Saturday, August 18, 2012


*Every one of the amazing and beautiful images of Grady Hospital in this post 
were taken by my dear Emory student-friend, Cathy M.

When trying to express oneself, 
it's frankly quite absurd,
To leaf through lengthy lexicons 
to find the perfect word.
A little spontaneity keeps conversation keen,
You need to find a way to say
precisely what you mean...

~ Mary Poppins in "Supercalifragilisticexpialidocious"

Yesterday was kind of crazy. Busy in the busiest of ways, but not necessarily in the bad kind of way. Which I am sure is a description that makes absolutely no sense . . .but it was one of those days that's hard to corral into just one adjective, you know? Either way. I like having days like these. When they end, even though I'm exhausted both physically and mentally, I close my eyes and fall asleep with my mind swirling like steam off of hot cocoa. Good swirls. With soft ribbons of ideas and thoughts and reflections that lull me to sleep just like a mug of cocoa would at bedtime.

Yeah. Kind of like that.

So. . .  here are a few of my favorite parts from that day.


I was running late in the morning for my eight o'clock teaching session at the School of Medicine which had me kind of frazzled. Emory is a "pedestrian campus" so what that really means is that when you park there, you need to factor in two extra hours of walking to wherever it is you have to go. Okay. I exaggerate but there is no convenient, in-out type parking. So even if you're on time to get there, the parking will shoot you in the foot.

But me, I'm married to the BHE who took the kids to school and then pulled right into the driveway like a knight in shining armor. Out came his gleaming smart phone where he texted his wife saying, "Want me to drop you off?"

And I said, "Yes!" Even though I would have to figure out my way home or need to walk back, he knew I was late enough to need that offer to take me to school and drop me in the front just like it was the carpool lane.

So he did. And that seven minutes I got to spend with him was just as wonderful as he is. I appreciated him shaving fifteen minutes off of my commute. I appreciate him just being who he is even more.

Teaching Small Group Gamma was awesome and worth my morning hustle bustle. We were doing cases on sickle cell anemia and they were engaged and prepared and learning. It was good. Really good. Lately, I've been sharing stories with them about real patients affected by the diseases they're learning about to add an element of humanism and reality to the concepts. Yesterday, I read them a story about this patient with sickle cell anemia.

And they listened and paid attention. We honored that patient and respected that terrible disease. And that part was good, too.

When I was leaving, Erica U., one of the Gammites, offered to drop me off at home. So we walked and talked on the long stroll across the pedestrian campus to her car. We talked about school-things and not-school things, too. And then we rode to my house and as we did, I realized that every single one of my student advisees would know exactly how to get to my home without me telling them. That made me smile.

Erica let me out in the driveway and waved good-bye. I appreciated the lift. I appreciated the E.T. (Erica Time) even more.

That part was good.

*Here Cathy used this cool effect from an app called "Glaze." Makes photos look like paintings. Way cool.

Next: Jumped out of her car and then into my own and headed to Grady for rounds with my team. The team was on call so things were already rocking and rolling when I got there. My resident, Aaron G., is hardworking, responsible and smart. That's a good feeling to have when you have to teach in one place while your patients are in another. Things were in order, as I knew they would be.

After meeting with the team for a bit, I set off alone to catch up with some of the old patients as they admitted new ones. I was strolling through the hall on my way to a room and heard my name.

"Dr. Manning? Heeeeey! I thought that was you when I looked down the hall!"

I knew that voice before I turned around. It was the husband of the patient I'd seen on Monday--the one whose bubble I'd burst. His Fred Sanford voice was unmistakable and the big smile on his face was in stark contrast to the last time I'd seen them.

"Heeeeeey sugar!" He walked right up and kissed me on my cheek. "What you doing up here in the main hospital?" His light and jovial attitude surprised me. Especially as yucky as we'd left things on Monday. I shifted nervously on my feet, not knowing what to expect next.

"Oh, I take care of patients up here, too. What are y'all doing here?"

"She getting the PALL-A-TIVE chemos today. She feeling good, though. Reeeal, real good. I was jest trying to sort out her 'pertments cawse she was 'sposed to see a doctor today but we in here so we missed the visit. I don't want to be a no show."

Wow. With all they had going on, he was concerned about inconveniencing someone by them not showing up for a clinic appointment? Wow.

"Who was she supposed to see today?" I asked.

And so he told me who the doctor was and it was someone I knew. I offered to call and he was quite appreciative. After making that call, I popped into her room and told her hello. She was as warm and welcoming as he, and I can't even begin to tell you how that felt. Wait, yes I can. It felt like . . .like. . redemption.

Like redemption. Yeah.

How is exquisite is this photo Cathy took from a hospital window? It even captures the original Grady Hospital--red building below.

Later that afternoon I saw one of my favorite nurses, Ms. Dawonde, and she gave me the biggest, tightest hug ever. And then she told everyone on the floor that she has known me since I first got to Grady. Which is absolutely true. That felt good, too.

Sure did.

We had a family meeting planned that afternoon and with the new patients coming in, things were really crazy. We decided to divide and conquer--Aaron and the interns would admit our new peeps, and me and the PA student, Meredith, would go and conduct the family meeting.

That family meeting was hard. Hard because it really and truly felt like some kind of deja vu from what I'd gone through Monday when speaking to that same lovely couple about that horrible train speeding through her body. This train was out of the station, too.

A roomful of people stood by and listened as we had this discussion and I tried my hardest to factor in love's myopic view as I spoke to them all. Love's myopic view. . . .the disconnect between what we see through loving eyes and what is. The image of who our loved ones are or who we are painted by love and memories. Unshakable images that are based upon hearts and feelings and never, ever logic.

Yeah. So I thought about that and acknowledged that but that didn't make the topic any less heavy. At. All. But you know? It's good that I considered this because in the epicenter of all of that heavy discussion, there came one point where my patient said to me:

"I know I got this cancer. I know it's all through my body and everything, too. And how you looking at me, you looking at me like you can see all of that going on in me. Like you sad for me 'cause you know something bad is gon' happen. But let me tell you how I feel. Even with all that happening--and I know it's happening--somehow, some way I still feel like. . .really in my heart. .  .I feel is like I'm in the greatest of health." She repeated herself for emphasis. "The greatest of health! My wind is short and I get tired. But I jest don't see no sick person when I look at myself. I don't! I just don't! I see myself healthy. In the greatest of health."

And she patted her bosom and stared at me with such an intensity that it moved me deep down in my soul. It also made every single one of her family members cry big, fat wet tears down cheeks of all ages. Because that? That was a collision of harsh reality and love's myopic view right there in that room.

And what do you say to that? Tell me. What? 

That room was filled to the brim with people. Loving family who wanted to know what all of this stuff we were saying meant. Really meant. And this time, I still told the truth but as carefully as I could. Treading softly and respectfully. . . and in full recognition of love's myopic view. They cried and listened and asked. At one point, I'm (only slightly) ashamed to admit that I cried, too. Right in front of that entire roomful of people. Sure did.

And all of it, even though it was sad, was in some kind of way good, too.

I also felt thankful for running into that couple from Monday because that taught me that tincture of time is a mighty, mighty thing. Especially in situations like this.

Yes, it is.

Oh! I heard the best story on rounds. A daughter was in the hospital visiting her father who was our patient. She told me that the day that she was born, her father went to the newborn nursery and said, "Don't tell me which one is mine. I will know her when I see her." And she said this while mimicking her father's very thick accent from their mother tongue. So she walked across the room pacing like a person inspecting babies in a nursery. Furrowing her brow in the most animated way and rubbing her chin for effect. And finally she stopped. Froze over the pillow on the bed and just stared. She reached down, lifted that pillow and said, "This is her. She is mine." She lost herself in that story and, for a moment, I was a fly on the wall in that hospital far, far away in another continent. Yes, I was lost, too.

Her father was unable to speak, but he reached for her hand, grabbed hold of it and squeezed it as tight as he could. A squeeze that said those same words:

"This is her. She is mine."

And that? That was awesome. Not just awesome in the "like, totally" way but truly awe-inspiring. Divine even. I was so glad I was there for that moment. Man, I was.

My resident asked me to go and see one of the sicker of our new patients. Our entire team went to her bedside and listened to her and carefully examined her body. We did what we could to make certain that she was as comfortable as possible and not afraid.

The comfortable part seemed more successful than the afraid part.

We weren't certain what was wrong with her but we had some strong suspicions. So after we left her room we gathered and talked as a team and put all of our brain power together to get to a diagnosis for our patient. I sat at a computer and the searched the literature as Aaron looked something up on his iPhone. And this was good because the hierarchy was flattened. We were not the attending and the resident and the interns and the medical student. Instead we were one team with one unified goal to get to the right answer and ultimately the right management for this very ill patient. This meant that suggestions from any member of that team was fair game. Fair game because this patient was acutely, acutely ill and big dog-little dog tactics weren't the best use of our collective ability.

And let me just say that there are times to be the big dog--there are. But this was not one of those times. So this moment where we all so fervently thought and tried on the behalf of this patient was good. Really, really good.

Cathy's unique eye caught this image of Grady from the parking garage.

I was leaving the hospital and on my way out, I ran into my friend Lorenzo D. (known to this blog as the ultimate medicine nerd.) He saw me in the hallway and asked if I could give him a lift since his car was in the shop. I immediately said yes, partly because he's my friend and other-partly because doing so felt like a great way to pay the universe forward for me needing the same earlier.

So we rode in the car and I learned that Lorenzo, too, is on the wards right now. And we talked about our day and the things we'd seen and learned and taught. I picked his brain about my ill patient and asked what he thought. He's one of the smartest people I know so I was pretty happy when his thoughts were similar to our team's. I was also glad to hear his way of articulating those thoughts particularly since he has a way of expressing himself that always makes me feel like I'm learning. Probably because I am.

Anywho. That part of my day was good, too.

When I reached Isaiah and Zachary, they were both in high spirits. Zachary literally leaped into my arms and Isaiah told me that his day was "supercalifragilisticexpialidocious." I looked at his brown eyes and then thought about my day. My day that, up until that moment, was indescribable. I laughed out loud saying, "You know what, Brother? My day was, too. My day was supercalifragilisticexpialidocious!"

Then all three of us went to Yogli Mogli for frozen yogurt and sang that song in our very best Mary Poppins voices for the rest of the evening.

"Supercalifragilisticexpialidoctious. . . um diddle-diddle-diddle-um-diddle-eye. . . "

And that? Perhaps that part was the very best part of my entire day.

Happy Saturday.

Now playing on a loop on my mental iPod thanks to Isaiah. . . . 

and also this just because I'm in Atlanta and I love me some old school Andre 3000 and I like the play on supercalifragilisticexpialidocious from this vintage OutKast song. . . .

Cathy M.
And of course, a huge thank you is in order to Cathy M. who allowed me to share all of her beautiful photographs of Grady Hospital. Don't you just love how she has managed to capture these images between medical student moments? These photos warm my heart. There are many more lovely images and reflections on her blog. (She also does acro-yoga which makes her very, very cool.)


  1. You know, reading about your day helped me remember the many moments for me in the last week that were special. Thank you. And, I'm glad you got to see that couple again.

    1. Oh Jill. Me, too. I was so glad I got to see them, too. Thanks for your kind words.

  2. You make what it is to be a physician / caregiver so very tangible with your words. You are so very talented in so many ways-just wanted to to be reminded of that fact.

    Maria, fellow Meharrian

  3. When I read that you cried in front of your patient and her family, I immediately burst into tears. As a person who has sat on the other side of that desk and listened as the doctor told me that my 50 year old mother was going to die of cancer, your display of emotion touched me in my soul. Please don't feel ashamed. While I know my mom's doctor was sad, he didn't cry...and her radiologist showed absolutely no emotion and never had (not sympathy, not empathy even when she was going through some horrible radiation treatments). It feels right that you showed emotion over this horrible situation. Your tears were acknowledgement that this isn't just a patient, this is a person who is loved by many and that the situation will change their lives in ways they can't even imagine. Anyways, I just wanted to say thank you for being real with your patients and for feeling a little of their pain with them. For sharing the weight of that burden with them, even if for a few minutes. I know they appreciated it and so do I.

    1. Christie, it's funny. We are often conflicted about emotion because there is a fear that it will make our patients uneasy. . .seeing us as these emotionally wishy-washy types. Doctors should be stoic! Wait--shouldn't they? Sigh. I don't know. All I can be is me.

    2. I see what you are saying. I am a teacher and while I do have a relationship with my students and I care about them, there has to be a certain amount of professional distance. However, some of their problems and struggles just touch me and I have teared up in front of them...and then proceeded to cry in the car all the way home. I think you just have to feel what you feel. It really touched me that you cared that much about your patient. I love your blog! And every time I drive to Atlanta to visit my sister or my dad and I pass Grady I think "That's where Dr. Manning works!" Kinda like we're friends but have never met. Ha!

  4. Grady has long been one of my heroes...the teaching, the taught,the triumphs, the tragedies, the healing, her wide open arms and heart. Grady is a large part of the soul of this city and your words capture her essence exquisitely.
    Love, Coach B

    1. And you KNOW that you are one of my heroes. I'm so happy to know you. I really, really am.

  5. Loved the pictures (thank you Cathy)..and the father-daughter story was one which had me sighing (and tearing up a tad).

    My dad wasn't there when I was born - I came in a week earlier and my mom still chuckles when she tells me dad's first words on hearing that he now had a baby girl - "What? But she was supposed to get here on Friday - I booked my leave from Thursday onwards". Needless to say, from the moment he picked me up for the first time on that Thursday, I've been daddy's girl ever since.

    -- Tara

    PS: Missed your blogs over the past few days Dr M - I need my regular GradyDoc fix. Thank you for getting this in before the withdrawal symptoms kicked in :D

    1. Hey Tara! Yes--I was so busy in the first few days on service that I could barely do much of anything. Thanks for sticking with me and checking back in! And yes, aren't Cathy's photos amazing? And of course, of COURSE your daddy was in love from day one!

  6. Loved loved loved reading this.

    It felt like a script from Grey's Anatomy <3

    Faaaaabulous & Overflowing w/ Passion.

    I appreciate that you cried w/ the family as the patient told her story.

    You are the kind of doctor I would want, dear.



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