Sunday, June 10, 2012

We cool.


"What you hear sometimes got more to do with where you at than what the other person say." 

~ Mrs. Freeman

______________________________

"Oh, there she is. Finally."

That's what I muttered under my breath when I saw her standing in the doorjamb. Ample arms folded tightly over her bosom and a "don't mess with me" expression over her face. This was my third time swinging by her room in hopes of finding her there.

As I approached her she raised a suspicious eyebrow. It spoke loud and clear enough to slow my sure footing down to a shuffle.

"Hey there," I said. I tried to be cheerful and pleasant, hoping she'd see it as an olive branch and sweep everything under the rug. No such luck. Instead, she flared her nostrils and inwardly sighed. Then she just stared at me with those same elevated brows. "I was looking for you. I'd been by here a few times, so I'm glad you're here."

"And why was you looking for me?" Her voice was staccato, her reply terse.

"I wanted to talk. That's all."

"You don't need to talk to me. And I don't need to talk to you. We already talked and that was plenty for me."

Oooph.

"Well. . . I guess I was just hoping that--"

She cut me off quick and clean. Kind of like a knife so razor sharp that it slices you down to the white meat before your body even realizes that it should be bleeding. "I don't like you. And you know I don't like you. I don't like how you talk and I don't like your know-it-all attitude. So thanks for coming by--" she leaned in and looked at my badge in the most exaggerated way--"Dr. Manning--but I'm done with you. Good bye." Then she turned her body away from me and flicked her hand outward to let me know that she meant it.

"But I do like you. And I think we may have gotten off on the wrong foot. Please. Let me talk to you for a moment." The way she glowered as I spoke was downright uncomfortable. I waited to see what she'd say next.

"See . . .what you fail to realize--Dr. Manning--is that I don't really care what you think at this point. Here's what I think: I think you should be ashamed of yourself for how you talked down to me earlier. Staring all in my face like you got the last word on everything and like since I'm poor I don't have no choice. And even worse you was talking to me like that in front of all them white people, too. One of your own."

I felt my face blazing. These are the times I'm so happy to have this brown complexion; it hides the blushing that my fairer comrades cannot hide.

"Mrs. Freeman, I . . .I am so sorry that you felt that way. That wasn't my intention. At all." I meant that. My eyes were getting wet and I could feel the muscles in my stomach clenching up.

She pointed straight in my face. "You know? One of them young doctors was right beside you. Black like us and you showed him that this how you treat your own peoples. This. You stand in they face and you call them a addict. Like they ain't no better than a dog in the street. And don't you think for one minute that God didn't put you here. He brought you here and this what you do? To your own people?" She shook her head hard and looked away. I was glad she did because her searing eye contact was about to make me cry right then and there.

I tried to replay what happened. I put it on slow-motion so I could make certain that my perception wasn't off and also to explore whether or not I had talked down to her. Had I?

It started out simple enough. She was admitted to the hospital for something potentially serious. That part had been worked out and she was on the mend. So much so that we were preparing to let her go from the hospital. The encounter on rounds was pleasant enough. But the fall out happened later when our team was passing by to see another patient.

She asked about pain medication. Pain pills for a chronic pain that had nothing to do with her reason for admission. Mrs. Freeman explained to me that the other doctors always give her this certain narcotic pain medicine and was confused about why we hadn't done the same.

But the thing is that we were in the hallway and headed to see the rest of our growing census of patients. That said, I didn't want her to feel like we were blowing her off so I stopped and gave her my attention for a moment as the team stood by.

"Allow us to review your prior records, okay? We just have to be careful about medications like these."

See? I thought that answer was quite vanilla--at least bland enough for a hallway. I prepared to leave as I anticipated her agreement with this plan but couldn't when she continued.

"I don't get it. What's wrong with me getting this medicine?"

"Mrs. Freeman, I'm not saying that there aren't reasons why this medicine is the one that some doctors choose for certain problems. Medicines with this ingredient called oxycodone--which the pill you're talking about has in it--can be habit forming if we aren't careful."

"Habit forming?"

"Yes, ma'am."

"Oh, well that isn't my problem at all. I'm not some kind of addict."

"That isn't what I said, Mrs. Freeman. I don't want you to to feel like this isn't important. Would you give us a little bit of time to make sure this is safe for you and the best thing for your care?"

"I'm in pain now. This is ridiculous. What's the big deal that makes your team feel like you need to reinvent the wheel?"

I could feel that this was getting to be too much for the corridor. I could see my team nervously shifting. I tried to clean things up best I could. "Mrs. Freeman, I couldn't see in your record where this medicine was appropriate for you." As soon as I said those words "appropriate for you"--I wanted them back. They came out wrong. Not how I meant for them to.

She nodded slowly and turned away from me. But not before saying under her breath, "Wow. You have offended the hell out of me. Let me get away from you. I'm fine. I don't need nothing else from you."

And with that, she walked away.

I wanted to chase her, but I had a lot more patients to see. So I didn't.

After lunch, I swung by to find her and she wasn't there. I stopped by once more around 2pm and still no cigar. Finally--this time--she was there in the threshold of that door with those folded arms.

That replay told me that one, I shouldn't have allowed that discussion to go on as long as it did in a hallway and two, I needed to come back to improve our relationship. Interestingly, she was a patient who'd been admitted to another team a few days before which technically made her what many refer to as a "bounce back" to another team. That describes the patient who is cared for by you in the interim until the original team assumes care the following day. I could have just shrugged my shoulders and let the other team deal with it all.

I could have.

Her words stung like someone flinging tiny shards of glass in my direction. I knew I could have handled that situation better. But me? Not understand the privilege of caring for patients--many of whom look like me--at Grady Hospital? Me? Talking "down" to my patients and not believing that, on some spiritual level, that I owe them the most level playing field that can be achieved? Me?

No way. Not that. Not me. So I told her.

"Mrs. Freeman? I shouldn't have had that discussion in the hall with you. I should have asked my intern to follow you into your room so that we could privately discuss your concerns. I apologize for that. I really do."  She kept glaring at me so I continued. "But what I will not receive is this accusation that I don't know how to treat people--especially ones who share so much with me. I know who I am. I know why I'm here. And if I didn't give a damn about you, Mrs. Freeman, I wouldn't care that you felt this way. I wouldn't be here at your room listening to these hurtful words."

"Your words hurt me," she said, voice softening up a bit. "You made me feel like I was a addict."

I thought about that statement -- "made me feel." In my head, I know that no one can "make you feel" like anything. And that how you feel is how you feel. But, see, perception is reality. That I know for sure.

"I'm sorry." I kept it there and stared at her a moment longer before adding, "Can we please step inside to talk? I do care. I do care how you feel."

And she answered by heading back toward her bed by the window in that room. She sat on the bed and I sat on the chair in front of her. She told me about how she was sick and tired of being sick and tired. She spoke of the control she lost over her life due to her illness and how me and that pain pill was the last straw. No control at all.

And I listened quietly and nodded my head.

Finally, she told me that she was sorry for saying those things to me. "I realize that I must have misunderstood you. You wasn't calling me a addict. You was just saying that the pills can be dangerous."

"But I shouldn't have said that in the hall. That wasn't cool. So I'm sorry, too." And I said that because I meant that. I was sorry for that part.

"We cool," she replied with a smile. "We cool."

I stood up and she did the same. I narrowed my eyes and cocked my head playfully. "We cool? You sure?"

"We more than cool," Mrs. Freeman chuckled. Then she opened her arms and enveloped me tightly. I hugged her back just as hard. I wanted her to know that I was not who she said I was. I wanted her to believe that and I wanted me to believe it, too.

When we let go, she reached for my hands. "Be blessed, okay? Do what you was called to do, okay?" Her eyes were serious. She meant those words.

"Mrs. Freeman? Did I . . .did you feel like I really talked down to you?" I felt my face warming up again and now my eyes were stinging. "Because. . .I. . " As if someone pulled a plug, I stopped talking. I knew right then, right there that if I said one more word, I'd blow. A full on, unrelenting ugly cry. So I stopped. Mid-sentence.

"No. No, baby." She shook her head and squeezed my hands. "What you hear sometimes got more to do with where you at than what the other person say."

And I got that. I understood it well and scrawled it onto a mental post-it note to save in my head for later.

"Bye, Mrs. Freeman."

"Bye, bye, sweetheart."

"We cool?"

"We cool."

I closed the door behind me and left her room. Then I went to the nearest bathroom and cried and cried. I'm still not sure why.

***
Happy Sunday.

Now playing on my mental iPod. . . . .

24 comments:

  1. Wise words from Mrs. Freeman. I'm going to remember that. 'Nuff said!

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    1. Yeah, that was a good word, right Mom?

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  2. Hey Dr. Manning,

    Considering how many of your posts make me ugly cry in public .... Please keep doing what you're doing. It means a lot to hear from an attending what it's really like to feel for your patients, to turn around and be as brave as you are and sit with someone who has just been upset at you and really hear what she has to say. It takes a lot of bravery and heart to do that, and I respect that so so much. So please, for us students old and young, please keep doing what you're doing.

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    1. Awwww! Hey sweet girl! I already miss you so much. I love knowing that you are reading. It makes the world feel so much smaller. Thank you for being here and thank you for being you. Love and miss you tons!

      xo, Dr. M

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  3. Bravo to you and to Ms Freeman. It takes courage to apologize and find out what the REAL situation is instead of shrugging your shoulders and moving on to the next thing. It also takes courage for her to listen to you and forgive. I have to fight against holding onto my grudge, or anger and open myself up to really hearing what the other persons has to say. Mrs Freeman is spot on with her advice. Thanks for that.

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    1. She was spot on. I am so glad we finally got to talk to each other. Every time I think about what if I never reached her, i shudder. She ended up being my FP that day. (Favorite patient.)

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  4. I probably would've cried, too. That was mean. Especially knowing your intent and care. But yes, it's all about what else the person is going through that can twist your words and even the best of intentions. I've been on both ends, the twister & the twistee, and neither is fun. I always learn or confirm something here. Thanks for that.

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    1. Yep. We've all been there. And I'm glad to know that I'm not the only cry baby. But it is tough for the twister and the twisted sometimes. Yes it is.

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  5. Every day I learn something from you. You ARE a teacher. And every day I get a little glimpse into human behavior and how to treat our fellow humans.
    Thank-you. So much.

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    1. You do the same for me, Sister Moon. You read so many blogs. I continue to be honored that you read this one and comment often. Heart you so.

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  6. I think that not only are you wise and caring but you are deeply empathic. I'm guessing, of course - but I expect you cried because you unintentionally hurt another person. And you realized it. I would have cried too, had I been in a similar situation.

    I agree with the poster who said you are certainly a teacher, as well as a wonderful woman and doctor. I too learn something every time I visit your blog.

    God bless you greatly, Dr. M. You do much good in an often sad, painful, lonely word.

    Thank you for sharing yourself with us. I appreciate it more than you can know.

    Jae in Clayton

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    1. Jae, I hope that's why I was crying. I'm still not sure.

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  7. This was such a good post! I'm glad you shared this story with us. It shows the power of communication and forgiveness and understanding. I'm so glad you kept looking for her.
    - Bridgette

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    1. Me, too, Bridgette. Thanks for reading.

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  8. THAT WAS AWESOME!! I've heard it said that "Communication ain't what you said; it's what they got (e.g. heard, understood, felt)!" This story really drove that wisdom home... and showed there are really good doctors with hearts so BIG they MUST wear them on their shoulders (only place they'll fit)!

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    1. Awww cuz! What's up?! Thank you for reading. 'Preciate you.

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  9. I just recommended your blog to one of your Delta sisters. She helped me at Bed Bath and Beyond and we got to talking. She graduated from Temple U in Philadelphia. She was very impressed I knew the color and everything. She managed a neurology group before this job so I know she will like the medical as well as the non medical postings. Who wouldn't?

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    1. Look at you knowing about the Delta girls! :) Thanks for sharing. . . it's the highest compliment you can give a writer.

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  10. Humility and authenticity separate a good doctor from a great doctor. It's clear you are a great doctor!

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    1. C.D., I am a work in progress. I hope to be a great doctor every single day. Thank you.

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  11. What a truly humbling experience. I needed this post. I will take those words and right them down on a place where I can see it daily at work.
    So glad you shared this.

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  12. you're good like gold and i miss you like a crazy person. won't you come on down here and visit me?
    xo

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  13. I'm so impressed by the respect for patients and the love of life that comes through in your writing. It sounds like you are really able to speak to people in a way that both shows your respect for them and inspires a feeling of trust and safety. Even in this example of where that didn't work out as well as you had hoped, it was easy to see that you cared a lot about your patient.

    Is that something that can be learned? Or is it innate? I am hoping to become a doctor myself someday, but I worry about the communication skills it will take. I'm good at communicating with my peers, but tend to use humor to connect with people, which is not really appropriate in a patient care setting. I wonder how I will connect with patients and show them I care while still being as respectful as the situation demands... Are you taught much of this in medical school? Or is it more about having good instincts and good mentors?

    Anyway, your blog is wonderful and really inspiring! As a married person considering medicine it's great to hear about how you are able to balance your family and your work so happily. I don't personally have much in the way of 'role models' for being a woman in a demanding career and still having a family. So I hope you won't mind if I consider you a sort of virtual role model. :) Thanks so much for writing.
    --Sara

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  14. excellent! You MUST write a book! And, I think it'd be cool if you had a "Ask the Grady Doctor" post :o)

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