Sunday, December 21, 2014

No place like home.

"When I think of home I think of a place
where there's love overflowing
I wish I was home, I wish I was back there
with the things I've been knowing."

~ from The Wiz

Those situations usually seem so hypothetical. Even though I work at Grady and know that they aren't, no matter how hard I try to avoid not seeing all of these logistical changes that way, the inertia of every day living blurs out the reality. I wish I could say I was so deeply and consistently empathic that I haven't fallen short in this way. But I can't.

Our inboxes were flooded with emails about this. Well, maybe not flooded per se, but definitely we got our share of notifications. The contract between Grady Hospital and Blue Cross/Blue Shield of Georgia had been terminated. Those with that as their insurance carrier would need to seek care elsewhere. And I guess if the majority of your patients have no insurance you hear that and think, "Man, well that sucks." But I'm not sure if it mobilizes you to march on Washington or social media or whatever it is folks march on these days.

But seeing you last week felt like a stinging slap across the face. You, who'd entered this world at this very place. You wore that badge with pride--"Grady baby"--and had stayed loyal to the brick and mortar building that initially welcomed you. "I'm always gonna be a Grady baby," you said. That is what you said every time we saw you.

Not only did Grady give you life, you'd trusted us to save your life, too. Now officially middle aged and, yes, insured, you had a choice. But you continued to choose Grady. In fact, you even paid a higher premium to afford you the chance to do just that. You sure did.

I remember that day when I, along with the amazing resident doctor caring for you, gave you quite the tongue lashing about cigarette smoking. You countered it a bit but then gave in to the tough love recognizing the love more than the tough. "Y'all care about me," you said. And you were right.

We spoke of highly personal things that required trust and patience. The barriers to caring for you had long since come down so the things we dissected didn't make anyone blush or shift in their chairs. It was all love and all a part of the tapestry that had been woven over years and years of being a Grady baby. Medication changes, tests, and referrals. You did as we asked of you, asked great questions, and formed what I know for sure is the very best kind of therapeutic alliance--one built on genuine caring and mutual respect.

The muddy sclera of your eyes glistened when you told us last week. "This will be my last time here for a while. I have to go somewhere else." And at first I was puzzled but wasn't for long; your resident primary doctor clicked on the screen and up popped your insurance information: Blue Cross/Blue Shield of Georgia.

"Is there anything that can be done?" I asked, my naiveté  almost embarrassing. Both Dr. Spicer and you looked somber and acknowledged this inconvenient truth: Immediately? No.

Immediately, no.

And your health still requires "immediately." Close follow up and such. And it's never been a burden for you or for us to work you in because beyond the business parts there is the relationship part. The laughter, the fun-poking, the explaining, and the exploring. The parts that people don't show on the six o'clock news when speaking of Grady.

Maybe there are fine details that I don't get and surely there are high-level things regarding the dissolution of that contract that some person reading this can argue with a fervor that I cannot. I admit that I should know far more about the political ramifications but I don't. In fact, I'll even accept that I could have a better understanding of many other things related to health care and health equity that are still a bit fuzzy and slippery whenever I try to grab them in three full dimensions. That's the honest truth. But this? This encounter with you and your tearful eyes was as real as it gets.

Not slippery. Not fuzzy. Nope.

And so. We spent part of the time talking about your "immediately" things and the rest holding hands and saying good bye. At least, good bye for now.

When you told me where you'd be going, I wanted to be positive. "They'll take good care of you," I said.

"But not like Grady," you replied. "'cause there's no place like home." And all I could do was squeeze your hand in acknowledgement. . . all the while wishing that if only I could click my heels three times to fix this.

I can't, though. . . .at least, not immediately.

"Living here in this brand new world might be a fantasy
but it taught me to love so it's 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

Happy Sunday.

Now playing on my mental iPod and making me cry this morning. . . one of my most favorite performances of ALL TIME that never, ever, ever fails to give me chills or cause me to break down crying. I am so grateful to find it on youTube this morning. Thank you, Miss Diana Ross for words that are a part of my daily soundtrack while walking into Grady.


  1. This still makes me so sad…this is my second patient who has had to leave me in the last month, and both of them really needed to have good continuity of care. #BeFAIR2Grady

  2. holiday season is spreading its joy all no place can be as beautiful as home


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

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