Tuesday, November 1, 2011

That's all.

"I see you."

~ from the motion picture Avatar.

I was talking to a medical student the other day and even though it was a simple conversation about how things were going and not really about much of anything else, that student broke down and cried.  Wait, I take that back. I saw the emotion mounting in the student's face and asked about it. Then those tears came. I probably shouldn't have asked but I really wanted to know--where were the tears were coming from? This is what that student said:

"I just appreciate the time and attention. I really do. That's all."

And those tears came down fast and furious after that. More than expected and catching us both off guard. But they were welcomed because each one was genuine and sweet and necessary.

But was that trusting cry because of what was invested this time or what wasn't last time?  I don't know. All I do know is that those tears made me want to try harder. All I know is that I had times as a medical student (and probably beyond medical school) where I tried my hardest and still felt exactly like I was as transparent as glass. Or worse, like some kind of speed bump placed by the city but not wanted by the people--slowing down busy commuters and simply in the way. I wondered if that feeling had something to do with all that emotion.

"I just appreciate the time and attention. I really do. That's all."

Was there something unusual about the attention you were receiving this time? Was this a sharp detour from what you'd experienced up until this moment when all someone did for you was notice you and regard your presence as a learner? Or were you just glad in general and the kind of person that turns on the water works at times like this no matter how frequent they are and the kind that bawls on Hallmark commercials, too? Was this really not deep at all-- or was it instead telling of how a whole lot of medical students (and folks beyond medical school) feel?

That? See that stayed with me for the rest of the day. I don't know. Something about that twitching upper lip and red nose hurt my heart. It also made me feel ready to charge up a flight of stairs picking up and teaching every stray medical student along the way.  But I know I can't do that all the time for all those people. I can do a lot though. Like look people in their eye and give them my full attention when they speak. Like smile and pronounce their names correctly and hear about their futures. And no, I can't do it for everyone, but dammit I can do it for someone. And I will. Because honestly? They're giving me their time and their attention, too.

Yes, they are.

I put those precious tears into an imaginary bottle in my pocket as a reminder and walk away feeling both committed and conflicted.



  1. I once had a doctor appointment FOR ME (and not my daughter who has a chronic condition) -- a general physical -- and I hadn't had one in years and years (except for OB/GYN stuff). I still remember the internist spending so much time with me and when he examined me, he placed my hand on my stomach and asked me what I felt -- I could feel a pulse there, and he told me that was my life force -- that though faint it was strong and deep and I needed to find my way back to it. I lay there with tears running down the side of my face because I'd been seen and paid attention to and that was overwhelming.

  2. You are so cool. I have been reading your blog for awhile and really look forward to coming here and partaking of your great wisdom. Joanne

  3. You are such a treasure.

    When I was in law school and broke up with my fiance on another continent and had various other things going on, I went to see the university's doctor. She had made me promise to see her every couple of months and have my TSH and T3 tested (I have some funky thyroid thing going on and I refuse to let them "treat" it because it's stable, whatever it is, and regular tests show that I have my own normal range even if the textbook disagrees).

    And on that visit, we talked as we usually do and she could tell things were off and asked and I let loose with sobbing like I've never done in front of another person. (Oh my, this is making me cry again.) And it was just that - the time and attention that she always showed me and that I really needed right then.

    Whenever I read your posts I think of her (she has two young girls, about your sons' ages) and how awesome she was - very much like how you are awesome. THANK YOU I say to you, for all the people who don't take time to, because you make the world such a better place!

  4. You may be a medical geek but you are also a real, live human being. Do you know how unusual that combination is?

  5. E -- that doctor sounds amazing and super insightful. what an experience.

    Joanne -- I appreciate you reading. I don't always feel so cool, but I will take that compliment and carry it with me today.

    NOLA -- It's funny how sometimes people know to simply ask you what's wrong and how bad you wish they would. Even if you didn't realize you were wishing it. That doctor of yours sounds amazing, too. There are some good ones out there. There sure are.

  6. If I ever end up at Grady, I hope you are my doctor.

  7. Like look people in their eye and give them my full attention when they speak. Like smile and pronounce their names correctly and hear about their futures. And no, I can't do it for everyone, but dammit I can do it for someone.

    I love this and I love how you remind me to pay attention. :)

  8. We need to have more teachers like you, especially in the medical field. I think that type of caring is lost these days, which is ironic considering the type of field medicine is. It is so rare that I see people invest into our med students or even the interns and residents.... on a personal level you know? And I just have to wonder what it would be like if more people did invest in such a way. I think it would change not only the medical team but it would branch out into nursing, and other services of the hospital. Caring goes a long way.
    Thank you for caring.

  9. Looking people in the eye and giving them our full attention is SO important--for students, for patients, for our loved ones. I need to work on it more myself. Thanks for the reminder.

  10. As an MSIII I am often struggling with the heavy feeling of being a burden, a nuisance, or at best, a non-entity to a number of the attendings and residents on rotations. Some of them barely acknowledge my existence even though I try very hard every single day - I step into the hospital with joy in my heart every morning no matter how little sleep I have had the night before, I smile, I work hard, I offer to do whatever I can think of doing and when I can't think of anything to offer I ask if I can be of use, I try to anticipate things and get them done before someone has to ask or tell me to do them, I am almost invariably the last in my group to leave the hospital (with the exception of the on-call person). I do not expect praise for this, nor do I look for special treatment or even acknowledgment of my zeal - I think this should be standard behavior for a medical student. However, what I do hope to get is at least a marginal desire on the part of the attending to share with me some of his/her knowledge and expertise, to recognize the fact that even if something is boring and obvious to them it can be far from obvious to me. What I find most condescending and disingenuous is when an attending or resident hides behind the "I should not have to teach you anything, whenever you see me do something that you don't understand you should be motivated to go read and research the topic on your own" statement. More often than not this is not motivated by a real desire to encourage independent learning (especially for a slightly older student who has had a bit more experience in this game of life and is already motivated to research and learn independently every chance she gets) but by a desire to not be bothered by students.

    Dear Dr. Manning... your students are beyond lucky. You have taught me much in the relatively short time I have been reading your blog, and I can only imagine what it would be like to spend even 10 minutes on rounds with you. Being taught and mentored by someone like you would bring tears to my eyes as well - genuine and grateful tears.


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

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