Wednesday, August 31, 2011

How'd it go?




Okay, y'all!  It's August 31--the last day of the No-Self-Hateration Pledge Campaign.  We had lots of pledges, too!

Give ya'selves a hand! 

Well?  Well?!? How'd you do?  Did you fight the urge to hate on yourself? Did you find it impossible not to call your butt big or your tire spare?  Did you struggle with not insulting that lovely nose with the big bump that you inherited from grandma or cracking jokes on that scary second toe that's curiously longer than your big toe, or pointing out to your best friend that eh, you think you do look good for your age but your hands look old. Don't my hands look old? No? Are you blind? They're horrible.

Or.

Did you discover that it's more fun to be alright with yourself than not?  That your curves are actually kind of like Beyonce's (depending upon who you ask and how much they've had to drink) and that, actually, part of Beyonce's appeal is that no matter what she has going on, she totally OWNS it.

And isn't it funny how that person who is clearly imperfect or dealing with all kinds of everything who just decides to OWN it instead of drinking all that self-haterade . . . .isn't it funny how they always somehow pull it off?

That person could (and should) be you. For reals.


Look. We're all works in progress. But the point is that self hatred/self deprecating behavior/self picking-yourself-apartedness or whatever you want to call it, is like feeding yourself poison and expecting not to feel sick.

I think I'm just going to try to keep rolling with the pledge. I had several close calls--okay, straight up lapses--where I let some negative commentary slip while putting on my clothes. But mostly, I did okay. And I liked the idea of being kind to myself. It felt pretty darn good, actually.

On the way home from school yesterday, Zachary said, "Mom, you know what? I'm smart. You know I'm really, really smart to be only four. When I'm five, I'm going to be able to read inside my head without you hearing me because when you're smart you can do that."

"Oh yeah?"

"Yeah, Mom. And I am good at basketball even though I'm short. When I get taller I'm gonna be SUPER good. SUPER-DUPER good, right Mommy?"

"Fo' sho, Zachary."

I thought about the innocence of this declaration and wondered what I was or wasn't doing to foster him continuing to have that kind of positive self image. I didn't come up with the answer to that, but I do think being loving toward myself is a good start.  Not oblivious to my imperfections or complacent about areas of needed improvement.  Just loving in the meantime and in between time.

That's all I got.

I'd love to hear how it went for y'all or what your thoughts have been during these last two weeks!


Oh yeah--I got this, too.

I'll leave you with two excellent songs playing on my mental iPod today. Both are my go-to jams when I need to be reminded of why it's good to be alright with me. . . .

If you don't know the music of Miss Erykah Badu--fix that problem right here, right now by listening to this little sampling:

First up--"Cleva"  -- one of my favorite songs.  The lyrics are awesome--especially the end where she simply says over and over, "I'm alright with me. . . said I'm alright with me. . ."

"I got a little pot in my belly
and nowadays my figure ain't so fly
My dress ain't cost nothin' but seven dollars
but I made it fly--sh--I'll tell you why

'Cause I'm clever
when I bust a rhyme
I'm clever -- always on your mind
She's clever
and I really want to grow
but why come
I'm the last to know?"



. . . and another favorite from Erykah Badu -- "Bag Lady." Wow. The sista preaches on this one--do you hear me? P-REACHES. The song is essentially about how harboring all that negative energy (read: self-hate, an unforgiving spirit, anger, resentment, envy. . .)  can end up blocking your blessings. . . .whew! Steps on all kinds of toes, man! If you have a minute, watch this artistic video. It's amazing.

"Bag lady
You gon' miss your bus
You can't hurry up
'cause you got too much stuff
When they see you comin'
People take off runnin'
from you--it's true
Oh, yes they do. 

One day
All them bags
gon' get in your way
I said, one day
all them bags
gon' get in your way

so. . .pack light."




***
Have a cleva day. Oh, and pack light.

Tuesday, August 30, 2011

Potty meat.

*Names and details changed to protect anonymity . . . . .you know what's up!
Low in salt. Just not sodium.





"What questions do you have for us?" my intern asked his patient diligently one morning on rounds. Mr. Purifoy immediately craned his neck over to his wife who sat next to his bed.

"You gon' ask about what you was sayin' earlier? About my legs?" he asked her.

Mrs. Purifoy did all the talking. No matter how many times we tried to get him to ask his own questions, he preferred to have his wife take care of such formalities.  Which reminds me. Tonight Harry was trying to add a new "app" to his iPod Touch and for whatever reason "needs" me to assist him with all things Apple. Seeing as I love him and don't mind pushing the two to three (super easy) buttons on the device to get him what he needs, I just go ahead and help the brother out. And Harry always turns my car around in the car port and also gets rid of any scary/non-ladybug insects in my sight. Even if I was the one who did the honors of squashing it with my Ugg boot (which yes, I do wear in my house even though it's summertime.) Sigh. . . yes, I digress. But, see,  the point of me telling you this is that I get Mr. Purifoy leaning on his wife for certain things that he technically could do himself.

Antywho.

So Mrs. Purifoy, who had just sat down to the bedside tray table with a full meal/snack that she'd just brought in, looks over in our direction with her mouth a-watering and her eyes half-mast. She then looks back at her husband. "You talkin' 'bout the water pills?" She shifted back to us. "His legs was swelling sometimes. Tha's why we was wondering does he need more Lasix pills in case they swell again."

I looked down and inspected his legs once more. He had very trace amounts of swelling, and he had no signs of volume overload.  Before I could say anything, my intern chimed in. "Your legs look fantastic, Mr. P. We've had you on a low salt diet, and I think that's helped a lot."

"See, I told him don't be eatin' all that salt!" Mrs. Purifoy announced with a curl of her lips. She picked her teeth with her thumb nail and nodded. "Ummm hmmmm. I told him. See me? I don't use no salt.  I mean, I know it can hide up in stuff but I don't eat that stuff."

I looked at the tray table and surveyed her bounty.  The entire meal was from the hospital gift shop--which couldn't possibly be low on salt since everything needed to have a decent shelf life.

Here is an inventory of what she had:

  • A jumbo bag of Ruffles potato chips.
  • A big, dill pickle.
  • Some kind of sandwich wrapped up in foil, from where--I do not know.
  • And. Wait for it. . . . wait for it. . . .
  • Yes. A can of Vienna Sausages.

Vienna Sausages?Seriously?

0_0 ----> look on my face

My little Harry buzzy-bee/guardian angel (whose sole purpose is to get me to mind my own business) began furiously swirling around my head. "Watch your own lane!" he hissed. "Don't even START with this lady! She is NOT your patient!"

"But how is she just gonna bust on his salt intake when she has VIENNA-freakin'-SAUSAGES at the bedside? That's, like being a TOTAL hypocrite, man!" I subconsciously replied.

"STILL!" the little imaginary drill sergeant hollered. "It AIN'T your lane, nosy girl! Drive in YOUR lane!"

And for two seconds I did drive in my lane. But then she started situating herself to eat what might has well have been a salt lick and I could. not. take. it.

"So. . . .uhhhh. . . .do y'all know how much salt you should stay under for the day?"

I directed this right at Mrs. P since she seemed to be the speaker of the house. And she lit right back at me, calm as could be. "Oh yeaaaaahhh.  I checks all the labels for saturated fat and all that."

"Okay. . .let's just go over it again to make sure it's fresh on your mind, okay?"

She nodded--while still getting her food ready.

"Mind if I use this for example?"

The Harry buzzy-bee was in my ear again.  "You KNOW you are wrong if you pick up those Vienna Sausages. You are TOTALLY being an a-hole if you do because you know how salty they are."

"Go right on ahead," she said. "Bay? Make sure you pay attention 'cause you be the one eatin' all that salt.  See me?  I got sugar diabetes and I don't eat no salt. Tha's him. See bay? No salt."  She bit the pickle.

Lawd, Lawd, Lawd.

Could. Not. Take. It.

"Okay, so here is where the sodium is. You know this already, but  the sodium is the salt. You both want to keep it under 2000 milligrams of sodium. So you have to count it up. . . ."  I looked at the label of the can. "If you eat this can. . .it has 2.5 servings total. . . . . and if you eat the whole can. . .that's like a third of what you can have for the day in terms of salt.  And let's check the chips. . . . okay. . .so 590 milligrams in this bag. . . . and you're already well over half of what you can have for the day.  See? Watching salt is really, really hard to do."

"He eats potty-meat. Tha's waaaay worse than Vi-ennas. Tell him, doctor."

0_o

"Potty-meat?"

"POTTED meat!" a voice of another patient clarified from the neighboring bed.

On second thought, "potty" meat may have been more accurate.


"Aaaaahhhh," I said.  "Is potted meat pretty salty?"

"Horrible!" exclaimed Mrs. Purifoy. "Jest HORRIBLE!"

I stood there for a few beats watching Mrs. Purifoy as she popped the airseal on the bag of chips and peeled open her can of Vi-ennas.

"Mrs. Purifoy?  You both really need to watch the salt. If you have diabetes you probably should avoid this stuff, too."

"I told you. I don't be eatin' salt like he do."  Again she bites the pickle.

Killing me.

I glanced up at the clock and then at my interns. They were shifting on their feet and obviously wondering how long I would let this go on.  Much to my disappointment, I knew I would be forced to do the unthinkable--get in my own lane.

"Do you think we can get you both to come see us at the Primary Care center?"

"Oh yeaaaaah. He definitely need to see y'all."

"Okay. But. . .what about you, Mrs. P? Will you see us, too?"

"I could probably see y'all, too."

"And can you do me one more favor, Mrs. Purifoy?"

She raised her eyebrows.

"Can you make this your last can of Vienna Sausages after today?"

She looked down at the can and back up at me. "It's that bad?"

I nodded slowly (knowing that if Harry were there he'd be shaking his head and giving me the hairiest eyeball ever.)

"Okay then," she conceded.  "But Dr. Manning?"

"Yes, ma'am?"

"Make sure you tell HIM about that potty-meat, okay? 'Cause I just know tha's waaay worse than Vi-ennas."



Ummm, yeah.
If this makes you dry heave, that makes two of us.

Confession: I read this post to Harry who had this to say:

Harry: "You never had some potty meat on crackers? Shoooot! You trippin'!"

Me: 0_0

Harry: (laughing hard) "With some crackers, Babe? Some Saltines? Shooooot!"

Me:  x_x   eeeww.

*sorry, just threw up in my mouth a little bit*


Seriously?  Never. Kissing. Him. Again. Ever.


***
Happy Tuesday, y'all.




Monday, August 29, 2011

Getting my Gershwin on.


How cool is this glass cork?

This summer has been full of the innocent laughter of children, the easygoing laziness of long days, and the kind of energy that comes from being with great friends. Days like these make you want to put the summer in a bottle that perfectly fits in your pocket. . . . forever and ever. . .

These are also the days that remind you to count your blessings and teach your kids to do the same. Sigh. . . Yeah. I have been enjoying this summer. . . .yes, I have.


So much so that I feel compelled to break out in song. Wanna hear it? Here it go!

*ah hem, ah hem*
 
(Picture me loudly singing this with head back, eyes closed and jazz hands--because I am.) 


"Summertiiiiiiime. . .


And the livin' is eeeeeeea-sy. . .


*(picture my jazz hands really going crazy here)*


Fish are jumpiiiiin' . . . 

And the cotton is hiiiiiiiiigh . . . .


Your daddy's riiiiich
And your mama's goooood lookin'. . .  

Rich!! Really?

O-kay! O-kay! 

Your daddy's NOT rich, alright?
 But dammit--your mama's
DEFINITELY good lookin'!
I DARE YOU to say otherwise!
 
*Ah hem. . .where was I?  Mee-mee-meeee. . .*

. . . .So hush little baby
Don't you cry. . ."

~ lyrics by George Gershwin

Better yet. . .let's just let Ella and Satchmo sing it instead. That's what was playing on my mental iPod before I busted out into my own version anyway.  Grown folks--enjoy! (You youngsters don't know nothin' 'bout this here kind of music. . .I'm just sayin'.)

***
Happy End of Summer. 

Friday Night Sights.



Here are things I saw while walking to my car from the hospital on Friday evening:

  • A man with a backpack on doing "the running man" on the corner.
  • Two medical students sitting on a bench eating packed lunches at dinner time
  • A very young boy holding the door for a woman who appeared to be nearing her 80th year.
  • A colleague interpreting Spanish for a family that appeared to be lost
  • Them looking relieved that she really hablas-ed Espanol for real, not Spanglish or that quasi-Spanish where people talk louder and make weird hand gestures
  • A man smoking a cigarette while leaning his elbow on the "NON-SMOKING ZONE" sign.
  • Another man asking him if he "got another square?"
  • That smoking man handing him a cigarette and me learning what a "square" is.
  • Two teenagers arguing while walking down the street.
  • One of the teenagers holding (read:lugging) an infant carrier up the street. With a very young infant being carried in it.
  • The boy (who clearly didn't do the infant carrying in utero) also wasn't the one doing the infant carrying now either.
  • Him not noticing my hairy eyeball because he was too busy dropping F-bombs.
  • A woman sitting straddle-legged behind a man on the steps of our Glenn Medical Education Building. . . . lovingly placing cornrows in his hair like they were at home.
  • That hair-braiding woman asking me for "some money for food because we homeless" which let me know that, actually, they were at home.
  • Me looking at my tapping foot as she spoke and hoping that if I gave them money it would not be spent on the terrible habit controlling nearly half of my inpatients this week.
  • That hair-braiding woman shaking her head no when I told her my concern about giving money.
The Glenn Building at Grady

  • Three residents waving at me from across the street
  • One security officer teasing me about the fact that I often forget my badge
  • A senior faculty member passing me on the way to their ground level "senior faculty level" parking space
  • My iPhone with two text messages across the front: One from the fourth year medical student who had been on my team all month asking about "his patient." All the way from San Francisco where he was at the time.  Felt my heart swell at the reference of this person as "his patient" and the fact that from his vacation he was still concerned enough to reach out about him. 
  • Quickly punched a reply: "Your patient--just saw him and is recovering from his surgery well. Asked about you and would be happy to know you asked about him, too!"
  • The other text? One from the B.H.E. . .very simple and very Harry:  "Love you."
  • Before pulling out of the garage, tapped back our favorite reply:  "Me too."
Totally wanted to yell, "Do the running man! Do the running man!" 
(Click the image if you don't know what "the running man" is.)

***
Happy Monday.

Sunday, August 28, 2011

Come on, Irene.

As my blog-friend says, "Irene can suck it."

Mother Nature was nice to us in Atlanta this weekend. But that doesn't mean we aren't thinking of and praying for those to whom she hasn't been as kind.
I pray that you and those you love and are worrying about are shielded from any calamity or catastrophe that this hurricane is trying to bring. And if for some chance they or you are affected, may the recovery be swift, the assistance be abundant, and the resources be great.

Amen.

***
Insert "Irene" for every place that Dexy's Midnight Runners says "Eileen." I admit I still have no idea what this song is about. But it works for this situation. . . .

Friday, August 26, 2011

A different position.


There's something in the way she moves,
Or looks my way, or calls my name,
That seems to leave this troubled world behind.
If I'm feeling down and blue,
Or troubled by some foolish game,
She always seems to make me change my mind.

And I feel fine anytime she's around me now,
She's around me now
Almost all the time.
And if I'm well you can tell that she's been with me now,
and she's been with me now
Quite a long, long time
And I feel fine.

~ James Taylor "Something in the Way She Moves"


This month I cared for two different patients who, for the most part, had been completely healthy before being hospitalized. These patients were polar opposites in a lot of ways. . . . .one was an elder of a non-Christian faith with skin of deep espresso. He had the kind of medical problem that is super common and rather serious. . . .but also one that usually doesn't concern younger folks. Either way, he didn't let that frustrate him. He would smile with all of that peace oozing from him which always seems to be the case when I meet people of his faith.

The other patient was a man at least fifteen years my junior. His voice had a musical twang and his pale skin would flush every time I laid my stethoscope on his chest. The Holy Bible sat on his window sill and so did a Nascar racing magazine. He asked me if I knew anything about Jimmy Buffett because he was on the television above his head, and then laughed out loud at me when I asked, "Is that the guy with all the money?" I immediately wanted to take it back because three seconds later I remembered my friend talking about him and Margaritaville and such. Oh well. Jimmy Buffett, Warren Buffett. . . tomato tomah-to. . . picky-picky.  Either way, it sure made for some good fodder for me to bond with my patient and his wife that day on rounds.  (Jimmy Buffett fans are surely spitting out their coffee as we speak. . .)

Anywho.

They both had one major thing in common, though. Both had wives perched beside their beds every single time I came into the room. Every. Single. Time.

Wait.

Not "wives" as in a big group of sisterwives or something like that. Errrr. Not that I have any strong opinions about sisterwife situations; I'm just clarifying what I'm saying. Anyways. Each man was accompanied throughout their hospitalization by his own wife. The entire time. The peanut butter to their jelly. The sho' to their nuff. The "o happy" to their day. And it was noticeable and special and inspiring.

So what was funny was how very different they appeared on the outside. The elder's wife smiling softly with layers of beautiful fabric covering all but her lovely face. Framing her twinkling eyes and smooth cocoa complexion. And then the Nascar-fan's better half. . . . sitting cross-legged in the bedside hair. She had stick straight hair pulled high into a tight pony tail that flipped from side to side every time she looked at her husband . . .framing her pristine porcelain skin that had been protected by (mostly) youth and (likely) judicious application of sunblock. But she too had those twinkling eyes.

See, the thing about them both is this: I always felt the same way every time I entered the room. Like the love was palpable, you know? I could feel the concern that these women were feeling for their loved ones, and the concern that the patients felt for their wives being concerned. And no. This wasn't about the fact that it was a man and a woman, either. What was striking was that it was love. Just pure and simple love.

This morning I'm reflecting on love. Pure and simple love. What I know for sure is that no matter how different we all appear on the outsides, on the inside--literally--our hearts are virtually indistinguishable. How we feel in our hearts starts off roughly the same, too. And just like those literal hearts, they can change with what we do to them. Life and upbringing try hard to morph our hearts from seeing love for what it is, but. . .  when (and if) we'd just step back and marvel at these tiny moments. . .  the truth always leaps out. . . .just like those twinkling eyes.

I sat on a parenting panel with a woman who had a small child with her same-sex partner. The animated movements of her hands and enthusiasm in her voice when speaking of her child was identical to my own. The crackling of her words when describing the first seconds when she saw her partner laboring with the baby was just like mine when reminiscing on Harry coaching me as the boys came into the world. So alike. But on the outside? So different.

That Grady elder said something to me that I stuck into my pocket to revisit later. He told me, "You know, we are so much more alike than we are different. As long as you have love in your heart, we are the same religion, the same color, the same everything."

And I am telling you. . . .as sure as I type this, those are the words he said. He went on to tell me that you have to position yourself to receive love. Position yourself to hear things like this from patients and to see good. He said that some folks don't have conversations like this because they don't bother to position themselves for this kind of thing. Hmmmm.

Position yourself to receive love?

I loved this concept and stuck this in the pocket over my heart.

Today? I'm going to try to position myself to receive more love. I'm going to watch and listen and look for the similarities and not just those differences. Yeah, man. That's what I'm going to do.

That's all I got today.


"And now these three remain: faith, hope and love. But the greatest of these is love." ~ 1 Cor 13:13

***
Happy Friday.


Now playing on my mental iPod. . . .one of the best songs ever.

Thursday, August 25, 2011

Top Ten: The Kitchen Table.

First day of Pre-K. August 2011


They grow up.

*sigh*

Yes. .  . they do.

Our kids, yes.  But see, if you're an educator of any sort you know that your students eventually take wings and fly away, too. . . . .

With Small Group Alpha at the AIDS Walk, Atlanta, Georgia. October 2008.


In July of 2007, I had the joy of starting a journey in medical education with my first small group of medical students.  This past March, all but one (who was getting a Masters in Public Health) matched into the residency programs of their choice. It was such a proud moment.

With Small Group Alpha at Match Day. March 2011.


In May, the same group graduated from medical school.  And I got to do the honors of actually hooding them with their doctoral hoods.

In a word--wow.

Yeah. That was another proud moment.


Commencement. Emory SOM. May 2011.


Like any mama who's seeing some of her birdies leave the nest, it was bittersweet.  Would they remember sitting around the kitchen table sharing about all the new things they'd been learning? Would they somehow become strangers to me. . . .eventually moving on so far that our time together becomes no more than some remote memory that evokes a warm nostalgia?  Even more. . .would they still be family to each other?  Would they?

I had an adviser in medical school that I felt sure I'd never lose touch with. She was smart and helpful and caring and the best role model. In fact, she was the one who alerted me that I didn't actually want to be a surgeon. She said, "Kimberly, if you love the wards and talking to patients, but hate being in the OR. . .I don't know how to break it to you, but this is what they call Internal Medicine."

Ah haaah.

I was sure I'd always be in contact with her. . . but I confess that hasn't been the case. I did see her briefly at my five year med school reunion, but admittedly haven't seen or spoken to her since.  I don't know what this says about me but I do know that time marches on and little birdies fly away. Out of sight and (seemingly) out of mind.

But not always.

These seven birdies? I've let them go, yes.  But lucky me, they still seem to find their way to my virtual kitchen table. . . throwing pancakes at each other and squirting milk from their noses.  Laughing out loud and sharing painful moments of internships that make me cry.  Just like old times.


This week, they all checked in with me.  I was feeling particularly nostalgic and had an idea. "Take a picture of what you're doing right now wherever you are," I said. "As long as it isn't obscene."  (Which I have learned is a good idea to tell twenty-something year-old people when making such requests.)

And so. I bring you a top ten. . . .dedicated to my recently departed little birdies who, much to this mama bird's delight, have continued to chirp loud enough for me to hear.


Top Ten

#10  ~  Alanna.
Alanna at UC San Francisco, August 2011

Hard at work on the wards in San Francisco. Connecting with patients. Making care a verb. And then coming home to hug her sweet husband, Luke. Here is what a patient's family wrote to her last month:

"I don't need a crystal ball to see that you'll be a great doctor."

And here is the view she sent me from the hospital parking garage earlier this week:

Can you believe this picture?

#9   ~  Antoinette.

Ant in Guatemala, August 2011

Here is the most fluttery of my birds. . . my world traveler, Antoinette.  She added an extra year to school to get an MPH and now she is applying to Ob/Gyn residencies.  This photo was taken where she happens to be currently -- Guatemala.  She is participating in a research project there and is further developing her (already amazing) Spanish-speaking skills.

Ant is a 100% fearless traveler and live-er of life. She has a self-awareness that is unparalleled. Knowing her makes me better.  Here is what she had do say at the virtual kitchen table the other day:

I don't think any one of us really knew the power of reflection and reflective writing when we wrote that first piece, together as a small group, in that basement room in the SOM.  And while I know Dr. M has made reflection a part of daily living, I still feel like I've got a lot of work to do in that department. But I know I am more self-aware and more aware of others and their stories because of you guys." 

Hello? If you get any more self aware there will have to be two of you.


#8  ~  Tony.
Tony in Detroit, Michigan. August 2011

Here is a snapshot of him signing a prescription as a sho' nuff and bona fide doctor.  Doesn't he look happy about it?  That's because this future ENT doctor is happy about it.  Being a doctor, that is.

Here is what he sent our small group the other day:

"Okay, so I don't know if this hits you guys every now and then. . . but wow. I can't believe we get to do this for a living. Amazing."


Yeah, man. Amazing, indeed.


#7  ~  Jin.

Jin in Washington D.C. , August 2011

Jin is in a military residency and is caring for America's heroes.  Here is what she had to say about her experience the other day:

I never thought about what's going on in the middle east until I started taking care of these guys. It's shocking to see how mangled they come in, though it's equally miraculous what he multi-disciplinary surgeons do here to piece them back together. My team is swamped but I'm surrounded by an awesome group. . . they're so pro-active and so practical. It's inspiring."


Preach, Captain Lee.

#6  ~  Adam (aka "Sparky.")
Adam on night float, St. Louis, MO. August 2011

One day during his first year, Adam walked into small group with a new hair cut. The first thing out of my mouth was, "Well hello there, Sparky!"  And what can I say? The name stuck.

Adam has been loving life as an intern in Internal Medicine at Washington University in St. Louis. He is surely living up to his name--"Sparky"--because he is truly like a light. . . .

Here's what he had to say about his experience recently:

"Medicine here is awesome. I love it. I am DOING things; that's what I signed up for. Also, I only have to talk about feelings about 10x/day."

(As opposed to the 10,000 times required in my small group. Ha.)

I can't get over how grown up he looks in that picture. Like he's on his way to save someone's life. I'm sure he was.

#5   ~ Hreem.

Hreem in the ER. Chicago, IL. August 2011
Hreem (pronounced "Rim") has been loving life in Chicago.  In preparation for her Ophthalmology residency, she is doing a Transitional Year first. Right now she has been on the front lines doing her ER rotation. Seeing lots. Learning lots.  Here is what she had so say in a recent message:


"As for the patients I'm taking care of, I've had some moments that have reminded me of how much I really love medicine and also how it is a constant learning process."

Ain't that the truth.


#4  ~  Doug.

Doug after a night shift in the Pediatric ER. Atlanta, GA. August 2011

Doug is so, so funny.  Not in that Chris Rock kind of way, but more in that effortless way that comes from never taking yourself too seriously. When he received my request, he took it literally and sent this. So, so Dougie of him.

Doug recently shared with us that a patient sent a message of thanks to him. The patient signed it "Psalm 147:3."  He looked it up and that scripture says this:

"He heals the brokenhearted. And binds up their wounds." ~ Psalm 147:3

Doug had this to say:


"Getting that from a patient when I had gone the extra mile made my night, my week, my month!"

Mine, too.



#3, #2, #1  ~  The Whole Nest.

Small Group Alpha, Class of 2011

 I'm so happy to have a growing nest. . . .and an expandable kitchen table.  The above picture is from when my Small Group Alpha was in their third year.  Hard to believe that this photograph below is of my Small Group Beta from around the same time in their med school training.  We all laugh at that thought because they all talk about how "grown up" these guys seemed to them back then.  

Small Group Beta, Class of 2013
  
I've built some equally magical memories with these guys and have heard some wonderful tales over pancakes with them, too.  They're all on their hospital rotations these days and just had a wonderful "fall break" between rotations.  I loved hearing of all the fun things they were doing this week. . . .like surfing down the coast of California. . . . traveling home to Indiana. . . .and visiting special people in Europe.

Oh yeah. . . and sending text messages like this one:



"Dr. M! I got engaged!!!"

Congrats Jenna and Rod!
See, it's fun to teach medicine and demonstrate the physical exam. But, man. It's also really, really fun to be on the short list of people that get called after pivotal moments.  That text message came after 11 PM on Saturday. And I didn't mind one bit.


And finally. . . introducing the newest members of the kitchen table. . . 

. . .hailing from Notre Dame, Duke, UNC Chapel Hill, Stanford, Emory, Davidson College, University of Wisconsin Madison, and Georgia Tech . . . .

Small Group GAMMA!

Don't they look just full of promise?
  

 And yes. I am already in love with all of them, too.

Oh, and if you're wondering how I manage to do my job and love my husband and love my kids and love all of these students, too. . . it's just like my Mudear told me when I asked her the same question of her eleven kids and thirty-some-odd grandchildren. . . .

"Your heart just makes room."  :) 

Ain't that the truth.
***
Happy Thursday.

Now playing on my mental iPod. . . .a favorite at my non-virtual kitchen table with Isaiah and Zachary. . .Nick Jr. style!

Tuesday, August 23, 2011

The Green Lantern.

"Then you'll finally see the truth
that a hero lies in you."

~ Mariah Carey


Does anybody have the manual that came with their children? I'm just saying. . . if you do, can I please borrow it for . . .I don't know. . .the next eighteen years?

I promise. . . I don't make this stuff up. . . .

***

Yesterday in the car on the way home from school:


Isaiah:  The legs broke on my Jake Justice and I really, really liked my Jake Justice.

Me:  You'll have to be kinder to your toys in the future, bud.

Isaiah:  Would you be able to get me another Jake Justice? We had him for a long, long time remember?

Me:  You've got plenty of toys to play with. Maybe we can see about you getting another one when Christmas comes around.

Isaiah:  Christmas! Christmas?  (lip starts quivering.)

Me:  Oh, come on, Isaiah. Really?

Isaiah:  It's just that . . . I really, really liked my Jake Justice. I really, really did.  (now crying)

Ugggghhh.  

Me:  Come on, son. This is not something to get this upset over. Besides, you have tons of toys and this is not the first time one has broken.

Isaiah:  (now whimpering/wailing) But this is different, Mom!  He's the one that makes me not feel left out!

Huh?

Me:  I don't understand what you mean, Isaiah.

Isaiah:  He has brown skin like me, Mommy.  He's one of the only superhero guys with brown skin! Nobody has brown skin that's a superhero but him, Mom!



Speechless.

Isaiah:  Mommy, not even Green Lantern. Remember? The Green Lantern in my bedtime book has brown skin but they changed him in the movie to have white skin.

Speechless.

Isaiah:  Why did they change him, Mom? What was wrong with him having brown skin?



Rut roh.



Whew.

Isaiah:  I just want another Jake Justice, that's all. (now a little whimpery whine.)

Lawd.

Me:  Isaiah?

Isaiah:  Yes?

Me:  Your skin is beautiful and so are you.



Isaiah:  Yes, ma'am.

Me:  And Isaiah?

Isaiah:  Yes, Mom?

Me:  A long time ago when they first drew the Green Lantern in a comic book he had white skin. And then they changed him and he had brown skin. And then they changed him again for the movie and he had white skin again.  But the whole time he was still tough and a superhero and helped people. No matter what color his skin was.

(Okay, okay. . . I admit that I had Wikipedia-ed this question when the trailer first came out.)

Isaiah: But, Mom? Sometimes it makes me feel left out when none of the superheroes have brown skin like me. Not Superman, not Spiderman, not Batman, and not even Captain America. The only one was Green Lantern in my bedtime book. And my Jake Justice. But he's broke now.

Me:  Broken. (habit, sorry.)

Isaiah:  Bro-ken.  And they changed the Green Lantern to not have brown skin anymore. 

Gulp.

Isaiah:  And sometimes. . . .sometimes. . .  that kind of hurts my feelings and makes it seem like it's better to not have brown skin. Like the Green Lantern.

Oh Lawd. Somebody call Dr. Huxtable, for real.  

Me: (stammering) Uhh. . .so. . . do you think that? Like . . .think that it's better if you didn't have brown skin?

Gripping steering wheel real, real tight. . . knuckles whiter than the new Green Lantern. . . 

Isaiah:  (thinking) No. . . . I like my skin. But that makes me feel like somebody else doesn't like it when they changed the Green Lantern like that. Like they liked him better if he didn't have brown skin.

Mom? Dad? Can I get a consult here?

Me:  You know, Isaiah. . . .I'm not sure why they changed the Green Lantern. Maybe it wasn't even that big a decision when they did. But you know. . . there are some people who don't like other people for nonsense reasons. Like for having brown skin or being too short or being too tall or speaking another language or liking who they like. Really dumb reasons. So you just have to love how God made you no matter what anybody else thinks, you know? And then you just have to keep it moving.

Isaiah:  What does 'keep it moving' mean, Mom?

Me:  It means you look in the mirror and know that the way you were born was exactly right. You give yourself a thumbs up and then go on back to doing what you were doing. Like playing or coloring or doing karate chops. You remember that you are wonderfully made and once you know that you keep it moving.

Isaiah:  Okay.

Me:  Hey Poops? You know what?

Isaiah:  What?

Me:  Those guys are all make believe, you know. Those superheroes. And you can make believe anything you want in your own imagination. In your imagination, superheroes can be any color you want. Even blue-skinned with green hair.

Isaiah:  Blue!  (giggling)

Me:  Oh, yeah. Blue with big blue muscles. Especially if they're make believe.  But there are some real superheroes who do have brown skin just like you.  In real life.

Isaiah:  Like Obama?

Yaay. Yay, Yay, YAY.

Me:  Obama? He's one of them. . .yeah.

Isaiah:  And my dad. . .and my Papa. . . and my Uncle Shannon in Iraq.

Me: Yep.

Isaiah:  Mom? You could say Martin Luther King, Jr., too.  (now smiling)

Me:  Yep, you sure could.

Isaiah:  Can you think of any more?

Me: Yep, I've got one that you forgot.


Isaiah:  Who, Mom?

Me:  You.

Isaiah:  Me?

Me:  You. 



I looked in my rearview mirror at Isaiah. He was looking out of the window smiling. At what? I do not know. But the sight of it still made me smile too. . . .



That night, I logged onto Amazon and ordered him another Jake Justice.  And it wasn't even Christmas.

***
Happy Tuesday

Now playing on my mental iPod. . . . India.Arie singing "Brown Skin". . .just sang a "Mom version" of this to my kids. :)

Monday, August 22, 2011

Paradigm shift.



"Oh man, I heard you guys got him on your team last night. Oooo weee."

"I think this is my first time taking care of him," I replied.

"Really? Damn, how could that even be possible?  Dude. Everyone has had him before."


This was the exchange I had with a colleague the day after my team admitted this frequently admitted man to our service. Yes, him. He was well known to nearly every physician in our hospital because of his constant revolving door hospitalizations for his underlying--and yes, complicated--medical problems.

But mostly, he was also known for being difficult.  Real, real difficult.

"He will cuss you out and then throw you out." This was what one of the senior nurses had to say about him. She went on to say, "Chile please. . . . I've taken care of him so many times that I don't even take it personally any more. He's just a miserable, miserable little soul." She shook her head and punched in a code into the pixis system.

Hmmm.

Him. That difficult guy of legendary status. Challenging enough to grate on the nerves of even the most seasoned Grady nurses--which is pretty difficult to do. Him. Also known as "a miserable, miserable little soul." Guaranteed to either demand that I get out of his room or yell expletives in my direction until I turned red in the face and am rendered completely useless as a clinician. This was the word on the street about him.  Demanding and difficult. Demanding his pain medications. Demanding someone to "cave" in the face of his unruly behavior. And just downright demanding a whole bunch of things.

Yes. This was the rundown that I'd heard.  And no. Nothing about him sounded appealing. At all.


Even one of the nicest people in the entire hospital had this to say:

"Look, there's just no other way to spin it. He's just an asshole." 

Damn.

An asshole?

Look. We're all grown folks here and sure, I'd like to pretend like every single health care professional is SO professional that he or she would never, ever even go so far as to THINK of a patient as "an asshole"--let alone actually say it. But the reality is. . . .members of health care teams are human. They have feelings and nerves that, despite their altruistic origins, can be stepped on. And deep down inside of every single one of them is that "OH HEEELLLL NAW!" button that some patients just push.  If they can find it.

And this guy? He seemed to know exactly where to find it in every person he encountered.

So the count was now at "oo wee" and "miserable, miserable little soul" and now, "an asshole."

My team had seen him first and I knew they would tell me all about him on rounds. A palpable heaviness came over the entire team as we got closer to his room.

Everyone who had already met him looked so tired. The intern. The resident. Even the bright-eyed bushy-tailed medical student. This man had found their button and pushed it hard. They looked so tired. Which immediately made me feel tired.  And I hadn't even met the dude.

Before I could even get down the corridor in the ward, another person saw us approaching and chimed in their jovial two cents.  With a thumb pointing in the direction of his room, the passerby laughed and said to me sarcastically:

"Wow.  . . . Good times, Dr. M."

This was getting nuts. I offered a half-hearted smile and nodded as I watched the passerby disappear into the neighboring room.

Uggghhh.

We paused in front of the door and all focused our attention on the intern. The same tired-looking intern who'd been given the distinct pleasure of admitting him to the hospital. Not tired-looking as in I-was-up-all-night-and-might-be-an-assassin. More tired-looking as in this-dude-is-working-my-nerves-so-bad-that-I-am-dangerously-close-to-catching-a-case.

The intern's face was twisted and emotionally exhausted as he reached into his pocket for his notes.. He shifted between his feet and did his best to channel the most empathic part of his psyche. Next, he launched into this patient's story. The same story that seemed to be playing like a broken record all over Grady Hospital.

Suddenly I heard someone hollering from the other side of the door.

"Jest get the f--k out of my room! I ain't doin' none of that! Get the f--k out!"

My intern looked over his shoulder at the door and then down at his shoe laces. Kind of like a child that was being forced to do something he really, really, really didn't want to do.

"Wow," I said wincing as one of the patient techs passed through the door after being kicked out.

"It's bad," my resident said.

"It's awful," the intern cosigned.

"Oo wee"
"Miserable, miserable little soul"
"Asshole"
"Bad"
"Awful"

I felt like a person who was waiting for a fight after the school bell. All this build up was just too much for me to stand any more.

"Alright, y'all."  I finally interrupted my own thoughts and the intern's presentation that he'd just resumed. "Let's think about this for a minute."  The whole team paused, almost like they were all being operated by a DVR remote controller. I sighed hard and was honest with my intern. "I'm feeling completely drained by this patient and I haven't even met him yet."

"Dr. M. . .he's difficult. Like. . .so manipulative. . .it's just. . .I don't know. I'm sorry."

"No, I hear you." I stared at the card with my notes scrawled all over it and looked over at his door again. "Okay. Let's make a pact. Regardless of how he treats us, we will treat him with kindness and respect. And we won't fight with him. No passive aggressive stuff from us, either." That statement seemed to make my team bristle a bit, so I quickly tried to clean it up. "I mean. . .there is no way that this guy is getting the warm and fuzzy treatment here. No way. I haven't even been in there yet and nearly five people have already made it very clear that being tazed by the Atlanta Police would be far more pleasant than being the person caring for him."

"Tazed?"  one of the medical students asked.

"Yeah, tazed," I repeated. I reached in my pocket for my phone and pretended to jolt him in the arm with it. The team released a bit of much needed nervous laughter. "I'm just saying, guys. How about we just decide right here and right now to throw everyone a curve ball?" I had their attention so kept going. "Look, y'all. Every body was once somebody's baby. This man could not have aspired to be in and out of Grady Hospital infuriating ER staff and ward teams when he was five years old. Like, do you really think he drew himself like this with his crayons when he was in kindergarten? I don't think so." No one said anything. "I know it probably sounds corny but. . . .I say we just try to see that five year old."


Yep. Corny indeed, Dr. Manning.

So in we went. We talked to him as a team and examined him, too. And you know? It wasn't so bad.

I'd be lying if I told you some lovely story of a cosmically heartfelt interaction shared between us. Okay. . .yeah. . .  wouldn't it have been nice if I told you that the heavens opened up and that he'd become wonderfully angelic? Wouldn't a perfect ending have been for us sing kumbayah and all cry together? Yeah.  He was still 100% difficult, 200% unreasonable, and 300% annoying and manipulative.

Yes. I said it. Annoying and manipulative.

But you know what? Sometimes my kids can be annoying and manipulative. And hell, depending upon what's going on with me and my husband, I can be the same way--especially when I'm dealt a hand that I don't like.

Hmmmm.


Shortly after we saw him that day, someone walked up to our team and made another negative comment about this patient. In unison, we all just sort of looked at each other and didn't really respond. For the rest of his hospitalization, we spoke of him with compassion, paid no attention to references about his prior behavior, and . . .dare I say it? Simply showed him some love.

Cliche, I know.

And you know what happened next?

By the end of his hospitalization, nearly everyone else did, too.

***
Happy Sunday.

"The greatest healing therapy is friendship and love."  ~ Hubert Humphrey.

Wednesday, August 17, 2011

Leave it to the professionals.




"If I gave you sanity
For the whole of humanity,
Had all the solutions
to the pain and pollution
No matter where I live,
Despite the things I give,
You’ll always be this way
So go ‘head and….

Hate on me, hater
Now or later
‘Cuz I’m gonna do me
You’ll be mad, baby
(Go ‘head and hate)
Go ‘head and hate on me, hater
I’m not afraid of
What I got I paid for
You can hate on me
."

~ Jill Scott's "Hate on Me"


_________________________________________

I was talking to a (beautiful, brilliant) friend on the phone the other day who laughed and said this during our idle conversation:

"Seeing as I'm a fat cow, I don't need to be eating anything."

Wait, huh? A fat cow? Wow. That's kinda harsh.

Alright, so here's what's on my mind today. . . .

Okay, can I please just step up onto my little soapbox for a moment-tito?

Ah hem. Don't mind if I do.



"Don't need no hateration. . . ." ~ Mary J. Blige

Now check it. I can assure you that if you have lived on this earth long enough, there is somebody somewhere who has had a negative word or two to say about you. Yes, YOU. They have either done so maliciously or through the ever-elusive backhanded compliment. Sometimes that person is a total stranger and other times it is one of the people nearest and dearest to you. Regardless of all that-- trust me, you've been "hated" on. Perhaps, like my friend did to herself, they have also gone so far as to criticize your eating habits. . . . referring to you as something even worse than a "fat cow." Maybe, just maybe, they called you a "beluga whale" instead. Or maybe even a "hungry, hungry hippo."

Yowza.

What if weight isn't your issue? What if it's something like. . . . how you talk or how you walk or how you do whatever it is you do? What if you are too short or too tall or speak with an accent or speak with an impediment or have a mole on your forehead or are gay or are effeminate or tomboyish and seem gay but aren't or are very conservative or are very not conservative or . . .or. . .or. . .sigh. See what I'm saying? There's always something to hate on.


I have found that of the worse things that YOU can come up with to hate on yourself, there is always someone somewhere who can do it better.

Which brings me to my soapbox and my mantra on self-deprecation-slash-self-hateration:

Leave the hating to the professionals. They are much better at it.

Someone who is looking to really insult you or cut you to all the way down to the white meat can probably do it much more efficiently than you can. Like, you might look in the mirror and pick yourself apart piece by piece. One tiny shred at a time. How inefficient! See, this is why you need a professional hater to do that for you. 'Cause a professional hater? Chile please. They rip the band aid right off.

Case in point:


You say "fat cow."
They say "gastric bypass called and said they missed you last week."

Ouch.

See? I'm saying. Why should you even bother insulting yourself? You just have know that someone has already made that their full time gig. And most are willing to work overtime at it. So leave it to them.

I know, I know. This sounds so unlike the Pollyanna Grady doctor, right? But honestly? It's really a feel good message. It really is. Because being mean can become habitual. And my point is that there are plenty of miserable people that have made it a habit to do just that--and they don't need your help.

But.

There are scores and scores of us who have targeted ourselves for our most consistent insults. Almost like we have this need to preemptively strike against ourselves before someone else can. And to that I say, Eeeeeeeehhhhnnnnnn! (*buzzer sound*)

So as of today, I declare the rest of this month: "No Hating on Myself Month."

Here's how it will work--quite simple, actually. The rules are that you can't say anything negative about YOURSELF for the next two weeks. In other words, for the rest of August, you make a pledge to leave all hating to the professionals. (Remember--they're much better at it.)



Here is the pledge:

(Place your right hand over your hip and then let your backbone slip)

I, insert your name here, do solemnly pledge to allow no insults directed toward or about myself to leave my lips for the rest of the month. This includes but is not limited to references about the following:
  • butt size

  • hair length

  • baby weight

  • belly circumference

  • skin surface

  • crows' feet

  • height

  • complexion

  • salary

  • material possessions

  • marital status

  • relationship status

  • grades

  • achievements in comparison to someone else

  • achievements of your children

  • size of your house

  • make of your car

  • mistake from your past

  • compliments to others with reflexive insults to yourself in same breath

The good news is that you can liberally make reference to the following:
  • Craziness of your own family members (but only in presence of other family members)

  • Annoying quirks of your significant other (but only in absence of your significant other)

  • Any person who stars on any reality television show including but not limited to any Kardashian, Snooki, the people on the Parking Wars show, and any of the housewives Real or Basketball. (Exception to this rule: "Swamp People" and the daddy on "Pawn Stars.")

***(play the anthem below and shake what your mama gave you if you commit)***

Vowed on this day in August 2011. . . . (insert your name here.)

***

If you are prepared to go on this self-hateration diet for the next two weeks and you pledge to leave it to the professionals, make your mark, people!

Oh. . .errr. . .or just comment. Heh.

Okay but on a serious note--JoLai and I did this last summer and it was amazing to have it brought to our attention how often we insult ourselves. We were floored at how much thought it took to not dog ourselves out--because even when it's done in humor, it's still not cool. And please don't get it confused--not hating on yourself doesn't mean that you aren't self-reflective or self-aware. If you cut people off when they talk and you notice that about yourself, by all means work on it. If you drive through the Chick-fil-A window and have that 1500 calorie shake three days a week, rethink that, too.

But calling yourself a "stupid blabbermouth" . . .or rather referring to yourself as a "fat pig?" That's a counterproductive no-no. Ya dig?

Alright, who's down?




You wit' me?


***
Happy Wednesday.

***
Now playing on my mental iPod--the "No Hating on Myself Pledge" anthem. . .
The one and only Jill Scott singing "Hate on me hater."