems one way but isn't.

Ah hah.

Now I had their attention. Woo hoo! Campfire time! By now, the medical students who work with me know that I'm always good for a story that has virtually nothing to do with medicine. Somehow, I get around to the point I'm trying to make.


Here's what I told them about which, hand over heart, is 100% true:

Fall 1988. . . (insert wiggly hands taking you back in time with me here)

"The Yard" (aka the campus of historic Tuskegee University)

When I was a freshman in college at Tuskegee University, it was a whole new world. I was this L.A. girl transplanted to rural Alabama and, despite the fact that Tuskegee was our family's tradition, the culture shock for me was huge.


There were a few "shocks" that weren't so bad about college. For starters, there were things like. . . no curfew and no parent asking you to clean up the kitchen or take out the garbage. No hairy eyeball if you wanted to eat pizza for breakfast or cereal for dinner.


There were boys. College ones. Lots of them from all parts of the country and from all walks of life. Short ones, tall ones, fair-skinned ones, cocoa-colored ones, quiet ones, loud ones, New York-big-city-cool ones, Chi-Town-midwest-swagger ones, Caribbean-smooth ones, and Sweet-as-pie-Southern ones. Whoa.

Although I never thought of myself as boy crazy, I'm not blind. Say what you want--this was a feast for freshman eyes for sure.

School Daze. . . .

During the fall semester of my freshman year, there were several fraternities and sororities going through the process of initiating new members. At historically black schools (back then), the pledges rose early in the morning and marched across the campus in a line singing like soldiers running through a military base. Their voices would ring over the entire yard as the sun was rising. We'd run to our windows, throw them open, and peer down on perched elbows. Especially at the boys.


My favorite part was when they would reach each residence hall and then greet us each morning. The "dean of pledges" would hold up his or her hand and in the most important way ever, give them permission to speak. We'd already be packed in our windows with rollers in our hair and scarves on our heads waiting to hear them say:


"Hey y'all!" we'd all coo and wave back (at the fraternities, that is.) When the sorority girls came around, we'd be so intimidated that we'd just sit there as frozen voyeur statuettes. One person would always accidentally say hi, followed by the sound of crickets. (We all knew that sorority pledges became sorority members, and that overexuberant speaking now could become an issue later.)

Now. Back to the boys.

There was this one pledge. Aaaah. I'd nearly break my neck getting out of bed to see his pledge line when they'd come singing up that hill on the side of my dorm. He was this dreamy, pecan colored Southern guy with ginormous dimples and unbelievable eyelashes. The first time I'd ever seen him was with his pledgebrothers walking solemnly in a line along the side of my Biology 101 class. In addition to being completely mesmerized by all of the Greek buzz that semester, I could not wait to catch a glimpse of this beautiful stranger any chance I got.

For background purposes, you need to understand how historically black greek letter organizations worked during that time. After at least one year of college and several hoops to jump through with trying to get to know the organization's members, finally (if you were lucky) you'd "make line" or get the chance to be initiated. Anyways, this meant that Cute-Pledge was at least a sophomore or junior which, to my freshman eyes, made him seem just that much more interesting and mysterious.

Okay, so literally, for six weeks, I would gasp and punch my roommate's arm every time we saw them  (read:him) walking along the campus dressed identically. Or sitting in the cafeteria with their exaggerated grimaces and shaved heads. Or quietly perched like statuesque ducks in a row as their big brothers poked fun at them in front of all us onlookers.  And because he was a "lowly" pledge, throughout this whole time, I never once heard him talk. It made him just that much more interesting-er mysterious-er.

My crush grew exponentially.

One evening, my friends and I were sitting in our dormitory watching TV.  Suddenly, we heard horns honking all over the campus and people screaming. Someone burst into the TV room and announced,


"crossed:"  term used to describe someone making initiation into a historically black fraternity or sorority; refers to a process called "crossing the burning sands" into membership.

"probate show:"  a performance put on by new initiates of historically black fraternities and sororities

We sprinted out of the dorm as fast as we could, elbowing our way through the crowd to do our best to see. There were people everywhere. I'm talking folks in trees, sitting on shoulders, standing on cars--you name it (which believe it or not, still happens regularly to this day on black college campuses when new initiates storm their college campuses on their crossing night.) And right there in the thick of it all, was Mystery-Cute-Pledge turned Mystery-Cute-Frat Boy.  And with his new found swagger--stepping and chanting amongst his newly minted fraternity brothers-- my fascination inched up two more notches.

Later on that week, I'd see him from afar and stare waaaay too hard. Smiling all easy with his brand-spanking-new fraternity paraphernalia on and navigating through his new-found notoriety with the girls. If he got within two feet of me, I'd nearly become incontinent from the nervousness, so would somehow manage to get away before he actually spoke to me. Then, one day, something happened.

I was with three of my freshman girlfriends from my dorm hall and we'd decided to go to this fraternity party (the same fraternity as Mystery-Cute-Pledge-turned-Frat Boy.)  It was completely packed in the party, but the music was great and the energy was high. We danced and laughed in the corner when suddenly, I turned around and there he was. Him. Mystery-Cute-Pledge-turned-FB standing directly in my line of sight. Looking. Right. At. Me.


I looked around from side to side. OMG. Nope. He was looking at me.  Then. He started walking towards me.  Thump-thump, Thump-thump. My heart was about to jump out of my chest. Finally, he was standing right in front of me. My roommate was pinching my back so hard, I thought I'd faint. Thump, thump. Thump, thump. Feeling lightheaded.

He gave me this big, flirtatious smile. Oh. My. Good. Golly. Please don't lose continence. Please don't lose continence. Those dimples sunk straight into my heart and turned my legs into noodles. I could not believe this. I could not.

I had played this out in my head a few times before, but more as a daydream during my Biology lab. Him floating up to me with a big, romantic grin complete with the whitest teeth ever -- ting! What would he say? Something suave and debonair a la Billy Dee Williams in "Mahogany?" Something shy and sweet like . . . .errr. . .somebody shy and sweet?  Maybe he'd just present a single rose or pay me a compliment. Either way, I was having full on palpitations. . . .

He leaned in so that I could hear him. Wow. Wow. Wow. Could not. Believe this.  A whiff of his cologne wafted by my nose. Okay, a slightly heavy application of . . wait. . Stetson cologne? But still. Wait. Is he wearing dress shoes without socks?  Errr. Okay. I can ignore that. Because. He's adorable. And he's standing here. Ready to talk to me. Me, the freshman. The freshman who had the ginormously ginormous crush on him for the past eight weeks.

He licked his lips. . . .placed one hand on the wall beside me. . . .and then. . . .he said over the crowd:

 "So . . .uuuhhhhhh. . . . .WHATCHO' NAME IS?"

Yes. Those were the words-- exactly, verbatim that my mysterious, sweet super crush spoke to me for the first time.  No exaggeration. Wait. I take that back.


That's more exactly how he said it. In a high-pitched, nasal, almost scary southern drawl-y, milquetoast-y voice, no less. Waaaaaahh!

You are so not my husband. Ugggh. What a let down. (In hindsight, I think the whole being dressed alike thing masked some questionable fashion sense, I'm just saying.)

So much for my big white wedding at twenty-one years old in the University Chapel. 

"Whatcho name iyyuh?" Really? Really. Worst pickup line ever. Ever. Oh, and for the record: Tuskegee alums, I refuse, do you hear me? Refuse to confirm the exact identity of mystery-cute-pledge-turned-mystery-cute-frat-boy-turned-overwhelmingly-disappointing-nonfuture-husband. And considering the fact that as a freshman I had a major crush nearly every two seconds, it could literally be anyone. So don't try to figure it out. And don't ask.

Wait. . .what was the point of this story again? 

Oh well, I can't quite remember. But it is a great story. . .and at least I have the medical students' attention now.  Ah hem. Let's talk about community-acquired pneumonia now, shall we?

Spike Lee's "School Daze" - This captures (in a Hollywood kind of way) what 
life was like for me as a freshman at a historically black college in 1988.
Watching this floods me with warm nostalgia, and probably anyone else who attended an HBCU. 

Back on "the yard" at Tuskegee University for my own Delta Sigma Theta sorority reunion in 2008
(not yelling back at those sorority girls paid off)

Monday, October 18, 2010

Drifting on a Memory: A Family Centennial

1910 ~ 2010
If I live. . .

in a time and place where you don't want to be
You don't have to walk along this road with me

My yesterday
won't have to be your way. . . .

~ from "If I Could" 

On this day one hundred years ago, my paternal grandfather was born in rural Alabama. Things were different back then. Being born in 1910 is a far cry from being born in 1970. Today I am reflecting on what a difference a few generations makes.

He married my grandmother and together they had eleven children. There were three other families on their street with ten or more children. He went to work every day, all day, in a coal mine. He would come home covered from head to toe in soot. Slaughter a chicken or a pig for dinner. Discipline a child. Then, he'd do it all over again the next day.

It was a hard row to hoe. But he stuck with it. And through his stick-with-it-ness, he taught Dad the same. And he taught us the same. Dad says that granddad would walk along the rail road tracks to that mine and look back at his house thinking, It would be easier to just keep walking. Dad says a lot of people's daddies did just that. But not my granddad. 

All eleven children were born on the floor, in their house. I always respected my grandmother for enduring ninety-nine months of pregnancy, but it wasn't until I personally experienced labor that I decided that eleven babies sans epidural or pain meds was pret-ty hard core. Oh, and did I mention? Thirteen people, one house, and no running water. An outhouse complete with a Sears and Roebuck catalogue (instead of Charmin) and, at night, a slop jar. (Don't ask.) And. Folks shared the bath water on their "bath night." (Yeah. Bath night.) Wait--what was I complaining about earlier today?

Things were different back then.

a time and place where I don't want to be

When my dad, who was the first to go to college, came home to Birmingham, Alabama for a weekend visit, times were changing more. It was the height of the civil rights movement. My granddad was probably like "Civil who?" All he knew was a world with back door entrances and colored-only seating. His son was in college and catching the glimpse of a light at the end of a tunnel that had been dark for him. His son came home with his head held high, making direct eye contact with "white folks" that granddad could only say "yassah" and "no suh" to. His college son stuck his chest out and questioned things that didn't seem right.

"Boy, you gon' get yourself lynched!"

Yeah. That is what he said to his son, my father. And he meant those words. Because, in his lifetime, that was a real concern. Imagine that. Instead of worrying about bullies coming for his manchildren, he was worrying about torches and nooses. Times were changing.

One day he wrote my dad a letter that said, "I'm proud of you."  My stoic granddad was not one to say such things. In his time, men generally didn't say such things. But times were changing.

I was in elementary school when my granddad passed away. He had been very sick after a stroke, and even though I was very young, I still remember all of these pictures of my aunties and uncles next to his hospital bed. I still recall their pained expressions and forced smiles; awkwardly leaning in toward the head of his bed. . . .trying to grin and bear the sight of watching their patriarchal oak tree wilt before their eyes like a dandelion plucked from the lawn. I used to hate it that those pictures stood firmly as one of my strongest memories of my granddad.

After he "went home," Dad brought him to life for us over the years. I was glad, because it slowly erased that former image. Dad told us of his funniest quirks, and also of his wishes for his family and his love for my grandmother and their children. Told us all about the lessons he gave to him that have now been given to us. That we now give to our children.

"If you can't get along with ya mother, you can't get along with me!"

(Told you he had some winners.)

Dad says he would have been proud of us. Proud to see his grandson the veterinarian opening his thriving practice, or his two granddaughters that finished law school. Dad says he also would have been proud of me, the doctor. That he loved nothing more than a good brag, and could embellish details better than anyone ever born. By the time he finished telling it, I would have been the Surgeon General. Ha.

backdoor entrances for my grandfather

Today I am reflecting on my grandfather and the legacy he never lived to see. I am squinting my eyes and trying to imagine all that he faced that his descendants like me and my children will not. I am reflecting on how, just two generations later, I live in a time when I can say to my "colored" sons, "You can be president of the United States. Literally."

Instead of: "Boy, you gon' get yourself lynched."  


Yeah. Times continue to change.

Even still, some things remain the same. Faith, hope, love.

But even one hundred years later, the greatest of these is still love.

Dear Pipes,

Thank you for walking that hard road for me. You would be proud to know that your yesterday won't have to be my way. Happy birthday, Pip-a.  I'm proud of you, too.

With love from your granddaughter,

the doctor-slash-Surgeon General in Atlanta

 New life in the deep south: 
these are the only trees I have to worry about my sons hanging from. . . .