Wednesday, July 4, 2012

Loving you like a child.

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You treated me like a stranger
And all the time I was loving you
All your slick moves
They were once innocent moves
I wanted to look up to you
I really trusted you
and every word you said. . .

All the time you were smiling
the same smile
I was loving you like a child
I really trusted you. . .

. . .and every word you said.

~ Sade "Every Word" 


We looked all over for next of kin. The people who came to his bedside were all "friends" and "associates." The lady who kept vigil identified herself as simply his "old lady." When I clarified what that meant, she let me know that it meant she was his girlfriend of two years and not his wife.

"Do any of his people live in Atlanta?" I asked. And by "people" I meant somebody, anybody who could come in and legally call some shots on behalf of our patient, Mr. Dyer. He hadn't given his "old lady" his blessing as durable power of attorney and we needed someone with that authority.

"A daughter," she replied after a pause. It almost seemed like she wasn't sure if she should even say one way or the other. "But he don't talk to her. She live somewhere up near Suwanee or some place far like that."

"Does Mr. Dyer's daughter know he's sick?"

"She don't know nothing about him, like I said. She don't fool with him at all." His old lady balled her fists up and gently rested them on her ample hips. She looked disheveled. Her shirt was a soiled and threadbare tee that clearly had been worn for several days. Every time she moved, her pendulous, unrestrained breasts did, too. Years of hard life and gravity had pulled them closer to the floor than the sky.

"She lives here in the Atlanta area, though? I'm sorry. I didn't ask you your name, ma'am."

"My name Marsha."

"Okay, Ms. Marsha. Do you by any chance know his daughter's name?"

"Yeah, ma'am. I could get her information if I look around. Let me see what I can do."

I started to ask Marsha why he'd been estranged from his daughter but was pretty sure I had some idea. Even though my patient was well into his fifties, he'd spent more than half of his life using crack cocaine and running the streets. It was a hard life, and one that I would imagine would be especially hard for a child.

Even a grown up one.

It took Ms. Marsha longer than expected to get contact numbers for us. The original urgency was because Mr. Dyer was crashing from what was likely some kind of severe vascular catastrophe. The lining of his aorta had torn apart like tissue from years and years of high blood pressure and cocaine abuse. This led to an emergent operation to repair it but it was all complicated by a perioperative stroke and heart attack. All of the teams of doctors from the neurologists to the cardiothoracic surgeons to us in internal medicine stayed involved because it was all snowballing too quickly not to. Things didn't look good at all.

I needed to reach his daughter because Mr. Dyer could likely die. His body was already weak from street life and I wasn't sure what kind of meaningful recovery we could expect, if any.

After a lot of dead ends, one of the interns finally reached Mr. Dyer's daughter. She arrived just as a swarm of physicians ran into his room after hearing the code sirens. He had gone pulseless.

The team of resident physicians methodically drove through the advanced cardiac life support steps. One was drawing up medications while another called out orders. Everyone worked in concert but none of it was working.

I caught a glimpse of her standing in the hallway outside of the door. I recognized that it was his daughter not only because she bore a resemblance to her father but because of the awkward interplay I saw between Marsha and her. Tightly folded arms and a complex facial expression; she was off limits to her father's "old lady" and fortunately Marsha had the sense to respect that.

In my opinion, codes aren't usually good things for families to witness. For many reasons, but mostly because it's quite traumatic to see. The chaos, the pace, the shocks, the all of it. And this code was a perfect one in the sense of how it was being carried out but still. It isn't a great thing for a loved one's eyes.

"Hey there," I said softly while stepping right in front of the woman who I assumed was his daughter. "I'm Dr. Manning, the senior doctor taking care of Mr. Dyer."

She reluctantly peeled her hand from under her folded are and shook mine with only her finger tips. "I'm Andrea. He's my biological father."


I cast a glance over to Marsha who looked troubled. "Ms. Marsha? This is a lot. Let me have someone take you over to the family area, okay?" The acknowledgement made her cry. "I know, Ms. Marsha. This is hard. I appreciate you being here, okay?" One of our senior nurses instinctively put an arm over her shoulder and escorted down the hall.

I found Andrea scowling in their direction when I turned back toward her. It was a searing and resentful gaze, but the minute she realized I was looking at her she closed her eyes tight and drew in a breath. Flinging her eyes open again, she spoke. "This is what happens when you smoke crack all day and all night. It was bound to happen sooner or later."

I bit the inside of my cheek and tried to think of what to say next. I had no words at that moment so I simply gestured for us to ease closer to the end of the hall and away from the doorway to the room.

"I don't even know why she even told y'all to call me. I don't even know how that crackhead lady knew my name."

"Ms. Marsha was really kind about helping us find you. Andrea. . . your dad is very sick. He's had a tear in his aorta which is the big blood vessel next to the heart. Our surgeons did an emergency operation on him but he had a heart attack and a stroke from the strain of it all. His heart started beating irregularly and now they're trying to bring him back."

"Why? He's a criminal. He steals from people and uses drugs. Why try to save somebody like that?" She sucked her teeth and rolled her eyes.

"Andrea, your dad --"

"This man is not my 'dad.' He's a man who got my mother pregnant thirty one years ago and then got strung out on crack and left us without a pot to piss in."

"He's sick, Andrea. When somebody is this sick and they haven't told us they want something otherwise, we do everything we can to save their life. Sometimes we manage to keep them alive but not in a good physical state. Sometimes families choose to have us back off of the heroic things if it gets to that point."

She widened her eyes and cocked her head sideways. "You all expect me to be that person? I haven't dealt with him since I was like fourteen! That Marsha or whatever the hell her name is lady can do that. She obviously gives a shit and I don't."

I stared at my feet because this was hard. I didn't know the whole story behind all of this and I wasn't sure now was the time to find out. So I didn't say anything. I just stood at the end of the hall by the window next to his daughter. In silence.

Then someone came out of the room. They looked from side to side and I could tell the news wasn't good. I immediately walked toward the resident and confirmed what I suspected. Mr. Dyer was gone.

The room cleared out surprisingly fast. Before I knew it, the hall was pretty barren and quiet. I approached Andrea who still waited near the window with those folded arms.

"Your fa--" I cleared my throat and started over, "Mr. Dyer is. . .he passed away."

She just stood there for a moment like she didn't hear me. Her next move surprised me. Andrea briskly walked down the hall to Mr. Dyer's room. When she reached the doorway she froze and put her hands over her mouth. A nurse reached her before I did and wrapped her arms around her.

I felt like some kind of voyeur watching her crying these complicated and muffled sobs into the nurse's shoulder. After a few moments she abruptly pulled away and turned to pace the hall.

"I have no idea why I even give a fuck. Why? Why do I even care!" She shook her head and rubbed her eyes with the heels of her hands. Then she spoke straight into that open doorway. "You weren't good to me. You left me. You left us for that life. Why do I even care?"  She lifted her hands to her face and cried into them again. Something about her body language told us all to leave her be.

And a few moments later she'd gotten it out.

"What needs to be done?" she finally asked me. Her tone was all business.

"Right now? Just notify the rest of your family. We can call the coroner, okay?"

She nodded in response.

"Andrea? I'm sorry. I know he disappointed you but. . . . he was sick. I think he was sick, you know?"

"No, I don't know," she shot back. "And you don't either, Dr. Manning. You don't know what it feels like to have your daddy stay and leave at the same time."

"I'm sorry."  I felt my face warming up because I feared I'd sounded condescending. I repeated the apology. "I'm. . . sorry."

Her eyes fixed on the door leading to his room and slowly filled with tears. With those same folded arms she stood with her whole body rocking from the tapping of her right foot. Her lips were slightly parted like she wanted to speak and her brow was furrowed with pain. Those tears pooled right on the edges and threatened to fall.

I whispered to her again in a tiny voice, "I'm so sorry."

A tear spilled over her lash and she quickly wiped it. She closed her eyes and nodded for a few beats and then changed over to a shaking of her head. I wasn't sure what to do so I said the next thing that came to mind. "You okay?"

Time froze. The afternoon light painted her face and I could see the tears glistening below her eyes. She drew in a deep sigh.

"Am I okay? Yeah," she spoke while still looking at his room. Her tone was disconnected from my question; her expression was far, far away.  "I'm okay. I've never had a choice but to be."

Then she turned and disappeared down the corridor.

And I never saw her again.

Love is complicated. Especially when people don't do what they're supposed to do. But sometimes the heart doesn't get the memo and continues to love with the innocence of a child in spite of all of that.

And that's hard.

But that? That's real life. And Grady is real life.

And this? This, too, is Grady.

Welcome to Saturday.
 Playing on my mental iPod. I remembered this story for you, Anonymous. . . you were loving like a child. Sometimes we can't help that.

*Obligatory disclaimer: Names and details have been changed but the message always remains authentic and true.


  1. I wasn't there when my old drunk daddy died and I didn't cry very much when I got the phone call and I didn't cry very much at the funeral, either. Didn't know the people there, although they knew me, twittered around like birds, sort of. They were his kin, mine too, I guess, but I still didn't know them.
    When your daddy leaves you when you're young, it's like a leaving of over and over again and then, when he finally does leave, forever, it's like- nothing's changed- except that one tiny place in the heart of your inside child that always thought maybe he'd come back.
    And then you go on.
    Like that girl said, no choice.

    1. You know. . . I thought about you when I wrote this. You've mentioned before that the abandonment feels like a reciprocating loop. . . and that woman was right--I don't know what that's like. I realize I'm blessed that I don't.

      Thank you for sharing your truth.

  2. That she came down to Grady shows there was something still there for her, no matter how faint and painful. She didn't have to come.

    1. I guess technically she didn't. . . .but in a way it seems like she was pulled there by some kind of magnetic force. Perhaps--like Sister Moon said-- it was that one tiny place inside the heart of her inner child that thought it might make a difference.

  3. Powerful writing and oh so sad. My heart feels for the both of them.

  4. Dr. Manning. I was the anonymous poster who sent you the side message the other day. Thank you for this posting. It captures so much. And Ms. Moon you have no idea how much your response means to me. I am dealing with this situation now and you have helped me understand that I'm not alone in my current feelings. Still caring about someone who treated you like less than a daughter is hard. But when that person dies you still have lost a father even if it was just a biological one. And it hurts...still.

    1. I heard that Sade song on a loop in my head after this happened. It was a few years ago but I always thought to myself, "loving you like a child" is such a powerful metaphor. Children love with such innocence and purity. I remember when my little cousin used to live with us and he always sat out on the porch waiting for his mother to pick him up on Fridays. More often than not she was late -- so late that we'd have to make him go back inside because it was dark. And every week it was as if he had amnesia, waiting on that porch all over again.

      The same happens in romantic relationships. Loving like a child is hard because you can't make sense of it. Thanks for getting me to write about this. I'm sorry for your pain.

  5. So sad, both of them. But she came, didn't she? Many people would not have given that much. Sometimes, I think love and genetics are not enough to bridge the damage done by addiction and dysfunction. And I wonder a lot about being your brother's or parent's keeper, especially when they won't be kept or won't even help themselves.Some people can't even love themselves, let alone their own family.
    It is so complicated, and sometimes I think disassociation is a fine survival technique, much better than anger or resentment.

    Thanks for telling another true story, just the way you saw it happen. What would you do with all this, I wonder, if you didn't have the writing to help you process and transmit all the things you witness? Life can make you crazy if you see and feel too much, but I think you're doing a fine job of witnessing and testifying Life, not just at Grady, but everywhere.

    1. I appreciate your kind words. I really do.

      I love writing here for the very reasons you describe. I am able to get the lessons much better that way. That's what I want to do the most.

  6. This story hurts to read, it is so sad, but there's also so much that's beautiful in it. Mr. Dyer's "old lady," who stayed with him while he died. The daughter who came for the father who abandoned her, who managed to care about him, despite everything. The doctors and nurses who understood that the family needs care as well as the patient. What a privilege to be there for such a moment. Even in its dark moments, medicine is the best job ever.


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

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