Tuesday, August 28, 2012

Be a lion.

Ted Ross as The Lion in "The Wiz"

There is a place we'll go
Where there is mostly quiet
Flowers and butterflies
A rainbow lives beside it

And from a velvet sky
A summer storm
You can feel the coolness in the air
But you're still warm

And then a mighty roar
Will start the sky to cryin'
But not even light'ning
Will be frightening my lion

And with no fear inside
No need to run
No need to hide
You're standing strong and tall
You're the bravest of them all

If on courage you must call
Then just keep on tryin'
And tryin', and tryin'
You're a lion
In your own way, be a lion. . .

Come on. . . be a lion.

~  "Be a Lion" as sung by Diana Ross in "The Wiz"


I have learned a few things after being in medical education for more than a decade. I've learned that there are many things that we have to offer our learners. More than just medical knowledge or concrete instructions on how to perform bedside procedures. A whole lot more.

Some of my colleagues are masters at helping residents and medical students understand complicated theories and pathophysiology. Others have a knack for teaching them how to cannulate tiny veins and arteries on the first try. And while I am no slouch when it comes to either of those things, I don't consider that my strength.

It sounds kind of silly, I guess. But me? I'm an encourager. I think I'm good at shining lights onto learners which ultimately gives them a safe space to let their own lights shine. There's something about seeing someone evolve from slumped shoulders and disappearing behind shadows. . . . into chest back, shoulders up confidence that excites me. And actually. . . encourages me.

More than you could ever imagine.

When I was an intern I spent August of 1996 rotating in the intensive care unit (ICU.) As I've said before, it was the setting that I found the most terrifying of all. My attending that month was . . . intense. He was serious about those patients and he had no qualms with tearing any and every person a new one who stood in the way of them getting as close as possible to a full recovery.

This was how our mornings went. We'd be standing there shaking like leaves and our attending would review the numbers on the ventilators. He'd then ask us about the overnight events (that our resident and fellow had advised us how to deal with) and then. . . .

"Aaaaaggghhhh!" Then he'd smack his face and shake his head. And that was the feedback.

Next, the fellow or the resident would begin defending the management and eventually he'd calm down. My fellow told me over and over again that he was harmless. That this was just his passion for patient advocacy coming out and that it was never personal. But despite all that reassurance, I was terrified.

Eventually, I became so afraid of this attending (coupled with this setting) that I would become paralyzed on rounds. I'd stutter and apologize. And seriously, the only thing that made me not look the most horrible of all the team members was the fact that he scared my co-intern even more. She even burst into tears two different times on rounds.

That didn't exactly make me feel better about being there, though.

I wasn't nervous only because of that attending. I didn't trust myself with these patients. I was too junior, too green to be writing orders on their charts or progress notes in their records. The resident, who was slated to be a chief resident, would pat my shoulder and remind me that we always had "supervised instruction." Still. I just didn't feel good about being there. Not one single day.

I wasn't fully organized. That was one of my problems. I wasn't sure how to keep track of all that data or how to retrieve it quickly when Dr. Intern-slayer asked me for it. There would be papers falling all out of my pockets one day. A giant clipboard with way too much stuff the next. And eventually, I settled on a stack of index cards that I spent more time fearing I'd lose than anything else.

But then there was this one night where I took call with the cross-covering fellow on call. She was only with me for the night--only there to cover me on call. Her name was Shobhana and she was highly competent, confident and smart. I knew that she'd been a chief resident prior to her critical care fellowship and often saw her in passing at conferences. Every time I encountered her, she was kind and attentive--if only for a moment in the hallway. Though I didn't know her well, that little bit of background was enough to make me feel safe on her watch.

Initially, we were busy that night. We admitted a few new patients and dealt with some active issues with the ones who were already long term players. Shobhana was right by my side for all of it, and I was deeply relieved. I double checked every single move with her and constantly apologized for bothering her with my questions. Eventually, things calmed down and we were sitting in the resident's workroom talking and snacking.

That's when Shobhana decided to go there.

"Kimberly? Why do you say sorry so much? You are a good intern. You water yourself down that way." And she said that as she pulled seeds out of a pomegranate, carefully popping each one into cupped hands to avoid staining her scrubs.

"I guess I didn't know I did that. And I don't know about me being such a good intern. I'm not totally horrible, but 'good' might be pushing it." I meant those words, too. I didn't think of myself as a good intern at all. At least not here I wasn't. More like one who wasn't an assassin.

"Why would you ever say such a thing?" Shobhana pressed.

"I'm nervous. I don't know enough. And I don't feel so organized." And right after I said that, my eyes welled up with tears. Her eyes softened in response and I started to full-on cry. "Ugggh. I'm sorry."

"Stop saying sorry! Listen. You've got to start seeing yourself differently. Knowing that you belong here because you do. So yeah. Read and get organized. Then you won't be nervous. But mostly, you have to be a lion." She patted her closely clipped nails on a brown paper towel that she'd brought over from the bathroom. It was covered with pomegranate drippings and seeds which, since then, have always made me think of her whenever I see that fruit.

"That's easier said than done." I let out a half-hearted laugh.

"Noooo. Not at all, sweetie," she replied. Abruptly she stood up. "Come on. Come. Let's get your nerves out."

So she looked at my system for tracking my patients and gave me some pointers. We printed out a unit census and, at three o'clock in the morning, started rounding in that unit. And Shobhana listened to me and coached me. She stopped me mid-sentence and gave me do-overs. Told me to stand up tall, lift my voice, and not say 'sorry.' She also affirmed the things that I was doing right with high fives and sistergirl applause. It was awesome. She easily spent two and a half hours with me that night. Pushing me, encouraging me, and helping me to get more organized with both my patients and my learning. And you know? Maybe it wasn't 2 and a half hours. But to me, it felt like an eternity.

I never ever forgot her kindness. It proved to be a pivotal moment in my medical education. And one that I have vowed to always pay forward.

This week I spent some time with a few learners who needed encouragement. All at different levels and all needing different things. No, I didn't inundate them with cutting edge medical information or anything of the sort. Instead, I simply tried my best to do for them what Shobhana did for me. Coached them. Encouraged them. Pushed them to be the lion that I could see inside of them.

Because in medicine, sometimes you've got to learn how to be a lion.

So I had one of those meetings today and on my way to it, I heard Diana Ross in my ear singing the words that I swear it feels like Shobhana sang directly to me that night in the ICU. Her voice was just like that music. Her hand claps and high fives made my confidence rise up like bubbles, lifting my feet from the ground. And just like when Diana Ross' Dorothy was first purring and then belting out those lyrics into the ear of that cowardly lion at some point all of it erupted out of him into his big, bellowing, celebratory finale.

"I'm a lion! In my own way!"

I've seen that before in medical students and residents. I've seen it in junior faculty. Hell, I've seen it in myself. A simple nudge. . . .giving someone the courage to be a lion. Yes! A lion. In their own way.

It's as important as the medical knowledge. Or the procedural skills. Teaching and helping someone to believe that they're as good as the potential you see in them is critical to making it in this field. Hell, it's important in most fields.

And just maybe some call that mentoring. But I'm not so sure. I think it's something more than that. It's one of those things that takes time and patience and a heart for people.

So no. I don't remember every medical fact. I can't tell you the odds ratios of every study in every journal. But I do have a heart for people and try to do my best to encourage anyone that I can.

Perhaps that's why I felt so tired this week.


But you know? I wouldn't trade that part of my life for anything. Yes, it can be exhausting. . .but the pay off is so great. And I'm starting to realize that as long as I save some time to encourage myself, I'm good.


Look. I don't know what's going on with you right now. But truly I hope that you have someone in your life that's waiting side stage and singing softly in your ear. Inviting you to be a lion and convincing you that you can be one. Over and over and over again. . .  until finally you feel strong enough to step out into that spotlight.

And if you do or if you have, it's your duty to pay it forward to someone else. Just like somebody did for you.

If you don't, consider these words for you -- and apply them in whatever part of your life is calling for you to be a lion.

Come on. . . be a lion!


The Lion's part:

I am standing strong and tall
You're the bravest of them all
If on courage you must call
Keep on tryin'
And tryin', and tryin'
I'm a lion
In my own way
I'm a lion

Happy Tuesday. Again.

And, of course, the song playing on my mental iPod. . . .please listen if you need to feel encouraged today.


  1. This is so very much on time: so very, very much. Again I say, you touch people whom you have never even set eyes on. Thank you.

    Maria, fellow Meharrian

    1. Maria, you are always so supportive. Thank you. It means a lot.

  2. Replies
    1. Good morning, Stacey. I'm always glad to see you. Glad this was timely for you.

  3. I loved this post, but you've got to stop making me cry into my coffee! I'm going to stop apologizing so much, thank you. And thank Shobhana for her kindness and you for paying it forward.

    1. And thank YOU for your kind words of affirmation.

  4. Did you know that I became a teacher because someone believed in me more than I believed in myself? Sure did! Love her still, always will.

    1. I know who that person is. I am thankful she pushed you--you are one of my favorite lion-role models now!

  5. Funny... I went to see Mackenzie in her summer drama camp's production of "The Wiz" on Sunday.


    PS-- Who always encourages me to be a lion? You do.

  6. My absolutely, all time favorite movie in the world, THE WIZ! I have the DVD and soundtrack on ready. My mom would always encourage me to be a lion and say "you're the bravest of them all." I am undone after this one, such a sweet encouraging blog! Thank you

    1. And now I'm undone after imagining your mom saying that to you. Sigh. That is so, so special.

  7. Totally sending this post to the Resident that encouraged me to be a Lion as a med student. Thanks, Dr. Manning!

    1. I wouldn't dream of doing anything less.

  8. Kudos Kimbo! I can still hear you clowning me about punking out as Adaperle and not belting out...'And in a flash...you will be HOOOOOOME!" I needed the Be A Lion encouragement from you back then! Tee-heee....

    1. Now you KNOW this has me laughing! And you KNOW I know this is you, Stacy! LOL! That is the FUNNIEST memory--thanks for that reminder!

      Tee heeeee. . . .


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

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