Reflections of a Grady Doctor: I get so emotional every time I think of you

Showing posts with label I get so emotional every time I think of you. Show all posts

Tuesday, May 29, 2012

Love's Myopic View.

me and my daddy, eighth grade graduation 1984

"It's like forgetting
the words to your favorite song.

You can't believe it

You were always singing along.

It was so easy and the words so sweet.

You can't remember

you try to feel the beat."

~ Regina Spektor

________________________________________
Daddy, I see you in a three piece suit. With a brown suitcase gripped tightly in your right hand and an afro so perfectly round that it defies the laws of afro-nature. I also see you with a bright gold headband around that same natural that, on weekends, you allowed to be distorted by terry cloth and elastic. Your goatee is immaculate, your shorts nineteen-seventies short and your socks Kareem Abdul Jabbar high. There are other times that I see you squatting behind twelve year-old Little League catchers with a that funny little umpire cap and a mask covering your face. Calling out in this throaty and animated voice phrases like, "Yerrrrrrrrrrr outta there!"

me and my daddy, Emory SOM graduation 2012

Later I see you with male-patterned cowlicks in your afro. But still I see you as a strong, athletic thirty-something father in a suit on weekdays and at Getty's Baseball Field on Saturdays.

mommy on my wedding day, 2004

Mommy, I see you as an officer in the PTA at my elementary school and with your brow furrowed over a Singer sewing machine before the first day of school. I see your hand on a steering wheel and hear you snapping Wrigley's spearmint gum in between KABC TalkRadio shows. I see your hair dyed some unnatural shade of reddish-blonde with your dark roots emerging --yet owning the look like the Beyonce of your time--eyebrows arched almost to non-existence. After that, I see you with your coif shorn into a natural. And later with some sassy version of the "Anita Baker" haircut.

retro-mommy with newborn, preemie JoLai (in her twenties, not thirties)

But still in all of those versions, I see you as a thirty-something.

And yes. On most days for me, Grandma Ernestine is fifty-five with speckles of salt in her hair. Granddaddy Cottrell is nodding off in an easy chair but smiling and loving when he isn't. Mudear is shelling peas on her porch or watching her "stories" or off on a cruise ship in her most dapper attire. Which includes a mink coat. T'Renee is standing in the House of Style Beauty Shop or, depending on the situation, in her kitchen pressing everybody's hair with a hot metal comb and Blue Magic hair grease while Auntie Mattie is smoking cigarettes after closing up shop for the day at Winchell's Donuts.

And yes, I know that Granddaddy Cottrell, Mudear, T'Renee and Auntie Mattie have all gone home. And I know that my Grandmama Ernestine is a rock's throw away from her ninetieth birthday and no where near the fifty-five years old that I constantly see when speaking to her on the telephone. But still. This is how I continue to see her. And them.

Just as I see you--my parents. Through the lens of a ten year old child.

I believe that no matter how old we get, we all do that with the people we love. Even if our childhoods were imperfect, we still freeze-dry people in whatever constitutes the simplest of times. More often than we even care to admit.

I call it love's myopic view. It's this nearsightedness or farsightedness or whatever you want to call it that somehow happens without us even thinking about it.

I know this is true. It's what, I think, often keeps people holding hands well into their sixth decade of marriage and through life-altering illnesses. It's what brings a daughter or son to change the diaper of a parent without even flinching.

Love's myopic view.

But you know? I believe that very thing is what makes it so difficult when matriarchs and patriarchs begin to age and show signs of being mere mortals. Mere mortals. Because to our ten year-old selves, they were never mere mortals. Even if they weren't perfect, they were still the closest things to superheroes in our lives.

And perhaps this is what that view beholds while changing the adult Pamper of a once healthy dear one once they've reached a point of being able to manage bodily excrement for themselves.

Perhaps.

But every now and then, you get a jolt out of that time-trippy myopia. You go to see an aunt or uncle or parent or grandparent and suddenly see them with glasses that are clear and not rose-colored. You notice the humped back of collapsing vertebral bones and those parchment paper neck skin folds. And you look and you think, "Who is that?"

I know I have. Especially when a lot of time has passed.

I know I'm fortunate to see my parents regularly. And despite my earlier statement, I actually realize that my mother is indeed sixty-five and that my father is sixty-eight. I know that Tounces (mom) has mostly silver and white hair instead of Dark 'n' Lovely auburn and that my daddy's once electric 'fro is a buzzed down white crop.

I know that.

But on the inside? It's totally different. My heart sees them as thirty-somethings. Totally.

Yeah.

That reminds me.

I have a fairly new friend whom I now hold dear. We actually met because of our blogs but now talk far more by phone and text than by our blogs. Which is both interesting and heartwarming now that I think about it. It's also besides the point, so I'll reroute from that and get back to my point.

One of her parents is sick. Her parent has been fighting a series of very serious illnesses. So far, the words "fighter" and "overcomer" have been understatements. The medical history defies much of what I know scientifically; her parent has lived to see the other side of some pretty hard diagnoses.

Today we talked on the phone about the most recent of these medical setbacks. She wanted to know what I thought. And I consider her a friend--I truly do--and I know she was asking me because she considers me one, too. So I told her that I was concerned. That this sounded serious to me and that, if she was ready, here are a few questions she might want to ask the doctors. And I rattled those questions right off.

Then I froze.

Because I could hear it in her voice. I could hear that struggle between her image of a strong and virile afro-wearing parent rolling around on the lawn at age thirty-five and this reality that her doctor-friend was speaking over an iPhone. It made me imagine that this was my own parent. How would I even get my head around that?

I can't.

When Poopdeck had a massive heart attack, he survived. Just like the thirty-something I imagined him to be, he lived to power walk at the park every single morning and spend summers with his grandsons. So even when he tells me of any ailment, I have to shake myself hard enough to listen and acknowledge it with some pragmatism. And not see it as something for Excedrin or Alka Seltzer only.

Her voice was stoic. She is a professional and an extraordinarily smart human being so she got the facts I was telling her. But no matter how many degrees you have, it's hard to shake that ten year-old image of your parent. No matter what somebody is telling you.

I worried after we spoke today. I reflected and had this ah hah moment after we'd talked. I felt that I'd been insensitive to that ten year-old time warp and gave the facts too direct, too harsh. She never said or did anything to suggest that, but it's how I felt.

Which reminds me.

When I was in residency my Mudear's baby sister lived not even five miles away from my apartment. My daddy made sure that I got to know his mother's sister and I'm glad he did. Auntie Mac was the only person I knew in Cleveland when I got there and even though she was in her sixties and I was in my twenties, we spent a lot of time together. We grew close and developed a very special relationship over coffee and chats. Even though she looked a lot like my Mudear, her personality was uniquely her own.

I loved her.

From the moment we got to know each other she'd already been dealing with health problems. So my lens was not a ten year old one at all. It was that of an intern and a newly minted physician. I saw her as a mortal, albeit a mortal I loved. Her health failed more and more. In my second year of residency, she peacefully slipped away in home hospice.

I was sad mostly because I would miss her. I would miss taking her three dollars and running to the corner to "play her numbers" or even her getting into the passenger seat of my car while holding an overfull cup of Folgers that always, always spilled all over my cloth interior.

But I knew she was mortal. Even if I would miss her dearly, I saw her with eyes that were okay to let her go.

me and my Mudear (in my Auntie Mattie's kitchen)

When my Mudear came to Cleveland for her sister's homegoing celebration, she sat right beside me on that pew. Like a little girl she fell into a heap on my lap and cried hard and deep. I patted her platinum curls just as anyone would their own child because that was the right thing to do. But what I said in that moment was less so. I remember saying, "It's okay, Mudear. Mac is at peace now. She's at peace."

And don't you know that my Mudear didn't even lift her head? All she said through her muffled sobs was this:

"She's my baby sister. My baby sister."

And she wept and wept until her body sputtered like a car out of gas. While I rubbed her head and closed my mouth.

It didn't matter that Mac's body had been decimated by organ failure and pain. It didn't matter one single bit. This was her baby sister. That was her myopic view of that day--through the lens of a big sister. And when you see it that way, you know that there's nothing natural about being at your baby sister's funeral. At all.

Especially if you still hold her in your heart at a certain point in time. Now I know in my heart that my Mudear was mourning the loss of that version of her baby sister the most. The one that got on her nerves and asked to borrow her things. Not the one with jaundiced eyes and an edematous body.

And you know? I don't even know where I'm going with all of this. And I know that I'm rambling and I'm all over the place. But really I'm just thinking about all of this and trying to flesh it out. That's all.

Yeah.

Talking to my friend made me reflect on my Auntie Mac and how it felt to console my grandmother when she died. It made me think about what she must have been feeling and how this translates to my friend and the health of her parent and how she might be feeling.

And honestly? I just want to be sensitive to the dichotomy between the cherished images of our loved ones that we have seared into our hearts -- and the ruthless picture painted by reality. Because there is a dichotomy there. There so is.

I guess the point is that I'll try to remember this when I'm talking to my patients. I'll choose my words more carefully--and tell the truth, yes--but do so while knowing that this dichotomy exists and must be considered if I truly strive to be empathic.

Hmmm.

I just thought of something. Not only do we see our parents and loved ones through love's myopic view--we see ourselves the same way, too. We're shocked when we pass a mirror and see grey hairs here and also there and crows feet bursting from our eyes in photographs. Unnerved when we feel hot flashes and back pains or bewildered when somebody prescribes us with blood pressure medication. It doesn't match up with our myopic self image, does it? I'm thinking that maybe--just maybe-- we, too, see ourselves at our most fertile and virile. No matter what reality and calendars are talking about.

Hmmm.

Maybe I'll put that thought on a mental post-it note for later.

So yeah. That's what I'm thinking about tonight. And maybe none of it even makes sense. Or all of it makes perfect sense. Hell, I don't know.

Either way, that's all I've got for now.

Oh, and a few more of these lyrics:

"You spend half of your life
trying to fall behind.

You're using your headphones
to drown out your mind.

It was so easy
and the words so sweet.

You can't remember

You try to move your feet...."

Sleep well. And thanks for listening.

***
Happy Tuesday.

Now playing on my mental iPod. . . .I can't believe I'd never heard of her until I heard her interviewed on NPR's "All Things Considered." The sweet and haunting voice of Regina Spektor. . . hear that whole song here:

Tuesday, May 15, 2012

Acute-on-Chronic Parental Pride.

a·cute

[uh-kyoot] : sharp in effect; intense; sudden

chron·ic

[kron-ik] : constant; habitual; continuing over a long time or recurring frequently

_________________________

My parents are chronically proud of us--that is, their children and grandchildren. They have no problems showing an entire iPhone folder's worth of photographs of their offspring to perfect strangers--or even YouTube videos in case that isn't enough. But, yes, the word for it is chronic because just like some longstanding medical condition this feeling for them is constant and habitual. And fortunately for us, it has continued over a long time.

Sometimes a person comes into the clinic with an intense and sudden pain. We call that kind of presentation acute. Acute--like the definition describes, can be sharp in its effect. . .and kind of like the angle you learned about in 9th grade geometry, it has a swift incline. When we're talking about pain, that delineation between acute and chronic is important because it totally affects how we see it . . . .and how we treat it.

Pride for your kids is kind of like that, too. It can certainly be acute, depending upon the situation.

Sometimes in medicine, we see a patient who has a chronic or longstanding problem like . . .say. . .a bad case of sciatica. (Sorry to keep using pain as an example.) On some days--just out of the blue-- that normal undercurrent of pain gets much stronger. . . .more sharp in its effect. We have some medical jargon for that kind of scenario, too. We call that kind of symptom "acute-on-chronic." That's when you already have something but then your symptoms get a little added umph to them on certain days.

Pride for your kids can be acute-on-chronic, too.

Stay with me. I'm going somewhere. . . . I promise. . . .

Yesterday I got to do something that forty-somethings rarely get to do. I got to make my parents acutely proud. So intense and sharp in its effect that my father broke down and cried. So sudden and strong that my mother came very close to exploding. But since my parents are already chronically proud of us, this was more of the acute-on-chronic type of pride. Which if you ask me, is something that deserves its own category.

Emory held its 2012 commencement exercises yesterday. This is a big day in these parts, and we have the traffic jams all around the Emory Village to show for it. Over 4,000 degrees were conferred altogether if you count all of the schools. Fortunately, only 130 or so of those were doled out at the School of Medicine ceremony.

me and Lisa B.

Okay. So first, I have to say this:

Our final "mean mug"

Antoinette graduated yesterday! And. . . guess what? I got to hood her! And look, this was a huge deal to me because you have to recall that I have known her since her very first day of medical school when she was assigned to my small group of medical students. So yes. Ant, my soul survivor from Small Group Alpha, received both her Doctor of Medicine and Masters of Public Health diplomas. . . . and I was the lucky person waiting on the other side of the stage. What an honor it was to be the first to hug her when they announced her name as DOCTOR Antoinette!

And aren't you impressed that I didn't even cry?

Now. . . of course you can see from this photo how acutely proud this made me. Or rather it was acute-on-chronic pride.

Yeah, that.

Which makes sense, right? I mean, she was getting a terminal degree and all. I know her parents felt an even greater sense of elation and perhaps some wistfulness, too. Because like I said . . . these hyper acute parental pride moments become fewer and more far between the older children get. So parents cherish them all the more. . . and they take lots and lots of photos to savor the moment for as long as they can.

At least they should.

Perhaps this is one of the toughest parts of seeing kids grow older. Less of those dizzying acute parental pride moments.

Maybe? Maybe not.

Anyways. After we marched into the ceremony and assembled in the faculty seating on stage, I noticed an unusual sight right away: My mother. I looked over at my colleague, Lisa B., who was sitting beside me and said, "Uuuhh, okay. Why is my mother at the Emory Med School commencement?"

And Lisa, who is the world's worst liar, looked over at me and tried her best to look doe-eyed and innocent. "Your mom? Why would your mom be here? It's probably her Doppelgänger."

Probably her Doppelgänger? Hello. It's my mom. Tounces. Shugsie. Cheesing with all thirty-two teeth showing and sitting on the fifth row.

"It's definitely my mom. I know my mom when I see her. I'm kind of freaking out. Why is my mom here?"

And Lisa just looked at me and then reached out to squeeze my hand.

A few moments later, I saw a smooth brown head peeking out of the crowd--right next to the lady who looked curiously like my mother. Unless there was also a Doppelgänger there for the BHE, it was official that both my mother and my husband were sitting in the audience. At the Emory University School of Medicine graduation. Wait, huh? Last I checked, I'd already received my medical school diploma sixteen years before.

So I lean into Lisa B. again and say, "Uh. . .okay. The twin of my mom is sitting next to the extremely hot twin of my husband." And her face just turned this very darling shade of red. Her eyes also started to water as only a true friend's eyes can in such a moment.

Deep breath.

The next part was surreal. A man -- who I am now lucid enough to acknowledge as the president of the Emory Medical Alumni Association -- goes to the podium and begins by first greeting and congratulating the graduates. After that he prepares to announce a major teaching award given by the Alumni Association each year called "The Evangeline Papageorge Distinguished Teaching Award." I happen to know just how big a deal this award is because a few years ago, the very friend who was sitting beside me (Lisa B.) was bestowed that very honor. In preparation of my obnoxiously effusive email to our colleagues and friends, I did some data mining about the history of the award.

And let me just say this: It's kind of a big deal.

"The award honors the legacy of Dr. Evangeline Papageorge, a graduate in the class of 1937 who was a beloved teacher and administrator. This coveted award is given annually at the School of Medicine diploma ceremony to a faculty member 'whose intellectual luminosity has generated the greatest excitement about learning among students and colleagues'."

Intellectual luminosity? Uh, yeah. That's kind of a big deal. Such a big deal, in fact, that when someone wins it, they often notify their family to be present.

That or their Doppelgängers.

And this is quite funny considering how many "intellectual luminosity" jokes I've cracked on Lisa B. since she won the award in 2009. But that's okay because I have other awards to tease her about.

Anyways. . . .ha ha. . .where was I?

Oh. . . so yeah, this gentleman begins reading excerpts of nomination letters about the winner. And these words are extra special because the only way to be nominated is by current medical students. So these were the words of learners. Verbatim.

The way Lisa was squeezing my hand made it clear to me that just maybe these were more than just words. Just maybe, on that day, those words were about me. My heart was about to jump out of my chest with every quote. All I could think about was the fact that my mother and husband were under the sound of his voice. And especially my mom. And though at this point, I can't say that I was absolutely 100% sure that this was me they were speaking about, I knew for certain that if it was, that what it meant for my mother to hear them was exponentially better than anything I could be feeling.

Exponentially.

And then it was confirmed. He said my name. And people started applauding and my legs started feeling like Jell-o. My heart was pounding so hard that I put my hand on the shoulder of Dr. Felner, one of the senior cardiologists, as I walked to the podium -- just to make a note of where he was in case I had a full on cardiac arrest.

The rest was like white noise.

As I returned to my seat, I sat there stuck in between two feelings--one of just wanting to run off the stage and hug my mother, my husband and all of my students -- and the other was just wanting to drop my head into my lap and do the full-on ugly cry. Then I thought to myself, "Now if my father had been here to hear that, he would have ugly-cried for every person in the room." That thought made me smile more than cry.

That and Lisa B. squeezing my hand super-duper tight and hugging my neck repeatedly.

My colleagues were kind and offered thoughtful words and shoulder squeezes. It felt good to receive those affirmations, but especially knowing that one of my parents got to see it in person. And Lord knows that the BHE was proud, too, but we all know that it's different for a parent. It just is.

So this moment was wonderful and just when I thought I could not get any more so, I marched off of the stage and saw -- right next to my mother -- wait. . . huh?

Gasp.

It was. . . . my dad.

Yes. My sweet Poopdeck standing on his feet and still patting his leaky eyes. He had flown in all the way from Los Angeles just to see his daughter get this award. And that? That was like a blast of helium that made me nearly float out of that chapel.

Wow.

I could see it in their eyes. This was not their regular chronic proud. Yesterday, my father and my mother were acutely proud. On top of the longstanding, chronic pride they already had. Deeply, intensely, acutely proud. It's hard to even put into words.

Lucky me. Lucky us.

Even my brother was there. As busy as his schedule is, yes, he was there, too. Sitting right beside my husband like the brother he is to both of us. And that? You know that made my heart soar even more. Because I know that my dear husband and my sweet friend, Lisa B., had gone out of their way to get those important people there. And it did not go unnoticed. And it never will. Not one single bit.

When I walked outside I made a decision to pay very close attention to this moment. To intentionally take mental pictures in the highest of definition and to allow myself to savor the fine details. And yes, I know that I don't need to win some big award to make my family happy, but still. . . .this was a pivotal moment. Any chance you get to make a parent this acutely proud is pivotal indeed.

Happy Mommy

This picture is so her--so, so her.

The B.H.E.

always by my side

Does the brother hang a suit or what?

Dr. Ant!

Tounces has hugs and flowers for more than just me! Ant is a part of our family so it makes sense.

More Tounces, the smiling mom!

Ant with Jen S.-- she's staying with us for medicine! Yay!

Chatting with big brother, Dr. Will

Omega Men -- Dean Lee (multicultural affairs), The BHE, Poopdeck

We are family.

Marla (SG Beta) and Nate (advisee extraordinaire!)

I felt like I was the one who graduated!

Funny. I initially thought I wouldn't even post about this. I worried that it would be self-important to be telling it on the mountain that you won a big teaching award. But I knew that I wanted to hold onto that day so I went ahead and fought back that "little voice" knowing that I had to write about it.

In fact, I read my writing mantra first. . . and then did just that. I wrote about it.

With Dr. Lee -- he's the best!

With my Department Chair, Dr. Alexander

with one of my favorite Grady doctors and leadership mentors, Dr. del Rio aka "CdR"

With Neil W. -- mentorific mentor extraordinaire and celeb on this blog!

With Dean Eley -- my kind of people

It's interesting. Acute things are often short-lived but can make our patients pretty unhappy. Chronic issues can ruin someone's quality of life longterm. And acute-on-chronic eruptions of whatever it is a patient is dealing with can be eerily similar to throwing gasoline on top of an already crackling bonfire--

BOOM!

Unless you are talking about acute-on-chronic parental pride. Then it's the biggest and best kind of explosion you could possibly imagine. . . . .

me and my daddy

BOOM!

Sigh . . . . yeah. . .like that.

***
Happy Tuesday.

My favorite shot of the day: Dr. J. Felner, prior recipient of the Papageorge Award --
"resting his eyes, not sleeping"

To the current and former Emory University medical students who took part in this nomination and who take part in my life every single day~

Words cannot express how grateful and humbled I am. I promise to honor your kind support and work even harder. Remember. . .the relationship between teacher and student has always been symbiotic. . .we need each other to survive. Thank you for teaching me, too.

Pay it forward--and always keep it human. . . .

Dr. M

TOTALLY playing on my mental iPod right now . . . "Closer" by Goapele -- please listen. . .it's beautiful and so is she.

. . .and if it couldn't get better--Poopdeck left this and went to see his granddaughter (my brother's daughter) receive this--straight A's on the Honor Roll. . . .on the very same day. Talk about hyperacute-on-chronic Grandpa pride! Go Tyler!