Thursday, February 12, 2015

I love you, I love you, I love you. . . .

*name and some details changed to protect anonymity though patient permission obtained.


These three words, sweet and simple
These three words, short and kind
These three words always kindle
and aching heart to smile inside

~ Stevie Wonder


I love my job. I really do. But some days, I extra love it. Like with whip cream, cherries, sprinkles and all that on top.

Yup.

On those days I feel like my heart will just explode. Like my skin feels tingly like God himself is touching me and saying, "This is exactly what I want you to do and you are exactly where you are supposed to be." And let me just tell you--that? That is a great feeling, man. I'm talking straight up euphoria.

Yep.

There are two primary times that this happens to me. The first is when I am quietly with a patient and we simply connect on a human level. Sometimes it is something as simple as learning about somebody's children or hearing of their back story. Without fail, I get an ah hah moment out of it or instead I am left with a newfound faith in humankind. And as crazy as this world is, I love it when these moments remind me that people are more inherently good than bad and that so, so many folks are more brave than lily-livered.



The other aspect of my job where I feel most in the zone and like I am walking in my purpose is when I am working with medical students and residents. Sure, it's fun when I'm teaching and rounding with them. But there are these fleeting moments where I can see it. Like, I can SEE them growing right before my eyes and it just. . . aaaahhhh. . . okay, I said this already but I can't think of another word for it. . . it makes me euphoric. Like. . .high, man. And when it is happening it is so, so cool because I know they feel it and see it, too. I feel doors beomg kicked open and new rungs being reached on  ladders. Man. It's so awesome.

I mean it--awesome. Like really and truly worthy of awe, man.

I want to tell you about a couple of examples just from my ward month so far of each of those pieces of my job that make me my happiest. It'll be quick, I promise.

The first was a week or so ago. There was this older gentleman who'd been admitted to my team and his admission was soft. We call admissions "soft" when someone was on the fence about whether or not to keep the patient hospitalized. But anyways, he got admitted and his issue was quickly sorted out and the very next morning he was ready for discharge. Nothing about his problems were exotic or earth-shattering.

We actually didn't seem him as a team on rounds that day. His issues were so straightforward that I'd agreed to see him on my own. He was nice enough and didn't have many questions when I got to the end of the encounter. And so. I reached for his hand and wished him well.

And that was that.

Well. Not really. I always like to find some way to connect with my patients or to show them I have interest in them as a person. This patient was pretty quiet so it wasn't exactly the easiest thing in the world. I tried any way.

"Is someone in your family coming to pick you up?" I asked. "If not, we can arrange a ride for you."

"My sister will be coming to get me. I'm okay with the ride part."

"Okay," I responded. I smiled and prepared to stand up from the bedside chair. "Do you have children, sir?"

At Grady that question feels rhetorical--especially when talking to the elders. Of course this man had children. He probably even had grandchildren and great-grandchildren.

"No, ma'am. We never had children."

He said 'we' not 'I.'  So I bit. "Were you previously married?"

"If I could have been, I would have been." He stared out of the window and his eyes began to glisten with tears. I wasn't fully sure how to proceed but I hungered to know from where the emotion was coming.

"Tell me of your love." That's all I said, sitting myself back down in preparation for his response. Vanilla enough. Forward enough. Maybe even too forward, but I didn't want it to be mistaken as anything other than the question it was.

He turned his head and gazed at me. This soft-spoken man who'd uttered very few words since his hospitalization touched his fingers to his lips and then pressed them together to hold in the first thing even close to a smile that I'd seen since walking in. "My love. That is a good word for him."

Yes.

"Tell me about him."

"His name was Morris. He was funny and loud and a really, really good dancer. He wasn't afraid of anybody, either. We met when I was still a teenager but we were inseparable. He didn't care what people thought about him loving me, either. Nobody."

"Wow. How long were you together?"

"More than 20 years off and on. He went to the military for a little while and I lived out west for a couple of years. Then we came back together."

"Morris sounds amazing."

"He was. I took care of him until he took his last breath. I held his hand and stroked his cheeks and just kept on saying 'I love you, I love you, I love you, I love you' until his last moment." He started blinking fast to remove the tears that were quickly forming. Then he sighed deep and hard. "He was so, so brave. He was the love of my whole life."

I was already crying. I patted my own cheeks and smiled. "I love that you just kept saying 'I love you' until the moment he died. That is probably one of the most beautiful things I've ever heard."

"It was so hard being gay back then. There weren't people clapping at parades for us, either. Especially in Atlanta. But Morris always said that life was short and that we needed to live. He said we deserved love and I believe he was right. One funny thing he always said was, 'You don't want to hear about, talk about or imagine your mama and her sex life. Why the hell you got your drawers all in a bundle about mine?'" He let out a moist chuckle and then quickly looked wistful. "He made me brave, too."

"Wow. What happened to Morris?"

"He died of AIDS. Back before they had all the stuff they have now. I got lucky somehow and didn't get it. But his family was scared of him and they weren't nice. That's why I wanted the last words he heard to be 'I love you.' I must have chanted those three words for more than six hours straight. I'm not kidding you. He was in and out of consciousness but I just kept on. Sip some water and then say it again. And again and again and again."

"I love you, I love you, I love you. I can think of no more beautiful way to make a transition."

"I pictured him hearing my voice and then God taking over with the same words." He looked over at me and smiled. I could tell the he was serious.

"Me, too." And with that my voice cracked and I started full on crying. I sure did. And he handed me his tissue box off of the tray table and I took three pieces. And then we just sat there imagining Morris escaping the pain of advanced AIDS and breaking out of shackles to run again. Following the sound of those three soul-fulfilling words.

I love you, I love you, I love you.

It was perfect, that moment. Perfect in how unexpectedly beautiful and pivotal it was. Every time I imagine him standing vigil over his brave Morris saying, I love you, I love you, I love you, I cry. And it feels good, too, because I know I'm honoring their love and that moment that I had the chance to be introduced to it.

Yeah.



The other situation happened with one of my medical students. Jeff worked with me during his very first week of medical school for something called "week on the wards." Now he is a graduating senior and is on his last medicine month. We were rounding yesterday and I was watching him talking to me and talking to patients. I imagined him as the wide-eyed first year with a nervous disposition. But not any more.

His shoulders were back. His head was up. Jeff had grown up. A lot. I reflected on the day I met his grandmother at the first year student White Coat Ceremony back in 2011. I imagined how proud his late grandfather, a former Grady doctor, would be if he could see him now. See, this wasn't only full circle with me as his teacher--it was full circle on a much larger scale.

I loved it. All of it. And just thinking of it makes my heart happy.

Here's the story from Jeff's white coat ceremony. I'm so happy I wrote about it then when it was fresh so that I could go back and reread it. How cool is it to get to work with him all over again?

Look at him now.




For me? Grady is the gift that just keeps on giving, man. When I walk into the hospital today and all days going forward, I hope some piece of me will always be softly murmuring . . . . I love you, I love you, I love you. . . . . because it's true.


Sigh.





That's all I've got. Thanks for listening.

***
Happy Thursday. Man, I'm just glad to be here.

Now playing on my mental iPod. . .the incomparable Stevie Wonder singing about the three words that Morris wasn't shortchanged from hearing as he took his last breath. We can never say it enough. Please, please listen and reflect with me.



6 comments:

  1. I am crying. Literally.
    "I love you, I love you, I love you."
    Thank you for that beautiful, tender, sad, gorgeous story.

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  2. I'll say it again. I wish you were our doctor. Love.

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  3. Oh my that was beautiful. My heart feels full tonight after reading this. Especially about your patient and Morris but also about the growth of the medical student. You keep going Dr.! Sweet Jo

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  4. Thank you for again describing so well what so many of us in medical education feel. Just the same as we think about refilling our vessel of compassion - reading your blog helps to refill my vessel of teaching strengths and skills.

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  5. What a wonderful story. I love hearing about your elder patients. You seem to have a real gift for listening to them. I'm also grateful that so many students get the chance to be exposed to you as a role model for how to be human with patients. So many docs forget that, and it truly makes all of the difference in the world.

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  6. Dr. Manning, having first come across your blog as an OT grad student, I fell in love with your work (both on page and from a clinical perspective). There were times in grad school, usually between 12 AM and God knows when, that I would stop my work to read your blog as a means to bring meaning into why I was putting myself through such suffering. Your words always brought me back to the root of why I wanted to be a clinician. But not just any clinician, instead, one with a passion to help those that would otherwise not be able to help themselves. As it were, I always knew that my life work would involve helping individuals like those that Grady serves. It was a dream of mine to work in a public hospital. Last June, I was given this opportunity. But not just any opportunity, the chance to be part of the Grady family! As such, I now have a new understanding behind the meaning and symbolism of the words you write in this blog. Thank you for continuing to inspire me to do great work, and thank you for the compassionate care you provide our patients. I look forward to our paths crossing in the future. Until then, keep up the great work!

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