Thursday, April 29, 2010

Reflections from a Golden Opportunity: Listening is an Act of Love


Seize upon that moment long ago
One breath away and there you will be
So young and carefree
Again you will see
That place in time...so gold

Steal away into that way back when
You thought that all would last forever
But like the weather
Nothing can ever...and be in time
Stay gold

But can it be
When we can see
So vividly
A memory
And yes you say
So must the day
Too, fade away
And leave a ray of sun
So gold

Life is but a twinkling of an eye
Yet filled with sorrow and compassion
though not imagined
All things that happen
Will age to old
Though gold


Stevie Wonder - "Stay Gold"
____________________________________________________

On January 21, 2010 I sat down across from my father and listened to him talk for forty minutes--almost completely uninterrupted--except for an occasional follow up question from me. It was . . .extraordinary. No, that's not the right word for it. It was more than extraordinary. . . .it was . . . pivotal.

Here's the thing. . . in this modern age of iPhones and iPads and text messages and emails and. . .well, stuff, it's pretty unusual to sit one on one with someone--especially someone that you love--and just hear them talk. Sure, maybe your friend with the Monday morning blues might pour her heart out to you over lattes or another might bend your ear about career or marital unrest. . .but that's not what I'm talking about. I'm talking about just sitting and listening to someone telling their story. Without an agenda. Without a destination. Without any pressure to give advice. Without it being about much other than. . .well, them and their story. This is what I did with my dad through something called the StoryCorps project.

Okay, for those non-nerds who are unfamiliar with the StoryCorps project, it is literally a recorded collection of peoples' stories. . .but not in just any old manner. Instead of people being interviewed by strangers, the interviewers are people who love each other, or work together, or who simply intrigue each other. One person does most of the talking. Another does most of the listening. And they record it. . . . . mostly for you, although a small percentage of them get played in excerpts on National Public Radio stations.

My first exposure to StoryCorps was when I first became an NPR addict shortly after moving to Atlanta. During the weekday lunch hour and on Sundays, they'd play these six minute snippets from these StoryCorps interviews, and invariably, I'd be driving down the street trying my best not to scare the people in the cars next to me with my snot-covered face. Because I'm usually alone in my car during this time (since none of my friends will listen to NPR in the car with me) I grip the steering wheel and just let myself go into the "ugly cry." (Think the kind of cry that gets a little too hard at some point--like when Halle Berry won the Oscar--classic "ugly cry.")

My favorite was one where this man who'd had multiple sclerosis talked to his wife of several years. He told her that he always felt like a burden because he could not provide for her the way "a man" is supposed to provide. If you listened closely you could hear the emotion mounting in his throaty voice as this likely stoic gentleman dropped his guard and shared this big revelation to his life's partner. It was like he'd finally told her some horrible secret. Finally pointed out the elephant in the room. (I can feel my eyes welling up just thinking about it.)

"Provide?" she said and then repeated,"Provide? You have provided me love. You have provided me with respect. You have provided me with unspeakable joy. Don't you get it? You have been more than a man and a provider to me. You have been a hero. And if I had my choice, I'd take my hero over anything else any day." His response was a quiet and relieved weep, all unabashedly captured on the recording.

Dude, I almost wrecked my car I was crying so hard! Not pretty. Not pretty at all. So needless to say, I love NPR, but I REALLY love StoryCorps. It's one of my favorite programs on the station.


A few months ago, I got this email (that nerdy NPR supporters often get) telling me that the StoryCorps sound booth (which is usually at Grand Central Station in NYC only) was coming to Atlanta. Atlanta! OMG! "Sign up and record your story in Atlanta," it said. I couldn't wait.

First, I made an appointment and interviewed my brother Will, which was amazing. Much of our conversation focused on our dad, in fact, the most moving parts were all about our dad. The minute Will and I finished, I knew that, more than anything, I had to do this with Daddy.

Okay, so by now, surely y'all know how I feel about my father. If you don't, you are a.) new to this blog, b.) not a person who knows me personally, or c.) all of the above. Talking to my father is one of my most favorite things to do in the whole world. The idea of having a conversation with him recorded in Dolby stereo forever-and-ever? What could be better?


Problem #1: Dad lives in Los Angeles. I live in Atlanta. Both parties must be present to win.

Solution #1: Dad is freakin' awesome. He flew all the way to Atlanta to talk to me in Dolby stereo for the StoryCorps project. How awesome is that?? Problem solved.

And so. . . . I sat with my Dad. And talked to him. No, I take that back. I sat and I listened to him. Listened to him talk about himself. Our family. Our lineage. Our legacy. The StoryCorps people are right: Listening is an act of love. His words brought people and times and places to life in ways I never knew. He spoke of his father--my grandfather--in a way that completely changed the way I think of him. Instead of the stern disciplinarian/patriarch of eleven children, through his vivid description he became my father's daddy. The guy who fiercely loved Daddy's mother--my grandmother--and the guy who, despite his limited education, sent Dad a hand-written letter when he was in college that essentially said, "I'm proud of you."

And then he described tender moments with his mother, whom he affectionately called "Mudear" (short for "mother dear.") He described how much he valued the way she praised him as a child whenever he did a good job at something. With a twinkle in her eye she'd say:

"You a cat! You just ain't got no kittens!"

Tears rolled down his cheeks as he remembered this. As he remembered her. It was her way of saying what her husband scrawled onto that note he'd sent Daddy in college. "I'm proud of you." And like any child, it was like a gold star to receive such affirmations. Lucky for him he did. Lucky for me he did.

I learned so much in those forty minutes. I heard about the day Mudear died. Her last actions. Her last words. I learned that Daddy was sitting right next to her, and watched her take her last breath. I never knew that before that day.

"I'm counting on you to make sure everything is okay," she told him, "I'm tired. . . and I think it's time for me to go now."


"Mudear, it's okay," he bravely replied, "You've had a good life. You rest now. It's okay."


And she took a few deep breaths and died. Just like that. With her loved ones surrounding her. With Dad watching. With perfect peace. With dignity.


On January 21, 2010 through listening (as an act of love), I was introduced to another side of my father. . . . but more important, I was introduced to my family history redefined. . . . and ultimately to a better understanding of myself. It was a life-altering experience. . . . one that was more precious than gold.

Thanks, Dad. Thanks, StoryCorps. :)


***


If you have never heard of StoryCorps, please . . . .visit the website and learn about this amazing project. Put this on your "bucket list" . . . I mean it. And if you ever have the opportunity to do this. . .and I SO hope that you do. . . . you, too, will know what a remarkable gift it is to listen. . . .a gift to the one you love and even more of a gift to you, the listener. . . .

www.storycorps.org

(Right now WABE NPR is doing their spring fund drive which is probably what got me reflecting on this. . .if you are an NPR nerd. . .give. .give. . .give. . .)

Me and Daddy after our interview. . . I tried to upload a part of it but couldn't figure out how!
(Probably is best, 'cause you would've gone into the "ugly cry" from hearing it!)

Saturday, April 24, 2010

Reflections from a Grady Doctor in Canada: Thoughts a-boot Toronto, AT&T and "food-weirdness"



View from my hotel room window

Live and direct from the
American College of Physicians National Meeting!
Toronto, Ontario


Colleague-sista-friend: "Girl, we MUST go to the ACP meeting in 2010!"

Me: "Oh yeah? Where is it?"

Colleague-sista-friend: "It's in TORONTO, girl!! Toronto!! How awesome is that?"

Me: "Apparently, very. . . . ."
_________________________________________________________

THE HYPE DEMYSTIFIED. . . . .


I'm in this quasi-foreign land called Canada right now. . . . it's like having one foot in America and one foot in somewhere completely different. It starts off subtle. . . .

"Hello there! Are you looking for your connecting flight?" That's what this really nice lady said to me when I stepped off of the plane into the Toronto Airport terminal. Her accent was totally vanilla--like somebody from Nebraska, you know? Basically, no accent. Hmmm. Very interesting. . . .

"No, ma'am," I answered her with a big smile. She gave me this suspicious tight-lipped expression in return; clearly telling me that "we don't ma'am here." That would be last time I said ma'am in Toronto.

Next sign that we were so very not in Kansas, Toto, came when I pulled out my cell to text Harry that I was indeed safe in Canada. I swiped the iPhone screen only to get some heinous message telling me (just so that there would be no surprises) that "this is SO not a part of your AT &T plan so don't use me with reckless abandon or else!" Maybe they mean calls, right? Made a few text messages . . . .figured this was safe. Was wrong. Called AT&T who told me that even though people standing outside of your plane in terminal sound exactly like they are American-- (that is until they say "a-boot" or "soo-rry")-- the cost of talking to OR texting any of them or your loved ones via cell phone will cost you.

"So wait--how much are we talking about anyway?" I grilled the customer service rep from AT&T global over the phone.

"50 cents per text and 79 cents a minute per phone call," said Khalid, the dude who was very likely recording my phone call for training purposes. And he was way too cheerful about it.

"Dag, Khalid! There ain't no kind of hook up you can give a sista?" (I wish I could tell you that is not exactly what I said to Khalid, but I did.) Oh yeah. I am always trying to get "the hookup." Even in Canada. Here's the thing--in the states, you have a 50/50 chance of the name "Khalid" being attached to a brotha from Brooklyn, NY so I figured I'd take my chances. Heck even if he's Canadian, perhaps I'd stumble upon someone from the Bed-Stuy equivalent in Canada-- you know, a place that would inspire a fistbump even this far north. I mean, just maybe Kha-leeed, as I was pronouncing it, was one of the homies and just maybe he had "the hookup" on international talk minutes. (Note: "the hookup" is very different than "hooking up." Let's just be clear on that, people. . . .)

"Pardon me?" Khalid replied, sounding genuinely puzzled. One thing his answer suggested: he is probably NOT one of the homies with "the hookup." Turns out this Khalid was more of a Khah-lid than a Kha-leeed. Dang.

"Never mind," I groaned. "Can I at least just use my iPhone in wi-fi hot spots? That's free, right Khalid?"

"I'm afraid not. The data is not free. You pay (5 trillion dollars per) MB that you download. But you can get an international package if you are interested." (Also for 5 trillion dollars.)

"That's crazy, Khalid! Don't you think that's crazy?"

"Soo-rry . . . . even when you're oot in an area with wi-fi, now it still incurs a fee. ("now" pronounced like "know.") I can have our global specialist talk to you a-boot international plans if you like." I have now noted that Khalid is a sho-nuff and bonified Canadian, and now am sure 100% that he is NOT one of the homies.

"I'm cool, Khalid. I'll just suck it up."

"Pardon me?"

"Errr, soo-rry, Khalid. I meant to say, 'No thanks--but I appreciate your help." Canadian Khalid didn't have the hookup on international anything. (Should've said 'preciate you just confuse him.)

Later that day, had an epiphany that I am a grown woman with a job + benefits, so I should still be able to afford to talk/text even in Canada when I please. This is what you do when you are grown, right? This is what I told myself. Either way, decided Harry and the ninos are definitely worth well over 50 cents per text and even more than 79 cents per minute.

Next Toronto observation: It is clean. Like real, real clean. There is no trash on the ground anywhere. And it's almost impossible to throw stuff away. Every where you go, the trash is separated into "organics" and "cans/bottles/plastic/glass" and then "paper." I asked this man where gum goes and he said, "Hmmm. Never thought a-boot it." Decided that since I saw no wads of gum on sidewalk, side of tables or anywhere else whatsoever that gum was just not the thing in Canada. Especially if a full grown Canadian man couldn't tell me where to dispose of it. (Sidebar: Hey, did you know that in Singapore it's illegal to chew gum in public? A friend dropped that pearl of wisdom on me today which gave me peace about the gum conundrum in Toronto. Not having a place to spit out gum is nothing compared to getting flogged for having it in your mouth.)

In addition to the fancy, earth friendly trash situation in Toronto, they are also dead serious about energy conservation. Made the mistake of leaving my iPhone charger and computer plug plugged in inside my hotel room when leaving out for lectures. Twice. When I returned to my room, the bed was turned down, chocolate was on the pillow and all plugs unplugged. Twice. Soo-rry! (Oh, and the gum that I parked on a piece of paper weirdly did not get thrown out. What is it about Canada and gum?)


Random Canada Observation: They don't jay-walk here. What is THAT about?

The food: Yummy. Lived up to the hype for sure. This part I really like about Canada. While I've already admitted that I think Canada in general does have it's own subtle weirdness, fortunately for me it isn't food-weird. "Food-weirdness" always crosses into the kind of weird that makes me nauseatingly homesick. You know how you go some places and the water is sort of weird and the Diet Coke is just not right and the chocolate is a bit odd and even the fruit is something that you have never even heard of or seen before? Well not in Canada. The ethnic food is authentic and yummy, yet still recognizable to wimps like me.


Had a lovely, lovely dinner with two former residents/Grady doctors, Julie and Joyanna, on last night. Lovely, lovely for a few reasons.

1. Dinner started with bottle plus of yummy red wines selected by our self-appointed sommelier, Joyanna. Nobody was driving, so perfect time for such an indulgence. Chitted y chatted all about grown woman adventures peppered with only tiny doses of work-related adventures. Nice.

2. Strolled through clean, clean Toronto streets laughing and talking and wondering why even the alleys are clean and the dumpsters don't stink in this city. This is where J and J brought to my attention that nobody jay-walks up here. Snarky cabdriver told me that no Canadian is in a hurry and that all Americans are in a hurry which I decided explains this no jay-walk phenomenon.

3. After aforementioned wine, made late arrival to concierge-recommended Thai restaurant and nice man allowed us to be seated even though they were clearly closing in, like, one minute. (Told you they weren't in a hurry.)

4. All aspects of concierge-recommended Thai restaurant were on point. Either that, or the bottle of red wine was so good that everything else was, too.

5. It was an overall good night for me, who is usually a timid-traveling-eater. Decided I was happy with my travels and glad I came.

Random Canada Factoid:
Hush yo' mouth! Did y'all know that DRAKE*, the current "it-guy" on the hip-hop scene,
is from TORONTO, Canada?? Now I bet that HE would have had the Canadian hookup on international minutes!



Does Canada count?

My medical student student advisee, Ant, is like, the queen of travel. She also regularly reads this blog and is surely apalled that I would even have the nerve to intimate that going to Canada counts as travel. (Hel-lo?? It necessitated a call to Canadian Khalid at AT&T global?? Hel-looo??) But we cannot all be "Ants." Truthfully, I think God made some people world-travelers and others domestics on purpose. He had to do it that way or else all the planes, hotels, hostels, etc. would be overrun with world-travelers or instead the homefront would be overrun with domestics. It's all divine, man. Me? I'm mostly a domestic, and (depending upon the place and duration of travel) a milquetoast world-traveler at best. (Despite how ridiculously cool I seem.)

****

HYPE VERDICT:

So I give this year's ACP Meeting site a solid B+. Would be an A were it not for Khalid and the phone-fee assault from AT&T--oh, and the surprisingly high number of folks here who smoke cigarettes. Other than that, Toronto is a cool city. . . .clean, diverse, mostly friendly, and with good vittles. My kinda place to visit. . . . .visit, not live. (Soo-rry, it's not you, it's me. . .) Even the free health care and clean streets are not enough to make me move. . . .I don't know. . .I guess I need my "ma'am's" and my "y'all's" more than I realized. But even if I don't want to live here, and even if it doesn't count as sho-nuff and bonified travel, now that I've visited, I can definitely see what all the hype is a-boot.

(By the way, what do you know-- after ALL THAT my hype-raising colleague-sista-friend reneged on this "awesome" trip! Ha!)


s-n and b traveler Ant being charmed by Isaiah

** Wanna read about real travels? Check out my med student advisee, Ant (Antoinette's) blog :

www.belligerant.blogspot.com.


Her earlier posts chronicle her sho nuff and bonified (s-n and b) travels through South America, Thailand, Europe, etc. For some reason, she makes no mention of Canada. . . . . .I'll have to talk to her a-boot that. . . . . hmmmmm


________________________________________________________

*(More randomness:
If you ever watched "Teen Nickelodeon", rapper Drake used to be on that Canadian teen show DeGrassi High. Bet y'all thought he came out of no where, when he really just came out of CANADA. Who knew?)

Sunday, April 18, 2010

Reflections from a lifelong learner on a Sunday off from Grady: "Bored" Review

A view to a kill-- my kitchen table this morning
________________________________________________
Re-upping your sho'nuff and bonified status

Turns out that they don't just let you go to med school, then go to residency, and then just doctor for good. Well, I take that back. If you finished your training "back in the day" then that's exactly what they let you do. They call it "grandfathering" in. Like, literally, you might be a doctor who's somebody's grandfather or grandmother, so by virtue of all your gray hair, blood, sweat and tears (and maybe visual disturbances and possible computer illiteracy) they let you be official forever. (It's probably fair, considering those guys all trained before anyone cared about duty hours, feelings, feedback, or anything else touchy-feely.) For the rest of us, every 7 to 10 years we must be tortured with taking boards again. They call it re-certification. Uggghhh! (You mean to tell me that they think we might forget the twelve trillion facts we learned a decade ago?! How rude!)

That's what I'm up to right now--preparing for my boards. Yup. I have to take an all day, computerized test that gives me the sho'nuff and bonified stamp of approval for ten more years. And now that I'm studying, I think the powers that be just might be on to something. Turns out that maybe you do forget a thing or two in a decade (even if you've been practicing.)

Here's the problem: Studying ain't like it used to be. I used to throw on some sweats and my favorite t-shirt, don a ratty baseball cap and a pair of clogs, and then schlep all my notebooks over to the nearest coffee shop for some hard core studying. Back then, you woke up, you needed to study, and you went and studied. Period. With notebooks and paper--not laptops (crazy, I know, med students!) And while we did have cell phones in the year 2K, that was back when each talk-time minute was dear, so your studying wasn't interrupted by your girlfriends calling to ask you random things like, "Hey girl, do you know how many fat grams are in a filet o' fish" or "Does a frappachino have milk in it?" Nobody was texting you, sending you multi-media messages or youTube links, and there was no temptation to check email or facebook or surf the net on your iPhone (or your laptop for that matter as there was no wi-fi.) Oh, and did I fail to mention? No little crumbsnatchers were marching around your study-zone singing "Itsy Bitsy Spider" at the top of their lungs, or demonstrating their very best kung fu kick that you must--Mommy! Are you looking?--stop what you're doing and watch. Now it's all different.

The two minute window where Isaiah said, "Mommy, I have to study, too."


I'm trying to study, I am. But I am also an almost forty year old woman with two rowdy preschool age boys who have looked out the window every day this weekend, saw "Mr. Sun" wake up and are asking what they're going to do today. Normally, we'd be skipping into church right now or planning a delicious pancake breakfast somewhere. Instead, I am at the mercy of the Nickelodeon channel and my dear husband (who I promised I'd let sleep for a bit this morning.) On top of that, I've discovered that I'm kind of bored with board review. I'd much rather blow bubbles with the kids than blow the whole day being completely humbled by factoids that I can't seem to narrow down correctly. Uggghhh.

Reality bites. . . . .

Yep, reality is mother (especially now that I'm a mother.) I didn't finish my training "back in the day" so I'm going to be taking my lumps on Tuesday along with several thousand other poor, unfortunate almost-forty-and-over-somethings who need to remain sho'nuff and bonified. I've decided that surely they must be equally as distracted and bored with board review, and surely the test-writers took this into account when doing their test-writing. (At least this is what I am telling myself as my studies get interrupted by temper tantrums, sticky fingers, and daydreams. . . .)


Wish me luck. :)


Studying circa 2010 with vultures circling the table. . . .

. . . .and singing and dancing around the table. . . .

video

Friday, April 16, 2010

Reflections from the conscience of a Grady Doctor: "Only a bit of turbulence"


I was speaking to one of my learner-friends today who was flying on one wing. Doctoring is hard, and learning how to be a doctor is damn hard, too. My learner-friend, like many of us do sometimes, was dealing with some self doubt. That little self-deprecating voice was getting bigger and badder, and threatening to throw life into upheaval:

Are you even cut out for this?

You aren't as smart as you think you are.

You aren't as smart as they think you are.

Everyone understands this but you.

Are you even supposed to be here?

You suck.

Been there, done that. I'm not sure if folks realize how daunting the whole medical training thing can be. I mean, it's not just the time issue. Like, a lot of people say, "How long did you have to go to school to be a doctor?" And you shrug and say, "4 years undergrad, 4 years med school, oh and another 4 years in residency. So, what? 12 years?" To which they reply with either a slow nod that implies "mad respect" for your resilience, or they simply say "damn!" which could mean all kinds of things.

What they don't usually factor in, though, is the part outside of the time commitment. The whole idea of wrapping your head around being responsible for human beings. It's not like when you forget to pay a bill and get a scary reminder in an obnoxious pink envelope. It's heavier than that. Your oops could cause someone to be hospitalized, or worse, die. So you try hard. Real hard. How many people have to worry about being an assassin on their jobs? I'm just saying--it's heavy.

When I was an intern in the NICU, I used to sit in the stairwell and cry. I had discovered which stairwell was the most deserted, and I'd leave the beeping monitors and panting ventilators to hide myself and my face in my hands. And I'd cry. Hard. Feeling sad for babies who were sick. Feeling scared that someone had trusted me with such a fragile life. Feeling conflicted about fighting to keep a baby living that may not grow to have a very good quality of life. It was one of the hardest times of my training. I'd emerge from that stairwell with my game face on, though. . . .right after shadow boxing behind the door. You can do this, I'd tell myself. You can do this. Sometimes I believed it. Many times I wasn't so sure.

So, I guess that sums up what I told my learner-friend. In fact, here is part of exactly what I said:

"alas, there's nothing new under the sun. we're all flying on one wing sometimes or even in a tailspin but doing our best to speak confidently into the microphone saying, "folks, please keep your seat belts fastened, this is only a bit of turbulence" (knowing full well that it is waaaay more than turbulence.) the key is to right the plane. . . .and to keep speaking confidently to yourself until you perceive everything as just that -- "only a bit of turbulence." "


Now that I've been at this longer, I've learned to combat those occasionally negative thoughts that creep up with positive ones. And the more time that goes by, the better I get at amping myself up with atta-girls. I can't say I was this good at cheering for me when I was at my learner-friend's level in medical training--this kind of coaching of yourself takes time. Here is one of my favorite auto-responses to the negative internal commentary that faces nearly all (truly introspective) doctors and doctors-in-training:

You suck.

No! You inspire.
And you can do this.
And you're supposed to be doing this.


Now I do believe it. And I hope someday my learner-friend does, too. The bumps? Aaaaaah. . . . . just a bit of turbulence. . . . .prepare for landing, my friend. . . . . . prepare for landing. . . . .

Saturday, April 10, 2010

Reflections from a mother on a weekend off from Grady: "I get it now."

During my residency, I used to see these tiny babies in the NICU born to moms who'd spent thousands and thousands of dollars on in vitro fertilization. It wasn't unusual to see multiples--sometimes there would be two, three, or once I even saw four little babies all of whom had been nudged into existence by the help of modern technology. One mom told me, as she spent each and every waking hour that she could in the NICU, that they'd been "trying" for almost twelve years before conceiving. First, the standard way for two years, then nearly ten more of costly intrauterine inseminations, hormone shots, frozen and fresh embryos, and "transfers"--all for this--the chance to be a mom. Another nurse in that very unit had flown all the way to Russia to adopt a baby girl from an orphanage in some remote village. In my ignorance, I recall shaking my head over tepid coffee in the resident lounge smugly saying, "There is no way I'd go through all that. I just don't get it." Although conceiving wasn't difficult when that time came in my life, I now feel like such a heel for being so insensitive and not "getting it" back then. The minute I emerged tearful from our guest bathroom with the positive pregnancy test that would become Isaiah, I got it. I so got it.

Why the talk on mommyhood? I've spent the last two days on Mommy-only kid duty. Fortunately, this is unusual in my house as Harry (whom I miss no opportunity to dance pirouettes around due to my nauseating love for) is an uber hands on dad. But it's been all mommy all day for the last two days, and though usually, I would be giving my husband the hairiest of eyeballs after just one afternoon of Mommy-only duty (or sending him scathing, passive-aggressive text messages about how ridiculously tired I am) --right now I am not. I am so not.

My two stinky boys at Centennial Park today

My Mommy-only funfest has been glorious. We've played in parks, danced in the kitchen, hit the YMCA, ran through the sprinklers at Centennial park, shared great playdates, eaten yumtacular frozen yogurt with waaay too many toppings, and even snuggled in my bed together for decadent mid-afternoon siestas. Two stinky boys plastered to each of my sides creating the most perfect mommy sandwich ever. And because my heart was feeling so full of love, it did not bother me that my siesta kept being interrupted by Isaiah's teeth grinding and Zachy's tendency to pat my face and suck is tongue while he sleeps. It was all music to my ears.

Now they're happily watching the last few minutes of "Planet 51" -- the animated movie I promised I'd let them stay up and see tonight for "movie night." Isaiah asked me to "pop some popcorn please, but not the bag kind but the real kind, okay Mommy?" I happily obliged him feeling good that a.) my 4 year old son even knows the difference between microwave popcorn and sho nuff/bonified popcorn ('cause surely there is one), and that b.) I actually had "real" sho nuff/bonified popcorn in my cabinet that hadn't expired in 2004. I felt like supermom as I filled the whole house with the smell of "real" popcorn popping in a heavy bottom pot, old school style. I looked at my reflection in the microwave (that I wasn't using), pointed at myself and said, out loud, what my husband says to me all the time: "You're a great mom." That sentiment was further affirmed when the kids began jumping up and down on the couch squealing with glee as I brought them the way too big bowl of hot, buttered kernels to scarf down--just for the two of them. Their happiness made me want to go back into the kitchen and pop fifty more bowls (and not the "bag kind" either.)


I have discovered that of all the things I've ever longed for, hoped for, prayed for, and dreamed of, very few actually live up to what I imagined. Even the things that turned out to be great are still not as big a deal in reality once they actually happen. Aaahhh, but the exception is motherhood. Oh, I wanted it. And I yearned for it, prayed for it, and okay, I'll admit that a few times even coveted it when picking out gifts for my girlfriends' baby showers. But I have to say. . . .I had no idea of what it would really feel like until the day they handed me a 9lb 2oz screaming baby boy that we all stared at incredulously considering he had been just pushed out of a not-so-big-ish pelvis. Then one day that baby and the baby after him said, "Ma-ma," and then learned words like I, Love, and You, melting my heart into emotional lava. Motherhood. It is, hands down, the only thing I can think of that is exponentially, indescribably, and insurmountably better than it looks on paper or in your dreams. And what's even better than that? Try motherhood with someone you are madly in love with who loves you back just has hard-- and who loves your kids just as much as you. Now that's living.

The bible says you're not supposed to covet anything, but sometimes I wonder if parenthood should be placed on the side as an exception. You cannot place a price on getting to do this in your lifetime. You cannot. Now that I know what I know, I understand someone exhausting their bank account or jumping through twelve thousand hoops to become a parent in whatever capacity. If the payoff is even half of what I experienced for the last two days, then I wouldn't blame them one bit.

So today, I guess I'm reflecting on how blessed I am to know motherhood and familyhood for myself. It is the best of the best things I have done and the best of the best things I am. And to every mother and potential mother who jumped through hoops, depleted savings and even coveted motherhood, I sincerely apologize. Because I get it now. I so get it.

As good as it gets?
(Mom and Dad say grandparenthood exponentially trumps this, so I'll stay tuned. . . .)

Monday, April 5, 2010

Reflections from a Clinic Session at Grady: "It's in my nature."

*Note: Name changed, multiple details of story modified to protect anonymity.

"If they say, why, why?
Tell 'em that it's human nature


Why, why does he do me that way?

If they say, why, why?
Tell 'em that it's human nature


Why, why does he do me that way?

I like livin' this way
I like lovin' this way. . . .
"

~ from Michael Jackson's "Human Nature"
_____________________________________________________________

"I stopped taking them medicines, I ain't gon' even lie."

That quickly explained why someone on three different blood pressure medications would still have a reading of 174/104. His muscular arms were folded tightly and he tapped his foot nervously on the floor. I couldn't quite tell his age. Salt and pepper at the temples, youngish facial features, and a bit of a spare tire--forty something? Hmmm. I couldn't tell.

"How old are you, Mr. Darby?" I decided to ask him instead of looking at the chart.

"Almost 46," he answered quickly. Then he added, "And I'm too young to be on all that medicine!"

"Yeah. . . ." I thumbed through his chart while facing him at the desk. The notes dated back to 2006. Each encounter said the same thing: Hypertension, poorly controlled. I looked up at him intently. "You are a young guy, Mr. Darby, but from looking through your chart, you've had a high blood pressure reading for a while. When did you stop taking your medicine?"

He raised his eyebrows and gave an exaggerated sigh. He didn't want to answer too many questions. "Look, can't you just put me on one strong medicine? I'm serious, doc, I ain't tryin' to take all these pills and potions. I'm for real."

"You didn't answer my question."

"I stopped them medicines like a month ago. My body just wasn't right and I didn't know which one it was so I said, 'to hell with all this stuff' and stopped it all." His cell phone started playing a loud rap tune and he leaned back in his chair, straightened out his right leg and fished around in his pocket to retrieve it. Without so much as an "excuse me, doctor" he took the call right there in front of me.

"Hey," he spoke quietly, "I'm in here with the doctor so you gon' have to call me back."

I could hear the garbled reply of what sounded like a pretty feisty woman speaking back to him. She didn't seem to care too much about the 'I'm in here with the doctor' or the 'you gon' have to call me back'. He listened intently for a few seconds and then interrupted her.

"Yeah, okay, but I need to go. The doctor right here staring in my face." (He didn't even look at me when he said this which is rather amusing.) More Charlie Brown's-teacher-esque talking from lady caller. Again he intercepted her tirade. "Okay! I will! Damn!"

Lady-caller got a little fired up with that snippy response. Although I had no idea what she was saying, I could tell it wasn't good. I take that back--I think I'm pretty sure I heard something in there that resembled "Aww HELL naw!" He let out the exaggerated sigh once more and slapped his open palm over his brow. Dragging his hand down his face, he shook his head and tapped his foot again. You could still hear from escalating garble that Lady-caller meant business. My patient decided to lay down the law.

"Look here, you 'bout to upset me. I said I would. Now that's the end of it. I'm getting off the phone with you now." And with that, he snapped his Motorola shut and stuffed it back into his pocket.

"Sorry about that, doc."

That's what you'd think he would've said, right? Think again. Mr. Darby didn't even flinch--or acknowledge that I'd just sat through an episode of the Peanuts. Crazy? Possibly. But so very "Grady" and blogworthy? Oh-yeah.

"What do you mean 'your body wasn't right?'" I launched right back in. If he wasn't planning on wasting time on pleasantries, neither was I.

"Just what I said. It wasn't right. Made me feel crazy and all 'flicted."

"You were 'flicted like how?" (By the way, 'flicted is a good ol' slang word used mostly by Southern African-Americans that's short for "afflicted." It's what you say when something is messed up, sick, injured, or just not right.) I could feel a smile creeping over my face because I found it endearing that he'd used such an advanced slang term with me. I knew Mr. Darby had unleashed this word because he felt comfortable and knew I'd get it--kind of like the way Spanish speaking folks start talking real-real fast to native Spanish speakers. And he was right. I did get it. His doctor was no "Grady gringo."

"So you was 'flicted like how?" I repeated, breaking my subject verb agreement just to reaffirm that he hadn't used "flicted" in vain. Mr. Darby just sat there staring at me with this exasperated flaring of his nostrils. I could tell that I was beginning to get on his nerves, similar to Lady-caller. That's when it dawned on me. Ah hah!

"Mr. Darby, sir? Can I ask you a question?"

"I got a feeling you gon' do that no matter what I say, doc," he retorted. I chuckled and was a bit relieved when he did, too.

"Mr. Darby, sir, tell me. . . . .your phone conversation. . . . .did it have anything to do with why you stopped taking your medicine?" My searing eye contact said, That's right, I asked it. And I ain't backing down. He cocked his head to the side and squinted his eyes.

Oh what the heck. Why not just go there, Manning? "Mr. Darby, why'd you stop taking your blood pressure pills? Was it because they. . . . affected your nature?" Yep, that's right, I said it. (Nature. Code for "ability to get an erection" but without the embarrassing words "ability" or "erection.")

He rubbed both palms over his eyes, tapped that nervous foot and then nodded his head slowly. "Lord have mercy," he mumbled under his breath, "I can't believe I'm speaking to a lady doctor about this."

"Mr. Darby, this isn't an unusual side effect, so don't worry." He glanced up at me sheepishly. "So let me just be sure. . .you want to be with your lady friend, right? Like, you have the desire?" I needed to make sure this wasn't a libido thing, which wouldn't be the blood pressure pills at all. He offered a fast nod. "Do you get there at all? I mean, like, enough to do anything?"

Mr. Darby folded his arms again and looked down. "I mean, doc, it get almost there but then run outta gas, you know? Not enough to do anything." It reminded me of what I once heard an elderly gentleman say to describe his aging "nature"--"It get a little heavy for me sometimes, doc, but tha's about it."

"Hmmm. What about when you first wake up?"

"Yeah, it seem okay when I first get up, but like I said, not enough to do the deed, you know?"

"Gotcha," I responded in the most non-judgemental way I could. "Okay, then. Well from looking at your chart, they added on metoprolol two months ago, right? Even though the other pills may cause problems with your nature, I think it might be from this one that just got added." I looked at him again, and he nodded for me to go on. "Why don't we start back these two, and bring you back in two weeks?" Mr. Darby looked agreeable. Whew. "We also need to talk about these cigarettes. You know they can mess with your nature, too, over time." Fortunately for me, and his nature, he was amenable to that suggestion, too.


We chatted a bit more about his overall frustration with his blood pressure, his erectile dysfunction, and everything in between. We wrapped up the visit with a plan for him to consider setting a "quit date" for smoking cessation, a careful plan for blood pressure control, and a close follow up appointment. After answering Mr. Darby's questions, I made my way to the door.

"Dr. Manning?" he asked, "How you know what she was asking about?" I looked back at him and shrugged my shoulders as if to say, I just knew.

"Mr. Darby, let her know we will try this first and bring you back, okay? We can talk about other stuff if that doesn't work. She can come with you if y'all want." He looked at me incredulously, and then let out a hearty chuckle. Then I added,"If I give you Viagra now, you might not come back to get that pressure controlled."

"Dang, doc, you good," Mr. Darby laughed as I pulled the handle to the door. "Listen here, doc. . . thanks for making me more comfortable. I sure 'preciate you."

'Preciate you. Aaaah. It's like a Grady gold star. . . .one of the highest compliments a Grady patient can give you.

***

"Why'd you stop taking your medicine?"

Sometimes it's "nature," other times it's something else. . . . one thing I now know for sure after nearly a decade of working at Grady is this: people don't just stop taking their medicines for nothing. Maybe it's money or transportation to the pharmacy. Could just be fear or lack of trust. Or who knows? It could be that you simply feel 'flicted every time you take it. Just maybe it's all of the above. No matter what it is, whenever somebody keeps missing medicines, missing appointments, and altogether missing the boat, now I know that our job includes the following steps:

Wonder.
Why.
Ask.
Why.
Listen.
Why.
Think.
Why.
Figure.
Why.
Discuss.
Why.
Determine.
How.


. . . .even when you feel frustrated and even when you don't feel like it. . . . .and just maybe your thoughtful listening and care will eventually become second nature. (Couldn't resist the pun--totally intended.)

***

Mr. Darby's ringtone chimed in the hallway as he exited the clinic. After the tell-tell snap of his flip phone opening, the last thing I heard him say as his voice trailed away was this:

"Hey. Yeah, yeah, we talked about it. Naw, I didn't get what you said, but we talked about it. . . and . . . .I think we gon' be alright. . . . ."

Friday, April 2, 2010

How to be the best doctor ever? Balance

During my medical school days at Meharry back in the early 1990's, we put on a huge step show every year that was an absolute blast. Every time I think about the time we took to organize, choreograph, rehearse, and then perform the show each year, I shake my head and call my med school classmate Jada R. saying, "Giiiirrrrl! How in the world did we find time to do that? We should've been somewhere studying!" Then we both share a hearty laugh, reminiscing on our extracurricular craziness and the good times we had playing hooky from our course work. It was my first introduction to the real duel between the balance for work and play.

Work/Life Balance

Back then I thought of anything studying and school-related as "work" and everything else as "play." I felt guilty every time something fell into the latter category (but that never stopped me.) Now that I'm a sho' nuf and bona fide grown woman, the fight for top gun position is between work and life. One husband, two children, and fifteen years later, I now know for sure that balance is everything. Revise a paper or take my kids to the park? Work on a lecture or post on my blog? Listen to a medical journal podcast on my iPod or Usher's newest release? What's a Grady doctor to do?

Work vs. everything else. No matter who you are and what you call it, you need fair amounts of both. Too much of either is no good, and not enough of either is a recipe for disaster. If you're lucky enough to find ways to get work and life to harmoniously overlap, you've achieved work/life nirvana.

Sho'nuf and Bona Fide Nirvana

A few weeks ago, our current first year medical students put together an amazing "class video" for their annual talent show. It perfectly underscores a great work/play nirvana overlap. It warmed my heart to see our hard working medical students learning early that you must take a moment for a little bit of fun. (This can be especially hard for us doctors.)

We try our hardest to get everything right. . . .and that can get kind of heavy. But no matter how busy you get, every now and then it's good to stop what you're doing and just have some fun. And that's exactly what our students did. . . .check out this link below (and see how diverse the class is!)
Click this link below:




The legacy lives on: Harmonious overlap
Me dusting off my step shoes and teaching med students to "step". . .
. . . . and about work/life balance


(By the way, the good news is that students who participate in "extracurricular craziness" indeed grow up to be upstanding, board-certified physicians and role models. Eh hem. . . . trust me on this.)

Bonus Footage courtesy of a YouTube search:


More of the legacy living on: Meharry Medical and Dental Students participating in the 2007 version of the campus step show (now a much smaller event, but still appears to be just as much fun as we had back in '95!) YES. These are ALL medical students and dental students, hey or medical doctors and dentists by now!

For those unfamiliar, Meharry Medical College (my alma mater) is one of the oldest historically black medical school and academic medical center in the US. This clip is of Delta Sigma Theta Sorority--who I must admit, I'm partial to since I'm a Delta girl. :) Yep, folks, that was what we were doing during those prolonged study breaks! Would have shown you our (awesome, hello?!) step show from '95, but that was in a pre-historic and pre-youtube era! Enjoy this very good (but clearly inferior) substitute!
:)