Reflections of a Grady Doctor

Road Trip.

2012-02-13T23:46:00.001-05:00

One mommy + one daddy + two little stinky boys + nine-and-a-half hours-in-the-car + four different states + lots of snacks + one hard-working DVD player + two Star Wars Clone Wars DVD packs + "thank God you guys are boys so we can just pull over right here" + "Eeeww Harry! Nobody will be 'using a cup until we stop'!" + a whole lot of laughter + a whole lot of singing + a whole lot of talking + a whole lot of friends + a whole lot of good times =

A whole lot of uninterrupted family time that may not now but likely will later be just one part of a whole lot of wonderful childhood memories.

Which made that crazy-long drive a whole lot of worth it.

***

Now playing on my mental iPod. . . . . and bringing back memories of our childhood road trips as a family. Best family road trip song ever.

Stronghold.

2012-02-13T07:00:00.004-05:00

Giving up
is so hard to do
I said I've tried
But it just ain't no use

But my light of hope

is burning dim

But

But in my heart I pray
That my love and faith in the girl
will bring her back someday

~ from Donny Hathaway "Giving Up."

"Sit down on that chair, hear? What did I say?"

This sixty-something year old woman furrowed her brow and pointed her finger sternly at the two toddlers fidgeting in the chair beside the examining table. A little boy and a little girl -- certainly no older than three and clearly a big handful.

"Gran'mama, I'm hungry!" the little boy whined.

She didn't say anything in response. Instead she reached into her pocketbook and pulled out a little box of animal crackers and opened it up. Next she whipped out a little package of travel tissues and quickly secured one tissue in each hand. Holding both up to each child's nose simultaneously she directed them. "Blow."

*phhhhhttttttthhhhh*

Those little toddlers did just as they were instructed. This grandmama meant business.

I had just stepped into the clinic room with one of the residents when I caught all of this. And honestly? It wasn't exactly unusual to see a patient with children in tow. I kept things light and made a little small talk.

"Hey there, Ms. Ashton. I think we may have met before -- I'm Dr. Manning and I work with your resident doctor." I reached out hand shook her hand even though she'd just had a snot-filled Kleenex in it. "I see you have your grands with you today, huh?"

She made and exaggerated eye roll. "Honey, I got my grands with me every day--y'all stop dropping' all them crumbs all over the place, hear?" The obedient toddlers shifted nervously in that shared seat.

"Are they twins?" I asked. Partly because I was still making small talk but also because I was just curious.

"Mmmm hmmm, chile. And they a handful, too. Sweet little babies, but they a handful for sure. Cain't you tell?"

We all laughed, the resident, Ms. Ashton and me.

"You keep your grandbabies during the day?" I chuckled and reached out for the little girl's hand. It warmed my heart when she let me.

Ms. Ashton grabbed the box of animal crackers and dusted the crumbs off of their laps with her other hand. Her wide hips shook as she swished her hand and caught crumbs into the box. She returned to her chair and let out a sigh. "I keep my grands all the time. They stay with me 'cause my daughter cain't take care of 'em herself."

I widened my eyes and prepared to back off. I cast a quick glance in the direction of my resident because none of this had come up when she'd presented the patient to me. The look on her face suggested that this was news to her, too. I suppose she'd simply assumed that a kind grandmother was watching two of her grandchildren.

"Her mama got a stronghold. Hooked on that crack mess. So the state was gon' take her babies but I said, 'Naw, we don't do that in this family.'"

"Stronghold." Sure, Merriam-Webster has its own meaning for this word, but coming from a Grady elder, I knew exactly what this meant. A stronghold. The term the elders use to describe an addiction or gripping weakness; usually referring to how powerless it renders its victim.

I remembered that woman today. I remembered her not because of the medical problems we treated her for that day but because of our very brief conversation about her daughter. She went on to say a few words about her daughter and her addiction--always referring to it as a "stronghold."

"It's out of your hands. That's the thing about a stronghold. All you can do is love 'em and pray. Getting' mad at 'em don't help nothin'. So you jest love 'em and pray. Other than that it ain't much you can do."

***

This past weekend we went to visit some of our closest friends, Shannon and Michelle, in Virginia. The weekend was full of joy and laughter and memories and all of the things that time with old friends affords. Saturday was full of celebration. Their youngest child, Colin, turned five and we spent the day swirling in kid-centered fun. The night involved sugar-hyped children and dance games on Wii consoles. Wonderfully trapped in the basement where no one could get into much of anything. Which for us grownups meant clinking wine glasses and adult conversations. It was the very best kind of time.

At some point after a few too many laughs and after the Pinot Grigio had just about worn off, a couple of us wild and crazy kids decided that nothing would better than some Dunkin Donuts coffee for the after party. So my friend Nikki G. (who was one of the only ones who'd passed on the Pinot) agreed to drive and off the two of us went on an 8 PM coffee run. On a Saturday night. Which, okay, now that I think of it, sounds like a very lame and forty-and-up thing to do.

But I digress.

Anyways. Here we are all loquacious and happy like some twenty-somethings who are just leaving the club. LOL-ing and OMG-ing. And full of life and vigor and joy as we danced our way into that empty Dunkin Donuts. And, yes, it was totally empty because, as it turns out, America might run on Dunkin but Dunkin Donuts is not EVEN the hot-spot on a Saturday night. At least in Alexandria, Virginia it isn't.

But for me, it was the place to be because I felt light and free and relaxed. My kids were having a great time with great friends in a safe place around people I trust. And at the very same time, Harry and I were, too. The older you get, the more you appreciate these moments. Yes, you do.

So yeah, Nikki and I bust into the spot all giddy and goofy--her just because and me because I'm out of town/away from work/and okay, perhaps with some remnants of Pinot Grigio--and it was a perfect moment. It truly was. I even had on Zachary's Paul Frank monkey hat which made us laugh even more. And that made it just that much more perfect.

"Dude! Since when do they have plasma TVs up in Dunkin Donuts!" I joked. Still laughing and giddy. With my monkey hat on.

But then, just as Nikki prepared to counter my observation, we look up at that screen and see this:

And just like that we stopped laughing. Both frozen in our tracks, staring at this literally sobering news. Because we both knew that this was one of those "where were you" moments. So we just stood there in silence for a few seconds letting it sink in.

Whitney Houston Dead at 48.

"NO WAY!" I immediately yelled out.

"WHAT!?" Nikki screeched a mere two seconds later.

CNN. That's reputable. Wait, huh? Whitney? Whitney Houston? Our Whitney? Dead? According to CNN?

"NO WAY!"

"WHAT?!"

And then we just paced back and forth, looking at the flatscreen television and repeating those same words over and over again. NO WAY! WHAT?!

Then I turned my shock toward the poor, unsuspecting South Asian man behind the counter. "WHAT HAPPENED TO WHITNEY? WHAT DID THEY SAY HAPPENED TO WHITNEY!?"

And yes. I meant to put it in all caps because I was speaking loudly and was probably being a close-talker to boot. Hearing that Ms. Whitney Houston was no longer alive was disorienting. So much so that I decided that Mr. Dunkin had some kind of hot off the presses information that we hadn't yet learned. I mean, seeing as he is up in there with that flatscreen on CNN all day.

"YO! What they say happened to Whitney?!" I demanded again. And yes, I meant to write "what they say happened" because honestly? This is exactly what I said. I mean, somebody had just said that Whitney Houston had died. This was no time for standard English.

where I was when I heard

So Mr. Dunkin just shrugged in this weird way that looked partly like he had no idea what I was talking about and partly like he was deeply afraid that this was about to be a stick-up. I believe that my interpretation of that shrug is spot on.

So we go from pacing to just standing there with our arms folded shaking our heads. Then we both get tearful for a moment as the same images keep showing over and over and over again.

Whitney is dead. No, wait. Whitney Houston--our Whitney Houston--is dead.

That's when that word popped into my head:

"Stronghold."

So apropos, that word. I thought of Whitney Houston's mother, Sissy. I imagined her daughter, Bobbie Christina. I even thought of Oprah Winfrey applauding her big comeback and punctuating it with a two-part episode in her final season.

Stronghold.

I thought of every single woman who has ever sang a song or wanted to have a big and unforgettable voice and how by definition she had to look up to Whitney Houston. Because regardless of her struggles, her voice was unmatched.

That voice made her very rich and very famous. But despite her talent and fame and fortune, she wasn't immune to that stronghold. And just like Ms. Ashton said that day, it was nothing her family could do. Hell, it was even too big for Oprah Winfrey herself to love her through.

Ms. Ashton spoke a good word that day between passing snacks and wiping noses:

"It's out of your hands. That's the thing about a stronghold. All you can do is love 'em and pray. Getting' mad at 'em don't help nothin'. So you jest love 'em and pray. Other than that it ain't much you can do."

Ain't that the truth.

So today I'm reflecting on Whitney Houston--our Whitney Houston-- and her stronghold. I'm also reflecting on Sissy Houston and Bobbie Christina Brown and every single Sissy and Bobbie who have ever had to stand by helplessly in plain view of their loved one being strangled by some kind of stronghold.

Because the worst part about it is that it's out of your hands.

A lot of us were disappointed in Whitney. I guess we thought that with a voice like that, that she was superhuman and supposed to do more with her legacy. Seeing her erratic behavior was so hurtful yet we still loved her and accepted this version of her. That's the thing about a stronghold.

Yes, we loved her and saw her as a golden girl. We wanted a scapegoat so we even blamed Bobby Brown for a while, but over time it became apparent that she was ill. And even if Bobby sat next to her acting quirky and high on Barbra Walters' show, he still had his own stronghold. And Whitney's belonged to her.

No, I don't know the specifics of Whitney Houston's cause of death. But I have lived long enough and worked at Grady long enough to know that even if it wasn't specifically related to drugs, it still was. We had waved good bye to the old version of her some years ago. That lanky, confident songstress with the poise of an opera singer and had forced ourselves to get used to this new person in her place. That's the thing about a stronghold. It's like watching a slow death. . . . even before someone dies.

I have seen people escape strongholds. Very few--but I still have.

I've seen Ms. Ashton a few more times since that first meeting. Every time those grand babies are in tow. And most of the time, we've moved on and chatted about mundane things as if her lost daughter was just "one of those things" that you know of but tried not to think of. But you quietly promise in your heart to pray about it because the love is the part you can't forget. Even when they're gone.

Kind of like we did with Whitney all those years.

That's the thing about a stronghold. We hold on, too.

***

Now playing on my mental iPod. . . . "Giving Up" by Donny Hathaway. . . .the song that always reminds me of strongholds -- and especially the people loving someone through one. His haunting voice and the musical accompaniment seems like it was recorded for this very moment, I swear. Please. . .please listen to this one,okay? Thanks.

You were loved.

2012-02-11T21:58:00.002-05:00

Whitney Houston (1963 - 2012)

We all want to make a place in this world

We all want our voices to be heard

Everyone wants a chance to be someone

We all have dreams we need to dream

Sweeter than any star you can reach

is when you reach and find

You've found someone

You'll hold the world's most priceless thing

The greatest gift this life can bring

is when you look back and know

You were loved

You were loved by someone

Touched by someone

Held by someone

Meant something to someone

Loved somebody

Touched somebody's heart along the way

You can look back and say. . .

You did okay.

You were loved.

~ Whitney Houston in "You were loved."

***

We don't know exactly what happened. And sure, we can all speculate. But what we do know is that she was loved. I guess that's what makes it so sad.

More later. But for now, may your soul rest in peace, Ms. Whitney.

And now playing on my mental iPod. . . . one of Whitney's most beautiful (yet rarely heard) recordings. . . ."You were loved."

Red light, green light.

2012-02-09T07:04:00.007-05:00

Driving down Ponce de Leon Avenue yesterday. Helped give prospective parent tours at the kids' school that day so had a few open morning hours afterward to run errands.

Red light.

Do we have any bread?
Dang. The classical music is already on on NPR.
I actually like classical music.
I think the "Second Cup" classical music show lady secretly kind of creeps me out.
Yes. That's what it is.
Just how old is that NPR "Second Cup" radio-lady Lois Reitzes anyway?
I need to Wikipedia that.
Is today somebody's birthday?
Wait--was yesterday?
Did I give a check to after school care?
Apples. We need some apples.
Will the kids know the difference if I tell them the Gala apples are Honeycrisp apples?
Damn, why do Honeycrisp apples cost so much? Oh. They taste good.
I wonder what Jay-Z and Beyonce's baby looks like.

Green light.

Turned to a music station. But no music. Just a whole bunch of loud talking. At the moment loud talking is about some photograph of Beyonce and her post-baby body. I need to make sure I Google that. She look good, one personality said. Yeah, now I really believe that she actually had that baby 'cause you can see it all up in her face, was the reply. She lost all that baby weight already? A caller calls in. Naaaah. That's just Spanx and a good girdle.
Yeah. You gotta love those Spanx.

Red light.

The Spanx slimmer-stocking-thingies can easily take five pounds off.
That and five years worth of cellulite off if you're lucky.
Also smooths down a mean mummy tummy.
Eeew. Hate it when someone wears thigh length Spanx and you can see their Spanx-line.
Looks like a sausage being choked by a rubber band. The worst.
*Yawn*
Do we have any milk? I mean 2% milk, not soy.
I wonder if soy products are really bad for you. I know it has estrogen in it. The plant kind.
I wonder what Oprah is up to. I haven't watched OWN in ages.

Green light

Glancing around the front of my car. This thing needs cleaning out. Badly. Finally some music on the radio. Guess who? Beyonce. Singing "Love on Top." Think I am Beyonce'd out for the morning. Turn back to NPR. This time some dude is reading a poem. Love NPR for that. Where else can you hear a random dude reading a random poem on the radio? He probably isn't so random. He may be the "it guy" of radio poetry for all I know. Either way, I like it.

Red light

*Yawn*

Look over to my right. A lady is sitting on the bus stop. She looks to be at least sixty but overall it looks like she's had a hard life. That could mean fifty. Or even forty-something. Something about her draws me in. Her hand. One hand is rhythmically beating, as if to music. I know it isn't supposed to because she keeps pressing it into her torso to make it stop. Side effect from a psychiatric medicine? Uncontrollable.

Beating. Beating. Beating.

Her mouth is moving. I can't hear but she is talking. Definitely talking. And not like me talking in my head but a full on conversation with someone. But no one is there. Yes. Definitely, a psych medicine. Schizophrenia?

Beating. Beating. Beating.

She reaches for her matted hair with that renegade hand. To smooth it perhaps? No. Just to scratch it. Then I see on her wrist. An armband. No, two armbands. From the hospital. Lips protruding and face is sunken in from being pasted over an edentulous mouth.

Beating. Beating. Beating.

Her head swings from side to side. Nervous. Paranoia. That conversation appears to become argumentative. Belligerent. Indignant. But still, no one there but her. And me, sort of. Watching through my window. Big plastic bags at her feet filled with what actually looks like paper. But she keeps on clinging on to it, pulling it in closer with her feet and non-renegade hand like some sort of precious cargo.

Beating. Beating. Beating.

A man passes her and stares. Doesn't even try to hide it. Picks up his pace and hurries away. From this "crazy" lady with the hospital bands on her arm. And she barely notices. She just keeps on yelling at those vacuous people threatening her all day. Waving her beating hand and clutching her plastic bag of nothing-but-everything so that no one takes it away. Alone. With no one there but her. And me, in a way. Watching and wondering and wishing at a red light. If only for a moment.

Green light.

Silence.

***
Happy Thursday.

Now playing on my mental iPod. . . .my favorite Beatle, Mr. George Harrison.

The difference.

2012-02-07T22:39:00.002-05:00

"We are a family
Like a giant tree
Branching out towards the sky

We are a family
And so much more
Than just you and I. . ."

~ Family

My father's sister died in her sleep last night. Her daughter called her several times and didn't get through. Eventually she trusted her instincts and went to her mother's house. Several knocks and one police officer later, my cousin learned why my aunt wasn't answering her calls or the door. She couldn't. She had slipped away.

I wasn't close to my Auntie Liz. My recollections of her are built on childhood shenanigans leading to swats on our behinds and loud clapping hands as cousins all performed at family holiday gatherings. I also remember those same clapping hands on the dance floor on my wedding day. I hold this as a fond memory.

No, I wasn't close to her. But I am close to my father. And my father has lost his only living sister. His baby sister.

There were eleven of them to begin with. Seven boys and four girls. Three brothers and now four sisters have since made their transition. Now there are four. Four boys left, including my father.

Dad sent me a text message when he found out. I'm not sure he was ready to talk so he sent a simple text heavy-laden with sad-face emoticons. Something about that hurt my heart somewhere deep. I called him immediately.

Hearing him caused an ache much greater than those emoticons ever could.

You know? I deal with life and death regularly. I've seen people moments after losing a loved one and have heard them cry out with as much gut-wrenching angst as you can imagine.

But today, I heard my own father quietly weeping into the phone. Sighing and weeping and telling me he was sad. And no matter how much death and life you see on a daily basis, hearing your father weeping is akin to having a ruthless hand clawing straight through your chest. And pulling your heart out.

This is the difference.

***

Ribbons.

2012-02-07T00:00:00.014-05:00

*some names and minor details changed to protect anonymity. . . . yeah, yeah, you know.

"This is not a coincidence.
And far more

than a lucky chance."

~ Stevie Wonder in "A Ribbon in the Sky"

I walked into a room today to see a patient that I'd never seen before. Well, I take that back. Technically, she was like many patients I've seen before-- a middle-aged black woman with some of the most "bread and butter" medical problems you can imagine. Diabetes. Hypertension. High cholesterol. Oh, and "a little extra weight."

That said, even though I had seen all of her problems before, it was true that I had never seen her. And so. Moments before entering her room, I'd quietly listened to this senior resident presenting her case. It was fairly straightforward. A follow up visit for all of those everyday problems, all of which seemed to be under excellent control.

I found her still sitting on top of the examining table where Farrah, her resident doctor, had left her before coming to get me. Her spine was as straight as a ruler and her hands were resting calmly on her lap.

"Good morning," I greeted her. "My name is Dr. Manning and I work with your doctor. We were just putting our heads together a bit about you and I wanted to come and meet you."

"It's a pleasure to make your acquaintance," she quickly replied.

A pleasure to make my acquaintance?

I loved the formality of her voice and the silky quality of it. Despite her nearly seven decades of talking, her vocal cords show no evidence of wear and tear whatsoever. No crackling sounds reminiscent of old 45's spinning under nickel-weighted needles. No gravelly hoarseness or wobbly tremulousness. Just this buttery smooth sound floating from her lips like silky ribbons in the sky. The pleasure was all mine. Already.

She reached her hand out and shook mine firmly. With her perched atop that table, that hand shake brought me directly into her personal space. Neither of us seemed to mind, though.

As I closed my fingers around hers, she erupted into a smile. A big, beautiful smile surrounded by nothing but confluent espresso-colored skin. And that skin was void of even the tiniest signs of aging. Not a single age spot, crinkle, or wrinkle in time to save nine at all.

Surprising that there weren't even any laugh lines considering how wide and easy that smile came on.

"Now that's just not fair. You have, like, NO wrinkles whatsoever!"

Yes. Although I had just met her, this is exactly what I said to her. That handshake welcomed me to say such a thing and that smile reassured me that this would be that kind of interaction. And it was.

"You know, my dear, I have been seeing Dr. Farrah for almost three years now. She has taught me how to eat and take good care of myself. I suppose it shows in my skin." And with that she looked right over at Farrah and beamed. She said those words sincerely, too, and focused on Farrah's young face with eyes so sure that no one dared refute that compliment.

"Well, it certainly does. And yes, Farrah is one of our very best."

"I would agree," she replied in that same liquid-smooth tone. And then she added, "Dr. Z is wonderful and a blessing to me."

A blessing. Ah, yes.

So we chatted a bit more about things fully unrelated to her health, mostly because I was so enthralled by her voice. Next, we moved on to address a concern that she'd been having. She explained that while she wasn't very worried about it, it was important to mention things to her doctor. That is exactly what she did.

So she talked and we listened. Then, based upon what she had told us, Farrah examined her as I stood beside her observing. And since Farrah is a senior resident with exceptional interpersonal and clinical skills this was all I needed to do. I quietly listened as Farrah then negotiated a plan with her patient--one that was inclusive of her patient's thoughts and not just ours.

Farrah escorted the patient off of that exam table and over to the chair beside the desk. At this point, I was beginning to feel like a bit of a third wheel. I prepared to bid this lovely woman adieu.

Taking her hand again, I told her exactly what I was thinking. "It has been a pleasure meeting you. A real pleasure." Because that is what I was thinking. It was truly a pleasure.

She smiled gently. And in that moment I imagined that every time she smiled, some kind of angel was churning that buttery voice in preparation for her next word. "I love Grady," she said. "Grady doctors saved my life so I will always have loyalty to Grady." She said these words while still holding my hand. And I am so glad she didn't let go.

"Wow," I whispered.

"Back then--the first time I came here--I had no insurance. I had been at another hospital and they were nice but sent me here. The Grady doctors carefully looked at my films and then did some biopsies that the other hospital told me I didn't need. That is how they found cancer in me and that was almost twenty years ago. They saved my life."

"Wow." I sounded like a broken record, but that was all I could think to say.

She went on. "I do have insurance now. And I will still keep coming here. I will."

Again that smile. That big, beautiful smile.

"Well, I'm glad because that way I can learn all of your skin secrets!" I teased. We all laughed.

"You know," she spoke with her face growing serious, "really you just need to be kind to people and not hold onto a lot of anger. Anger comes out of you. Makes you ugly and ages you. Just let things go. Grudges, pain, wrongdoings." Farrah and I quickly caught each others' eyes. I could tell she loved the richness and regal quality of her voice, too. "Don't dwell over who did what to you. It will make you older than your years. You must make that decision to not harbor things inside."

And like that same 45 skipping like the nickel fell off the needle, I repeated that same word a few more times. "Wow. Wow. Wow." Because that's what I always say when I hear "a good word."

"Oh, and get your rest. Getting rest is important, too."

I smacked my forehead playfully and said, "Sleep? Uh oh!"

Farrah laughed at my response to that piece of advice and feigned a worried expression. Her upcoming Cardiology fellowship would make this one hard for her to follow, too.

"You know? People need their rest. Like how sometimes your kids don't want to wake up? Sometimes just let the babies sleep." Now she was pointing her finger for emphasis. "Sleep is important. The body needs rest and you have to give in to that. Let them sleep in sometimes. The children. And you, too. Not on a school day, of course. But other days relax a bit. Allow everyone some rest. It keeps you young."

And I just sat there with Farrah taking it all in. The wisdom, the advice, and all of the ribbons in the sky she had to offer us. I held her hand once more because she let me. And then, I excused myself from the room.

"If allowed, may I touch your hand?

And if pleased may I once again?
So that you, too, will understand. . ."

You know? There was nothing unusual about that encounter at all. At all. But for some reason, just writing about it has brought me to tears. I guess it's because getting to do this--to step inside of people's lives if only just for a few moments--is such a tremendous honor. Sigh. . . I know, I know. . . . it sounds so sappy and cliche to say that, but. . .it's true. It's so true. I mean, this was just one moment with one patient. Just one. And I get to do this all the time. Every day.

So I guess that's why I'm feeling so full right now. Because I don't take this lightly. I don't. And you know? Just sitting here at my computer recalling this one little snippet in my morning has pushed those tears straight onto the edges of my lashes.

I read something a close friend wrote and shared with me today. She said:

"Being a doctor and having the opportunity to share in patients' lives is definitely the highpoint of my professional life. . . ."

And she, a former Grady doctor, has said this kind of thing to me many, many times over. . . . marveling at the awesome amount of trust that human beings must put into other human beings for this whole doctoring thing to work. And how important it is for us to stop and think about that sometimes. All the times, actually.

Wow. Wow. Wow.

So maybe I have seen patients who look, at least on paper, a lot like this patient. The diabetes, the high blood pressure, the high cholesterol and those "extra pounds", too. And sure, maybe I have seen black-don't-crack skin before and smiles that melt my heart, too. But whenever I slow down and really savor what is unique about each and every individual--and see that meeting as an opportunity and an honor--it's always like a brand new adventure.

This time? A speaking voice poetic enough to rival Miss Maya Angelou herself. Oh, and a loyalty to Grady built on a testimony that preceded her young doctor and the one supervising her. And especially a song in her heart made up of peaceful notes that floated from between her lips . . . .unexpectedly creating ribbons in the sky of that clinic room.

All before 10 o' clock in the morning.

You know? I'm not sure if this is a coincidence. . . or even if it's far more than a lucky chance. But either way? Man. I'm just glad to be here.

***
Happy Tuesday.

Now playing on my mental iPod. . . . Mr. Stevie Wonder singing "A Ribbon in the Sky."

*sidebar random thought: I wonder if someone reading this is waaaay too young to have any idea what is meant by "a nickel-weighted needle playing a 45?" Like, do people under 30 (other than Jameil-the-old-soul) even know what a 45 is?

Hmmm. . . .

(The nickel or quarter sits on top of the needle as a weight. So it won't skip. Got it, youngsters?)

Lapel Pin.

2012-02-06T15:09:00.000-05:00

Apply this liberally wherever you see fit. I do.

Music makes the people come together.

2012-02-06T07:00:00.001-05:00

"You can dance. . . .for inspiration."

~ Madonna in "Get into the Groove"

Man. I wish someone had been filming me while I was watching the Superbowl Halftime Show last night. Can I please tell you about how absolutely HYPED I was to see Madonna's show? Can I? Well, since you insist. . . . .

I enjoyed every second of it. When searching for a picture, I ran across some very critical comments saying things like "she lip-synched too much" or "she's getting too old to be gallivanting across the stage like that." And to that I say, "What.Ever."

"You can dance. . . .for inspiration."

You sure can, Miss Madonna. You sure can. Oh! The best part of it was that I watched it with my good friends--and our kids. The little ones were playing Legos since some parts were a little mature for them but the older kids were right there rocking out with us. My friend Marra has an 11 year old daughter and the two of us vogued it up and struck poses--together. We were going hard, man! Full on pose-striking. . . the whole shebang. And! She had never even heard of Madonna! This made me love the halftime show even more. Totally.

"Music can be such a revelation. . . ."

Ain't that the truth.

I guess I love a good throwback, you know? A nice homage to certain eras in my life because what it really does is let me know that it's all really one big confluent era, isn't it? And if I can bring an eleven year old into the early nineties with me, then why can't she bring me into 2012 (which is exactly what she did when she explained to me who this group called LMFAO was.)

What is the point of this ramble? Oh. None whatsoever. I'm just excited that Madonna was voguing and strutting her fifty-something all over that stage like the old Madonna. My only regret was that she didn't sing "Get into the Groove!"

Ha.

****
Happy Monday. . .. .off to the clinic to make it a Funday.

Now playing on my mental iPod. . . .

Top Ten: Peace, Love and Souuuuuul!!!

2012-02-04T00:41:00.007-05:00

"Peace, love and souuuuuul!"

As far as weeks go, this was a pretty good one. Work was good, family life (though frazzled) was good, and all of that swirled together made it fair for me give this week a good solid B+.

Why not an A? It's because I was bummed to hear that Don Cornelius from Soul Train took his own life. For that reason, this week could only achieve a high B.

Anyway.

I'm overdue for a top ten, aren't I? Alright. Then here it is.

Top Ten Moments, Thoughts, and/or Random Questions from This Week!

#10 -- Writing with Ant.

This is Antoinette. She is a senior medical student and happens to be the one student I still have remaining from my very first student small group. (She did an additional year to earn the Masters in Public Health along with the M.D.) Anyways, Ant is doing a writing elective with me this month and I can already tell that I am going to get just as much from it as she is!

Essentially, we read books together, we discuss them, and explore the themes and writing styles. But the other thing--the really important part--is that we write. Antoinette is already a gifted writer. So this presents an added challenge for me to push an already bad ass writer to take new risks.

So guess what we did at our last session (or "sesh" as we like to call it)?

I came up with imaginary scenarios. For example: Two men are standing outside of Grady talking trash and sharing a cigarette. One is very old and one is rather young and they aren't related. Despite that they are like old friends.

Then the challenge is to paint that picture with words. Don't tell me, show me.

And that is what we did. We wrote and we shared and then we wrote some more and shared some more. It was good. Really, really good.

#9 -- Legally blind.

Me floating through the halls in clinic on Thursday. Feeling good and girly in one of my favorite dresses with this cute empire waist paired with the happiest canary colored cardigan ever. Looked into an open room and saw one of my F.P.'s waiting on his resident doctor. Couldn't resist slipping into the room and sitting on the edge of the chair for a few moments to talk to him.

"Awww, Mr. James! It's good to see you!"

"Hey Miss Manning! I seent you on TV on Wednesday!"

"Did I do alright?"

"You did real good, Miss Manning! You was breaking it down."

"Thanks, Mr. James!"

*smiling as I stand up to walk out of the door*

"Hey! Miss Manning, I ain't even realize when I saw you on TV that you was with child."

*EErrrrrrrrrrrrrrrrt! EX-squeeeeeze me?*

"WHAT?! Mr. James! I'm not pregnant!"

*starts fluttering his eyes and waving his fingers in the air.*

"Awww, baby you know I got the sugar and my eyes bad! Did you know? I'm legally blind."

*surly glare on my face*

"Mmmmmm hmmmmmm."

Never. Wearing. That. Dress. Again.

#8 -- Hawks Game.

I had the best time the other day! I joined a few members of my first year small group along with a handful of other med students at an Atlanta Hawks basketball game. I was the only attending which instantly makes me either cool or a chaperon. (I prefer cool.) Anyways, we laughed and talked and talked and laughed for the whole game. Actually, a whole lot more than we did actually watch the game. Which was probably a good thing considering how badly we got blown out.

Eek.

Funny part: When they said, "What do y'all want to get into next?"

I said, "Let's all go home and tuck our kids in and kiss them on their heads while they sleep! YEEEAAAAAHHH!"

Okay, maybe chaperon. Ha.

#7 -- That's no way to treat a ladybug!

Dude. What is up with all of these ladybugs in my house right now? They are chillin' in the sunroom. Posted up in the bathroom on a mirror. Lounging in the kitchen. Here, there, everywhere.

One of those girls was on my bathtub and I flicked her in the tub as I was washing it out. She floated right on down the drain.

EPIC FAIL.

Isaiah saw me do it. And let me just tell you: Washing a ladybug down the sink is right up there with littering in the park to that kid. The unthinkable!

He hazed me for no less than 72 hours after that.

#6 -- My first Nutella.

This little creamy potion of chocolatey-nutty goodness. For whatever reason, I had never had it. Tuesday, for the first time I did. With pretzels.

I really enjoyed it until I read the nutritional information. Oh well. It was fun while it lasted.

#5 -- L.L. Cool K.

I realized that I know every single word to L.L. Cool J's "Mama Said Knock You Out" when it came on the other day. Like E-VER-Y word (give or take like one or two) complete with threatening hand gestures and dance moves. I recited the WHOLE thing in Zachary's face (with a couple of minor censors) which he LOVED. Loved do you hear me? He laughed so hard he almost peed his pants.

Then he asked me to do it again. Which I happily did.

Isaiah just stared at me like this: 0_0 and looked embarrassed. Kind of like someone who's mother is wilding out to a 90's rap tune and gyrating around like a hip hop back up dancer.

Hater.

(Why do I know every word you ask? Well, partly because this is a song I work out to often because it hypes me up. I guess I just didn't realize how many words I knew from hearing it on my iPod nano)

#4 -- Pumped up!

Those who have read this blog for a while know of my deep love for the best gym class in the whole world: BODY PUMP. I fell in love with it as a resident in Cleveland at the Downtown Cleveland YMCA. I was super stoked when I found that my local Y had the class here in Atlanta! Woo hoo! So literally, twice per week at 6 AM, I was there with my favorite teacher in my favorite class.

But then Isaiah started "real school." That really cramped my PUMP style, for real. So despite my best efforts, I could no longer make my favorite class with my favorite teacher filled with all of my favorite work-out buddies.

WAAAAAHHH.

But guess WHAT? Y'all!!! My sister JoLai found out that Body Pump was now offering an "at home" version-- and she SENT IT TO ME!!!

YAHOOOOOOOOO!!!!

I am ridiculously sore because I've been over-pumping. For real. Now I'm calming down and about to get normal. I really, reaaly miss my class and my friends in that class. ..but for reals. . . .you have no idea how happy I am about having PUMP in my life again!

#3 -- Girlfriend time

An unexpected opening in my schedule became some wonderful girlfriend time. I texted my friend and fellow Grady doctor, Wendy to see if she could sneak away from her office for some coffee and chit chat and girlfriend time. The stars aligned and since they did, so did we and so did girlfriend time. Which was wonderful and genuine and great. (Even if it was during the middle of the day and without red wine.)

And! We did NOT talk about medicine AT ALL. (Which is an astounding feat for two doctors, especially ones of the Grady variety.)

At Java Jive in Midtown

Oh, did I mention? We met up at this extremely cute place called Java Jive that for reasons that are totally incomprehensible to me, I'd never been to. Totally retro and adorable with this fun server named Ron who assured me that the big ol' buttermilk biscuit I ate there had no calories at all. I will so be back.

#2 -- Feet don't fail me now!

Y'all! I had a coupon to this place called Heavenly Foot Massage and used it today. O.M.G. A one hour foot massage. Foot massage, y'all! Twenty dollars. That's it!

They put me in this comfy chair with all kinds of serene sounds and smells such as lavender, eucalyptus and the like. And then this woman went to town on my feet and calves. I love a good foot massage so for me this was heaven.

Have I ever told y'all how I feel about full body massages? I could do without them. I can never fully relax. I'm always weirded out by having my body rubbed on like that by a stranger. Balancing my checkbook and trying to remember song lyrics in my head instead of imagining a babbling brook or something.

But feet? Now that's different.

Dude. I was KNOCKED OUT up in there. Seeing as it cost only twenty bucks, I had some sweet dreams, too. I WILL be back.

How do y'all feel about massages and such?

#1 -- Almost Famous.

Woot! Woot!

Hey! I was up in Publix supermarket and this little young chick with freckles on her face and a flouncy pony tail walked right up to me. She asked if I was the writer of that "blog about Grady." I said, "Yes, I am."

Dude!

She was so excited! Like I was some kind of celebrity or something. She was a college student with an interest in medicine and she said the sweetest things!

"I feel like I know you and your kids and OH MY GOSH I am in love with the Grady elders! OMG!"

And seriously? She treated me with so much familiarity that I can honestly say that I was both flattered and weirded out.

Ha.

***

Okay. That's all I've got y'all. Happy Saturday!

Always playing on my mental iPod. . . . . best Soul Train performance ever. . . Ms. Re Re with Rock Steady!

Little mama.

2012-02-03T22:16:00.010-05:00

(the Atlanta skyline at sunrise)

I like the sunrise 'cause it brings a new day
I like a new day it brings new hope they say
I like the sunrise blazing in the new sky
Nighttime is weary

and oh so am I

Every evening I wish upon a star
That my brand new bright tomorrow isn't very far
When that heavy blue curtain of night
Is raised up high way out of sight

I like the sunrise so heavenly to see
I like the sunrise and I hope it likes poor me

Here comes the sunrise...

~ Duke Ellington

____________________________

She almost ran me over. Right outside the Grady entrance by Jesse Hill Jr. Drive.

"Sorry, 'scuse me!" she said without even looking my direction. Instead she flipped her shoulder upward to secure the pink padded diaper bag she was holding. Her youthful face was troubled and full of urgency and determination. Too much urgency and trouble in it to be so young if you asked me. But unusually determined, yes. The next words were for the preschooler who, instead of keeping up with her, was studying me.

"Come on, here!"

I playfully raised my eyebrows and wiggled my fingers at the child who, instead of giggling or smiling, recoiled toward her mother. Still, as they passed me by she craned her neck keeping those eyes fixated on me in my long white coat.

Oh yeah, that. I started to announce that I didn't have any shots, but there was no time for all of that. They were clearly on a mission. Headed somewhere fast. Our little exchange didn't even register with mom. She reached out her hand and quickly pulled her in close.

And that was the end of that.

In the other hand was the tiny palm of her other child. Two years old? If that. Gait still wide-based and staggering. Kind of like Fred Sanford on Sanford and Son but cuter and more innocent. His cherubic face had perfectly symmetric features; this was made even more noticeable by the fuzzy trim of his coat hood tightly covering his head. Every few steps he seemed to drag a bit. Feet lifting off of the ground because there was no way he could keep up with her footing with only six to nine months of full-fledged walking under his belt.

Something about the urgency that he was being subjected to at such a young age gave me a pang in my heart. And even though I wanted to help out, for some reason I was like some sort of voyeuristic statue. . .thinking and watching but not moving.

Those little feet bobbed up and down on the sidewalk. Pick him up, I wanted to say. Can I help you out? But my mouth was as cemented as my body.

And then, like some kind of gun was shot in the air at a Triple Crown race, something changed. Things got even more urgent and her fast-paced strut erupted into a run. Or better yet, some kind of discombobulated jog. That overfilled diaper bag now pulled across the length of her torso. Strap lost between ample breasts appearing more so by the ill-fitting brassiere she wore.

"Ma-ma! Ma-ma! Oooooowww!"

That almost two year old maybe was two after all because he had words of protest when her hand grip clamped down like a vice. Cheeks turning red and mouth open and panting, she pulled him right along. At this point his toes now did nothing but graze the concrete.

"Owwwww. . . .hoo. . hooooooo."

Next that pre-kindergartner melted into a pool of tired whimpering. Complete with the little kid noodle legs.

"Ma-meeeeee!"

But wherever she had to go, it was important. Too important to fight against synchronous crying fits or gelatinous legs. She dug in deeper, strengthened her resolve and gritted her teeth. Next her head swung from side to side because she was talking to both of those kids this time. Out came a throaty growl meaning business and nothing less.

"Come-ON!"

Tired toddlers and pre-schoolers don't get this language, though, so it fell on deaf ears. More crying. More whimpering. More noodle legs.

And statue-me still just kept standing there frozen. Watching now from behind; bag now swung all the way around to her back and two small children floating behind her running legs like two human kites.

Where are you going?

Then, from the corner of my eye I saw it as she ran diagonally across the street with kids in tow: The MARTA bus. Just as she came gasping onto the curb it blasted her and her human appendages with tailpipe exhaust. And it pulled away from the bus stop.

Damn.

Like clockwork, she slowed herself down. The first few steps appeared defeated and tired, but not even three steps later they quickly returned to some sort of normal.

Kind of like she was used to losing.

She finally picked the talking two-ish year old up and planted him on her hip. Next she used two saliva-covered fingers to tidy up the hip-baby's face and then, with a second finger lick, the preschooler's. And I kept on watching as that previously uncooperative pre-k kid perched her face skyward and let her. Wincing but still. . . . this time cooperating and allowing her mother to do what was necessary. What was most striking, however, was that she was not reacting the least bit to the fact that instead of winning the bus-catching race they'd just received a big, gray plume of smoke as the booby prize. No tears, no nothing.

Kind of like she was used to losing, too.

And then somebody yelled out. "Hey! Hey little mama!"

A dude with his head out of the window of that bus. Stopped right in between the intersection and waiting. On them.

I stood and secretly cheered inside of my heart as they hustled over toward that bus that they obviously needed to make. My frozen body began melting and my feet shoved off toward wherever I had initially meant to go. But not before casting one more glance.

And thank goodness I did. . .for in that moment I caught it--a glimpse of the side of her young face and the spit-shined faces of her babies, too. Smiling, finally. All three of them.

As that bus disappeared down the block with them in it, I wanted to run behind it to yell through the window just like that dude had a few moments before.

"Hey! Hey little mama! Sometimes you win, okay?"

Yeah. Sometimes you win.

***
Happy Friday.

Now playing on my mental iPod. . . . Amel Larrieux singing a beautiful, haunting (and non-embeddable) version of Duke Ellington's "I Like the Sunrise." It makes me cry. This is one that I'd recommend you take a moment to hear--really. Then tell me you've heard something lovelier today so I can tell you you're lying.

. . .oh, and also. . . . the lovely Ms. Larrieux singing with Sade's band Sweetback on "Baby, You Will Rise" (with lyrics equally apropros.)

Spirits and Groundhog Day.

2012-02-02T00:00:00.005-05:00

*names, deets, all that changed to protect anonymity. . . you know what's up.

"Do you ever have déjà vu?"

"I don't know. . .but I could check with the kitchen!"

~ from the movie Groundhog Day

_____________________________

It had been a long week on the wards. One of those weeks where you round and round on the same people over and over and nothing seems to change. Your medications don't seem to be working, your interventions don't seem to be helping, and your consultants don't have much to add. Yeah. One of those weeks.

The kind of week that just might drive a person to drink. That is, if spirits are their thing.

Anyways, the worst part of that week was that it always seemed to start and end in the same place--the 5B stepdown unit. This floor was dedicated to those patients who were too sick to be on the regular medical floor yet not quite sick enough for the one-to-one nursing required by the intensive care unit. I had two patients on 5B that week and they were both right on the tippy-tip edge of being just sick enough to be in an ICU. But not quite.

This is what made that week suck.

I love the nurses on 5B, so it wasn't them. I even had love for my two patients that were on that floor. But what I didn't love so much was their ruthless medical problems both of which were alcohol-related.

And these two patients weren't just sick. They were sick-sick. But despite all that, these problems were the kind that, more than anything, were treated with supportive care and watchful waiting. Which after about four days without any improvement whatsoever was getting kind of old.

Oh woe is me, right?

I know. I shouldn't have been complaining about the situation considering I'm the one who signed up to be a Grady doctor, right? But the thing is--the honest to goodness truth--is that this had nothing to do with why they had been hospitalized. No, it wasn't the self-inflicted liquor-thing at all. It's just that. . . .I like seeing people get better. I like seeing them ambulating through the hallways and getting well enough to start complaining about the food. I like when they get to the point of fussing about the poor choices of television channels and leaning over the nurses' station like it's some sort of neighborhood bar.

But these two? They wouldn't budge. No matter what I did.

So every morning, I walked onto the 5B corridor and stopped at Mr. Paxton's room first. He had been admitted for alcoholic hepatitis complicated by alcohol withdrawal. He was mostly somnolent; eyes hidden behind puffy eyelids. In the fleeting moments that his eyes did crack open, the goldenrod hue that had replaced the whites of his eyes revealed the most startling jaundice that I'd ever seen.

Mr. Paxton had decided to stop drinking -- cold turkey. Bad idea considering he'd been drinking for his entire adulthood. Man. That body of his rebelled like nobody's business with seizures, agitation, vomiting and terrifying hallucinations. His blood pressure shot clear up to where they land the Grady helicopters and then his liver went berserk. Totally berserk.

All of this bought him one day in the Grady ICU but once he was stabilized, he came down to 5B . . . and subsequently my team. Great.

His wife looked tired. I remember how thin and haggard she appeared each day at the bedside and almost every time I secretly wondered if she was just worried or if she, too, had a thing for spirits. I never quite teased out which it was.

Anywho. The day Mr. Paxton came to us was punctuated by the arrival of another man who would eventually become his 5B neighbor--Mr. DiMarco. Like Mr. P, Mr. D had a long, strong history of throwing back stiff ones. He also had a doting wife who consistently sat perched by the bed or who could be found quietly ringing her hands in the family waiting area.

Mr. DiMarco was a lot older than Mr. Paxton. He probably had him by a good twenty years or so, and in those years he'd become set in his ways. Despite a weakened heart from alcoholic cardiomyopathy, he was still unapologetic about his daily drinking.

"Old habits die hard," he said to our team the day we'd met him in the Emergency Department. On second thought he sort of puffed those words because he was so short of breath from his decompensated heart failure.

I remember grabbing Mr. D's wrist while we were talking and feeling his speedy pulse. It was going well over 100 and was what most would describe as "irregularly irregular" -- a term reserved for the erratic rate noted in a type of heart dysrhythmia called atrial fibrillation. Though common in several other conditions, both chronic and binge alcohol drinkers tend to be at risk for this. The problem with atrial fibrillation (or "a fib" as we affectionately call it) is that the blood begins to sludge inside the ventricles from all that catty-wompus beating--which ultimately puts the person at risk for a stroke.

Mr. DiMarco's love for the spirits hadn't made taking medicines--like the ones designed to control his heart rate or the ones for thinning out his blood to avoid blood-sludge--much of a priority. And so. That galloping heart rate in an already pooped out heart made things worse. So we jumped on him full guns blazing--and seemed to be gaining headway after a few hours. That is until someone called us to ask:

"Was he weak on his left side before?"

Shit.

So yeah. Mr. DiMarco with his weak heart muscle and fast heartbeat now had a stroke to boot. Oh, and did I mention? He was a daily drinker so we could count on his body to start withdrawing just like Mr. Paxton's in five, four, three, two. . . .

*beep, beep, beeeeeeep*

Sigh.

So here is the part where medicine gets real. Extremely real. Where all that novelty starts wearing off and reality starts doing more than just kicking in. It starts kicking your behind.

Oh, and these were just two of the eighteen people we were caring for. Um, yeah.

So every day, I'd come and round in the morning on 5B with my team starting with Mr. Paxton. I'd hear what the intern and resident thought and listen to the update on the labs. Then I'd walk in the room with the team in tow and carefully examine him.

First, I'd say hello. No response. Next, a knuckle in the sternum to see if he'd respond. Nada. Unless you count a flash of fluorescent yellow eye-white as a response.

I'd feel his belly and listen to his heart and look for signs of seizure activity. Nothing.

We'd wrap up the plan and head over to Mr. DiMarco's room two doors down.

*ssshhhh, sssshhhh, sssshhhh, ssssshhhh, sssssshhhhh, ssshhhhh*

The sound of every person pushing their hand under the hand sanitizer dispenser followed by a synchronous sound of hands rubbing together that I can't quite describe. Just like before, the first thing would be a greeting. If his wife was there, it would be to her first. And then to him.

"Hey there, Mr. DiMarco!"

*heavy breathing in response*

With the team forming a semi-circle at the foot of the bed, I'd examine him, too. . .periodically glancing up to ask my resident if the Neurology team had any new recommendations for us beyond their initial interventions.

Nope.

So seriously? That week was starting to feel exactly like that movie Ground Hog Day. You know -- the movie where Bill Murray wakes up over and over the same thing keeps happening no matter what. So this was what it was like. No matter what we did each day, nothing changed. At all.

And all because of spirits. Whiskey and bourbon and gin and beer. And sometimes grain.

Spirits.

I would end my day on 5B as well. Hoping that somebody would surprise me by asking me to get them a Co-cola or to even rub some salve on their foot. Something. Anything. But every single day the same thing. Nothing.

On the seventh day, I couldn't take it. The late afternoon sun was beaming through the windows and casting a glare on the electronic medical record. Labs--unchanged. Clinical findings--stagnant. With both patients. After seven days.

Great.

I got up from the nurses' station and slid my coat on. One of my favorite nurses, Ms. Johnson, looked over at me and caught my shoulders curling downward. Next I let out a big, exaggerated sigh and she tenderly said to me, "It's gon' get better, Dr. Manning."

And I looked over at her and then just closed my eyes and sighed again. Because I wasn't sure. Was it going to get better? I mean, yes, technically my week would but would these patients? Would they? The jury was still out on that. On second thought, the jury was about to come to an agreement and I wasn't exactly excited about their decision.

"You know, Ms. Johnson? I don't know what else to do. I'm serious. These two patients just aren't getting any better."

"Well. . .they're not getting worse, Dr. Manning. That's one way to look at it."

"That's not good enough for me. I need them to get better."

Ms. Johnson furrowed her brow and looked over at me as she opened up the tube filled with medications she'd been awaiting from the pharmacy. She shrugged her ample shoulders and raised her eyebrows. "You know what, doc? Sometimes it ain't in your hands."

But this wasn't what I wanted to hear. I wanted my patients to get better. I wanted my hard work and all my fretting and reading and worrying to pay off. So this? This wasn't what I wanted to hear.

"So how do we do this, Ms. Johnson?" I plunked back down on the seat with my coat on and lay my head into the crook of my arm.

"We just think and try and give our best. But at some point you realize it's something bigger involved in all of it, you know?"

I whipped my head up and stared at Ms. Johnson intently. "Well, this might be one of those times because I'm all spent." I gave a sideways smile and released the world's most anemic chuckle. I hate to admit it, but I was spent. I felt worn out and out of gas.

"Maybe, Dr. Manning. Maybe." Ms. Johnson stood still; studying me with her wise eyes framed with graying brows matching the crown of silvery curls on her head.

This was feeling heavy. Heavier than I wanted so I tried to lighten things up. I playfully lifted my hands in the air, "Alright, Jesus! I need a consult! An intervention! A somethin'! Come on and help a sista out!"

And Ms. Johnson and I both laughed out loud which lightened things up indeed.

"You want me to put that in the computer?" Ms. Johnson teased as she headed off to administer her medications. I gave her a playful wink, threw my bag on my shoulder and waved goodbye.

"See you later, Ms. Johnson."

Yeah. See you on Ground Hog Day.

The following morning, my resident was in clinic. I'd arrived earlier than normal and decided to sneak by 5B before making work rounds with the interns. The floor was quieter than normal. I attributed this to being the seven o' clock hour unlike our normally later rounding time. I couldn't decide if it was peaceful or eerie. Regardless of which it was, I followed my standard Ground Hog Day ritual. First, I stopped at Mr. Paxton's room.

Hmmm.

Bed one had a lady in it that I didn't recognize. I strolled over to bed two -- his bed-- and froze. Empty.

No, no, no! It can't be!

Recognizing that alcohol withdrawal and alcoholic hepatitis can both be life threatening, I had to know that having them both at the same time could not portend the best of prognoses. But damn. I wasn't expecting Mr. Paxton to be gone. I realized how right Ms. Johnson was when she'd tried to encourage me by saying, "At least your patients aren't getting worse."

Well this was about as "worse" as it could get.

I dreaded getting the details. And even more, my heart began to sink as I imagined looking Mrs. Paxton in her tired eyes. I dragged my feet over to the nurses' station and found a clerk sitting behind a computer.

"What happened to Mr. Paxton?"

The clerk seemed find my anxiety a bit off-putting and didn't hide it one bit. "He's in room 52 now. He got moved," she said nonchalantly. My face washed over with relief and I let out an audible pheew!

I turned toward 52 and paused. Well, this was convenient. He was now in the same room as Mr. DiMarco. Mr. Paxton in bed one and Mr. DiMarco in bed two. Imagine that.

I stuck my hand under the foam dispenser and approached Mr. Paxton's bed while rubbing my hands together. My mouth was already fixed and ready to ask my daily rhetorical question and it came out before I could even take in what he looked like.

"How you doing today, Mr. Paxton?"

And do you know Mr. P was leaned over the tray table circling his choices on the food menu? He glanced right up at me with those canary eyes and replied, "I'm good 'cept for y'all ain't got nothin' for me to eat. What's the RE-NAL DIET? I don't wont this. Or the no salt."

Seriously? I almost leaped on that bed and patted his face. I wanted to squeal with delight but instead kept it cool. "Mr. Paxton, you're talking! I'm so happy to hear you talking!"

And the whole time I examined him, he bitched about that diet and I swear it was music to my ears.

"I'm 'on have my wife brang me some real food up here today. She on her way."

"She is? That's great!"

Mr. P acted like he hadn't been knocked out for seven days and looked at me like I was crazy. "Seem like every channel y'all got is Jerry Spranger or a damn judge show!" he went on.

And that? That really made me want to waltz around his room with him.

Finally, I stepped out of the room to reapply the hand sanitizer before going to Mr. DiMarco's bed. "Well at least somebody has turned a corner," I mumbled to myself while extending my arm. Just as my hand went below the dispenser, I froze in my tracks. . . .recalling the last few words exchanged between Ms. Johnson and me the night before. I could hear her voice like she was right there:

"We just think and try and give our best. But at some point you realize it's something bigger involved in all of it, you know?"

I nervously pushed the dispenser over and over allowing way to much foam to go into my hand. For some reason, my pulse was quickening and I didn't know why.

What if. . . .? No.

When I stepped around the curtain, the first person I saw was Mrs. DiMarco. Her hand was wobbling and she was carefully scooting a cup of water with a straw in it up to husband's lips. The hairs on my neck began to stand at ninety degrees.

"Good morning, Mr. and Mrs. DiMarco," I spoke quietly.

Mrs. DiMarco looked over at me and smiled sweetly. "Oh hello, doctor," she said with a Kathyrn Hepburn-esque tremor in her voice. Her lips quivered gently as she shifted that smile back to Mr. DiMarco. From the corner of my eye I saw his left hand and arm moving toward the cup.

No. Way.

"He's moving the left side now?" I asked incredulously.

"Yes. It started late last night," Mrs. D responded while still focused on her husband.

"Wow." I couldn't hide my amazement at his improvement.

"Well," she spoke in her bumpy voice, "the Neu-rologists did say that we could start seeing some improvement and that it was just hard to say with all the rum fits and all."

The spirits. That's right.

By my second visit to 5B late that afternoon, those two guys were in there talking crap about the food and the television together. It was unbelievable.

Why they were put in the same room, I have yet to find a solid explanation for it. At least, not one that makes clinical sense. And I promise you--as sure as my name is Kimberly Manning -- this series of events is a true story. Hand over heart.

Okay, honestly? Y'all know I'm a person of faith. I've always been transparent about that among other things when writing here. But this? This shook me to my core. It really did.

"We just think and try and give our best. But at some point you realize it's something bigger involved in all of it, you know?"

You know? I think Ms. Johnson was right. There has to be something bigger involved in all of it. The human body and healing it is way too complex for it to be just explained by what's in our books. Regardless of what you believe or don't believe or are undecided about how you feel on what that "something bigger" just might be. . . . there are just some things that do not make clinical sense. Changes in patient outcomes that seem to happen almost independently of the things we are doing. Sometimes for the worse. And other times for the miraculous better.

Kind of like this.

No. I'm not saying that what we do medically isn't extremely important. But I am saying that I recognize that I am just a piece in a puzzle. A puzzle that is far more complex than even I understand. And that? That week on 5B? That was about more than just me, man.

At least that's what I believe.

So, this year on Groundhog Day, I guess I'm reflecting on that week on 5B. A week made unforgettable by sick-sick patients and spirits . . . . of one kind or another.

***
Happy Groundhog Day.

The Inquisition.

2012-01-30T07:06:00.001-05:00

Isaiah: "Mom, what is 'gay'?"

Me: "Gay?"

Isaiah: "'Gay.' What's that?"

Me: "Gay? Uhh. . .it means that you're happy."

Isaiah: "No, the other meaning."

Me: "Of gay?"

Isaiah: "Yes, mom. I heard this boy say that the way somebody was jumproping was 'so gay'. The other boy that was jumping got really, really mad. Like really almost crying mad."

Me: "Was he trying to be mean to him?"

Isaiah: "I think so, Mom."

Me: "Sounds like he was. Is he a friend of yours?"

Isaiah: "Who?"

Me: "The boy who was being mean. Or the boy who was jumping rope."

Isaiah: "No. They were both older. Like maybe fourth grade. I know them, though. I was just there because we were out there playing."

Me: "Oh.

Isaiah: "So is that a bad word? 'Gay'?"

Me: "When used like that it is. It's a very mean word when used that way."

Isaiah: "Mom, that boy says 'stupid' a lot, too. And I think I even heard him one time saying a real bad word. One of the real ones that grown-ups use, not like stupid."

Me: *coughing* "I don't want you to ever call somebody 'gay' like that or say what someone is doing is 'gay.' That's not cool. At all."

Isaiah: "I didn't think so, Mom. It sounded mean how he said it. Why is it a bad word?"

Me: "It's not always a bad word. But explaining what it means is kind of a mature thing to try to get you to understand. You know like how I say some shows on TV are mature?"

Isaiah: "Yes. Like 'The Family Guy' even though it's a cartoon."

Me: "Exactly. Like that. So when you get older I can explain why that word when used like that might hurt somebody's feelings. For now, just don't say it."

Isaiah: "Okay, Mom."

Me: "I'm glad you told me, though."

Isaiah: "Mom?"

Me: "Yep."

Isaiah: "Can you take us to Target today to buy us a new toy with our allowance?"

Me: "No, dude. We just went. Remember?"

Isaiah: "'Dude' seems like a bad word when you say it."

Me: "Well, it's not."

Isaiah: "You always say it when you say 'no' or you want us to hurry up or get out of your face."

Me: "Oh yeah? Alright, dude. Go ahead play and let Mommy finish reading her magazine."

Ha.

***

Happy Monday.

Random Rambling: Twelve steps.

2012-01-28T22:15:00.009-05:00

Here's how I thought it would all work:

You fall in love (while you are still rather young-ish), get married, and love each other forever.
You (effortlessly) conceive and have a baby.
You (perfectly) love and parent the baby.
You (unfailingly) read to the baby.
The baby grows into a (wonderful) child.
The child goes to (the best) school.
The child is gifted (of course).
The child excels at nearly everything he or she tries.
The child gets into (all of) the colleges of his or her choice and/or gets all of the opportunities of his or her choice. You and your perfect spouse are still there to enjoy it.
The child graduates (on time) from the college of his or her choice (plus or minus an advanced or terminal degree of his or her choice.)You and super-spouse are over the moon.
The child (immediately) becomes a gainfully and irrevocably employed grown-up in the field of his or her choice. You and super-spouse have bought a vacation house over the moon.
The gainfully employed grown-up child subsequently meets someone and falls in love. You and super-spouse prepare to be super-grandparents.*

*(Because that child has now returned to step one.)

Here is what I am learning:

It doesn't usually work that way.

I am reflecting right now on these twelve imaginary steps. Twelve steps that don't ever seem to fall into this perfect little order that we imagine. Nope, not at all.

When I look at this list--one through twelve--I realize that virtually no person sails through this list without a hitch. No, not one. I'm also recognizing that depending upon where we are in our lives, we worry about different parts of this list.

Or. We mature enough to scrap it altogether and enjoy the lives we have and to find what is perfect in them.

Yeah.

When I first moved to Atlanta, man. . . all I ever thought about was step one. Worried about it. Prayed about it. Talked about it. Fretted about it. Well, actually. . . . I worried mostly about the step before step one--meeting someone.

Eventually I met Harry so I was on to worrying about other things. Just like my friends were.

Anyways. Today I'm looking at my own little world and thinking about the hiccups I've had on that twelve step list. And let me be clear--as far as my life goes, these are not major hiccups. They are things that, in the grand scheme of things, aren't earth shattering really . . . . .but matter. At least to me.

Like, for example. My son, Isaiah, talked non-stop from the day he turned one. His memory is like a steel trap and his soul could rival that of any Grady elder. He is wonderful and insightful and smart and everything else you can think of. So naturally I figured he'd take all of this wonderful and insightful and smartful into the classroom when he started school. But you know? School has not been a cake walk for him. It hasn't been horrible. But it hasn't been a cakewalk either. And that? That caught me off guard. Damn, it did.

It was supposed to be so simple. He'd show up and simply blow their minds--just as he'd blown ours. But you know? School and kids and learning can be complicated. More complicated than I had given it credit for. And no, my child is not doing horribly in school or anything like that. But it isn't what I expected. It isn't what I recall from my days as a student in elementary school. No, it is not. Oh yeah. And he also isn't me.

See? That's what's stressful about that list. It's all about expectations and how you think things are supposed to go. You get all bent out of shape when it takes a turn somewhere in Albuquerque. At least I did.

That's why you need people who care around you.

This year Isaiah has a teacher who, instead of focusing on whether or not he is gifted, has chosen to focus on the fact that he is a gift. And not just him. Every child in that class. And it is amazing. Really, really amazing. She has helped me to stop and remember that my child is a gift. And I thought I was someone who would never need to be reminded of that. But school is different. She, through her caring, has helped me to remember:

Forget whether or not he is gifted. He's a gift, remember?

It kind of reminds me of when I struggled to breast feed Isaiah right after he was born. Oh, how much I cried and cried when it wasn't working! It finally took our pediatrician to remind me that I needed to stop trying to follow some perfect to-do list and just enjoy my baby.

Oh yeah. My baby. Enjoy him.

But anyways. I guess Isaiah's wonderful teacher has helped me to do the same thing. Enjoy my baby. And see the things that those twelve steps make me forget sometimes. And all this caring is happening in a public school, no less. Yes! Man, I could go on and on about her. . . . but I won't because it might lead to the ugly cry. Or worse her reading this and having the ugly cry.

Ha.

You know what else? The point of maximal fretting on that twelve step list of expectations totally depends upon where you are in your life. It really does.

Like. . . . I have several friends with relationships that are unraveling. Some quietly unraveling like one loose piece of yarn in a crocheted afghan that gets tugged on softly until nothing remains but a large pile. Others unraveling suddenly. . .so suddenly that everyone around them is dizzy from it.

See? Failed again by that list of steps and weeping into the crook of an arm because it didn't happen as planned. As we planned.

But does life ever really happen exactly as we planned? Does it?

Someone wants to fall in love. Someone is in love but wants to be married. Someone is married but is in a different city than their spouse. Someone wants their child to go to college. Someone wants their kids to graduate from college. Someone is upset that their college graduate child isn't gainfully employed. Someone wants their gainfully employed married college graduate child to have a baby already.

See?

It never stops. Someone wants to have a baby and can't. Or they did have a baby and that baby has health problems. Or they had a perfectly healthy baby but really want another baby. Or they finally got all their babies but now their marriage is unraveling. Or something else altogether.

But always something. Something to groan about. Some step on that pesky list to get you all hung up.

And I'm not saying that this list of expectations is all-inclusive. I'm also not saying that college is on everyone's radar or that every person reading this actually gives a hoot about every single one of these steps. But I am saying that somehow some version of this list has become the circle of life for a whole lot of people.

Even the really, really blessed ones like me.

So today, I say we all just scrap that list altogether. I say we wake up and give our best. That we strive for great futures for ourselves and our children but all the while. . . we stop and smell as many roses as we can along the way. And surround ourselves with people who care.

Because all of it is really a gift. . . .a perfect gift.

Oh yeah. My baby. Enjoy him.

Oh yeah. My life. Enjoy it.

Got it.

***
Happy Saturday.

First comes love.

2012-01-25T23:50:00.015-05:00

"I'm you

You are me

and we are you. . ."

~ Maxwell

______________________

I saw this young couple in the residents' clinic several months ago. Super young--like not even twenty years old. And it was a rather odd visit to have in an Internal Medicine clinic at a public hospital. This couple was here together because even though they hadn't been using any birth control methods for several months . . . . they hadn't yet conceived.

"So we just came to get checked out." That's what the young woman said as she looked over at her partner.

"Checked out?" I asked.

"Yeah, ma'am," he quickly answered. "Like to make sure we can have a baby."

And I looked at this teenage couple and coached myself not to have a judging facial expression. I hoped my face didn't show my thoughts.

Which included:

Say WHAT? What the hell are y'all thinking? A baby? A BABY!

But they sat there patiently--her in the chair next to the desk and him rolling around on the wheeled stool. Faces as innocent as little cherubs and eyes twinkling-twinkling like little stars.

Even though they were young, I liked how genuinely and lovingly they looked at one another.

"Do you mind me asking how old you all are?"

"Both of us nineteen," she replied. She scoldingly cut her eyes at him and he abruptly stopped rolling back and forth on the chair.

I cleared my throat. "Are you . . .like trying to get pregnant?"

"Yes, ma'am. We're the last ones in our family. Everybody be asking what we waiting for." When he said that, he looked at her and laughed.

And honestly? This sounded completely crazy to me. Two nineteen year-olds who'd been trying to conceive since age eighteen sitting in our clinic asking to have thyroids checked and sperms counted up to see what was keeping a bun from going into their oven.

Wait, huh?

"Ma'am, do you think we gon' be here more than another hour? I got to go to work and need to know if I should call my job," he said.

His face was so boyish and the way he kept twirling from side to side on that chair made him look even younger. I couldn't imagine what kind of work he was doing.

"What kind of work do you do?" I queried.

He then told me of his job working in a storage warehouse. Good money. A very solid, substantially-more-than-minimum hourly wage. And health benefits even.

"Including dental," he added proudly.

And her? She was finishing up cosmetology school.

"It's going real good," she shared before launching into telling me about the upscale salon where she hoped to get a job.

"Yeah, she always been great with hair. She do everybody hair already so I'm glad she in school for it." He was quick to support her. It was endearing.

"That's great," I responded. Because that was great.

Great yes. Even though in my head I still thought the whole idea of two nineteen year-olds intentionally trying to get pregnant was a little off putting. And even more, I found the thought of those same two nineteen year-olds getting sweated by their respective families because they hadn't had a baby yet rather . . . crazy-ish.

That said, we ran a few simple tests on them both. Each received a full physical exam and everything checked out okay. After referring them to the family planning clinic, I bid them adieu and wished them well.

And by well I meant growing older and maturing some more before conceiving a human.

Anyways.

The other day I was standing next to the clinic elevators and who did I see? Them. Side by side still and looking at each other just as lovingly as they had before. I glanced down at her unbuttoned coat and noticed an increasing abdominal girth poking out of the opening.

"Pregnant!" I said out loud when I saw them.

They immediately remembered me. He spoke first. "Yeah, ma'am. We just kept tryin' and we finally got pregnant!"

I love it when men refer to pregnancies as a "we" phenomenon. And you know? They were a "we." A nineteen and a half year-old we. But a "we" all the same.

I looked at their hands and their laced together fingers. Next I noticed the cursive name on his uniform. Just coming from or going to work again I supposed.

"You all having a boy?" I asked.

"Naw, it's a girl! We just fount out!" she squealed. "But everybody guessed it's a boy!"

They looked at each other again and smiled.

"She gon' be so spoiled," he said with a shake of his head. "I know it already." He glanced over at her again with her petite body with it's new miniature beachball in front. Beyond that, she didn't look pregnant at all.

"You know why they keep guessing boy, right? It's because you look so good." I figured I'd throw in my mother-wit as I mindlessly pushed the "down" elevator button repeatedly.

"Oh yeah," he chimed in, "'cause them girls rob you of your beauty right? Tha's what they say? Ha ha!"

"That's what they say." I giggled at that old adage.

"Well, not her. She been pretty since the day we start going together."

Going together. Wow.

"How long has that been?"

They both knitted their brows in tandem thinking. "Middle school," she finally answered. "Or a little before that."

We stepped onto the elevator and I watched them. He carried her purse and held up his arm for support even though she wasn't that big or tired appearing. It was just the gentlemanly thing to do for the lady you love.

And it was obvious that there was love there. Love between that young couple for sure. And no, they weren't married and yes, nineteen is hella-young if you ask me. . .

But.

Nobody asked me. And even if they did. . . . who am I to judge their readiness to start a family? A tax payer you say? Was this your initial thought?

Hmmm.

Funny that my initial thought was negative. . . . or rather, it's actually not funny at all. The truth? Here I was imagining for them some life tethered to government support and generational poverty and ignorance. All because they wanted a baby at nineteen. Or was that all?

Hmmm.

Look. I sure as hell wasn't looking to have or feeling ready for a baby at nineteen. But that doesn't mean they aren't. Or that someone else isn't.

What if this hadn't been at Grady? What if this was some young ivory-faced nineteen year-old couple with tiny crosses around their necks and vermeil bands on their ring fingers?

Hmmm.

I waved good bye to them and congratulated them once more on the pregnancy. As I watched them walk away, I froze for a moment.

Wait.

Had I passed judgment on them for being young, black and working poor? Had I sized them up and assigned them a life and a future that, in all actuality, I had no idea about at all? Had I?

Damn.

All that they had shown me up until that point was youth, yes. . . .but more than that, just love and devotion. The same things we had when we were expecting our first baby. Harry taking off of work and holding my coat and my arm at those prenatal visits just like them. And just like our first baby and the one that came after. . . .the main thing their little daughter would have in common with Isaiah and Zachary was that she was wanted. . .and conceived in love.

Young love, no less, but love all the same. I had no grounds for thinking anything else.

As they disappeared from my sight, this word popped into my head:

prejudice [prej-uh-dis]: an unfavorable opinion or feeling formed beforehand or without knowledge, thought, or reason.

I stopped at the glass door and caught my reflection. . . . .

I told that woman in the mirror, Careful, profesora. . . . Be careful.

***

Happy Wednesday.

Now playing on my mental iPod. . . . .Maxwell singing "I'm you."

It's just an ordinary day.

2012-01-24T09:26:00.004-05:00

*names and details changed to protect anonymity

(added hair courtesy of Parissa's ponytail.)

The more that I learn, the less that I know.
Never thought I would want to slow down.
Just focus on clouds in blue skies,
Above all the rain, the sun shines.
It's just an ordinary day. . .

I'm much to strange for this ordinary world.

~ from the television show "Smallville"

Short coiff = blasphemy or illness according to Grady elders

_________________________________

In the Resident's Clinic yesterday:

Resident: "Hey Dr. Manning. . . Mr. Purifoy is here and told me to make sure you saw him before he left. He was asking about you."

Me: "Oh yay! Love Mr. Purifoy!"

Resident: "Yeah, he's a pretty awesome guy. He's in room 46, okay?"

Me: "Gotcha. Thanks!"

Two minutes later in room 46

Me: *knocking on door and peering head inside of the room* "Hey there Mr. Purifoy!

Grady elder: "Hey sugar! I was jest askin' 'bout you!"

*gives me the hairy eyeball*

Me: "What's wrong, Mr. P?"

Grady elder: *sucks teeth* "You cut your hair some more?"

Me: *rubbing my head* "Uhhh, probably. I cut it every chance I get."

Grady elder: "But whhhyyyyy? Why you do that?"

Me: *chuckling* "Awww, Mr. Purifoy! Why you busting on my hair today?"

Grady elder: *squinting eyes* "And it look like it got grey since I seent you last! You meant to do that? Cut it and grey it? Maybe tha's my cataracts actin' up!"

Me: *cracking up laughing*

Grady elder: *now looking serious* "I'm not laughing, Miss Manning. I'm for real. Why you keep on cutting off your hair, sugar? Why you do that?"

Me: *taking zero offense considering this comes up often with me and the Grady elders* "Ha ha. . . . you never have been a fan of this short hair have you Mr. Purifoy?"

Grady elder: "I jest always think a lady look so niiiice when she got her hair long on her shoulders.. . .'specially when it look all silky. I bet if you stopped cuttin' on yours it'd grow clear down your back."

Me: *shudder* "Eek."

Grady elder: "Bet it sho' would."

Me: "Actually, Mr. P., I can assure you that this is true."

Grady elder: "What? Then yo' hair does grow? Then why you cut it all off? What would make you do such a thing, Miss Manning? What your mama say when she saw that?"

Me: *laughing still* "I don't know what to answer first, Mr. P!"

Grady elder: "Like what was the whole thang goin' through your head when you set down someplace and told somebody to cut all your hair off your head like that?"

Me: "Uhhhh. . . .well, let's see. I was thinking, 'This might be real cute.'"

Grady elder: *nose wrinkled*

Me: "Dang, that's cold, Mr. P."

Grady elder: "And you such a pretty little thang, too."

Me: "Guess what, Mr. Purifoy? You won't believe this but my husband loves my hair short. I grew it to my chin after my last baby and he liked to have passed out when I cut it back off! He was so happy!"

Grady elder: "Happy?"

Me: "Happy."

Grady elder: *snort*

Me: *snort back*

Grady elder: "What he said about them grey hairs popping up in front?"

Me: "It was his idea for me to stop fighting it. We call it 'The Anderson Cooper Look'."

Grady elder: "The who?"

Me: "Never mind. Hey! Your blood pressure and blood sugar look really good today! Your resident doctor just showed me your numbers."

Grady elder: "Yeah, that new pill she gave me helped a lot."

Me: "Good! Have you thought more about the cigarettes?"

Grady elder: "Naaaaaw, don't even start either, hear? Hey! You know that girl. . what her name. . . BE-yawn-say?"

Me: "Beyonce? Do I know her? Uhh, no. Do I know OF her? Uhhh, yeah. She just had a baby, you know?"

Grady elder: "A who? Oh, well my granddaughter say she take them hair weaves to make her hair so long like that. So you know, if you wont that kind of hair you can jest pay for it you know."

Me: *laughing out loud* "Now you're trying to get me a weave, Mr. Purifoy?"

Grady elder: "It's jest that I don't know about all these pretty women with these little boy hair cuts." *shakes head* "When I was coming up the only folks with hair like that was sick."

Me: "Sick? W-ow."

Grady elder: *looks apologetic* "I was just suggesting it in case you wonted a change or something."

Me: "I know, Mr. P. I'll keep it in mind, okay?"

Grady elder: "Alright then, sugar."

Me: *smiling*

Grady elder: "And I'm workin' on them cigarettes, hear? It's jest been more than fifty years so it's hard, baby. But I'mon try."

Me: "Good, Mr. P." *squeezing his hand for a moment* "Okay then, sir. . . Let me go ahead and let your doctor finish wrapping up the visit, okay? So good seeing you as always."

Grady elder: *looking pensive*

Me: "Sir?"

Grady elder: "Look here, Miss Manning. . ."

Me: *hand on the doorknob with raised eyebrows*

Grady elder: "I didn't hurt your feelins did I? Sayin' all that stuff about your hairdo?"

Me: "Not one bit, Mr. Purifoy!"

Grady elder: "Oh good, baby. Cawse you know I love you don't you? Even with your hairdo like that."

Me: *palm on chest* "You know what? I do know that, sir. And I love you right back."

Nope. Not offended. Nope. Not annoyed. Because this? This is the best part of what I do. The people. The relationships. The funny little exchanges. The laughter and the hand squeezes. All of these things swirling together every single day and all of these things that make these ordinary days feel so extraordinary.

That's all I've got today.

Hey. . . .Pay attention to something ordinary today. . . . and find the extraordinary in it, hear?

***
Happy Tuesday.

Now playing on my mental iPod. . . .Greg Jones' Smallville anthem -- "It's just an ordinary day." Couldn't embed it, sorry!

BE-yawn-say and her hairdo.

I see you, too.

2012-01-23T17:00:00.002-05:00

Wow. This picture speaks volumes--regardless of who you're down with politically. . . or how you feel about Al Green.

***
Happy Monday, y'all.

Right on Target.

2012-01-22T14:35:00.008-05:00

Isaiah and Zachary have wallets. Dreadful little nylon wallets with Velcro closures that they open and close repeatedly. They needed these wallets because this was the first year we started giving them an allowance. Oh, and before you say, "An allowance? What?!" Please. . . .don't get too excited. Their "allowance" certainly ain't much.

It actually involves what has become a very complicated school/home behavior and reading chart. I didn't mean for it to become so intricate, but thanks to Mr. Isaiah A. Manning it has become just that. Essentially, every day I fill out what is called "The Heart Chart." The chart has all these categories like "school", "homework" and -- my favorite of all -- "Mommy." The "Mommy" one simply refers to your overall interaction with ME that day. Oh, and did I mention? Isaiah came up with these categories.

He also came up with the system for interpreting it. Each day, you can get one of three things per category--a heart for the best behavior, a dot for neutral behavior, or an X for unsatisfactory behavior. If you get ten hearts, that adds a dollar to your baseline four dollar allowance at the end of the week. For every two Xs, you lose a dollar. Dots are neutral across the board.

Oh yeah. And for every ten books you read, that's a dollar, too.

So essentially, this ends up yielding somewhere around three dollars per week between Xs and books and hearts. On a really, really good week though, it can get as high as six dollars. The whole point of it is to teach them a lesson. About earning and saving and the value of money. About calculating their earnings for that week and the consequences of their actions. I even have them use their money for church contributions and charitable things, too. It's all meant to teach them something. At least, I hope it will.

Last week was a good week. Isaiah earned seven dollars because, in addition to having a good school and home week, he slam-dunked "Mommy" and threw back some books as well. So yeah. This was a good week.

With allowance plus Christmas money from the grandparents in their wallets, the kids came to me requesting that I take them to Target to buy something with their money. And seeing as Target is never a hard sell for me and that they had saved a fair amount, I obliged them.

In we go to Target. It was kind of cute watching them carefully reading the prices and trying to decide if something was actually worth the money. I even decided that I wouldn't cover tax--which I usually do cover. By the way--this whole tax thing really ticked Zachary off. He was like, "It really isn't fair for you to have seven dollars but you can't buy a toy that cost six dollars and ninety-nine cents 'cause you have a tax."

And to that I said, "Ain't that the truth."

Anyways.

Isaiah decided on a giant Bakugan. Zachary chose to purchase a new Beyblade. And I would digress to explain just what a giant Bakugan is or help you understand what the hell a Beyblade is, but really? It wouldn't help at all even if I did. Just know that the Cartoon Network and their anime animators have captured the hearts and attention of all boys between the ages of five and eight, and a giant Bakugan, a new Beyblade, Pokemon cards, Ben 10 and all of those things fall under that umbrella.

So the Bakugan toy cost $17.99. And the Beyblade cost $7.99. Both plus tax. Which was fine since they each had enough to cover it. I handed them their wallets and told them to be prepared to pay for their toy. This would involve "speaking up like a young man" and also knowing how much money you gave the person as well as having some idea of what you should be getting in return.

Just in case.

So we stand to the side and painstakingly do the math. And me, I'm feeling like a rather kick-ass mama for this whole thing. Like just maybe it's the kind of thing my kids will be blogging about as grown ups. . .reflecting on this teachable moment in Target and such.

Mmm hmmm.

We situate the money thing and then choose a line. A manager lady sees us walking toward a checkout kiosk and redirects us to another one. "She'll take you over here on six!"

I smile and nudge my boys over toward six. Velcro wallets and all.

"Can I buy me some candy?" Zachary asked.

"No."

"But I have enough money. This cost point sixty nine, Mama."

"Sixty nine cents. And no."

"Could I help you please?"

A voice interjected abruptly and impatiently as I plucked a candy bar out of Zachary's hand. Not only was it impatient--it was followed by an unmistakable little huff.

Hmmm.

The tone of that request was slightly funky. Yet funkily familiar. I glanced up and. . . .gasp!

Say it ain't so.

Her again. Yes. Teenage Mutant Target Checkout Chick.

I bullshit you not. I couldn't help but laugh out loud to myself. I knew this would not be the patient and tender moment I was hoping my kids would get.

"Son, go ahead and hand her your Bakugan," I said to Isaiah briefly giving her the benefit of the doubt. I could tell by her lowered eyelids and raised eyebrows that she recognized me. And I curled my lips and dropped my own lids half mast to let her know that I was not even fazed by her or her funky attitude. Then or now.

"Here you go, ma'am," Isaiah spoke carefully. His high-pitched voice was careful and rehearsed as he passed the twenty dollar bill to her.

She snatched it like he was twenty years old and buying a pack of cigarettes instead of a first grader obviously paying for his first ever anything.

Heifer.

She didn't say two words to my baby. She just threw that money in that drawer and yanked the change out of the drawer like it was ten extra cents for cheese on a Whopper. Then she looked over his head and toward me. Well not really toward me. Just at me with this bored and exaggeratedly annoyed expression with my little math lesson. "Ninety one cents your change." She held up hand toward me palm down and preparing to give ME his change.

"I'm not your customer, ma'am," I replied dryly. Hand now on my hip with backbone fully prepared to slip.

She gave a mini-eyeroll and dropped the change into Isaiah's splayed little hands. A quarter fell on the ground and she didn't even flinch. Or say sorry.

Awww hell naw.

Fortunately, Isaiah was so proud of his transaction that he was none the wiser. He slid his coins into that little Velcro wallet and kept it moving. Sure did. I figured that I'd just take the high road with him.

But then as Zachary stepped forward, I caught her eyes rolling again. Not even subtle about it either.

And that was it.

"Dammit, you know what?" I said through gritted teeth. Gathering up the few items I had and Zachary's toy, I stood on my tippy-toes and looked for that manager. She looked at me with this "what's your problem?" expression--which made me even madder. I repeated myself. "Dammit. . .you got me confused for somebody else. . .dammit. . . where is that manager?" And the manager query was really rhetorical because I saw exactly where that manager was.

Oh. And I made certain to ice-grill that cashier before excusing myself from her line.

Zachary demonstrates a classic "ice-grill" here.

Mmmm hmmmm.

My boys looked confused as I abruptly scooted out of the line again. And I wish I could tell you that I didn't say "dammit" repeatedly since my kids were there. But I can't because I did. And in this instance I did because it was 100% called for. Call me a horrible parent, but you know? Sometimes an expletive is 100% called for. Or should at least be 100% excused.

Anyways.

I decided right then and right there that I wasn't waiting for strike three with her. No I was not. I marched right over to that manager--kids in tow--and let her know exactly how I felt.

"I come to this Target all the time. That young woman you have over on register six"--I pointed right at her as she glared in my direction, "--has a terrible attitude and absolutely horrible customer service. Horrible. And not just today either. It's ridiculous and actually. . . .an embarrassment to me. And it should be to you, too."

That sister-manager looked at me intently. She knew that I was talking about a hell of a lot more than just the fact that they both worked at Target.

And so. Since I had her attention I went on to tell her of how funky she had just treated Isaiah and how obvious it was that my six year-old son was trying to pay for his toy himself. My voice started quivering while I was talking of my child and I didn't even try to fight it. I explained that we were the only ones in that line and that even if we hadn't been, her attitude was totally uncalled for.

THEN I went back to the day she miscounted my money into the drawer and accused me of being short. Sure did. I even ratted on her for how nasty she treated that man with his Trader Joes bags on that day. Yep, I went there, too.

"I should have found a manager on that day, but I was in a hurry," I went on, "but today, I'm not. I'm not in a hurry and I am not having it. You need to know that she makes your store look bad which makes YOU look bad. Look. . . .I don't want her to lose her job, but now I know that she wasn't just having a bad day on that first day. You have to do something."

"Actually, I see you here a lot," the manager said.

"Oh, I come here often," I replied ignoring the fact that my Target habit had just gotten called out. "And I'm not a difficult customer. At least I don't think I am. People shouldn't have to deal with this. They shouldn't. I need to pay for the rest of my stuff on another line because if I go back over there she might get cussed out."

Or worse, get a Inglewood beat-down plus a 1981-era T-Tone pulled on her.

"Thank you, ma'am. Really." The manager was professional and appropriately serious. I appreciated that.

Then that sister-manager walked right over to register six and moved TMTCC out of the way as she--the manager herself--personally completed the rest of our transaction. Or rather my son's transaction. She smiled and acknowledged Zachary as he proudly gave her his money out of his crappy little wallet. That manager counted his change right back into his little hand and even waited patiently as he put it into his wallet. "Here you go, little man," she announced while handing him his bag and receipt.

"What do you say, son?" I coached him.

"Thank you!"

And as my boys danced around me all giddy with their new bags filled with the toys they bought with their own money out of their own dreadful Velcro wallets. . . .that manager looked back at me and repeated herself. "Thank you, ma'am. Really."

Right after that, a woman stepped into the line behind us and began putting her things on the revolving belt. The manager held up her hand like a crossing guard.

"I'm sorry--but this aisle is closed for now," the manager told her. And just like that she shut off the light and gestured toward the back with her surly employee shuffling beside her.

I felt a little bad. But the whole point was to teach her something. At least, I hope it did.

As we approached the door, Zachary looked up at me and said, "We did good in Target, right?"

And although I felt a little pang inside of me for getting that girl--that teenaged girl who looked like me--in trouble with her manager, I knew it was the right thing to do. And it was overdue. "Yep, bud. We did do good in Target."

Dammit, we did.

***
Happy Sunday. Two posts in one day! Woot! Woot!

Bears repeating.

2012-01-22T09:45:00.005-05:00

with one of my favorite Grady elders ~ photo shared with his permission

Thursday

I was walking through the hallway in the main lobby of Grady. I was supposed to be meeting a medical student and I was already late. My feet were going fifty miles per hour and my mind even faster. . . .

CRASH!

"Oh my gosh! Pardon me for not looking where I was going!"

I looked up at this sweet-faced Grady elder that I nearly mowed down next to the gift shop. I reached down to gather the hat that had fallen off of his head and furrowed my brow apologetically. Instead of looking annoyed with me, he glanced down at me in my white coat with twinkling eyes.

"That's okay, baby," he gently replied as I handed him his cap. His voice was rough like cookie crumbs and immediately I loved it. He paused for a moment then snapped his finger and then pointed right at me. A big smile crept across his octogenarian face. "Ha! Ha! I know you! You that TV doctor that be on Fox 5! Ain't that you?" Before I could answer he grabbed both of my hands tightly, studied my face some more, and came to his own conclusion. "Sho' is! Sho' is you!" He stomped his foot for emphasis. "Ha! Haaa! I be seein' you!"

With every word, he kept squeezing my hands rhythmically and grinning from ear to ear. Man. He was so tickled to have me in front of him--which was kind of funny considering how those local Fox segments are only like three minutes long.

"Yes, sir!"

"Manning! Miss Manning, right?"

"Yes, sir!" The "miss" instead of "doctor" title didn't bother me in the slightest. "You doin' alright today, sir?"

I realize that I have an almost musical quality to my Grady-elder-Southern-respect voice. The words roll together and my intonation floats up and down like crescendo decrescendo notes. I first noticed it one day while giving an almost ninety-something year old lady directions in the hallway a while back. Every time I said, "No ma'am" or "Yes ma'am" I could hear it--musical. Different than the "No ma'am" I'd use for the fifty-something year old lady in the post office asking me if she could help me with anything else. I wondered in that moment if it was patronizing.

You doin' al-right today-sir?

"Baby, if I was any better I'd be twins!"

This Grady elder sure didn't seem to think so. He just squeezed my hands again and laughed out loud. "I feel proud to see you! You know I be seein' you on the television, right? Sure do. And you a doctor, too? Go on keep it up, hear?"

"Yes, sir." The song in my voice quieting a bit as I thought about what he'd just said.

And so. He stood there just smiling at me and nodding for a few seconds more. So before I left, I reached out and hugged him tight. Tight like I'd known him for way more than those twenty seconds. It was natural and easy and reciprocated.

And then that was it.

I know, I know. If you've been reading here for a while, you've heard versions of this story before. Grady elders seeing me in the hospital and telling me they feel proud. Me walking off thinking about who they are and what they've seen and where I am now. Yawn. . . I know.

But honestly? It never gets old for me. Not ever. Every single moment like that stops me in my tracks and makes me want to write it down to honor it. Because I never stop feeling indebted or moved or lucky to be here, you know? I don't.

Remember the time that man stopped me outside of McDonald's after I'd been on CNN? I am so happy that I wrote about it because I literally reread that story once every couple of months. And every single time I do, I cry and cry.

Oh and remember when the two Grady elders broke out in song while waiting for the Grady elevator? Singing "I won't complain" at the tops of their lungs? The words used describe that moment have kept it closer to me. . .in high definition even . . . .because I don't want to forget it. I don't. And I won't.

So pardon the redundancy. It's just that some things bear repeating.

My meeting with that first year student was wonderful. I found him waiting for me patiently in the other entrance of the hospital scanning all that was around him. . . .the people, the sights, the sounds. . .all of it. He was standing tall and proud in his overly-white white coat that screamed "pre-clinical medical student". . .but that was okay. As I walked up, I looked at his cocoa-colored complexion and smiled; he could totally pass for a much younger version of the man I'd just left.

"This place is amazing," the student said earnestly.

I squeezed his hands just like that Grady elder had just squeezed mine. "Yes. . . it is. It really, really is."

***

Special.

2012-01-18T10:55:00.011-05:00

Kindergarten me

"Gonna use my arms
Gonna use my legs
Gonna use my style
Gonna use my sidestep
Gonna use my fingers
Gonna use my, my, my imagination

'Cause I'm gonna make you see

there's nobody else here

No one like me

I'm special

so special

I gotta have some of your attention

give it to me."

~ The Pretenders "Brass in Pocket"

______________________________________________________

Last night I was talking to my sister, Deanna. Because she is an awesome sister, she picked up the kids for me yesterday evening since I had to teach late at the medical school. Deanna is an educator and, like my parents, is hard-wired with that patience for teaching kids and, especially like my parents, has that special ingredient for making them feel good about themselves.

She was also a rock star student growing up.

I'd say that I was definitely a more-than-decent student growing up. I won't go so far as to say that I achieved rock star academic status, though. But my sister Deanna? Man. When we were in school, she was valedictorian-salutatorian smart. She was straight-A-no-not-never-a-B smart. And me? Eh. . .not so much.

I still think this rock star student thing involved some kind of genetic coding that I didn't quite get. Like Deanna and our baby sister JoLai were those kinds of students for as long as I could remember. I spent half of high school in shared classes with JoLai because she was just too damn gifted to be in the ones for her grade. My brother got the luxury of experiencing the same with Deanna, which for him was slightly worse since she was two grades below him instead of just one like JoLai was to me.

At some point, my parents would barely even look at their report cards. Especially JoLai's. Even though Deanna was brainy, she has always been a social butterfly. The only times she ever got in trouble for anything on her progress reports related solely to conduct. But by the time my parents reached JoLai, it had been perfected. She was smart and knew how to close her mouth and do her work. Imagine that.

Me and my rock star sisters

And so. Last night Deanna and I sat at my kitchen table talking. She'd stuck around after I got home to hang out with the boys as she often does and was gracious enough to finish up homework and such with Isaiah. I smiled as I watched her teaching him about people like Rosa Parks and Dr. Daniel Hale Williams, who she may have had to remind me was the first person to do successful open heart surgery.

Just maybe.

Anyways. After all that knowledge she dropped on the boys, we started talking about what it was like for us growing up.

Deanna squinted her eyes and said, "I think I always believed that I was smart, you know? I really did."

That made perfect sense to me. I can't say that during those years I felt that way. I did always know that my parents had high expectations. But I'm pretty certain that I didn't feel quite as strongly as she about my ability to deliver on those expectations.

"I'm not sure I felt that way," I replied. "In fact, I'm sure I didn't. I didn't think I was dumb or that I wasn't able. But I'm pretty sure there wasn't a dialogue going on in my head telling me how smart I was--at least not one that was coming from me."

Deanna stacked up some papers and slid them into Isaiah's folder. He gave her a quick hug and ran off to the playroom with Zachary. She looked over at me and started chuckling to herself. "Girl, one time when I was in the third grade, this boy said to me, 'I'm the smartest boy in this whole school!' I looked him dead in his face and said, 'So what. I'm the smartest person in this whole school!'" We both cracked up laughing.

"I don't remember you being such a jerk about being smart."

"Naaaah, I wasn't. But I did know I was bright. I'm not sure how it happened but I really did."

"Hmmm. . . . I wish I had felt that way. Ugghh! Especially in middle school. Now that? That was rough."

Deanna teaches middle school so we both nodded knowingly.

"You know. . funny you should mention middle school," she spoke with a nostalgic smile. "Daddy had warned me about middle school and how tough it could be. He told me that kids from other schools would be there and I may be challenged by the fact that a lot of other smart kids were there, too."

I nodded and listened as she went on.

"And you know? I distinctly remember it. Three weeks into being there it dawned on me. 'I'm smarter than all these kids up in here. I get stuff that they don't get. Damn.'" We both laughed out loud.

But even though we were laughing, it was true. She was smart like that. She did always seem to "get" hard things and master hard concepts surprisingly better than her peers.

I thought about her words and what they meant. I thought about the fact that we had grown up in the same house and that despite all of those things, I never really felt that. Not about being smart, per se. "You know, Dee? That's a powerful thing for a student to have, don't you think? An internal belief that they are smart and capable. I want my kids to feel that way."

She smiled at me from across the table. "They will."

We sat in silence for a few moments. I reflected some more on our upbringing and how different we all were as kids and even as adults. My mind began to wander and a scene from many years ago popped into my head crystal clear.

Middle school me.

I was in 8th grade and I was preparing to audition for this drama club. Essentially, I'd gotten interested in acting and drama mostly because my best childhood friend had been involved in lots of theater. She was the one with the acting chops, and I had just sort of come along for the ride. Eventually, I started having fun and since it allowed us to spend more time together, I stuck with it for quite some time.

Anyways.

This particular situation was different. This drama company, though for children, was based out of Loyola Marymount University--so the children auditioning were from all over Los Angeles. These kids had headshots and composites and video demo reels and experience. They had training and resumes and all kinds of swagger that me and my just-got-dropped-off-by-my-Inglewood-mama-and-that's-it butt didn't have AT ALL.

And so I sat. And I watched. Kid after kid. Projecting their voices from their well-trained little diaphragms and waving their jazz hands. Some even having the ability to bring themselves to tears. Tears!

For a few moments I felt nervous. Me with my skinny, underdeveloped body and awkward, oversized glasses. Up against them with their shiny curls and high-end clothes and gleaming braces and glossy photographs. But then. . . something happened. I remember it like it happened four seconds ago. A voice. In my head. But instead of this voice in my head telling me that I was smart or the smartest or bright or the brightest, it told me something else.

"Kimberly, you're special. You have something that is uniquely you. And not one of these kids has what you have. Not one. Even if they are awesome and talented. You have something else that can't be duplicated. You're the only you there is. And you? You're special."

Now. I know that sounds crazy, but I swear to you it's true. I stepped up onto that stage knowing that every single one of those children and their stage mamas was watching. I ignored that bright light beaming in my face and felt all of those anxious nerves connected to knowing that nearly a hundred plus eyes were focusing on me in that dark theater trickling down into a puddle at my feet.

And so. There I stood. Ninety pounds soaking wet with a body that rivaled Olive Oyl hearing that word over and over in my head. Special. Special. Special. I pulled my narrow shoulders back as that giant spotlight blinded me from anything and everyone in the room. And in that moment. . . .I believed it. I believed that I was special.

Damn, I did.

So without the jazz hands or the forced tears, I lifted up my voice and my ah hah moment over that entire auditorium. Langston Hughes. Yep. I recited a poem by him that I had learned a few years before. Nope. No special scene from some well known play. Nope. No Romeo and Juliet or MacBeth or any such thing. Just a short, simple and meaningful poem by the poet Langston Hughes.

Special. Special. Special.

My heart was pounding and I could hear it because that room had fallen unusually silent. I paid close attention to the intonation of my voice and the meaning of those words as I spoke. Not overdoing it or trying to be someone I wasn't. Just. . . .doing me. Special me. In that moment I convinced myself that my uniquely me way of doing this would work and that even though I didn't have a headshot or a composite or a demo reel. . .that I wasn't competing with them at all. I told myself that . . I know it sounds silly but. . .I told myself that I was special. I really did. And . . . .I believed that what I had to say was worth every single person in that room hearing. I sure did.

Then something funny happened. Everyone in that room did, too.

Reciting that poem that day was a pivotal moment in my life. It's bizarre because although the people in that room stood their feet and gave me thunderous applause. . . . .what I remember the most is that. . .for the first time, I had already given it to myself. That felt better than anything else. Even better than their standing ovation. It really did.

Yeah. . . .

I snapped out of that daydream and looked up at Deanna. She listened intently as I told her that story. Then I finally said quietly, "You know? I don't think I really thought I was smart. Maybe later on I did. . . .but not back then I didn't. But what I did believe was. . . was that I was special. I. . .I really did." I patted my chest but then immediately felt a little embarrassed for saying it.

Deanna was so gracious. "I know you did."

I was so glad that she understood. But then she always has gotten things fast.

I let out a big sigh. "Man. . . . I hope my kids feel that way, too."

"They will," she replied softly, "They will."

***

As spoken by an eighty-eight pound eighth-grader:

"Democracy will not come

Today, 
this year

nor ever

through compromise 
and fear

I have as much right

as the other fellow has

to stand on my own two feet

and own the land

I tire so of hearing people say,

'Let things take their course.

Tomorrow is another day.'

I do not need my freedom when I'm dead

I cannot live on tomorrow's bread

Freedom 

is a strong seed

Planted

in a great need

I live here, too.

I want freedom

just as you."

~ Langston Hughes

***

Happy Wednesday.

Now playing on my mental iPod. . . .

A Tale of Two Gradys.

2012-01-15T18:53:00.018-05:00

Segregated Grady Hospital during the Civil Rights era (aka "The Gradys")

Today is January 15, 2012. My name is Kimberly D. Manning and I am a medical doctor. I received my medical degree from Meharry Medical College in Nashville, Tennessee. For the past ten years, I have had the honor of teaching Emory University medical students and training Internal Medicine resident physicians at Grady Memorial Hospital in Atlanta, Georgia.

And I am a black female.

Fifty years ago today the date was January 15, 1962. Dr. Martin Luther King, Jr. was somewhere blowing out thirty three candles on his birthday cake. During that time, the vast majority of black physicians in the United States were educated at either Meharry Medical College or Howard University School of Medicine--both historically black institutions. In January of 1962 more than a quarter of the population in Atlanta, Georgia was black.

And Grady Hospital was segregated.

"White" Grady and "Colored" Grady. Known by most during those times as "The Gradys"; this plurality serving as the perfect descriptor for these separate but not-so-equal hospitals within one hospital. Yes, in 1962, Grady hospital was segregated.

Fifty years ago today.

Not only segregated. On January 15, 1962, there were no black physicians with staff privileges there. None. As a matter of fact, during that time there were approximately 4,000 hospital beds at hospitals in the Atlanta area. But physicians who looked like me could only practice in less than 500 of them. 438 to be exact.

Fifty years ago today.

If an African-American patient that I cared for as a primary care provider was hospitalized fifty years ago today, yes, they could be admitted at Grady. However, I would have to give up all patient care privileges at the moment they hit the door. Because, you see, while black people could receive care on the segregated C and D wings of the hospital, they could not receive that care from physicians of their same race.

No, they could not.

In January of 1962 there were groups picketing in front of Grady Hospital. Groups like SNCC and others in the community inspired by a thirty-three year old preacher who had become the face of the Civil Rights Movement. The same preacher who preached around the corner from Grady Hospital at Ebenezer Baptist Church. So there they stood. The Student Nonviolent Coordinating Committee withstanding hateful stares and venomous words. Young people bravely holding up signs criticizing the inequity of the care offered to "negro" patients at Grady Hospital -- and also the fact that black physicians weren't allowed there.

Fifty years ago today.

Other than it being just wrong, there were other problems with that whole no-black-doctors thing. See, just like it is now, Grady was the hospital that served the indigent patient population in Atlanta. And just like now, many of those patients were black. With segregation like it was, many of those folks were cared for by black physicians in the community. And back then, your primary doctor was usually who cared for you in the hospital, too.

Unless, of course, you needed to be admitted at Grady. Regardless of your wishes, that nice black doctor of yours would likely have been called a "boy" and sent on his way.

Or "gal" or "nigra" had it been me.

Fifty years ago today.

I guess it was good that there was at least the "colored" Grady. I mean, it could have been worse. In addition to Grady, at least there was Hughes Spalding Hospital (the colored hospital) across the street. Across the street. Yeah. So fifty years ago today, your negro doctor caring for you across the street from Grady couldn't come to care for you there. No, he or she could not. Oh, and if you weren't poor enough to be considered "indigent"? That made it even more complicated.

All that was going on on this day in 1962.

In January of 1962, my father was a freshman in college at Tuskegee Institute. He had graduated from high school in Birmingham, Alabama that previous year and, like many black folks back then, was the first person in his family to go to college. But also like many black folks back then, he wasn't the first smart person in his family.

No, he was not.

My paternal grandmother valued education. She celebrated my father for his academic achievements and applauded his decision to get higher education. Like me, my father excelled at science and things involving interpersonal skills. He enthusiastically told his counselor in 1961 that he wanted to major in Biology and go to medical school. Unfortunately, that counselor discouraged him. Shot down that dream quick, fast and in a hurry telling him that it was too much of a gamble. If a black man is going to go to college and he wants a job, he needs to go get an engineering degree. And let go of this pipe dream of being a doctor.

"What if you don't get into medical school? Then what?"

Going to college was already a big deal. And it wasn't like there was a doctor in the family for him to call for advice or to counter with, "But what if you do get in, son? What if you do?"

Yep.

So fifty years ago today, on January 15, 1962, my gifted-in-science father was struggling in math and engineering classes at Tuskegee Institute where it would take him more than six years to graduate. Because that's where the world was back then. Race and gender clearly dictated decisions and created ceilings made of a hell of a lot more than glass.

Me? I chose to go to Meharry Medical College because it was a good fit for me. Not because there was no other option or other place willing to let me fit. But had I thought of medical school on January 15, 1962, my medical education story would be different. It would have been Meharry or Howard or bust.

Or perhaps, for a woman, nothing at all.

Fifty years ago today.

Today I'm reflecting on how far things have come on what would have been Dr. Martin Luther King, Jr.'s eighty-third birthday. I am imaging a life for me in his world, a life at Grady Hospital some fifty years ago. And what I am realizing is that I wouldn't have had any kind of life there. At least, not as a doctor. And damn sure not as a teaching physician at Emory.

Oh, did I forget to mention? 1962 was also the first year Emory University integrated its student body. 1963 marked the admission of the first black student in Emory's School of Medicine-- a young man named Hamilton E. Holmes. As for the faculty part, I'm not sure when that part fully changed. I do know that Dr. Asa Yancy Sr. was the first brother-faculty member appointed at Emory which technically took place in the late 1950's (even though he still couldn't get privileges at Grady.) Something tells me that it probably took a little more time to get some sister-doctors on the roster.

But that's just my guess.

So yeah. A lot has gone down in fifty years. So instead of posting the "I Have a Dream" speech or even discussing some of the annoying criticisms that have come up about Dr. King after his death or talking about President Obama or even ranting about how black history should be discussed in more than just the winter months . . . .I am simply sitting here quietly feeling thankful. Thankful that I am right here right now and not fifty years ago today.

And even more thankful that people like Dr. King and my daddy were there.

Sometimes I feel angry that the doors open to me were shut in my father's face. But when I see how proud he and my mother are of their children and what we have become, I feel a little better. And when I listen to his stories of growing up poor, black, and one of eleven children in the epicenter of the Jim Crow era--and I see what he has become--I feel proud, too.

Proud. Proud of where I can go and what I can do. Thanks to all of them taking a whole lot for the team some fifty years ago today.

Kind of makes me wonder what I'm doing for the team.

Hmmm.

See? This Civil Rights thing was more than just a notion. A whole lot more. Me? I get to be a Grady doctor. And no, not in the figurative sense--in the literal sense. I literally get to be a Grady doctor because somebody wasn't afraid to be spit at and hosed down and hit across the head with a brick. I get to be a Grady doctor because some surely terrified individuals put themselves in harm's way on Freedom riders' buses and some peaceful young person in my own father's neighborhood got attacked by German shepherds just for standing up. Because of them I get to be where I am right now. A doctor. At Grady.

Man.

So to all who lived through it, I say thank you. For every time you had to stand there and hear someone call your grown-ass father a boy or a nigger or your beloved matriarch a gal or a nigra, thank you. To those who bravely went against the grain when it would have been much easier to hunker down in some false sense of pink superiority, thank you, too. Because I know that there was a lot more moving in that movement than just black folks.

Yes, there were.

My son, Isaiah. . living the dream.

***
Now playing on my mental iPod. . .with gratitude.

Top Ten: Small Stones.

2012-01-12T17:11:00.006-05:00

One of my writer-mommy-friends, Elizabeth, has been doing this thing on her blog this month called "small stones." Every day she makes some kind of observation about something and then jots down a few words about it. It can be just about anything. Something in her house. On a photograph. An action observed in one of her children. Or even just some everyday object like a chair. That's it.

So Elizabeth got this idea from this writers' blog and linked over to it when she started this. Here's what they say about the whole "small stone" thing:

1. Notice something properly everyday in January.
2. Write it down.

Hmmm. I admit I was a wee bit intrigued. (And seeing as Elizabeth often intrigues me, this was not unusual.)

Seeing as I was feeling all intrigued and such, I linked over to that writers' blog and read this part of their spiel:

"Pay more attention and fall in love with the world."

Now that I can get with.

Don't get too excited. I'm not nearly as organized as Elizabeth. But I do believe in paying attention and falling in love with ordinary things through careful observation.

And so. . . since I don't have my act together enough to do one per day for the whole month of January, I thought I'd do the next best thing--a top ten!

Ladies and gentleman, damas y caballeros! I bring you this week's really introspective top ten. . . . .inspired by Elizabeth. . . .

TEN SMALL STONES FROM THE START OF 2012!

Technically, it isn't a top ten but a list of ten. . . but you get the picture. Also, Elizabeth effortlessly uses words like bougainvillea which aren't really in my vernacular . . . but that's okay. (She'll be proud of me anyway.)

Hey! Stop by and read some of hers if you want some of those delicious words because they are delicious and . . . intriguing, for real. Any writing that makes me want to read more or write more is my kind of writing, man.

Here's my crack at it.

Small Stone 10

Hands held high, fingers splayed like so. Playing defense or hoping for an offensive rebound. High tops squeaking on slick wooden floors. My hands clapping, splayed like so -- I didn't realize you knew how to dribble with one hand! My heart swells with pride but also a hint of melancholia, remembering those same hands once tiny and reaching for me to lift you. . . .fingers splayed like so.

Small Stone 9

I showed this photograph I took with my iPhone to Isaiah and he saw what I saw immediately.

"ROY G. BIV," I told him. Then I smiled my smart-mommy smile anticipating his little-boy question surely to follow my cryptic statement.

"Mom? What is the 'I' for again?" he asked nose wrinkled.

"Indigo."

"Oh yeah. Indigo."

Not what I expected, but maybe I should have.

Small Stone 8

"Are those special shoes?" you asked me while pointing at my feet. I look down at them and realize that perhaps a shoe with such a thick rubber sole and outwardly visible staples might warrant some explanation. "They look a little bit like the orthotic shoes," you add, "You know what I'm talkin' about?"

And in response to this I smile at you, then chuckle and nod. Partly because I do know exactly what you are talking about. But mostly because you are a Grady elder who didn't think twice about letting me know this fact.

And me? I love every minute of it.

Small Stone 7

Hands over hearts, mouths moving in synchrony and voices ringing out in unison. Your faces full of first grade mischief, fingertips drumming on your chests and eyes trained on the Lego table. You say this part the loudest:

"Indivisible, with liberty and justice for all!"

I walk away laughing, wondering if you think this pertains to the United States or the Lego table.

Small Stone 6

Time blocked out to talk about career guidance and all things academic and future-related. A sharp turn takes it somewhere else. First one tear and then many more. Fast, furious, hot, necessary. I scoot the box of Kleenex closer to you. You talk. I listen. That's it. That's all.

I want you to feel safe and whole and not alone. Before you leave, a hug instead of a handshake. You cry some more because you can.

Small Stone 5

You unlock the door and I hear your feet strong and sure on hardwood floors. The next sound is of keys splashing on the table--and even with kids sitting at the kitchen table, you greet me first.

Eyes on eyes. Smiles on smiles. It doesn't matter how your day was or mine was. Now? It's already better than it was before. My arms encircle your neck and then, my lips press firmly against yours. You kiss me back, eyes closed. Then, you open them and look at my face, the same as always.

"Eeeeeewww!" Zachary squeals.

"Disgusting!" Isaiah chimes in.

Decidedly I tighten my embrace and kiss you once more. . .intentionally. . .deliberately. Knowing that this can and will become a teachable moment for our sons on how to make love a bidirectional verb.

Small Stone 4

In between emails and work and more, eyes quickly scanning to see. Do you like me? Do you really like me? This day there is a paucity of comments. Very few reactions, responses, replies or epiphanies. Is anyone even reading?

Oh please, I tell myself, Don't tell me you're disappointed.

Then I do what always provides the affirmation I am looking for--read my own words. Clicking and reading. Reflecting and feeling. And then I am there again. In those moments, those lessons, and all inside of those words. Yes, I am.

This is why you are doing this, I tell myself, Remember? This is why.

Ironically, that night I click the stats bar. 1,034. The most unique visits ever in a single day.

Lesson there: Sometimes when you don't feel like a hit, you are still getting hits. But the real lesson there: You need to be a hit with yourself first.

Ah hah.

Small Stone 3

I study your face to make certain you are okay. . . inspecting your eyes for some hidden exhaustion and watching your smile to see it quivers from being forced. Instead I find you relaxed and whole and more than okay--you are great. Us? We go waaaay back like car seats . . .way back to your very first day of medical school when you didn't even know the difference between words like distal and proximal.

Now those early days seem distal; here you are an intern with two capital letters behind your name that you earned fair and square.

But on this rainy Wednesday morning we laugh and catch up over hotcakes and hot coffee. You are passing through town and in all that hustle bustle thought to call me. Me, of all people. And so I study your face and hear your laughter again . . .remembering that through those shared moments our hearts remain proximal for good.

Small Stone 2

Retro-green and busy with fuzzy wool that pills and catches on any and everything. But so what. You are like my tomato red pants or my leopard print kitten heel pumps; when I put you on, I feel good. And even if I already felt good to begin with, when I slide you over my shoulders I feel better. Even on my glasses days.

Stuff you put on can do that to you sometimes. At least for me they can.

Small Stone 1

Behemoth and burgeoning, the worse off business gets for this country, the more business seems to come your way. And just how your business comes to you--a lost job, a lost insurance plan--it doesn't matter. You don't make it your business to dissect or judge or turn away. Instead you remain steadfast--standing tall, mighty and welcoming to all. To all.

You accept broken English and broken lives. You also accept the criticism that comes with opening your doors to the least of these. To the least of these.

I am proud to be a part of you; you heal more than just patients. More than just patients.

***
Happy Thursday.

Retaliation.

2012-01-10T20:35:00.001-05:00

Manning Boys' Playroom Door, January 2012

In response to the "No boys and no toys" house rule about stove proximity:

Me: "What's this 'No moms allowed!?' What's up with that?!"

Isaiah: "Actually, it says, 'No MOM allowed.'"

Zachary: "Mom. Not Moms."

Isaiah: "Like you, Mom. Not all moms. Like without the 's' just--"

Me: "Um yeah, I think I got it the first time."

***
Happy Tuesday night.

The Old Man and the Knee.

2012-01-10T08:46:00.004-05:00

Arthur-itis.

"Hey there, Miss Manning!"

You announced that greeting to me while craning your head out of the door of a clinic room. Me, I was hustling and bustling through the hallways trying to get things situated for the afternoon session. I glanced back in your direction and couldn't help but slow down.

"Hey sir! What you know good?" I spoke to you in that easy and familiar language that we both know so well.

"Awww, I ain't no count!" And then you laughed out loud, slapped your knee, and then winced a bit. "Woooo! I bet' not stir ol' Arthur up."

Arthur. As in Arthur-itis.

I stopped in the doorway with a stack of papers in my hands and smiled at you. Today you were alone instead of with your daughter. This was fine because even though she sees about you, you "do for yah'self." Your dark leathery complexion has weathered the storm of your "eighty-some-odd" years quite well and I decide today that I love it all. Including those milky, bluish rings now filling the irises of your aging eyes. An interestingly beautiful contrast against that coffee-colored complexion.

Yes, I love it all because it represents so much of what I love about Grady. Storms weathered with beautiful contrasts.

"I don't think I recall you havin' so much gray hair, Miss Manning!" You announced this in that unapologetic way that only the Grady elders can. "But tha's alright. I still think you a pretty little thang."

Pretty little thang? Ha. That's what I'm talking about.

I carefully watched you as your mouth moved. Cheeks with deeply chiseled lines and scarce remains of what was once a beard pasted around your chin and cheeks. The teeth in your mouth looked to be the ones you were born with; large and rectangular but now with a tannish hue and old school dental work gleaming from the sides. Your neck with its redundant skin is supported by shoulders that have remained unusually broad and strong.

"Chopping wood," you said. "Asked my grandson to do it, but he ain't no count." We both laughed again.

You've taken the liberty of removing your coat, folding it neatly on top of the plastic bag you'd carried in that day. And like the perfect patient that you are, you'd also removed every single one of your medication bottles from that same bag and lined them right up on the table.

"I stopped coloring it," I added in reference to the gray hair again. "Too much trouble, you know?"

"Yeah, I hear you. I never got too much gray but I thank I woulda took the gray over losing it all!" You cackled while rubbing your shiny hairless scalp. Then you slapped that knee again and woke ol' Arthur up again. "I jest went on and shaved on off. It never really came back after that."

"Less trouble though, right?"

"Reckon it is!"

I saw your cane leaning against the wall. Weathered but still quite functional. Just like you.

"Knee still giving you a lot of trouble?"

"You know? Not as bad since they inject that medicine in it. But you know, these ol' knees been good to me so I manage just fine. This right one like to get stiff in the mornings. He get to loosenin' up as I get up and around though." The pronoun reference to your knee warmed my heart. You warmed my heart even more. I knew I could stand there talking to you all day so I decided to move on.

"Alright then, sir. Your doctor is checking your lab work and will be in here in a few minutes."

"Okay then, baby. Good seeing you, alright?"

"You, too, sir."

"And Miss Manning? Keeping a smile on your face make you look prettier than any old hair dye can any day."

That's what I'm talking about.

One of the nurses overheard that part as she came in to check supplies in the room. I looked over at her from the doorway. "You hear that? That was a good word, huh?"

She laughed and replied, "Ummm hmmm. But I think I'm gonna smile AND dye my hair."

Ha.

This day was a good day.

***
Happy Tuesday.

Today was hard.

2012-01-09T22:41:00.006-05:00

To survive at Grady, you gotta have this.

______________________________________________

Sometimes? Sometimes I just don't know, man. For real. I wonder. . .like how? How do folks slug it out like they do? Take the hits they take, see the things they see, feel the pain they feel and still get up, stick their legs into their pants one at a time and then get on a bus or a train to come to Grady Hospital? How?

I asked a patient if he drank alcohol today. And he said, "Hell naw, I stay away from all alcohol!" And I asked him why. Then he started laughing and telling me about how ALL his peoples were big, big drinkers when he was coming up and how his mama used to be "dranking and swerving and cussing and nodding off behind the wheel."

Oh, and how he, at the tender age of like eight or nine, used to grab the steering wheel with both hands all the time. To keep them from crashing into the median.

And one time? When it was real, real bad? He even drove all the way home. But that was later--like when he was twelve.

Ha ha ha. That's why he "don't touch that stuff."

Yeah. Ha.

Somebody sat in the waiting area for nearly three hours waiting for a family member to let them know if they could wire them some money for the co-pay in the clinic. And it never worked out. If I told you the amount, it would make you cry. And honestly? If there weren't multiple situations like this all day, I would reach in my own pocket and try to deal with each and every one. But I can't.

This is not the first time or even the second time I heard a story of somebody waiting on a ten dollar Money Gram. Oh. Meant to keep that amount to myself.

Oh well.

Somebody with chronic pain and chronic unemployment due to chronic pain was crying in front of me today. A grown ass person. Crying the "ugly cry." I didn't know what to do because I was out of suggestions medically. All out. Not a surgical candidate. Maxed out on pain medications. Limited income. Denied by disability.

And so I just offered all I had. Concern and a hug. And man, oh man. That patient wept and wept. Body shaking and all.

It sucked.

So I thought. . . man. . sometimes? Sometimes I just don't know man.

Why is it so unbalanced? Why do the poor have it so bad here? I still remember when my patient told me one day: "Folks is LOSIN' out here!" And I heard his words and remembered him pounding his hand down on that table. I remembered his words with all those people I encountered today.

I'm sorry. But sometimes on some days. . . it just cuts me down deep. It's a horrible, vicious reciprocating engine. Eight year-old kids grabbing steering wheels and eighteen year-old kids wiring money to mamas and daddies. Somebody's baby sitting on the floor while somebody is cooking up some crack in the kitchen every single day and somebody else watching their mama get stomped straight into that same kitchen floor after giving her body for some of what the rock is cooking.

Yeah.

And then some clueless dude writes a highly offensive article in Forbes Magazine called "If I Were a Poor Black Kid." Trivializing all of this stuff I'm seeing by saying, in so many words, "So what if your mama is nodding off at the wheel (because her daddy was nodding off at the wheel and his daddy before him was, too) and who cares if you are home alone at six or your mama is a child herself! Buck up, kid! Get good grades and make the most out of the free opportunities available to you!"

Chile, please.

If I haven't learned anything at Grady, I have learned this: Poverty is complicated. And overcoming its aftermath is not that simple. No, Mr. Freelance Writer, it is not.

People who grow up without resources or consistent attention or with the wrong kind of attention or with impaired loved ones or uninspired environments, schools, and neighborhoods have a hard row to hoe, do you hear me? It takes a hell of a lot more than some free computers in a public library and free lunch to fix.

Oh. And mix that with some health issues and no insurance and you have not only a big stack of bills, but nothing to work with. At all.

Sorry to unpack this on y'all. But sometimes you just got to unpack.

Sigh.

And THEN I turn on my television and hear folks debating about this, that and the other. I look at those talking heads and hear their issues and watch the spit flying out of their mouths as they vehemently defend their positions on their issues. And I feel my blood boiling because I know Jesus, too, and from what I know, he sho' nuff was down with the poor.

Oh and before somebody thinks I'm "talking politics" know that I am not and do not. I am talking real life and real people waiting in public hospital waiting rooms for somebody to send them a ten dollar wire. And then having to go home because it never came. That isn't politics. That's real talk.

Man. Sometimes I want to jump through that television and yell into that microphone:

"Hey! HEEEYY!!!!It's people LOSIN' out here! LOSIN'!"

But then, I don't even know the solution so even if I could get through that TV screen I'm not sure what it would help. It's so discouraging, man. Seeing people hurting is discouraging. And sometimes? This job is hard. You just ask any Grady doctor and they will tell you. Some days you drive home crying at the imbalance and the enormity of it all. And those days? Man, those days are hard.

Yeah. Today was one of those days.

Man. Sometimes? Sometimes I just don't know.

But here's what I do know. I was born to do this. I'm inspired by the resilience of my patients and feel honored to be here. And no. Not every one of our patients is destitute or without education or caught up with substances of abuse. But still. Our patients deal with a whole, whole lot. Hell, a lot of people are dealing with a whole, whole lot.

So just like them, dammit, I will stick my legs in my pants one at a time and slug it out. And then I will listen and try and think and fight. Then I'll wake up the next day and do it all over again.

And when that doesn't work, I'll just hold on as tight as I can while you weep and weep.

***

Now on my mental iPod. . . .nobody sings it like Teddy Pendergrass

. . .and one of my favorite movie scenes ever that captures how I'm feeling. . . . and what I wish those talking heads would do.

Pink Cadillacs and New Math.

2012-01-09T00:00:00.003-05:00

Overcast Atlanta Skyline.

Random non-medically related rambling ahead. . . .

The weather was crappy here this weekend. Overcast and dreary. Too wet to really hang out or do much. Too warm to enjoy your cold weather fashion.

Oh--you didn't know? The only good thing about cold weather is cold weather fashion. Mmm hmmm.

What the weekend was good for was snuggling. Zachary and I got some superior snuggling in on Saturday. Isaiah was at a play date and Harry was in and out running errands.

The snuggling was Zachary's idea which made it win-win considering how dog-tired I was. He decided that we'd take a nap together because he "was exhausted after his basketball game."

Oh you didn't know? Five year old full court hoops is exhausting people. Exhausting.

image from the Epic Saturday snugglefest, courtesy of Harry's cell phone

Oh!

You aren't going to BELIEVE this. Wait. Let me say it how I really want to say it. Y'all ain't gon' believe this! Yes. You have to hear this mess that happened right here in the Atlanta area this year. As in 2012-this year. You will think I'm making it up, but I promise you I am not!

Okay, so check it. How 'bout this school in Gwinnett County, Georgia sent some homework home with some third graders that said something like this:

"A tree has 56 oranges on it. If eight slaves pick an equal amount of oranges, how many oranges would each slave pick?"

What-what-whaaaaat????? (insert wrinkled face here)

Oh, and if that wasn't enough. . . . how 'bout this one:

"Frederick gets two beatings per day. How many beatings does Frederick get in a week? Two weeks?"

Whaaaaaaaaaaaaaaat???????

No, people. I am not making this up. Nor am I exaggerating.

Yeah, Denzel. I thought this was some bulljive, too!

Can I please tell you that this happened last week? As in January of 2012 last week? Can I also tell you that Gwinnett County is less than thirty minutes north of where I live and happens to be where my mother lives? Bananas. Just bananas.

Slave beatings? Slave beatings? Seriously?! Seriously.

So I know you are wondering what I was wondering--what were they thinking? Oh, well according to the spokesperson for the school, this was an attempt at a "cross-curricular assignment." Oh come on, y'all. . . .don't be so sensitive. You know. . . . a little social studies mixed in with the math. Come on! Isn't that exactly what someone wants their third grader to get in school? A little imagery of somebody's great-great-great granddaddy getting treated worse than cattle in the numerator and somebody's great-great-great grandmama getting impregnated by mas'a against her will in the denominator?

Umm, okay.

That's all I'll say on that. And someone asked why folks still have to give "the nod."

For more information on that story, just go to:

www.WHATTHEHELLWASTHESEFOOLSTHINKIN.NOTHEYDI-INT.OHYESTHEYDID.com

Heh.

Let me switch reels before I drop an f-bomb.

Oh! Quick question--should doctors tell other doctors that they're doctors? I mean, when you go to a hospital or something, should you come right on out and disclose your doctorhood? This is what I am wondering.

I was visiting a friend in the hospital last week and was slightly annoyed by how the doctor explained things to my hospitalized friend. But it's not like I fronted like I was just one of the homies. That guy knew I was a fellow physician because my friend told him so. But still--I was wondering what's the rule on that. What do y'all think? Maybe he gave that crappy explanation because he thought I would fill in the blanks. Maybe.

What else? Oh. Yeah!

I went to the eyebrow threaders today. I was looking a woolly mess and was very sad to learn that my favorite threader-lady had moved to Chicago. Say it ain't so! It gets worse. Lady-next-to-my-lady wasn't there and the only other people there were butcher-brow lady and some lady that I didn't know. Now clearly I wasn't going to butcher-brow lady so I took a deep breath and gambled on new-lady.

Epic FAIL.

Okay, not EPIC. But definitely a fail. In addition to my eyebrows being asymmetric, I also have a slight bit of Curious George action going on. Not quite as bad as the Great Manscaping Debacle, but still. I just should have come back later for a more predictable eyebrow job.

Yeah. So if you see me and I look surprised to see you--it's just the eyebrows, not you.

Is it normal for Target to be a form of therapy? Some people drink when they need to blow off steam. Some work out. Some eat an entire tub of ice cream. Me? I resort to what I like to call the T.T.R. (therapeutic Target run.) This is when you go to Target absolutely needing nothing whatsoever. Just because.

Well today I needed some Target therapy to ease the annoying parts of my week. I even went to Target Greatland which is kind of like making it a double.

Today I walked in through the out door (because that's what you do on a T.T.R.) and hit the dollar bins. Not because I wanted something. Just because I wanted to look at them. Next was the children's clothing. Nothing much there. I scooted over to look at the drug store make-up which I must admit is one of my favorite things of all. Two L'oreal lipsticks later, I headed over to get some snacks because I think I might be snack mom soon for Isaiah's class or Zachary's basketball team. Of course I look at the clothes for women. Miraculously, nothing really caught my eye. In the end, I left with kid snacks, two lipsticks and a pair of gnarly gloves that allow you to use your smartphone while wearing them.

Oh, did I mention? A successful T.T.R. shouldn't exceed $25. It's an art, I tell you.

Oh yeah. When I was looking at the air fresheners and fabric softeners, this woman walked by me and smiled. Her smile was almost flirtatious. Then she stopped, smiled again and then turned around to come back to me.

"Excuse me," she said cheerfully, "Do you mind me asking you a question?"

Now. This woman appeared to be in her late twenties and was dolled up in a trendy little outfit. Her hair was in perfect ringlets and her makeup looked like it had been applied at a department store makeup counter five minutes before. In her hand was a fancy pocket book with some sort of designer scarf tied around it. Her smile was strikingly white and she was grinning so wide that you could see both the top and bottom row of those fluorescent sparklers.

Quick! What do you think happened next?

Do you think she hit on me? Was she lost? Did she mistake me for Halle Berry? (What? It could happen!)

Well, let me tell you. I knew exactly what she was about to say before she even asked that question. Yep, I sure did.

And so, I took a chance and countered, "Only if I can ask you a question first."

And she kept that high watt smile going and replied with a cute little wrinkle of her nose, "Absolutely!"

That's when I knew for certain where she was going with this drive by.

And so I asked her: "Do you work for Mary Kay?"

Yep. That was my million dollar question. And that bottom row of teeth disappeared for the first time as she nodded in the affirmative.

Arrrggghhh! Have I told y'all about how for some reason I'm a Mary Kay Cosmetics Saleslady magnet? It's the craziest thing! They almost always walk by me. Stop. Smile. And then double back and ask the exact same question every time: "Excuse me--do you mind me asking you what you do for a living?"

I am not kidding. This has happened to me in malls. In Targets. In restaurants. And even once next to a lady on a plane. In my head I'm always saying, "Wait for it. . .wait for it. . . ."

Man. I don't know whether to be deeply flattered or deeply offended because clearly I am meeting some sort of Mary Kay Lady criteria. Not kidding.

Anyways. I let homegirl know that I wasn't interested in getting in on the Mary Kay action so she kept it moving. Before she even got to her first pitch. I just hate wasting people's time, that's all.

Maybe I should hold out for that pink cadillac that high sellers from Mary Kay get!

Me and the B.H.E. had a wonderful date night on Friday. We picked up some burgers from this new burger joint in the Morningside area and then came home and watched a movie on demand. The movie was called "Hall Pass" -- have you seen it? Absolutely laugh out loud funny. Kind of naughty at times though. Just saying before somebody rents it from a Red Box and hates me afterwards.

What else? Oh. Last night I was walking out of Barnes and Noble and this woman says to me, "Excuse me are you single? I have a match making service and thought I'd ask you."

Seriously? Seriously.

A matchmaker? Lawd. If it isn't Mary Kay ladies it's a matchmaker. Ay yi yi. . . .I need a makeover.

Hmmm. . .what's next?

Oh. Is it bad that my kids wore their pajamas for the entire day today? Is it even worse that their "pajamas" consisted of soccer shorts and t-shirts so technically those pseudo-peejays became their clothes for the day? Horrible, I know. It was Isaiah who brought this to my attention.

That's all I've got. What's up with y'all?

***
Happy Sunday.

Oh and one more random. . . I love this commercial and all of the ones from Obama's fatherhood initiative. Sure is a lot more positive than math problems about slave beatings. . . um yeah.

Stayin' alive.

2012-01-07T20:28:00.035-05:00

*Names, details, etc. changed to protect anonymity. . . y'all know what's up.

"But now it's alright. That's okay.

You can look the other way.

We can try to understand

The New York Times' effect on man

Whether you're a brother

or whether you're a mother

you're stayin' alive. . ."

~ The Bee Gees' "Stayin' Alive"

_____________________________________

It was chaotic. People running and pointing and reaching and grabbing. So many moving parts. And so all-of-a-sudden, too. This wasn't supposed to happen. I mean technically it could happen at any point. But it wasn't on my radar. Or anyone's radar.

And neither was she.

I'll never forget that day. This lovely phlebotomist was on the ward preparing to draw blood for that four hour time block before it happened. Smiling with her wide smile--unusually striking because of the large diastema between her two front teeth--but stunning and beautiful in its imperfection and in how she owned it. Every time I saw her, I always made time to chat and laugh, mostly because that smile of hers warmed my heart. Gap and all.

So this is how I remembered the timeline from that afternoon. That easy exchange with the phlebotomist standing in front of her rolling cart of Vacutainers punctuated the start of the time clock.

"Hey lady!" I greeted.

"Hey there, doc! You cut your hair some more?"

I rubbed by hand over what little hair I have and chuckled. "Probably since the last time you've seen me. You know? I'd buzz it right down like a little boy if I thought my husband wouldn't disown me!"

And just like that she unrolled that high beam grin on me while simultaneously unrolling a rubber tourniquet to use on the next patient. She caught me looking at her wispy hair--also a short style--but with long bangs swept behind her ears and held snugly with bobby pins. "Yeah, chile. This is about as far as my husband will let me go."

"I like it. It suits you." She blessed me with that perforated grin once more, letting me know that it was time for her to get back to business. Off she went into that room, easy and confident--perfect ingredients for someone charged with the task of finding tiny rolling veins under redundant skin folds.

I could hear similar pleasantries being exchanged between her and someone inside the room with a tone that sounded relaxed and familiar. She was more than likely talking to the daughter of Mrs. Gentry--the patient in bed two--who had been dutifully at the bedside throughout her mother's entire hospitalization.

I went back to what I was supposed to be doing which, at this moment, was typing a note into a portable "W.O.W."-- workstation-on-wheels. I waved at a group of rounding residents and students walking by and gave a fist bump to one of the environmental services workers. I yawned and returned yet again to my task.

I must have zoned out because what happened next caught me by surprise. One minute things were calm and mundane. The next, people were moving all around with a sense of urgency. When the phlebotomist had gotten to bed two, she found Mrs. Gentry to be unresponsive and with cool extremities. She yelled for a nurse to come help and Stan, the nearby nurse, leaped into action.

"Get a crash cart in here!" he bellowed to the other nurses while placing the heel of his hand into the center of Mrs. Gentry's sixty-something year-old chest. "And call a code. NOW!"

By the time I got into the doorway, the team of residents that had just passed by, along with a Cardiology fellow, had already swarmed the scene and a code was underway.

Chest compressions. Monitors being connected. Meds being drawn up. Lines being emergently inserted. And Mrs. Gentry lying there listless like some kind of lifeless ragdoll.

"What's the story? Does anyone know this patient?" The Cardiology fellow had taken over as the leader of the code and tried to grab some history while getting her heart in motion. Those words flew out over the room to whomever had the answers.

"She was. . .I mean I was. . . Oh my God! I thought she was just sleeping!" her daughter squeaked out in response just before someone else spoke over her with a booming voice.

Of course she knew the patient. He wasn't talking to her. He was talking to everyone else.

"Sixty-seven year old female with a known history of coronary artery disease status post two stents placed last year and ischemic heart failure who'd been admitted for acute decompensated heart failure. I think her ejection fraction is around twenty percent and this is hospital day three." That description offered by the intern was firm, loud and controlled. "Slightly elevated potassium this morning but otherwise everything lab-wise was okay."

I noticed the beads of sweat popping out on Stan's brow as his stiff arms rhythmically worked to revive Mrs. Gentry's heart. Right on beat, almost like a pendulum was swinging to help him. That or he was hearing what they teach you in Basic Life Support to sing in your head to help you keep a steady compression pace--"Stayin' Alive" by The Bee Gees.

"Hold compressions!" announced the Cardiologist. "Checking rhythm. . . . .pulseless electrical activity! Resume compressions!"

More voices. More chaos. More people in white coats swarming around the bed.

"Shit! I can't get this guidewire to pass!" The twisted face of the gowned and gloved resident speaking these words showed his frustration. He'd been charged with putting in the central venous line necessary for giving lifesaving medications but wasn't succeeding. "Dammit!"

Members of the critical care team had come in from the intensive care unit and flooded into the room by this point. One of them stepped in to take over for the frustrated resident. Before you could say Rumplestiltskin, that guidewire was passed and the line was being flushed with saline.

More chest compressions. More voices. More people. More medications, now being pushed through a working line fast and furious. Controlled chaos all around.

"Hold compressions!" That Cardiology fellow had the kind of quiet confidence that was needed in these types of situations. All eyes on the monitor to check the electrical activity of the heart at this point.

"V. Fib! Prepare for cardioversion!" he announced--still sure and controlled as he gave his interpretation of the monitor: ventricular fibrillation.

"That's still PEA! I don't think that's shockable." These were the words spoken (loudly) by a member of the critical care team to the code-leader. He had just arrived from the ICU where running codes is their thing. But he wasn't running this code. The Cardiology guy was.

Eek.

"Look, what do you want me to do?" pressed the nurse holding the paddles over the patient's chest. Her eyes were on the Cardiologist who was standing there with folded arms and a now furrowed brow.

"Exactly what I just said. Prepare for cardioversion. All clear!" All of those moving parts and moving people stepped back from the bed as those paddles pushed down firmly on Mrs. Gentry's chest.

I remember the first time I saw someone get defibrillated with an electrical current. I was a third year medical student and was right there front and center doing the chest compressions. My arms were exhausted and I was nearly out of breath; I couldn't tell if it was from the actual act of pumping a chest to "Stayin' Alive" or just the adrenaline pumping through my own veins. Those paddles went down and someone shouted "CLEAR!" and that patient got a big shock.

Well, sort of. His body made a tiny flinch that looked nothing like codes I'd seen on "E.R." No high arching torso flying upward and then landing back onto the bed like some kind of deep water fish recently reeled out of water. Disappointing.

So Mrs. Gentry's shock was equally disappointing but for different reasons. That shock didn't bring her heart back to where it should have been and what was worse was that there was now a question about the heart rhythm altogether.

Clear again. Shock again. Meds again. Nothing again. Intubated by Anesthesia. Shocked some more. More meds pushed but nothing improved. That roomful of chaos that initially looked like some rapidly swirling twister was dying down. . .swirling slower and slower. . .a spinning top that was losing its spin. The frantic bodies were moving with less deliberation; the voices now twinged with the sound of defeat.

"Do you want to call it?" spoke the paddle-holding nurse to that Cardiology code-leader in a voice that was as tender as it was tired.

Call it. Stop the hope. End the twister.

"Ummm. . . .let's try some bicarb," the Cardiologist finally said with a quiet clearing of his throat. Anyone in that room senior enough to have run a code knew that this was the worst part. Calling off the fight.

Bicarb. Yes. Let's try it. The pharmacist began drawing it up and that tired twister spun a little more.

That's when I saw something from the corner of my eye. Backed against the wall wedged between an IV pole and the wall-suction shaking and weeping and looking horrified. Mrs. Gentry's daughter. Who had been standing in the room and present for the entire code.

Shit.

It was like every person in that room began to move in slow motion and become blurry amorphous blobs. Her eyes were wide like saucers and she was clutching her mother's purse against her chest probably out of shock more than anything else. Those saucer eyes were darting around the room, bouncing from voice to voice and horror to horror. Aimlessly tossed about like some sort of ball in a pinball machine.

Shit.

No one was holding her hand or rubbing her shoulder. No thoughtful soul had eased her out of the room or compassionately bearhugged her as she kicked and pleaded to stay. No, not one person at all. Not even that charming gap-toothed phlebotomist with her easy laugh and steady hands. Instead, we had all let Mrs. Gentry's daughter melt into the background and become a fly on the wall of what would likely represent the worst day of her life.

I heard it over and over like a nauseating chant. . .

"Life going nowhere.
Somebody help me
Somebody help me, yeah.

Life going nowhere.
Somebody help me, yeah. . "

It was like she had been singing that refrain to "Stayin' Alive" the whole time and no one had been listening. Not even those who weren't doing anything but standing there watching.

Mrs. Gentry wasn't my patient but I'd chatted with her and her daughter in passing. I'd cracked a joke with them on that first hospital day about her stack of Word Find books and had even made small talk when I saw them both doing bible study together on the bedside tray table. No, she wasn't my patient but I felt like I had somehow failed them both.

Sometimes there are so many people inside of a code that if you arrive even one minute into it, you feel useless. You count up the cooks in the kitchen and make a decision--join in or not? Then, if you don't join in, you might decide to wait near the door in case someone needs you to make a fast break down the hall to grab some kind of supply. And if there's someone there to do that, sometimes. . . you just stand there watching. . . .which is what I did on this day. Humming to the internal beat of "Stayin' Alive."

How could I have neglected to look to see where her daughter was?
How could I have just stood by as a foot-tapping voyeur without catching that part?

But it was chaotic. People running and pointing and reaching and grabbing. So many moving parts. And so all-of-a-sudden, too. This wasn't supposed to happen. I mean technically it could happen at any point. But it wasn't on my radar. Or anyone's radar.

And neither was she.

"Time of death: Four thirty-two P.M." said the Cardiology fellow. He called it. Finally. And just like that, the chaos ceased and like many twisters there was nothing but debris and destruction to show for it.

The only sound in the room was the whimper of Mrs. Gentry's daughter, now burying her face downward into that weathered pocket book. Holding on to this piece of her mother. . . smelling her smell and holding on to her energy. Those whimpers morphed into some guttural moans; sounds that I wish I could say sounded unusual. But at least an earnest medical student had thought to wrap her in a hug. Still young and non-jaded enough to follow some instinctive rules of empathy. And to still be intensely bothered by the sight of this kind of grief.

Thank God.

People filed out. A death packet was completed. Hushed words were spoken to the family. Everyone went back to work and doing whatever they had been doing; the phlebotomist went to draw some blood from the patient in the next room. And that was it. Just like that, a mother, a grandmother, a bible-reader and a word-finder was gone.

Even though that happened a long time ago, something about that scene still haunts me. I hate knowing that this is how someone has to remember losing their mother. I hate that. Even more than that, I hate knowing that someone in that room could have done something to make that memory different for Mrs. Gentry's daughter. . . through a simple touch . . a kind word of explanation. . .by gently guiding her out of that code-algorithm tornado . . . .or . . . .something. Anything. Something. But not just nothing.

Most of all, I hate knowing that that someone could have been me.

The primary team of doctors was talking to Mrs. Gentry's daughter and son-in-law when I walked by. I wanted so badly to interrupt and tell her how sorry I was and even lingered for a few moments hoping I could. But then I realized that those words would be for me and not her.

After all those years of hearing the beat to "Stayin' Alive" in my head during codes, I finally heard the words. And now. . .for Mrs. Gentry and her daughter. . .I always will.

***
Now playing on my mental iPod. . . .

*And to my friend who lived through a similar horror and reminded me of this story. . . .

I will remember to keep others on my radar and teach others to do the same.

History will teach us everything.

2012-01-04T23:25:00.008-05:00

(Guest Post by Neil W.)

Why are these women here dancing on their own?
Why is there this sadness in their eyes?
Why are the soldiers here
Their faces fixed like stone?
I can't see what it is that they despise

They're dancing with the missing
They're dancing with the dead
They dance with the invisible ones
Their anguish is unsaid
They're dancing with their fathers
They're dancing with their sons
They're dancing with their husbands

They dance alone

~from Sting "They Dance Alone"

______________________________________________

Reflection is a powerful tool. It grounds you. . . reminds you. . .awakens you. . .inspires you. I have spent many days closing my eyes and trying to walk in the footsteps of those who came before me. . . which, for an African American woman working inside of Grady Hospital, hasn't required a far stretch of the imagination. I have pored through books about the middle passage, slavery and Jim Crow horrors--because this is a part of the history of my people. And it helps me to appreciate my life more.

Neil W., a fellow Grady doctor and good friend, shares here about his reflections on a piece of his family's history. Neil, like many people of Jewish faith in the U.S., is the descendant of Eastern European ancestors. The journey of his people to this country was often one of sacrifice and pain. With the help of his cousins and other family, Neil has carefully excavated facts and connected the dots between the true story of his maternal ancestors. . . a bittersweet journey of tragedy and triumph.

This story? Yes, it is of one family. But this family tells the story of someone else's family, I'm sure. Someone reading this will recognize these places, these horrors as if their very name had been inserted instead. And. Some reading this will learn of these facts for the first time. And that's okay. Because like we said before, getting each other is a good thing and getting down to the nitty gritty of history can be a good place to start.

And yes. Sometimes. . . . . history will teach us everything.

___________________________________________________

"Remember and never forget it all your days;
and pass this memory as a sacred testament to future generations."

Dr. Elkhanan Elkes, Community Leader of the Kovno Ghetto

Recently I traveled to Buenos Aires to attend a medical conference, then took the opportunity to visit my family in neighboring Brazil. Normally the prospects of gallivanting through South America would’ve had me flying high, but as the trip neared I felt conflicted. My 22-month old son Matthew had become quite the little man and our strong bond was growing with each and every day. Leaving his side for a whole week seemed almost too much for me to bear.

Matthew takes his morning run

Just before my trip, I received a priority package from my uncle Elliott, who was retiring and moving out of his long time Chicago home. Being the keeper of the family tree that I am, he’d decided to send me his collection of family pictures & memorabilia.

The convergence of these seemingly disparate events forged a powerful reflection, reminding me of just how fortunate I am to be living here—in this time, in this place. To understand my sentiment you have to know the story of my family; it begins in Eastern Europe around the turn of the 20^th century.

Lithuania

The Grobman Family

My great grandparents, Isaac and Elke Grobman, and the generations that preceded them lived in the largest city in Lithuania called Kovno (in Polish) or Kaunaš (in Lithuanian). Throughout history the Jews of Kovno were periodically exiled by the town’s leaders and were forced on many occasions to leave. They didn’t need to go too far however, as they were allowed to settle in an impoverished district across the Neris river called Slobodka (Vilijampole is the formal Lithuanian name). It was in this village or “shtetl,” that Jewish life and religion took hold.

A shtetl in Poland (image credit)

Isaac and Elke had 5 children, the youngest of whom was my grandmother Fruma (often changed to “Florence” by emigrants to the United States.). Several months after her birth in 1915, Isaac died at 36, from complications of diabetes, leaving Elke to struggle in poverty as a single mom. Around this time World War I broke out and the Jews of Kovno suffered terribly as they were expelled (regardless of illness or handicap) from the city of Kovno. It was a difficult way of life and Elke tried desperately to provide a better opportunity for her family.

In 1928 the oldest Grobman child, Leo, along with his wife, had an opportunity to teach a recently created language called Esperanto (touted as the universal secondary language) in Brazil. And so they set out to South America for a better life.

The following year, my grandmother got an opportunity to leave next. Her aunt (Dobra Grobman), had emigrated to the United States two decades earlier, settling in The Bronx, New York. She was contacted and agreed to care for my grandmother--at least temporarily--as plans were made for an arranged marriage in Chicago (by whom I do not know).

I could only imagine how difficult it must’ve been for my grandma to get on a boat alone, at the tender age of 14-- not speaking a lick of English--and then travelling thousands of miles to a new world and family that she'd never met before. If I close my eyes, I see a clear picture of her with tears in her adolescent eyes as she said goodbye to her mother, 2 sisters (Hinda and Hana) and her brother Dovid (Yiddish for David).

Given their proximity in age, Dovid was the big brother who always watched over my grandmother. He was a kind soul and anyone who had the pleasure of meeting him considered him a real “mensch” (Yiddish for a person of integrity and honor). My grandma would miss the security of his presence and her mother’s wisdom the most.

Ellis Island.

My grandmother arrived at Ellis Island and was met by her Aunt and cousins. She did, at some point, travel to Chicago but pulled the plug on the arranged marriage soon after the rendezvous. (I remember asking about it years ago and her referring to the guy as a wimp, “not for me.”) Anyone who knew my grandma understood she had a penchant for telling it like it was.

She came back to The Bronx, worked manual labor jobs scrubbing floors and sent whatever she could back home (items such as cigarettes, gum and candy were hot commodities that had a high trade value). She then met my grandfather Abe, whose family had emigrated from Poland.

Dapper duo, my grandparents circa 1933

A few years later they married in 1935. Their first child, Rhoda (my mom) was born in December of 1939. Three months earlier, on the other side of the Atlantic, the German army steamrolled into Poland, marking the beginning of the Second World War.

Despite these concerns there was much to be thankful for. Lithuania had enjoyed an independent 20 year period after WW I and despite waves of anti-Semitism, the Jewish community in Kovno had grown, comprising a quarter of the city’s population; many were respected professionals, skilled artisans, and small business owners. My grandma wrote home with excitement, proudly displaying pictures of her new bundle of joy. My great grandmother playfully wrote back; handing out motherly advice, like not to sleep with the baby in bed for fear of rolling over. There was other good news as well: Hinda and Hana, each had two children of their own and Dovid had a newborn son. Leo also was making a life for himself in Brazil and now had two children as well. The family was spread apart on 3 continents but remained close as ever.

Soon after Germany’s invasion of Poland, Soviet troops (a result of the connivance between Hitler and Stalin) once again marched into Lithuania, executed large numbers and deported many to Siberia. Despite the significant number of Jews among the victims, Lithuanian anti-Semites spread propaganda that this was Jewish “revenge” against Lithuania.

The Soviet Union’s annexation of Lithuania lasted approximately a year, until June 22, 1941, when the German armies crossed the Soviet border and invaded. Most Lithuanians welcomed the Nazi occupation as it meant freedom from the brutally oppressive Soviet regimen.

One day after the German attack, the last Soviet forces had left the city, but the Germans had not yet arrived. In this temporary power vacuum, an “independent” Lithuania was proclaimed on Kovno radio. Lithuanian nationalists and pro-Nazi partisans patrolled the streets, robbing, beating, humiliating and killing Jews. On June 25–26 a massive pogrom took place in Slobodka, savagely killing over 800 Jews. On the next day, in a sadistic spectacle, dozens of Jews were beaten to death in two garages in the center of Kovno. The most well documented of which was the Lietikus Garage, which occurred in broad daylight as an audience of several hundred cheered and clapped enthusiastically as 68 Jews were killed one-by-one with iron bars.

Two weeks later the Jews of Kovno learned of the establishment of a ghetto in Slobodka-Vilijampole. My family had already been living in Slobodka and the conditions there were poor; small wooden houses, with no running water or adequate sanitation. The majority of the Jewish population however, (nearly 30,000) lived in Kovno, and would have to cross the Vilija bridge into the ghetto, which would be divided up into a large and small section. A quarter of the population of Lithuania’s largest city would now be crammed into just a few blocks. Anyone defying these orders would be killed.

On August 15, 1941 the ghetto was “closed,” encircled by barbed wire and heavily guarded. Living in my family’s home already were my great-grandmother Elke, her children Hana, Hinda, and Dovid, along with their spouses and all the children. I’m sure others were required to pack into their residence as well, as the living space available in the ghetto averaged a mere 10 square feet person.

Cramped quarters in Slobodka

Life in the ghetto was brutal. It functioned essentially as a forced labor camp for the German military. If you couldn’t work, you were another mouth to feed and expendable. Rations were meager and most starved. Those who could work outside exchanged whatever valuables they had left for food. Every Jew inside and outside the confines of the ghetto was forced to wear a yellow star. Three days into the closing off of the ghetto, 534 people were killed in the first series of anti-Jewish operations, called “Aktion” in German.

Then on October 4^th, the Small Ghetto was liquidated and half of its occupants (1800 men, women and children) were taken to one of a series of Forts (Fort IX) that surrounded the city and were executed. The hospital for contagious diseases was set on fire and burned to the ground with its patients and staff locked inside.

On October 28^th all Jews were told to assemble in Demokratu Square. Sergeant Helmut Rauca, the head Gestapo officer, along with S.A. Captain Fritz Jordan, began what was referred to as the “Great Action.” Each of the 30,000 inhabitants of the ghetto had to pass before them. While they tried to make reassurances that the process was only to sort the labor force, most knew otherwise. This was a decision as to who would live or die. Below is an eyewitness account:

“From the beginning it became evident that Rauka was judging the people basically from their physical looks, their clothing, cleanliness, and size of the family. The younger, stronger and better-dressed people, with smaller families, that had less children or aging parents, were sent to the "good" side. The elderly, the ill, the weak looking people, families that did not have a man as the head of the family, families that were badly dressed or didn’t look clean, he sent to their death. There were hair-raising scenes when the murderers would decide to separate between families. Parents from children, and husbands from wives. Heart rending cries of despair could be heard throughout the huge place as families were torn asunder. The square began to fill up with dead bodies of the old and the sick who couldn’t endure anymore the rigors of the day and gave up their ghosts. Only the two henchmen were tireless, standing the whole day eating sandwiches and drinking coffee brought to them by their orderlies. Finally when Jordan and Rauka got the word that ten thousand men, women and children were now in the small ghetto, they called it a day.”

I can only imagine what my uncle Dovid experienced as he waited his turn in line. He was a strong man with a chiseled physique--over 6 feet tall and 200 lbs, and he looked every bit able to care for his family. My aunts were also married so everyone had a head of the household. To the best of my knowledge, everyone in my family survived this death selection. Tragically, the near 10,000 who were destined for death were taken to the Small Ghetto, then led to Fort IX the following day, where they were executed and thrown into freshly dug pits.

The “Great Action” stunned and sent the ghetto community into despair, as everyone knew someone who had been murdered. Comparatively, the following two years was a period of relative stability as Jews labored away in hunger and fatigue for the German war machine. At home in The Bronx, my grandmother was busy raising my mom and had just given birth to her second child in 1942. Her anxiety grew as she heard rumors about the German atrocities and had completely lost contact with her family.

Jews in the ghetto strived to maintain some form of normalcy. Two schools of about 200 students each were set up in supremely crowded conditions. The Germans closed this down a year later but clandestine private education continued. Another ghetto hospital opened and made use of whatever supplies were on hand. There was no maternity ward as pregnancy was made punishable by death.

On November 1, 1943 the SS (German secret police) took control over the Kovno Ghetto and it was officially transformed into the Kauen Concentration Camp. With rumors of other ghettos being liquidated and with the SS carrying out brutal and mass deportations to Estonia, most felt as if the camp’s days were numbered. Parents desperately tried to find reliable and accepting Christian families to smuggle their children out. Others attempted to build hiding places in case another killing time were to come. During late 1943 and early 1944, a resistance movement took hold. Money to buy arms, to provide transportation and to bribe guards was raised in the camp. Hundreds of Jewish partisans escaped to the forests of Lithuania and continued to run operations.

The Germans eventually became aware of the relationship between the underground and the ghetto police (Jews assigned to keep law and order; in exchange for privileges such as protection from deportation). On March 27, 1944, 130 members of the ghetto police were tortured, and after efforts to get more information were unsuccessful, 36 were killed at Fort IX. On the same day began the nightmarish 2-day “Children’s Action,” in which approximately 1300 victims—children under the age of 12 as well as those over 55—were dragged from their homes and hiding places. It is during this event that the children of Dovid, Hinda and Hana (my cousins) were all killed—except for one, Isaac.

The depths of desperation and despair my great aunts and uncle must have felt are unfathomable. They had already survived inhumane conditions, dodged bullet after bullet, only to have it come down to having their children forcibly ripped from their clutches. What else could there have been to live for?

Life, if you can call it that, dragged on for several more months in captivity until the midsummer of 1944, when the Soviet armies again entered Lithuania. With the threat of the advancing Red Army, the time had come to liquidate the concentration camp. Over a 6-day period from July 8—13^th the Germans evacuated the camp, burning it to the ground with grenades and dynamite, then deporting most of the remaining Jews on boxcars to the Stutthof camp in Prussia. There the men were separated from the woman and sent to the Dachau concentration camp in Germany. The time had come for my uncle Dovid and his two brothers-in-law (one of whom survived) to say goodbye to the Grobman women. I am certain they too, had to be forcibly torn apart. As they uttered their goodbyes, they surely hoped and prayed to see each other again.

It never happened.

Elke and her daughters Hana and Hinda were later killed. Three weeks later, August 1, 1944, the Soviet army liberated Kovno, but it was too late.

My uncle Dovid arrived at Dachau physically and emotionally tormented. He summoned an inner strength however, and pushed onward. Perhaps it was the hope of seeing the remnants of his family or maybe it was bearing witness to the atrocities that had befallen his people. Over the next 10 months he managed to work and stay alive.

As American war planes streamed overhead and bombs pounded the ground in April of 1945, the Nazis stepped up their killing. I don’t know the exact details, but at this point my uncle had grown weaker and weaker, nearing death. He may have been left for dead and tossed on a pile of corpses or perhaps during a mass execution he managed to avoid being shot and fell first. Whatever the circumstances, he was barely clinging to life when American forces came rolling into Dachau on April 29, 1945.

Upon their arrival, the GIs could not wrap their minds around what they were witnessing. Battle hardened men became sickened and nauseated by a site of horrors that defied description. While government officials in the U.S. had long knew of the genocide of European Jews and other “non-Aryan” peoples (the politics of rescue are a book in of itself) those on the ground had little in the way of forewarning. Bodies lay everywhere; thousands and thousands of corpses that had not made it to the crematorium. One GI saw slight movement on a mountain of corpses and shouted for assistance. Together they dragged out a 60-lb. pound skeleton—my uncle Dovid.

My uncle was then taken to a Red Cross Hospital where he eventually regained his strength and made a full physical recovery. Many inmates survived liberation but were not as fortunate, as their illnesses were too severe. After being released from the hospital uncle Dovid was sent to a displaced persons (DP) camp. There he met Feige, whom he had known in Slobodka. Feige had also suffered tremendously in the ghetto, marching 3 miles each way to the Aleksotas Military Airfield (which still exists as a civil aviation terminal at Kaunaš), then laboring as many as 15 hours a day and marching back. She had been married with several children too, but they were all gone. In their grief my aunt and uncle found love and companionship and soon married. While in the DP camp they had twin girls. It was a common occurrence to see children born in the DP camps, as couples were defiantly fruitful. Additionally, experiencing a new beginning and infusing joy into one’s life quite possibly may have been the only way of remaining sane.

Back home in The Bronx, my grandma immediately assumed the worst. How could she not? The Jews of Lithuania had numbered 244,000 before the war. Now there were only 6,000; almost 98% had been killed. Think about those numbers for another second. The odds of survival were bleak.

Losing her whole family had thrown my grandma into a state of unimaginable grief, but life had to go on. She had a family of her own and was pregnant with her 3^rd child (Uncle Elliott, who sent me the family memorabilia). Then one day while collecting mail outside of her apartment, she opened a letter which read:

Dear Florence Rubenstein,

“There is a displaced person in a European refugee camp by the name of Dovid Grobman from Slobodka, Lithuania, who lists you as a family contact. If your maiden name is Grobman and you are indeed the Florence Grobman that he is referring to, please contact HIAS officials at….”

My grandma hit the ground, pregnant belly and all and began wailing. Neighbors came running to offer assistance. Joy soon rang out as my grandma, through heavy sobs repeated, “Dovid’s alive, he’s alive.”

The Hebrew Immigrant Aid Society (HIAS) helped to facilitate my uncle’s arrival in the U.S. The Society has a long history of aiding displaced persons (read how there may not have been a Google without HIAS (http://www.nytimes.com/2009/10/25/us/25donate.html). In order for my uncle to gain entrance into the country, my grandparents had to complete a ton of paperwork, ensuring the government that my uncle would find meaning work and not be a societal burden.

Then on that fateful day, after being apart for 20 years and thought to have been gone forever, my uncle, aunt and their two children Rita & Eleanor, stepped off the S.S. Ernie Pyle at Ellis Island. What a reunion it must have been. Several news agencies covered the story and followed my family back to the The Bronx. I remember seeing pictures from the NY Daily News at our house, but for many years I could no longer find the newspaper articles. I had given up looking for them and hoped that someday they would somehow reappear. Little did I know uncle Elliott had also kept a copy.

Photo from the New York Daily News Mar 24, 1948: Stepping off the S.S. Ernie Pyle at Ellis Island

Photo from the New York Daily News Mar 24, 1948: Arriving at my grandma’s apartment in The Bronx

Upon arriving in New York, Uncle Dovid and his family proceeded to live in my grandparent’s Bronx apartment. My mom, who was 8 years old at the time, recently described to me what life was like. She, along with her two brothers, were moved out of the second bedroom and had their beds placed in the hallway or living room. Nine people (four adults and 5 young children) proceeded to live in a 2-bedroom, one bath apartment. Of course there were sacrifices, like waiting for the bathroom or having little privacy, but they made do. My mom was old enough to understand that her uncle had suffered a great, unimaginable tragedy, but that’s all she knew, as it was a topic off limits for discussion. However, the sorrow was all around. From her hallway bed she would occasionally hear the night terrors as my uncle slept; the heavy sobs and groans piercing the doorway of the bedroom.

After several years, working and saving, Uncle Dovid and his family moved to St. Albans, Queens, and continued to work in grandpa’s haberdashery business. I have fond memories of my uncle, the most vivid is as a young boy when he would stealthily hand me spending money, then make me promise not to give away our secret until he was long gone. He passed away before my tenth birthday and I never had the opportunity to learn about any of the family history which I just shared. My aunt Feige, lived well into her 80’s and only recently passed away.

Survivors: Uncle Dovid and nephew Isaac

The Story of Isaac’s survival

Isaac was born in 1926 to my aunt Hana. He was the first Grobman grandchild and was approximately 3 years old when my grandma left for the U.S. The following year, Uncle Dovid sent her the picture above of his nephew (Isaac) and him. A little over a decade later in 1941, Isaac, now 15, attended a summer camp in Palanga (a popular Lithuanian resort town along the Baltic Sea). That move, unknowingly, saved his life.

As news spread about the German invasion, there was no going back home to Slobodka; Isaac never saw his parents or his 4 year old baby brother Melech (a Hebrew-Yiddish first name meaning “King”) again. The camp directors evacuated the children to Russia where at first they were taken in by an orphanage. Isaac then worked tirelessly at a factory, making weapons for the Russian army. After the war he returned to Kovno only to discover that none of his family had survived. He was drafted into the Russian army for a 4 year term then immigrated to Israel. Eventually he traveled to the U.S. in the 1970’s to reunite with Uncle Dovid (by then called “David”). My mom had the opportunity to travel to Israel for the first time 5 years ago to visit with him. Unfortunately he was in declining health and passed away several years later. I am deeply indebted to Isaac; although I never had the honor of meeting him, much of what I am now telling you comes from him in response to my queries. As painful as it was to relive, he gave his daughter Frida a detailed account of his life back in Slobodka. Frida was then nice enough to meticulously jot everything down and email it to me.

Of course, it would’ve been simpler to have asked my grandma these questions during the thirty years we shared. However, every time I would broach the subject it was like releasing a spigot of tears. I quickly realized that it was more compassionate to remain ignorant regarding my family’s history than to put someone who I loved dearly through so much pain.

However, from what she did tell me, the pictures, my mom’s recollections, Isaac’s account and my study of the Holocaust, I have been able to piece together the details. My grandma passed away in 1995 during my second year of residency training. Not a day goes by that I don’t think about her in some way. Her love for her children/grandchildren, outlook on life and tireless work ethic are just a few of her legacies that live within me.

"One day we'll sing our freedom
One day we'll laugh in our joy
And we'll dance. . .and we'll dance. . . "

~ Sting

Better Times: Celebrating my medical school graduation with grandma and the rest of the family at Carmine’s in Manhattan, May, 1993.

I would like to thank my mom’s second cousin, David Fishlow. David, at the age of 5, was at the fateful family reunion in 1948 on the dock of Ellis Island. His family however, moved out of The Bronx soon after and lost touch for the next 50 years. We serendipitously connected online, given his strong genealogy interest and met for the first time the following year during a visit. I am indebted to him for his detailed stories about his trek back to Lithuania and visiting the site where the old house stood in Slobodka.

Lastly, I'd also like to thank my Brazilian cousins who have welcomed my visits to South America with open arms and warm hearts. My great uncle, Leo passed away years ago and another link to the old country was lost. My cousins however, have been eager to come along on this journey with me as we discover more and more about our family’s history.

After the medical conference: Visiting with my Brazilian cousins who still bear the Grobman name (Sao Paulo, Brazil)

Here with my mom, Rhoda.

Epilogue

While the trip to South America and the family photos summoned these powerful memories there’s another even more persuasive reason for me to finally document my family’s history—I am now a dad.

My uncle’s children were 4 and 2 years of age at the time of their deaths and part of me rationalized that their young ages somehow mitigated the emotional trauma both he and my aunt experienced. Now that I’m a father, I see that in many ways what they went through was even worse.

In the short time that my son Matthew has been here, I can’t remember what life was like without him. At so young an age, he’s developed a personality, can communicate what he likes and dislikes, and everyday seems to reach another milestone. I have spent hours instructing him and playing ball with him, placing my hopes and dreams upon him for every possible success. And that’s the point; to have those hopes and dreams shattered, to have your child ripped from you, crying out, with you powerless to “make things all better,” is the worst thing on earth I can possibly imagine.

When I arrived home from South America I entered the door to find Matthew playing with his toys. He looked up, gave me a big smile and then returned to what he was doing. I dropped my luggage, snuck up on him and gave him the tightest of embraces, ever so grateful to be living here—in this time and in this place.

The next generation: Matthew at several weeks of age (making his WebMD debut), my wife Tamara and Kim. A big note of thanks to Kim for making my trip to South America possible, covering my work for a whole week!

***

Now playing on my mental iPod. . . a song inspired by a different historical tragedy (executions in Chile) but with a melody that moves from tragedy to triumph. . .reminiscent of what Neil's grandmother must have felt when she saw her brother Dovid . . .alive.

Drumroll.

2012-01-04T11:23:00.003-05:00

Of the more than five hundred posts that have appeared on this blog, only one of them was written by someone else. My one and only guest blogger happens to be my mentor-slash-friend-slash-fellow-Grady doctor, Neil W. And as of 2012, this fact shall remain.

Believe it or not, it was Neil who I credit as part of the impetus behind me writing more. A few years back, he asked me to write a chapter for a book of narratives he's been working on, and one chapter became two chapters. Writing again felt so exhilarating that I was inspired to do more of it. And so. Voila. Enter "the little blog that could."

Neil and I chat a lot about our families and all sorts of things during our meetings. Neil has shared a lot of stories with me. Some of those stories, like the day he paid a homeless guy in Brooklyn to break into his dad's Cadillac, are laugh out loud funny. Some, like the story of when he lost his beloved Cadillac-loving father, left me tearful and speechless. One day he mentioned that there was one story in particular that he'd been thinking of writing about. Interestingly, this was one that we had never discussed.

Coincidentally, I posted about an experience I had with a patient with swastika tattoos that I'd seen at Grady one day. Realizing that Neil reads my blog and is of Jewish faith, I asked his thoughts about that experience, wondering what it might have been like for someone like him. Over that discussion he said this:

"Remember that story I said I was going to write about? It would probably explain a lot about how I feel about all of this."

And I just left it at that.

A few days ago, Neil sent me what he'd written. And I am so, so honored that he has decided to trust us with this story. Yes. It will be posted here, which keeps Neil W. firmly in the role of the one and only guest blogger ever to write for "the little blog that could."

Yup.

Whenever people are coming to our house for any reason, I make a point of telling Harry and the kids. Even if it is someone stopping by for two minutes, if they are coming into our home, I give them a heads up. I just think when folks are planning to sit on your furniture or enter into your personal space, you should know in advance, don't you? It also lets you prepare to welcome them properly.

This is no different.

And so. Come back soon to read the words of another Grady doctor. Those words gave me some added cultural competency, a bit of a history lesson and even more perspective on what it means to love. And you know? I am learning piece by piece and bit by bit that love makes hearts soar in every language and makes pain and loss hurt just as deep on any continent and in any color. Yes, it does.

Thanks, Neil. We 'preciate you.

***

Top Ten: The Best of 2011.

2012-01-04T10:09:00.003-05:00

Floating wish lantern, December 31, 2011.

Well. Here we are in 2012. 2012! Yep.

Okay.

Can I give a tiny confession? 2011 wasn't my most favorite year. Wait--that's negative isn't it? I mean. . . in the big picture sense it was definitely a good year. I guess there were just some parts of it made it . . .well. . .just not my favorite, that's all.

Sigh.

Either way, being the Pollyanna that I am, I can always wave my hands and focus on the good parts--which there definitely were good 'n' plenty of in 2011.

And so I will. So here's to 2011 . . . . . . . .

The Top Ten Favorite Parts of 2011 (which fortunately made the least favorite parts less annoying.)

By the way, living life with the B.H.E. and Things 1 and 2 go without saying. These are perennial favorites so this should always be understood.

#10 -- The Big Snow of January 2011.

Last January it snowed in Atlanta. Yes, it snowed. And snowed. And snowed some more. The problem with it, though, was that the temperature hovered somewhere between freezing and not freezing for several days. This meant that during the day, it would start quasi-melting. The quasi-melted parts would then freeze at night. That made driving anywhere absolutely impossible (unless of course you're Neil W., but that's a whole 'nother story.)

Anways. I am sure this all has you wondering, "Uuuuhh. . .so why is is this on your list of favorites?"

Here's why:

For seven days, we did things like this. We built forts. We drank real hot chocolate. We watched movies. We cuddled. And we had wonderfully uninterrupted family time. At some points we didn't even have cable so there wasn't even any television to compete with.

It was awesome.

#9 -- Rediscovering School House Rock with my kids.

YouTube is something pretty special, man. Thanks to YouTube, my kids and I watched every single episode and song from School House Rock a minimum of five trillion times. Zachary took to them in particular, and knows nearly every word to every song. Well, sort of knows the words.

Case in point:

#8 -- Match Day and Commencement 2011.

Match Day:

Commencement:

Among my favorite-favorite-favoritest moments of 2011. Hands down.

#7 -- The Bieber Bomb and other laugh-out loud moments with my kids.

I laugh OUT LOUD at this every single time I hear it. It never, ever gets old. Ever.

This is actually a video but appears dark because we were lying in bed with the lights out. This was during our "lullaby time" and our favorite "lullaby" to sing together happens to be an old James Taylor song called "Close Your Eyes." Even if you've seen/heard this before, it will still make you laugh. This PERFECTLY captures the relationship between and spirit of my two children. I will cherish this forever and am so happy I pushed record that night.

(Remember -- non-YouTube videos won't show up on your smartphone or iPad so be sure to come back and check it out on your computer.)

Bwaaah haaaaaaa haaaaaaaa. . . . .phew! This was just one of many funny, funny moments with my kids.

#6 -- Mama (y Papa?) Gallina.

As most of you know, I do some media appearances from time to time. What you may not know is this: To me, the very best part of being on television--especially any national segment--is how ridiculously proud it makes my parents.

Oh. Em. Gee.

Sometimes I question whether I should ever go to CNN again for fear of my father's health! Talk about excited. Lawd. . . it never gets old for him.

But seriously, though. . .I realized that once you become a full-grown adult, you don't have as many opportunities to make your folks that kind of proud. You know. . . that proud they feel when you say your lines loud and animated during the elementary school program or when you win the spelling bee or make a soccer goal? Yeah, that. It's funny. . . once I graduated from medical school and residency. . .those kinds of moments became rare. I mean, yes, I know my parents are proud of me on a day-to-day basis, but I'm talking about those super-duper poked out chest moments, you know?

My friend Shanta's husband, Fernando H., has a name for this. When she gets super proud of their kids or her family or her friends he calls her the "mama gallina."

Shanta Z. (aka mama gallina original) y los pollitos.

In the literal sense, this probably translates to being a "mother hen" which technically isn't the most flattering thing in English. But it isn't English, now is it?

Ha.

Yeah. . . .this term--"mama gallina"--I like. I like it because it captures the sound in my parents' voices and the emoticon-laden text messages they send after any television appearance I do. Okay, and even though my dad is actually a "papa", he definitely gets the "mama gallina" poked-out chest like nobody's business. (Remind me to ask Fernando and Shanta if there is a male version of "mama gallina.")

I assure you that my father sent a minimum of one thousand texts when this aired.

So anyways. The point of all this is to say, at forty-something years-old, it feels really, really good to make my parents so acutely proud. It really does.

#5 -- JoLai's Big 4-0.

Nothing against any of my other siblings, friends, or family, but my sister JoLai is probably the best person I know. Being in L.A. to celebrate her birthday with throngs of people who felt the same way was one of my most favorite moments of 2011.

#4 -- Small Group Moments.

Small Group Alpha (Class of 2011)

Small Group Beta (Class of 2013)

Small Group Gamma (Class of 2015)

Next to caring for patients, my small groups are the very best part of my job. I care about them in a way that goes beyond how you care about your students. Working with them for four entire years does this to you. The group dynamic evolves into something special but also the individual relationships I form with each person are even more special. And what's really nice is that these bonds are formed in classrooms and hospitals, yes. But often because of the nature of our curriculum, they are built right in my house where they all feel welcomed and relaxed and safe.

SG Beta, small group session.

Barefoot learning with SG Alpha at the Manning house.

Now that I think of it, this is what made me love Match Day and commencement so much. Because of moments like these, the mama gallina in me got to feel a little bit of what their parents were feeling, too.

#3 -- Camp Papa.

Two boys. One grandpa. Four weeks of fun on the west coast. The best part about this year is that now they were both old enough to remember it. I am so happy to know that this is a memory they will carry with them for the rest of their lives. Grandparents and parents don't live forever. But memories do.

#3 and a half -- The Kids returning from Camp Papa.

There's nothing like the sight of seeing children who are happy to see their father. (Especially when you happen to be madly in love with their father.)

Gaaaaahhh.

#2 -- Summertime with children.

All of it.

#1 -- Writing this blog (and talking to my mother about it.)

I'd like to think that I inherited my interest in writing from my mother. She's an avid reader and a damn good writer, too. (Remind me to harass her about starting her own blog--she technically has one but never posts.)

My mom reads my posts religiously and quite often leaves me a subsequent text message informing me of my typos and grammatical errors. Sometimes before she even finishes reading the post. Although I give her a hard time about it, I love that she does it. It's one of the ways we've bonded over the last few years. Not that we needed any extra bonding. . . but that's been a nice bonus of doing this.

I have also loved building relationships with other virtual friends through my blog and through their writing this year. People like Sister Moon and Angella Lister have become sho' nuff and bona fide friends-slash-mentor-esses. So have people like Ann I., Dr. Toni B., Elizabeth A. and the adorable Rachael C. I've followed the brave fight of one beautiful little red-headed girl named Ella against leukemia and stopped by Oklahoma to hang out with Sarah D. who also has a B.H.E. Yep, this world has introduced me to fun people like Omgrrrl and the ever-honest, ever-hysterical, ever-potty-mouthed (yet ever-so-sweet) SB.

And. Through this blog I have become face-to-face friends with people like Psonya from Pserendipity and Lisa R. who did her hair in fancy buns like Princess Lea for her son Bob's birthday. I have also been able to travel all the way to Uganda and even dip my feet in the Nile with my dear-heart Kris R. thanks to her lovely writing, too.

Then there's the people who don't blog but who read. Sometimes you delurk and comment but even when you don't, I feel you sitting there with your coffee as if we were having it together. And that's really, really special.

L'chaim!

But best of all? I've gotten to know me better in 2011 thanks to writing here. I've gotten to hash out my kooky thoughts and put them back together again. Thanks to this, I've found a place to come back to them, to laugh at them, and to cry at them over and over again. And oh, how I love this! It helps me remember the fine details that get lost sometimes. Yes, it does.

Oh yeah! And! And, and, and! My F.P.s (favorite patients) get to stay with me in high def forever. And now . . . some of them have become your F.P.s, too.

(Mom has a particular love for the Grady elders.)

The lady in the orange shirt.

You've listened to my mental iPod with me and gone on all sorts of journeys from hospital elevators to restaurants and even to the Target checkout line. You've sat by patiently as I looked for stuffed puppy dogs, parented my children and professed my nauseating amount of love for my husband. Your comments have helped me to understand myself and the world a bit better. And that? That's been rad.

All of it.

The woman in the elevator, Miss Regina.

So there you have it. My top ten favorite moments of 2011, which now that I think of it, was a pretty good year after all. I'm sure I'll remember something or someone I left out.

Or my mom will. Ha.

***
Happy 2012, y'all.

Just do it for love.

2011-12-30T17:50:00.002-05:00

"In your world of noise
Or in your quiet place
Whatever you say
Whatever you do. . . .

Just do it for love."

~ anonymous man on the beach

This lovely man sang an original song for my friends and me today on the beach. He threw back his head and lifted his voice over that salty air like no one was even watching. And it was beautiful. Really, really beautiful like bells ringing in unison or Etta James singing "At Last."

I asked him his name and he just laughed real easy-like and said, "Yeah, mon, I'm just the singing guy." And that was as much as he was willing to say so I left it at that.

The Singing Guy sang that song plus another by Tracy Chapman that was hauntingly soulful. We applauded and he beamed brighter than that Caribbean sun -- seeming to appreciate our genuine entertainment far more than those few loose bills we dropped into his hat.

That made me think about all of the amazingly talented people in tiny pockets all over the place and how few people get to see them or hear them. Strumming guitars and writing music that sounds as perfect as anything I could purchase on iTunes. Or maybe even better.

As a writer, I relate to this. Our applause was affirming. And affirmations feel good.

And so I offered more. "Singing Guy, I loved your original song the best of all. Those are good words for me to hear in my head going into a new year. Thank you for sharing them with us."

And he beamed again. This time even brighter.

I recorded his song and have replayed it for myself two and a half times already. (That's how I remembered the lyrics.) Even though he gave me permission to share his picture and my little iPhone video, I wasn't fully sure if I should. Hmm. Will think about that some more.

"In your world of noise
Or in your quiet place
Whatever you say
Whatever you do. . . .

Just do it for love."

That's a good word on a whole lot of levels. Yeah, mon.

***
Happy Friday.