Wednesday, March 13, 2019

The little girl who didn't cry wolf.




Your chest was hurting. This was your chief complaint. "Like pressure," you'd said. Then you shook your head and closed your eyes. Your hand pushed into the center of your chest for emphasis.

I asked what you were doing when it came on. You shrugged and insisted that it was nothing out of the usual. Then you scratched your shoulder vigorously. The suddenness of the gesture startled me.

"You okay?" I asked.
"Yeah," you said. "I just be itching sometimes."

I nodded. And then went back to the discussion.

Pressure like chest pain at rest that made you miserable enough to come to the emergency department. A little bit of shortness of breath. But not much. No numbness or tingling in your arms. You weren't exerting yourself in any way.

Nope.

And yeah. You USED to use crack. But not any more. You were adamant.

"I fell to my knees," you said. "I was so tired, Miss Manning. I fell to my needs and asked God please. Please take this stronghold away from me."

I kept listening. Almost feeling like I didn't deserve to be on the other end of this testimony given my mood. My team was surrounding me during this conversation. They followed my lead, saying nothing.

You went on: "Then? Just like that. He took it away from me. I swear. It's been three whole months. THREE WHOLE MONTHS." You repeated that last part.

"Wow," I said. My 'wow' didn't sound wow-ish. It sounded mechanical and fake. My hand was rubbing the side of my neck. I was listening to you and watching you. Your eyes were dancing and your hands were animated. The laxity of your jaw as you spoke reminded me of the many heavy crack users I'd seen over the years and the patient years ago who pointed to Bobby Brown on the television and said, "That way he move his jaw like that? That's when you use a whole, whole bunch of crack." So yeah. This was what I was thinking about. The whole time that you were talking about what God had taken away from you.

Sigh.

I didn't fully believe you. Not that I didn't think you believed what you were saying. But I was tired. Very tired this day. And I just needed something to just bark exactly like a dog and say, "Hello. My name is Fido."

Sigh.

The third year medical student, however, was new to this. He'd heard your story and presented you to me as the last patient at the end of a busy day. And every drop of your kool aid, he'd lapped it all up, gleefully reporting your newfound abstinence. "I believe her," he said about you. His young face was emphatic and his greenish eyes glistening with advocacy and defiance. He repeated himself. "I believe her."

I wanted to. But my bias against you was so strong. And I was tired. Like so, so tired. Not take-a-nap tired. But emotionally tired of watching how this sickening crack epidemic decimated my people and how it was all beginning to feel like a hopeless version of that movie Groundhog Day.

Uggh.

I remembered what I'd learned about ways to fight bias. Being aware of triggers like exhaustion and such. And so I held your hand and did the things we do for chest pain. I nodded my head and mumbled words of affirmation about God's intervention like "Won't He do it."

Then I said sorry in my head right after that. To God for fronting and using his name in vain.

"We didn't check a urine drug screen," the student said outside of your room. "I mean, we can. But I will be so disappointed if it's positive."

I was tired. So I just dragged a breath of air and said, "Me, too. But still. Check it." Which he did.

Yeah.

Today when I came to see you, you looked so happy to see me. Your face was still full of light. The gladness in your eyes to see this black woman doctor was palpable. I could see it before I even turned the light on. "My doctor! Heeeeey Miss Manning!"

You reached for my hand. I grabbed it. "Hey sis," I said softly. Then I sat down. My face was serious. And my eyes almost immediately welled up with tears.

"What?" you queried. Your eyes looked worried. About ME. "What?"

I swallowed and gained my composure. "I owe you an apology." Your eyes widened. "I. . .I just got back your urine drug screen. The student didn't want to get it. But I insisted." You kept listening. "It was negative."

The expression on your face was inexplicable. Then what you did next surprised me. You held open your arms and asked for a hug. I obliged you.

"You be wanting to believe, don't you? But you can't always believe."

I nodded and sighed. "I do want to believe. I do."

"It's okay. That's the thing about a stronghold. It make reality and fantasy look like one and the same. Bet you heard a whole bunch of folks cry wolf before."

I tapped my foot and bit my lip so I wouldn't cry. "I am very proud of you. And so happy for you."

"And I believe you," you said. Then you squeezed my hand.

When I left your room, I went to a stairwell to cry. Mad with myself because every day I am preaching to my teams to believe that today could be the day. Here "today" was staring me in the face and my bias and exhaustion wouldn't let me believe it. Or at least try to believe it.

Sigh.

No. I don't have all this shit figured out. No, I do not. But you were right. I be wanting to believe. Damn, I do.

Yeah.

P.S. I told my medical student I was sorry, too.

***
Happy Wednesday.

Monday, March 11, 2019

Sister and the Warrior.



Afternoon rounds last week

Her: "Did you feel nervous when got that?"
Me: "When I got what?"
Her: *points at my wrist* "That."
Me: "Oh this? First yes. Then no."

*silence*

Her: "Wow. I never saw a doctor with a tattoo on her wrist."
Me: "No?"
Her: "Nope."
Me: "So. . .I'm curious. How does that make you feel?"
Her: "I'm young. So it mostly make it seem like you cool."

*laughter*

Her: "Nawww, but real talk? I think it just make me know you a person."
Me: *listening*
Her: "Like, to me, a tatt supposed to tell a story. Like, it should mean something."
Me: "I like that."
Her: *pulls gown off of shoulder* "See this one? It say 'WARRIOR.' Because I been through so much with my health but I come through stronger every time. I'm always gon' fight back!" *kicks foot out of sheet to show her foot* "This one on my foot say 'Follow my footsteps.' That one remind me that even though some people let me down when I was little, I ain't no victim. I can create my own path, follow God's path and be somebody other people want to follow, you know what I'm sayin'?"
Me: "I do. That's dope."

*silence*

Her: "I mean, you gotta be careful about where you get ink. And what it say. But you also got to do you." *covers feet back up with covers* "And you can't be drunk or nothing."
Me: *nodding* "I know that's right."

*fist bump*

Her: *points at my wrist again* "Okay. So what's the story behind that?"
Me: *turning my wrist to look at it* "Well. . . I lost a sister."
Her: "Oh man. Sorry."
Me: "Yeah. But she was awesome so I like remembering her this way. I also have another sister living. And I'm forever a sister to her, my sister who passed and to my brother. I believe in women having tight bonds so I'm a sister to my women friends. And then there's my sorority. . .that's another sisterhood I'm in."
Her: *smiling* "That's what's up."
Me: *still looking at my wrist* "Yeah. I was gonna put it somewhere else at first. But then I realized that I wanted to see it every day. So I put it here on my right wrist."

*silence*

Her: "See? I told you a tattoo make people know you a person."
Me: *laughing* "I'm not so sure everyone would agree."
Her: "I think sick people don't care about that. They just want to know you a person who care and not a robot."

Me: *listening*

Her: "I saw that and you know what I thought?"
Me: "What's that?"
Her: "That sister gon' take care of me. 'Cause she got love in her heart for somebody."

*silence*

Me: *wanting to cry so bad*
Her: *just staring at me smiling*
She seemed like she knew I wanted to cry.

*silence*

Her: "I love your tattoo, Dr. Manning."
Me: *staring at my wrist again and smiling* "You know what, little sister? I do, too."


Damn, I love this job.

***
Happy Monday.

I love you x 3.



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 or send them home. 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.

Nope.

We actually didn't see 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 an interest in them as a person. This patient was pretty quiet so it wasn't exactly the easiest thing in the world. I tried anyway.

"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.' Hmmm. So I bit. 
"Were you. . . previously married?" I kind of wanted to smack my forehead after saying that. I was relieved when he didn’t seem to take offense to that question. 
"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 more." 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.

Nope.

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. Him. Aaaah.

"Do you mind telling me more?" 
He smiled and shook his head. Then he began to speak.
"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's 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 that 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 horrible stigma and ignorance and not being accepted and advanced AIDS and just feeling free and loved. 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.

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

Yeah.

Wednesday, March 6, 2019

A cup of joe.



Today was my day to drive carpool. That makes my morning crazier than usual and the struggle even real-er than it is at baseline.

Grrr.

I was hustling out the door so fast that I spilled half of my coffee in the driveway. Which, if you know how much I love a good cup of joe in the morning, is a really big deal.

Grrr.

I got stuck behind a train. Right by the kid's house that I was already running late to get. And fortunately, his mama is cool and so is he. But still. That mixed with no coffee wasn't my favorite.

Grrr.

I forgot my gloves. And I have those hands that turn fifty shades of ghastly grey when cold. They hurt, too. So after dropping kids off, I kept doing this thing where I'd stick one hand under my thigh while driving with hopes of the car seat warmer toasting it up. Let me tell you something: That doesn't work so well.

Grrr.

The Grady garage was already filling up. Which was annoying considering it wasn't even 9am. I circled up and up and up until I reached the roof. That is, the 10th floor. Which adds like 7 minutes to your commute home. And that's a lot when you are almost always on two wheels trying to get to a kid during hospital service time. Did I mention that I spilled almost all of my coffee?

Grrrrr.

Like always, I felt a little better when I got to work. But that was short lived because my office door was locked when I got to it. Which, for most people, is no big deal. But for me it is since I don't like my office locked nor do I carry around the key.

Grrrr.

Bump it. I decided to just grab my white coat and roll out across the street to the hospital. Fortunately, Linda, this super nice woman on our admin team had just made a fresh pot of coffee. She waved her hand from her cubicle and told me she could feel that I'd want some. She was right.

Sigh.

I pour a piping hot cup to go. Carefully, I place a top on it to be certain, certain, certain that I wouldn't spill it. My colleague friend waited for me beside the elevator because he was going to round, too. And we chatted about our teams and my icicles (both figurative and literal) started to melt.

Whew.

So we strut out of the office building and the cold hits us in the face like a mad ass pimp. (Yeah, I said it. Because that's what I was thinking.) But even that was fine because I had this really, really hot and really, really fresh cup of coffee that Linda had put love into. She even told me that I could have some of her fancy creamer if I wanted. I added a tiny splash. Which gave me something to look forward to.

Yup.

So we were just walking and talking. Really fast, too because it was, to quote my dad, cold as adunnawhat. So we are hustling quickly with our white coats pulled super tight. Making our way into Grady before freezing in place.

That's when I heard it.

"'Scuse me! Miss Doctor? 'Scuse me!"

I stopped and turned around to face him. It was the voice of what appeared to be a man at least 20 years my senior. This elder appeared to be living out in those elements. Shit. I braced myself for him to ask for cash. And immediately wished I'd placed a granola bar in my pocket.

Grrrr.

"Um, could you tell me where I can get coffee?" he said.

He had his hand wrapped around himself, rubbing his bony shoulders. His coat was not warm enough. Not at all.

"Um. Let me think,"I replied. "We have a coffee shop inside."

"Oh. Okay, thank you, hear?" He didn't walk toward the entrance, though. Instead, he turned the other direction. Maybe it was because he didn't have cash. I'm not sure.

I thought about just walking him into the coffee shop to get him a coffee. But I knew that, one, my team was waiting. Two, the line was going to be long at this time of day. And three, I never give cash money outside of the hospital. Plus I didn't have any money on me anyway.

Sorry, sir. That's what I said in my head before continuing on my way. We resumed talking and walking. I looked back over my shoulder as my brisk footsteps took me further away from him.

Then, I felt something. It was like God Himself grabbed my shoulder and said, "What about your coffee?"

"This one? With the special splash of creamer? Dude. Seriously?"

I stopped in my tracks. Spun on my heel and called out. "Sir!" He turned around. "You want my coffee? It's hot. I just got it."

His eyes widened. That's when it occurred to me that he never intended for me to do THAT. He just hoped I knew of some magic place to hook a brother hard on his luck up with a cup of coffee. Turns out I did.

"Oh yes. I would really, really like that," he said. And I knew when I put it in his hand that I would be going to round and into my day without that yummy special creamer and minus that perfect backup cup of joe.

Did birds start chirping and heavens open up? Nah. But that was okay. Because maybe, just maybe, God showed HImself to me today. And you know what? I saw Him.

Yeah.

***
Happy Wednesday.

Tuesday, March 5, 2019

Scrappy.



"Baby, you will rise. Limit is the skies. 
Don't you let nobody fill your head up with their lies."  

- Amel Larrieux



I was once sitting at a table after giving a lecture as a visiting professor at a medical institution. I'd mentioned in my talk about how I'd applied to Emory for both medical school and residency but how I wasn't granted an interview either time. How my grades were good but my standardized test scores weren't at a high enough percentile to make the cut. Then I went on to share how later I would join the Emory faculty and build a successful career there--in spite of all of that. The message, geared toward medical students primarily, was about grit and resilience--both of which are critical to the success of any physician. They seemed to receive it well.

Over coffee and dessert after the lecture, I made small talk with the nearly fifteen senior faculty members, medical students and esteemed guests sitting at my table. Of all the people there, not a single one looked like me. Or even close to like me. But still. They spoke kind words of affirmation and asked polite questions. And I answered them all and it was fine.

But then, this happened. A subtle microaggression straight from the mouth of a grey-haired full professor who, I guess, meant well.

Him: "Your talk was so inspirational. Thank you for that."
Me: "Thanks. I appreciate your kind words, sir."
Him: "It looks like things really worked out for you. I guess I'm just wondering how we zero in on the ones like you and not overlook them. When they don't quite meet the standard, how do you reconcile that?"

*silence*

Me: "Well. I guess the first thing I will say is who defined the standard? Perhaps that standard isn't the best measure for everyone. You know?"
Him: "I'm not sure I understand."
Me: "People like me weren't there when those standards were being created."
Him: *still not getting it* "I hear you. But I guess what I am wondering is how do you know that, if you DO take a chance, someone will be scrappy like you were? How do we not pass on the ones like you? The diamonds in the rough?"

He smiled showing all of his big, yellow teeth. I did not smile back.

*silence*

Me: *in my head* "Did this dude just call a visiting professor 'scrappy' and 'a diamond in the rough?'"
Me: *out loud* "Sir, where I came from? I was able to shine from the very start. I got my education at Tuskegee and at Meharry. I always was a diamond right out in the open. I was never in the rough. Not then and not now."

I swallowed hard and held his gaze without smiling. He needed to know that I wasn't kidding. Because I wasn't. And even though a tiny piece of me wanted to cry, I pushed it down because even if he didn't know and even if they didn't know way back when, I was always enough. Always.

After that, we all sat in an awkward silence. Me sitting with my spine stick straight with a relaxed facial expression. And him, along with several others, looking nervous and apologetic.

I let them squirm.

I didn't say much after that. I was pleasant for the rest of the dinner and was gracious to my hosts when I left. Even the grey-haired dude. But here's what I wish I'd said:

"You know what? I am scrappy. But not the kind of scrappy you think. Scrappy in that I know who I am. Scrappy in that I know how to put my mouthpiece back in and fight even when the fight isn't fair.

That kind of scrappy.

And also. . . you, sir, don't get to call me that. Because just maybe the 'rough' you speak about is in your eyes and was never the students like me at all."


People say some crazy stuff sometimes.

Yeah.

***

He hurt my feelings. But that's okay because I'm scrappy. Now playing on my mental iPod. . . 

Sunday, March 3, 2019

60 seconds.






"All I need is one minute of your time." - Mary Mary

____________________________________________

Sunday rounds today, my senior resident and me


Me: "What questions do you have for us?"
Her: "I don't have any questions. Y'all answered them. Thank you."

*smiling*

Me: "Okay. Is there anything else you need from us before we go?"
Her: "May I have one minute of your time?"
Us: *looking at each other*
Me: "Sure. Tell us what you need."

She extended both of her hands out toward us, gesturing for each of us to take one of them. We did.

Her: "I'd like to pray for you. Is that okay?"

My breath hitched. I didn't want my resident to feel pressured or uncomfortable. Had I been alone, this would have been a no brainer. Fortunately, my resident didn't seem to mind.

Our patient then closed her eyes and clasped our fingers inside of hers. Softly, deliberately she petitioned on our behalf. She spoke over our careers, our families, asked for our protection, patience, wisdom, compassion and that we be empowered with the energy we need to keep going. She asked that no weapons formed against us ever be able to prosper and that we always, always recognize that we have been commissioned as healers.

Commissioned as healers, she repeated.

After saying amen, she hugged us one at a time, tangling us up in her IV and oxygen tubing. It was so tender and genuine. It was like she had made up her mind to infuse us with as much grace as she could possibly muster.

"I receive this," I told her. "Thank you so much."

"Let Him use you," she said.

And we nodded in response.

If you had any idea the things that this patient was battling, you'd fall to your knees crying. I'd hoped she'd ask me for something like an ice-cold Coke from the vending machine. Or a pack of gum. Or even a latte from the coffee shop. But instead, she wanted to give.

To give, man.

The older I get, the more I recognize that a heartfelt gift often blesses the giver more than the recipient. I'm not sure where my resident stands when it comes to faith, but I love that she was gracious and welcoming of what our patient had to offer.

Yeah. That.

That reminds me: A friend of mine who doesn't believe in God once said, "But that doesn't mean I turn down folks praying for me. I need all the prayers I can get." Remembering that made me smile and wonder less about my resident.

Yeah.

We finished rounding in time for me to scoot across town to join my family for church service. As I slid into the pew to join Harry, all I could think of was this tender prayer spoken over my life and that of my family by a critically ill patient who had every right to think of no one but herself.

Whew.

I closed my eyes. Lifted my hands. And decided to return the favor.

Yeah.

***
Happy Sunday.

Now playing on my mental iPod. . .

Why.




There was a code blue on the ground floor. Weird considering no code blue is ever called there. I mean, not that they don't happen there. But it never reaches the overhead sirens since almost always it is happening in the emergency department where everyone is already there and ready.

Weird.

I was on the tenth floor when I heard it. Typically those nearby run to get there. In case they are the first responders, the rule is to try. I wasn't near. But I did wonder what it was all about. Grady is busy, though. There's lots that I wonder about. And then I go on to thinking of something else.

Yeah.

I few hours passed and I was up in a patient's room. He was an elder and I'd come back to check on him one more time. The patient in the bed next to him was talking about what he thought had happened. "Somebody got shot in front of Grady," the roommate said.

"Really?" I replied. "Oh my goodness. I didn't hear that."

A nurse in the room turned away from what she was doing and chimed in. "No. That's not true. Some young brothers pulled up with somebody who'd been shot. Dumped him right on the curb in front of Grady like some luggage and pulled off." She shook her head with hard disapproval. "That's a damn shame, right?"

"Wow." That was all I could think to say. I wondered if my family and friends had heard this on the news and were worried. "So . . .no one was actually shot in front of Grady?"

"No, I don't think so, But isn't that awful? Just throwing somebody on the ground not caring if they live or die? And pulling off before you could see what happened?" She sucked her teeth. Hard.

"You said 'brothers,'" my patient said. The nurse paused, balled up her espresso-colored fist on her hip and curled her lips at him in response. She didn't speak--instead she just cocked her head for emphasis. My patient turned back toward the television and said nothing else.

"That's just TERRIBLE." That's what the neighbor-patient said. Then he said it like five more times in case we didn't hear the first time.

"Wow," I mumbled. Again, because I still couldn't think of what else to say.

After that it was silent for a few moments. That nurse wiped my patient's fingertip pad with an alcohol wipe and pricked it with a lancet. He winced. She rubbed it in this tender way that showed that she cared about his discomfort. I liked that.

"Man. I hope the guy who got shot did okay," I finally said.

The nurse kept shaking her head angrily. Then she moved on to flushing my patient's IV line. "Me, too. Such a damn shame," she said. "Who does that?" The roommate made a few more comments about "not knowing where this world is coming to" and "letting our ancestors down."

No one disagreed.

Finally, my patient, a Grady elder, spoke:

"Look to me like them kids who dropped him off cared a whole bunch about whether he live or die. Bet you they somewhere distraught about they friend."

"Friend?" the nurse said. Her face looked disgusted and her lip jutted out. "FRIEND? With friends like that, who needs enemies?"

The Grady elder turned his head in her direction and looked at her; his face impassive. "If you didn't give a damn about somebody, would you bring them someplace where you KNOW they'd do everythang to save they life if they got shot?"

He kept his eyes trained on the nurse. We all stayed quiet. He raised his eyebrows and went on.

"Look to me like that was they man. Somebody they really cared about and hoped would be okay if you ask me." He shrugged and started fishing around in the sheets for his remote control.

I stared at him, taking in every word. I didn't want to miss a thing. The nurse was frozen in her tracks and the neighbor had (finally) stopped talking. All eyes were on the elder.

"The real question is this: Ask yourself WHY would some young brothers in a city like Atlanta feel scared to bring they friend into Grady after he got shot? WHY would they not be willing to stay long enough to make sure they friend don't bleed to death? You really thank it's 'cause they don't care?"

When nobody had a reply, he let out a chuckle and shook his head. His expression suggested how naïve we sounded.

After that, he turned his television back up and settled into The Steve Harvey Show. And didn't say another word. But you know what? He didn't have to.


Damn, I love this job.


***
Happy Sunday.

Thursday, February 28, 2019

Keep it to yourself.



I was sitting at the nurses' station typing notes the other morning. One patient caregiver with curly hair pulled into a puff on top of her head was standing at the printer. Another patient caregiver wearing rather tight scrubs walked up holding some IV bags and tubing. I knew them both well so looked up, smiled, and returned to my charting.

Scrubs: "Hey girl."
CurlyPuff: "Hey. This printer is tripping."
Scrubs: "Turn it off and on again. That's what I do."
CurlyPuff: "Okay, cool."

CurlyPuff shut off the device and waited for it to turn back on. She stood there with her hand on her hip looking impatient. It was clear that she was busy and a faulty computer was throwing a speed breaker down in her flow. She sighed. I glanced up from my seat at her briefly in solidarity because I knew exactly that feeling.

Scrubs: "You know what? You look tired."
CurlyPuff: "Tired?"
Scrubs: "Yeah. You look tired."
CurlyPuff: "You mean like sleepy?"
Scrubs: "No. Like. . .tired. Like I'm looking at you and thinking, 'You look tired.'"

CurlyPuff turned her body away from the printer in Scrubs direction and just stared at her for a moment. Her face made it clear that she didn't care for that observation.

Here we go.

Scrubs: "I say it out of concern."
CurlyPuff: "That I look tired? Not sleepy but tired?"
Scrubs: "Yeah."

CurlyPuff keeps staring at Scrubs. She looked up and down at her without expression, blinked slowly and sighed again. Then she spoke back.

CurlyPuff: "You look like you gained weight."
Scrubs: "What?" *looking embarrassed*
CurlyPuff: "You do. Like I'm looking at you and thinking, 'Your scrubs are getting tight. You look like you gained weight.'"

Oh snap.

Scrubs: *looking offended* "Wow. Remind me to never say anything to you."
CurlyPuff: "No. Remind yourself never to walk up to a woman, look her in the face and say something like that. At least, not like that. That she look tired? Not sleepy but tired?" *shook her head and patted the side of the printer*
Scrubs: "I was saying it out of concern."
CurlyPuff: "Just 'cause you think it don't mean it need to be said. What I said to you was something I thought before. And it could be out of concern, too."

Oo wee.

Scrubs: *speechless*
CurlyPuff: *putting arm around Scrubs* "Look, baby. That just ain't the thing a woman can receive in a way that make her feel better. Nor do it make a woman feel good to hear that--especially coming from another woman. That she look tired? Naw. Just ask how I'm doing. See about my needs if you concerned. But don't walk up on the hall and announce out loud that I look across-the-board tired. That didn't make me feel good."
Scrubs: "I'm sorry."
CurlyPuff: "Me, too, girl."

They hugged it out. And after that, the printer started working again, too.


Damn. I love this job.

***

*For the record, I'm not a fan of being told one looks tired either. Honorable mention: "Fun" to describe hair, clothing or anything else that you were being dead serious about when you put it on.

***

More on bias.




I think so much about bias. About MY biases. About OTHERS' biases. And about all that happens as a result.

But these days? I mostly just spend time unpacking my own biases. Trying my best to have the courage to make my implicit biases explicit to me. So that I can start doing the work to be my best doctor and person.

Yup.

This is exactly what I saw in the Grady emergency department the other day:

1. An elderly black woman was sitting in a wheelchair having her blood pressure taken by a nurse. She had a blanket over her shoulders and her grey hair was in plaits. She kept dozing off. Her ankles were very swollen. Her nails had been painted with a bright color by someone.

2. On the other side of the room, this young white man was sitting on a gurney with his legs dangling off of the ends of it. HIs shoes looked very new. And very expensive. He was staring at a smart phone, periodically sighing super hard. I was thinking it was to let everyone know he was tired of waiting. But maybe he was sighing for a totally different reason.

3. Somebody was hollering behind a curtain. Like, super loud. All of a sudden, that hollering person ripped back the curtain and looked around. I made eye contact with the person--a very slender woman with pale skin, stringy hair and really, really bad teeth. Her eyes widened when she saw me looking and her hollering started being directed at me. "DOCTOR! ARE YOU MY DOCTOR? DOCTOR!" she screamed. I wasn't her doctor. I slid behind a column out of her line of sight.

4. A Spanish-speaking woman and man were sitting together in one chair. He was on the chair and she was on his lap. She had an IV in with nothing running into it. And he was wearing what appeared to be clothes from a construction site. I don't speak Spanish, but I could tell they were concerned. And tired. But he was making her laugh. And every time she laughed I could see the gold rimming her front teeth. A few moments later, he was falling asleep, too. Just like that elder in the wheelchair.

5. A gender-nonconforming hospital employee walked by. Smiled in my direction and said, "Hey Dr. Manning." I said hey back, but the greeting given to me was so warm and familiar that I felt too ashamed to ask for the name I probably should have already known. I'd seen this person many times before. I noticed a new facial piercing this time.

6. A big commotion came from up the hall and in comes two uniformed officers with a lean, muscular young man with hands cuffed behind him. He isn't resisting, just looking really mad. He was shirtless and his beltless pants were nearly falling down. HIs hair was in locs--part brown, part blonde--and they shook every time he moved his head. Even though he wasn't fighting those officers, it seemed like they were fighting him. He caught me looking, too. He stared at me, almost like he was daring me to judge him. For some reason, with him, I didn't move behind a column. I just tried my best to make my eyes as soft as possible. He looked a lot like my youngest son.

All of this was in the span of 60 seconds.

Yup.

My bias was at play in every single one of those scenarios. Since I know that now, I see stuff so differently. My friend Shanta Z. and some others have helped me a lot with getting more woke in this aspect. Now, after moments like this, I walk around asking myself stuff like:

Who are you?
What are you afraid of?
What are afraid other people are afraid of?
Who are you trying to protect?
Who are you not trying to protect?
What are you mad at?
What are you sad at?
What makes you feel at home?
What makes you feel lost?

And the list goes on and on.

And yes. I say this stuff to my learners, too. Not to hear their answers. But just to get them seeing what I see, too. Or seeing what they see, too.

Yeah. That.

America is a bugged out place, man. And if you think white folks are the only ones trying to sort through their implicit and explicit biases, you just met someone who will help you to stop thinking that.

The answer to all this? Shit. I don't know. But acknowledgment is a start, man. I just want to be better. Do better. Be brave.

Yeah. That.

***

Me and mines.

Mines.



Last month on rounds

Her: "Before you say anything, hold on for a second, okay?" *fishes around in bed for her phone* "I need to get my sister on the phone." *opens flip phone*
Me: "You know. . . . if you want, we could call her for you. You know. . . and update her on everything."
Her: "Nawww. Let me go on and call her right now, okay?" *holds up index finger telling me to wait*

*inward cringe* 😬

CONFESSION: The whole "let me get somebody on speaker phone" thing in the middle of rounds is so not my favorite. Like, at all. For one, I don't enjoy having to speak louder and more animated to bring someone else into the discussion. And lastly, by definition, people on the phone seem to need more to make up for not being able to see your face and expression as you talk. It can get lengthier than normal. Which isn't always so fun when you're super busy.

Terrible, I know.

But I do have a workaround. The compromise for me is that I offer to personally call that loved one afterward. And usually that's fine. This time? Not so much.

Me: "You sure you don't want me to just call her directly? I am happy to do that, you know."
Her: *chuckles* "See, if it was just up to me? You calling her later would be fine. But that ain't the case."
Me: *inward cringe* "Okay."

*silence as she scrolls through her contacts*

Her: "See, my sister? She don't play. She like to hear WHAT they telling me WHEN they telling me. She said she don't like no after the fact summary for the family, you know?"
Me: *presses lips together and nods* "I can see that."
Her: "Some doctors don't like all that, though. They ain't patient like you."

*inward cringe*😬

Her: "Like, this one surgeon? I said I need to call my sister and he flat out said, 'Your sister needs to be up here if it's that important to her to hear every single thing play by play."
Me: "Whoa."
Her: "That dude was talkin' 'bout some, 'You want to be IN the game? You got to be AT the game.' He started laughing, too. Like he said something funny."
Me: "Wow."
Her: "What's messed up is that I laughed, too. Even though that wasn't funny."

*silence*

Her: "Let me tell you what else wasn't funny though--when my sister called to ask me why I ain't call her when them surgeons came by and I told her what he said. You know, about the game and all."
Me: *squinting eyes and wincing*
Her: "Baybaaaaaay."

*laughing*

Her: "When I say she took the WHOLE DAMN DAY off from work the next day to wait for his ass? Girl, like a damn playground bully after the school bell!"
Me: *laughing*
Her: "That dude walked in and she was like, 'Oh. You the one who said that stuff about me being in the game, right?' He called his self laughing it off, too. She was like, 'Let me tell you ONE GOT DAMN THANG about ME AND MINES!'"
Me: *eyes widening and erupting with laughter* "She didn't go to the 'ME AND MINES' did she?"
Her: "Girl, he ain't knew that when somebody black say 'ME AND MINES', it don't NEVER end well."
Me: *doubled over*
Her: "Dr. Manning! She was like, 'OH. ME AND MINES? We ONE BALL, boo boo. I'm in EVERY GAME, you hear me?' Patting her chest, looking all crazy and all up in his face." *laughing and shaking her head* "Lawd. That po' man."
Me: "Wait--did she really say 'boo boo?' 
Her: "SHOLL did."

*hollering laughing*

Her: "Chile, for the rest of that week that man was calling my sister so much she got sick of him!"
Me: "It was the 'ME and MINES' that had him shook."
Her: "Please believe!"

*laughter*

After that, she pushed a few buttons and then put her sister on the speakerphone. We all talked about what was happening with my patient--her sister--and what to expect next. Sister was tough--as expected. She asked a ton of questions and with each one, my patient rolled her eyes and shrugged in my direction. Eventually, all the questions were asked and answered. And all was well.

Yup.

Was it awkward to be talking in Dolby stereo over an antiquated flip phone? Of course. But did I do it? You're damn right.

I'd be lying if I said that now I've had this epiphany about how much I'll now enjoy bringing in family on speakerphones during rounds. Nope. But I CAN say that I haven't stopped thinking about Sister's reason being that she wanted to hear EXACTLY what the doctor said to her sister EXACTLY when they said it. This was advocacy on a whole different level.

I remember when a family member thought she had uterine cancer because of the way her fibroids were described by the doctor on rounds. "Tumors on her uterus," they'd said. Which, to her, meant cancer. I wonder what those 72 terrifying hours of thinking she had cancer would have been like had she insisted I get brought in on speakerphone that day. . . .

Me and mines.


So this? This is why I take a moment every day to sit and think about what's going on around me. To let empathy push down my selfishness and remind me that you and yours are as important as me and mines. And that we ONE BALL.

Yeah.



"I'm in EVERY GAME, you hear me?" 

- a badass baby sister who took exactly ZERO mess from anybody.

****
#amazinggrady #idontmakethisstuffup #meandmines #supportisaverb #standbyyourfolks #andstayinthegame

Come together. Right now.





"Come together right now. . .over me." - The Beatles


Partner: "Can I speak with you in private for a moment?"
Parents: "Can we speak with you in private for a moment?"
Partner: "Don't mention anything to his parents about this but. . ."
Parents: "Don't mention anything about this to his girlfriend but. . ."
Me: 😬

One person expressed one thing. Somebody else expressed something altogether different. Everybody loves him. But the messed up part is that those people that all agree on loving him, agree on very little else.

Nope.

Are they rude? Nope. Screaming and hollering? Not so much. But mostly, the room is just filled with this icy coolness when I walk in. If everyone is there at the same time, count on it to be filled to the brim with passive-aggressive nice-nastiness.

Yup.

Partner: "I just don't even try with them anymore. They think they know what he wants and needs but they don't. They barely know him."
Me: "How long have you all been together?"
Partner: "Oh goodness. Easily ten years. We might as well be married.”
Me: "Gotcha."
Partner: "Essentially, they don't like me and I don't like them. So we never talk. I mean, he talks to them, but I don't. I steer clear of them as much as I can."
Me: "I see."

*silence*

Partner: "Well I know they're saying they want to do one thing when he leaves here. But that's not what I want to do. I want something else and I think he'd want me to make that decision."
Me: "Have y'all talked about it? You and his parents?"
Partner: "I tried to be polite. But they always thought he could do better than me. Like they wanted him to get married and have a wife who was skinny and went to college somewhere and who don't got any kind of background."
Me: "Hmmm."
Partner: "That ain't me. So far as I was concerned they could kiss my ass."
Me: "Dang."
Partner: "Now since he can't speak for himself, they all high on they horse. That's some bullshit."

*later in the same day*

Parents: "Thanks for talking to us."
Me: "No problem."
Parents: "We plan to take him home with us after this. We have a lot of good things to assist him on getting back on his feet."
Me: "I see. I know he has a live-in partner. Have you all talked to her?"
Parents: *eyeroll* "No. And we don't need to either."
Me: "Umm. . okay. Well I know he can't speak for himself right now. But what do you think would be his preference?"
Parents: "Well. Seeing as he has no insurance and not much else? I hope his preference would be to go with whatever is best for him."
Me: *silence*

Damn.
Damn damn damn.

There was drama later. Major drama. Those hushed voices began to escalate. In the hallway. In the room. Near the elevator. And probably some other places that I don't even know about. But it was sticky and yucky and contentious and just. . .yeah. I did my best to stay out of it. But it isn't as easy to do that as it sounds.

Sigh.

*steps onto soapbox*

Look here, man:

Everything--and I do mean EVERYTHING--is about relationships. Working at them. Clarifying them. Solidifying them. And, when possible, taking necessary actions to seal them as legal.

For real.

Those almost in-laws you don't mess with? That estranged spouse that "might as well be divorced" from someone? Those siblings with whom you're at war? That parent that you don't talk to at all anymore over some kind of petty disagreement or even some major disagreement? Look man. I implore you to do whatever it takes to get on the other side of that complicated.

Yep.

If you fall ill and can't speak for yourself? Guess who gets to call the shots? Your legal power of attorney. Married? Your spouse. Not married but without a power of attorney? Your parents. Or your siblings. Would you be cool with the person who would legally get to be the shot-caller for you as of this very moment doing so? If not, I suggest you do something about it. Stat.

And even if you DO have the legal parts all copasetic and such? Still work at the relationships. Because if illness falls, it WILL call for y'all to interact. A lot. Grown siblings. Grown grandkids. Long-term boo-thangs. Those folks want to have a say. And even if you make up your mind that they can't have one, you might lose a few years of your life through angst and worry just trying to stiff-arm the ones who want a seat at the table.

Yup.

The good news is that I see lots of long term partners who navigate life-threatening illnesses well with families. But that is always when it is anchored in some kind of respectful understanding of their position. With this patient? That wasn't the case.

And that? That sucks, man.

*steps off of soapbox*

Come together. Right now.

Or else.

***

F that.



SuperBowl Saturday rounds

Me: "Who you got for the Super Bowl, sir?"
Him: "Nobody!"
Me: *laughing* "Nobody?"
Him: "Nawwwwl. I don't give no F--K about no Super Bowl."
Me: *chuckling* "Fair enough."

*trying not to laugh since he isn't laughing AT ALL*

Nurse: "Dr. Manning, I think he might be boycotting."
Him: "SAY WHAT?"
Nurse: *flushing his IV* "You know, taking a knee. Boycotting the NFL."
Him: "Boycott the WHO? Maaan. . . F--K a BOYCOTT."
Nurse: "Now you gonna stop all that swearing, sir!"
Him: "F--K that."
Nurse: *stares at him*
Him: *glares back*

*holding in my laugh as nurse walks out shaking her head*

Me: "How long you been cussing, sir?"
Him: *laughs out loud* "Since I was 9!"
Me: *laughing* "Nine?"
Him: "Yup. In the 1950s when I was standing outside downtown minding my business. Not breaking no laws or nothing. And this teenager come up to me talking 'bout some 'GIT OUTTA HERE, N---R!' And I looked around like, 'What I do? Git outta where?'"
Me: "Whoa."
Him: "That white boy say he just want me out his sight. Just 'cause. So I let him know what I thought."
Me: "Which was. . ?"
Him: "Every cuss word I could thank of!"

*laughter*

Him: "But when I got older I just like how some words felt in my mouth. And the folk that don't say the F word just don't know what they missing."
Me: *chuckling*
Him: "You ever been mad and tried to hold back a good F--K? Sometime no other word do the trick."
Me: "Ha ha ha that's real talk."

*laughing*

Me: "So what's the reason anyway? For the no Super Bowl?"
Him: "Oh, I'm a watch it. But really, I'm just trying to make it to another day, Miss Manning."
Me: "I hear you."
Him: "My granddaughter say 'Granddaddy why you don't boycott the NFL?' She say that all the time."
Me: *just listening*
Him: "Know what I told her?"
Me: "What's that?"
Him: "F--K that. I'm almost 80 years old and I'm black. My whole life a MF knee."

He laughed after he said that. But I didn't.

The more I do this job, the more I realize not to underestimate my patients. A little colorful language and cantankerous behavior don't mean that you don't know what's going on. Or that you ain't all the way WOKE.

Speaking of which, he also said this:

"And anybody that thank Brady ain't gon' send them Rams straight home with a L? They a F--KIN fool."

No lies told, man.

Haaaaaa.

Oh, how I love this job.

***
Happy Last Day of February.

Wednesday, February 27, 2019

I be praying.




"I hope you find your peace, falling on your knees. . . .praying." 

~ Ke$ha
________________________________________

Afternoon rounds with my patient:


Him: "Losing somebody to some kinda accident or violence? That's the worse thang if you ask me."
Me: "You think so?"
Him: "Yeah. Like, you get on with your life and all. But something inside of you gone always stay balled up like a fist. Always."

*silence*

Him: "The problem is that it haunt you like a boogeyman. You be replaying it in your head thinking 'bout what if this or what if that, you know?"

*silence*

After that, my patient started weeping. He turned his head away from me to look at the Atlanta skyline through the window. I sat on the bedside chair, reached for his hand and just held it--gazing at the same view.
Me: *whisper* "I'm so sorry, sir."
Him: *whisper back* "Me, too, Miss Manning."

Finally, he shook his head, let go of my hand and pressed his palms into his eyes. I just sort of watched him helplessly. Because I knew I couldn't take this away from him.

He spoke again.

Him: "I be praying, Miss Manning. I be praying so hard. Asking God please don't do nothing else to nobody. Please God." *starts crying again* "Almost make you scared to love somebody real hard."

*silence*

I wish I could tell you that I said something wise that made all of this better. I didn't. Instead, I just held his hand in silence and coached myself with all of my might not to cry.

It didn't work.


Since I'm a pray-er, before I close my eyes tonight, I will allow my heart to touch and agree with yours. Petitioning God to protect the people we love from calamities and catastrophes. And to fight those lurking boogeymen so that you can finally unclench your fists.

Yeah.

***

Now playing on my mental iPod

Tuesday, February 26, 2019

Bias is heavy.



There is this thing I had to fight off the moment I laid eyes on you. This feeling, this bias that I wish I didn't have toward you but that I know I do. As soon as I stepped over the threshold into your room, I could feel my heart shadowboxing to try to press it down, hold it back.

Sigh.

They make whole television shows about you. And people tune in as appalled voyeurs, wondering how someone could reach the kind of weight that renders them immobile. Or totally isolated. Or maybe not isolated but still unable to fully participate in the kinds of things that most people can do. Admittedly, I don't watch. But I'd be lying if I said it was because of my tremendous empathy and disapproval of people making your reality into a spectacle. Instead, it just reminds me of those who come before me as my patients who are like you. And how helpless I always feel.

Yes. That.

See, that's my bias. I like feeling like I can do something. And a body mass index that matches my age always makes me feel like my hands are tied. And like there is nothing I can really, truly do. Especially when resources are low on top of it.

Sigh.

So after I saw you, I told my team what I am saying now. That I am struggling with my bias and I want to do better, be better. And that I would try. Like, really try.

"How?" my student asked me.
"I don't know," I said. "But I think first? I'm just gonna be still and think about it."

Which I did.

And so. I came back. And this time, I didn't just go through the motions. I sat down and spent some time talking to you. I told you flat out about how sometimes I struggle with seeing my patients who carry as much weight as you. And then I said sorry in case it sounded mean. You said it was cool.
But then we started talking. About music. About family. About parents saying crazy stuff and what we put them through as kids. We laughed about land lines and how kids now will never know how it feels to have somebody pick up the phone and start dialing while you're trying to ask somebody to go with you. Or pretend you ain't eavesdropping on a three-way call. We cracked up laughing.
Then, after that, you took out your phone and showed me a picture of yourself. Not in the hospital. Standing outside at a cookout. And yes, you were still as heavy as you are now, but your eyes were dancing and you looked alive. You did.

"You still struggling?" you asked me.
I thought for a minute. "You know what? No."
"People don't see me," you said.
"I didn't before. I do now," I replied.
"It's crazy because when you real, real big, people treat you bad and the world seem like they cool with it." You shook your head. "I'm not talking about being husky. I'm talking about when you get like me. Like people let they kids stare or they look at you and frown right to your face. Like 'Uggh.' And don't nobody say nothing."

"Dang." That's what I said.

Because that was all I could think to say. And because I felt my toes squishing under the weight of that truth.

I'm learning that confronting our biases head-on is one of the only ways to overcome them. I'm also constantly reminded that the longer you stay with someone, the more you'll find where you intersect. And the more you'll see them.

Because I saw you, I took better care of you. The plan became more meaningful and, as the leader of the team, allowed me to help my whole team see you, too. Like, for real see you. I also told them what you said and we all promised to do better. Or at least try, man.

Thanks for helping me to be a better doctor. I'm a work in progress for sure. But today--thanks to you--I think I progressed.

Yeah. 

***

Monday, February 25, 2019

Homeless-ish.




When my alarm went off this morning, I didn't want to get out of bed. Not because I'm a person who struggles with mornings--I don't. And not because I still felt super sleepy--I didn't. Mostly, it just felt super comfortable. And safe. And just. . . peaceful.

Yeah. That.

I hit the snooze button, stilled myself, and just listened. I could hear the tinkle of Willow's collar and his feet padding the floor while exiting Zack's room. Then I heard the plop of his body settling to the floor outside of my door. A few dry coughs came from the direction of Isaiah's room. And Harry's rhythmic breaths added to my ambient morning music. It all felt so good.

It did.

And this? I'm learning that this is not a tiny mercy. It's a big one. Just having a bed that you can lay down on that you either look forward to getting into or that you feel reluctant to leave? Man. This week reminded me what a huge deal that is.

Like on this day:

Me: "You're looking so much better, sir. You're off of oxygen and walking to the bathroom and back by yourself. And your fevers have gone away. I think we can let you go today."
Him: "I don't feel all the way better, Miss Manning. I prefer for you to just go on and hold me until I'm back to a hundred percent."
Me: "I'd sure love to do that. But it's a lot better for you to just finish recuperating at home away from all the beeping sounds and people waking you up." *trying to laugh*
Him: "That don't bother me. I'd just rather stay a few more days."
Me: "So, we do have to go ahead and discharge you today now that your body is strong enough to finish getting better at home. But how about we send a home health nurse there to see about you?"
Him: *looking visibly distressed*
Me: "You okay?"
Him: *tearful* "No. I just really, really want to keep getting better here."

*silence*

Me: "Remind me of where you live again?"
Him: "With my daughter. And her family for now."
Me: "Okay. I say when you get back there, you just slide on under the covers and keep on resting when you get home. We'll get you the prescriptions and get you all set, okay?"

*silence*

Me: *trying to look positive* "Okay?"
Him: *now tearful and frustrated* "First of all, I stay on a COUCH not in a room. And it's just . .just . . .just CHAOS all 'round there! Kids in and out, teenagers. People walking all around and smoking and cussing and talking all loud. TV on all hours of the day and folk letting me know I'm in they way. Like, 'Naw, we don't want it so comfortable that you don't get up outta here.' And I don't blame 'em."
Me: *silence*
Him: "I know you can't hold me past what you s'posed to. But I wish SO bad I had some place that just feel good, you know? Where I can just get in my bed and like it there. And get all the way better. But I ain't got that."
Me: *tiny whisper* "Man."

After that I asked him to tell me what he meant by "CHAOS" and he did. And nothing about it sounded pleasant or like a good set up for a brother that's trying to convalesce after dealing with some real serious health stuff. It sucked.

And this? This situation of unstable housing and "staying with somebody for a while" because of lost jobs or disability or strongholds? Man. This is way more common than I wish it was. Way, way more. That patient gave it a good name: "Homeless-ish."

Wish I could say there was a plan B for me to offer my homeless-ish friend that day. There wasn't. At least, not a fast or immediate one. And because I was keenly aware of the large numbers of sick patients down in the ER waiting for beds on the hospital ward, the chaotic couch would have to do.

Sigh.

So this morning before the snooze went off again, I prayed for him to find some pocket of solace in the next few days. Prayed that someone in that house would choose to speak in their inside voice or skip the loud TV or insist that everyone tiptoe and close the doors softly. That somebody would lightly place a comforter over his body and bring out a pillow and ask if he's okay. I prayed that until I could see it. I did.

After that, I gave gratitude for tiny coughs, jingling dog collars, low pitched hums of sleeping husbands, goose down comforters, alarms with snooze buttons and just. . . peace. Because somebody somewhere would give anything for it, man. This I know for sure.

Praying friends? And my non-praying friends, too. . . . remember my homeless patients, okay? And my homeless-ish ones, too. Thanks.

That's all.

***

Sunday, February 24, 2019

Alix. Alix. Alix.

2015


When she was a first-year medical student, I ran into her in the lobby of the medical school. She knew my name before I knew hers. Which isn't an unusual thing for those junior to you in a place where you're both underrepresented minorities. "Hi Dr. Manning!" she said as I passed. Her eyes were dancing with admiration and deference. I was busy, but still. I wanted to try to show her the same.

I stopped. I smiled. I asked her name, too.

"Alix," she said.
"Nice to meet you, Alix," I replied. Then I said:

"Alix. Alix. Alix."

That's what I do when I meet someone and want to be sure to seal a name into my brain. And that is exactly what happened. After that, whenever I saw her moving between classes with an oversized bookbag or chatting with her comrades, I made sure to call her by her name.

"Alix. Alix. Alix."

Yup.

Ultimately, that created a space for us to talk more. I gave her my number and told her to reach out anytime. Because I care about our students, yes. But especially because I know exactly what it feels like to be a black female navigating a large majority medical institution.

Yup.

One day during Thanksgiving break of her first year, she sent me a text asking if she could join me on rounds. I replied that she could and offered some future dates. "I was hoping to join you this week," Alix said. It was Thanksgiving week. And she was on break. But once I asked if she was sure, she confirmed that this was exactly how she wanted to spend the Saturday after turkey day. And so she did.

Yup.


2015


That was in 2015. Fast forward to this month and now she is a senior medical student rotating on my team. She's a few weeks away from matching into a residency. Her stride is more confident. Her comfort level navigating around Grady so much different than the nervous freshman student who stuck close to my side back in November of 2015. I looked at her on rounds yesterday and felt a pang in my chest.



2019


"This is a full circle moment," I told her yesterday after rounds.
"Yes, it is. I feel so lucky."
"Do you remember that day you came to round with me?"
"The Saturday after Thanksgiving. I will never forget."

After that, I didn't say much. I just sat there staring at her with the same admiration and deference that she'd offered to me in the hallway nearly four years ago.

"Damn, I'm so proud of you."
"I know."
"You do?"
"Yes. I do."

We both sat there smiling for a few beats. Then I spoke again.

"Pay it forward, okay?"
"I will."
"You know what? I already knew that."

And I said that because it was true.

Alix. Alix. Alix.
I'm so glad I took the time to learn your name.


I love this job. So much, man.

Yeah.

***

I took those photos that day right after she'd finished rounding with me back in November 2015. Because I knew I'd want to go back and savor that moment someday. You know what? I was right.

Saturday, February 23, 2019

You are not.



You looked at me with this bored expression. You yawned, folded one elbow behind your head and scratched your ashy torso with the other. "I'm a lost cause," you said. "Some people just like to get high. Me? I'm worse than those kinds of people. I LOVE to get high." When I didn't say anything, you laughed out loud. Hard.

I did not.

"I just keep shit one hun-ned." You shrugged. Then you laughed again. This time harder.

I did not.

There was such unapologetic resignation in your face. You meant what you said, believed it even. You spoke of all the people who had come in front of you, trying to convince you to quit.
"Sobriety is for who want it, man. I don't want it. I want to get high. As much as I can."
"I appreciate your honesty," I said.
"I'm always gon' be that. You can call me a junkie. You can call me a addict. But what you ain't never gon' call me is a lie, though." You chuckled once more.

I did not.

It started with some pills after an injury. You broke a bone and they gave you Percocet. Then they gave you more. At some point, you felt sick without it. And lucky you, you were down with somebody who knew how to help you not feel sick.
"You scared of needles? It involve a needle," your friend told you. You said, "I just don't want to feel sick." After that, it was a wrap.

Over and over again, you called yourself a junkie. Such an old school word coming from someone so young.

"I'm a lost cause, man. Don't waste your energy." You laughed every single time you said that. And every single time you did, I made up my mind to not join you.

So you kept talking. And I kept listening. You kept laughing, too. The whole time you did. I did not.
At some point, I reached out and touched your hand. You jumped a little. Then, for the first time, you looked into my eyes. You were genuinely surprised by my gesture. I closed my fingers tighter in response, ignoring the confetti constellation of needle marks and scarring. I was stunned that you let me.

Me: "You keep saying you're a junkie. And a lost cause. That's not what I see."
You: "Oh yeah?"
Me: "No. I see a smart, beautiful, black son."
You: *holding my gaze*
Me: "I know you like to get high. But little brother . .you are so much more than that."
You: "No I'm not."
Me: "Yes, you are."
You: *silence*
Me: "YES, YOU ARE. You ARE."

What happened next surprised us both. You started crying. Hard. And as soon as you did, I couldn't hold it in. I cried, too. Right then and right there. And the whole time I was squeezing your hand and you were squeezing your eyes as tight as you could to hold back those tears.

They came anyway.

This didn't end with you promising to never get high again. Or with me safely delivering you to a rehab center and all of us rejoicing in the hallways singing mumma-say mumma-sah mu mah koosah either. But you did let me hold your hand way longer than I thought you would.

After I left your room, I stood in the hallway weeping. My shoulders were shaking and my fist was balled up and held to my mouth. I shook my head and kept saying out loud, "I am so, so sorry, little brother. I am so, so sorry." My whole team was standing right there for all of it, too. And I didn't care. The part inside of your room and the part outside in the hallway, too.

"Do you think this could get him to stop?" my student asked.

“I don’t know," I said. "But I do think just like mean stacks up so does kind. So I keep trying, you know?"

She nodded in response. I meant every word.
***

Dear little brother,

You are not a lost cause. 
You are not a lost cause.
You are not a lost cause. 
You are not.

Okay?

***