Saturday, July 14, 2018

Barriers to caring.



"She doesn't speak English," my resident said.
"Okay," I replied. "Let's call the interpreter and then go see another patient until they are ready for us."
"We can use the phone line or the video chat interpreters."

That's what the med student said. And honestly, it was a very good suggestion considering how busy we were that morning.

But.

See, I had never met this patient. And though I am deeply appreciative of the technology that affords us easy, prompt ways to close language barriers, whenever I can help it, I like everybody talking on that first meeting to have a pulse that I can feel.

Our Grady interpreters are so amazing. They have this way of melting away during a discussion and allowing you and your patient to really, truly connect. And again--sometimes I have no choice but to use the phone or video interpreter. On this day, though? I had a choice, man. I did.

Yep.

And so. With the help of Maria, one of our exceptional Spanish interpreters, I listened to the story of this patient. And not just the story of her present illness. The story of her life outside of the hospital. Of her six children who make her very, very proud. Of the tiny details of her symptoms that only come out when feeling unhurried. I also loved that her fluent-in-English son and daughter didn't have to interpret but instead got to sit there and just do what every single other family with a matriarch in the hospital l gets to do: Love their mama, ask their questions, and worry as only they can.

Yup.

The next day she felt better. And, again, I called that human-being interpreter even though the technology and bilingual family member options were readily available. And since she didn't feel sick anymore, this time I learned even more about my patient.

Here's what I learned:

We both have a spoiled labradoodle.
We both have danced all night at a wedding in Mexico City.
We both wish we'd worked harder in school to learn the native tongue of the other.
Neither of us like cheese. (Yuck.)

She's never been to my hometown so I told her all about southern California. I've never been to or even heard of hers so I listened to her paint a vibrant picture of her hometown in Mexico--a place with breathtaking waterfalls and rivers so blue they make you want to cry. "Agua turquesa!" she said with closed eyes for emphasis. Her kids nodded in agreement. Then her English-speaking son insisted that me and his mom Google image it right then and there. Which we did. And she was right--words didn't do those turquoise waters justice. No, they did not.

And I want you to know that that human-being interpreter shared everything we said word-for-word. And none of it took long but all of it made my patient feel better. Which made me feel better, too.

Here's what I know for sure:

Barriers to care can create barriers to caring. Every single time I call and wait for an interpreter to come, it honors my patient. Now more than ever, I want to do that. And though I (always) feel slightly annoyed with myself for being a Los Angelino who doesn't hablás español and though I'm (always) impatient with the time (no matter how short) I have to wait for the human-being interpreter to come, not one single time have I ever regretted it after the fact.

Nunca.


I'm really thankful for our interpreters at Grady.
***
#mejortrabajodelahistoria #elamoresloque #bestjobever #loveisthewhat #amazinggrady #iwanttogotosanluispotosinow #herhometownisdope #nowaterfallsininglewood

From from.






“Where are your people from? Maybe Mississippi or an island?” 

- India.Arie, “Brown Skin”


Grady elevator, July 4.

Him: “Hey doc.”
Me: “Hey there, sir.”
*silence*
Him: “Hey doc? Where you from?”
Me: “Me? I’m from California.”
Him: “No I meant like, where you FROM FROM.”
Me: “Ummmm. Born in Compton. Raised in Inglewood.” *holds up hand gesture* “West syeeeeeed.”

*laughter*

Him: *squints eyes* “But where your peoples from?”
Me: “Alabama.”
Him: “Alabama? So you just regular black? I was thinking you was something else.”

Me: *shrugs and smiles* “Nope.”
Him: *still pondering my ancestry*

*silence*

Me: “So tell me, friend. Where’re you from?”
Him: “Straight out the A. Vine City.”
Me: “Gotcha. Is that where you’re FROM FROM? Like, your peoples, too?”
Him: “Yep. I’m just a regular ass n*** from Atlanta.”

*silence*

Me: “So, why are you at Grady today on Firecracker day?”
Him: “To see my grandmama. She been real sick.”
Me: “I’m sorry to hear that. Are y’all close?”
Him: “She my heart.” *eyes glistening so looks down* “I see her every day.”
Me: “I bet she’s so glad to see you everyday.”
Him *nods and keeps looking down*

After that, I asked his name and told him mine. I told him that I thought his grandmama was a very lucky woman to have a special grandson who came to see her every single day. And then I reached my floor and the doors opened. I stepped out but then turned back to face him with my hand on the door.

Me: “Hey grandson? Can you do me and your grandmama a favor?”
Him: *looks up* “Yes, ma’am.”
Me: “Please don’t ever, ever refer to yourself as a ‘regular ass n***’ again, okay? Like, ever. Because you’re not.”
Him: *staring at me while I stand in the doorway as elevator buzzer starts going off*
Me: “Alright then, grandson. Go see ‘bout your heart. She waiting on you.”
Him: “Alright then, doc.”

Me: *smiling*
Him: *smiling back*

Both of us: *fist bump*

I love this place.❤️🏥

***
#slowtojudge #hewasspecial #peopleoftenaskwhereimfromfrom #butonlymyownpeopleask #itscooltho #totallycoolwithme #dialoguestarter #amazinggrady #loveisthewhat #alwaysandinallways

Thursday, July 12, 2018

Thick as thieves.





Afternoon with a Grady elder:

Me: "I heard you had a lot of visitors today. I hate I missed them."
Her: "Yeah. It was mostly good."
Me: "Mostly?"
Her: "Mmmm hmmmm."

*silence while watching TV*

Her: "My granddaughter got upset with me."
Me: "Oh yeah? Why?"
Her: "She say I ain't got no business laughing at the TV or at anything else when so much serious stuff happening with my body. She don't like me to be talking about or thinking about anything that ain't concerning my health. She feel like I shouldn't do that."

Me: *just listening*

Her: "Here's what happened: My granddaughter came in here with her friend and her friend just cut her hair all down with some clippers into one of these little afro hairstyles." *pats her head to make sure I understand*
Me: "Wait--what does that have to do with. . ."
Her: "'Cause it look a mess." *laughing hard and smacking the cover in front of her* "Oh Lord. Not cute on her at all. Bless her heart."

*laughter*

Me: "Now that's cold. Did she ask your opinion about her hair?"
Her: "When she came up in my room she did." *laughing even louder*
Me: *shaking my head and trying not to laugh*
Her: "And 'fore you say I got hate in my heart for being black it ain't that neither. Some of these little naturals look real nice. I just don't like it when somebody go and cut they hair off and don't do nothing. Just show up looking like somebody bad ass grandson."

*laughter*

Her: "I want you to pick it or put some pomade in it or somethin'!"
Me: *laughing*
Her: "And then you act like since it's a afro I can't say nothing. That's where you wrong."

*more laughter*

Her: *now serious* "But that ain't what made her mad. It was just that I could laugh period."
Me: "I see."
Her: "And I tried to tell her--'Baby, even when sad and heavy stuff happen 'round you, it don't erase the happy and light stuff.'"

Me: *staring at her*

Her: "Like, if you lose your wife, right? I can tell you I'm sorry and mean it. And then if your little next door neighbor come over and borrow a cup of sugar but want to tell you a joke he heard in school that day, I got it in me to laugh at it."

Me: *still listening*

Her: "I can be sad 'bout your wife and laugh at that joke, too. And it don't make me no less sad 'bout your predicament neither. 'Cawse, see, I think happy and sad--they thick as thieves. So I go on and let 'em live in harmony."

*silence*

Me: "I wish I could record this to play back to myself later."
Her: "Naw. You a good listener. When you listen good, you catch it all."

*silence*

Her: "I don't want nobody turning on they sad on my account. Just be you. If you see me and you feel sad, then be that. But if somewhere in there you got some glad in you, don't go pushing it down on accounta me."
Me: "I love this. Thank you--for real."
Her: "Bet it don't even make sense."

*suddenly I want to cry*

Me: "The thing is. . . it makes so much sense that it makes me want to cry."
Her: "Cry?" *laughing* "Why you want to go and do that?"
Me: "I just feel guilty sometimes. When I feel sad and happy at the same time."
Her: "Don't. Your heart would go crazy if it had to just be one of those all the time."

*silence*

Me: "Do you feel sad about everything sometimes?"
Her: "Sure I do. Sometimes I be in here crying, too."
Me: "You do?"
Her: "Wouldn't you?"

*silence*

Her: "But look here. . . .if you seent that hairdo on that child? Whoooo weeee. You woulda laughed, too. Shit, maybe even cried."

*collective laughter*

Sigh.

My patient was right. I DID listen. And I caught it all. 

Happy and sad are thick as thieves.
And, like her,  I've made up my mind to just let them live.

Yeah.

***
#agoodword #gradyeldersrule #thickasthieves #amazinggrady #loveisthewhat #lettherebelight #andlightenTFupwhileyouatit

Wednesday, July 11, 2018

The town crier.



"Let her cry. Let the tears fall down like rain." 

- Hootie and the Blowfish

I used to try my best not to cry in front of patients and families. In medical school and residency, I'd excuse myself abruptly and tear out of the room and into a hallway or a bathroom when I felt my eyes stinging. I knew that if I didn't, the volcano would erupt and my secret would be out: I'm a crier.

Yeah.

One day, I didn't make it. I broke down crying while giving some bad news. And you know? The world did not end. I held it together enough to speak in full sentences but, yeah, I cried. Hard, too. And I cried because I was talking about something worth crying about.

Yeah.

Somebody was losing their mama. And that mama was a good mama, too. A sweet, sweet mama. You could see it in the way they rallied around her and rubbed her cheeks and kissed her head. Those grown kids couldn't be objective. Love had them all myopic to how bad this all was.

But not me.

Today that happened to me again. Almost exactly as it did that time many, many years ago. And it happens to me just about every time that I am on the hospital service. I step into the circle of love as one of the only ones who can see. But when they let me in, I start to feel that love, too. I do believe in miracles just like they do. Still, I owe it to everyone to be honest. To tell what I know.

"I don't know what to do," the daughter said.
"I am here to help you be brave," I replied.

And then we both cried. Hard. And I'm crying again writing this.

I'm okay with it, though. When it doesn't hurt is the only time I'll worry. Until then, I'll continue to keep two tissues in my pocket just in case.

Yeah.

***
#thisisgrady #bestjobever #humanityliveshere #letitburn #myteamsawmecrytoo #andiwascoolwithit #amazinggrady #john13v35 #loveisthewhat

Tuesday, July 10, 2018

Question askers.



I love it when people have people. Like, when they are sick in the hospital and I come in to see them and there is a loved one there at the bedside? That's a good thing, man.

The ones that perk up when you walk in are my favorites. They have the steno pads with questions on them and read your badge then write down your name. These are the folks that ask the questions that the patient is too tired or too sleepy or too scared to ask. They keep you honest and on your toes.

And.

They point out those things that aren't life-threatening but are quality-of-life-threatening like:
"Can y'all do something about how dry his lips are?"

or

"Is there something prescription you can give her for those ashy elbows?"
or, my favorite this week:

"Miss Manning, can you PLEASE have somebody maybe from surgery come and see about fixing his outty?"

O_o

Um. You mean as in, the outty belly button that has been in such a state since Muhammad Ali was telling folks he wasn't fighting in no war?

Chile please.

Seriously though? I don't mind. Because seeing you at the bedside is right up there with seeing balloons, cards and flowers. It's a sign that somebody loves my patient. And somebody loving you is a positive prognostic indicator, man. You got a bunch of questions? That's cool. Bring it on.
That is, unless you start asking me about YOUR ashy elbows. Or YOUR outty belly button from 1965.

Then you got to go.

Good times, man.
***

Monday, July 9, 2018

Affection control.




Late afternoon rounds today

Me: "Hey there."
Patient: "Hey."
Me: "I just came back to check on you and--"

*notices another person in the bed*

Patient: "Oh we ain't doing nothing in here. We just cuddling." *pulls back cover* "See? We dressed."
Me: "Wow. Umm, okay. Soooo. . . that's like. . .uhhh. . . . . yeah."
Patient: *smacks lips* "You act like we in here hooking up!"
Me: "Ewww. Seriously?"

*laughter from both.*

Me: "Okay but for real. Y'all spooning in here is an infection risk. Soooo . . . .you have to get up out of this bed." *laughing and shaking my head*
Patient: "Awww man."
Me: "Sorry not sorry."
Patient: *pouts* "But that's my boo."

*laughter*

Me: "Well. Boo? You ain't got to go home but you got to get up out this bed I know that. Before the infectious disease team comes to get me."

*laughter*

Patient: *scowling as Boo gets out of the bed* "Miss Manning, you was probably a blocker back in the day wasn't you?"
Me: "Wait. A what?"

*laughter*

Me: *shaking my head* "Okay but for real. The bed is for the patient only, okay?"
Boo: "I got to leave anyway, babe."
Patient: "SEE, Miss Manning? You a BLOCKER."

*silence*

Me: "I'm sorry, I just threw up in my mouth a little bit."

*laughter*

I love this job.


***
#nospooning #idontmakethisstuffup #yourewelcomeinfectioncontrol

Saturday, July 7, 2018

Fear of dogs.



When you came in, this problem was barking like a dog. It looked like one and behaved like one, too. A few tests later, it was confirmed to be just that. A dog.

Albeit not a very nice or well-behaved one.

This is the kind of dog that requires the help of expert dog tamers. And we have very good ones who stepped right in and made recommendations. Special tricks to acquiesce the gnashing teeth of this dog.

They say what to do and we do it. I am only the middleman. And you feel fine, mostly. So I come in to see you, do what the experts suggest, and not very much more. Which can sometimes be how it is with exotic breeds like yours.

“Has everything been explained to you?” I ask.

“It has,” you reply. I confirm by pressing you a bit with questions. Your understanding is accurate. Your exam unchanged. There is nothing to do.

“I was so scared I wouldn’t see you by yourself today,” you say. “Outside the team rounds.”
“I’m here,” I say. "I'm back, okay?"
You smile and your dry lips crack. “I'm glad.” The look on your face makes me feel glad, too.

And so. I sit beside you and lay my hand before yours. You reach for it and close your fingers. And then we just sit and hold hands. I listen to your thoughts. Hear about what makes you afraid. We talk about how you are scared of dogs. Real ones and metaphorical ones, too.

I'm not the dog whisperer and no, I don’t have all the answers. And, yes, I'll admit that I have fears of lions and tigers and bears—and, just like you, those cancer rabid dogs, too. But what I also know is this: Even though I’m not the expert, I am brave enough to hold your hand and face them with you. I am.

Or to at least show up and try.

Yeah.

***

Thursday, July 5, 2018

This time.

*image shared with permission


I’ve passed you too many times to count in the last decade and a half. Our eyes always meet and the same thing happens. I wave my hand and say hello. And you offer a gentlemanly nod accompanied by a gesture for me to look at your collection of items for sale. I smile in response and, without fail, you say, “Maybe next time.”

Every. Single. Time.

This morning I woke up thinking of you. Recounting the hundreds of lunches that I’ve had that called for me to pass you and for us to have that same Groundhog Day-like exchange. I decided that today would be the day that I stopped and really, truly looked at what you were selling.

Yep.

I walked up slowly, to let you know I wasn’t in a hurry. And when you held out that flattened palm toward that rectangular cloth holding all of your goods, this time I halted, kneeled down, and gave it all a good, hard look. I asked you prices and questions. You were patient and answered each and every one.

“I like the copper bracelet but don’t have enough cash on me for it,” I said. “Maybe I could make a donation instead?”

You asked if I needed socks. Or perhaps some African oil? What about some shea butter? You didn’t want a handout. It was clear.

“What about you play me some music? And I pay for that?” I asked. You seemed to like this suggestion best of all.

And so you played. A sweet little ditty that I’d never heard before. But sweet all the same.

After that, I decided that I didn’t want us to be strangers anymore. I learned your name. You learned mine. I discovered that, like me, you love people more than you fear them and believe that we are all more alike than we are different. I found out that—no, you aren’t a Rastafarian from the West Indies. You are a bona fide ATLien—a Grady baby born and raised right in the heart of the 4th Ward. You’re a musician, an entrepreneur, a jewelry maker, a singer and, especially, a man who loves the pulse of a thriving city. You used to live in New York City for many years but found your way back home to Atlanta. You thought Dinkins could’ve done more as “the first brother mayor of NYC” and that Rudy Giuliani was decent but that he had no business running for President of these whole United States. Oh, and you like that Mayor Keisha Lance Bottoms is one of Atlanta’s own just like you.

Yep.

I bid you adieu and went to have some lunch after that. On the walk back, you gave me that same gallant nod and gestured to your spread. “Maybe next time, Dr. Kimberly,” you said this time.

“Yes, Mr. Harun,” I replied. “Maybe next time indeed.”

I love this place.

***
#amazinggrady #ilovepeople #objectsarecloserthantheyappear #loveisthewhat #iseeyou

Wednesday, July 4, 2018

Grandson.


“Where are your people from? Maybe Mississippi or an island?” 

- India.Arie, “Brown Skin”

______________________________

Grady elevator, July 4.

Him: “Hey doc.”
Me: “Hey there, sir.”

*silence*

Him: “Hey doc? Where you from?”
Me: “Me? I’m from California.”
Him: “No I meant like, where you FROM FROM.”
Me: “Ummmm. Born in Compton. Raised in Inglewood.” *holds up hand gesture* “West syeeeeeed.

*laughter*

Him: *squints eyes* “But where your peoples from?”
Me: “Alabama.”
Him: “Alabama? So you just regular black? I was thinking you was something else.”

Me: *shrugs and smiles* “Nope.”
Him: *still pondering my ancestry*

Me: “So tell me, friend. Where’re you from?”
Him: “Straight out the A. Vine City.”
Me: “Gotcha. Is that where you’re FROM FROM? Like, your peoples, too?”
Him: “Yep. I’m just a regular ass n*** from Atlanta.”

*silence*

Me: “So, why are you at Grady today on Firecracker day?”
Him: “To see my grandmama. She been real sick.”
Me: “I’m sorry to hear that. Are y’all close?”
Him: “She my heart.” *eyes glistening so looks down* “I see her every day.”
Me: “I bet she’s so glad to see you everyday.”
Him *nods and keeps looking down*

After that, I asked his name and told him mine. I told him that I thought his grandmama was a very lucky woman to have a special grandson who came to see her every single day. And then I reached my floor and the doors opened. I stepped out but then turned back to face him with my hand on the door.

Me: “Hey grandson? Can you do me and your grandmama a favor?”
Him: *looks up* “Yes, ma’am.”
Me: “Please don’t ever, ever refer to yourself as a ‘regular ass n***’ again, okay? Like, ever. Because you’re not.”
Him: *staring at me while I stand in the doorway as elevator buzzer starts going off*
Me: “Alright then, grandson. Go see ‘bout your heart. She waiting on you.”
Him: “Alright then, doc.”
Me: *smiling*
Him: *smiling back*

Both of us: *fist bump*

I love this place.❤️🏥

***
#slowtojudge #hewasspecial #peopleoftenaskwhereimfromfrom #butonlymyownpeopleask #itscooltho #totallycoolwithme #dialoguestarter #amazinggrady #loveisthewhat #alwaysandinallways

Tuesday, July 3, 2018

Baby Daddy.



Him: "You got kids, Miss Manning?"
Me: "Yep. Two sons."
Him: "They grown? Like my age?"
Me: "Nah. Thirteen and eleven."
Him: *eyes widen* "Damn. Doctors be waiting to have they kids."
Me: "Ha. Some do. Some don't."

*silence*

Me: "You excited about being a dad?"
Him: "Very. But it scare me, too."
Me: "What part?"
Him: "Getting it right."

*silence*

Him: "Miss Manning? You think if you didn't have no good daddy, you can be one to your kid?"
Me: "I think there's a lot of good daddies who are the first good daddies in their family."
Him: "Kind of like the first to go to college, huh?"

*silence*

Him: "I just hope I got what it take to be a good daddy."
Me: "You do. You got love. And love is the what, man."
Him: "Take more than love."
Me: "It's a start though. That and showing up."
Him: "I can show up and love her. I can do that."
Me: "Good stuff, man."

*silence*

Him: "That's what your daddy did, huh?"
Me: "What?"
Him: "Showed up. And loved you. I can tell."
Me: *silence*


He changed the subject after that and just watched the TV. And I just sat there on the chair next to him. At first, I wanted to cry. But then I decided to go ahead and give thanks for the amazing father this young man will become.

Because he will. I claimed it.




Yeah.

***
#whynothim #hegotnext #loveisthewhat #amazinggrady #iprayformypatients #gooddadsrule #hewasrightaboutmine

Monday, July 2, 2018

Divine intervention.




A fist has hit your face. A strong hand has gripped your arm hard. Spit has flown from lips as they spewed forth words cursing you. And you took it day after day, year after year. Now your body is sick and growing older. The energy it took to be a crouching tiger from this hidden dragon is needed for other things. Except this is all you know. Or all that you've known for most of your adult life.

"God called me to this place. I am trusting Him." That is what you said to me when I asked about all of this. You explained it with such simplicity. Like, this was your lot in life. Your destiny of lumps that you would just have to take.

Like you had been taking for all this time.

When I explained that I worried about this and said I didn't believe love should hurt like this, your eyes filled with tears. When I told you that I knew it was complicated but we wanted to protect you, they fell. Onto your cheeks and in splashes on your blue hospital-issue gown.

We sat in silence for a bit. Then you squeezed my hand tight and said, "I'll be okay. I've made it this far. I will be okay. God's got me." You smiled. And when you did I saw your cheek quivering. But you nodded hard and sure. So brave and full of fight. You meant those words.

You did.

"No." That's all I said. Then I closed my hand tight over yours, shook my head and clamped down hard. "No."

And you understood what I meant. That this idea of you fighting this old fight and this new fight at the same time was not going to happen. Even if it was super complex and lumpy and scary. We can't unhear it. I can't unknow it.

I can't.

I gave you a hug before walking out of your room. And you hugged me right back. You sure did.
I didn't say anything more after that. But I hope that hug conveyed what was on my heart.

I recognize that you are scared and respect that you believe that God has called you to this place. But I need you to remember something, okay? Just maybe He called me to this place, too.

I will do my best to fight with you. I will.


Yeah.

***
Happy Monday.

Sunday, July 1, 2018

Rules of Intern Year.




10 Rules of Intern Year

1. Show up.
2. Do your best.
3. Listen to the nurses. 
4. Don’t lie.
5. Put the patient first. 
6. Do fun stuff when you’re off.
7. Cry when you need to. 
8. Laugh out loud when you need to.
9. Eat lunch and take the stairs. 
10. Care like it’s yo’ mama.



July 1. One day down, 364 to go. You’ve got this, interns. And we’ve got you. Let’s get it! 👊🏽🏥 #gohardest #bespecial #carelikeitsyomama #youarereadierthanyouthink

Tuesday, June 12, 2018

Stick together.




"I was next!"

"No you weren't!"

"Why are you cheating?"

"I'm not cheating!"

"You are!"

Their voices escalated from down the hall. I sunk my face into my hand and groaned. I wasn't in the mood.

"Mom!"  I took a big drag of air and tried to ignore it. It was repeated with more urgency. "MOM!

Next came a cacophony of clattering plastic. I'd attempted to sit at my kitchen table doing nothing enough times to know the exact sound of a PlayStation video hand control device falling to a hardwood floor. I squeezed my eyes tight and pressed my lips together.  Next came the feet stomping in my direction.

"Mom? Isaiah was supposed to --"

"No. No, he's exaggerating," Isaiah protested before his brother could finish his sentence.

I swung my head from side to side between them. Zachary was now blinking back mad tears and fuming. Isaiah held the plastic controller behind his back so that Zack couldn't reach it. They were at a stand still. And I hadn't even uttered a word of mediation.

And wasn't going to.

Clasping my hands in front of my face, I looked straight ahead into the space between them. "Listen," I said. "You will argue sometimes. You'll frustrate one another, too. But no matter what, I just need you to always remember what I say about brothers." Both boys stared at the floor, still fuming. I cleared my throat hard, "What do brothers do?"

The answer came as a mumble. They'd uttered that response so many times that me asking to have their words repeated had far more to do with me just wanting them to speak up than not hearing. I pressed them in a firm voice. "What do brothers do?"

"Stick together," they replied in low unison.

"Solve this. You solve it. And if you don't, nobody gets to play." I turned back to my computer and let them know I was done. Because I was.



Last week at Grady, I took care of a man with an advanced cancer. He was up in age. His parents had passed several years back. The ex-wife he'd had remotely was no longer in is life and they'd never had children. He'd had a few strokes that left him with labile cognitive function. And his health issues were significant and active enough to warrant somebody thinking about him and advocating for him.

Yeah. That's what he needed.



Again--there was no spouse. No common law boo wringing hands at the bedside in woeful misery. No parents filled with that unconditional parental love and no aunties or uncles who'd doted on him since he was a child. All there was was one person: His brother.

Now. This man's brother was a grown man with a full life. He had a wife and adult kids and grandkids, too. He had a business that he ran and a church where he deaconed and a square of lawn in front of both his house and his church that called for him to mow it on a weekly basis. But the other thing he had was a brother.

Sure did.

He'd come in with a work uniform on. Soiled with a full day's work and with this little hint of masculine mustiness that would waft into my nostrils whenever he moved. Sometimes he'd wipe his forehead with handkerchief or just the back of his hand. Or rub his eyes with the heels of his palm. But no matter what, you could count on him seeing about his brother.

Yep.



Brother was only the next-of-kin for my patient. And since some days my patient was with it but on most other days he wasn't, we needed someone to step in. We did. And let me tell you--Brother was there.

"I'm sorry to keep putting so much on you," I said to him the other day.

"It's okay. I just hate I can't get up here no sooner. My wife would've come for me but 'cept she got some hip troubles and ain't driving right now. So I can't get here 'til I get off."

"I understand."

"He look a little better to me today." Now he was dabbing that same hankie on his brother's brow.

"He always seems to perk up when you come in." I realized that may have sounded negative so I corrected myself. "He does look to be a little better."

We sat and talked some more. Brother asked hard questions and I answered to the best of my ability. We discussed next steps and what he thought would best honor his brother's wishes. This was a day that my patient wasn't flying on both wings mentally. That was happening more and more frequently.

Brother signed a few papers and placed the pen down in front of him. A big yawn escaped his lips, causing his body to let out a tiny shudder at the end.

"I can tell you're tired."

"It's okay. That's my brother."

I squinted my eyes at him and twisted my mouth. "I have sons."

"Yeah?"

"Yes, sir. Two of them. Sixteen months apart."

"They fight?" Brother laughed at his question. "I know they do. You always do when you close in age like that."

I laughed. "Pretty much."

"See, our mama always told us this: 'Take care of your family, take care of your mama and your daddy, and take care of each other. I don't care what you got going on. You stay connected to your peoples.' So I hear my mama straight in my ear sometimes. I be tired but I come on down here."

"I love that."

"I'm all he got."

I didn't know what to say do that so I said nothing. Then I finally said, "He's blessed."

"We both blessed."



We sat in silence for a few moments. Brother stood up and put his soiled trucker's hat back on his head. This time he addressed my patient. "Okay then, Junior. We'll see you tomorrow, okay?"

"Okay," my patient replied. Brother reached down to give him a tiny hug in the bed. Then he gave one more of those big yawns. He waved goodbye to me and before I knew it he was gone.

The whole way home I thought about them. I thought about a mother infusing this idea into her children of staying united. Letting no weapon formed against them as siblings prosper.

Ever.




That night over dinner, I shared with my boys about this story. With privacy protected, I explained that my sick patient had no one to look out for him in this whole world except his brother. And that his brother worked all day long and came anyway.

"I'd come for you." Zack looked at his brother. His face was serious.

"Me, too. I'd come for you, too."

And that was that.



I felt a tiny heave in my chest. Followed by a shiver like the one Brother had. Something about my boys saying those affirmations to one another had given me chills.

Yeah.

I've probably had to ask that same rhetorical question about what brothers do some fifty times since then. But after watching those two men fulfill that duty to one another, I knew that it was an important seed to keep on planting.

I'm learning day by day that connectedness requires intention. It involves forgiveness and redemption and resilience and commitment. And it especially calls for us to fight for the relationships we value the most.



The mama who raised those two men did something right. She made love and loyalty a rule. And no--sometimes it doesn't work. But what I do know is that the kind of sacrifice I witnessed between those two brothers didn't just happen overnight.

No it did not.

Do brothers fight? Sure. And will brothers get on one another's nerves? For sure. But as for me and my house? They will stick together--and stay connected. If I can help it, at least.

"I don't care what you got going on. You stay connected to your peoples." 




Damn right.

***
Happy Tuesday.

Friday, June 8, 2018

On Anthony Bourdain.



“Life is complicated. It’s filled with nuance. It’s unsatisfying. If I believe in anything, it is doubt. The root cause of all life’s problems is looking for a simple fucking answer.”

- Anthony Bourdain (1956 - 2018)


I remember watching this dude on TV and thinking, “Damn. He seems cooler than the other side of the pillow.” I dug the way he treated people the same regardless of their position. He listened to the short order cook in a Bangkok dive with just as much interest as he did Barack Obama. I always thought that was dope.




Yeah.

I met him once during those years when I used to do segments with CNN. He was good and famous by then. And though I don’t watch a ton of television, I’d seen his show more than enough times to know that fan-girling over him wouldn't be necessary. I was waiting for my segment and he walked through the room where I was. When he saw me, he was exactly the non-diva that I imagined he'd be. He paused, shook my hand and said, “Hey. Anthony.” And I nodded and said my name in return. He looked to be in a hurry but I said I liked the show. Because I did like the show. He stopped, looked at me, smiled and said, “Hey thanks.” Then he pointed at my hair and said, “Joining the silver fox club, huh? Welcome!” We both laughed and he walked out. And that was the time I met Anthony Bourdain.

Yep.



That was like 5 years ago. I had just started letting my grey hair come in so him pointing it out was pretty damn observant. And he wasn’t being even remotely fresh. He just saw me. And acknowledged me. Which was cool.



Turns out I was right. That dude really was cooler than the other side of the pillow. I’m glad he noticed people and lived so voraciously. I’m glad he got to break bread with people all over the world and that he looked at me not through me when I encountered him that day. I’m sad to hear of his death.



It's cliché to say things like, "No matter how rich or fulfilled you seem, that won't make you happy." So I won't say that. Instead I'll just say that I'm thankful that Mr. Bourdain--I mean, "Anthony"-- shared so much of his world and this world with so many people. And though he lost his life to suicide, I think his life included a lot of joy. I've learned from living and watching and listening that we all have parts unknown. Happiness is an everchanging spectrum. Sometimes light and darkness dwell together. It isn't just one or the other.

And it's complicated.

Thinking of every person I know who has ever been affected by suicide. I know this has been a tough week. You’re all in my thoughts, okay? I mean that.


***
Happy Friday. And rest well, my fellow silver fox.

Wednesday, May 23, 2018

Zone of Development.





Funny thing about life. We want to be comfortable in it. Like, we want things to mostly be predictable and painless. Low on stress and curveballs, right? And while it may seem like the next predictable sentence is some reference to how it isn't that way at all--that's not what I'm thinking. I'm actually thinking that many times it is like that. Comfortable. Predictable. A rolling ball down a straight path without even the tiniest hint of anything to break the inertia.

Yeah.

At first, that feels good. Kind of like when you run and get to a pace that feels manageable. You get out and you do it. Until, at some point, it feels less satisfying. And as a result something has to shift. Maybe you will do hill work. Maybe you will start running faster and aim for a better time. Or just maybe you will stop running altogether. Why? Because being comfortable is overrated man.

For reals.

I heard this guy once talk about how the most fulfilling place to be is in what he referred to as a "zone of development." This is the place where you don't know how to do everything and some piece is a wild card. Your are working up to it, broadening your fund of knowledge and skillset, shaking things up. Contrast this to your comfort zone--where all is predictable and mostly easy.

Yeah.

I think the older you get, the easier it is to land in comfort zones. I find myself wondering if there is an age where this is nirvana--being in a perpetual comfort zone. While I'm not sure if that's true, I know that if it is, I'm not old enough for it yet. Not for long period s of time.

So yeah. Here lately, I have been thinking of this. Feeling ready to push envelopes and thrust myself into some zone of development. Lucky for me, that can all be done at Grady and with my current employer. But it will call for me asserting myself and learning some new things. I think I'm ready to do that, too.

Yup.

I'm ready to move intentionally into a zone of development. Do I know what will happen there? Nope. But what I do know is that this is where growth lies. And what I also know about where growth is?  Peace and fulfillment are somewhere nearby.

Yeah.

***
Happy Tuesday.

Friday, March 23, 2018

Affirmative actions.




Best moment of my week at Grady:

Yesterday I encountered a young man at Grady who spoke to me by name.

"Hi Dr. Manning!" he said. Even though I wasn't sure where I'd known him from, I smiled big and responded in kind. He went on. "I know you don't remember me. But I just want you to know that I just matched in Emergency Medicine and am about to graduate from medical school at Morehouse School of Medicine!"

"That's fantastic!" I replied. "Where are you going?" He told me and I congratulated him. Genuinely, too. Because matching into a residency program is a big effing deal and a huge accomplishment. And since he stood there still smiling, I repeated myself. "That's really, really awesome."

And I said that because it was. But then he jogged my memory about how we'd met:

About 5 years ago, I was making rounds at Grady one afternoon. This young man was working as a one-to-one patient safety sitter (not for the faint at heart at ALL) and, since his patient was fast asleep, he'd brought along books to study to make the most of his time. I was seeing the patient in the next bed over and couldn't help but notice how fervently he was scanning the text in front of him. This kid meant business.

"What are you studying?" I asked him.

"Ma'am? Oh, studying for the MCAT," he replied.

And honestly? I mostly remember was that I liked his hustle and the tenacity in his eyes. So I told him just that. Then I extended my hand and introduced myself because I knew what it meant for him to be a black man sitting in that chair studying for a med school entry exam with a black doctor standing in front of him.

I really did.

This was 2013--within the year that Deanna had passed. My intention with people changed when she died. Even the tiniest moments I think about, wonder about . . like, "Hmmm. . .. what am I supposed to be doing with this one moment in time with this person?" Heavy, I know. But this was my paradigm shift. And so. I know exactly what happened next: I gave him a word of encouragement and told him that I was sure he would become a doctor. And that big smile on his face showed me that he believed me.

Then I took his picture so that I would remember that moment in time. And I am so glad that I did.
Yep.

You know what? When I ran into him, I didn't remember him. But you know what? He remembered me. He also remembered that I encouraged him, too. Then he reminded me that I had taken his picture that day. Sure did. And I knew then and there exactly who he was and could see the moment crystal clear.



Here is what I know for sure:

Life is but a twinkling of an eye. Every little sliver of time that we get is an opportunity. And sure--from this 2013 photo, it's clear that this young man was already well on his way to succeeding. But I love knowing that God placed me in his path that day and that I noticed him. I really am. I could have walked right by and not seen him at all.

My goal is to see people. Like, for real see them. I loved this moment and the affirmation it brought to us both about the power of letting our lights shine.

Yeah.
***
#idontmakethisstuffup #bestjobever #thisisgrady #choosekindness #hegraduatesinmay #howdopeisthat #whoareyoumissing #speakaword #wordshavepower #morehouseMD #meharryMD #lookatGod #iseeyou

Tuesday, March 6, 2018

The Gospel.




I was told one thing. That your aortic heart valve was narrow and tight and that, just maybe, one day very soon you would need that valve replaced.

Aortic stenosis. That's what I was told. With clear certainty and not so much as an eye twitch or a blink. From his lips to my ears like it was the gospel. Aortic stenosis.

I entered the room alone. Armed with the gospel that I had been told about you. Aortic stenosis. I spoke to you for a few moments and talked about what was going on. "What is your understanding of what is happening with your heart valve?"

"The blood rush over it in a way that's not normal. They heart valves don't open and close like they s'posed to."

I nodded because, for the most part, that was true. It was. And I went into a description of what it all meant. Your tight and narrow heart valve. I said the words over and over again. "Aortic stenosis" this. "Aortic stenosis" that. You looked a little bit confused but when I asked if you understood you said, "I think so."

I think so.

Next I pulled my stethoscope from my pocket. Slipping the rubber tips into my ears, I looked at you and smiled. You smiled back. Then I gave the diaphragm a vigorous rub with my palm remembering that a Grady elder had told me once: "Even though it don't do much to warm it up, something 'bout seeing you try make me feel good."

So I did that. And I do that. Most times, I do.

I close my eyes and place the instrument on your chest. I follow the map of listening areas taught to me as a medical student and quietly listen for the tell tale sounds of aortic stenosis:

First a soft sssssssshhhh. Then it grows louder to a SSSSSHHHHH. Falling down quickly to the that soft hush again.

I know it when I hear it now. And so, instead of fighting to discern what it is, I am armed with experience. You patiently allow me to confirm what we both already know. My breathing slows. My hand glides with the stethoscope over your skin.

You are so cooperative and kind, I wish I wasn't alone and that a student could be beside me. To hear and learn right next to me. Aortic stenosis.

My eyes open.

Wait huh?

I am hearing sounds, yes. But they are NOT the ones I expect. I squint my eyes and listen harder (as if this changes what the ears hear.) "Can you hold your breath?" I ask. And you do.

Same thing.

A soft whoosh followed by what sounded like a deep sigh between heart sounds. Again and again I listen. And again and again, I hear the same thing.

Shit.

"They told you your heart valve was small? Like tight and stiff?"

"They told me something. I don't know if it sounded like that."

"What about a leaky valve? Did somebody say that?"

"I don't know, Miss Manning. Y'all be saying so much sometimes."

And you're right. We do.

You don't have aortic stenosis. And while you do have an issue with your aortic valve, it isn't that. And though I am not a cardiologist, I can say that right now it doesn't look like you need surgery either.

You were gracious when I told you I was wrong. You shrugged and laughed a little. Like none of it was a big deal.

While my face burned hot like coals.

This happened a while ago. But what it taught me was that, like all gospels, I need to listen for myself, examine for myself and interpret for myself. Because even though a lot of times there is no discrepancy. . .sometimes there is. When telling someone life impacting information, it's good to have at least checked for yourself before talking.

Whew. Preach, pastor.

I also learned that there is a lot we say that gets missed. Yeah, so I work at doing a better job in that area, too. Explaining until you know so. Not just think so.

Yeah.

Last I checked, you hadn't had your aortic valve replaced. You were still doing well and seeing the cardiologists regularly. Today I am hoping and praying that you know exactly why. This is what I am hoping. And that the gospel you hear is the gospel indeed.


Yeah.
***

Monday, March 5, 2018

Get (TF) out.




I used my softest voice. Tender and earnest. Made sure my body movements were slow, gentle and nonthreatening. You'd been through so much already. And even though your distrust and refusal to cooperate with nearly every doctor who'd stepped into your room was so unwavering, I knew that NOT seeing you wasn't an option.

"You'll probably get kicked out," someone said.
"We'll see," I replied.

And so I went.

"Hi there."
Your eyes flung open, suspicious and glaring. "Who are you?"
"My name is Dr. Manning. I'm the senior doctor that's going to be taking care of you."

You stared. Didn't say anything.

"How do you feel?"

Still nothing.

I asked two more questions and you shut me down. "I don't know you," you said. "You could be anybody."
"I could," I responded. "But I'm not. I'm your doctor."

The next things you said made no sense. They flew out of your mouth and splashed against the walls and floors. I tried to grab them up and make sense of them. But I could not.

I could not.

"May I examine you?"
"No."
"No?"
"Hell no."

I didn't know what to say so stayed silent.

"Can I--"
"Get out." That's what you said. Then you said it again. "Get the fuck OUT."

Which is what I did. As you turned up the television, rolled on your side and refused to look at me.

Two hours and some change later I came back. This time you were nice. Like, super nice. Like none of that had ever happened. You complimented my hair and my shoes. Then said it was really nice meeting me. Then you asked me for some strawberry Boost and a ginger ale. And the name of where I got my boots.

The interface between medical illness and psychiatric illness is one of the hardest parts of my job. They wrestle each other to the ground and when they aren't on the ground they play a hellacious game of tug-o-war. It sucks. A lot of days it really does.

But I signed up for this. And you? You signed up for nothing. So I'll keep coming back. Again and again I will.

Before I left, I placed three things on the bedside tray table in your room:

A ginger ale.
A strawberry Boost.
And a piece of paper that said, "Frye. But they sell them on Amazon or eBay for cheaper."

Yeah.

***

Happy Monday.

Tuesday, February 13, 2018

Lean on me.




When you work at the only hospital that turns NO ONE away? Sometimes it gets kind of busy. And on the busiest times of your busiest days? That means either be taking a few flights of stairs to save time OR stepping into an elevator filled to the brim with me and you, yo mama, and your cousin, too. (Somebody missed that.)

Ha.

Okay so check it: I was up on the 11th floor at lunchtime today and was trying to get down to the ground floor. And OH--random sidebar--while I HAVE been known to bust out 11 flights going UP the stairs, as a rule, I almost never walk DOWN anything over 3 flights. (See: Knee replacement surgery - no thank you.)

Anywho.

After what felt like 300 trillion green arrow UP elevators coming and going, I finally see that luscious red DOWN arrow light up with a "ting." The doors slowly part and all I see is racks on racks on racks of people. All heights, all weights, all ethnicities. Some in Grady uniform attire, some in street clothes, some in white coats, and one dude in a hospital gown tied like a kimono with a Newport tucked behind his ear. They were shoulder to shoulder all the way to the front.

A lady right next to the key pad offered me a quasi-apologetic shrug from across the threshold of the lift. She looked around herself and said,"Pretty packed here. Next one?"

I threw my head back and diabolically laughed in response.

Okay, I didn't really do that, but she had me confused if she thought I wasn't getting on that elevator. With no shame in my game, I slid right on in next to her. She cleared her throat and pressed her back against the wall.

Sorry, not sorry.

A man in the middle of the pack said, "When you've been working at Grady long enough, ain't no such thing as a elevator too full." A lady in a Food Services uniform chimed in, "I know that's right!" We wanted to laugh but decided against it.

The next-to-the-keypad lady was looking salty especially after our little peanut gallery commentary. I decided to try cheering her up. "You looking over at me like, 'No this doctor lady DIDN'T step her behind on this already full elevator!'" Her face immediately went from aggravated to warm. "Mmmm hmmm. . .I see you judging me. Mmmmm hmmm. But real talk, I'm hongry. Not hungry--HONGRY." That made her laugh out loud.

Which made me happy.

The door opened on 7a and two more people slipped into crevices. Then a Grady elder with a platinum combover said, "Grady the only place where a crowd in a tight space don't damn near give me a heart attack. My fear of not getting to this cafeteria got my fear of this elevator BEAT!"

Everybody howled.

We stopped on 5 with a bit of jolt. A lady lost her footing and stumbled into the middle-of-the-pack man. He steadied her with his two hands. Then--I kid you not--he threw his head back and started singing in a LOUD, TERRIBLE singing voice.

"LEAN ON ME! WHEN YOU WANT LUNCH THEN I'LL BE YOUR FRIEND!"

I started clapping and joined in, "I'LL HELP YOU CARRY ON--come on, y'all!"
THEN--OMG--y'all!! EVERYBODY chimed in either singing, clapping or both.

"FOR IT WON'T BE LONG. . .TILL I'M GONNA NEED. . . . . SOMEBODY TO LEEEEEEEAN ON!"

We all exploded in cheers and laughter. Right after that, the doors flew open on the second floor and let out half of the people, including the platinum-combover man that was heading to the cafeteria. And a few moments later, the rest of us filed out on the ground floor. . . .offering these knowing smirks and giggles to one another as we slipped pass the folks trying to get on.

Best. Thing. Ever.

If you DON'T work at Grady, you'd think I made this up. But if you do? You know it's as plausible as rain on a Tuesday in Atlanta.

Love that this is the song he chose--especially because it embodies all that we do at Grady. I walked down the street humming and hearing Bill Withers smokey voice singing the rest of those words on my mental iPod:

***
"You just call on me brother--if you need a hand. 
We all need somebody to lean on.
I just might have a problem that you understand
We all need somebody to lean on.
If there is a load you have to bear 
that you can't carry
I'm right up the road, I'll share your load
If you just call me. . . . call me. . .if you need a friend. . ."

Seriously? Seriously.


Whew. Yeah, man.
***
Happy Rainy Tuesday.

Now playing on my mental iPod. . . . 

Monday, February 12, 2018

Two for the price of one.



Her: "You a extrovert, ain't you?"
Me: *pointed at my chest* "Me? Extrovert? Hmmm. I definitely think of myself as a lover of people. But I'm not so sure I'm a true extrovert."
Her: "Chile please. Extroverts feel at their best with people around. That's where they get all their energy. That's you."
Me: *shifting in my seat* "I'm not so sure that's what I am."
Her: "No?"
Me: "Nope."
Her: *eyes squinted*
Me: "I'm serious. Like. . .I like being alone with myself and my thoughts . . .like. . .a lot, actually. After that, I like the people parts. Because I like thinking with other people and hearing their thoughts on certain ideas, too."
Her: "So what's that make you? An introvert? You AIN'T no introvert. I don't care what you say."
Me: "Sometimes I think I'm an introvert with very good social skills. But I become an extrovert when I feel very, very comfortable and safe."
Her: *nodding head* "That make sense."

I crossed my legs and leaned back in the bedside chair. This interaction felt comfortable and safe. Maybe that's why she accused me of being an extrovert. That made the corner of my mouth turn up.. I propped my foot on a pulled down hand rail on the bed, slid on my reading glasses and pulled my patient list out of my pocket.

Her: "Miss Manning?"
Me: "Ma'am?"
Her: "Do you ever. . . get lonely?"

Lonely?

I bit the inside of my cheek and gave her question real, true thought. I closed my eyes and took an inventory of my feelings to see if "lonely" would bubble up to the top.

It did not. I realized that that was a blessing that I'd not thought of before then. Not feeling particularly lonely.

Me: "No. I don't really think so."
Her: "Even when you by yourself?"
Me: "Especially when I'm by myself. I crack myself up."
Her: "Ha ha ha . . .that's good."

The room filled again with the ambient noise of the hospital ward and the overhead television.
Her: "I ain't never been lonely a day in my life. My whole life."
Me: "Wow. Do you think it's because you're an introvert?"
Her: "Naaaaw. It's 'cause I'm a GEMINI."

I swung my head towards her and looked confused. In response, she held up two fingers at me and winked.

Her: "That's 'cause it's TWO of us. And both of us like each other."

We both laughed out loud. I gave her hand a squeeze and headed to the door.

Me: "I'll see y'all later."
Her: "You know where to find us."

That I do.  :)

Yeah.

***
Happy Monday.

Sunday, February 11, 2018

3 kinds.




"The opposite of love is not hate, it's indifference. 
The opposite of art is not ugliness, it's indifference. 
The opposite of faith is not heresy, it's indifference. 
And the opposite of life is not death, it's indifference."

- Elie Wiesel



I was sitting in the bedside chair talking to a Grady elder. I'd finished rounding and had come back by to spend some time in the late afternoon. This was a practice I've had since my intern year, taught to me by one of my favorite attending physicians. "Just pick one person or two every day. And go and sit with them. That's it."

Best advice ever.

The television was on over our heads and was on "The Jerry Springer Show." I realized then that, were it not for moments such as this one, I'd not even know the show still aired. Two women were fighting. Allegedly, the same gentleman had fathered their children within like 2 weeks. Instead of being mad at him, they were mad at each other. The crowd was screaming and roared even louder when one person lost a clip on pony tail.

Me: "This is a mess."
Her: "Bless they hearts. Poor chil'ren."

Another woman came flying out of the audience like superman. Her arms were swinging like windmills and legs kicking in the direction of the woman holding the pony tail. The security dude on the show feigned some deep interest in holding her back. The only thing less believable was the quasi-alarmed and stunned look on Jerry Springer's face sitting in the chair across from them.

Poor chil'ren indeed.

Her: "You know what Dr. Manning?"
Me: "What's that?"
Her: "There's three kinds of people in this world."
Me: *turning my head toward her and readying myself for this good word*
Her: "There's the ones who wish you WELL, see. Then there's the ones who wish you HELL."
Me: *silence*
Her: *silence*
Me: *turning my head from the TV to her* "That was only two."
Her: "Two what?"
Me: "Two types. What's the third type?"
Her: ""Oh the last one? Those the ones who don't even see you. They the worse ones of all."
Me: "Hmmm."
Her: "See, they the ones that don't give a damn if you live, die, or fall off in a ditch never to be heard from or seen again."
Me: "Dang."
Her: "Worse than that. They don't even know you there. And they don't even know that they don't know, neither."
Me: *raising eyebrows* "Wow."

*silence*

Things on the television got calm for a moment. But then another guy came from back stage as some kind of surprise. He was reportedly the boyfriend of the two-baby daddy. The crowd went berserk again. And, once more, Jerry Springer looked fake-stunned.

Her: "You know what? I'll take a person who wish me hell over the one who don't see me any day. I'd rather you come at me fighting, kicking and trying to punch me than just walk by me altogether. 'Cause at least THEN I know you feel something."
Me: *silence, just listening*
Her: "If you hateful to me, it just say something about how you feel about your own self. So those folks I just feel sorry for and steer clear of, you know? But them ones who don't even acknowledge you?" *shakes her head* "They do the most damage 'cause you can't even change they heart. They cold as ice."

This time I moved my whole body in the bedside chair to face her. I thought about all that she'd seen in her nearly 8 decades and all of the people she'd experienced. She knew what she was talking about.

Her: "Just 'cause you look in somebody direction don't mean you see."
Me: "Wow. I have to remember that. 'Some people wish you well and some people wish you hell.'"
*pause*
Her: "And the rest you can't tell. . . . 'cause you so invisible that they don't give a shit."

So sad. But so true.

Damn.

***
Happy Sunday.


Saturday, February 10, 2018

Intersections.




"I am ready to stop all this stuff," she said.

"You can, you know. You can." That response surprised her. I rested my palm over the top of her hand and repeated myself. "You can."

She smiled at me and I smiled back. "You say that like you believe it."

"It's because I do."

After that, I changed the subject. We talked about her beautiful skin that lay over her high cheekbones like a brown satin sheet. I asked where she'd left her wrinkles and pretended to look under the bed and outside the door. That made her laugh.

"Guess it's just my genes," she giggled.

"I'll say," I replied.

"The rest of this in my genes, too. Like people in my family wired for strongholds."

"Yeah. My family, too."

Her eyes widened. "For real?"

"Oh yeah."

She sat there staring out of the window after that. My hand was still on top of hers and now she was holding my fingertips tightly. I let her.

"You think I can stop?"

"I think you can do anything."

"You saying that like you mean it."

"It's 'cause I do."

That soft smile crept over her lips again. I curled my lips and nodded for added confirmation.
And that was it.

I have no idea if she will overcome this addiction after this hospitalization. But here's what I do know: The tiniest spark of belief from one person can ignite a fire of change in another. I've learned that haters and naysayers can be found everywhere. I prefer to shock the shit out of people with real, true optimism.

I do.

You are not a "crackhead."
You are not a "drunk."
You are not a "homeless lady."
You are not a "psych patient."

You are none of these things. You are your possibilities. And you are a child of God.

And no. I don't always get all of this perfect. And yes, I do fall short on empathy sometimes. But mostly, I keep trying with all of my might to find the intersection in our similarities. And what I know for sure is that it is always, always there.

Always.

Only grace separates circumstances in most instances. At least that's what I think.


Yeah.

***
Happy Saturday.

Something beautiful.



In my sweet sixteen-plus years as a Grady doctor, I have never seen it like this. I've never seen the hospital so filled to the brim with sick-sick people in need of our care.

Never.

Waiting rooms have become overflow patient areas. There are mobile units outside. Flu swabs are coming up positive and making even the healthy-healthy ones sick-sick. It's crazy.

At first, I was like, "Why not just close the doors, man?" But with each person I see, I ask myself where they'd go were it not for Grady. And since I know that answer, it pushes me to rally on. That doesn't mean it isn't tough, though.

No, it does not.

Times like this can burn you out. It can leave you walking like a zombie led by the one-eyed stethoscope, aimlessly placing it upon heaving chests. But if you pause for a second, even a second, you snap out of it long enough to see what is beautiful.

Just maybe you can.

Today one of our patients came back to the hospital. I cringed when I ran into him in the ER, thinking of all of the roadblocks it took to move for him to get discharged in the first place. The intern went to investigate it all and came back looking pretty hopeless. Given all the obstacles and low resources, there wasn't much more we saw that could be done.

But.

In stepped one of our Grady Emergency Department senior doctors. In the midst of that busy-busy day caring for the sick-sick humans in that ER, he hit that same pause button. He thought outside of the box and advocated for this patient in a way that almost defied belief--especially for someone who has worked here a long time. He found a teeny-tiny open door and pulled it all the way open. And that patient got a safe discharge and avoided a rehospitalization.

I get tired sometimes. Tired of the list of patients growing and never shrinking and tired of seeing people hurting. But these stories over the last week have sustained me. Intentionally working at this habit of reflection allowed me to see the patient-centered tenacity of a colleague. . . in a time when I'd already given it in to public hospital inertia. I needed to see that today. I did.

Working here isn't for the eternal pessimist. No 'tis not. But for those who believe deep down that hope can float and that fighting for a life involves more than fists, cardiac shocks and medications? It's just right. That's what I saw today.

And today? I feel like going on.

Yeah.

***

Wednesday, February 7, 2018

Covered.



I walked in and found her sitting up in bed with pieces of the Atlanta Journal Constitution spread all around her. Her face was hidden behind the crossword page but those elegant, espresso-colored fingers gave it away. That was my patient. And I could tell she felt better.

Me: “Good morning! How are you feeling today?”

Her: *puts down paper and smiles* Well hello, sweetie! Other than being cold, I’m fair to middlin’.” *gestures for me to sit down*

Me: “Ha! Did you say ‘fair to middlin’?’” *sitting down* “Wow. My granddaddy used to say that.”
Her: “Is that right? The Tuskegee granddaddy or the Birmingham granddaddy?”

Me: *smiling wide because she remembered* “The Tuskegee one.”

She jutted out her bottom lip and shrugged. Just then I realized how much of myself I’d shared with her during this hospitalization. Even though she was the patient and I was the doctor, she asked far more questions than I did. I reflected on what a privilege it had been to soak up her wisdom in that bedside chair each day. Listening to her stories unfold through that gravelly voice was the best thing ever.

Like:
*The dress code they used to have when she was at Tuskegee (long skirts and stockings always!😳)
*When they used REAL china and REAL silver in the Tompkins Hall cafeteria!😮🍴 🍲
*When she and her friends were giggling at George Washington Carver’s funeral because somebody had on a crooked wig. 🙊🙈

Yes. THE George Washington Carver, man. I’d be sad to see her go.

Me: “Guess what? I have something for you.” *reaching down to pull a package from my bag* “You ready?”
Her: *eyes widening* “For me?”
Me: “Yes ma’am.” *opening it up* “Look. It’s a Tuskegee blanket just for you. And it’s right on time since you feel chilly. Here let me help you.”

For the first time since I’d been caring for her she was speechless. Her eyes glistened with tears as I lay the soft fabric over her lap.

Her: “You got this. . .for me?”
Me: “Actually it wasn’t me. It was someone else.”
Her: *eyes widening again*
Me: “Remember that picture of our hands? The one with the pin that you gave me permission to share?”
Her: “You mean share on the Facebook?”
Me: *chuckling* “Yes, ma’am. The Facebook.”
Her: “Where I had all the people that like me?”
Me: *laughing* “Yes ma’am. They sure did like you a whooooole lot, too!”

Now she was holding the cover up to her cheek rubbing it against her face. My face started feeling super hot.

Me: “A classmate of mine shipped it to my home. Just for you. And he said to thank you and your parents for the legacy you helped leave for us at Tuskegee.” *clearing my throat so I wouldn’t get emotional* “He also sent you a pin just like the one of mine that you liked so much.”
Her: “He did? Isn’t that something!”
Me: “Yes ma’am.” *handing her the pin*

Her mouth fell open. Then she stared at me so tenderly and incredulously that my eyes immediately filled up with tears. She was genuinely touched.

Her eyes then cast down to the blanket and pin again. She spoke softly:

“Mother Tuskegee sure made some good ones, didn’t she?”

I gave her a big smile. “Indeed she did.”

Indeed she did.



***
Happy Wednesday.


Tuesday, February 6, 2018

Something to cry about.



Arm folded over his eyes, tears rolling down his cheeks, and body heaving to the rhythm of a beat all its own. "I'm so sorry for crying like this," my patient said. He pulled back his arm, wiped his face hard and looked back up at me with glassy eyes.

I wasn't sure how to respond so I just reached for his forearm and held it. I sucked in a drag of breath and searched for something affirming. "It's okay, sir. Really."

"I want to do so much. I have people I love so much. That's the thing. For me, it's not so much the me parts. It's the me AND them parts."

I swallowed hard and felt words escape me again. I held his gaze for a moment in silence. To break the tension I finally spoke again. "I'm sorry for all of this, sir. I really am. But we're here, okay? And so are you, okay? You ARE here. Right here, right now. And you've got a testimony."

He pursed his lips and started fighting back a fresh wave of emotion. "I'm just grateful for. . ." He tried but couldn't finish his sentence. Up went his arm again and muffled into the crook of his arm were those same guttural weeping sounds. This time, though, they were stronger, deeper. . . almost primal. "I'm just so gr-gr-grateful for . . "

"Take your time," I told him.

"For the. .the . . .the kindness. . .just the ki-hi-hi-hndness." He erupted all over again, his body shaking so hard that he had to grab the bed rail and steady himself. He finally regrouped and tried to finish. "The kindness. From the EMS people to the nurse in the triage to the people in the emergency and now this team . . .I was just so scared and. . . everybody was just so. . .so . . kind." He took a deep breath and blew out hard. "Make you feel so much better when people are kind to you. Especially when you're scared. . . .especially when you scared you might. . . you might. . . ." He put both of his flattened palms over his entire face this time.

And again he wept. Hard.

He didn't even try to finish. And I didn't need him to.

Here's the thing:

Humankind is mostly good, I think. Even at the places where you least expect it--like a "notorious" safety net public hospital. And listen--you don't have to be a doctor caring for folks at Grady to extend unnecessary kindness to people. You don't. I'm learning that our kindness can be the difference between hope and despair. . .. which often become synonymous with life and death.

I will remember this when I am having a particularly crappy day or when I find myself consumed in all things me.

Yep.

I've seen a LOT of grown men cry at Grady. And what I've noticed is that it is almost always about two things and two things only:

Family and kindness.

And you know? That's something to cry about.

Yeah.

***
Happy Tuesday.