Monday, October 7, 2013

A little boost.

I came into the room and there was already commotion. A nurse was laughing out loud, leaning over onto one knee holding on to her side. Another woman, who had just come to pick up an empty food tray, was there, too. She was shaking her head and trying to keep a straight face. The moment I saw his mischievous expression, I knew he was the culprit.

He saw me and immediately gathered up the covers to hide his bare chest. Out came an animated squeal, like what you'd hear if the daintiest lady ever had just seen a mouse or, worse-- if after seeing that mouse--she'd then locked eyes with a peeping Tom in her kitchen window. Everything about it was funny. Effortlessly so. The kind of funny that some people are just born with that brings the kind of joy that requires little to no planning or trying.

I didn't even bother to find out what the joke was that he'd been telling them before I arrived. I was just meeting him but could already tell that he'd have a fresh set of jokes uniquely for my encounter.

And that he did.

"I drank two of them Boost drinks. But you know? They don't agree with a grown man that can't process lactose." He raised his eyebrows and smirked. And just when I thought I could get away with not laughing out loud, He rippled the covers on his bed for emphasis and feigned passing out. "That's the best way to get your own room, you know. Hey, keep them Boost shakes coming, hear?"  That made me laugh a lot which seemed to make him happy, too. 

He was waiting for a biopsy. And when I asked my predictable questions like "Are you in pain, sir?" or "Is there anything that you need, sir?" he pretty much said no. "Unless you got some Lactaid pills in yo' pocket."

"Regrettably, I don't," I replied. "But you know? I'll look into it. I will."

"No! Don't! I'm trying to stay in my own room, remember?"

We both chuckled again.

I examined him from the right side. My stethoscope gently touched his chest in the places where good doctors always listen no matter what. Then my hands searched his abdomen for masses to explain his symptoms. Hearing none and feeling non, I smiled in his direction. "You sound great," I said.

And when I said that, he somehow found a way to make that amusing, too.

"No pain in your belly at all, no?"

"Nope. But you know it's kind of a pain that y'all don't have no HBO up in here! Who I need to talk to to get me some premium channels in Grady?"

More fluffy laughs. All of which were good.

So that's how the encounter went. Him with his witty one-liners and me oft times weak with laughter just like the two women I saw earlier. And as it ended, he gazed at me carefully.

That's when I was jolted back into reality.

Those yellow eyes. That unnatural and fluorescent hue now replacing the whites. And while he was on to telling me the next joke, in my head I was thinking, 

"Shit. Painless jaundice. This is bad."

 I was thinking about that and he was still talking. "So my biopsy is tomorrow, right? Nothing by mouth after midnight. Except Boost." He gave me an exaggerated wink and fanned his blankets once more.

"Umm. . . I'd go easy on the Boost, too." I tried to smile, but it wasn't really convincing. I know it wasn't because of what he said next. His expression appeared serious for the first time since I'd been there.

"So I'm told having yellow jaundice and nothing else is pretty bad news, huh? Like this is a time when you want to have pain at the same time, right?"

I just kind of stared at him when he said that. He'd been joking so much that I wasn't sure if he this was setting up a punchline or what. But his face remained straight. He wasn't laughing.

"It can be pretty serious," I finally replied.

"I know." That was all he said. Except for when he shrugged one of his shoulders and repeated himself. "I know."

"What other questions do you have about the biopsy? Like. . .is there anything I can explain?"



He stared out of the window for a beat and then, suddenly, he perched himself up tall in the bed and smiled. "If you ask me, your mood about something is a choice you make. I choose joy. Even when things don't look good, I make myself choose joy."

I narrowed my eyes and nodded. Because that? That was a good word. And one I knew I'd think about for the rest of the day, if not much longer.

I choose joy. Even when things don't look good, I make myself choose joy.

His imaging and biopsy confirmed the worst but most likely scenario.

But you know what? I saw him again and he was still smiling and putting people in stitches. And no, he wasn't in denial and no, he didn't lack insight. Not one bit. But what was obvious was that he'd made up his mind to be as happy as he could. This was his choice. This was his way.

And this? This is Grady.

Choose joy today, okay? Even when things don't look good, make yourself choose joy.

Happy Monday.

Now playing on my mental iPod. . . . . I like this song. It made me think of my patient.


  1. So how do you tell a person like that that he probably has pancreatic cancer? How??? I could not do your job, and I'm not blowing smoke here. There's a reason I'm a scientist and not a doctor, and having to give bad news to good people is right up there on the list of why. :(

    1. I understand that it is an unpleasant task to tell people that diagnosis is serious and the prognosis isn't good. I'm sure the radiologist who had to tell me that I had cancer and that it had already metastasized was having as guard a time with it as I was. But what I remember was the kindness and concern he showed when he told me. It made a world of difference.

  2. That's the kind of patient my dad was, right up to the end. He didn't want to dwell on the awful realities, but rather wanted to make people smile. He wasn't in denial, just choosing to control how he let his failing body affect his life and the lives of those around him. It was one of the best lessons he ever taught me, but I'm not sure I'm that strong. and
    I'm sorry for your patient's prognosis, but thankful you shared him with us. I'm going to choose joy today.

  3. Thanks for the reminder. I am going to try.
    And what Mama D said? Uh-huh. Me too.

  4. That is a good word, Doc!! It is humbling to witness someone face that kind of adversity with so much determination. Thank you for the glimpse...
    Coach B

  5. I am so extremely grateful you exist in the world. Thank you thank you and thank you.

  6. man, that's powerful Dr M

  7. Have to tell you...this post is still in my head. Having a hard time shaking it; finally wrote out my feelings. Bless you and all the doctors like you.


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

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