Saturday, May 11, 2013

Continuity of caring.

I was walking through Grady the other day en route to the clinic. I strolled through the main hallway by the very-full financial counseling office and past the always-packed "Grady card" area. That corridor opens into this multilevel atrium and another main Grady entrance. On this particular early afternoon, there were people everywhere. Some in hurries. Others just waiting for something. And all of the rest somewhere in the middle.

"Hey there, doctor!"

I looked over and met the twinkling eyes of a middle-aged woman that I'd seen a few times before in the clinic. She was smiling this thousand watt smile; partly because she just seemed happy and partly because of the gold ornamentation on her teeth. Something about that smile made me immediately smile in return. "Well, hey there to you too, pretty lady!"

My reply was easy and familiar. Because that was the nature of this exchange and many such exchanges in the halls of Grady. Especially with people you know. But even with those you don't. She beamed when I called her "pretty lady" which made her only more beautiful to me.

"You doing alright today?" I asked in that rhetorical, small talky way.

On this day she was pushing a stroller with her grandson in the front and her pursed propped on the handles. "Yes, ma'am! Me and my grandbaby jest up here to get my medicines from the pharmacy that's all."

I looked down at his cherubic face and then back up at hers. "He looks like his granny."

"That's what everybody say. They say I wiped my face and then jest wiped his." She threw her head back and laughed when she said that part, and her laughter made her tiny Doppelgänger do the same. That made me chuckle, too. I put that on a mental post-it note for the next time I saw her.

And you know? That was that. Off she went with grandbaby in tow and on I shuffled through that crowd toward the Green Pod clinic.

"Miss Manning! Miss Manning!"

I hadn't even taken five more steps before hearing that. And I already knew from the tone of it that it was social and nothing more. I smiled even before I knew who it was.  Spinning around in the crowd, I tried to place where the voice was coming from.

"Miss Manning! Over here by the newspapers, sugar!"

And that "sugar" meant that this was a Grady elder. Once I turned toward the AJC newspaper table I confirmed it to be one of my FPs of all time. The minute we made eye contact, we both erupted into huge grins.

"Hey there, my friend!" My voice was exuberant--genuinely so--because I truly love this man. I love him in the way a doctor loves her patient. Especially the ones you've known for a long time. He was perched on a metal folding chair beside the man who sells the Atlanta Journal Constitution each morning. He was pretty much in the "salesman area" but that man in his blue AJC t-shirt didn't seem to mind one bit. In fact, my patient had his cane lying flat across the table beside all those newspapers and that salesman just continued on with his transactions as if this was no big deal. I bet that metal folding chair was his, too.

They weren't near me. In fact, that table and that metal chair were clear across the vestibule and since I know that my patient walks slowly, I knew there was no chance he'd be getting up to come to me. I also knew that, because of the nature of our relationship, he fully expected me to come over and give him a big hug and "see about him" even though we weren't at an appointment.

He was right to think that.

"What's going on, sir? I didn't see you on the schedule this week," I said once I reached him.

"My legs had this rash on 'em. But y'all seent it before, Miss Manning. 'Member? I had to see the skin doctor in Dermatology."

"Oh, good. They got you in pretty fast. That's good."

"Yeah. And they gave me some salve to put on it. But what's funny is that look like it's healing up with jest some time." And with that he rolled up his pants leg and showed me. Right there in the middle of the Grady lobby. And you know what? I looked at it and nodded my head because he was right. It did look better.

"I agree."

"I'm 'on still put this salve on it, though. Look like it won't hurt. What you think?" He handed me the tube of cream that he'd just filled at the Senior Pharmacy. I scanned the label and gave a shrug.

"This should be fine. Let's follow their advice since they saw you today, okay?"

"Yes, ma'am."

"Alright then, sir." I reached down to hug him in his chair.

"You look so pretty today, Miss Manning."

"Awww. Thank you, sir."

Then he twisted his mouth and pointed at my leg. "Almost forgot to ask you. How your leg doing?"


"Ya leg. The ankle that you was hobbling all about on that day from when you was running. 'Member you told me you was running too much?"

I was touched that he'd remembered. "Oh! Yes, that! I had what they call a stress fracture. But now it's all healed and I'm running again. Thank you so much for asking."

"Oh good, Miss Manning. You gon' be able to run your race? You know, the one for your sister that went home to be with the Lord?"

And something about him knowing and remembering and asking about that immediately made my face feel hot. Without warning my eyes started stinging with tears that I tried to blink back but failed to contain.

Here's the thing: I hadn't thought about whether or not I'd make that original race. Well, I take that back. I have thought about it and the answer is that I have set my sights on later races. But really, I haven't had to articulate that to anyone nor had I been asked so directly before then.

"It's hard, I know, Miss Manning. I know 'cawse I lost a lot of family including brothers and sisters. I know." And he reached out and squeezed my hand hard. I let him.

So I stood there holding his hand as he remained in that metal chair and didn't say much more for a few moments. Finally, I looked at him and said, "Thank you, Mr. L. Thanks for remembering."

"You special. I'm always gon' remember you, baby."

And that only made me want to cry more.

And so. I told him that I had postponed that race and that others would come and that I would be sure to tell him how it went. And he promised to let me know how that salve worked on that rash. And that was that.

With continuity of care, it is our job to remember our patients. On this day, I recognized from another perspective why that's so important to patients. It's because patients are people. And people like to be remembered. I call that continuity of caring. It goes both ways.


Happy Saturday.


  1. I just LOVE the Grady elders!!

  2. I am so glad that you are able to run again!

  3. There you go making me cry again. Beautiful post.

  4. what Mel said. Honestly, I just grab Kleenex before I sit down to read. I just got a note from a patient I helped with breastfeeding 25years ago! You just never know the impact you have on a person so keep up the continuity of caring Miss Manning.

  5. So beautiful. You are a cool human being. Sweet Jo

  6. Just catching up on your posts, and here I am, on a sunny New Mexico morning, crying into my coffee. What a great post.


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

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