Thursday, June 30, 2011

Top Ten: Maximum Flair.

Yes. That's a tiara. I'm expressing myself. You got a problem with that?

"You DO want to express yourself, don't you?"

~ from the movie "Office Space"

One of the interns was in my office for the first time one day. He looked around, laughed and said, "Wow, Dr. Manning! You sure have a lot of flair up in here!"


You know flair, like in that hilarious movie "Office Space" when Jennifer Anniston was told that she didn't have on enough flair? You know--the part where she had on a mere fifteen pieces of flair (which is the minimum) when her coworker had on a whopping thirty-seven pieces and "a great smile?"

Yeah. Like that.

Flair. The more I think about it, the more I realize that that intern was right. I do have a lot of flair up in here. But like that manager at Chotchkie's told Jennifer Anniston-- Flair is about fun, people. Fun.

Oh yeah--it's also about expressing yourself. Hey--and you DO want to express yourself, don't you?

This week's top ten is devoted to my office flair. Today, I bring you the top ten pieces of flair in and around my office at good ol' Grady.

For the record?


I'm just sayin'.


#10 - Monkey see. Monkey do.

I got these guys during my chief year back in 2001. I secretly think all chief residents should have this little sculpture in their office. I am now trying to figure out how to get one for my house since Isaiah and Zachary seem to never admit to seeing, hearing or speaking evil.

#9 - The Teddy Bear Doctor with the Whitney Houston Wig (and tiara.)

The teddy bear was a Christmas gift a few years back from Fox 5 Good Day Atlanta. The Whitney wig came from the year Harry and I went to a Halloween party as Bobby and Whitney. (That was Harry's compromise after turning down my first request to be Flavor Flav and New York.)

I still think it would have been gnarly.

The tiara was given to me by one of my ward teams. I think I sent them a page one day and signed it "Queen Manning." They called me that all month and gave me the tiara on the last day (which I wore all day on rounds.)

See what I mean about flair? Good times, man.

#8 - My Levelor Thank You Card Collection.

Seeing my favorite cards from students and residents perched on my blinds every day puts a smile on my face. I pull them down and read them when I'm having a bad day. It always cheers me up.

#7 - My Jim Crow Sign.

I bought this at an antique flea market in my dad's hometown of Birmingham, Alabama. Seeing it reminds me of how blessed I am to have been born when I was born. It's so hard to believe that my own father spent his formative years abiding by signs like this one. Maybe it was this one.


#6 - My elephant collection.

Confession: This isn't the whole collection. I have all kinds of random elephants in my office. I'm a Delta girl, so of course I have elephants. But they're also good luck, so that's another great reason to have them. I like the energy they bring to my office. I also like that many were given to me by special students and residents that have worked with me.

#5 - Random Artwork.
This one was painted by my brother when I was still a medical student!
Self Portrait: Isaiah Manning, Kindergarten

This one was drawn for me by one of the Grady elders. Awesome.

#4 - Flowers and plants that don't need water (because they are fake.)

Roses are red. . .and orange.
I like this one because the pot is really a calabash gourd from Barbados.

This fake bamboo is real good luck. For real, y'all.

#3 - Random words of inspiration. (Wretching permitted.)

"If you want to stand out, don't be different be OUTSTANDING."(bleeccchh.)
Outside of my office. Good times ahead.
Outside of my office door. More flair. More gags, perhaps?
How 'bout some Yiddish? This means "meant to be." It perfectly describes me and the B.H.E.
#2 - My Meharry Pre-Alumni T-Shirt.

Meharry Pre-alumni shirt, 1994
I designed this t-shirt when I was a second year medical student. We sold these and wore them for our annual community day of service. All of us med students walked from our campus to a nearby housing project and signed up over one hundred kids for a day of fun and education. We worked hard, solicited sponsors and donations and did a whole lot of planning between classes and exams. A few weeks later we all came back to escort them over to our school for a fun-filled day. Man, it was awesome and we were so proud of ourselves. It remains one of my fondest memories from my years as a medical student.

That shirt inspires me. That's why I keep it in my office. Since opening its doors in 1876, no single institution has educated more African-American physicians and dentists in the world than Meharry Medical College. Meet a doctor or a dentist that's older than sixty? Chances are he or she probably went to Meharry. Seeing that little cartoon guy that I scribbled on a piece of notebook paper for this silk screen way back in 1994 reminds me of this. Every single day.

Yes. I am upholding a tradition. I sure am.

#1 - Random pictures of the B.H.E. and the Cocopugs.

Wook at dat wittle Zachy. Just wookattum.
Look at that punim! (I'm nice with my Yiddish, man.)

This picture of Isaiah was taken when he was only six weeks old. No exaggeration. We should have known then that he'd be an old soul. I have a wallet size version of this taped to my computer monitor. Every time I look at it I smile and fall in love all over again. . . .

Sigh. Please tell me you've seen a cuter six week old so that I can tell you you're lying.

Bonus flair: My personal stash of green tea (plus a bonus photo with Isaiah!)
Allegedly it makes your tummy flatter. A doctor told me that.

Okay. So there you have it. My Flair Lair. You know. . . .I think I might be. . . a happiness hoarder. Yeah, that's it. Kind of like the way I tell my younger sister that she's a "friend hoarder." (She's the only person I know that is still in touch with people from first grade, t-ball, middle school, summer programs, and all of MY friends from the same places that I've lost track of. . . but I digress.)

Yeah. Like that.

What can I say? Stuff that makes me happy, I like around me. No, not all at the same time--but I do like reminders. I know. Some folks like very neat, empty spaces for . . .what's it called? Feng Shui reasons?


I'm sure a bunch of y'all are wondering how I get any work done with all that stuff going on in there. But I do get a lot done in there. I do. When it comes to offices, really barren and impersonal spaces make me feel kind of sad and uninspired. I flair them out--especially since I don't have to share the space with my husband (who does seem to be Feng Shui-ish.)

So. Yeah. That's all I got today. (And you know what? It's like waaaay over the fifteen piece minimum, man.) Don't get that joke? Watch the clip below.

What kind of flair do you have goin' on in your neck of the woods? The maximum or are you Feng Shui-ish?

Flair Minimum

Office Space


Wednesday, June 29, 2011

The tooth shall set you free.

Rut roh.

The other day I was folding clothes and Isaiah sees the edge of this plastic bag hanging out of the drawer on my nightstand.

"Hey, Mom! What's this?"

Lawd. Have. Mercy.

Yes. It is exactly what it looks like. A child's tooth in a ziploc bag that, yes, this bootleg Tooth Fairy made the error of sticking in a drawer next to the bed.

Rookie mistake.

Isaiah: "It looks like a tooth, Mom."

Me: (Still sputtering and gasping.) "Sure does, doesn't it?" Gulp.

Isaiah: "Is it your tooth, Mom? Maybe Dad's? No, probably yours since it's on your side of the bed."

Me: (Standing there speechless--not wanting to say the wrong thing. Sick smile on my face like I just swallowed disgusting food at someone's table.)

Isaiah: "Hey Mom?"

Me: (Raising eyebrows only. Still too scared to speak.)

Isaiah: "Can I have an ice cream sandwich?"

Me: "You sure can." Dude, you can have anything if it means you'll get off of this subject.

And off the kid runs without a further drop of fanfare. Hallelujah.


Okay, people. I was a little perplexed about this. Now I feel a bit bad about not being honest--but in my defense I looked at it as protecting his innocence. Wait. Does that count as protecting his innocence?

Anyways. You know this isn't over. Grandpa Isaiah will surely let this marinate and crack me over the head with the topic again when I least expect it from the back seat of the Volvo. I want to be ready, y'all. And, Isaiah has a whole lot more teeth in his head that need to fall out, and his little brother has yet to lose one at all. This is problematic! I need advice people! Wisdom from my peoples!

Is this thing on?

Rookie mistake, I know. I've put that tooth (and the three other ones sitting in that drawer) away in some covert location. But I need your input for the imminent cross examination. Because it is sho' nuff coming.

Sigh. Come on, y'all. Am I pretty much screwed? Is all lost? Tell me something good. Yeah. All y'all.

Happy Humpday.

Monday, June 27, 2011

Duty Hours Pre-Form Part 1: Can you even do that?

image credit

When I was an intern I was once on a rotation where we took call every third night. While it wasn't as bad as the "24 on/24 off" schedule that the Surgery residents did--it was still pretty sucky.

So yeah. One in three. That meant that on any given day you were either on call, post call, or post-post call (which everyone knows is twenty times worse than being post call.) Anyways. For those still confused, it meant that every single weekend you were guaranteed a crappy schedule.

Friday: On Call
Saturday: Post Call
Sunday: Exhausted and dreading on call.

Your weekdays were equally crappy:

Monday: On call
Tuesday: Post call and staying around because there's only two other interns.
Wednesday: Post-post call and stuck with all the work because you're the one nobody feels sorry for.

That's pretty much how it worked. This was also before anyone gave a hoot about duty hours or sweatshop working conditions which meant that this little schedule was even more heinous than it sounds. Let's examine the old school, pre-ACGME Duty Hour Rules era call schedule a wee bit closer, shall we?

The dreaded post call in clinic schedule:

Wednesday: On call and with out a single drop of sleep all night.
Thursday: Post Call
Thursday morning: Post call morning report in front of the whole department.
Thursday later in the morning: Getting grilled on rounds with more questions as if the ones you got on morning report weren't enough.
Thursday at noon: Sitting in noon conference while writing progress notes because you have to be at noon conference yet you have clinic at one p.m. and need to get them done.
Thursday at 1 PM: If this were today, you'd be starting your car. But back then, you bought a cup of coffee, jumped into a call room to change clothes, and then sprinted to clinic.
Thursday 3PM: Asking patients the same questions over and over and over. Because you are sick with exhaustion.
Thursday 4PM: A bizarre second wind comes over you. Seeing patients, answering pages, kicking ass and taking names. Who's better than you? Answer: Nobody.
Thursday 5PM: Running from clinic back to the UNIT to join the sign out rounds. YES. I said "Go back to the unit." At 5PM. Post call.
Thursday 5:30: Leaving the unit because you "got to go first since you're post."
Thursday 6PM: Fall asleep at every single stop sign on the way home.
Thursday 6:20PM: Eat two poptarts. Fall asleep with all of your clothes on. On the couch.
Thursday 7:30 PM: Classmate calls and asks, "What's up!?"
Thursday 8:00PM: Jump in the shower to get ready to meet your classmates because you know that this is the only chance to do anything fun and this is your "Friday."
Friday 5:30 AM: Staring at alarm clock tearfully and fearfully.
Friday all day: Walking around like a zombie and getting worked to death because you are the only one who isn't "on call" or "post call" -- which is why that day always sucked.

So here is what's extra crazy. That month with that schedule, my co-resident and I decided that we each wanted two consecutive days off. So like the sleep-deprived idiots that we were, we made this executive decision to each take two calls in a row. Yes. In a row. Oh, and did we ask anybody's permission to do this? Uhhhh, of course not. That would be too much like right.

So check it. That was the plan. I take call on Friday-Saturday, my classmate would do Saturday-Sunday the next week. Stupid as hell! I know! Anyways. I come in with my bag on a Friday go through my heinous work day and then admit all night. And that night? Oh it was a rough one. No sleep whatsoever. So Saturday morning I'm sitting at the nurses' station with my head down on my folded elbow likely in a pool of disgusting slobber. Then I hear my attending's voice:

"Rough night, Kim?"

I popped up and looked at him with blood shot eyes. "Uuuuhhh, huh?"

"How many did you get?"

"Many what? What patients? Uuuhhh, I think we got like. . ." I pulled out my cards and started counting, "uuuhhh, like six people. They were okay. Well, one was kind of. . .uuuhhh. . .no, it was fine."

The attending narrowed his eyes and looked at me like I was a little off. This guy was just covering for the weekend so didn't really know me so well. If he had known me well, he would have known that I was off because not only was I nauseatingly tired but simultaneously stupid enough to be admitting for the next twenty four hours. Again.

"So, you're post call obviously," he said. I'm still not so sure I appreciated that little "obviously" dig. Then he looked around the unit and asked the dreaded question. "Where's the on call intern? It's 7:30 and I'm ready to rock and roll."

I wanted to splash my face with water or something to convince him that I wasn't as dangerous as I looked. No time for that. "Uhhh. . .yeah. . . the funny thing about that. . .yeah. . .well, I'm the on call intern."

He furrowed his brow and froze. "You? But you're post call."

"I know, sir. But I'm taking Kevin's call today so that we could each get some time off."

"You're taking two calls in a row? Can you even do that?"

I shrugged my shoulders and tried to smile. I wanted to give him as few words as possible. Besides--Kevin was no where near that hospital and he damn sure wasn't coming in to take call.

"Have you seen all of the patients and written notes already?"

"Yes, sir. I did." Which was true. Haggard, yes. Sloppy with work, no.

He shook his head and sighed. "Okay, then. Let's rock and roll." And that was that. No threats to call my chiefs or my program director. No screaming fit about how awful it is to put my patient's--his patients--in danger with our selfishly asinine plan. Nope. Just a head shake and a request to do what the man came to do. Rock and roll.

So that's exactly what we did. We rocked and we rolled. And then he left. And I stayed to admit seven more people that night. I did get like twenty minutes of sleep--which everyone knows is twenty times worse than getting no sleep when you're that tired.


On Sunday morning, I was in a stupor and I had altered mental status for real. I fell asleep standing up twice and wrote notes in charts that looked eerily like hieroglyphics. Not good. Not good at all.

I am pretty sure that nobody got hurt, but really? Two calls in a row--voluntarily? Really?

Okay. So today I'm reflecting on this new rule effective July 1 that prevents interns from working more than 16 hours straight. The hours can be longer for upper level residents, but first year-fresh outta med schoolers must keep it under 16. Wow. I'm so marveling at how sharply the pendulum has swung in less than fifteen years.

That two call in a row story used to be funny to me. But you know what? It's really not. It was one of the stupidest and most dangerous things I ever did in my entire residency. My friend Kevin and I told that story like old Army Rangers talking to young privates; "when WE were interns we worked for 53 hours straight!" Now that I am actually writing what we both did, it sounds even worse.

But the thing is. . . .as an intern and now, I intensely yearned to have a personal life away from work. I needed a minute, a real minute, just to be me and to breathe. And I needed some time to do it. Even if it meant working for 53 hours straight.

Isn't that terrible? Needing to risk my life and that of my patients just to have a minute to breathe? That's a damn shame.

Okay. So now it's kind of built into the rules for residents to have balanced personal lives--or at least to have time to try.

So what's the moral of this story?

It's good that things are different now. It really is.

Oh. And if you are currently an intern and you don't have a life? Blame yourself for being lame. Not temporary insanity. Or your crappy schedule.

Stay tuned for part 2: "No sleep 'til Brooklyn"-- The story about when Dr. Winawer mowed down a row of parked cars post call in Manhattan. You think I had temporary insanity? Laaaawwwwdddd. . .

Sunday, June 26, 2011


Yesterday marked the second year after Michael Jackson's death.  Yes, the dude was a tortured soul, but no mistaking--he was amazingly talented. 


Here's a couple of my archived posts that include notable mentions of the King of Pop. I revisited them and a few others today in his memory. Anyways. Thought I'd share them:

R.I.P. Michael.

Friday, June 24, 2011

Top Ten: Nothing fancy, actually.

The new pose I get on pictures.

What can I say? It's been a busy week. So busy that I have no good excuse for not posting the Thursday top ten. So. . .um. . . yeah. I won't give you one.

Anyways. Now that more than just my mama actually reads this blog, I feel the need to hold up my end of the deal. Therefore, here's what I have for you this week for the top ten:

The TOP TEN random things, thoughts and observations that amused me this week

#10 - Lolly, lolly, lolly get your adverbs here. . . .

What is it with four and a half year-old kids and their adverbs? Dude. Zachary is totally on an adverb kick and it's hilarious. Every single sentence includes one. Case in point:

"Hey, Zach-Attack. . . .your waffles are ready."

"Well, actually Mommy, I don't like waffles anymore."

"Is that right?"

"Well. . .usually, I liked them but actually, I don't really care for them anymore."

"Oh yeah? Well allegedly you ate them yesterday like nobody's business. I actually saw you."



#9 - A newer version is available for download. . .

My forty year old husband refers to bodily excrement as "boo-boo." No. I am not kidding. He says "boo-boo." Which I think as two parts hilarious and two parts embarrassing.

"Ugggh. Do you smell that?"

"Smell what?"

"Something smells like boo-boo."

"Wait. Did you just say 'boo-boo?"

Opens bathroom door. "Ugggh! Found it. One of your sons boo-boo-ed in here and didn't flush the toilet. Ever since you told them to 'let yellow mellow and to flush brown down' they've let everything mellow."

"Wait. Did you just say 'boo-boo?'"

#8 - Craz-eeeeeehhhhhh.

Zachary has taken to singing Cee-Lo Green and Gnarls Barkley's hit "Crazy" all day every day. No. I mean like all day. Every day. Like the whole day.

Oh, did I mention that my sister got to meet and hang out with Cee Lo this week? Oh. She did. And yes, her Los Angeles life is as cool as it sounds.

Anyways. Back to Zach and his rendition of "Crazy." It's pretty damn funny. His face is so serious, too, when he sings it. The best part is when he says "Ha! Ha! Bless your soooooul! Ya really think you're in control?" Dude. Hee-larious.

He sings the up tempo version. . . .but I kind of dig this version, too:

Oh well. At least this got him off of his Justin Bieber kick.

#7 - Alvin, Simon and Theodore.

The Squeak-uel is back again.

Remember the chipmunks who kept sneaking in my garage in the winter? Turns out they don't like being hot in the summer either. Oh, and they still look very rat-like. Especially when you are going to exercise early in the morning.


#6 - Hammer time.

I went to get a pedicure the other day. Okay, I admit that while my toes are fairly feminine and decent, the soles . . . uhhhh. . .let's just say I won't be asked to do any foot commercials. Anyways. I always assume that there is some hard core mess-talking going on in another language about these rough feet of mine. They lift my foot, pause for effect and then explode into what I think would be interpreted as this:

(My guess of what is being said about my feet:)
"Damn! Here she comes with those hard ass feet again. Can we switch clients. . .pleeeeaaase?"

"She doesn't even seem like she'd have these cat-pads underneath her feet. So stylish, too. That's a shame!"

"A disgrace! She said she wears high heels. Like she is the only one who wears high heels?"

(Asks me a question--"Do you want your toenail cut down today?"-- and then goes back to conversation.)

"And would you believe her cheap ass doesn't even want me to do the callous removal today? No wonder she looks like a cavewoman."

#5 - Found in Translation.

"Excuse me, ma'am. Are you talking about me in Vietnamese?"

"What you say?"

"I asked what you were talking to your friend about. My feet? Just curious."

She looked at me like "you paranoid crazy high-heeled cavewoman!" and then went there. "I look at you and say to my friend, 'She look too nice to have feet li' this one.'" She wrinkled her nose for emphasis.

Damn, really?

#4 - Running mate.

On Saturday, I went for (what I will refer to as) a run. As I prepared to leave, Zachary announced that he would be joining me. I let him know that I wasn't going with the jog stroller and that I was going alone. "I know, Mommy," he said, "We're getting our exercise."

Damn. My kid was showing interest in exercise for the sake of exercise. How could I turn him down?

I didn't.

Seriously? Zachary on "a run" with me? Cutest thing ever. Picture it: A four year old next to me stretching (and he was serious, do you hear me?) and then next to me running. He would have run further than me if he hadn't been sprinting to exhaustion.

Turns out that four year-olds have two speeds: As-fast-as-I-can-possibly-run alternated with sitting criss-cross applesauce in the middle of the sidewalk refusing to move.

Some people call that "intervals." I'm just sayin'.

#3 - Mob Mentality.

Oh my goodness. I am embarrassed to admit that this show called "Mob Wives" has become my new guilty pleasure. Why do I watch it? Blame my reality-TV loving husband who watches everything from "The Swampers" to the "Pawn Stars" to "American Pickers." Somewhere in the midst of all of those shows, I watched an episode of "Mob Wives" with him. (We won't even get started on that show about the Irish Travellers. Lawwwwd.)

Don't tell anybody I watch Mob Wives, okay? YEAH. 'Cause nothin' is woise than bein' A LOW-LIFE SNITCH, capisce?

#2 - Generation WHY.

"Dr. Manning, this patient has . . . uh. . .I don't even know how to explain it."


"His. . . penis. It's. . . .very abnormal."

"Like an infection or something?"

"Uhhh. . . . I wouldn't say that. It's . . . I don't even know how to describe it. . . .like it's . . .deformed. . . I don't know."

"Is that why he's here?"

"No. He's here for a refill of Viagra."

Saw the patient and his "deformed" anatomy. And now for the teachable moment. . . wait for it. . .wait for it. . . .

"Okay. . . .this is what they call an 'uncircumcised' penis."

They still make those, you know.

Um. . .yeah.

#1 - A guy thing.

At Outback Steakhouse on Thursday:

"Mom, I need to go to the rest-a-room."

"Okay, Isaiah." (speaking to Harry and Zachary) "Be right back."

Isaiah heads toward Men's bathroom.

"Bud, I need you to come in here with mommy."

"No, Mom. I need to use the original and the girls don't have that in their rest-a-room."

"The who?"

"The original."

"The original?"

"Yeah, Mom. It's where boys stand up and pee."

"Uuuhh, do you mean a urinal?"

"Can I go in by myself?"

"No way."

Pouts as we go into the women's bathroom. With folded arms dragging feet behind me.


"Now what, Isaiah?"

"Something smells like. . .(fans his nose) . . .something in here actually smells like boo-boo."


Happy Friday.

Wednesday, June 22, 2011

Fox-y Lady.

*Staff members' names and some minor details have been changed to protect anonymity.

This week in the clinic at Grady:

I had just finished seeing a patient with a resident and exited a patient room. As I passed the front desk, I made eye contact with one of our patient access representatives.

(Holding up her finger to me while speaking on the phone.) "Uuuuh. . .okay, ma'am. . . but Dr. Manning is with a patient, ma'am. . . .uuunhhh huh . . . . okay, I'm going to have to ask you to hold on."

I walked over toward the window and mouthed, "What's up?"  Just as I prepared to push the blinking hold light, Ms. Johnson rolled her eyes and grabbed my hand.

"Dr. Manning, you might want me to take this one." Her expression was mischievous.

I gave her a curious stare. "Why? What's up?" I asked aloud this time. I was a little scared to hear the answer.

She froze for a moment looking at me with serious eyes for beat. Then she started laughing. . . hard.  That laugh came from way down deep in her belly and floated over her head like smoke. People in the waiting room who had no idea what was going on seemed to chuckle, too. One Grady elder in particular seemed to enjoy the energy she was witnessing between us. "You don't even want to know, Dr. Manning. This lady has called up here three times in the last week looking for you."

Apparently she'd gotten the attention of Ms. Thompson, one of our senior nurses. "Oh. . .that lady? Again? She called about Dr. Manning again? How funny is that!"  They both erupted for a few seconds and quickly regained their composure. The Grady elder kept smiling in our direction.

"Okay, y'all are starting to scare me. What is it?"

"Better yet--go ahead and take the call, Dr. Manning.  I'm. . " Ms. Johnson snorted to keep herself from laughing, "No, for real. I'm serious. Go ahead. . .  on the blinking light."

I stood there staring at them suspiciously.  I wanted to know what I was getting myself into. "Is this someone who could be mentally ill? Like is it inappropriate?"

Ms. Thompson pressed her lips together to keep from giggling. "Is it inappropriate?  Hmmm." She exchanged another glance with Ms. Johnson. "Well, I guess that's a matter of opinion. Drastic circumstances call for drastic measures."

"I know that's right!" Ms. Johnson cosigned. Again she pointed to the blinking light. I narrowed my eyes as Ms. Johnson grabbed the receiver and quickly said, "Dr. Manning will be right with you. . . .uh huh. . .okay. . . .unnh huh. . . okay."  She placed the hold button again and gave me an exaggerated grin.

"Is it like a medical emergency?" I asked, immediately recognizing how dumb that question was.

"You know what?" Ms. Thompson answered with her eyebrows raised, "Technically, this could be an emergency. Right, Johnson?"

"Oh yeaaaaah. Definitely."

I gave Ms. Thompson a playful scowl. "Oh, see. Y'all tryin' to be funny."

"I'm for real, Dr. Manning!  It could be an emergency depending upon who you ask."

"Shooooot. 911, even."  Ms. Johnson took a big sigh and held up the entire phone, blinking light and all.

I couldn't take it any more. Stretching my arm behind the counter, I released the hold button while balancing the receiver on my shoulder. "Good morning!" I announced, "This is Dr. Manning!"

"Dr. Manning? Oh! Hey, Dr. Manning!" The voice was young, enthusiastic, and female. It was also in direct competition with what sounded like at least three kids in very close proximity.

"Good morning, ma'am. How can I assist you?"

"Oh! Well, this is my third time trying to reach you. I'm so glad I got you! See, I called twice and -- SIT DOWN! SIT YO' LITTLE BUTT DOWN! DON'T MAKE ME--SIT DOWN! --sorry, yeah, I called and said it was important. Did you get my messages?"

"Ma'am, I apologize. I haven't been in the clinic much this week, I'm sorry.  I hope it wasn't something life threatening?" I cut my eyes over at Ms. Johnson who was now covering her mouth with both hands to keep from doubling over.

"Well, it was important. . .not life or death, but important, you know what I'm sayin'?-- PUT THAT DOWN! DON'T TRY ME! I MEAN IT! WHAT THE. . DO IT AGAIN! SEE WHAT HAPPENS! --  See, I saw you on Fox 5 News.  In fact, I see you every week when you on there." (One of the kids is now crying in the background--loud.) "I seen you last week and said, 'I'm 'bout to call Grady Hospital right now!'"

Now I was feeling nervous. What the heck was she calling about? "Okay. You've got my undivided attention. Tell me, ma'am. How can I help you?"

"Well, I seen you on Fox 5, and like I was saying, I always be seeing you. And -- SHUSH YOUR MOUTH! THIS THE HOSPITAL ON THE PHONE!! THIS IS IMPORTANT!! -- Sorry 'bout that. . . yeah, so when I see you, I always think, 'Damn, her hair is hot to death!'


"So, yeah I see that cut every week and love how you rock that short cut, you know. And--HEEEEY! DID YOU. . .AWW HELL. . .IS YOUR SEATBELT OFF?? AWWW HELL NO! -- Excuse me, Dr. Manning." (scrambling, scolding, mama-with-gritted-teeth-voice muffled through phone) "Sorry, 'bout that. . .   so, yeah, last time I saw you I was like, 'Oh yeah, that Dr. Manning? Tha's my girl!' 'Cause you know, I been thinking 'bout goin' short again."

0_0  -----> (look on my face) 

"So ANYway. . . I called up here and asked for you, you know? And-- TOUCH THAT SEATBELT AGAIN AND SEE WHAT HAPPENS!"

0_o -----> (me) 

"Yeah. . .so anyway. . . I left like two or three messages, you know?  I said, 'I'm just gon' keep callin' till I get her on the phone! Like I said, I been thinkin' 'bout goin' short again, so -- BOY! IF YOU DON'T GET OUT MY PURSE!'"

I cleared my throat. "Uuuhhh. . . thanks?"

"Yeah. So . . .wait let me get a pen. . .hold on. . . . . okay. . .  . so, yeah, I wanted to get the name of your hair stylist. . . .okay. . .I'm ready. . . ."

Wait. Huh?

Seriously? Seriously.

(Oh, and in her defense? Take it from this black woman--when it comes to sisters and our hair, the situation can become an absolute emergency. Like 911, even.)
Happy Wednesday.

Tuesday, June 21, 2011

They got next.

image credit

Words to describe my first day of medical internship on June 24, 1996:


Funny. Not much different than how I feel about our interns first day today. . . .

. . . or how I still feel almost every day.

Happy First Day of Internship.

Sunday, June 19, 2011

Who's your Daddy?

Father's Day 2011, Breakfast-on-couch

Ankle shackled to a bed. Eyes wild and angry. Mouth spewing vitriol in every direction. This time, admitted with some kind of infection. Last time, some kind of drug ingestion. Looking through his archival it became obvious that he wasn't a stranger to Grady. The dictations described prior hospitalizations with similar circumstances--in police custody, positive urine drug screens, abusive and impossible behavior on the ward. And not even thirty years old.

"Hey there, sir. I'm Dr. Manning."

"Okay. Get to it 'cause I don't feel like a whole bunch of extra shit." He rolled on his back, folded his lean brown arms and placed his hands behind his head. The security officer mandated to sit at his bedside cut her eyes sideways in his direction and then rolled them with a tiny shake of her head. She gave her finger tip an exaggerated lick and turned the page in the paperback novel sitting on her lap.

"I came to see about you this morning along with the rest of my team of doctors. We'll be the ones taking care of you while we try to get this infection under better control."

"Tell them to bring me a double portion. I want a double portion on my tray."

I looked at the shining metal cuff locked snugly around his right ankle. The left foot was covered with a blanket, but occasionally the other that was bare and exposed would reflexively fight against being restrained with a backward pull. A telling red ring on his skin was evidence.

His body smelled of rebellion, and his matted hair and poor oral hygiene made it a little hard to look at him. Especially when combined with how unabashedly rude he was.

"I think we can get you a double portion. That's not a big deal."

I then asked his permission to examine him. Normally, I would ask more questions or recap what the residents had told me on rounds, but in this instance I knew that he could kick us all out at any minute. I carefully inspected his thin and muscular body, searching for clues about his recurrent infections. The skin was smattered with excoriated bumps and picked scabs, likely related to his lifestyle outside of the hospital. I moved on to start pulling back dressings and gingerly removing packing from an infected wound.

"This seems to be draining pretty well, sir. You know the packing helps you as it heals. We're also giving you some antibiotics through an IV because this infection is hard to treat with just pills."

"Hey!" he suddenly yelled out to a nurse's aid that walked in to pick up a pill cup. "Why you didn't get me the apple juice I asked for? Get me two. And some ice!" He shook his head hard and muttered under his breath (but quite audibly) some expletives involving his feelings about Grady Hospital.

"Are you from here?" I asked, working to quickly deflect him from further picking on the aid.

"Bankhead, shawty." He smiled wide, like he was proud of his west side Atlanta neighborhood. "What you know about Bankhead?"

I smiled back and shrugged. "Not that much. . . .but. . .isn't that where the rapper T.I. is from?" I recognized how lame I sounded by using the words "the rapper" before the artist's name. So forty-something of me.

"Aaiight, then, Doc. You know wha's up! Yeah, he from the west side. He from Bowen Homes. Tha's al-right that you know that!"

I felt a bit of relief wash over me as his eyes softened in my direction. After looking at his arms and palms, I reached for his hand. Surprisingly, he allowed me to hold it.

My purple glove and yellow infection control gown separated our contact somewhat, but in that moment, he stilled. I covered this hand with my other hand and allowed the team of onlooking interns, students and residents to blur in my peripheral vision.

"Sir. . . Where is your family?"

"I don't have no family," he quickly responded. I could hear the venom rising up in his voice again as he drew his hand back.

"No family? Where was your family? Your peoples? Like. . .who raised you up?" I had to know because black folks in the south rarely have nobody. Everyone has a "mama'nem" or "play cuzzin" or two.

"Nobody, like I said. The state. The system. Shit, nobody." He laughed when he said that part. This inappropriate chuckle that was laced with pain and cynicism. I didn't flinch so he kept talking. "Yeah. My mama was a crack fiend. My daddy was a n--a she prob'ly let do her for a five dollar rock." Again that strange and unsettling laugh. His use of "the n-word" made it even more uncomfortable than it already was in the room. The security officer lifted her head the minute he said it, freezing for an instant and then returning to her book.

"I'm sorry." I squinted my eyes and then asked, "Did you get much time with your mom? I mean, before she . . I mean, before you had to go to foster care?"

"Yeah, shit. . .too much time. Basic'ly I was right there while she was gettin' smoked out and f--d by anybody and everybody so she could get right. I remember all that shit. Somebody would come in there and beat her ass like a dog in the street and she turn around and get on her knees." Another laugh.

"On her knees?"

"Yeah, you know what I'm talking about. On her knees talking 'bout, 'Daddy I'll be good' so she could get high. Gettin' dudes off right in front of me. A lot of them cats was dealers, and my mom was pretty even though she was a crack fiend so they would still do her. But you know, them cats ain't stupid. . . they wasn't lookin' to die or nothin' so they would just let her take care of them with her mouth, you know. 'Cause shit you don't have no idea what these fiends out here got. The AIDS, whatever. But yeah. I was right there seein' all that shit. And I was just a little man, too."

"Did anybody ever try to touch you?"

"Touch me? No. Shit, nobody even knew half the time I was even there."

"Then what happened? How did you get out?"

"One day some white people came in there and saw how f--d up everything was and took me out. But where they took me was just as f--d up." I noticed a pattern. With all of the most disturbing parts of his story, he chuckled.

"There wasn't any other family?"

"Naaah. Plus I had behavior problems and nobody was trying to f--k with all that, so yeah, I went to foster care so yeah whatever, you know? It's f--ked up out there. Ha ha ha. . .now here I am." He held his hands out like tah dah.


He leaned back in the bed and scratched his abdomen. It was covered with crude, jail tattoos. With a bored yawn he asked, "So, why you want to know all that? Wha's that got to do with anything?"

"I want to know because I'm looking at your eyes and your face and wondering who let you down when you were a little boy." He gave me a puzzled expression, like genuinely puzzled. I went on. "That's the truth. That's why I'm asking all that."

Because that was why I was asking and I did want to know that. I looked at him and wanted to know-- who let him down? Who? And yeah, I know. A lot of folks have hard lives and yet they somehow at some point pull themselves up by the bootstraps and get their act together.

But what about when you don't even have any boots to pull straps on?

So that's what I'm reflecting on this morning. It's Father's Day and, honestly Father's Day always gets me thinking about parents in general. Probably because there's so much symbolism tied up in the role of the patriarch. Like, your dad is supposed to be your bridge over troubled waters; he's the one you jump behind when something goes bump in the night. And for a lot of folks--and I do mean a whole lot of folks--that father in the traditional sense wasn't there. But if they were lucky somebody else stepped up to the plate. So I guess that's what gets me thinking about Father's Day this way. I think about it in terms of what having one affords you. And what it denies those who don't.

This morning while standing in my kitchen I was thinking of that patient. . . this beautiful, cocoa-complexioned manchild whose ankle was locked to the end of a bed. I remembered his round brown eyes and dark, lush lashes. I could see the chicken pox scar on his cheek and the distinct facial features. I wondered if he was, perhaps, the spitting image of someone who never knew or cared to know of his existence and what that might have meant to his entire life. I also wondered how it all would have turned out if he'd just had someone looking at him lovingly on a daily basis.


As I cracked eggs into a sizzling frying pan and sauteed steak for Harry's Father's Day breakfast in bed, I asked myself--What is the best thing a parent can do for a child besides love them? And then, while stirring creamer into a steaming cup of coffee, I thought about this:

A parent, in whatever capacity they are a parent, should fight tooth and nail to stop anyone or anything from robbing their child's innocence before it's time. Period.

Kid eyes just don't seem wired for processing overly mature and overly awful visual images. Hell, adult eyes don't do such a great job at it either. But it's worse for kids. And I'm not sure how you can have a fighting chance when at seven years old you saw your mama on her knees calling somebody who just called her a bitch to her face "Daddy."

Up until I was about twenty years old, nearly everything I did or did not do was out of wanting to make my parents proud of me (or not disappointed in me.) At some point, things shifted and I wanted to do the right thing because of myself, but sometimes I wonder what it would have been like to have been forced to figure out all the things I've figured out with the help of loving parents on my own. I needed those wagging fingers and swats on my behind for coming in after the street lights came on, and I thank God for the standing ovations I received for fourth grade performances and at medical school graduations. More than all of those things, though. . . working at Grady has shown me how blessed I am that my eyes were shielded from things not meant for them. And for real? I thank God for that.

For some folks, it's in their DNA to make it despite a hard childhood. But most folks? It isn't. At all. Turn on a television and watch those Penitentiary/Lock up reality shows and you'll know it's true. Story after story of childhoods ruined by innocence lost followed by broken adult existences. Which sucks because there's not a whole bunch you can do to fix that.

Damn. Father's Day is supposed to be a feel good day. I didn't mean to get heavy like this. But the point of it all is this--if you had somebody waiting at home for you, expecting the world for you, covering your eyes for you, and sacrificing for you, you might want to call them up and tell them thanks. Not just "Happy Father's Day" but, for real, thank you for slugging it out for me. Thanks for letting me be a kid during the time when I was supposed to be a kid and for kicking me squarely in my behind when I tried not to be one. And if your parent failed at some parts of it, tell them I love you anyway because at least you tried. Because one thing I know for sure is that a whole, whole lot of people for a whole, whole lot of really complicated reasons don't try. At all.

Our plan was to deliver Harry breakfast in bed. We took longer than expected so it ended up being breakfast on couch, but he seemed to like it all the same. I knelt down next to Isaiah and Zachary outside of the kitchen and whispered to them before we brought the tray to Harry. I wanted to make sure they knew what to say.

"Tell him Happy Father's Day," I said. "But make sure--no matter what--that you tell him 'Thank you for being a good daddy to me.'"

And Isaiah asked, "Mom, is it hard to be a daddy?"

I grabbed his face with both hands and looked in his brown eyes--round with sprawling lashes just like my patient's. Then I answered, "No, son. . . .not when you know how."

Happy Father's Day. To all y'all.

Now playing on my mental iPod. . . .the song I danced to with my father on my wedding day. Eva Cassidy sings this in a way that stirs my soul. Maybe you can add it to your mental iTunes, too.

Thursday, June 16, 2011

Thursday Top Ten: Twenty-four.

This evening we celebrated the completion of internship for our Transitional Year interns. For those unfamiliar, a Transitional Year is essentially a twelve month clinical experience following medical school graduation that provides a general medicine foundation for young doctors entering fields like Radiology, Neurology, Anesthesiology, Ophthalmology and Dermatology. For the last five years, I have served as the residency program director for this program of twenty-four diverse and dynamic individuals, and my oh my. . . lucky me.

Here's the thing--internship is such a pivotal time. . .and the thing is. . .I realize that. I really, really do. Despite all that you learn as a medical student, being an intern is kind of like being shot out of cannon high into the air. The learning trajectory is ridiculous; the personal growth indescribable. My internship remains one of the most memorable experiences of my entire life. In fact, most physicians would tell you that about their rookie-doctor year.

I get the chance to play a key part in that period for twenty-four fresh, new doctors--every single year. On that first day of July, we finally take off their medical student training wheels, strap on their helmets and walk behind them carefully as they pedal onto a sometimes bumpy sidewalk. We resist the temptation ride for them and grab the end of the bike only when necessary. And because the stakes are high--and human--we know what "necessary" is and on those days we do grab the end or even step in to ride tandem with them. If they fall and they will because they're learning--and human--our job is to provide them a soft place to land while providing our patients with a safe place to be.

So this, in addition to all of the other cool things I get to do with medical students and patients and colleagues, is yet another reason why if I didn't have my job, I'd sure wish I did.

This week's top ten? No question. I bring you the top ten moments and reminders from this evening that underscored why I love being the Transitional Year Program Director for The Twenty-Four.


#10 ~ Evolutions.

Knowing someone as a medical student and now seeing them step out into being a resident is a pretty magical thing. This is Katie S. (pictured here with her sweet fiancee.) I still remember meeting her when she was a medical student fretting over an epiphany she'd had about choosing a residency. I told her that she'd earned the right academically to do whatever she wanted to do and that it was okay to change her mind (since that's what she was about to do.) In other words, I suggested that she follow her heart.

She did.

#9 ~ Boys to men.

I love seeing this picture and recalling their first day of internship. I imagine them with graying beards, sitting in the same seats some thirty years from now.

#8 ~ Priorities.

This is Ryan B. and Sara G. They both had the joyous experience of brand new parenthood during internship. Ryan had a sweet baby girl and Sara a juicy and adorable baby boy.

Internship is hard. Having a baby during internship is. . . .damn. I have no idea because I didn't experience that. But here's what I do know -- children are a joy and family is a priority. Always.

Tonight at dinner, Ryan said to me, "I remembered what you told me about that time you missed your sister's graduation. I remembered that story and knew to keep my priorities straight. Family is always first."

Who knew when I said that mantra or told that story that someone was listening? Someone was.

#7 ~ Collaboration.

This is Deb B., my associate program director (pictured here with her amazing husband, E.J.) She is--in a word--unbelievable. She is smart. She is organized. She is kind. She is understanding. And best of all? She's just a cool person to work with.

Our styles are so complimentary. I get my bright ideas and jazz hands suggesting some new change and Deb is the one who concretely lays the nitty-gritty of it into an excel spread sheet--quickly letting me know if it's a good idea, a great idea, or a "there's no way we can do that" idea. We are almost always on the same page about things, and she is so easy to work with.

And. Don't let that relaxed look fool you. She is crazy accomplished. This woman? Oh, she was only promoted to FULL PROFESSOR this year. Hello? Full-frickin' professor which, in case you didn't know or aren't in the academic sector, is kind of a big deal. She's so humble that the way she told me she got promoted was like . . .I don't know. . . the way you tell someone to turn off the light or hand you a Diet Coke from the fridge. That's my favorite thing about Deb. She is one uber-smart Radiologist who is so "over it" when it comes to "oooh-aaaaahh, look at me"-ing.

I deeply admire this woman and feel fortunate to work with her so closely. Deb = Rad.

#6 ~ Smiling faces.

This is Jessica C. Her smile is one that always reflexively makes me smile, too. I bet her patients in Anesthesiology will appreciate that smile so much. I sure did.

Imagine getting to see twenty-four of these all over the hospital every single day.

#5 ~ Getting to know you. . .getting to know all about you. . . .

When the year starts, a lot of the interns are strangers to me and each other. I love watching them become friends and also personally getting to know them better. This is a picture of Tom L. and Neil S. Neil was on my ward team once this year and almost every day, he taught me something new and made me laugh out loud. It was one of my favorite memories of this year. They're both going to be Radiologists, like Super-Deb.

This picture is of Pavan K. and Dan W. Pavan went to Morehouse School of Medicine and Dan is an Emory SOM alumnus. Interestingly, despite the fact that both of these institutions are in Atlanta--and even in Grady, the students at each of the schools don't interface or know each other as well as one would think. As a Meharry Medical College graduate, I know this dynamic well; our much smaller, historically black med school was in Nashville just a few miles away from the academic powerhouse Vanderbilt.

Like Morehouse students, we were proud of our institution and loved every moment of our experience. But also like Morehouse students, we would often find our school hidden in the shadow of Vanderbilt's reputation and prestige which created this odd separation between us. We knew the gems held inside of our walls, but at times, few others did or were even willing to try. For some folks, it was outright disdain, but for a lot of people it was just . . . .this weird indifference. . .almost like we were invisible. Something about that always hurt more.

No. It wasn't everyone at Vanderbilt just like it isn't everyone at Emory. But it's more prevalent than it should be. Yeah. It's hard to explain unless you've experienced it.

Anyways, Pavan from Morehouse and Dan from Emory became fast friends while working in the Grady intern trenches together and became like brothers. It's kind of like finding out you lived around the corner from someone who becomes super important to you years later. And you know? Something about that friendship and what it represents warms my heart. It just does.

(Dan actually wasn't one of my twenty-four, but I adopted him this year so he was welcomed to our dinner table.)

#4 ~ Thoughtful gestures.

This is Pavan K. (again) and Marae S. They were elected by their classmates to serve as class representatives and helped to keep my finger on the pulse of what was going on with the class. Pavan has a personality that can only be described as magnetic. Marae has this way of immediately making you feel important just by the way she looks at you and listens to you when you talk.

They presented us with the kindest cards and gifts--which we totally didn't expect. When I got home, opened the card and read all of the words from them, it made me cry. The best thing about these two class representatives is this: They truly represented all that was good about this year's twenty-four.

#3 ~ Hands on deck.

This is Tanya C. She's our residency program coordinator for our residency program and an absolute godsend. For the first few years that I was in this position, I didn't have consistent administrative support. Through the efforts of some wonderful people like Melanie L. and a few others, Tanya joined our team in late 2008. I had no idea what I'd been missing until I got her.

She rocks.

#2 ~ Being Trusted.

This is Dairon G. (pictured here with Deb B.) I adored working with him, partly because he's smart and fun but more because he's thoughtful and honest. Dairon came to Deb and I with some career direction questions and found himself asking hard questions. I feel so honored that he trusted us with those concerns. Everything worked out better than he ever could have imagined, and we were fortunate to have been there to listen.

This sweet girl is Allyson S. She is one of the strongest people I have ever met in my life, and the kind of person that makes a parent so proud they could explode. This year, she trusted me so much that the moment I tried to hand her the certificate of completion I was immediately brought to tears. Just like the ones I'm blinking away as I type this.


#1 ~ I'm O.K., You're O.K.

I don't always drag the B.H.E. (best husband evaaaah) with me to all my work functions. Our rule is that he simply asks me, "Is this one you want me to attend?" and he simply follows suit with whatever I answer. I realize that I have quite a few commitments and that, no, we aren't in political office or anything. Harry's time is valuable, too, and I try hard to respect that.

Yesterday, I answered "Yes" when he asked me that question. I wanted my interns to see my soft place to land and the rock that I cling to when my waters get troubled. Because even when you are an attending physician and a program director and even a full professor like Deb, your waters still get troubled sometimes and your bike without training wheels still gets wobbly.

So as I read those kind words scribbled by each of the twenty-four into that card, I thought about how easy it is to go to work and parent your kids and live your life when you're okay with you. And though I have my wobbly days, I pretty much am okay with me on most days. On the days when I question who I am, it's Harry who grabs the back of my bike, tightens the chinstrap on my helmet, and tells me to "Go get 'em." And that makes me ride even harder.

Yeah. It was a great day and a great year with our interns. And just think. . . . on Tuesday, I get to do it all over again with twenty-four more.

Oh happy day.