Tuesday, May 15, 2012

Acute-on-Chronic Parental Pride.


 [uh-kyoot] : sharp in effect; intense; sudden


 [kron-ik] : constant; habitual; continuing over a long time or recurring frequently


My parents are chronically proud of us--that is, their children and grandchildren. They have no problems showing an entire iPhone folder's worth of photographs of their offspring to perfect strangers--or even YouTube videos in case that isn't enough. But, yes, the word for it is chronic because just like some longstanding medical condition this feeling for them is constant and habitual. And fortunately for us, it has continued over a long time.

Sometimes a person comes into the clinic with an intense and sudden pain. We call that kind of presentation acute.  Acute--like the definition describes, can be sharp in its effect. . .and kind of like the angle you learned about in 9th grade geometry, it has a swift incline. When we're talking about pain, that delineation between acute and chronic is important because it totally affects how we see it . . . .and how we treat it.

Pride for your kids is kind of like that, too. It can certainly be acute, depending upon the situation.

Sometimes in medicine, we see a patient who has a chronic or longstanding problem like . . .say. . .a bad case of sciatica. (Sorry to keep using pain as an example.) On some days--just out of the blue-- that normal undercurrent of pain gets much stronger. . . .more sharp in its effect. We have some medical jargon for that kind  of scenario, too. We call that kind of symptom "acute-on-chronic."  That's when you already have something but then your symptoms get a little added umph to them on certain days. 

Pride for your kids can be acute-on-chronic, too.

Stay with me. I'm going somewhere. . . . I promise. . . .

Yesterday I got to do something that forty-somethings rarely get to do. I got to make my parents acutely proud. So intense and sharp in its effect that my father broke down and cried. So sudden and strong that my mother came very close to exploding. But since my parents are already chronically proud of us, this was more of the acute-on-chronic type of pride. Which if you ask me, is something that deserves its own category.

Emory held its 2012 commencement exercises yesterday. This is a big day in these parts, and we have the traffic jams all around the Emory Village to show for it. Over 4,000 degrees were conferred altogether if you count all of the schools. Fortunately, only 130 or so of those were doled out at the School of Medicine ceremony.

me and Lisa B.

Okay. So first, I have to say this:

Our final "mean mug"

Antoinette graduated yesterday! And. . . guess what? I got to hood her! And look, this was a huge deal to me because you have to recall that I have known her since her very first day of medical school when she was assigned to my small group of medical students. So yes. Ant, my soul survivor from Small Group Alpha, received both her Doctor of Medicine and Masters of Public Health diplomas. . . . and I was the lucky person waiting on the other side of the stage. What an honor it was to be the first to hug her when they announced her name as DOCTOR Antoinette! 

And aren't you impressed that I didn't even cry?

Now. . . of course you can see from this photo how acutely proud this made me. Or rather it was acute-on-chronic pride. 

Yeah, that.

Which makes sense, right? I mean, she was getting a terminal degree and all. I know her parents felt an even greater sense of elation and perhaps some wistfulness, too. Because like I said . . . these hyper acute parental pride moments become fewer and more far between the older children get. So parents cherish them all the more. . . and they take lots and lots of photos to savor the moment for as long as they can.

At least they should.

Perhaps this is one of the toughest parts of seeing kids grow older. Less of those dizzying acute parental pride moments. 

Maybe? Maybe not.

Anyways. After we marched into the ceremony and assembled in the faculty seating on stage, I noticed an unusual sight right away:  My mother. I looked over at my colleague, Lisa B., who was sitting beside me and said, "Uuuhh, okay. Why is my mother at the Emory Med School commencement?"  

And Lisa, who is the world's worst liar, looked over at me and tried her best to look doe-eyed and innocent. "Your mom? Why would your mom be here? It's probably her Doppelgänger." 

Probably her Doppelgänger? Hello. It's my mom. Tounces. Shugsie. Cheesing with all thirty-two teeth showing and sitting on the fifth row.

"It's definitely my mom. I know my mom when I see her. I'm kind of freaking out. Why is my mom here?"

And Lisa just looked at me and then reached out to squeeze my hand. 

A few moments later, I saw a smooth brown head peeking out of the crowd--right next to the lady who looked curiously like my mother. Unless there was also a Doppelgänger there for the BHE, it was official that both my mother and my husband were sitting in the audience. At the Emory University School of Medicine graduation. Wait, huh? Last I checked, I'd already received my medical school diploma sixteen years before.

So I lean into Lisa B. again and say, "Uh. . .okay. The twin of my mom is sitting next to the extremely hot twin of my husband."  And her face just turned this very darling shade of red. Her eyes also started to water as only a true friend's eyes can in such a moment.

Deep breath.

The next part was surreal. A man -- who I am now lucid enough to acknowledge as the president of the Emory Medical Alumni Association -- goes to the podium and begins by first greeting and congratulating the graduates. After that he prepares to announce a major teaching award given by the Alumni Association each year called "The Evangeline Papageorge Distinguished Teaching Award."  I happen to know just how big a deal this award is because a few years ago, the very friend who was sitting beside me (Lisa B.) was bestowed that very honor. In preparation of my obnoxiously effusive email to our colleagues and friends, I did some data mining about the history of the award. 

And let me just say this: It's kind of a big deal.

"The award honors the legacy of Dr. Evangeline Papageorge, a graduate in the class of 1937 who was a beloved teacher and administrator. This coveted award is given annually at the School of Medicine diploma ceremony to a faculty member  'whose intellectual luminosity has generated the greatest excitement about learning among students and colleagues'."

Intellectual luminosity? Uh, yeah. That's kind of a big deal. Such a big deal, in fact, that when someone wins it, they often notify their family to be present. 

That or their Doppelgängers. 

And this is quite funny considering how many "intellectual luminosity" jokes I've cracked on Lisa B. since she won the award in 2009.  But that's okay because I have other awards to tease her about. 

Anyways. . . .ha ha. . .where was I?

Oh. . . so yeah, this gentleman begins reading excerpts of nomination letters about the winner. And these words are extra special because the only way to be nominated is by current medical students. So these were the words of learners. Verbatim. 

The way Lisa was squeezing my hand made it clear to me that just maybe these were more than just words. Just maybe, on that day, those words were about me. My heart was about to jump out of my chest with every quote. All I could think about was the fact that my mother and husband were under the sound of his voice. And especially my mom. And though at this point, I can't say that I was absolutely 100% sure that this was me they were speaking about, I knew for certain that if it was, that what it meant for my mother to hear them was exponentially better than anything I could be feeling.


And then it was confirmed. He said my name. And people started applauding and my legs started feeling like Jell-o. My heart was pounding so hard that I put my hand on the shoulder of Dr. Felner, one of the senior cardiologists, as I walked to the podium -- just to make a note of where he was in case I had a full on cardiac arrest.

The rest was like white noise. 

As I returned to my seat, I sat there stuck in between two feelings--one of just wanting to run off the stage and hug my mother, my husband and all of my students -- and the other was just wanting to drop my head into my lap and do the full-on ugly cry. Then I thought to myself, "Now if my father had been here to hear that, he would have ugly-cried for every person in the room."  That thought made me smile more than cry.

That and Lisa B. squeezing my hand super-duper tight and hugging my neck repeatedly.

My colleagues were kind and offered thoughtful words and shoulder squeezes. It felt good to receive those affirmations, but especially knowing that one of my parents got to see it in person. And Lord knows that the BHE was proud, too, but we all know that it's different for a parent. It just is.

So this moment was wonderful and just when I thought I could not get any more so, I marched off of the stage and saw -- right next to my mother -- wait. . . huh? 


It was. . . .  my dad

Yes. My sweet Poopdeck standing on his feet and still patting his leaky eyes. He had flown in all the way from Los Angeles just to see his daughter get this award. And that? That was like a blast of helium that made me nearly float out of that chapel. 


I could see it in their eyes. This was not their regular chronic proud. Yesterday, my father and my mother were acutely proud. On top of the longstanding, chronic pride they already had. Deeply, intensely, acutely proud. It's hard to even put into words.

Lucky me. Lucky us.

Even my brother was there. As busy as his schedule is, yes, he was there, too. Sitting right beside my husband like the brother he is to both of us. And that? You know that made my heart soar even more. Because I know that my dear husband and my sweet friend, Lisa B., had gone out of their way to get those important people there. And it did not go unnoticed. And it never will. Not one single bit.

When I walked outside I made a decision to pay very close attention to this moment. To intentionally take mental pictures in the highest of definition and to allow myself to savor the fine details. And yes, I know that I don't need to win some big award to make my family happy, but still. . . .this was a pivotal moment. Any chance you get to make a parent this acutely proud is pivotal indeed.

Happy Mommy

This picture is so her--so, so her.

The B.H.E.

always by my side

Does the brother hang a suit or what?

Dr. Ant!
Tounces has hugs and flowers for more than just me! Ant is a part of our family so it makes sense.

More Tounces, the smiling mom!

Ant with Jen S.-- she's staying with us for medicine! Yay!
Chatting with big brother, Dr. Will
Omega Men -- Dean Lee (multicultural affairs), The BHE, Poopdeck
We are family.
Marla (SG Beta) and Nate (advisee extraordinaire!)

I felt like I was the one who graduated!

Funny. I initially thought I wouldn't even post about this. I worried that it would be self-important to be telling it on the mountain that you won a big teaching award. But I knew that I wanted to hold onto that day so I went ahead and fought back that "little voice" knowing that I had to write about it. 

In fact, I read my writing mantra first. . . and then did just that. I wrote about it.

With Dr. Lee -- he's the best!
With my Department Chair, Dr. Alexander
with one of my favorite Grady doctors and leadership mentors,  Dr. del Rio aka "CdR"
With Neil W. -- mentorific mentor extraordinaire and celeb on this blog!
With Dean Eley -- my kind of people

It's interesting. Acute things are often short-lived but can make our patients pretty unhappy. Chronic issues can ruin someone's quality of life longterm. And acute-on-chronic eruptions of whatever it is a patient is dealing with can be eerily similar to throwing gasoline on top of an already crackling bonfire--


Unless you are talking about acute-on-chronic parental pride. Then it's the biggest and best kind of explosion you could possibly imagine. . . . .

me and my daddy


Sigh . .  . . yeah. . .like that.

Happy Tuesday.

My favorite shot of the day: Dr. J. Felner, prior recipient of the Papageorge Award -- 
"resting his eyes, not sleeping"

To the current and former Emory University medical students who took part in this nomination and who take part in my life every single day~

Words cannot express how grateful and humbled I am. I promise to honor your kind support and work even harder. Remember. . .the relationship between teacher and student has always been symbiotic. . .we need each other to survive. Thank you for teaching me, too. 

Pay it forward--and always keep it human. . . .

Dr. M

TOTALLY playing on my mental iPod right now . . . "Closer" by Goapele -- please listen. . .it's beautiful and so is she.

. . .and if it couldn't get better--Poopdeck left this and went to see his granddaughter (my brother's daughter) receive this--straight A's on the Honor Roll. . . .on the very same day. Talk about hyperacute-on-chronic Grandpa pride! Go Tyler!

(p.s. Sorry for all these weird giant spaces. They weren't for effect! Blogger was punishing me for some reason!)


  1. Wow Dr. M, CONGRATULATIONS! It comes as no surprise to me that you were given this most distinguished award. Your enthusiasm for and excellence in your work has been evident in each and every one of your blog posts. I can just imagine witnessing the real thing

    Very cool acute-on-chronic analogy of the pride of your adorable parents, gorgeous husband and sweet brother. And then to be followed up with your dad being there for your niece and your niece getting straight A's... The love, the support, the obvious family brightness gene - it is all so very lovely.

    Bask in your good fortune and know you deserve every great thing that comes your way.

  2. Congratulations!!! From reading your blogposts it's not a surprise. I believe teacher goes right underneath being a parent. Truly they can change a child's life for the better. And though your students are adults same difference. We that come here and read you know how humble you are. I thank you for sharing all that you do with us. Truly this world is a better place for having you in it and sharing your humanity with those you touch in person and on here.

  3. Okay, you got me with this one, a full on ugly cry, lol!!!!

    Congrats on a very well deserved award, in a line of many more to come!!!

  4. Your posts keep making me cry!

    Congratulations to you and to your family! So glad that your friends arranged for your family to be there to witness your amazing day.


  5. Oh, wow. CONGRATS!!!! A very well-deserved award. So glad your parents could be there to see it!!

    1. I knew you'd appreciate that! Your parents are AWE-SOME! Hello?!

  6. First of all, I cried when I read this. Congratulations. I know how important Daddies are. My mother is my rock, but Daddy is my heart. I love stories about daddies and their daughters.

    I don't even know you and I'm proud. Your post encourages me to go on and pursue greatness in my own life, at just the right time... when I'm tired and wanna give up. Thank you for your encouragement.

    Third, I wrote down your mantra. And I read it each morning. And I write each day.

    Thank you.

    1. No, thank YOU. . . .'preciate you, Alisa Renee!

  7. I was fine until I got to the picture of you and your daddy. Then I cried.
    You know why.
    We are ALL so proud of you. You are, in a way, OUR doctor-sister.
    And yes, your husband CAN hang a suit. And your mother is beautiful and your brother is fine.
    And you are amazing. I don't want to take one drop of credit away from you but when I see the love of your parents and their pride, I know exactly why you are the woman you are and have been able to achieve what you have achieved.
    I am SO glad you listened to your inner voice and posted this. Thank you for sharing it with us. Thank you.

    1. Thank you so much, Sister Moon. You are a real friend indeed.

  8. I am linking this post. That's how proud I am of you.

  9. Wow! Congratulations! OK, that resulted in some major tears/nose-blowing for me :-)

  10. Congratulations KD! This is just love on top of love! I can see it in their eyes...you are truly blessed and highly favored. Keep shining!

  11. wow....congratulations...fab phots can just feel the pride and joy!!

  12. Congrats... If you are good enough for Ms Moon you are more then good enough for me. That must have been a wonderful day, the result of years of labor. The pride of your parents is heart warming!

  13. You do us proud Dr. Kimberly Dyan Manning. You do us proud, INDEED.

    Dr. Maria Danielle Shindler, fellow Meharrian

    1. My fellow Meharrian, I deeply appreciate you. You know this, right?

  14. Hahaha! I knew about the award, and of course, I knew about Daddy flying out to see you. He & Shugsie are STUPID PROUD! We all are! Congratulations on your award, and a BIG WHOOHOOOOO to Dr. Ant on graduating! We're all very proud of her as well!

    Love you & see you in 48 hours!!! (you know the ONLY reason I didn't come out was because I already had a ticket to come out this weekend!)

    Biz JD (like Biz Markie, get it?)

    1. Counting down the hours, little sis! I love you!

  15. I consider you as one of my teachers Dr M, even though I haven't met you in real life. As a medical student, when the road gets a little rough and I find myself thinking "Why here, why now, what next", your posts gently nudge me to introspect and find myself. I love medicine - the field, the people, the challenges and the opportunities. With each bit of your life that you share with us, I see a new dimension of my life, and maybe discover some new ones as well :). You've definitely got my vote for the DTA - Thank you for being you!

  16. Congratulations on such a fabulous honor and the chance to share the experience with your parents and peers. Most excellent!

    1. Hey Steph! I appreciate your kind words. I was so awesome to have my parents there. It so was.

  17. You had me teary-eyed! Congratulations! I agree with others who know from reading your blog that you deserve this! I can't wait to make my parents chronically proud again soon!

    1. Jameil, you always make me proud. You know that don't you? Especially with your running. . . but no, I will never love oysters as much as you do. Bleccchh.

  18. What a happy and joyous day! I realized you had won the Papageorge when I recognized the first excerpt of nomination letters as mine! I almost stood up then and there in applause... Congratulations again!

    Master Doctor Ant (haha)

    ps. Also so excited to be inducted into the Draper/Manning family.

    1. Awwww, my little Ant! That means so much to me--but you already know that. Our relationship has been so special and just as we have said over and over . . .it's not good bye but "see you later."

      Ugggh. Water works.

      I'm outta here.

      P.S. Drapers and Mannings love them some Master Doctor Ant.

    2. No Ant waterworks yet. I imagine that they're being stored somewhere internally and won't be released until I get to Chicago and I settle into my new apartment and realize all that I have had to say goodbye to. ATL, you will forever have a piece of my heart.

  19. Congratulations!!!!!!

    I'm so glad you posted about this, but it doesn't surprise me one bit. I read between the lines and I know you are one amazing teacher. The first clue is how much you care about your students, how much you care, period. I am so happy for you. Heck, I'm exploding with big sister pride!!

    You deserve this award. And, um, your BHE is FINE.


    1. Ain't he fine, though? Ha ha ha. Love to you, Sister Lister.

  20. Wow! Congratulations! I am so happy for you that your parents, brother, and husband were there. The love of your family can make you soar to greater heights than ever expected. I don't doubt for a second that they helped you to achieve this awesome award.
    - Bridgette

  21. Congrats!! You had be boo hooing in my living room:-)

  22. Congratulations! It looks like it was an amazing day.

  23. Congratulations Kimberly! You are obviously doing a great job teaching, mentoring and setting high standards. I am proud of you as well, my friend.

    Sharon Clark

    1. Are you updating your vision board?

      Sharon (Phillips) Clark

    2. Hey Twin! Funny you should ask about my Vision Board. I was just looking at it and thinking I needed a Vision Board Party soon. Did I mention that my VB Parties are usually just me and a good bottle of red? Ha ha ha ha. But it's still a party.

      What about you?

  24. Congratulations, you put the A in awesome. And your posts keep making me cry, but they're happy, joyful tears. Even your comments on this one make me weepy.

    Thanks for sharing your achievements, your thoughts and your family with us. It's an honor.

    1. Crying rocks! We need those happy cries, don't we? Thank you, Mel.

  25. Amazing!!! I loved reading this.

  26. Huge congratulations! From everything I've read on your blog, you strike me as exceptionally worthy of this award. I'm glad that your family could be there to celebrate with you.

  27. I just soaked up every word of this post. You are so very deserving of this award. Congratulations!

  28. I simply cannot find adequate words. YOU are wonderful, inspiring, beautiful and so much more! You deserve every award, recognition, accolade possible! And in that big "YOU" I am also including all the amazing people who are part of you - your parents, your children, your husband, your brother and sisters, you colleagues, your students.

  29. A hearty congratulations to all! I love reading this kind of post, and laughed when it went from something as God-awful as sciatica (been there, done that) to something as awesome as awards and fabulous pictures! Loved the acute-on-chronic analogy too, something I see often enough in the course of a day. Sometimes your posts just brighten up an otherwise ugly or dreary day...thanks so much for sharing with your bloggy friends!

  30. Where is the Kleenex when you need it???? What a wonderful honor for an extra deserving woman-doctor-daughter-wife-mom-sister. As my daughter's dance professor said, "be lifted and gifted, black and beautiful". My daughter danced in the Black Movements Dance Theater at Georgetown (and yes, she was the only white face in the crowd), but she learned so much from some wonderful teachers much like you!

  31. Wow! Thanks so much for all the love. Seriously, it means so much. My friend the Profesora in Pittsburgh along with all of you helped me to stop feeling weird about posting this. But I am learning that even though the saying is that "misery loves company", the same holds true for joy. So thank you.

    It warmed my heart to hear that my virtual friends felt proud, too. I feel so proud so very often when I read what you write. I really do. Thank you for your kind words and thoughts. They mean more than you'd ever know.

    xo, KM

  32. I am late to the game, Dear Dr. Manning, but I'm just so thrilled. It's like I KNOW you or something and want to brag about you to all my Atlanta friends. I think I will.

    CONGRATULATIONS! We are all so proud of you, and I am so happy that you shared this here. So, so happy and thrilled for you.

  33. From start to finish it was, indeed, a wonderful day. Your dad and I are SO proud of our children and grandchildren. It's a lovely feeling!
    And Ant - meeting your family was a heartwarming event. The love and joy they felt for you was evident in their smiling faces. I know that you will go forward and continue to make us all proud. We love you!

    1. Thanks for chiming in, Mom. And I love that you had flowers for Ant, too. That was so YOU.

    2. Mama Draper, thank YOU for being you! As KDM puts it so aptly, I 'preciate you and Team Draper/Manning.

  34. Dr. M,

    Congratulations on a most deserving award. I continue to be in awe of you and your humility. It is evident in the praise from your students that you are not only an exceptional teacher and physician, but you truly care about every one of your interns and patients and so many times go above and beyond for all of them. Emory is lucky to have you, as are the students and patients you educate and care for each and every day.

    It is individuals like you who influence students like me to embark on a career in medicine. I can only hope to have a mentor as eloquent, knowledgeable, and kind as you when I begin my studies this fall. You inspire me to want to be an exceptional caregiver. Thank you for the advice via email and the continued motivation from this blog. It is your examples of extraordinary patient care that I will take with me as I begin my career as a nurse practitioner. On behalf of everyone you’ve positively influenced, I thank you.

    G. Eliza

    1. Eliza. . .what kind words. I deeply thank you and look forward to seeing what unfolds for you!

  35. I know I'm late, but I had to comment. Congratulations!!! I'm so very happy you received this award. The description of the award epitomizes you and what you're all about. And newsflash-- YOU are kind of a big deal, not only as a phenomenal physician and teacher, but as a phenomenal PERSON. And that shines through so clearly on this blog, that I know others see and feel it vividly in person. Poopdeck and Tounces did good!!!!!!
    Ask them when the parenting book is coming out :) I'm sure a lot of parents would love to take pointers. Again, so very happy for you.

  36. Kim - I have never cried before while reading a blog. First time for everything... Congratulations and thank you for such a lovely post!

  37. Comgratulations! I'm so happy you received such a distinguished award-- you deserve it! I've only heard wonderful things about you, and from reading your blog, it is evident how much you truly do care.

  38. Hi Dr KD,
    I read this again just to find out that my comments had been lost!!! I guess that I was so choked up that I did something wrong. Just wanted you to know that I did comment.
    Love you a bunch and was proud way beyond word can communicate.


  39. Congratulations!!!! I'm so glad you decided to share. I rarely comment but no way should you have kept this to yourself. Dang, I had tears! So very very cool.

  40. Congratulations! Glad to see everyone acknowledge how awesome you are. See you this summer


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

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