Tuesday, July 31, 2012

"This."


Makes me that much stronger
Makes me work a little bit harder
It makes me that much wiser
So thanks for making me a fighter
Made me learn a little bit faster
Made my skin a little bit thicker
Makes me that much smarter
So thanks for making me a fighter

~ Christina Aguilera's "Fighter"

___________________________________

I'd always thought of myself as a pretty open-minded individual. You know -- the kind of person who accepts people for who they are without some deep-seated disapproval. And no--not just for pretend--but like someone who really, truly is that way. I hold so many conversations with myself that even when some kind of mean-girl thought pops up, my inner good-girl is there to smack her right back into submission.

Sounds good right?

A little too good, I know. But despite that, I let myself believe that this is who I am. . . . this doctor without a judging bone in my body. What I now have come to realize is that I'm really just an imperfect human being who wants to be this way. That physician who walks into the room of a six hundred pound patient and genuinely feels not a wave of uneasiness but instead neutrality and the exact same feelings I'd have if that patient was one hundred and sixty pounds.

Yeah.

I met a woman who turned a mirror on me one day and showed me that even those who profess themselves to be "the open-minded types" are not always that way. At least their actions aren't congruent with that. And what should be the actions of that type of person anyway? In my opinion, it means being so empathic that no matter who the person is you advocate for them, fight for them, champion their cause and go to the mattresses on their behalf. At least as a doctor, you should.

So me? I thought I did that. I really did. And no, I'm not the self-deprecating type at all and I will even say that I am quite proud of how I treat most people in most situations. But this moment was one of the most eye-opening experiences I've had with self reflection and self examination. And yet another powerful reminder that I am a work in progress.

***

Grady Hospital, Fall 2004

I was in a good mood that morning when I walked into the Medical Clinic. Back then, in addition to sessions where we supervised the resident physicians, some of the sessions were just for direct care of walk-in patients. While my preference is usually to work directly with learners, I always welcomed these detours on my schedule. These were times with brand new patients with often unpredictable and challenging concerns of an urgent nature. I was glad that this was where I'd be for the morning.

After cracking a few jokes with the nursing staff, I plopped my bag down into the physicians' room and prepared to get started. This was before our electronic medical record so there wasn't really a one-glance way to know exactly how the flow would be. That meant one thing and one thing only--getting straight down to business right away.

At this point I'd been at Grady for three good years and pretty much had the routine down. I was working two rooms and rocking and rolling along without a hitch. Somewhere toward the end of my session, I got ahead of the nursing staff. Instead of waiting for them to place my next patient into a room, I grabbed the chart and leaned my back against the swinging door to the waiting room. Next I called out exactly what was written on the identifying stamp.

"Ava Moreira! Miss. . . . terrrr. . . uhhhh. . . Ava Moreira!"  I glanced down at the sticker with the name printed across it. I recognized that it wasn't of English origin, but that wasn't what threw me. It was the patient that stood up the moment said those first two syllables: A-VA. See, this chart indicated that this patient was male--and that was not consistent with that first name or who responded to my call.

The person walking toward me looked like some kind of supermodel or movie star. Not in that red carpet kind of way but more like those ridiculously gorgeous candid photographs you see in People Magazine of Halle Berry pushing her daughter on a swing. The minute she headed toward me, I dropped my head to double check the identifying information:

MOREIRA, AVA 31YO  M

I tried to look natural as I took a closer look. There wasn't a trace of facial hair, I saw no Adam's apple, and her gravity-defying breasts were a perfect and rather envy-inducing C cup. Her glossy brown hair was like the lady on the Pantene commercial; it took every ounce of restraint to not reach right out and run my fingers through it.  Before I knew it, she was standing right in front of me.

"Are you. . .uhhh. . . Ava Moreira?"

"Yes, I am Ms. Moreira," she answered. Her voice was husky. It could certainly be the voice of a genotypic female for sure, but coupled with that big 'M' stamped on the chart, I sensed it wasn't. I tried not to study her mannerisms but couldn't help it. Perhaps it was all in my own head, but suddenly her movements seemed almost hyper-feminine and overly delicate. The way she tossed her hair over her shoulders and secured her pocketbook on her shoulder. It all seemed so deliberate--maybe too deliberate even.

Maybe.

Or maybe not. Most women don't get picked apart for how natural they are at slipping their hair behind an ear or checking their makeup in a compact. So now that I think of it, that wasn't and isn't a fair way to figure out whether or not someone was born a male or a female.

And see, I said at the beginning that I am a work in progress so I am including the unflattering parts, too.

Speaking of which-- I'll even admit the first thing that came into my head--Austin Powers' faux British accent saying:

"That's a man, baby."

Even then, I knew that wasn't nice. So I scolded myself quickly.

Tsk, tsk, tsk.

I shook that mean-girl off and assumed my good-girl, open-minded stance. You know. That one that's hypersensitive to the fact that it must be mortifying for Ms. Ava Moreira to deal with such scrutiny about how she carries a purse or crosses her legs. And the one that bends over backwards to do and say things that let Ms. Ava know that I am 100% down with seeing who she is on the inside and treating her accordingly.

"Pleased to meet you, Ms. Moreira. Is. . . . this what you prefer for me to call you?"

Uggh.

I kicked myself right after that because I knew that I was already trying too hard. That isn't usually a question I'd hit someone with right out of the gate--and by "out of the gate" I mean walking from the waiting area. It wasn't natural.

"Ava is fine."

The voice was sultry and lower in its octaves but not dramatically so. It was mostly in that Demi Moore kind of way. Nothing about it made me take notice or give her a hairy eyeball. And coupled with her narrow waistline and surprisingly fine features her convincing femininity suggested good genes more than a good plastic surgeon.

"Okay, then, Ms. Ava. You can follow me." I stepped into the room and held the door open. She sauntered after me and sat in the chair beside the desk. Ava was clearly alright with herself. In fact, she was more alright with herself than most people I know. It was impressive.

"Ms. Ava, what brings you here to see us today?"

She blinked her eyes nonchalantly and then began. "I recently relocated here from the east coast and unfortunately don't have insurance coverage anymore. I need to get a regular doctor so that I can get regular check ups and to be able to get medication refills."

That was easy enough. Establish care. Get refills. I looked at the triage sheet and noticed her perfect blood pressure reading. Her weight was also not an issue nor did it seem like there was any other underlying medical condition that I could readily make out. I felt a sinking in the pit of my stomach as I asked my next question.

"Umm. . .okay. . .were there any problems you wanted to discuss?"

There. That was safe and neutral. And somewhat openminded-ish.

"Problems? Uhhh nooo. . . .no problems that I can really think of," she replied while resting her hands in a stack on top of her purse. With a relaxed smile, she went on. "Mostly I just don't want to go without my medications so I want to get me a primary doctor to avoid that, you know? But problems? No, I wouldn't say I have any problems." She shrugged and returned to that easy expression.

Piece of cake, right?

Wrong. I knew the minute that I met her that "medications" meant feminizing hormones. I knew I wasn't comfortable with prescribing them so this wasn't going to be a piece of cake at all. I swallowed hard and got the confirmation. "What medications are you needing refilled?"

That's when she took the bottles out of her purse and showed me. High dose estrogens and anti-androgens. Three or four bottles of different hormones with no more than two tablets left in each container.

"Here is my former doctor's card from Massachusetts. He should be able to make sense of my whole process for you."  She slid a card toward me and as she did, I noticed her perfect manicure with French tips. Ms. Ava didn't flinch nor did she seem like any of this was a big deal at all. And perhaps, if I was as openminded as I professed to be, it wouldn't have been such a big to do for me either.

"Did your doctor make a specific recommendation for you to see . . . .a certain person? I mean. . .did he . . like give you a name?"

I ripple of irritation went across her precision-arched brow. "A name? I'm uninsured. He knew that so suggested I come to Grady Hospital."

Duh.

So I sat there looking pretty dumb, I'm sure, but trying hard to be cool. I wanted to be that easygoing person who normalized any and everything and who would treat this just like hypertension. So I coached myself to relax. I adopted her easy smile and leaned onto an elbow. "Okay, then. Let's look at your meds, shall we?"

Whew.  I figured that would bide me some time while I figured out what to say or do next.

I stared at the bottles and wrote them on the chart carefully. I nodded my head and periodically looked up at Ms. Ava to make sure she knew that I was just fine with all of this. Next I performed the world's most awkward physical examination. Not because of how SHE was behaving, but because of how I was acting. Jumpy. Unnatural. Scared I'd say or do or reveal the wrong thing.

Finally, I asked her to give me a moment while I checked on a few things. As soon as I got on the other side of the door, I melted with relief.

"What's up?" One of my colleagues was walking by and noticed the odd look on my face. I explained the situation and his response was similar to my initial thoughts. "Yikes."

"I don't know what to tell her. I'm not even sure who to refer her to see."

"Yeah, dude. That kind of sucks. But you have to consider the risks of clots and all that, too. I think I'd be a little nervous to write somebody all those hormones, you know?"

So that ended that conversation and something about hearing this from a trusted and responsible colleague gave me the courage to go and tell Ava that this was over my head.

"Ms. Ava? I was just speaking with a colleague about your medication refills and we both agreed that the medications that you were taking are best managed by a specialist."

"Of course," she said confidently. "My physician several years back was an endocrinologist. I figured might want to refer me. But the last person I had was just a general guy, so I guess it differs from place to place. I'd be fine either way."

"Uhhh. . . but the problem is that off hand I can't exactly think of a specific person to refer you to. Like. . .I know there are people in the city who do this. . .but umm. . . .off the top of my head, I can't think of somebody here, you know?"

"Do those 'people in the city who do this' see patients without insurance? Because I don't have coverage, Dr. Manning. That's the issue." I could tell that I was beginning to frustrate her. She had that look of someone being discriminated against and I immediately felt ashamed.

"Honestly? I'm not really sure."

"Okaaaaaay. . . .then can you find out?" Her voice was laced with a sarcasm that let me know this was going downhill fast. "And either way, you will be able to at least give me a month of refill prescriptions, right?"

"Uuuhhhh. . . . I'm concerned about these doses, you know? Hormones can lead to blood clots and can even make the chances higher of you getting certain cancers. I'm not fully comfortable writing for these medications."

There. I said it. No.

Ms. Ava looked down and smiled. Not a happy smile but the kind that goes with a phrase like "Et tu, Brute?" Then she shook her head and abruptly reached for her medications from the counter. She shoveled them back into her purse and gave it an exaggerated zip for emphasis. Ms. Ava looked back up into my face and threw the ball not only into my court but into my face. I didn't know what to do.

"I'm sorry." 

My voice was tiny and I felt like a milquetoast personified. I should have kept quiet but something about the empty silence made me feel that anemic apology was necessary. The disingenuousness of it made the situation worse.

"Sorry?" she scoffed, "What are you sorry about, doctor? Please, tell me." The sardonic grin was killing me and her Portuguese accent seemed to highlight everything I was doing wrong. No question--Ms. Ava was tough and smart and she was fed up. I was getting exactly what I deserved.

"I'm sorry that. . .  I. . . can't be more helpful."

"You mean sorry you won't be more helpful. It's pretty disappointing actually."

Disappointing. Ouch.

"It's just that this isn't my expertise, Ms. Ava. It's not." I pushed myself to make eye contact with her so that she would believe me. "I try not to move too far out of what is in my jurisdiction to treat, you know? I just don't know enough about this and don't really think it's appropriate for me to write prescriptions when I have so many questions."

She nodded and kept searing me with green eyes. I squirmed under her gaze and felt my chutzpah pooling at my feet with every second ticking on the clock.

"Dr. Manning? What do you do when you aren't comfortable with any other problem? Tell me--what do you do when new medicines hit the market or guidelines change? Do you just announce to people that you 'aren't comfortable' and 'you don't know?' Do you? Or do you go and find out? I guess it has to be a problem you think is worth treating and even acknowledging."

"That's not fair, Ms. Ava. I read a lot about many things. It's just that this isn't that simple."

"'This?' 'This?' You can't even say it! Listen, Dr. Manning. 'THIS' is my life. 'THIS' is who I am and what has saved me from a world of misery. 'THIS' is what finally allowed me to be okay with the skin I'm in and to finally feel like I wasn't in costume. 'THIS' is not just an 'oh well, tough shit' thing to me! It's as life and death as any of the other things you do to save peoples' lives every single day. The things you look up and learn and find out to keep people alive."

My face was on fire. I was speechless. Every time I tried to open my mouth, nothing came out.

"It's funny," she went on. "On the outside you seem like someone who takes pride in being all renaissance and open to all different lifestyles. You even made a point to call me 'MISS' and made sure I heard you talking to that nurse when you referred to me as a 'SHE'. But at at the end of the day, you might as well have called me 'SIR' and subjected me to a hernia exam--it would have been just as humiliating. Just as humiliating."

My foot was shaking under the desk. I started thinking of something, anything to make me not cry in front of her. Her words stung and they stung because they were true.

"I don't know what to say," I finally eked out.

"You should ask yourself why you've never taken it upon yourself to learn more about . . .'THIS'." Ms. Ava waved her hand in front of her body. "Are you even who you think you are? Maybe your feelings aren't what you think they are. Do you even know how high the risk of getting a clot is with this? Do you? My guess is that you have no idea. Just another bullshit excuse to avoid having to get involved in. . .this."

I couldn't take it any more. I stood quickly and excused myself again. Before she could even grant me permission I was out of that room and  headed for the nearest bathroom. The minute I got on the other side of the door I started to cry.

You know I did.

Do I even know who I am? Do I? I stared at my crying face in the mirror and asked myself those questions again.

How must Ms. Ava have felt? I thought of me, a black woman, and the times I've felt like a novelty or an afterthought based upon the actions of others. Folks who said and did the right things with me kind of like I did when I called my patient by the preferred pronoun. But then, through their indifference or neglect, erased every one of those things in one fell swoop.

Next, my mind drifted to the many times I've pushed to get people what they needed and what I believed they deserved. I thought of the articles I'd read over the years about various things and various topics--all with a goal to get myself proficient with treating a particular condition. I remembered the man I'd treated in the hospital the very month before with acute intermittent porphyria and how hard I'd worked to understand the pathophysiology and treatment. A lot of effort when into his care--and I was the one who treated him.

I was. Not the "porphyria expert" on call.

Why didn't I know those answers to those questions about the hormones? Why? Ms. Ava wasn't the first transgender or transsexual person I'd ever seen. She wasn't. But she was the first to call my ass out for casting a judgement by my refusal to acquire more knowledge of the very thing most important to people like her.

Damn.

I rinsed my face and patted it dry with a coarse paper towel. I took a deep breath and walked down the hall to the physicians' room. Quietly I picked up a phone and got the number to the Endocrinologist on call. Once I got them on the phone, I let Ms. Ava's cutting words nudge me into action.

"This is urgent. My patient is a male to female pre-operative transsexual who recently relocated here from Massachusetts. She will be out of her hormones in three days and it is imperative that I get her linked in to someone who can maintain her feminizing hormones and androgen suppressing therapy."

I held the phone and waited. And you know what? That consultant was extremely helpful. She put me on hold and spoke with a colleague who had several suggestions. I hung up with a clear plan and a good way to bridge Ms. Ava as she got established with a new longterm provider.

And that was that. I knew in that moment that my words to that Endocrinologist made a difference. They were words of advocacy instead of apathy. And it greatly affected the outcome in the end.

So I went back to Ms. Ava and shared the plan. She looked relieved but still was not backing down from me.

"Thank you," I said. "Your words hurt but they opened my eyes. They really did."

"This is hard," she replied. "You learn to stand up for yourself."

And I got that because she was right.

So from there, for the first time, the exchange became natural. I heard about what it was like for her in her home country of Brazil and how she'd come to the Eastern seaboard to go to college. She explained how tough it was in her very Catholic household to be trapped in the wrong body and how much taunting she endured over the years. "It made me strong," she said. "It made me a fighter so I don't take nothing from nobody. I just have to live my true life so I'm not apologizing to anyone for that."

And I got that part, too, because I feel the same way. Damn, I do.

To this very day, I think of Ms. Ava often. I remember her words and let them kick me straight off of any high horse I decide to climb on top of. I examine my actions--my authentic actions--and ask what do they mean? Am I being an advocate? Am I open-minded? And if my actions are simply because of some deep-seated belief, instead of fronting like it doesn't exist, at least I acknowledge it for what it is.

Yeah.

Me? I am a work in progress. I am a human being with quirks and feet of clay. I am thankful for a place like Grady that reminds me of this every single day.

***
Happy Tuesday.

Now playing on my mental iPod. . . . "Fighter."





Sunday, July 29, 2012

Everyday wonderfulness.


"The colors of a rainbow
so pretty in the sky
are also on the faces
of people going by 
I see friends shaking hands
sayin', "How do you do?"
They're really sayin'
I love you."

~ as sung by Louis Armstrong aka "Satchmo"


_____________________________________________________________

We were talking about everyday things. Well, not necessarily everyday things for everyone but definitely for a doctor and a patient. Nothing about it unusual.

"You know I been smoking longer than you been on this earth?"

That was how you countered my totally predictable queries about your readiness to put down the cigarettes. You were only in your early fifties so I challenged you back.

"You mean to tell me you started smoking before you even turned ten years old?"

You raised one eyebrow in the most animated way ever. "Hold up. How old you are?"

And animated right back at you I held up two hands to show you that your estimation, though flattering, was off. Four. One.

The edges of your mouth turned downward and you nodded your head. "Well hell. You know black don't crack!" We both laughed out loud. "But for real, doctor. I'm still getting my mind ready for it."

I could respect that. You weren't ready and that was understandable. Even if it wasn't forty one years that you'd been smoking, thirty two years was still quite a long time. So I did what you are supposed to do in that instance and provided you some patient education and reasons that you might want to quit.

And that was that.

So we moved on to other things like what kinds of foods you were eating and how you could get more exercise. And all nestled in that discussion was familiarity and one-line jokes that made it not feel like a visit to the doctor at all. Instead if was more like sitting on lawn furniture talking and holding glasses of ice cold sweet tea sweating with condensation.

You'd think we'd known each other much longer than the ten minutes of that visit. But this was our first encounter. Our easy exchange reminded me of how there's something about Grady that accelerates through the awkward first-meeting phases and goes straight to the good parts.

"You know what, baby?"

"What's that?" I responded. And no, I was not the least bit offended by you calling me baby because it seemed to be just as woven into the fabric of your everyday being as that thirty two year tobacco habit of yours. Plus there was something about the way that word rolled off of your tongue that made me feel special to be on the other end of it.

"I'm thinking 'bout getting me some of that nicotine gum today." You drummed your fingers on your lips, almost like you were thinking of reneging on that statement.

"It sounds like you are getting more ready to quit. That's really wonderful."

"I think so."

So I smiled at you to affirm the step you'd just taken. I suppressed the yearning to wag my finger and explain to you that you can't smoke and chew the nicotine gum and even swallowed back the not-so-encouraging truth about how it isn't really like gum-gum but more like a peppery hunk that you park between your cheek and your gums.

I just squeezed your hand and let you know that this was good. And I continued to savor all of the everydayness of you and our encounter.

"Who knows, baby? My day might be right around the corner, yeah!"

We chuckled together and you tightened your leathery hand around mine. Something about it was electric and in that moment I felt very glad to have been the person randomly led into your presence that day. I let your words marinate. Your intonation, your slang. This was not a Georgia Peach vernacular.  Southern, yes. But not from here.

"You are not from Georgia. This I know for sure." I stepped out on my assumption and made that bold proclamation. This observation amused you.

"No ma'am! Been here for a while now, but no this ain't home."

"Knew it!"

"Okay, baby. So where you thinking I'm from? Let's see how good you is!"

"How many guesses do I get?"

"One."

"One!?"

"One."

I narrowed my eyes and that made you laugh even more. Pursing my lips, I rubbed my chin and then pointed right at you.

"New Orleans."

"Final answer?" you deadpanned.  I loved how you played along.

"N'awlins," I stated with a firm downward head not. I banged my palm down on the desk for emphasis. "Final answer!"

You gave me an obligatory pause before reaching into your bag and pulling out a key chain with a fleur de lis hanging off of it. "New Orleans born and raised! You know it, baby!"

And I clapped and laughed in unison with you.

"You know? I can tell you ain't from here either," you finally said after my celebration subsided.

"Yeah? Take a guess?"

"Oh, I ain't good with places. But I will say that you one of them folks who ain't from the South but got the South in you. I can tell that."

A big grin spread across my cheeks because I could not imagine a more accurate description of me and my connection to this part of the country.

"California. By way of Alabama." I nodded and pointed at you again.

"Knew it. Your peoples from the South. Tha's how I could tell it's in you. You say 'yes, ma'am' like somebody that got the South in they blood. But something else sound like you from outside of these parts."

"Really? Like what?"

"How you pick out every syllable on every word. That sound like another part of the country."

"Gotcha." I stuck that on a post-it in my head for a later time.

"How you knew I was from New Orleans?"

"First, it was the way you said 'today.' It sounds kind of like 'to-dey.' I associate that with New Orleans. Or maybe South Carolina. But the 'beeebbby'? Now that clenched it."

"Yeah, beeeebbbby. Nobody say it like us in Looziana, bebbbby!"

That extra cajun that you put on top of it warmed my heart. Even though I felt like I could have sat and chatted with you for another hour, I knew I had to go and so did you. I stood from my chair and shook your hand again. Still unable to repress my grin, I told you exactly what I was thinking. "Such a pleasure meeting you."

"You, too, baby. You, too."

And that was that.

This was only our first time meeting. Perhaps the next time I can ask you about shrimp étouffée or whether gumbo tastes better with roux or without it. And maybe you'll tell me that you quit smoking altogether. Maybe.

Yes. We were talking about everyday things.  And no, nothing about it was unusual. But in it, I was reminded that in all of those everyday things--whether we are Louisiana pralines, Georgia peaches or California raisins--we are always more alike than we are not.

Always.

And this is what I love about people and about Grady and about everyday moments. This is what I love about it all. Because these things never fail to make me think to myself, What a wonderful world.

Oh yeaaaaah.

***
Happy Sunday, beeebbbby.

Now playing on my mental iPod. . . . .Satchmo sings it best.



Saturday, July 28, 2012

Sounds of This American Life.



Things I heard today. . . .

Birds chirping.
Isaiah whispering.
Coffee brewing.
Refrigerator door opening.
Cereal bowl filling.
Milk pouring.
Zachary's feet padding.
Lips kissing.
Kids screaming.
Mommy shushing.
Coffee sipping.
Shoe laces tightening.
Feet pounding.
Breath panting.
Neighbors waving.
Heart rate climbing.
Legs stretching.
Shower running.
Music playing.
Turkey bacon sizzling.
Eggs cracking.
Daddy teasing.
Kids screaming.
Kids pouncing.
Daddy fake-falling.
Mommy laughing.
More coffee pouring.
Adult voices talking.
Adult lips kissing.
Kid voices interrupting.
Nobody shushing.
Kids talking.
Parents listening.
Dryer buzzing.
Bag zipping.
Car starting.
Daddy count-downing.
Kids screaming.
Hands clapping.
Zachary singing.
Isaiah shushing.
Zachary singing.
Isaiah groaning.
DVD player playing.
Cartoons talking.
Kids watching.
Parents reconnecting.
GPS re-routing.
Car door opening.
Kid feet running.
Parent hands grabbing.
Mommies "hey-girl!"-ing
Daddies man-hugging.
Kids squealing.
Friends laughing.
Sunblock slathering.
Chlorinated water splashing.
Cannon ball announcing.
Brows sweating.
Barbecue crackling.
Daiquiris blending.
Teen lifeguard duty-ing.
Grown-ups too-loud talking.
"Marco!" yelling.
"Polo!" answering.
Mommies gossiping.
Daddies shit-talking.
Grandparents beaming.
Fingers snapping.
Hips shaking.
Time ticking.
Dusk falling.
Kids crying.
Families goodbye-ing.
Wheels turning.
Kids whimpering.
Mommy shushing.
Kids dozing.
Daddy driving.
Mommy dozing.
Garage door opening.
Tub filling.
Daddy military-ordering.
Kids quick-bathing.
Daddy handling.
Mommy thanking.
Zachary already snoring.
Isaiah stay-up-longer-negotiating.
Daddy shushing.
Toilet flushing.
One last kissing.
Television talking.
Daddy watching.
Daddy snoring.
Crickets symphony-ing.
Mommy yawning.
Mommy reflecting.
Mommy sighing.
And almost crying.


Because this? This was a perfect day filled with beautiful sounds in a blessed life. And I'm thankful for that.


***
Laptop closing. Happy Saturday.






Thursday, July 26, 2012

Top Ten: Early Morning Thoughts.



Good morning, friends. Here are the top ten things I am thinking about over my morning coffee.

No pomp. No circumstance. Just these thoughts. Okay?

#10  --  You are fine.

This week I sat across from one of my learners who has been flying on one wing. Feeling inadequate, defeated. . . and less than. I tried my best to chuck their chin and tell them how wonderful they are. I thought of ways to improve their feelings about who they are and to stop worrying so much about what others think or say.

And I was doing that because the nature of our meeting was for me to brainstorm with this person ways to improve. There had been a few hiccups and perhaps, some people had identified this learner as sub-par at some point.

It was a high hill to climb. Tears were involved, too.

And you know? I am mentioning it because I have meetings like that at least a few times per month with various people. But for whatever reason, something about this one hurt me in my heart.

I thought about that meeting all night. This morning I had an ah hah moment.  I realized that my perspective was that of someone who had not faced similar speed bumps with their work product or the harsh criticism this person had received. I imagined if I had.

I really, really meditated and let myself wear this person's shoes.

And you know? I felt angst. Deep angst. Fear. And worry.

I am not sure how to help. But what I know is that saying "you are fine, you are great" is not enough. Perhaps I need to think of ways to show them they are. Or help them get there? I don't know.

#9 -- Colombian roast.

That's what I'm having this morning. And yes, I can taste the difference. It is delicious and is making me quite happy.

#8 -- Bad Patient.

Yesterday, I didn't have to work until later so I took the boys to the pool. I sat out in the hot sun and waded around playing ball with them all morning into the afternoon. I was crazy about keeping them hydrated and neglected to hydrate myself.

That afternoon? I had a splitting headache, nausea, and even vomited once. I aggressively drank water to refuel because after my foggy brain put together a differential diagnosis, "dehydration" was on my list.

Water was the panacea.

Hey, people. Especially ones with kids--you need to drink water and use sunblock, too.

#7  Meditation.

I'm a prayer. Not so much a meditator, I don't think. I sat still and meditated after praying this morning. No books. No laptop. Just me sitting still thinking. Or rather being.

Sounds kind of heavy for no reason,  but it was good. I think I'll do it again.

#6  -- Hairy situation.

My friend Stacy H. was rounding in the hospital and her PATIENT was in the room with her husband. Guess what they were doing?

Nope, nothing dirty. Instead, this patient's husband, who wears his hair straightened a la James Brown himself, was seated in a chair getting his hair curled with a hot-hot marcel curling iron.

Mmmm hmmm. Sure was.

Yes. She was the patient. And they looked as in love and as content as could be. So don't even bother judging. Yes. I saw it with my own eyes--it was adorable.

#5 -- These lyrics, this song.

"Woke up in the morning feeling fresh-ta-death! I'm so blessed--yes, yes.
Went to sleep stressed woke up refreshed I'm so blessed--yes, yes!"

 My anthem this week, this month, this year. But especially this morning. I listened to the whole thing and watched this whole video and felt ready for my day.




#4 -- The Cicada Ladies.

Ms. Moon's daughter is in a group and plays the mandolin! They made a bluegrass CD that I purchased and am enjoying so far.

Hearing that music makes me feel connected to her, so I love that.

#3  -- Speaking of mandolins and Sister Moon.

Mandolins always make me think of R.E.M. No, it's not bluegrass but the mandolin at the start of this song could possibly be one of the best things I have ever heard. I love this song and I know Sister Moon does, too. Hearing it makes me feel connected to her, too.



I like being connected to people.


#2  -- Dropping balls.

Sometimes too much is going on in my head at once. I dropped a few balls in recent weeks. Instead of berating myself, I just sat still and tried to get to the root of why. What's going on with me? How to sort this out?

Here's what I did. I wrote all the things I'm doing right now on little circle pieces of paper and laid them in front of me on the kitchen table. I looked at them and said, "Which of these balls needs to stop being juggled?"

Seeing it concretely helped me know where I need to pull back. And that more of those balls need to be for me and me only. I haven't been consistently exercising, either. That ball needs to get added back in.

That exercise felt good. It made me feel better and perhaps it reminded me that "I'm fine, I'm good." Took away a bit of the angst I felt about doing too much, too. You should try it if you feel that way. Visualizing things like that was pretty powerful. Helps with where to say no.

Maybe this is something I can do with that learner. Not sure, but maybe? I don't know.

#1 -- July 26.

My grandmother turns NINETY today. And her sweet granddaughter, JoLai, my sister was born on her birthday. JoLai turns 41 today.

Happy birthday to both of these very, very special women.






***
Happy Thursday.

Tuesday, July 24, 2012

Like home.


Living here in this brand new world
Might be a fantasy
But it's taught me to love
So it's real, real to me

And I've learned
That we must look inside our hearts
To find a world full of love
Like yours
Like mine

Like home.

~ from "The Wiz"
_____________________________________


Do you ever just sit and reflect on something. . . . and allow yourself to get all worked up to the point of the ugly cry?

I do.

Not all the time. Just sometimes.

So tonight I was just looking at this picture. I was looking at this picture and thinking about the fact that this month marked my eleventh year as a Grady doctor.

Wow.

This image--that my patient graciously gave me his permission to share here--was taken yesterday in clinic. It includes one of my most favorite patients of all time.

And I don't know what it is. . . .but I cannot even look at this photograph without blowing my nose and wiping my eyes. Not even kidding. I think it's because it absolutely captures everything I love about working at Grady Hospital.

The people.
The privilege.

I look at this picture and. . . yeah. My heart just feels so glad. . . so happy when I look at this. I just feel so fortunate to be here. Sitting across from people who have so much to teach me about life and love and peace of mind. Of struggles and overcoming and joy and faith. About what it means to be alive.

We also share some good laughs.

On this day, my patient was with his son who looks EXACTLY like him. Almost to the point of looking like they could be identical twins. So I poked fun at them before getting down to business.

"So who is this guy?" I teased.

"That's my son!" he replied as a smile began to spread across his cheeks.

"Really? He looks nothing like you." I put on a pseudo-serious face, which made my patient laugh out loud. Big, bellowing laughs from deep down in his diaphragm.

"You don't see the resemblance?" I love how he tried to look serious too but his lips kept quivering from his amusement.

"No, sir. I think you should see about getting a paternity test to make sure." I stuck with my deadpan.

"A who?"

His spitting image son chimed in. "Daddy, that's a blood test they can do to tell you if you the daddy or not. They do it on Maury Povich all the time." And he chuckled a chuckle so eerily similar to his father that it made my mouth fall open.

My patient knitted his brow. "You mean they can DO that? They can tell you with just some blood for sure if you somebody daddy?"

"Yeah, Daddy. They been able to do that for a long time!"

My patient let that marinate for a bit -- like he wasn't sure if we were just pulling his leg. Then finally replied:

"Shoooooot. Bet that make for big ruckus at the family reunions, don't it?"

And with that, we all collectively laughed out loud without even the slightest concern for how it sounded. I took in the similarities of their mannerisms and even the lines framing their mirror image smiles. I was so happy to see my patient, and seeing his son beside him made me even happier.

Yeah.

I told a group of medical students today that the reason I love working at Grady Hospital so much is because when I am there it feels like home.


Home. 

So I guess when I look at this photograph of this very special patient sitting in this very special hospital I feel so full because it reminds me of how good it feels to be at home. Because home feels safe and right. I also know that a wonderful home that rises up to embrace you every single day is a blessing. It sure is.

For the last eleven years, that is exactly what I've had. A world that was initially a brand new world and so intimidating at times that it felt like a fantasy. But just like that song says--it's taught me to love, so now it is so, so real to me.

It is.

Grady inspired me to start writing here. . . and from that I gained the courage to do so many other things. And through it all--this privilege--I've learned now, in every aspect of my life, to look inside of my heart to find a world full of love. . . .

Like yours.
Like mine.
Like Grady.

Like home.

And when I think of that? That makes me cry.

***
Happy Tuesday and happy Grady-versary. May you feel at home and think of home often--wherever you are.

Now playing on my mental iPod and making me cry even more. . . .the late Whitney Houston singing "Home" in her first ever television debut. . . .




Saturday, July 21, 2012

Lighten up. Be easy.



I was fretting the other morning. Making mountains of molehills and creating stress where there really wasn't any. "What about this?" I asked Harry. "What about that?" I pressed between mouthfuls of toothpaste. Harry kept responding with reassuring one-line answers designed to get me out of my fretful do loop.

Since my car is in the shop, I decided to lament about that, too. Harry drove me to work while the kids chattered in the back seat. I went from the expense, to the inconvenience, and to what this would mean to us replacing that car. "It makes no sense to get all this work done to this car and then trade it in. I guess we'll keep it a few more years instead of getting a minivan."

Finally, he'd heard enough. "Babe? You need to lighten up."

Yes. This was his tender-hearted response. And it was okay that he said that because it was true.

I let out a big exaggerated sigh. "I do need to lighten up sometimes, don't I?"

"Just sometimes you do," he replied with a relaxed smile. "Sometimes you just have to decide to be easy and just go with the flow. Especially when it's not the end of the world."

So I put those words on a post-it note in my head as I leaned over the console to give him a kiss before jumping out of the car.

Lighten up. Be easy.

I saw this Grady elder in the clinic later on that morning. He was walking through the hallway and appeared a bit lost. Not lost in that way like where you don't completely know where you are, but more in that way where you know you're right near where you're supposed to be.

"Hey there, sir. Can I help you out with something?" I asked.

"Look here. . . is this where the nutritionist have the group class?" He said that while staring at this little blue index card that obviously served as his treasure map.

"X marks the spot."

I pointed to the open door that was right behind him. He swung around and then threw back his head and laughed.

"If it had'a been a snake, would-a bit me!" He erupted into that same joyous chuckle once again and I immediately felt glad that I was the person standing in the hall with him to enjoy it.

Joy was emanating from this man. He was a big man, both vertically and circumferentially. His skin was like sun-baked tobacco leaves--a warm hue of creamy brown with valleys pressed throughout. Years of that happy expression and laughter had permanently embedded an outline of glee into his aging face.

It was perfect.

"I think they don't start for a few more minutes, sir."

He nodded and smiled once more. "Long as I'm in the right place, I'm alright. Thanks, hear?"

"You're welcome," I replied. For some reason I didn't want to walk away from him. His presence and light brought me joy. "That's good that you're coming to the nutrition group."

Again came an outpouring of fluffy laughs. He grabbed this midsection with both hands and shook it like a bowl of gelatin. "I sho' need it, now don't I?"

I offered him a playful scowl. "Now, see? You trying to get me to put my foot in my mouth."

He gave his belly another pat which seemed to tickle him even more. Just then, I noticed that three finger nails on his right hand were painted. With nail polish. Three different shades -- blue, yellow, and pink.

He caught me looking and didn't look the least bit embarrassed. In fact, he splayed his fingers apart extending his hand in front of us both. "How you like this handiwork my great-grandbaby put on me last night?"

His eyes twinkled as the tricolored manicure reminded him of someone who surely was the apple of his eye. My heart melted right then and there.

"Awesome," I replied. "I think it's just awesome."

And I said that because I meant that. I surely did.

"You thank they'll mind if I just sit on in this room and wait for them to get started?" he finally asked.

"I'm sure that's fine."  I was still smiling at the image of his "great-grandbaby" painting his nails.

"Alright then, sugar. Take care, hear?"

"Will do, sir."

And just like that he was gone.

But not his image. Because this man embodied exactly what Harry was talking about. He was "lighten up" and "be easy" personified. Right down to his blue, yellow, and pink fingernails.

So I thought of him and thought of Harry often for the rest of that day and the days that followed. Recognizing that there are big things going on in the world right this very minute that warrant fretting and angst.

But none of those things were a part of my do loop.

And no, that doesn't mean that the things in my own life don't matter. Nor does it mean that for every issue that a person frets over. . . that someone else should come along and remind them of crazed gunmen opening fire in theaters to put them in their place.

Instead, it just means that sometimes. . . . it's good to just lighten up. To let yourself get lost. To let yourself look a little ridiculous. And just be easy.

No matter what.

***
Happy Saturday.


Thursday, July 19, 2012

Another random post.



Can I just start this post out with this photo I took of Isaiah with his pediatrician recently?

She has excellent bedside skills and I just LOVE the way she talks to my child. She always treats him like the visit is all about HIM and not ME because it is about HIM and not ME.

And.

She knows that I'm a doctor but she never treats me as if I need the Cliff Notes version of the well-child visits for my children. Besides, with all that focus on the kids and not me, there's no time to be worrying about me and whether of not I feel insulted by too much information. Which, for the record, I do not.

She also doesn't call me "Mom." Which I have decided that I appreciate now that I'm on the other side.

Anyways. Just wanted to start with that. Kind of cool to watch people who are good at what they do.

Yup.

What's going on? Hmmmm.

I was walking through the hall at Grady today. This nurse that I don't know personally said to me, "You must be busy this week. I was looking for a new post today."

"I know! I'm slacking," I replied.

"Yeah, I guess that hair mane-ifesto you wrote earlier this week left you exhausted. That was a long one! But a good one, though!"

And I laughed out loud because that statement made me happy and touched me, too. It was also funny that she called me out on such a long post. (She wasn't the only one.)

Yep.

So the thing is that usually someone or something reminds me of a lesson I learned at Grady or somewhere. Then I write about it. But for whatever reason, I don't have a clear idea of what I wish to write about tonight. So this will be an aimless random post. Or "mindspacing" as my friend Jameil calls it.

Yeah that.

So where to go next?

Oh yes--this:

Sculptures in the Hartsfield Jackson Atlanta Airport.


They have some beautiful sculptures from all over Africa in the Hartsfield-Jackson Atlanta Airport. You should peep them if you aren't in a hurry and want to get a good walk in instead of the train. I didn't get the artists' names, so forgive me for that.

Moving right along. Oh!

I've told you before about how I don't eat any cheese except for mozzarella and provolone. Okay, I do eat cream cheese and can live through ricotta when it's nestled into a very tomato-ey lasagna. Otherwise, that's it for cheese.

Why? Very simple. It smells like feet. Well, specifically toe jam inside of stinky feet.

Um, yeah. So most cheeses I take a pass on.

But fresh mozzarella? This I can roll with. In fact, a fresh caprese salad is one of my favorite things in the whole wide food-planet to eat. And any chance I see one on a menu somewhere, I order it.

Well. A few days ago I had a hankering for some beefsteak to-MAH-toes nestled beside some buffalo mozzarella and basil leaves. Oh, and drizzled with balsamic vinegar. And this hit me while strolling through my neighborhood Kro-gzey (also known to others as Kroger.)

So I bought me some of those juicy beefsteak to-MAH-toes and the rest of the trimmings and trappings for my very own caprese salad. Sure did. And was so proud of it that I asked it to pose for this picture before being devoured by yours truly.


Such a ham, my salad. Look at her posing for pictures like she's in some fancy-schmancy restaurant or something.

You know what really made this good? The tomatoes were sweet and ROOM TEMPERATURE. Random query: Am I the only one who doesn't like cold tomatoes on my teeth? Matter of fact, I don't like biting into cold foods period. But especially tomatoes because they're sweeter at room temperature.

Yep. Enough about the tomatoes.

Hey!

We had new interns in the clinic last week and this week, too. Super cute. It's so amazing to know that in just the blink of an eye we'll be hugging and saying good bye.

Sigh.

That reminds me. I got a text message from one of our recent residency graduates, Rob B. He is in Boston doing a fellowship in critical care and pulmonary medicine and I was especially happy to hear from him since I was working in the clinic where he was assigned for the last three years. What's funny about Rob is that he is super bright and funny and an amazing doctor -- yet very stoic. I was his preceptor in his continuity clinic every Thursday morning for three full years. And I had him for a full month as his ward attending at Grady during his training.  So my point is. . . I got to know Rob quite well.

Which isn't unusual for my relationships with a lot of our learners.

I found this old iPhone clip of him teaching as a second year resident on the wards. He was teaching EKGs to the medical students on our team--even though he was so mortified when he caught me filming that he stopped. The students with him (Ania and Emily) were on their first ward month in Internal Medicine as new clinical rotators. . . and both of them are now somewhere in their first month of Internal Medicine residency.

How cool is that?


video


Yeah.

So anyways. On his final day of clinic, I was on the wards and had come by to cover the lunch hour. When I walked in, one of my colleagues told me that Rob had been waiting for me. A few moments later, he came into the clinic and sat on a stool facing me.

Now. If you know this guy, you know that I expected him to crack a joke or say something witty but appropriate for a not-so-mushy good-bye. And seeing as one our going laughs was always about how Rob was an "ICU" kind of guy and how he'd rather be dragged over broken glass than be in his weekly continuity clinic, I was preparing for a good parting one-liner.

"I just wanted to say thank you," he started. His face was serious; there wasn't even a trace of whimsy there. Then he went on to tell me exactly what our working together meant to him and his career. Rob's expression did not waver in the least. His words were careful and genuine.

I looked at him for a beat and immediately saw him eagerly taking his first patient in the clinic three years before. My mind wandered back to us rounding together during his first supervisory month and me watching him getting his feet wet as a teacher and leader.

And that? That, when combined with him sitting in front of me all serious and grown up, was enough to start the water works. I cried right then and there and thanked him for teaching me so, so much. Because I am certain that he taught me just as much if not more.

And I knew I'd miss him.

Today I did. So I was really happy to receive that text message sharing that he was well.

Hmmm what else?

My car is sick. Not in that "do not resuscitate" kind of way, but enough to be in the "hospital." That kind of stinks. Harry says it's because I only wash my car every three months. To which I protested quickly, "EXCUSE ME, sir, but I do not get my car washed every THREE months."

"Oh, my bad--FOUR MONTHS."

"Get it right, dude." I showed him, didn't I?

Yeah, so pray for the Volvo. And wash your car if you haven't.

Hmmm. . .oh yeah!

Why did Zachary walk up to me with his shirt off flexing his abs and asking me if he had a "SICK-PACK?"

A "sick-pack?"

0_0

I will so be using that as a joke on someone in the very near future. I'm not sure who, but somebody who thinks they have a six pack will find out that it just might be a "sick pack" instead.

Oh yeah.

Worse than that, Isaiah referred to one of his body parts as his "nuts." Then later that night he referred to those same anatomical parts as "balls."

Owner and operator of Camp Papa? You got some 'splainin' to do. Ah hem. Yes, you do.

Mmmm hmmm.

What next?

My friend and fellow Grady doctor, David M.,  took this picture of me when we had dinner recently. And by dinner I mean Mexican beers and tacos. But something about this photo makes me happy because I was laughing when he took it and because we had a good time that day.


Oh! Guess what? My grandmama is turning NINETY in exactly one week! How cool is that?

My mama with her mama!

My grandmother lives in Tuskegee, Alabama and loves being at home. So much so that it is very unusual for her to leave to go out of town or anywhere requiring a whole lot of hoopla. Which, if you ask me, is her license after living this long.

So for her birthday, she made it clear: NO PARTY. NO HOOPLA. And no leaving her house.

Capisce?

So a comprise has been developed that I will report next week. And truthfully, I could just as easily tell you now since it is very unlikely that my grandmama is on-line reading blogs.

But. You never know.

No, you do not.

It meant a lot to me when my grandmama came to my wedding. To some of you, this might seem like a no-brainer, but for those who know my grandmama, it wasn't. It's a big deal for her to leave her home. Well, I take that back. She leaves but not often and definitely not overnight.

But on the weekend of my wedding she stayed. She was at the rehearsal dinner, in the hotel, and at the wedding. She even hung around at some of the reception before going back to her hotel room.

Which reminds me.

I married the BHE when I was thirty-three. This means that I attended and participated in a lot of weddings prior to us jumping the broom. I stood in a lot of packs with hands up trying to catch bouquets.

Which sucked.

Something about the whole bouquet toss thing used to be a bit humiliating. I know. That's mean to say. But it's how I felt. So I always knew that if I ever got the chance to get married, I would not subject my single friends to this horrid little tradition.

Nope.

Instead, I did what a lot of people have started doing (which I assume since I got the idea from a wedding magazine.) An anniversary dance where married couples danced and were picked off the floor by years married. And the last couple standing would be the recipients of the "tossing bouquet" and the garter.

Our cousins on the BHE's side won. Ann and her late husband Pete. And that process was sweet and touching and endearing.

But the other thing I did was not typical. At least I don't think.

I saved my "real" bouquet for my grandmama. And, similar to Rob B., my grandmama is very stoic. Not a crier at all.

And don't you know when she received that bouquet she cried and cried? My older sister took it to her in her hotel room during the reception and she described it all in full detail. And couldn't even tell the story without crying.





So, yeah. That was a special memory with my grandmama. She's a really special lady, too.

I remember a lot from our wedding day. I'm so glad that I do, too. The advice I always give people who are planning a wedding is to pay attention. Take in the people, the energy, the day. It may be the last time that many of the people you both love are all in one place celebrating.

For us, several of those people have already departed, too.

Yep.

What else?

The hair salon was pretty chill today. The peach cobbler man didn't come today but a different guy came and just said he was the "food dude." Which was fitting since he was a dude and he sho' nuff had some food. Fancy food, too.

I was taking a cat nap under the dryer so didn't take a picture or get his story. But I did open one eye long enough to chuckle at him saying "food dude."

Heh.

Hey speaking of the hair salon. . . am I the only one who feels like they have lost like ten pounds every time they get a haircut? This has not been a good body image week for me. Haircuts help me with that. Don't ask me why.

"Mane-ifesto." That was a pretty funny play on words now that I think about it again. Ha ha ha. My friend Julie J.M. said that my Hair Ye post was -- and I quote --

"A downright Dickensian treatise. You, my dear friend, have just accomplished the hair equivalent of Roots."

Even my Grady BFF Lesley M. didn't finish the whole post. I guess Roots was kinda long, huh?

Ha ha ha.

ten pounds lighter

Yup.

So yeah. . .even though the salon was pretty chill, we did have some good conversation. Today they were talking about this thing that this actress named Nicole Ari Parker came out with called the "SAVE YOUR DO" gym wrap.

Maaaaaan. . . . please.


It's this hair wrap thingy that is supposedly made of something that wicks moisture away from your scalp to keep you from turning into the Fresh Prince of Bel Air after you go to Spinning class.

Lawd.



Well. Let me just tell you that if the sistas in the salon serve as any kind of focus group on this product, it's a fail. But if the YouTube videos are a focus group, Ms. Nicole is making some moo-lah as I type.

But the salon peeps had this to say:

"If you sweat in your head, ain't nothing saving your do from being a don't--I don't give a damn if it's patented or not!"

And the salon church said a resounding AMEN.

Even the "food dude" was laughing.

So, I'm just kind of wondering if any of the working out sistas with hair of the kinky persuasion have tried this so that I can report back on it. Since I'm not a head-sweater, I'm not a good person to try it.

(And since I vowed to never spin again.)

I wonder if the Surgeon General is aware of this? I'm just saying.

Yawn.

Okay. That's all I got tonight.  Be easy.

***
Happy Thursday.

Unfortunately. . .now playing on every iPod and iPad in my house . . . . .The Kidz Bop version of "Dynamite"--just picture Zachary breakdancing and you might as well be right here in my house. Good luck getting it out of your head.

Tuesday, July 17, 2012

I'm here.



Got my house
It still keeps the cold out

Got my chair
When my body can't hold out

Got my hands doin' things like they s'posed to
Showing my heart to the folks that I'm close to

I got my eyes though they don't see as far now
They see more 'bout how things really are now

And I'm thankful for each day that I'm given
Both the easy and the hard ones I'm liven'

But most of all

Yes, I'm thankful for lovin' 
who I really am. . .

I'm beautiful
Yes, I'm beautiful

And I'm here.


~ "I'm Here" from The Color Purple 

_________________________________________________

I saw a lady recently whose chart wasn't making sense. Kept all of her appointments but wasn't following through on the plans her doctors gave her.

"That's weird, don't you think?" I said to the resident caring for her. "Doesn't make sense to come to the doctor but not do what the doctor tells you to do."

"It is kind of weird." My resident squinted one eye and thought for a bit then shrugged. "I'm not sure if she has some. . .I don't know. . .cognitive issues. I give her clear instructions and, I kid you not, when I see her again it's like it never happened. It's crazy."

"Who does she live with?"

"Her daughter. . . I think. . . hmmm." She tapped her finger on her lip. "I don't really remember. I know her daughter is very involved. She usually comes with her to the visits but isn't here today."

I nodded my head. Okay. That gesture meant that I'd heard enough and wanted to talk to the patient for myself.

We knocked on the door and entered the room. I had just put hand sanitizer on my hands and rubbed them vigorously together in preparation to shake her hand.

"Good afternoon, Ms. Jane. I'm Dr. Manning and I'm the senior doctor working with your doctor today."

"Hi Miss Manning," she replied with a big smile. I returned the gesture because for whatever reason I find the "miss" instead of "doctor" thing more endearing than offensive.

I sat on a chair and repeated several of the points her doctor had already spoken to her about. We chatted about her diabetes and how concerned we were about her taking the insulin the wrong way. Next we talked about the anti-platelet medicine called Plavix that she was still supposed to be taking but had stopped. Lastly we sorted out the blood pressure medication and reaffirmed that it was good that she was taking the cholesterol pill at night like it was prescribed.

She was very engaged and followed every word. So earnest and focused. So respectful and invested. So why were the plans unraveling every time? This didn't make sense.

"I hear your daughter is normally here with you? I'm sorry I didn't get to meet her."

"She got a different job that don't let her off so easy," she said. "She normally like to come but haven't been to my last few doctor 'perntments because-a her job."

"Do you live with her?" I appreciated that natural segue.

"No ma'am. But she do see about me."

I nodded my head. What came next should be predictable to you at this point if you know me or you've been reading here for a while. Yep. I started exploring the story. Her story.

"Ms. Jane? Where'd you grow up?"

"I grew up in Alabama. In the country."

"Is that where school was for you?"

My resident watched, knowing this line of questioning well. Her facial expression said it all--Here we go with Dr. Manning's line of literacy questions. 

"Yes, ma'am."

"What grade did you make it to?" I continued.

"I made to the tenth. But tha's when school only went to the tenth so I finished."

My resident looked at me and somewhere in her eyes I saw a tiny flicker of triumph.Or perhaps relief that her attending hadn't just uncovered literacy as the reason for nonadherance to the medical plan.

"What kind of work did you used to do?" I recalled that the resident had told me she was retired.

"Housekeeping and such. But I been retired a long time."

I nodded again. Then I just sat there in silence thinking of what to say next. Polite Ms. Jane waited patiently for me to find the next question.

"Ms. Jane? Do you ever. . . like. . .does it ever get kind of confusing to you to keep track of all your medicines and directions from us?"

That question caught her off guard. Her eyebrows raised. "Beg pardon?"

"You make the appointments but some parts . . . I mean. . .it seems like maybe it was hard to keep track of."

Ms. Jane just watched me for a moment, studying my face to see where I was coming from. She carefully answered me.

"Sometime. Sometime if my daughter not there it's kind of hard."

"What does your daughter help with?"

"She help with telling me what I'm s'posed to be doing and what all y'all want me to do. She good with all that stuff."

"Ms. Jane? What about when we mail things to you or give you papers to read? Do you feel comfortable with looking over that stuff if your daughter is at work?"

Again she hesitated. Then finally she spoke. "Sometimes. . . .no."

"Does your daughter realize that? I mean. . .that like. . .if she isn't there that you might have some trouble with the papers?" I chose my words carefully.

"Do she realize? Realize that. . . what? You mean. . . . " She froze and then readjusted herself in her seat. That was enough to stop her from finishing her sentence.

Letting go of our eye contact I looked down at a piece of paper in front of me and spoke while doodling with a nearby ink pen. "Sometimes, Ms. Jane. . .even when you went all the way through school, it's some stuff you didn't get. And that's okay, you know? Because nobody knows everything perfect." I looked up again and reestablished our gaze.

This was cryptic, I knew it was. But I was trying my hardest not to come right out and ask. But Ms. Jane had my number and understood where I was going. Her eyes began to fill with tears.

"Ms. Jane?" I said her name again to hold her attention. "There's some stuff I didn't learn well in medical school. I think to myself. . .  sometimes . . . .if people knew the things I wasn't so sure about they might laugh at me, you know? Then I just tell myself that it's okay to not be sure about everything. It's always good to keep learning."

The tears began to spill onto her cheeks and she wiped them quickly. She placed her hands into her lap and began to wring them nervously. "One time," she started and then stopped. She took a deep breath and went on. "One time, my daughter was at her new job and I got a paper from Grady. I know the Grady red sign so knew it was from y'all. I took it next door to my neighbor and asked her to help me. I told her I couldn't see it without my readers and could she read it for me." Then she began to weep. Hard.

I handed her the tissue passed to me by the resident and waited for her to finish.

"My neighbor--she so nice--she turned around and came back with a pair of readers. 'I got a spare,' she said. And she gave me her readers and closed the door. And I was jest standing there with them readers and them papers not knowing what to do." Her face twisted up in this complex mixture of shame and relief. It was like we'd rubbed a genie out of a bottle.

I  tread delicately--careful not to make assumptions. "So. . . .the readers weren't enough?"

Ms. Jane shook her head and squeezed her eyes tight, like somebody bracing for impact. "I don't read good, Miss Manning." Then she crumbled into full-on weeping but pressed on. "I be wishing I could read good but I didn't never learn. I wanted to go back to learn but I never had no time. It make you feel so bad, too, not reading. Like you always got to count on somebody."

I felt a lump building in my throat. "Does your . . . daughter know?"

Her forlorn expression told me that answer. More tears. More shame.


"The newspaper. It come to my house every single day. Every morning I take it out the plastic, open it up and look at the words and the pictures. Hoping it's jest gon' unlock in me one day. And nobody think I can't read good since I get the paper, you know? But to me, it's jest words and pictures and nothing else."

Now my eyes were welling up, too. I could see the unfolded sheets sprawled across her kitchen table. I could feel the defeat she felt when her well-meaning neighbor handed her a pair of reading glasses.

Damn.

"I'm so glad you told us. I'm so, so glad." I reached out and squeezed her hand and I swear to you it felt like someone deflating a balloon under pressure.

"We can make it a lot easier for you, okay? Thank you for telling us that," her resident doctor said. And that resident smiled at her warm and genuine which Ms. Jane seemed to appreciate.

I did, too.

And so. We spoke to our Grady pharmacists who swooped right in to help. They smiled and listened an normalized something that she'd been ashamed of for more than sixty years. Then they gave her a card that explained all of her pills with pictures instead of words making it easy for her to follow whether she  had readers or not.

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When the visit ended, we shifted off of the low-literacy issue out of fear that making such a big deal about it might make her feel self conscious. So I excused myself while they wrapped things up and shook her hand like it was really no big deal.

Even though it was.

Right before I left the room, I caught a glimpse of her pocketbook sitting beside her on the desk. Under it was a stack of papers from Grady tucked neatly into a manila folder. And peeking out of the mouth of that purse? Today's issue of the Atlanta Journal Constitution. Refolded because it had clearly been opened earlier that day.

Once I closed the door it dawned on me. Today, something did unlock. Right there in that room when one brave soul had the courage to tell her doctors that she could not read.

When I got into my car to head home and thought about that exchange, it hit me. Really hit me. I cried all the way home. No, Ms. Jane. You don't read good, but you're here.

You're here!

And now I'm crying again because I'm just so proud to be a Grady doctor. So appreciative to be where I am. So blessed to be here, too.

I'm here. We're here.

Yeah.

***
Happy Tuesday.

Now playing on my mental iPod. . . . Fantasia brings it home and puts me on my feet just like she did when I saw her singing this on Broadway. This is a song for every person who is still here. . . .damn, it is. (It sounds best when you periodically yell out, "Girrrrrl! You betta SANG that SONG!")

Where I'm from: The Hair Edition.


~ WHERE I'M FROM: THE HAIR EDITION ~


I'm from, "Sugar, you had to have heartburn 'cause that babygirl got a lot of hair!"  I'm from pink bows on baby afro-puffs but just for K-Mart pictures--otherwise a big, unrestrained fuzzball for everything else.

I'm from assembly line hair styling with Goody brushes and Blue Magic hair grease. I'm from, "Hold still",  from "Stop being so tender-headed," and from a smack on the back of the arm with a comb. I'm from "baby hair" with an old toothbrush and some Vaseline to hold it down.



I'm from "Let's play Beauty Shop!" and JoLai giving me my first (but not last) asymmetric haircut--with a pair of Fiskars Pinking Shears out of Mommy's sewing kit. I'm from bangs cut over bathroom sinks and a big pink sponge-roller in the front for eighteen out of twenty four of the hours in the day. I'm from Five-Minute Fast Set, Cream of Nature Shampoo and Pink Oil Moisturizer.

I'm from big multicolored hair "balls" and smaller ones tied on the ends of long twisted pony-tails. I'm from one pony-tail on the side, a zig-zag part down the middle, and two french braids that I did all by myself.

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I'm from sitting on three phonebooks and running from pressing combs. I'm from not understanding the difference between my hair "holding heat" and you just burning my damn head over and over again.  I'm from "my hair normally comes to my neck but when I get it pressed out it goes all the way to the middle of my arm--for real!" I'm from "Shirley Temple curls" on big holidays and "kiss curls" on regular days--and fully warranted vanity when returning to everyday places like school and the neighborhood playground when those curls held up longer than intended.



I'm from braids with foil and multicolored beads that took my homegirl across the street the whole sleepover to do. I'm also from losing half of them while running barefoot down the block to catch the ice cream truck and crying all the way back. I'm from "but everybody else has a Jheri Curl!" and really, really wanting hair like Ola Ray on the Thriller video.



I'm from bright orange patches in the front from heavy-handed sprays of Sun-In and even brighter orange patches when the same homegirl who braided my hair alerted me that "regular old hydrogen peroxide would do the same thing." I'm from Kool Aid rinses in junior high water fountains. I'm from first relaxers that left my hair feeling like straw but hair that laid down on my head for the first time ever in a swimming pool. I'm from Beauty College makeshift hairdos that always came out like hair-don'ts.



I'm from first paychecks and first time getting the cut I really, really wanted. I'm from big flips and fly girl mullets, from "OOO BABY BABY! SALT 'N' PEPA IS HERE!" cool girl haircuts that I paid for with my own money from being the cashier at Foot Locker but couldn't maintain at home. I'm from "pretty sleeping", Gold'n'Hot crimping irons and leaving hot curlers plugged in overnight to get them "extra hot."



Maaaaan, I'm from ten dollar relaxers in Fredrick Douglass Hall but only five dollars if you bring your own chemicals. From washcloths with burned hot curler marks on them from cooling off marcel irons that your roommate bought from Sally Beauty Supply last week. I'm from the new Hawaiian Silky perm that was both Hawaiian-looking and silky-feeling for the first week until it promptly fell out.

All of it.

I'm from returning to the press and curl and chemical free life before it was "in" and vowing never to relax my hair again--but relaxing my hair again. I'm from Janet Jackson in Poetic Justice "dooky braids" while studying for boards and when rotating on Surgery.




I'm from horseshoe bobs and Pantene samples, from "do you got some Indian in you?" and "Do you got some tracks in your hair, girl?" I'm from drugstore highlights and Jazzing hair rinses, from Aphogee hair treatments and Sea Breeze poured on itchy scalps pre-scratched with rat tail combs.


I'm from "Please, just cut it off" and "Yes, ma'am, I'm sure I want it that short", from "No, ma'am, I'm not depressed," and "I'm sorry you think I'm ungrateful for cutting it." I'm from jet black rinses for style at first then later to cover up sprouts of gray.


I'm from T'Renee, Bernetta, Mommy, Deanna, Violet, Treasure, Stefano, Meechie, Supercuts, and, now, Sakinah. I'm from The Jackson Five, Prince, Bo Derek in 10, Beat Street, Anita Baker, and Halle Berry. I'm from Alberto VO5, Stay-Sof-Fro, PCJ, Affirm and sometimes nothing at all.

I'm from natural reddish and auburn highlights and semipermanent rinses and eventually grey parts likely grandmama had that are no longer undercover.

I'm from "Young, Gifted and Black" and a story nestled into every single strand.

I'm from "we love you no matter what" and finally being alright with me, my hair, and my journey. . . .










. . . . a journey I wouldn't take nothing for now.

***
Happy Tuesday.

So tell me. . . .Where YOU from? I just KNOW y'all have some good journeys--ALL of y'all!