Tuesday, July 30, 2019

Stand by you.

"I'll stand by you." - Chrissy Hynde, The Pretenders

Rounds were over and, mostly, not much more had to be done other than write notes and arrange discharges. She, the resident physician working with me, was still at Grady. I was not.

That morning, things were fine. But then came the call from his nurse. A new complaint--one that hadn't been there before and that wasn't there on morning rounds. My diligent resident quickly went to assess the patient. Vital signs not normal. A heart beating over 120 times per minute, little beads of sweat on the forehead of a person who was cracking jokes just an hour before.


"He doesn't look good," she said to me over the phone. "I'm concerned about him."

And the way her voice sounded over the phone, I knew she meant it. Even crackling through my blue tooth car microphone, I could tell. I also knew because I'd been working with her all week and had seen her empathy in high def for nearly seven days already.

"What do you think is going on?" I asked. And, with that, she described everything she'd seen. A head to toe examination, a review of the labs, and a thoughtful differential diagnosis of things it could be.

"Does it sound like I'm missing something?"

"If I were by myself, I'd be thinking the same things," I replied. "I have nothing to add. This plan sounds very good."


"Would you like me to come up there?"

There was a pause. "I don't think so," she finally said. "I feel better since we talked through everything. But thank you for offering, Dr. Manning." And I could tell she meant that.

This woman is a senior resident. And not just that any senior resident. I highly competent, extraordinarily professional, incredibly thoughtful young physician with a knack for caring for the sickest of patients. Honestly? She was all over this. Her fund of knowledge in a lot of areas exceeds my own. In my head, I was saying these words: "You've got this." Because she did.

I came in anyway. It was almost 5pm.

Let me tell you what I saw when I got there: Exactly what she described without a single surprise. I examined the patient for myself, yes, but mostly? I simply came there to stand beside her.

I was standing at a computer scrolling through labs when she walked up. At first, I worried that she'd think it was because I didn't trust her. But as soon as she saw me, her face erupted into this complicated smile. "You came anyway," she said with a chuckle. Then she sighed this breath of relief.

"Yeah. I came to stand next to you. And worry with you. Is that okay?"

We both laughed and went to see our patient together. We talked to him and to each other and to radiologists and consultants. He was sick, too. And of all the people who looked the most relieved? He did. Having those two women standing side by side fretting about him on a sunny weekend day meant something.

I didn't say or do anything to change the ball my resident had put into motion already for this patient. It was she who saved a life that day--not me. I had nothing to add or change or suggest or modify. Nope. I just stood there, hands pushed down in my white coat pockets, nodding more than anything else.


Sometimes my job as a clinician-educator calls for lots of high-level medical knowledge. Other times, not so much. Either way, I came in because now I get it. What holds true for most aspects of life is true here, too: Sometimes the most powerful thing you can do is just show up--show up, stand next to someone, and be there. And nothing else.

And this weekend, that's exactly what I did.



  1. I wish my attendings in residency had done this. It was such an isolating, stomach knawing feeling of anxiety - having to do these things alone - and I think sometimes it made me want to stop learning, because I put more pressure on myself than necessary.

    I guess some would say it's just part of the learning process because you are 'alone' when you're an attending. But it's nice to know in real time, that someone with more experience sees what you're seeing in the patient.

    1. This is such a beautiful description of some beautiful decisions. I just love it, and I love you for using your powers for good.


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

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