Wednesday, September 6, 2017

Twenty for twenty: Number 5.

Please remain standing.

Back in the 80's at my Southern California high school, every single day we started the morning the same way: By standing and reciting the pledge of allegiance. First in English and then in Spanish. Every. Single. Day.


After we finished the English version, the person on the PA system would say in this booming voice, "PLEASE REMAIN STANDING." After that, came a chorus of Spanish--from everyone. The nerds. The jocks. The gangsters. The mean girls. The popular kids. The weirdos. The new wavers. Even the teachers. It was actually pretty cool. Back then we thought nothing of it but now I realize the symbolism in those three words:


It was so unifying and was an act of inclusion. Every single kid in our school recited those words together. And whether you are a fan of the pledge of allegiance or not--somethng about a few hundred (unilingual) kids speaking Spanish in unison with their bilingual sisters and brothers is kind of powerful. I bet you every kid who went to Morningside High while I was there STILL remembers saying this every day:


Juro fidelidad a la bandera de Los Estados Unidos de América
Y a la república que representa
una sola nación bajo de Dios 
indivisible con libertád
y justicia para todos."

I stand with the DREAMERS, man. Indivisible con libertád y justicia para todos.




Twenty for twenty: Number 4.


If I won the lottery--like the big, bad, super-inflated, multimillion dollar PowerBall? Let me tell you exactly what I'd do:

1. Get some sheets in the highest count attainable.
2. Get my currently periodic housekeeper to make my home her main and only gig.
3. Get a driver.
4. Make sure the driver is down for driving 24-7-365-52.
5. Get one of those cars with internet access so that I can do stuff like blog while riding.
6. Philanthropize like a BOSS.
7. Have a cook.
8. Pay off my house and my student loans (yes, I still have some.)
9. Keep my minivan

Oh, and of course, keep working at Grady.

I need to emphasize numbers 3 through 5. I really, really, really don't like driving. Outside of that? My life is rich enough, man. Like, I'm pretty sure I wouldn't do too much different if I suddenly hit a windfall of moolah on a random Wednesday. But the thing you could bet your life upon is that somebody other than me would be driving.


So, this is on my mind because in the past few days I've driven WAY more than I want to. I mean, I really don't want to ever at all. But when I do, I'd like it to be as limited as possible.


Yesterday, I was rounding and my patient kicked me out as soon as I walked in. He said, "I'm not happy. Y'all are making me leave and I don't even have no shoes, man. This is some bullshit."

And so. I tried to tell him that we'd go find him some shoes in the social work office but he announced that he had to pee and that I needed to get out. And that was that. But before I left, I did ask him what size he wore. Which was a twelve.


Well. Turns out that the BHE is a size twelve and since he is from the midwest where sneakers get retired after just one speck of dirt gets on them, I knew EXACTLY where to get this man a fresh pair of kicks.


It was Labor Day so I knew the BHE was off. I tried to get him to bring the shoes but he was hanging out with the kids and the dog away from home.


So you know what I did. At lunch time I drove my butt home. To get the shoes for the man who kicked me out of his room. And can I just say this? Bringing those shoes back to that brother made it worth driving across town, man. It was.

"Got you some shoes."

"Who shoes is those?"


"Them shoes look like new."

"Yeah. They come from a dude from Cleveland."

"Awww shit. Them cats from Cleveland, Detroit and Chicago? They crazy 'bout some shoes getting dirty."

"You know it."

"Damn. This is a good look, doc. What size they is?"


"No shit?"


"And they mine?"

"All yours."


"Can I examine you now?"

"Lady, you can make me do jumping jacks for all I care. Man. These shoes is great."

"I brought a pair of socks, too."

He just stared at me on that one. And looked almost like he wanted to cry. I've learned that socks are a big deal when you don't have stable housing. For reals.

So yeah. I drove for that.

Then there was today. I was at Grady in the morning rounding. And I had seen all but one patient but that patient belonged to the med student. It was noon and the students and residents were supposed to go to Grand Rounds. I didn't want to delay them going but I also had this one more patient. There was an easy solution: See the patient while the team went to Grand Rounds.

Oh, did I mention? Today I had to be at Emory at 1PM to teach my first year med students. So I'd need to either see the patient alone and not give the student a chance to present his patient to me (a big deal when you're a student) or go to Emory and come back explicitly to let the student have the chance to present his patient.


Yeah. So you already know what I did. I went to Emory. Came back to hear the student discuss the patient. And then? Did I mention? I had to go back toward Emory to meet my third year students. Oh, and I had to get Isaiah from school, too.


That student knew that I valued him when he saw me walking back into Grady to hear his presentation. That was worth a lot to me. But dude. That was a lot of driving. A lot, man. I really need a driver. For reals.

Yeah. So I've been in overdrive this week, man. But all of it is give and take, I guess. And if I could do it all over again, I'd do it the same.

That's it. Oh, that and the fact that I have nightmares about someone forcing me to drive Uber for the rest of my life. Like, full on nightmares.

I think that's it. Yeah.


Tuesday, September 5, 2017

Twenty for twenty: Number 3.

Mother and son.

When I walked in and tried to shake his hand, he took one step back. He clasped both hands together and nodded in my direction. His expression was warm, though. Kind even.

But, still. He didn't shake my hand.

The center of his forehead had this slight hint of hyperpigmentation. Because his skin was already a velvety confluent espresso shade, most wouldn't have noticed it. But coupled with him not wishing to touch my hand, it came together for me.

This wasn't personal. No, it was not.

The conversation about his mother was serious. His face was cloaked in pain and his eyes were glistening with tears that he dared to counter his stoic persona. "Please, doctor. Do everything. Everything you can possibly do," he said. The words came out staccato and firm, blended with his unmistakable mother tongue. I understood him, though.

I did.

But his mom. She was sick. The kind of sick that doctors can't simply put back together. The kind that, in an elder with other serious health conditions, often leads to everyone agreeing to step out of the way of the inevitable. "Let go and let God" the Grady elders call it. A concept that, in this situation, almost always resonates.

And you know? Even for the ones who don't hold fast to Jesus Christ--they, too, are usually on board with the letting go piece. At least, in my experience, they are.

So I realized that these two scenarios are where I am most comfortable. The bible thumping, hallelujah shouting families who have Jesus on the mainline at all times and the pragmatic ones who either don't subscribe to or are unsure of higher powers but who are just steadfast in their belief in love. The approach is the same really. It focuses on reducing suffering and achieving death with dignity. You tow the line of faith and pragmatism the best you can.

"We want everything," he kept saying. "Everything you can do to help."

I swallowed hard and glanced at my feet. I explained about how sick his loved one is. And I spoke more about how her body is nearing the end of life.

"We can focus on her comfort," I said. "Helping can often mean doing the things that make her not feel so bad. Sometimes when we do things we stand in the way as a person tries to rest. Like, the feeding tube we talked about. It could help her live longer but it could also cause suffering. And, like I said, stand in the way." I was grasping. I felt my voice trailing off.

"Stand in the way? That is not possible," he replied. Now his thick accent had a ripple of something indignant.

"I'm not sure I know what you mean," I said. I could tell he seemed offended.

He sat up straight and stared at me intently. "In my faith, we don't believe this is possible. To stand in the way of His will. You are a part of the will of Allah. The doctors and the things you can do to keep her alive. No person can stand in the way if she is to die."

I just stayed quiet. It was super uncomfortable. Still, he let me writhe in it. Finally I spoke. "When you say everything, tell me what you mean."

"I mean all that can be done to keep her alive. If her heart stops, you help it come back. Whatever things you have that can be tried. We want her to stay alive."

"But--" When I said that one word his eyes trained onto mine and away from his mother. "You want this. . . even if it could mean her suffering?"

"We do not look at it in this way." He swallowed hard and sighed. I could tell he wanted to cry. "We do not. . " his voice cracked and he cleared it hard and went on. "We do not say do nothing. We do not do that. What you do to try to help is okay. We want it all. If Allah is ready for her, she will go."

After he said that part he stood up from his bedside chair. That was his way of letting me know this discussion was over.  "Okay," I said. Then my voice grew softer. "Okay."

"Thank you."

"Thank you for talking to me," I responded.

We both just stood there for a few beats staring at his mother. Her comatose body lay limp and peaceful. Her chest rose rhythmically with each breath. And that was it.

"Okay, sir.  Remember, my name is Dr. Manning, okay? Let me know if there is anything that you need or if you have more you'd like to discuss later." And just like that I reached my hand for his, immediately wanting to kick myself for forgetting that he wouldn't shake my hand. "Oh, yes. I'm sorry."

I turned toward the door and slipped through the partial opening. As I pulled it closed, I could see him placing a cover over his mother's shoulders and pressing his lips to her head. Then he dropped his forehead to her chest and held it there. At that point I turned away since watching felt like a violation of his privacy.

What I am learning is that the expression of love looks so many ways. But no matter what, there is always something universal about the tenderness between a mother and her child. Regardless of what I thought about the decisions he made, there was no denying that every single thing he did was rooted in love. In that sliver of a moment, I made up my mind not to ask him about this again.

I would respect their wishes. I would respect their faith. I would respect their love.



Monday, September 4, 2017

Twenty for Twenty: Number 2.

The Alley Oop.

I imagine what life is supposed to be like in the sixth and seventh decades. I see grandkids screaming through houses, knowing full well not to stomp too hard in certain areas because something precious to grandmama will fall and shatter. Those kids have it down to an art. They hop and leap in the other areas. And the grandmama is cool with it.

And if, by chance, grandmama is not well enough to sweep her own floors and make her own bed and scramble her own eggs due to some unfortunate health detours, I see the same family responsible for making those rambunctious grandchildren stepping in to see about her. Coming to get grandmama to her doctor's appointment or going to the store to pick something up for her if she needs it. Lightening her load because that's what family does.


But that isn't what is going on here. You are a sixty-something grandmama. Wait. I take that back. I am not fully sure if you are a grandmama but, still, in those far away eyes I see the love and tenderness of one. So, in my mind, that counts. And you are here in front of me in this hospital bed staring into far away places. Your body is sick. But it is sick with the kinds of things that could be managed with some support. I mean, mostly managed. With support, that is.

But you don't have that.

Mental illness is what robbed you in broad daylight. Held you up at gunpoint one day and then came back for more. And nobody jumped in the way to stop the crime so you eventually lost all the things that people need to just be. Especially as you get up in age.

"Where are your people?" I ask.

You don't fully get it. It's like I threw a basketball for you to catch and shoot and instead you grabbed a bat to swat it like a baseball. Our conversations don't align; they don't match. "We were eating peach cobbler. And I said, 'Do you think this cobbler need some ice cream on it? Or some heavy whipping cream on it?' But everybody just kept on eating it."

My brow furrowed. "Who made the cobbler?"

"I just eat it. But not without any kind of cream."

"Who gave you the cobbler?" I wanted to know. There is love in peach cobbler. And just maybe that meant there was someone somewhere loving you. "Who served you peach cobbler?"

"Somebody said it feel like the autumn coming. To me, it feel mostly like summer time still. The mosquitoes still here. But they don't like me."

This time she kicked the basketball like a soccer ball.

"Where do you live?"

"There was the bench where we had the cobbler but I had to move from there. I had a daughter. She died from sickle cell."

My breath hitched. You lost a child?

"Jesus." I covered my mouth because I didn't mean to say that out loud.

"They came and cleaned up out there so you can't lay on the bench over there."

I swallowed hard and just kept gazing at you. Your hair matted down to your head in one confluent dreadlock. Your teeth fractured and denuded down to tiny browning chiclets. Your eyes super wild and industrious, oblivious to all of this. And your hands, unusually soft-looking in their appearance with a tapestry of bulging veins that look just right for grandmothering.


Oh, and the other thing about those hands? No burns or callouses on them suggestive of holding glass pipes or flicking lighters. Your labs also told the same story--this was all just unruly mental illness with low resources and no support. This was something I've seen and I see.

I hate it. Perhaps more than or as much as the things I see that I hate the most in this work.

And so. I will treat your illness. At least, the medical one that I can handle. I will call the social worker and try as hard as I can to advocate for you just like the doctor did the last time you were here. I will attempt to grasp the names that fly out of your mouth into word clouds above you, hoping to attach them to phone numbers and peach cobbler. This is what I will do.

And, even when it feels futile, I will keep passing you ball after ball. Praying with all of my might that, just maybe, this will be the time that you lean your body back, press your palm to the back of it and shoot it straight into the air and into the basket.

And it that doesn't work? That someone, somewhere will run to your rescue to tip it in on the alley oop.


Happy Monday.

Sunday, September 3, 2017

Twenty for Twenty: Number 1.

I will set a timer for twenty minutes. Then I will write. 
When the timer goes off, I will stop. 
That's it. That's all.


Magical places.

"Where you from?" I asked as I unfastened his gown to place my stethoscope on his chest.

"Opelika," he replied. "You probably ain't never even heard of it."

"Opelika, Alabama. Lee County."

His eyes widened when I said that. You could tell it was the last thing he expected me to say. "You don't even sound like you from Alabama."

"I'm not. I'm from California but I went to school in Tuskegee."

"Macon County," he responded. We both chuckled.

I pressed the diaphragm of my scope into his chest and instinctively he knew it was a drill to be quiet. As soon as I lifted it off of him, he spoke again. "What made you come all the way out to Alabama for school?"

"Oh, my whole family went to Tuskegee. And I knew I'd have to leave California. I'd always wanted to attend a historically black college so knew I'd have to at least go to Texas."

He squinted one eye and gave one nod. Then he pressed his hands down and sat up in the bed to lean forward. I listened to his lungs as he took big, deep breaths.

"I got a question," he said when I finished listening. "What makes somebody pick a historically black college anyway? Like, maybe me being a white guy and all, you know, that might sound like a dumb question. But I always wondered what the appeal was."

I paused for a moment to see if he was serious. He was. I pursed my lips and gave the question some thought. "I knew it was like a magical world. And that it was different than the real world."

He looked confused. I decided to go on.

"Like. . . . I had visited colleges back home. And I had also been with my parents to historically black colleges. And . .  . I don't know. It was just this special little slice of the world where you could be exactly yourself and then all of this culture surrounding you, too. It's hard to explain."

"A place to be comfortable?"

"Kind of. I mean. . .I guess the thing is. . . . a place where you get very comfortable in your own skin. While growing up, too. I knew that's what happens at an HBCU. I knew because of my parents and my friends' parents. Oh, and Spike Lee."

"Spike Lee?"

"Yeah. He'd just put out the movie 'School Daze' when I was a junior in high school. I was sold after that."

"I never saw that movie. Maybe I would've gone to one if I had seen it."

"Ha. Maybe you would have." We both smiled.

"I did like the TV show about the black college. The one with Will Smith's wife. Or Lenny Kravitz' wife, I think. Which one of them was it?"

"It was both of them."


I got to the end of his examination and sat on the end of his bedside chair. He asked a few questions about his hospitalization and I did my best to answer them. And that was that.  I shook his hand and prepared to leave.

"Hey doc? One last question--how far is Tuskegee from Opelika?"

"Maybe 30 minutes?"

"Hmmm. I think I'm on go there and see it next time I'm home."

"You really should."

"Can't believe I lived so close to a magical place and never went to see it."

That made my face light up. "You know? It's never too late."

And he gave me a bright grin with a thumbs up. I returned the gesture and left the room.

And that was it.

Not sure what made me think so much about this exchange. I guess he made me think about how we are often right next to people and places where there is magic happening. . . . but because of our cultural differences or believing our comfort zones don't align, we miss it all. By allowing just a few glimpses of ourselves to one another, the magic is shared.