Showing posts with label Seinfeld moment. Show all posts
Showing posts with label Seinfeld moment. Show all posts

Monday, October 24, 2011

Crack is whack.

Whitney was right: crack is totally whack.


True story:

Standing at the elevator this morning in my white coat looking all official-like. These Grady elders walk up and see me and then give me the proud-grandmama/proud-granddaddy twinkle in their eye. The one that says, "Look at her, she's a doctor!"  And I smile and stand all tall-like because I know that look, especially when it comes from people who look like me.

So there we all are. Them twinkling and me smiling.  Then my phone beeps so I reach into my pocket to get it. In that moment, the elders noticed my cracked-face iPhone 3G and seem to deduct every last one of the cool points they'd given me earlier. Yes, I'm cheap, okay? And yes, I know the new iPhone just came out, but this one still works. . . .

Verdict:

You can only have so much swagger with a cracked phone. Just saying.

P.S. Don't worry--my dad just got the new iPhone 4S and is sending me his old one to replace this one.

***
Happy Monday.

Tuesday, August 30, 2011

Potty meat.

*Names and details changed to protect anonymity . . . . .you know what's up!
Low in salt. Just not sodium.





"What questions do you have for us?" my intern asked his patient diligently one morning on rounds. Mr. Purifoy immediately craned his neck over to his wife who sat next to his bed.

"You gon' ask about what you was sayin' earlier? About my legs?" he asked her.

Mrs. Purifoy did all the talking. No matter how many times we tried to get him to ask his own questions, he preferred to have his wife take care of such formalities.  Which reminds me. Tonight Harry was trying to add a new "app" to his iPod Touch and for whatever reason "needs" me to assist him with all things Apple. Seeing as I love him and don't mind pushing the two to three (super easy) buttons on the device to get him what he needs, I just go ahead and help the brother out. And Harry always turns my car around in the car port and also gets rid of any scary/non-ladybug insects in my sight. Even if I was the one who did the honors of squashing it with my Ugg boot (which yes, I do wear in my house even though it's summertime.) Sigh. . . yes, I digress. But, see,  the point of me telling you this is that I get Mr. Purifoy leaning on his wife for certain things that he technically could do himself.

Antywho.

So Mrs. Purifoy, who had just sat down to the bedside tray table with a full meal/snack that she'd just brought in, looks over in our direction with her mouth a-watering and her eyes half-mast. She then looks back at her husband. "You talkin' 'bout the water pills?" She shifted back to us. "His legs was swelling sometimes. Tha's why we was wondering does he need more Lasix pills in case they swell again."

I looked down and inspected his legs once more. He had very trace amounts of swelling, and he had no signs of volume overload.  Before I could say anything, my intern chimed in. "Your legs look fantastic, Mr. P. We've had you on a low salt diet, and I think that's helped a lot."

"See, I told him don't be eatin' all that salt!" Mrs. Purifoy announced with a curl of her lips. She picked her teeth with her thumb nail and nodded. "Ummm hmmmm. I told him. See me? I don't use no salt.  I mean, I know it can hide up in stuff but I don't eat that stuff."

I looked at the tray table and surveyed her bounty.  The entire meal was from the hospital gift shop--which couldn't possibly be low on salt since everything needed to have a decent shelf life.

Here is an inventory of what she had:

  • A jumbo bag of Ruffles potato chips.
  • A big, dill pickle.
  • Some kind of sandwich wrapped up in foil, from where--I do not know.
  • And. Wait for it. . . . wait for it. . . .
  • Yes. A can of Vienna Sausages.

Vienna Sausages?Seriously?

0_0 ----> look on my face

My little Harry buzzy-bee/guardian angel (whose sole purpose is to get me to mind my own business) began furiously swirling around my head. "Watch your own lane!" he hissed. "Don't even START with this lady! She is NOT your patient!"

"But how is she just gonna bust on his salt intake when she has VIENNA-freakin'-SAUSAGES at the bedside? That's, like being a TOTAL hypocrite, man!" I subconsciously replied.

"STILL!" the little imaginary drill sergeant hollered. "It AIN'T your lane, nosy girl! Drive in YOUR lane!"

And for two seconds I did drive in my lane. But then she started situating herself to eat what might has well have been a salt lick and I could. not. take. it.

"So. . . .uhhhh. . . .do y'all know how much salt you should stay under for the day?"

I directed this right at Mrs. P since she seemed to be the speaker of the house. And she lit right back at me, calm as could be. "Oh yeaaaaahhh.  I checks all the labels for saturated fat and all that."

"Okay. . .let's just go over it again to make sure it's fresh on your mind, okay?"

She nodded--while still getting her food ready.

"Mind if I use this for example?"

The Harry buzzy-bee was in my ear again.  "You KNOW you are wrong if you pick up those Vienna Sausages. You are TOTALLY being an a-hole if you do because you know how salty they are."

"Go right on ahead," she said. "Bay? Make sure you pay attention 'cause you be the one eatin' all that salt.  See me?  I got sugar diabetes and I don't eat no salt. Tha's him. See bay? No salt."  She bit the pickle.

Lawd, Lawd, Lawd.

Could. Not. Take. It.

"Okay, so here is where the sodium is. You know this already, but  the sodium is the salt. You both want to keep it under 2000 milligrams of sodium. So you have to count it up. . . ."  I looked at the label of the can. "If you eat this can. . .it has 2.5 servings total. . . . . and if you eat the whole can. . .that's like a third of what you can have for the day in terms of salt.  And let's check the chips. . . . okay. . .so 590 milligrams in this bag. . . . and you're already well over half of what you can have for the day.  See? Watching salt is really, really hard to do."

"He eats potty-meat. Tha's waaaay worse than Vi-ennas. Tell him, doctor."

0_o

"Potty-meat?"

"POTTED meat!" a voice of another patient clarified from the neighboring bed.

On second thought, "potty" meat may have been more accurate.


"Aaaaahhhh," I said.  "Is potted meat pretty salty?"

"Horrible!" exclaimed Mrs. Purifoy. "Jest HORRIBLE!"

I stood there for a few beats watching Mrs. Purifoy as she popped the airseal on the bag of chips and peeled open her can of Vi-ennas.

"Mrs. Purifoy?  You both really need to watch the salt. If you have diabetes you probably should avoid this stuff, too."

"I told you. I don't be eatin' salt like he do."  Again she bites the pickle.

Killing me.

I glanced up at the clock and then at my interns. They were shifting on their feet and obviously wondering how long I would let this go on.  Much to my disappointment, I knew I would be forced to do the unthinkable--get in my own lane.

"Do you think we can get you both to come see us at the Primary Care center?"

"Oh yeaaaaah. He definitely need to see y'all."

"Okay. But. . .what about you, Mrs. P? Will you see us, too?"

"I could probably see y'all, too."

"And can you do me one more favor, Mrs. Purifoy?"

She raised her eyebrows.

"Can you make this your last can of Vienna Sausages after today?"

She looked down at the can and back up at me. "It's that bad?"

I nodded slowly (knowing that if Harry were there he'd be shaking his head and giving me the hairiest eyeball ever.)

"Okay then," she conceded.  "But Dr. Manning?"

"Yes, ma'am?"

"Make sure you tell HIM about that potty-meat, okay? 'Cause I just know tha's waaay worse than Vi-ennas."



Ummm, yeah.
If this makes you dry heave, that makes two of us.

Confession: I read this post to Harry who had this to say:

Harry: "You never had some potty meat on crackers? Shoooot! You trippin'!"

Me: 0_0

Harry: (laughing hard) "With some crackers, Babe? Some Saltines? Shooooot!"

Me:  x_x   eeeww.

*sorry, just threw up in my mouth a little bit*


Seriously?  Never. Kissing. Him. Again. Ever.


***
Happy Tuesday, y'all.




Wednesday, August 3, 2011

Q and A.


 This week on rounds at Grady. . . . .

Just finished up talking to one of my patients about what was going on with his body. Serious things were on the top of the list--all of them dealing with big organs in his body with important uses. First up? The liver. We go into the issues with how his liver is functioning and also how important the liver is to the body.

"Your liver is kind of like a giant filter and a plant that manufactures all sorts of important things." He seemed to like that description, so I keep it moving.

Next are lungs and test results related to those.  I launch into this whole soliloquy about his x-ray results and what they may or may not mean. I review the level of his oxygen that day and what I was hearing when I put my stethoscope to his chest.

Lastly, I discuss the goals of care. What he can expect, what we are looking into, what we still aren't sure about. I draw pictures on a sheet of white paper and add arrows to help him get the point. The whole process, complete with his queries for clarification took quite some time.

He looks somewhere in between being with me and being bored. Which is better than bored only.

Finally, I ask a simple question. "What questions do you have for me?"

And, seeing as he is looking partially bored, I prepare for a predictable response of "nothing" -- but, see, am already positioning myself to ask the same question again in a different way.  "What questions do you think your family would have for me--or you when they call you?"

"None."

Dang. None? No questions? Come on. There's got to be at least one question. And if there is at least one, I want to know it.

Because I am rounding by myself and this is a good time for us to just talk and talk and for him to just ask and ask. Time is on our side and I am not under any pressure to leave or run to the med school or dash off to a meeting. So I want to know, for real, "What questions do you have for me?"

And finally, finally, finally he looks at me with his strikingly jaundiced eyes and his sallow complexion. He doesn't speak he just stares after I ask for the umpteenth time, kind of like he's trying to tell if I really want to know what concerns him. And I wait patiently to show him that I do really want to know.

"Okay. I do got one," he eventually says. "But you may not know the answer to this question."

Hmmm.

"You are right. I might not. But it's worth a try. What is the question?"

Could it be a question to clarify a medical term I inadvertently used? Probing concerns about prognosis, perhaps?  Maybe he would point out an issue with a medication like "this one gives me diarrhea" or "that one make my head swimmy."  Either way, he had one and that preface made it sound like it was a good one.

And so. I wait for him to ask. And finally he did.

The question?


"What's a brother got to do to get a good CAPPUCINO up in this piece?"


No. Not kidding.  That was his question.

And yes. He was right--I didn't know the answer.


***
Happy Wednesday.



Clearly this is playing on my mental iPod. . . . .

Wednesday, June 22, 2011

Fox-y Lady.

*Staff members' names and some minor details have been changed to protect anonymity.


This week in the clinic at Grady:

I had just finished seeing a patient with a resident and exited a patient room. As I passed the front desk, I made eye contact with one of our patient access representatives.

(Holding up her finger to me while speaking on the phone.) "Uuuuh. . .okay, ma'am. . . but Dr. Manning is with a patient, ma'am. . . .uuunhhh huh . . . . okay, I'm going to have to ask you to hold on."

I walked over toward the window and mouthed, "What's up?"  Just as I prepared to push the blinking hold light, Ms. Johnson rolled her eyes and grabbed my hand.

"Dr. Manning, you might want me to take this one." Her expression was mischievous.

I gave her a curious stare. "Why? What's up?" I asked aloud this time. I was a little scared to hear the answer.

She froze for a moment looking at me with serious eyes for beat. Then she started laughing. . . hard.  That laugh came from way down deep in her belly and floated over her head like smoke. People in the waiting room who had no idea what was going on seemed to chuckle, too. One Grady elder in particular seemed to enjoy the energy she was witnessing between us. "You don't even want to know, Dr. Manning. This lady has called up here three times in the last week looking for you."

Apparently she'd gotten the attention of Ms. Thompson, one of our senior nurses. "Oh. . .that lady? Again? She called about Dr. Manning again? How funny is that!"  They both erupted for a few seconds and quickly regained their composure. The Grady elder kept smiling in our direction.

"Okay, y'all are starting to scare me. What is it?"

"Better yet--go ahead and take the call, Dr. Manning.  I'm. . " Ms. Johnson snorted to keep herself from laughing, "No, for real. I'm serious. Go ahead. . .  on the blinking light."

I stood there staring at them suspiciously.  I wanted to know what I was getting myself into. "Is this someone who could be mentally ill? Like is it inappropriate?"

Ms. Thompson pressed her lips together to keep from giggling. "Is it inappropriate?  Hmmm." She exchanged another glance with Ms. Johnson. "Well, I guess that's a matter of opinion. Drastic circumstances call for drastic measures."

"I know that's right!" Ms. Johnson cosigned. Again she pointed to the blinking light. I narrowed my eyes as Ms. Johnson grabbed the receiver and quickly said, "Dr. Manning will be right with you. . . .uh huh. . .okay. . . .unnh huh. . . okay."  She placed the hold button again and gave me an exaggerated grin.

"Is it like a medical emergency?" I asked, immediately recognizing how dumb that question was.

"You know what?" Ms. Thompson answered with her eyebrows raised, "Technically, this could be an emergency. Right, Johnson?"

"Oh yeaaaaah. Definitely."

I gave Ms. Thompson a playful scowl. "Oh, see. Y'all tryin' to be funny."

"I'm for real, Dr. Manning!  It could be an emergency depending upon who you ask."

"Shooooot. 911, even."  Ms. Johnson took a big sigh and held up the entire phone, blinking light and all.

I couldn't take it any more. Stretching my arm behind the counter, I released the hold button while balancing the receiver on my shoulder. "Good morning!" I announced, "This is Dr. Manning!"

"Dr. Manning? Oh! Hey, Dr. Manning!" The voice was young, enthusiastic, and female. It was also in direct competition with what sounded like at least three kids in very close proximity.

"Good morning, ma'am. How can I assist you?"

"Oh! Well, this is my third time trying to reach you. I'm so glad I got you! See, I called twice and -- SIT DOWN! SIT YO' LITTLE BUTT DOWN! DON'T MAKE ME--SIT DOWN! --sorry, yeah, I called and said it was important. Did you get my messages?"

"Ma'am, I apologize. I haven't been in the clinic much this week, I'm sorry.  I hope it wasn't something life threatening?" I cut my eyes over at Ms. Johnson who was now covering her mouth with both hands to keep from doubling over.

"Well, it was important. . .not life or death, but important, you know what I'm sayin'?-- PUT THAT DOWN! DON'T TRY ME! I MEAN IT! WHAT THE. . DO IT AGAIN! SEE WHAT HAPPENS! --  See, I saw you on Fox 5 News.  In fact, I see you every week when you on there." (One of the kids is now crying in the background--loud.) "I seen you last week and said, 'I'm 'bout to call Grady Hospital right now!'"

Now I was feeling nervous. What the heck was she calling about? "Okay. You've got my undivided attention. Tell me, ma'am. How can I help you?"

"Well, I seen you on Fox 5, and like I was saying, I always be seeing you. And -- SHUSH YOUR MOUTH! THIS THE HOSPITAL ON THE PHONE!! THIS IS IMPORTANT!! -- Sorry 'bout that. . . yeah, so when I see you, I always think, 'Damn, her hair is hot to death!'

::crickets::  

"So, yeah I see that cut every week and love how you rock that short cut, you know. And--HEEEEY! DID YOU. . .AWW HELL. . .IS YOUR SEATBELT OFF?? AWWW HELL NO! -- Excuse me, Dr. Manning." (scrambling, scolding, mama-with-gritted-teeth-voice muffled through phone) "Sorry, 'bout that. . .   so, yeah, last time I saw you I was like, 'Oh yeah, that Dr. Manning? Tha's my girl!' 'Cause you know, I been thinking 'bout goin' short again."

0_0  -----> (look on my face) 

"So ANYway. . . I called up here and asked for you, you know? And-- TOUCH THAT SEATBELT AGAIN AND SEE WHAT HAPPENS!"

0_o -----> (me) 

"Yeah. . .so anyway. . . I left like two or three messages, you know?  I said, 'I'm just gon' keep callin' till I get her on the phone! Like I said, I been thinkin' 'bout goin' short again, so -- BOY! IF YOU DON'T GET OUT MY PURSE!'"

I cleared my throat. "Uuuhhh. . . thanks?"

"Yeah. So . . .wait let me get a pen. . .hold on. . . . . okay. . .  . so, yeah, I wanted to get the name of your hair stylist. . . .okay. . .I'm ready. . . ."

Wait. Huh?

Seriously? Seriously.

(Oh, and in her defense? Take it from this black woman--when it comes to sisters and our hair, the situation can become an absolute emergency. Like 911, even.)
***
Happy Wednesday.

Monday, May 2, 2011

Hair-raising Tales Part 2: The snip heard around the world.

Isaiah with the baby 'fro (and God-daddy Shannon)



When Isaiah turned one, Harry busted out a pair of clippers and buzzed his baby afro straight down to a big-boy haircut. That cute little lop-sided poof that he'd become known for in those first twelve months was officially black history. Isaiah had a head full of loose curls that, for the most part, were very easy to manage. I slightly mourned the loss of his baby look, but felt my mama-bird chest swell a bit when he ran over to me that day looking like a complete big boy.



Now Zachary? His hair adventure was a bit different. Unlike his brother, he had a tighter wave pattern and had taken a liking to rubbing the sides of his hair and eyebrows while sleeping. For several months, he looked like some eyebrowless dude with several tiny little cotton balls pasted onto his head with clean patches on the temples. While it definitely wasn't making much of a fashion statement, it never bothered me so much. But Harry? Lawd. It annoyed Mr. Former-Military-Dude Harry a lot. So. . . . Zachary didn't quite make it to the year mark before getting snipped and shaped with scissors. And by his first birthday? Fuggeddaboudit. That kid looked like a thirty-five year-old man.

Baby buzz, Manning style.

Now.

This is actually a bit unusual from a cultural standpoint. For several non-medical and non-religious reasons, there is this understanding amongst black folks that you don't go cutting your kid's hair before their first birthday. The most popular of the non-medical/non-religious reasons is this one:

"Now you know if you cut that boy's hair before he turn a year he ain't never gon' talk, don't you?"

To which I have had to say on more than one occasion, "Uuuuhhhhh, yeah. Okay." For some cultures it is religious. Like, I know a few people of Jewish faith (Orthodox) who've told me that cutting hair before three is a spiritual no-no. And then there's been a few of my Punjabi friends who weren't keen on cutting their hair at all. But see, with my people it ain't (really) religious. Either way--the rule that someone wrote in the front of somebody's bible way back when about "no haircuts in black males before age one" might as well be the fifth gospel. For real.

I guess the reason I don't get so bent out of shape about the whole early haircut thing is because my father gave my older brother the full-on military fade complete with a razor line in the front when the dude was no more than nine months. Blasphemy, I say!

The pre-one year old buzz ~ Dad cutting Will's hair in 1967


Anyways. Despite it being a non-medical/non-religious/non-logic based and purely cultural doctrine, it is a gospel that my people of all socioeconomic and educational levels sho' nuff uphold at just about all costs. And the good news is that most folks know that.

Most folks.

Which reminds me of a story. . . . .like to hear it? Here it go!

***

Residency ~ Winter 1999

an ICU room


When I was a third year resident, I was taking care of this beautiful little baby boy who I'll call JaQuon in the pediatric intensive care unit (PICU.) He had been born extremely premature and had spent much of his eleven month life in hospitals for respiratory difficulties and surgeries. Seeing him lying in bed with tubes entering and exiting multiple parts of his tiny body was hard. He looked like a sweet cherub that had been dipped perfectly in chocolate with smooth, unblemished skin and a loose, fluffy halo of jet black hair. I loved touching it; it felt exactly like what I'd imagine a cumulus cloud would if my hand were long enough to reach it. Cute was an understatement. JaQuon was angelic.

In addition to him being very sick most of the time, he had a fairly young mother who seemed completely overwhelmed 99% of the time. This manifested as difficult interactions with the staff, complaints to administration, and threats to sue the hospital just about every other day. Between going to work and taking care of her other three children, she would blow in like gangbusters every evening grilling the entire team about every detail of JaQuon's care. As the primary resident caring for him, at times it was rough.

Fortunately, my attending that month was wonderful. He had the insight to teach us all that this mother simply loved her child and was doing the best she could. He helped us to look at the situation not as a threat, but as one that was complex. Every day we were reminded that it was a parent's right to ask questions, and that there was nothing natural about walking into a PICU to see your child several days in a row. I always remembered that lesson.

But caring for JaQuon was still kind of hard.

After nearly two weeks, I'd finally built an excellent rapport with JaQuon's mom. I diligently called her twice per day, and even worked with the nurse manager to have the same RNs rotated in caring for him when they were at work. He was slowly improving, and fortunately, those interrogations every evening became easier and easier. Eventually, JaQuon's mother could even be seen smiling while talking to us and one day, she even brought us a cake to show her appreciation. With every passing day as we turned down the settings on JaQuon's ventilator, we all felt proud of the progress we'd made with both him and his mother. Those three critical care nurses and I became like four fiercely protective aunties over every aspect of JaQuon's care, with love woven into every detail.

Finally, the day came when my attending gave the thumbs up when we asked if JaQuon could be extubated during our morning rounds. His oxygen supplements were minimal as were his pressures on the ventilator, and our trials of unassisted breathing were completely successful. We all high fived and hugged each other, knowing that our baby was going in the right direction.

A young nurse named Sara (who was a part of the four aunties) rushed off to her locker and returned with a tiny garment bag. She peeled back the plastic to reveal this adorable little three piece outfit, complete with socks. There was a baby blue onesie with "Mommy's Little Angel" embroidered across the front in a royal blue that perfectly matched the precocious big-boy sweatsuit that accompanied it.

"I've been saving this up for his extubation day!" Sara gushed.

I will never forget how moved we all were--even the attending choked back a few tears. It remains one of the sweetest gestures I've ever seen.

I knew that I would be in clinic that afternoon, but because I was on call that night, I was pretty sure I'd get to be there when JaQuon's mother blew in. I was purposely vague when I called her that day; I wanted her to be surprised when she saw her baby boy's sweet brown cheeks gurgling and cooing instead of covered in tape and masked by an endotracheal tube.

I hugged Sara and wiped a few tears. "That's awesome!" I said.

"I can't wait to see his mother's face!" Sara replied "I think I'm going to hang around until she gets here." Although her shift was ending at 3PM, this kind of investment in patients was not the least bit unusual for critical care nurses. Anyone who knows a critical care nurse would tell you that.

And so, as the story goes, we all applauded when sweet JaQuon was uneventfully extubated. The respiratory therapist even pointed out that he'd cut a tooth, which made us even giddier for his mother's arrival. I floated to clinic that afternoon, doing my best to imagine the elation that baby J's mom would surely have in just a few short hours.

I finally finished up with my last patient, and instead of dragging my feet due to the dread of taking call, I sprinted toward the unit as fast as I could. I'd made good time, and made it to the nurse's station just as the clock struck 5 PM.

"Is J's mom here yet? Did I miss it?" I panted.

"Nope, she's on her way so you're just in time!" Lisa, the other auntie, replied with a smile. "Girl, Sara's been fussing over him all day. Did you see that outfit, Kim?" Lisa placed her hand on her bosom and shook her head.

"Adorable," I laughed. "Even Dr. B cried a little when she took it out!"

"Honey, bless Sara's heart! His mother is going to be so happy," Lisa went on, "They've been through so much. It'll be great to see her get him home soon. Dr. B says he can go to the regular ward tomorrow and should be home in the next 48 hours."

"Awesome." I looked over toward Sara who could be seen adjusting his clothing through the glass partition in JaQuon's room. "Did she put it on him yet?"

"Yes, girl. He looks like a little man!" Lisa responded while drawing up a saline flush. She pushed the air bubbles out of the syringe, squirting a few drops of saline on the counter. As she reached for a disinfectant wipe to clean it off, she added, "Go look at him. You're going to die!"

I followed Lisa toward his room, and felt myself thinking how happy I was that this very senior critical care nurse would be in the PICU with me that evening. She pulled back the heavy glass sliding door and stood with me at the foot of the bed. She looked over at me to see my reaction.

Tears immediately filled my eyes as, for the first time, I saw JaQuon looking like a regular little baby boy. "Oh sweetie. . ." I murmured. The outfit hid some of the IV lines and every trace of adhesive had been removed from his face which was now glistening from Vaseline. The outfit fit him perfectly, and the pastel color shirt beautifully brought out the yellow undertones in his cocoa complexion.

"He does look like a little man!" I gasped while walking closer to him. I looked up at Sara and smiled warmly. We all glanced at each other while blowing him air kisses and taking exaggerated sighs. I leaned in close to him and said, "Hey there, handsome boy!" And he responded with a smile that melted my heart right there on the spot. I cocked my head and took a mental picture of the image.

That's when I noticed something.

I furrowed my eyebrows and grabbed a pair of gloves. Carefully, lifting the back of JaQuon's head, I confirmed what I hoped and prayed wasn't what I thought it was. The look of terror was all over my face.

"Honey, are you okay?" Lisa asked with a concerned expression.

I turned J's head from side to side, dropped my head and just shook it slowly. I thought I was going to be sick. "Lawd Jesus."

"What? What!" Lisa demanded.

"Kim, what's wrong?" Sara joined in. They both shot each other worried glances.

"Sara," I said flatly, "please tell me that. . . ."-- I drew in a deep sigh--"please tell me that you didn't cut JaQuon's hair."

"I. . .I . . what. . .I mean, I did just to get him. ."

When she saw me squeeze my eyes tightly and wince, she knew then that this was a problem. And not just a little problem either.

"Oh shit!" Lisa exclaimed while sweeping her blond bob behind her ears to see better. She let out a nervous laugh and then covered up her mouth.

"I . . .did I. . . I thought. . .I mean, I thought Mom would appreciate it," Sara replied as her eyes quickly filled up with tears.

Even though I already knew very well that he was, I scanned the band on his arm to confirm that JaQuon was indeed less than a year old. Eleven months, to be exact. With a newly clipped coif to replace his formerly abundant lamb's wool halo. I wiped my hand over my face and drew a deep breath. All the while I was thinking, No wonder everyone said he looked like a "little man." Sara had cut his hair down like he was grown-ass man!

Sara's cheeks were beet red, deeply contrasting her porcelain skin and her bottom lip was quivering uncontrollably. I wanted to reassure her but I couldn't. Lisa wasn't helping. She kept saying "Oh shit!" like a broken record, which made Sara grow more and more anxious.

"Where'd you put his hair?" I finally asked.

"Excuse me?"

"His hair, Sara. Where is it?"

Sara pointed at the wastebasket and then looked back at me. "Sara, we've got to get the hair and at least put it in a bag for Mom. Come on, let's hurry up." I took the top off of the trash can and prepared to wade into it.

"Do you really think his mother is going to be upset? I didn't hardly cut that much. Just--"

"Sara," I interrupted, "I know you meant well. But honestly, I don't even know another way to say this. Black people generally don't cut their kids' hair before they turn one. For some people, it's like a really big deal."

Lisa flushed JaQuon's IV and added, "That's not even just a black thing, Kim. Most folks I know are pretty OCD about their kid's first hair cut. Geeze, Sara. . .what were you thinking?"

"But it was a trim," Sara insisted. "Maybe Mom won't even notice." I raised my eyebrows and cast my eyes downward in a way that said, The hell she won't. Sara wrung her hands nervously and shrugged. "I suppose I'll just wait around in case it's an issue. I mean, it's the right thing to do." No one objected.

And so we sat. And sat. And sat. For what felt like forever, but was really only like an hour and twenty minutes. Me, quietly writing progress notes. Lisa, calculating meds and updating her charting. The other two RN's on the shift acting like they weren't waiting for all hell to break loose.

Finally, the call bell began chiming signaling that a non-employee was waiting to be let in. In the camera, there was JaQuon's mother shifting from side to side on her probably tired feet. When the doors first whooshed open, she blew inside like always. Instead of the relaxed smile that she'd been offering us as of late, her face was twisted and preoccupied.

"Hey there," I greeted her, "How was your day?"

"Hectic," she replied while vigorously scrubbing her hands at the sink. She was all business today. "How'd J do today?"

I stood tall and smiled wide--determined to soften things up. I made a gesture with my hand to demonstrate a tube being pulled from someone's throat. "He did great."

Mom swung her head around toward his room and then quickly put her eyes back on me. I nodded and gave her a thumbs up. In a flash, she dropped everything and ran over to JaQuon's room.

We stood outside of the glass watching the whole train wreck unfold like some kind of bad, slow motion silent movie. It went something like this:

  • Mom runs to the room.
  • Mom sees JaQuon without the endotracheal tube in his mouth.
  • Mom covers her mouth and starts crying.
  • Mom approaches the bed and notices his outfit.
  • Mom places both hands exaggeratedly over her chest and cries more.
  • Mom looks out of the glass at us and mouths the words, "Oh my God!"
  • Mom bends over the railing to kiss his face and rub his skin.
  • Mom plants a soft kiss on his forehead.
  • Mom freezes.
  • Mom steps back.
  • Mom steps forward.
  • Mom squints her eyes and then lifts JaQuon's head.
  • Mom's mouth moves and I can make out what she said: "What the (expletive.)"
  • Mom spins around and pulls back the glass door fast and furious.
  • Mom is not happy.
"Who cut my baby's hair? Who in the (expletive) cut my BABY'S HAIR!?!?"

Here we go.

"I wanted him to look nice for you and I--"

"You CUT my baby's HAIR? What the (EXPLETIVE!) WHO DO YOU THINK YOU ARE?" Mom exploded. "You CUT his hair? What would make you cut his hair!?!"

I stared squarely at my clogs, all the while wishing Sara would say nothing more. Nothing she could say was going to make this better. Lisa was equally frozen. Sara was on her own.

"I just wanted him to look handsome when you--"

"He WAS handsome! I can't believe you CUT MY BABY HAIR!!!" Mom started crying, but not a sad weep. It was more of a mad, tired cry complete with chest heaves and with tears that seemed to be made of boiling water.

Lisa and I completely threw Sara under the bus with this one. Although we stood next to her in solidarity (and in fear of moving), we didn't dare utter a sound. Not a single peep. This new one getting torn was all hers. Or so I thought.

"And where was you?" Mom suddenly asked shifting gears toward me. Next thing I knew she was ice-grilling me of all people.

Say whaaa..?

"Excuse me?"

"WHERE WAS YOU? WHY YOU LET THIS WHITE LADY CUT MY BABY HAIR?!?" she demanded. Her use of the word "white" made everyone uncomfortable. Even JaQuon squirmed a little in his bed.

"Uuhhhh, I didn't realize that--"

"You 'POSED TO BE LOOKING OUT FOR HIM. Especially YOU!" she yelled while pointing at me for emphasis. "I can't believe you let this lady cut JaQuon hair like that! I can't believe you of all people let this happen!"

Yikes.

And just like that, she rolled her eyes and marched out of the unit.

It was crazy. As crazy as it sounds, even. No. Crazier.

I never forgot that day. It was so complicated and awkward. Hands down one of the most uncomfortable moments I've had in clinical medicine. It has always served to remind me of how important it is to consider culture in our actions, but also how even the very best intentions can go awry. Poor Midwest Sara had no idea that cutting JaQuon's hair would become such a debacle. And never in a million years did it occur to me that the complexities of race and trust issues in health care were playing such a pivotal role in his mother's expectations of me, her son's doctor.

So how did it end, you ask? Well, the good news is that JaQuon continued to improve, was transferred to the floor, and was subsequently discharged in 48 hours just as predicted. The even better news was that I was working with Lisa, the senior critical care nurse, that night. She smoothed that whole horrid situation over like buttercream frosting over a Betty Crocker box cake.

How you ask? First, she took Mom into a quiet room and simply hugged her and listened to her. She acknowledged how tired the mother was and how hard it was to be in the situation. She gently explained that Sara only wanted to help and apologized on behalf of the whole team. She then presented Mom with a little gift box containing JaQuon's hair. And Mom wept and wept. Lisa was amazing. While I'd most appreciated her ability to crack the whip during a code or smell sick-sick a mile away, this night gave me new insight on the wonder of experienced nurses. And on the wisdom of folks over the age of fifty in general.

Hmmm.

I'm not sure there's a real moral to this whole story. Matter of fact, if you figure out one, let me know what it is. But even if you don't, it's still a great story. Oh yeah, and that part about your baby not talking if they get a haircut before they turn one? I have nonstop evidence that proves that that nonmedical/nonreligious theory AIN'T TRUE.

Daddy strikes again in 2006 ~ this time with his grandson, Isaiah.

***

Hey, what's the hair rules with your people? Are there any?

Thursday, November 18, 2010

Waiting on a friend.

*names, minor details changed to protect anonymity. . .you know the deal, people.

 I'm not waiting on a lady
I'm just waiting on a friend

- from the Rolling Stones "Waiting on a Friend"
 _________________________________________________________

This month on rounds at Grady:

Looking for Mr. Logan. The last person I need to see for the afternoon.

Patient not in bed. Light coming from beneath bathroom door in patient's room.

(Through the door.)

"Mr. Logan? Mr. Logan, sir? It's me, Dr. Manning."

"Yes'm! I'm here on the commode."

"Okay, sir. I'll come back in a little bit, okay?"

"Alright then."

Fifteen minutes later.

"Mr. Logan? Mr. Logan, sir? It's me, Dr. Manning."

"Hey Miss Manning! I'm in here on the commode."

"You okay, sir?"

"I'm alright. Thank I'm starting to run off so I'm jest stayin' here for now. My stomach is boiling."
 ("run off" = diarrhea)

"Umm. . . okay. Mr. Logan, I'm here to see about you. I need to examine you sir."

"Naww. You need to do somethin' 'bout my stomach."

"We actually just started you on a medicine called metro-ni-dazole for the diarrhea, sir. We can also give you something for your stomach."

"Alright then."

(Still through the door.)

"Listen. . . .Mr. Logan, sir? I'll give you a few more minutes and come back, okay?"

"Mmmm hmmmm."

Forty-five minutes later.

Grrrr. Patient still not in bed. Light below bathroom on. Grrrr.

"Mr. Logan? Mr. Logan, sir? You still on the commode?"

"Yes'm!"

"Sir, your stomach is still boiling?"

"No, Miss Manning. It's calmed down. The medicine helped it."

"Oh okay. . . . .so. . .what are you doing in there now?"

"Now I'm jest settin' here thankin'.  Sometimes I get some good thankin' done on the commode. Come on back, hear?"

Really?

"Uhhh, Mr. Logan, sir?  I really need to examine you. . . . "

"Jest come on in here then."

Eeewww. Really?

"Ugggghhh. . . .Mr. Logan, sir?" (Yes, I groaned.)

"Yes'm?"

"I'm not examining you on the commode, sir. I'm gonna need you to come and do your thanking out here."

Silence.

Door finally opens. Mr. Logan shuffles out pushing IV pole and carrying a Word Find book. Looks at me, narrows his eyes, and sits on the edge of the bed in an irritated huff.

I come at him with my stethoscope. He looks at me and says:

"Damn, you bossy."

***

I love this job.