Monday, May 16, 2011

The (wo)man in the mirror.

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

Today we celebrated the end of the spring soccer season in the park with Isaiah and Zachary's team. The Cheetahs had just finished their last game and, despite the fact that we totally weren't supposed to be keeping score or even being remotely competitive, we creamed the other team. Instead of the lovey-dovey-kumbaya-everybody-gets-a-turn-to-make-a-goal soccer that we were expected to be playing, the Cheetahs rolled differently all season long. Abbas, Harry and the rest of the coaches had the kids learning all about defense, blocking goals, and passing. And let me tell you, man. Those kids were walls, do you hear me? Walls. Oh yeah, and to be only four and five years old? They were totally bending it like Beckham, for real.

Therefore. . . we had a lot of butt-kickings to celebrate.

Wait--is it bad that I said that about a four and five year old team? If so, forgive me, alright?

Anyways. So there we were after our game having a lovely fellowship in the park with pizza and cupcakes. They kids ate a bit, received their trophies, licked icing off of cupcakes and disappeared into the giant contraption recently built in this newly renovated park. Even though we didn't bring any grown up drinks, us parents had a great time chilling under the gazebo.

That's when I felt the first rumbly in my tumbly. I knew that my quasi-breakfast and diet Coke would not hold me past one p.m., and seeing as it was now past three, it was official. I was hungry.

The problem is . . . all there was to eat was pizza and cupcakes. If you are, like, in kindergarten or pre-k, then that menu is fine. But if you are, like, over forty and, like, trying to make sure you keep the same wardrobe, then that's a problem. Well, not a major problem. It's just a problem if you ate a big juicy hamburger on Friday and cookies on Saturday. It's also a problem if you broke up with bread last spring.

Anyways. I felt my tumbly go rumbly again, and said, Bump it. I'm eating me some of this here Papa Johns. Which I did. Two greasy slices with a pepperoncini on the side. I followed it up with a cupcake since it was homemade and--I'm just sayin'--I didn't want to be rude. Washed it down with a juice box. Yeah, man. It was quite the meal.

I watched Harry from the corner of my eye as I scarfed all this mess down, especially since I am normally the one giving him the hairy eyeball for eating "kid food that you know is not even worth the calories or fat." God forbid he turn around and see me for the hypocrite that I am.

And speaking of being a hypocrite. . . . this reminds me of this one time at the Gradys. . . .

I was rounding in the hospital one day and came to see a patient with severe high blood pressure and heart failure. Before I even got inside of his room, I could smell the aroma of McDonald's french fries wafting out into the hall. I narrowed my eyes and folded my arms as I followed the floating potatoe-y smell to its source--my patient's bedside.

"Mr. Porter! I just know you aren't eating some McDonald's!" I scolded him with my hands on both of my hips. "McDonald's? In the hospital, Mr. Porter? Come on! You have to know how salty that is!"

But Mr. Porter just looked up at me and raised his eyebrows. Folding back the wrapper of his Quarter-pounder, he sunk his browning teeth into the sesame seed specked bun and chewed without apology.

"Mr. Porter!" I repeated with an incredulous laugh. "McDonald's?"

He dug into the french fries and then plunged the straw to his oversized drink into his mouth. His cheeks sunk in as he took a long, hard slurp of his refreshment. He was totally blowing me off.

"Mr. Porter, sir. . . you know, we're trying to work on your blood pressure and your weak heart, you know? Cutting back the salt is a real important part of everything we need to do. The McDonald's is so, so salty and--"

"I don't eat McDonald's every day. Just today." He said it dryly while making searing eye contact. I could tell that I was kind of annoying him, but not enough for him to really care. The indifference made me a little uncomfortable.

"But you shouldn't have McDonald's no day, Mr. P. Especially while you are in the hospital."

"Y'all didn't bring my tray this morning since I was off the floor and I was hongry. I got me some Mickey Dees, I sure did."

Did I mention that there is a twenty-four hour McDonald's right next door to Grady Hospital? Oh and allegedly it is the busiest, most money making McDonald's in the country. Um, yeah. But that's a whole 'nother post for a whole 'nother time.

"But Mr. Porter, sir. For you, even a little bit of Mc--"

"What YOU eat last night, doctor? What YOU eat for dinner last night? A salad? Some steamed broccolis and boiled chicken?" He snorted, a sarcastic snort. Yikes.

He caught me off guard with that. "Excuse me?" I queried.

"I said, 'What YOU eat for dinner last night?' You heard me."

And so I stood there nervously shifting side to side in silence, trying to recall what I had eaten the night before. It was then that I remembered that we'd gone out to La Fonda Latina and I'd eaten some flash-fried fish tacos and a whole, whole bunch of tortilla chips with salsa. I'd eaten part of Zachary's dessert and had even enjoyed a Mexican beer con limon.

Wow. I was no angel, that's for sure. For some reason, I told him the truth about my meal, down to the "con limon."

"Is that salty?" he asked. "Fish tacos and chips and salsa? That sound real, real salty."

It sounded real, real salty because it was hella-salty. I nodded and gave him that. I thought about saying, "But I don't have severely uncontrolled hypertension, so there." But I didn't. Instead I just kept standing there looking at him without answering.

"Don't you ever just do something bad sometimes? Eat something fatty and salty just to enjoy your food? Sometimes I just wont me a Quarter Pounder and some fries. And today, since my tray was late, tha's what I got."

I studied the white paper bag that he'd ripped straight down the middle. The fries were as aromatic as they were when I'd first entered. I tried to think of something to say, but came up with nothing. Suddenly, I felt relieved that there weren't any residents or medical students there to witness me getting called out like this.

"Doc? Let me ask you something. . ."

Lawd. Here we go.

He didn't bother to get my permission before launching into his "something."

"When was yo' last check up? Like. . .do you always do all that you s'posed to be doin' or do you cheat sometimes? Well, we already know that answer since you's eatin' chips and all. See, I bet even you done some thangs that would make yo' doctor a little disappointed in you, too."

All I could do was smile. I'd just run into my primary care doctor at a meeting a few days before and had avoided contact with her for that very reason. I was already overdue for my annual appointment, and knew that if he weren't my patient and instead was, say, one of the women I see in the hair salon, that I would have been on my third handful of McDonald's fries by now.

And so. . . .all I could do is just nod slowly and keep smiling. Because he was right. He was really, really right.

"Look here, doc. Jest be careful about sounding all like you preaching to folks, you know? I'm a grown man and I'm a lot older than you so jest be careful. It's like the bible say: don't be busy pointin' specks out in folks eyes when you got a plank up in yours."

Damn. I love the Grady elders.

"I hear you, Mr. Porter. That's real talk, for real. You got me." We both chuckled. "Okay, but seriously? I'm trying to get you out of the hospital. So if you are eating a lot of salt and drinking a jumbo sweet tea, you might be setting us back some, that's all I'm saying."

"Okay. Then jest say that then. The way you came in here at first, you sound like a hypocrite. Like yo' shit don't stank. And I been living long enough to know that everybody stuff stank. Everybody's."

Whew. Real talk, man.

"I'm sorry, Mr. Porter. I guess I overstepped my boundaries that time."

"Naw. Jest remember all the stuff you do that ain't perfect, you know? Even when folks got they weight under control, they still got they vices. You probably wish I'd give you some a these fries!" He threw his head back and laughed hard. He pushed the bag toward me. "You know you wont some. Come on, Dr. Mannings, you know you do." He was cracking himself up.

I just looked at him smiling and shaking my head. "I appreciate that honesty, Mr. Porter. I really do."

"That's jest me. I always calls it like I sees it."

"Okay, Mr. Porter. Can we back off on the salt so we can get the fluid off of you? What do you say?"

"I say, 'Okay.'" And with that, he balled up the fries and half-eaten Quarter-Pounder in the bag and tossed it like a basketball toward the trashcan near the door. It bricked off of the edge and hit the floor and as I reached down to grab it, he added, "Now don't go busting that paper open and eatin' my fries, doc." We both laughed that time.

Today I'm reflecting on how hypocritical I've been at times as a physician. Telling folks to exercise during the times that I'm not. Instructing folks to eat a low salt diet when I eat processed foods like crazy. I guess Mr. Porter reminded me to infuse that into my voice and body language when wagging my fingers at others. Maybe acknowledging how hard a low salt diet can be might be the first step in getting a patient to adhere to one.

image credit
"Why do you look at the speck of sawdust in your brother's eye
and pay no attention to the plank in your own eye?"

~ Matthew 7:3

Whelp. Guess he told me.

Happy Monday.


  1. Dang. He had me feeling bad, too!

    Another thing. How about there is a hospital here with a McDonalds INSIDE it. No comment as to whether I have actually eaten there....

  2. Awesome post! I love this patient already. I've had one or two do that to me, and I was quick to let them know that apparently I hadn't been "bad" as often as they were! lol
    Maybe that's why I'm always getting "called down to the office" for my mouth.
    Yesterday, I closed the door and said to a patient "If you were me, would you believe anything you said?" She said "no." LOL

  3. Busted and busted.
    I am sure the Grady elders love you back.

  4. What is it about hospitals and McD's??? We have one smack dab in the atrium between the hospital and the rehab facility! And I'm not saying that I know anyone who may - or may not - have eaten there :)

    But he's right. Sometimes you just have to throw all caution to the wind and go for the tasty, greasy deliciousness of it!

  5. A certain childrens' hospital in Philadelphia has a McD's in the atrium too. As a graduate nursing student, pregnant no less, I MAY have had a meal or two there, but I'll deny it.

  6. There used to be one at the CHILDREN'S hospital in Auckland!! :)
    And you're wondering why our youth are overweight and obese and at risk of all the things that go with that even with you healthy eating campaigns and programs in schools?! Puhlease!

  7. Your humility is inspiring beyond words. In a world where egos can be larger than life and authoritarian self-righteousness can run amok you are a as close to being a perfect role model as I have yet encountered.

    Thank you for all these "teachable moments" - I keep filing them away, and I know I will reach for them time and time again while on the wards.

  8. wow this was a good one. i always feel that way when someone is really condescending towards people who smoke. i get it. it's so flippin' hard to deal with and i'd bet if they had ever struggled with it they'd get it also. this is definitely a good reminder for all of us.


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