Friday, October 8, 2010

One is enough.

*names, details, etc. changed. . . .you know what's up.
"Baby, I can fly like a bird. . .
When you touch me with your eyes.
Flying through the skies, I've never felt the same
But I am not a bird
I am not a plane

I'm Superman."

from "Superman" by Barbra Streisand

Sometimes I wish I was a superhero. Better yet, two superheroes. Like one with super powers to do things like write long prescriptions in a single bound, and another to wipe snot from my kids' noses and console crying patients. But I know I'm not a cloned superhero. I'm just one person with two feet, two arms, and one brain. I work with what I've got.

I do still wish that sometimes, though.

Yesterday morning was crazy-busy. Our clinic session, which is supposed to end at noon but rarely does, kept chugging along despite our efforts to hustle. On Thursdays at Grady, our General Medicine division meets for a lecture or general business. Today, one of my friends was the presenter. I really wanted to make the meeting.

Fortunately, we have a system where a colleague comes to cover the noon hour while others make the meeting. We all take our lumps on this coverage schedule, but there's this unspoken rule that a few of us have where if it's crazy-busy, you stick around and help. At least to tie up loose ends.

There seemed to be a lot of loose ends yesterday. But still. I really wanted to make that meeting.

The more I'd kept trying to get out of the Residents Clinic though, the more things kept popping up. Like:

"Dr. Manning, somebody told this patient just to come down here and get a flu shot. She was in another clinic already. I know they have flu shots up there. That's ridiculous. I explained that you can't just walk in like that."

I look at patient: a doe-eyed woman on the brink of me deeming her a "Grady elder." I recognize her as one of our regular clinic patients. Hmmm. I make a quick glance at the clock: already past the 12:00 start time of our meeting. Uggghh.

"Okay. Well, tell me this. . . . what would we need to do to give her a flu shot here?"

The nurse looked at me and, I'm pretty sure, gave me the hairy eyeball. Dang.

"She could just go back to the specialty clinic where she was," she counters. I nod in acknowledgment.

"I mean. . . she's our patient," I say, "Yeah, she should have gotten a flu shot up there, but can we actually do it now that she's here?" I look at the patient and add, "I'm glad you know how important it is to get your flu shot."

The busy (and seriously, awesome on most days) nurse just sighs and says, "Fine, Dr. Manning. We'll just check her in." She muttered something under her breath as she walked off, but that was okay. I have a good working relationship with this nurse, so knew that she was just frazzled from the morning, just like me.

Okay. Now I can go.

A patient in a room calls me by name. "Miss Manning!"

I look. I don't know her. I walk over and raise my eyebrows. "Hey Miss Manning. . . .I see you on Fox 5 and you give some good information."

A compliment. Right now, I'll take it. "Thank you very much, ma'am. I appreciate that."

"Can I ask you a question?"

Despite the protests from my growling stomach, I oblige. "Sure."

"Do it mean you might have breast cancer if you had to repeat your mammogram?"

Loaded question. Great. I can't do it. Not this. Not now. "Did you see a doctor this morning? I'm sure they can review that with you, because it really depends on a what the mammogram showed."

She looks tearful. Ugghh. "I am waiting until my doctor come at one. I just got checked in. But I was. . . .worried. . . 'cause. . . I just been worried about the result and what it say. I ain't been sleeping 'cause I been so worried, waiting for this appointment." Tearful evolves to quiet crying with eye-patting.


I get her name off of the chart and address her as such. "Ms. Campbell, give me a minute and I will pull up your mammogram result. Your doctor will go into it more with you, but I can check to make sure it's up."


I go to the computer. Telling myself that this is crazy. Could be stepping into a bomb. Why are you getting involved? Her doctor will be here in 45 minutes. Tell her to wait. But I don't. I look. And thank goodness, it is just a simple need for "compression views" in a woman with large breasts. Repeat mammogram free of signs of cancer. Radiologist recommends follow up in one year. Cool.

I tell Ms. Campbell. I tell her that her doctor will examine her and explain more. But don't worry. She is so happy she cries. And hugs me.

It's 12:35 p.m.

Now I'm really trying to go. Then, I see one of our newest faculty members looking perplexed. She is stuck in the clinic still trying to sort things out that aren't user-friendly to a new person. "You okay?" I ask. (note: this is a rhetorical question. answer should be "I'm fine!")

"Ummm. I'm trying to admit someone to the hospital. . . but I'm not sure what to do next."


We work together, we get the patient admitted. It's now 12:43.

That superhero clone of me would really come in handy now. One could be at my friend and former Grady doctor, Christina P.'s, presentation at 12:05 at the latest. The other could have stayed behind to help. But I'm not a superhero with a clone. So this will have to do.

I do still wish that sometimes though.

I approach the double doors leading to the exit of the clinic, and I see Nurse C. talking and smiling with the patient from earlier in one of the clinic rooms. She had just administered the flu shot to the patient, despite the hassle of another late check-in. She caught my eye and winked at me. It was her way of saying, "We're cool." I appreciated that gesture.

Once out of the clinic, I scurry down the hall and toward the stairwell. My stomach is hitting high notes, wondering what's up with the lack of food. I'm walking 60 mph and simultaneously looking at my iPhone to make sure I didn't miss any emails. As I am sure you can imagine, I nearly mow down this patient making his way to the elevator.

I had dropped my coat and phone with the collision, but fortunately, he seemed okay. I apologize for not paying attention, and we both bend down to collect my belongings together. Just then, I realize that I know this patient.

"Mr. McCoy?"

"Heeeey, Kimberly!!!!" He let out a hearty laugh and gave me a big hug.

Mr. McCoy was a patient on my team a while back. He was, hands down, one of my F.P.'s of all time. (F.P. = favorite patient.) When he was on our hospital service, he'd passed out from what we discovered to be severe problems with his aortic valve. He needed that valve replaced.

Problem was he actively used crack. And was homeless. And didn't take his medications. There was some fear that he wouldn't follow up or take the required lifelong blood-thinner after valve replacement surgery. Despite all this, he had the best attitude of any patient I'd ever seen. He said, "I can do this, Miss Kimberly. I know I can." Seeing him on this day made me realize that I never found out exactly what happened with him. I left the service before a verdict was rendered on his valve operation.

"You doing alright, Miss Kimberly?" He handed my coat back to me, and smiled.

Mr. McCoy asked me on the first day we met if he could call me Kimberly. Funny. I'd never been asked by a patient permission to be called by my first name. At that point, he was already my F.P. for that day so I obliged. Kimberly or "Miss Kimberly" it was.

"I'm doing great, sir! But how are you? What ever happened with you?"

He gave me the biggest, warmest smile ever and then pulled his shirt apart like Superman. A well-healed vertical incision went straight down his sternum. That's when I knew that he'd had the valve replaced. He looked good, too. Healthy. Well groomed. Robust.

"Baby girl, I'm like a new man!" We both laughed. "I got my surgery. . .now Kimberly, I told 'em, 'Give me a pretty scar, 'cause I got to have a pretty chest!'" Awesome.

I stand there looking at him. Later and later for the last few minutes of the meeting. Will probably even miss out on the lunch. But this was worth it. I was really happy to see Mr. McCoy. I feel myself beginning to fret, hoping he is off the crack. He was insightful.

"I'm off that mess, Kimberly. I put it down. I even got a place to stay, too. No job yet, but my brother got me doing little jobs here and there with him. I go to Coumadin Clinic and the heart doctors. They said I'm a good patient. But I told 'em that Miss Kimberly already said that 'cause I was her favorite patient." Ha. True indeed.

"Wow. That has made my day, Mr. McCoy. I'm so happy I saw you."

"And I'm so happy I saw you, too, Kimberly. But you look like you lost a few pounds. I hope you eating."

(Is it bad that I wanted to hug him again for accusing me of weight loss?) I decide to let it be a compliment considering ninety percent of all comments I get in Grady Hospital regarding my weight are the converse of Mr. McCoy's.

"Naaah, just watching what I eat. It's so good to have seen you, and I am so proud of you, sir."

"I'm proud of me, too." Love that response.

"And you know what, Mr. McCoy? You are still one of my F.P. all-stars. That means you will always be a favorite patient of mine."

"Babygirl, I knew that already!" His hearty laughter rang down the hallway. "But for real, Miss Kimberly, I want you to know. . . .you my favorite, too."


I gave him a big hug and waved goodbye to him.

12:53 p.m.

When I reached the faculty office building, I had already missed all of the meeting, including Christina's presentation. But I was able to give her that hug.

As I scarf down what remained of lunch, I now know one thing for sure: I had been exactly where I was supposed to be at the time I was supposed to be there. I also know that if I'd had a clone, she would have missed out on seeing Nurse C. wink, on allaying the concerns of an anxious stranger, and of course, being there to witness Mr. McCoy open his shirt like Superman.

Nope, I am not a bird, and I am not a plane. But I do feel kind of like Superman sometimes.

I decide that one of me is enough.


  1. I'm a new follower of your blog and a second year medical student- thank you so much for sharing your ups and downs so honestly! I can count too many times when I've felt similarly- whether it's a single morning or over the course of weeks or months, this egging gotta go, go, go when hurdles spring up out of nowhere. And it does seem like in spite of the chaos, the pearls I've discovered along the way are so much more valuable than anything I'd have found on my original route...

  2. This is my new F.P. -- Favorite Post!
    Wait, I think I said that about the last post!!!


  3. So great.
    Plans are simply overrated, aren't they?

  4. Thamk you for such an honest and insightful post. As a physical therapist amd Director of a busy clinic, I have often expressed a need for a clone so that I can be in two places at once (or more). But it is when we take that extra time with a patient or family member that we make a differeence. Thanks for the reminder!

  5. Grady Memorial...there's a blast from the past! We used to get quite a few of your residents who finished their training a few miles north up I-75. The stories don't change, do they??!! I'm in a Neuoro ICU now and miss, miss, miss my medicine patients. I'll have to live vicariously through your blog. Best of everything to you:>)

  6. Interesting blog.... that illustrates the type of impact that physicians have on patients. The contributions provided by physicians aren't always from a medical perspective. Physicians have the ability to offer support from a moral standpoint as well. Doc. I commend you for setting aside your desires for the well being of others.


"Tell me something good. . . tell me that you like it, yeah." ~ Chaka Khan

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