Tuesday, July 3, 2012

Getting to know you.

Bryan O.: half med student - half musician

Getting to know you,
Getting to feel free and easy
When I am with you,
Getting to know what to say

Haven't you noticed

Suddenly I'm bright and breezy?
Because of all the beautiful and new
Things I'm learning about you
Day by day

~ from The King and I


Last month I had a student on my team that I'd never met before. I'd seen him in passing, yes. But no, I hadn't ever really met him. Anyways, this is actually one of my favorite situations to be in--working with people where I have no idea what to expect. Because you know what? I simply expect the best and treat the person accordingly.

That makes me think of a part of a book called "The Art of Possibility" by Rosalind and Benjamin Zander. The part I like in particular is this chapter called "Giving an A." It's all about how treating people up front like they are an 'A' -- or exceptional -- allows them to live up to it. It's about not waiting for people to fail or forcing them to live up to something. . . . but simply assuming that they will wow you and excel long before they do.

And you know what? In my experience, when you treat anyone this way they almost always do.


That wasn't my point so I won't stay on that. But let me just tell you about our June ward month. It was busy. Busy as I-don't-know-what. The patients were sick and perplexing. I was tired and our team was, too. The month required a lot of focus and reading and discussing. It was tough.


Every day when we'd get ready to round, I'd start with some small talk. Like, "What is your favorite dessert?" or "What's your favorite restaurant in Atlanta?" I'd also ask things like, "What did you do on your off day? Did you do something fun?" Then I'd listen as they answered and then share something about my thoughts on those same questions.

I do this with all of my ward teams. Invariably it allows me to get to know my team better. And that's super important for team-building and for establishing a good learning climate. It's also critical to not forget -- no matter how busy things get.

And this month? It was a busy one.

But still.

I found out that Bryan -- the student who I'd never known before the month -- is a newly wed and he describes his wedding day as "totally awesome." He's in his fourth year of med school but technically it's a fifth year since he just finished getting a Masters of Public Health. And, as of right now, he thinks he might want to pursue a career in Internal Medicine. 


He installed a chandelier in his house all by himself on an off day in June. And he plays a mean guitar and writes his own songs (most of which are for his wife.) Yep. 

Oh--and he got his first guitar when he was twelve.

So while we waited for elevators or walked to conferences and patient rooms, I learned all these things about him. Which made all the rest of the things we talked about -- like people being sick-sick or nearing the end of life -- easier.  It made explaining things like severe sepsis or HIV-related diarrhea or acute decompensated heart failure less daunting. It also opened the space up for questions to be asked and thoughts to be shared. Not just my questions and my thoughts--but everyone on the team. On every level of the totem pole. 

See, all that small talk creates a safe space and an easy space. Which is very, very necessary if you ask me.

That reminds me.

When I was a student on Medicine, my attending introduced himself to me three different times in one month. Asking me if I was the medical student on the team--because he had not made getting know me (or even remember me) a priority. At all. Do you know how unimportant that made me feel? How ignored and undervalued? So me, I go the whole other extreme. I want to know as much as I can about the people I'm working with. About my learners, yes.

But especially about our patients. 

I took pride in the random things I learned about the people we cared for last month. Some things were amazing--like how one of our patients had a dream to dance with the Alvin Ailey American Dance Theater or The Dance Theater of Harlem. And how he STILL does a meeeeean "six o'clock." 

Then he explained to me what a "six o'clock" was since I didn't know. He sure did.

Alvin Ailey Dancers: The one in the yellow is doing a "six o'clock" 
-- the other brother appears to be at about 5:50.

Other things I learned were awful--like my patient and his wife who told me that a few years ago their adult child got in a dumb argument with someone and then that someone shot him point blank in the head while he was eating a pecan waffle in The Waffle House. Then unloaded the rest of the gun into his chest ending his precious life. All over a stupid spat over some woman that he didn't even know.

The day I learned that I was rounding and they looked sad. I asked and they told me. It was the anniversary of that son's death so it was a hard day for them. They needed to talk about it and I was glad they did. So it turns out that the person who killed their son went to jail. And do you know what my patient said to me? 

"It never made me feel better, though. I watched that boy's mama's face when that verdict came down and knew in my heart that two people lost they baby that day." 

And his wife chimed in, "Wasn't even twenty-one years old and they put him away for good. They was both too young to be gone."

And I listened to that story and then I listened to his heart and his lungs, too. I've learned that doing the former always, always helps me with the latter. 


So the answer is yes. Yes, I did notice that suddenly you're bright and breezy. Because being intentional about getting to know you makes taking care of you or teaching you or treating patients with you more fun.

It also helps me with "giving an 'A'." 

Does that make sense? I hope it does.


That June month was a tough one. Tough and trying. But we took excellent care of our patients--that we did. We also got to know each other better. 

And that was a bonus.

I hosted our end-of-the-month team dinner at my home last week and asked Bryan to bring his guitar. You bet I did. And don't you know he gladly obliged me, sitting cross-legged on my sunroom floor strumming a song and singing words he'd penned himself? He sure did.

And that? That was a bonus, too.

Happy Monday-about-to-be-Tuesday.

This version is playing on my mental iPod. Might see if I can get Bryan to play this next time.


  1. You SO have it figured out. How to make it all work better AND be richer and fuller by looking at each person as a person, as an A- Person!
    I just adore you for this.
    Do you think it's possible that your attending when you were a student suffered from prosopagnosia? Or was he just an ass?
    That story you told about the parents of the murdered boy- that sums up perfectly what I think about the myth of "closure." And an eye for an eye. No such thing.
    Good morning, sister doctor. Love from Lloyd.

  2. I just wanted to say how much I love reading your blog. I always walk away with something; sometimes it's a lesson, sometimes it's a smile, but it is definitely an added blessing to my day. Thank you for taking the time to write.

    - Bridgette

  3. It's really funny, I've had attendings who preach extraordinaire about the value of knowing who the patient is and where he comes from, but they forget the value of knowing the names (and literally just that) of the people on their own team. You're right, it does make one feel undervalue and question whether they're even considered a part of the team.

    But then I've also have attendings who take the time to know not just my name, but me as a person. That extra five minutes of conversation (& their time) make me feel so valued.

    I'm sure Bryan appreciates you for this Dr M, I certainly do :)

    - Tara

  4. Dr. Manning,
    Just wanted to say you inspire me to live a more beautiful and loving life. Every time I sit down to read this blog. Thank you so much.

    p.s. I just bought that book on Amazon and I'm really looking forward to it.

  5. From the Deck of the Poop,
    My darling Kimberly, you just articulated, in a way that only you could, my approach to managing and teaching.
    People often ask how I got the nickname "Padre" when I was working. I basically did what you just wrote about. I looked for the best in employees or students and they somehow knew that I had a genuine interest in their well being. People talk to people and over the years people just came to my office to talk or ask advice or just to hear some of my thoughts. One day my secretary said to me " I think you missed your calling". She ordered a name plate and put it up on the entrance to my office. In bold caps it read "PADRE". I treasure that nickname even today.
    You keep doing what you're doing.
    Love ya


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