Thursday, February 28, 2013


Two sisters - Paul Gauguin
image credit

"Now come on and move your arm out the way, hear? It's cold out there, baby."

"I ain't cold, Sister. I ain't cold."

"You ain't felt that hawk jump on you yet, neither. Trust me, you'll be thanking me for making you wear this coat. Come on here."

Two sisters facing one another. One already bundled in her own coat and hat, fumbling to get her older sister zipped into hers, too. First, the zipper . . . all the way up to the chin where it stopped. Next, a ski hat was pulled into place, swallowing her silvery curls. The older sister squirmed to move away.

"Sis-terrrrr!" Her protestations were child-like. It was fitting considering their interaction.

They weren't strangers to our clinic at all. Ms. Lolita and her younger sister--whom she always referred to affectionately as "Sister"--had been coming to Grady for years. In all that time, I don't remember a single time that Sister wasn't with Ms. Lolita at a visit. She kept tabs on every medication, appointment, and recommendation and always took care of those things Ms. Lolita could not.

This time, it was getting into a coat on a wintry Georgia morning.

"Uh uh, Lo. Don't get to fighting me, now. Let me fasten these buttons, baby."

Sister dutifully slipped each toggle into its respective loop, pausing only once to pull her own gloves off of her hands with her teeth to help make her fingers more nimble. One by one she marched up the front of her coat until Ms. Lolita was enveloped in a cocoon of wool and microfiber.

"There you go, baby." Sister stepped back and surveyed her handiwork. "See, Lolita? Now you nice and warm, see? Snug as a bug in a rug."

"I ain't cold, Sister."

"I know, baby. But outside it's real cool, okay. Trust Sister, okay?"


I'd left that room five minutes or so before. The nurse had finished discharging them and I was in a nearby doorway watching them from a few feet away. They had just exited into the hallway and were preparing to leave.

The visit was simple enough. One sister with hypertension and diabetes here for a follow up. Brought in by the other sister, her caregiver.

They were nearly a decade apart in age. Growing up, it was Ms. Lolita who was responsible for seeing about Sister. Her mother had given her the charge of making sure her baby sister was clothed, fed, and bathed. And that is exactly what Lolita did, too. She washed out diapers and rocked her in her arms. When she was older, she cooked Sister oatmeal before school in the mornings and packed her lunches, too. She plaited her hair in tight squares and covered Sister's face with petroleum jelly on cold days to keep it from chafing.

But one day, something changed.

Things were fine at first. Lolita got married and had a baby shortly after finishing high school. That was when she was around eighteen or so. It was fine because, by then, Sister was a little bit older and didn't require as much of Lolita. Ms. Lolita could still manage to help out while her mother was working, even with a family of her own. Then, after her second baby came, that's when the voices started.

She wasn't even twenty one.

"I remember it like it was yesterday," Sister told us one day during one of our visits. "I came home from grammar school and went over to Lolita's like always. I couldn't get the door to open. She had blocked it with a couch because she thought aliens was coming from outer space. I looked in her eyes and she meant it, too."

"Wow," I responded. And actually, that was such a long time ago that we had that conversation that I don't fully recall exactly what I said. But I'm guessing that's really close to it.


Wow is what I always think when it comes to schizophrenia. I liken it to a perfectly knit garment with one loose string that has been hanging for twenty years. And then--just like that--right on the edge of adulthood's awakening, that yarn gets tugged and an entire life unravels into a big, disorganized pile.


Wow in that scary way. In that extra, extra fucked up way that you can only say with a whisper. Because it's too awful to say with anything other than your inside voice. Wow. 

Schizophrenia and disabling drug addictions have always triggered that for me. That anemic wow, so helpless and confusing and anger-inducing. You stand in front of the broken pieces wishing you knew how or where to start putting it all back together but you know you can't. Like a prized piece of hand-blown glass that you've super-glued and placed back onto a shelf.


Lolita was hospitalized several times in those early years. No one understood all of this or knew how to even start. But over time, the doctors found medications that quieted the voices and took away the paranoia. In exchange for the silence, the beautiful and vibrant Lolita had become a twitching, lip-licking shell of herself. She was gone.


Sister had children of her own and even a few grandchildren now. Their mother had passed on some years back and for all of her adulthood, Lolita had become her responsibility, too. Sister even took on caring for Lolita's kids from as early as when she was in fifth grade. And never once, did she seem to be bitter. In fact, Sister seemed happy to be caring for her older sister.

"I love how you call her 'baby,'" I said to Sister in the hallway. They both swung their heads in my direction and smiled.

Sister chuckled as she pulled her pocket book onto her shoulder. "That is funny, ain't it? What I look like calling you baby and you my big sister?" She cocked her head playfully and looked at Ms. Lolita. She was met with a blank stare by her older sister but it didn't seem to bother her at all.

"I love the way you love your sister." That was a rather loaded thing to say but it was true. I loved the way she cared for every detail and never seemed like she was even thinking of uttering a complaint.

"She raised me. Wasn't even old enough to cook on the stove without a milk crate, but you best believe she cooked me hot meals every single day. Mama worked long hours and had to 'cause our daddy passed in a accident and left her by herself. But Lolita always saw about me, you know, up until she couldn't no more."


"It ain't never bothered me none. I wouldn't be who I am if it wasn't for her. She was like a mama to me and I learned from her that seeing about your kinfolks is what you 'sposed to do. 'Specially in your 'mediate family. Ain't that right, baby?"

Lolita nodded.

"Alright then, Miss Manning. We'll see you next time, okay?"

"Yes, ma'am."

"Take care, hear? And make sure you dress them boys warm."

"Yes, ma'am, I will."

I headed down the hall but still watched them as they headed out. Sister was walking with an arthritic limp that I hadn't even noticed before then. Just as they reached the swinging doors out of the clinic, I saw Sister stop to fish something out of her purse--I travel-sized jar of Vaseline. She scooped a bit out with her finger, quickly emulsified it into her palms and wiped them over Ms. Lolita's cheeks and forehead. Then she popped it back into her bag, held the door open for her sister and followed her out.

Out toward the reality that continues well after the mornings at Grady Hospital.



Now playing on my mental iPod. . . ."Come to My Window" by Melissa Etheridge. Juliette Lewis' haunting portrayal of the ruthless thief, schizophrenia, in this video has always grabbed me by the neck. Her youth and her beauty, so lonely and wasted. . . .all against Melissa Etheridge's throaty voice. . . .makes this one of my favorite videos ever.

Tuesday, February 26, 2013

One year later.

When can my heart beat again?
When does the pain ever end?
When do the tears stop from running over?
When does you'll get over it begin?

I hear what you're sayin'
But I swear that it's not making sense
So when can I see you?

When can I see you again?
When can my heart beat again?
When can I see you again?
And when can I breathe once again?
And when can I see you again?
~ Babyface


So hard to believe that it's been an entire 365 days since that awful day when the heartbeat of a beautiful brown boy was silenced in a senseless act of impulsive violence. Yes. It's been a full year already.

And with the things this year brought to my family, I am seeing this differently, more somberly. The sudden loss of a child. No warning, no nothing. Yes. I've seen it much closer now--through the eyes of my own mother and father--in three dimensions and in highest definition.

Yes, it has been an entire year since Trayvon Martin was gunned down with a pack of Skittles and no weapons in his pocket. And yes, it was a big story in the media last year. But this year, more than ever, I know that when it was all said and done, he was somebody's baby.

I won't be at any of the vigils this evening, but I did rock my hoodie today in his memory.

And tonight I will rock my own beautiful brown boys to sleep. . .  stroking their soft skin, smelling their little boy smell, strumming her pain with my fingers. . . . all in an effort to force myself not to forget that another mother under the same moon cannot.

Rest in peace, Trayvon. Please find my sister and tell her we miss her. (She'll be the one rocking the crocheted hoodie.)

Playing this beautiful song for my mother, Trayvon's mother, and for any mother who knows the unnatural pain of losing a child.

You can read my posts on the boy in the hoodie here and here.

Monday, February 25, 2013

Good save.

Zachary:  "Mama! Look what I made!"

Me:  "Nice work, buddy!"

Zachary:  "It's a 'Z', Mama. For Zachary!"

Me:  "It sure is, baby! And a totally awesome 'Z', I might add!"

Isaiah:  "Dude. It's totally backwa--"

Me:  "HEEEEYYYYYYY! Back that thang up!" (Insert REALLY LOUD snapping fingers and awesome Mom-dance ---> HERE.) "Awww that LOOKS GOOD! Won'tcha back that thang up! You's a TALENTED BROTHA! Won'tcha back that thang up! Whoooooo! Yeeeeaaaaahhh!"

*now picture me backing that thang up--but the Mom version--still snapping the REALLY LOUD Mom-snap and attempting to do "the bump" with my kids*

Isaiah and Zachary:  *running away screaming in terror* 


Look, man. Motherhood requires us to be fast on our feet, people. It was either "Back That Thang Up" or letting an older brother squash the hopes and dreams of the next Picasso.

Mmmm hmmm.

Hmmmm. I guess I could have sang a Backstreet Boys song to mask that word "backwards," but -- I'm just sayin' -- I don't think it would have had the same effect.

*walks out of room waving hand at y'all*

Maaaaan. Haters gon' hate.

Happy Monday. Where all my real mamas at?!

And now playing on my mental iPod and now, regrettably, yours, too . . . . .

And, of course, some really EXCELLENT Mom-dancing by the FLOTUS. YAAAY-YUUUUHH!

Sunday, February 24, 2013

Building relationships: One handshake, one teaching point (and one cup of gumbo) at a time.

Mardi Gras Cafe (swanky signage coming soon.)

So you already remember that I had an all girl team in January on the Grady wards, right? Well, at the end of a ward month, it's the tradition of (kind) attendings to take their team out for a meal. Guess where we went? To the BHE's restaurant -- Mardi Gras Cafe!

I split the month with my colleague Stacie S. -- who happens to be a Louisiana native. With her New Orleans taste buds, clearly this wasn't a hard sell. No, 'twas not.

Oh! Before I forget. Here's an awesome tidbit -- Stacie S. was my ward resident a few years back. And on the last day of the rotation, it was just the two of us rounding one Sunday morning. When we finished, I took her to breakfast at Murphy's (another of my favorite eateries.) That day, over chilaquiles and hot coffee, Stace told me that -- "Ssshhhhhh! It's a secret" -- she was expecting baby and had just found out days before. I dang near exploded under the pressure of keeping that silent. (But don't worry, I did keep it to myself.)

Well, here's that baby now:

What a difference a day makes, right?

Yep. So it was a really cool full circle moment to be the other attending working on a ward month with her.  If ever there was a baby who was a perfect mixture of her parents, it's this little pumpkin. She looks as much like Stace as she does Stacie's hubby, David (also a Grady doctor.)


So yeah. We had a great time yucking it up and enjoying some good, casual comfort food (with a Louisiana twist, of course.) 

Baby Sofie kept us still at all-girl status, but the addition of my Things 1 and 2 ended that real fast. We just decided that they'd be "the team mascots" so that we could maintain our XX chromosome status.

The food was super yummy (as always) and -- if you read my last post -- WORTH IT. We all totally arrived ultra hungry so that we could enjoy every bite. And since the portions are hearty, even then there's plenty to take home. Just look at Stacie's smothered pork chops!

 And she said, "YES, I'm having me some pork chops AND mac 'n' cheese AND red beans and rice. SURE AM." I bet her hubby David was super happy for that ginormous portion because that meant he got half of it later on.

Before anyone says something -- let me just say that the good thing about Mardi Gras is that you can be as good as you want or as bad as you want. On my good-girl/bread-is-the-devil days, I have grilled fish and veggies, like this:

But that's not the mindset I was in that night. I paced myself all week with smart food choices so that I could enjoy what I REALLY wanted. What was it, you ask? A blackened fish po' boy and some gumbo.

Woo hooo!!

And no. These photos aren't from that night. I shamelessly stole them from the ones the BHE already had on my computer. Sure did. (Except for Stacie's big ol' plate o' pork chops which really was from that evening.)

 We had a great time. And, of course, the BHE was physically there taking care of us -- even though a group was having an event in the swanky upstairs lounge. He still gave us V.I.P. treatment!

This was right after Isaiah had eaten his own serving of the bread pudding. He, too, finds it a religious experience just like his mama.


Here's what I know: Working well together and creating a great climate for learning and mentoring is done best when you build relationships. I love having team dinners because it lets me see how well this was achieved. That's always one of my goals on my teams.

And my life.


That just reminded me: Remember my student Bryan O. playing his guitar in my sunroom at a team dinner? I always remembered that and feel so happy whenever I think of it.

Anyways. This past month? We succeeded at building relationships. With each other, with other parts of the care team like our nurses and social workers,  and, of course, with our patients.

 And that made me feel proud.

Happy Sunday. Again.


Straight from the BHE:

"Hey Babe? Thank the people who read your blog for coming into the spot, man. I've had quite a few of them come by for lunch or dinner and they say they heard about us from your blog. And they say, 'You're the BHE.' Ha ha ha. That's real, real cool." 

Then I said, "Well, Bro. Manning, can you hook them up with some kind of discount if they mention the blog? I'm just sayin'."

And he said, "Sure." 

And I said, "Bet."

Okay. So from now until. . . umm. . . . Easter. . . .yeah, Easter. . . .if you stop by Mardi Gras Cafe to get your grub on, you'll get 15% off of your meal if you mention that you read about it from the GRADYDOCTOR blog. Oh, and the secret code that you have to say is: The BHE.  Ha ha ha. Or not since he'd probably be mortified if a whole bunch of folks rolled in saying that. Okay.You could just say you heard about it from the GRADYDOCTOR blog, okay?

Why I just put GRADYDOCTOR in all caps, I do not know. I guess I was just feeling kind of self important. Ha. Especially since HLN gave me a nationally syndicated blog shout out under my name last week -- in ALL CAPS. 


Ha ha ha. That was a first, man. I have, like, SO arrived. 


Seriously, though? Thanks for being supportive--literally and virtually. The BHE tells me that small businesses thrive one handshake, one customer, and one good word at a time. So, as the wife of a small business owner, we 'preciate y'all. For real. And if you have a good small business in your community with good service and good products? Support them regularly so they'll stay open.

The take home point in all of this is the same: Remember to intentionally build sustainable relationships in whatever it is you're doing. Let folks know they're valued. Whether you're teaching, caring for someone, running a business, or just living. Build and they will come. (And, if you're lucky, they'll come back with some friends.)


Now for the shameless plug because I love my husband and am behind anything he is involved in:

Mardi Gras Cafe ~ Restaurant and Lounge is located at 886 Martin Luther King Drive, Atlanta, Georgia, 30316. They specialize in Southern comfort foods "with a Louisiana twist." Chef Will is an Opelousas, Louisiana native and has magic fingers. His magic ingredient is "love" which goes into everything he prepares. 

Harry (aka The BHE) is all about service and experience. You will be treated as if your time, money and decision to eat there matter. You can count on having attentive service but not intrusive service. And most of all, you can count on good food.  So stop by. It's right by the Georgia Dome and Georgia Aquarium on MLK Drive--and it's walking distance from the brand new WalMart that just opened on the same street earlier this year. (So get you some toilet paper and groceries while you're over there.)

That's all I've got.


Top Ten: Weight and see.

I talk about weight a lot at work. I talk to patients about it when they're reluctant to start another blood pressure pill. When knees are aching and hips are ailing, it works its way into those conversations, too. I calculate BMI measurements and explain what it all means. And most times, I find myself saying this:

"The extra weight didn't come on overnight, so it's okay if it doesn't come off that way."

Then I try my best to see where my patient is in the "stages of change" cycle.


Now. Most folks see this cycle used when discussing addictive behaviors like tobacco, alcohol, and drugs. For example, when someone smokes cigarettes, we are taught to assess what kind of readiness state that person is in. Like, are they precontemplative like this man I saw last week who told me that he "loves smoking, end of story" and that "somebody might as well go ahead and plan to bury him with a pack of Marlboros in his shirt pocket." 

Uhhh, yeah.

So someone like that? They aren't there yet. So there's no point in writing for Chantix or telling them to spend their hard-earned cash on patches and peppery gum. Nope. When someone is precontemplative? The best thing you can do is educate them with hopes of moving them from the one stage to the next. And the good news is that it often helps. A lot. 

So, yeah. Even though weight is technically not like crack cocaine or malt liquor, tackling it does involve these stages. Because just like those other things, it requires a lifestyle change from what is already known. It requires more than just saying you think it's a good idea and that you understand  the reasons why it should happen. Managing weight involves action. 


So here's the deal. Unlike cigarettes and alcohol, most of the patients and people I know who could stand to shed a few pounds aren't exactly like my Marlboro man was. That man was precontemplation defined. I find those dealing with extra pounds to be stuck somewhere between contemplation and preparation. Or something nudges them into action, only to swing right back around to relapse. Either way, it's a complicated work in progress. 

The education part that we tackle when folks are precontemplative? That isn't really as necessary. I haven't met too many people who are above their ideal weight who don't fully recognize the benefits of losing some pounds. But, damn, it's so complex isn't it? Moving people from contemplation or preparation into some real, true action and maintenance? 

Maybe because it seems so daunting. There's the exercise component, the food component, and the mind component, too. All swirled together, it's a pretty big pill to swallow. 

So you know what? I break the pill up. Sure do. I look for ways to be encouraging for the mind part. I acknowledge the fact that people have different food relationships and that it's hard to change them. Then, for exercise, I tell people that the best exercises are the ones you'll do. Like walking. Or whatever it is you feel okay doing. And then there's the food component. 

Yeah, that.

So this is where I've developed lots of thoughts and strategies. And you know what? They are ones I live by, so I feel good about sharing them. I tell my patients, "I'm going to make a few suggestions. You can pick and choose what you want to incorporate into your life, okay? These are mostly simple things that, if you changed, could lead to a start in your weight loss." 

And a start in weight loss is encouraging. And encouragement moves people from preparation to action. Or relapse back to action. And the ultimately into maintenance. 

At least, that's what I think.

So this top ten? Pick from it what you like and leave what doesn't work for you. Today I bring you:


Like to hear it? Here it go!

#10   -- Sit down.

DON'T eat standing up. Anywhere. Period. And, unless it's water or coffee, don't drink standing up either.

Simple enough, right? Uhh, wrong.

Clearing the table and popping those chicken nugget leftovers into your mouth? Making a pot of chili and telling yourself that the "little cup" you just served yourself doesn't count? Standing in front of the fridge and popping some grapes/pineapple/lunch meat into your mouth or taking a few glugs of juice? It all adds up. And guess what? A lot of times it adds up to more calories than you realize.

Have a seat when you eat. Scoot up to a table and have both feet on the floor. Think about what you're having. Standing while eating? That leads to stealthy weight gain. That little change could shave a cool 500 calories off or your daily intake. 

Which means shaving a little of that junk out of your trunk.

#9  -- Separation of Church and Plate.

If you never go to church, no worries for you on this one. But for those who do -- try this: Eat before you go. This takes the urge (and tradition) of feeling like you either have to a.) go somewhere for a big azz brunch, b.) come home and prepare a big azz brunch, or c.) alternate between the two every other week.

For the non-church goers, the same can be said for the big azz breakfast that you prepare on one of the weekend days. Cut something out of it to make it less. . . I don't know. . .big azz. 

Now. I admit that this is one that I struggle with. We enjoy breaking bread together as a family after church and, almost always, we do. Instead of something shmancy, we hit our favorite Waffle House. Harry and I can make smart choices and the kids have their waffles.

#8  --  Don't eat it if it isn't worth it.

I believe in allowing yourself something tasty. I do. Like, at the BHE's restaurant (Mardi Gras Cafe) there is this white chocolate bread pudding that is a religious experience. Yes. It is full of gooey, warm, sweet goodness which means a ridiculous amount of fat grams and calories. 


It's worth it. Every last bite. And I feel zero guilt after enjoying it because it is just so dang good. 

Now. In contrast, I ordered some food at the Sweet Auburn Curb market last week. And for whatever reason, it wasn't that good. This was one of those things that needed to be good for me to be eating it. So you know what? I just stopped. I stopped eating it and that was that. 

And so. A dry azz cookie sitting in a boxed lunch? If you're trying to watch your weight, ask yourself if it's worth it. Don't eat anything "bad" that's not really, really good. 

Oh, and making kids clean their plates? That's so last century. So don't.

#7  --  Don't drink your calories.

Period. Not a juice. Not a soda. Not a sweet tea. Not a nothing. You want to drop a few pounds? Refuse to let drinks that have more than twenty calories touch your lips. You'd be surprised how much they stack up. 

#6  --  Diet Nope.

That's what I now call Diet Coke. I gave up Diet Coke two years ago this month. And let me tell you, I lost five pounds the month that I did and those pounds have stayed away. 


So the data on this? Okay. It's inconclusive. You can't say, like, all scientifically that diet pop leads to weight gain. But anecdote-ally? Man, please. 

The word on the street is that when you drink more diet soda, you eat more. Whether or not this is true remains a topic of debate but I know that drinking water instead made me lose weight.

And for the record? I am like the smoker who still loves cigarettes when it comes to Diet Coke. A super cold one still looks good to me and I feel very tempted to take a swig whenever one is in my presence. 

But fitting my clothes feels better.

The caveat? Adult beverages. But not really a caveat. I no longer order margaritas with reckless abandon or mojitos, like ever. Maaaan, I saw how many calories were in those drinks one day and just about passed out. So. If you must have an alcoholic beverage, learn to like wine. Or drink only half. Or drink a whole drink but factor those 550 calories into what goes onto your plate. 


Get creative. My cure for margarita cravings in hot Georgia summer months? Mexican beer with a salted glass and some lime. You'd be surprised how satiating it is to be only 110 calories. Margaritas and such? They've pretty much moved over to my "not worth it" list. I'd rather have some Key Lime Pie.

#5  --  Exercise for the heart, watch the food for the weight.

Unless you are like twenty one years old or less, if you are serious about weight loss it won't come primarily from exercise. Now. Before you go off on me, I'm not saying don't exercise. But here's what I am saying:

Want to lose weight? Then change your food intake. Because it ain't gonna happen from the treadmill alone. 

I remember a few years ago when Harry, the kids, and I all went out to cheer on the runners passing by our neighborhood in the Atlanta Publix Marathon. I was astonished to see how many of them were overweight. I said to Harry, "How can someone run 26.2 miles as fast as that guy and have a spare tire?" It was a rhetorical question, really. The answer was simple. That guy was eating too much food.

I read in this running book an idea that stuck with me. It simply said, "Don't exercise for weight loss. Exercise for heart health and to feel good." Now. I will say that the good thing about feeling good from exercise is that you sort of don't want to eat just any damn thing. You feel tempted to be good.

So my point? If you're exercising? Good. It will extend your life. But if you want to lose weight -- like for real lose weight? It ain't gonna happen just from that.


#4 -   If you can't say no to it once it comes into your pantry, then make it a no for the whole house.

So. Your kids love Cheetos, Lays, and Cheez-its. But guess what? So do you. But you're just getting it for their lunches, aren't you? And they're kids for crying out loud. They should get things like Cheetos and Lays and Cheez-its, shouldn't they?

Nope. Not if you can't keep your hand out of the bag or the box. Look. Kids are resilient. They'll get over the absence of Cheetos. Trust me.

Bottom line:  If somebody needs to lose weight in that house, things like that shouldn't make it home from the grocery store. Period.

#3 --  Make your husband's or wife's plate.

Hee hee. This is my pesky way of controlling the BHE's portions. I make plates and then put everything away. So, OH DARN, I already put it all away and can't give seconds. I heard him telling a friend recently,

"Yeah, bruh. My wife puts me on a plan without even telling me. She's all like, Alright baby you getting a little thick around the waist."

Bwaah ha ha. 

#2  --  Ration the bread.

You already have heard me say it here before. BREAD is NOT YOUR FRIEND. No, 'tis not. Here's what I say:  Just pay attention. If you have bread at breakfast, have a low carb lunch. Pace yourself with the bread because it is the great inflator. 


Putting down the bread? Best deflator there is. Yep. Whenever I feel the thighs beginning to thunder more than they should? The bread is first to go. And you know what? I'm back to fighting weight in no time. 

Bread. Is. The. Devil.


#1  --  Start a list of "not worth its" and get okay with not having them.

My kids love Cinnamon Toast Crunch cereal. And you know? I probably could, too, if I let myself. But 230 calories on a bowl of sugary cereal? Not worth it. 

A baked white potato? Not worth it. Pop Tarts? Not worth it. A whopper from Burger King? Not worth it. Pizza Hut Pizza? Not worth it.


Key Lime Pie? Worth it. White Chocolate Bread Pudding from Mardi Gras Cafe? Worth it. But everything CANNOT be worth it. That list has to be short. Pick a few indulgences and allow yourself to have them. 

Or, if you're super disciplined, you can allow yourself small tastes of many decadent things. Kind of like the French do. But me? I ain't French. So I can't have a long list of things.

Lastly--read the calories of a serving of whatever it is you're having. Then, allow yourself to be appalled at it. Here's a small part of my list of OMFG appalling things that I can no longer enjoy now that I've seen the damage:

  • Chick Fil A cookies 'n' cream milkshake:  690 calories, 33 grams of fat.

  • KFC chicken pot pie :  790 calories, 49 grams of fat.
  • Big Breakfast from Mickey Dees:  1097 Calories, 56 grams of fat.

So my point is -- find out the damage. It's a powerful motivator. And whatever you do, DON'T ignore the damage. Remember:  A good thirty minutes of cardio might burn you 300 - 400 calories, depending upon what you do. Imagine working out and then having that milkshake. If you decide it's one of your indulgences, then recognize that you have to balance everything else out to fit it.

Oh, shoot. I almost forgot something I like to call "friend-poundage." This is where you only meet your friends over food. Make a list and check it twice. Do you and your buddies only get together when food is involved? If so, you probably aren't paying attention to what you're eating. Try getting together at non meal times. Or going for a walk or run together. Or just hanging out in the park while your kids play. Friend-poundage is dangerous. Watch out for it -- especially during times like wedding engagements, happy times, etc. 

Mmmm hmmm.

Does any of this make sense?

I hope so. I say try a few of these things and see what happens. Or none of these if they don't suit you. Either way, let me know your thoughts. And your cool (but not overly hard core and oppressive) tips so that I can share them with my patients at Grady.

Happy Sunday.

Saturday, February 23, 2013

The times.

I gave the door the obligatory tap before entering.

Knock, knock, knock.

I pushed the door open and found this regal Grady elder sitting in a chair. Her elbow was perched upon the desk and her cheek was resting in her hand. Her eyes were closed and her bosom rose and fell rhythmically. She looked so peaceful. I hated to even bother her.

"Hey there. . . . " I spoke quietly.

Her eyes opened slowly and her head turned in my direction. A smile unfolded across her face like a dinner napkin. "Heeey, sugar."

Sugar. Yes.

She was beautiful. Her coffee-colored skin was striking against the closely cropped mane of white curls that framed her face. You could tell that someone had lovingly placed rows of hair rollers into her fine hair as it remained separated by perfect geometric parts -- each curl in its own rectangle. That made me smile as I imagined her in a beauty shop similar to my own and myself in the same some forty years from now.

"I'm Dr. Manning and I'm the senior doctor working with your doctor today. I hated to wake you up looking so peaceful like that."

She softened her eyes and rested them on my own. Something about her expression was so inviting and . . . .approving even. I could tell that she was surveying my face, my presence and taking it all in."Did you say you're a doctor? The senior doctor here?"

"Yes, ma'am," I responded quickly, deferentially. I pulled my shoulders back and stood a little taller. I glanced over at the intern standing directly behind me. "I work with your doctor. We always put our heads together since we think two brains is better than one."

But she just sat there. Still smiling that layered and complex smile directly at me. After a few moments of silence, she lifted her chin and nodded her head.

I perched onto the edge of the chair across from her as my intern leaned against the sink. We reviewed the plans for adjusting her blood pressure pills and congratulated her on doing such a great job with managing her blood sugars. Together, my intern and I examined her knee--which had been giving her some trouble--and I listened to her heart and lungs, too. Beyond that, I just reinforced the excellent plan that her resident physician had already put together.

"It was an honor to meet you, Mrs. Farmer."  I shook her hand and paused. I wanted her to know that I meant that.

Her face returned to that same look. Distant, thoughtful, layered with complexity. She jutted out her bottom lip and nodded at me. "Just as it was an honor to meet you, Dr. Manning," she replied.

Then we both just sat there with our hands intertwined, as if to seal the moment. Just then, I noticed her eyes glistening with tears.

"These is some proud times we in, Dr. Manning," she finally said. "Some proud times." She shook my hands when she said that but kept holding them tightly.

My face started warming up and my eyes immediately began to prickle. I didn't dare let go, though.

"Do you remember when the hospital was still segregated?" I asked.

"Dr. Manning? I remember that and a whole lot more."

I nodded in response and my voice softened in quiet reflection."Yes, ma'am."

It was silent for another moment. But for some reason, nothing about it was awkward.

"The senior doctor here, you say?"

"Yes, ma'am."

"Mmmm. I feel so proud when I hear you say that. The senior doctor here." She shook her head. "Look like I just want to shout when I think about that."

Saying that made something stir inside of her. She tapped her foot and clamped down on my hands and decided not to fight the urge.

"Hallelujah! Thank ya, sir!" Her foot kept tapping and her face was now pointed toward the heavens. "My, my, my! Thank ya, Father! Aaaaah. . . yes. . . . hallelujah! Thank ya, sir!!"

I didn't know what to say. So I just squeezed her hands with both of mine to let her know I was getting it and feeling it, too. Touching and agreeing and appreciating it.

And her.

A few moments later, she returned her hands back to her lap and smiled at me once more. I finally thought of something to say. "Thank you for encouraging me, Mrs. Farmer."

"No, sugar. Thank you for encouraging me."

I slipped out of her room and stood frozen on the other side of the door. I let the emotion wane and eventually headed back down the hall.  Head up, shoulders back. . . . and wanting nothing more than to live up to these proud times.

Story image




Happy Saturday. This is Grady.

Now playing on my mental iPod. . . ."The Sweetest Days We'll Know" as sung by the lovely Vanessa Williams. The perfect soundtrack to this moment.

Thursday, February 21, 2013

He and I.


He and I
When words run dry,
he does not try,

nor do I.

We are on par.

He just is
I just am

and we just are.

- Lang Leav 


Happy Thursday.

Wednesday, February 20, 2013

Dual diagnoses.

Whelp. I broke down and saw Emory Sports Medicine today about my 'flicted ankle. Yes. One full week of rest and still moderately 'flicted.


Here's a glimpse into my visit. (I mean, in case you were really wondering exactly what happened when I saw Ortho today.)

Orthopod: "So what'd you do?"

Me:  "I've been training for a half marathon. Running a lot. Increasing my mileage."

Orthopod:  "Hmm. Okay. Did you roll your ankle?"

Me:  "Nope."

Orthopod:  "Okay. How many days per week were you running?"

Me: "Like five."

Orthopod:  "Five?"

Me:  "Errrr. . . . five-ish."

Me:  "I started having pain after running some hills. Then I rested it for a few days and ran again. It hurt worse. Then I rested it for almost a whole week. And I got some shmancy shoes."

Orthopod:  "Were you still having pain after that week?"

Me: "Un poquito."

Orthopod: "Un poquito?"

Me: "Un poqui-tito. Which is even smaller."

Orthopod:  "Umm. . . okay. So you ran."

Me:  "Yup."

Orthopod:  "And now you're here."

Me:  "Claro que si."

Orthopod:  "Do you speak Spanish?"

Me:  "In my dreams, I do. Fluently, actually."

Orthopod:  "Excuse me?"

Me:  "Uhh, nevermind. So my ankle. What do you think?"

Orthopod:  "Just point tenderness when you run or bear weight? Right here on the lateral malleolus?"

Me: "Regrettably."

Orthopod: "Excuse me?"

Me:  "Yes."

Orthopod:  "Okay."  Starts manipulating foot every which-a-way. Has me jump (ouch!) and walk and stand on my tippy-toes. Pushes on outer ankle bone once more.

Me:  "Owie."

Orthopod:  "Owie?"

Me:  "I mean, that hurts."

Orthopod:  "You mean when I do this?"  Pushes again.

Me:  "Dude."

Orthopod:  "Oh, I'm sorry."

Me:  "So what's the deal? Is it serious or am I just, like, 'flicted?"

Orthopod:  "What was that last thing you said?"

Me:  "I said 'flicted."

Orthopod:  "I'm not sure I'm familiar with that term."

Me:  "I think that, as an Orthopedic surgeon, you should familiarize yourself with that term. Because I'm sure you see lots of folks that are 'flicted."

Orthopod:  "Did you say. . . 'flicted?"

Me:  "Yep. As in AF-flicted. But never say the 'A' part. Just say 'flicted."

Orthopod:  (laughs.)

Me:  "It's when something used to work but doesn't now. It isn't limited to humans either. Cars, computers, all sorts of things can be 'flicted."

Orthopod:  "Got it."

Me:  "So am I just 'flicted?"

Orthopod:  "Hmmm. I'm thinking this is a dual diagnosis. Everything put together suggests something that isn't ligamentous. It seems most consistent with a stress fracture or a tibial stress syndrome. Those can lead to stress fractures."

Me:  "So why the dual diagnosis?"

Orthopod:  "Also -- how did you say it? Afflicted?"

Me:  (laughing out loud)  "No! It's 'flicted."

Orthopod:  "Okay. So that and a stress fracture."

Me:  "Dang. Well that sucks."

Orthopod:  "Not completely. You can still cross train and things like that. But no running for 4 - 6 weeks."

Me:  "So no running for 4 whole weeks?"

Orthopod:  "To six."

Me:  "What if I feel good at 4 weeks and I'm no longer 'flicted?"

Orthopod:  "Then you can try a gentle run."

Me:  "Okay."

Orthopod: "What's that word again?"

Me:  "'flicted."

Orthopod:  "'flicted! Yes, that's it."

Me:  "Best when paired with 'old.' As in 'old and 'flicted'. But I don't think there's an ICD-9 code for it, though."

Orthopod:  "ICD-9 code? Hold up -- are you . . . a physician?"

Me:  *coughing*

Orthopod:  "You're a doctor?"

Me:  "Uhh, me? Yeah. But, like, not an orthopod like you."

Orthopod:  "Ha ha. . . Let me guess--you must be an internist."

Me:  "Huh? Why do you say that?"

Orthopod:  "Because you guys are the main ones that always call us 'orthopods.'"

Me:  "Oh. My bad. But it's because the whole 'orthoPEdics/PAEdics' spelling is confusing."

Orthopod:  "That's funny."

Me:  "What's up with that random, fancy 'A' in OrthopAEdics anyway? What's that all about?"

Orthopod:  (now with hand on the door)  "Ha ha . . . that's the British spelling, I suppose."

Me:  "Uuhhh, okay."

Orthopod:  "Four weeks for follow up."

Me:  "Gotcha."

Later in the hallway as I was exiting.

Resident:  "HEY!!! Dr. Manning!!! I haven't seen you in forever!!"

Orthopod:  "You know her?"

Resident:  "Do I know Dr. Manning? She taught me in medical school AND she was my program director during my first year!"

Orthopod:  (looks at me with eyes raised.) "You're faculty?"

Me: "Claro que si."

Resident:  "It's so good to see you Dr. M!"


Me:  "You, too.  . . .hey, did I ever teach you what 'flicted means?"

Resident:  "Hmm . . . 'flicted? I don't think so."

Me:  "Okay. Well ask your attending here. He knows all about it."

Flashed a big smile.


And with that, I chucked them a deuce and hobbled on out. Still wearing my heels.

Mmmm hmmm.

See? Isn't my life super exciting? What's up with y'all?

Happy Wednesday.

Tuesday, February 19, 2013

Life in Pictures: The Puppy Mafia and other random things.

Hey. Feeling a little lazy today. Lots going on and have been super busy. Here's what I've been up to.

But first, here's a super random old photo I found in a box last week. That little baby is my friend Jada's son, Noah and he's now an eighth grader. Bananas.

That was from the weekend I was taking my Pediatrics certifying boards back in 2000. And yes, that wig looking bob is my hair. Um, yeah.

It's been a while since I've given an update on The Puppy Mafia. Well. This in no way means that my children have outgrown them. Puppy, Pup Pup, Puppy Dog, Little Guy, and the rest are still very much a part of the family.


Turns out that approximately 6 months ago, Isaiah was playing with Puppy outside and he got lost. Over the last several months, we've made a few weak attempts to find him--usually at dusk. We looked a couple of times during the day, but no dice. I was ready to give up on the pooch. Maaan, I got too much going on for all that. So me? I had totally given up. But as Isaiah always tells me (all matter of factly with eyelids at half mast,) "Puppy will never be lost forever."

Which has technically always been true. I still remain particularly impressed by Great Puppy Recovery of 2008 -- the nearly two year loss that occurred in my grandmother's house in Tuskegee, Alabama. You just try to find something in a house that someone has lived in for over fifty years. I just dare you. But Isaiah? He has Puppy radar. He totally found him. Even if it took almost two years for it to happen.


Oh, and as for all of the rain, sleet, and what-not that Puppy was facing? It was fine because he's "already brave" -- remember? (Long, ridiculous story. See hyperlink above.)

Whelp. On Saturday morning, Isaiah put on his jacket and his determination and declared that morning the one when Puppy would be found. "I will not give up until he is home safe," Isaiah said.


So you know what happened next. Mmmm hmmmm.

That's after a six month trip backpacking in our backyard. He actually looks pretty good, considering all that.

Here's some pictures from Tounces' birthday celebration.

It was a lovely time. She was happy. Which meant that we were all happy, too.

So, yeah. That was good.

Oh. I went to HLN  to do Raising America again today. That was cool.

Here's a funny thing -- one of the segment producers asked me for my Twitter handle. When I told him that I wasn't on Twitter or Facebook? He was all like:

Ha ha ha. Any excuse to use this GIF of Zachary. I'm totally hooked on this neat little app on my iPhone that makes these things. It's been a good time.

Anywho. After he stopped giving me the hairy eyeball it was cool. Ha ha ha.

I'll try to let y'all know next time in advance since HLN is a syndicated channel and most of you should be able to see it when it's on.

How cute is this baby picture of Isaiah? So smoochable.

Saw this last week in Kroger. But this time I didn't do the ugly cry like before, so it was cool. Instead I just felt happy and sort of wanted some lemon Jell-O cake.

What else?

Oh, these snaps from Zachary's playdate over the weekend with one of his buddies. They played video games for a few moments but then they opted for outdoors. For over two hours! I was so happy to see that some kids still want to play outside.

I was trying to have a cup of coffee and do some work a few days ago. I had an article due for this journal and was already past the deadline. I had work to do! Well. This gray-haired man sitting near me smiles. I smile back. Then he started talking my head off. OFF. Even though I was clearly BUSY. But he was an elder and thought he was funny. So I was polite. Even though I really was feeling all like:

Sorry. Another shameless excuse to use the GIF app. 

Dude. How much of a flashback is this button from Deanna's senior year jacket? 

Breakin' Fresh?

Cut. It. Out.
And this? This is just a cute picture of Isaiah.

That's all I've got for now. Night night!

Happy Tuesday.