First person chronicles, Chapter I: Urban legends.

It isn't like they say it is, you know. Like, this whole urban legend of it being like someone stuffing you into a cannon and exploding you straight out into the sky is actually just that. Legend. I think the folks who never tried it before are the ones that make those kinds of stories up.

Like just yesterday when I was on the MARTA train and heard some older lady talking about how people who smoke rock do it because they're always trying to chase that very first high. "It's like they go crazy, " she told her friend. Then she went on and on with more bullshit that I'm sure she didn't know first hand. And it was sort of pissing me off the way she kept talking with so much authority like she was the damn Surgeon General on street drugs or something. I started to lean over that plastic orange seat and give her an earful. Like a mean, cussing, one. But instead I just stared straight ahead and spoke loud enough for her to hear me.

"That--what you just said--ain't really true."

She swung her head from side to side like it's no way possible I was speaking to her. So I repeated myself. "That's not the truth what you saying. Obviously, you ain't never got high."

And would you believe that old lady was so stunned that she didn't even bother to respond to what I said? I guess she looked at me and made up her mind not to fool with me. Like a person riding in one of those open door buggies in a wild animal park where you ain't s'posed to feed or touch the wild animals. But me? I ain't no wild animal. Regardless of what I look like, I'm not.

I'm really just a regular person. A regular person who got caught up.

You might define regular as going to college and being filled with what everybody thinks is promise. Well. I didn't go to college but I did finish high school. I had me a good job with some benefits, too. That said, I could still be regular without all that. To me, regular mean you got your head screwed on and you have a damn clue. I did have a clue, too. I did. And I still do.  It's just that over time, I got caught up. And now I'm like I am now.

Anyways.

I had just got off the MARTA that day when I started to feel I was losing my breath every time I tried to walk. I'd walk for like a few feet then have to stop. Then my chest started tightening up. I knew enough to get back on and ride down to the Georgia State station right by Grady. With what I'd smoked that morning, I wasn't sure what this all meant but I wasn't gonna wait forever to find out.

Most of what they said flew over my head. I guess they think I had a light heart attack and all of it they relate to me smoking. So they talk at me and scold me and all that like that's all it would take. And me, I just sort of tune it all out because it's almost as annoying as that old lady on the MARTA.

There was one person I liked, though. This little medical student who works with my doctors came in my room every day asking me all about my life.. Like, she wanted to know about the first time I ever used crack and like, what all was going on when it happened. She seemed like she for real wanted to know, too. Then she made a reference to that same thing everybody is always saying that ain't true about running behind that first big rush.

"That's not how it is," I told her.

Her eyes got all big like saucers. Then she said, "Tell me, then. What is it like?"

I sat and thought on it for a few seconds then I asked her a question. "You ever had sex with somebody that you know you ain't got not business having sex with?"

Lawd. What did I ask that for? That child turned fifty shades of crimson when I said that. And I swear I wasn't trying to embarrass her. I was just trying to find an analogy that fit and, hell, she looked grown. At least, grown enough to be in medical school which means she already went to college before that.

"Look," I went on without making her answer, "it's kind of like the first few times you have sex with somebody. Especially somebody that you ain't got no business getting with. The first time, it's mostly that you are caught up in the moment or curious. It's not necessarily great but you find yourself thinking about what you did. Next thing you know, you made up your mind to try it again. 'Fore you know it, you can't stop yourself."

"So . . .  no crazy fireworks? Or like a really intense first high?"

"Naaaah. That's that bullshit people always feeding the world about crack. It ruins your life slowly. Like somebody ripping pages out of a book or pulling hairs from out of your head. Take you a minute to notice, you know? But once you do? Man."

She got that. It made sense to her and I could see her wheels turning.

That medical student sat and talked to me for two whole hours. She made me feel better than anybody else on that team. Maybe since she was't busy or maybe it was just that she knew how to not seem busy that I liked her.

She came back and told me that I didn't have a full on heart attack. The heart doctors had thought about having me do the test that checks to see if you have blockages in your heart vessels. But then when they heard I was still using crack, they shifted the plan. At least that's what I think.

Now, I get to go home. Which, at the moment, I'm not so sure what that's gonna be. And even that, not knowing where you really live, isn't like what people think. But that's another story for another day.

So anyways. My point in all of this was really just for you to know that the only way to know about the  real deal stuff happening with real patients is to just ask them. And if you want to know the real parts of the things that are mostly urban legends, it's best to ask the legends themselves. You find out some cool shit that way.

I'm just saying.

***
Happy Thursday.

Stuck in reverse.

When you try your best but you don't succeed
When you get what you want but not what you need
When you feel so tired but you can't sleep
Stuck in reverse

~ Coldplay

__________________________________

"Miss Manning! Miss Manning!"

I looked over my shoulder and saw you coming toward me and waving your hand. I waved back. I figured you were just saying hello so I kept walking toward the hospital.

"Miss Manning! Miss Manning! Wait! Wait! Wait!"

Your feet were shuffling quickly behind me. There was urgency in your voice. Once you reached me you repeated my name, more to catch your breath than get my attention because I'd already stopped to wait.

"Miss Manning," you panted and you reached out to shake my hand.

"Hey there, sir."  I squeezed it tight and covered it with my other hand. "What's up?"

Your eyes were dancing and your face had a film of sweat over it.  Your clothes were unkempt and pasted to you with sweat. There was a nervousness in your disposition that made me worry about you immediately.

"Miss Manning, I'm hungry. I'm hungry. I need some money to get some food."

I was going upstairs to round. But that wasn't the issue.

Something was up with you. Something wasn't right. Your voice was staccato. Your hands were waving and shaking so I could see the burns on your thumbs.  The erratic behavior, the jumpiness, and even the pressure in your walk suggested that something else was up with you.

And you weren't a stranger to me, so this wasn't the same as being presented with this request by someone I didn't know.  I decided to keep it simple in the interest of time.

"I don't have money. Let me speak to a social worker. Let me--"

"Miss Manning! Miss Manning! I'll wait for you to go get some money, okay? Okay? I don't have my medicine either. I need it. I'm sick. I don't feel good. Please."  Your feet kept shuffling. Your eyes bouncing wildly and that film of sweat now coalescing into beads on your brow.

"I won't give you money. You know I won't."

"Miss Manning! No, it's not. . . I mean. . . Listen I promise . . .I promise that I--"

"I don't know what's going on with you. This is making me feel nervous." I registered the security officer standing several feet away from me even though I felt pretty sure that you'd never harm me. But something was up with you that might turn you into a puppet on a string with actions you don't see or want or mean. "Sir? Are you using again?"

"The thing, Miss Manning, is that it's hard. You know it's hard."

"Sir. It makes me sad that you're telling me you want money for food and medicine if that's not what you really are looking for. What happened when you left us?"

I was referring to you leaving the hospital earlier in the month. You shrugged.

So we just stood there staring at each other. I was already late for rounds. It was like standing in front of a giant mountain that needed to be torn down brick by brick. All I was doing was yanking on one, somehow hoping this would cascade the whole thing down.

But deep down I knew. I knew I couldn't fix this in five minutes before rounds. Just like I couldn't fix you in those five days. And we both realize that the only one who can fix you is you.

That made me feel sad. And helpless.

I think you saw that in my eyes.

"It's hard, Miss Manning. Hard to break free." You wiped your face with your hand and shook your head. Then your feet started walking backwards away from me. Like a puppet on a string. "Be blessed, okay? I got to go. I know you care about me, Miss Manning. I do. I'm gon' keep trying to break free. I'm gon' keep trying, okay?'

Keep trying. To break free.

The last thing I saw was you diagonally crossing the street, disjointed like the marionette that you still are.

Still erratic. Still anxious. Still stuck in reverse and not quite ready or able to break free.



***
Welcome to Tuesday.


Now playing on my mental iPod. . . . . haunting words, haunting lyrics. . . please listen.

Puppets and birds.

I'm like a bird

I'll only fly away

I don't know where my soul is

I don't know where my home is

~ Nelly Furtado

________

I heard a ruckus and found you standing up in the door frame. Yelling out into the hall at the top of your lungs.

F-BOMB! 

F-BOMB!

F-BOMB!

I'm not even sure what you were so mad about. But you were mad. So mad that your colorful choice of words drowned out any black and white issues that you needed to communicate. The lady in the other bed in your room looked scared. I just wanted you to settle down.

Your actions fit certain parts of what some would expect of you from your history. A hard life and a stronghold of crack cocaine addiction. In and out of the hospital for complications of both. So you hollering out of the door and into the hallway gave people that same unease as walking by an erratically behaving addict on a downtown street. 

But see, I had spoken to you long enough to know that there was more to you than the words someone probably uttered under their breath. You were charming and intelligent. Witty and insightful. And you knew all about Atlanta history which, to me, was really cool. I wanted you to calm down. Calm down long enough to perhaps get some help this time. 

F-BOMB! 

F-BOMB! 

F-BOMB!

I placed a hand on your shoulder. A bold move, I know, but I knew that deep down you were a pussy cat. Or rather a feral cat backed into a corner but one who had already smelled my hand and knew I was a friend and not a foe. 

"What's going on?" I asked.

"I gotta get the --F-BOMB-- out of here." That was your answer. Then you said a lot of things that didn't quite connect for me. Something about how you once had insurance and how you were born at Grady. All of it suggested that you felt like you deserved a more VIP treatment than what we were giving to you. So I apologized and asked you to sit on the bed.

"I'm sorry, Miss Manning," you said. "I'm sorry."

I looked you in the eye. "That's okay." 

I sat beside you on your bed and asked a little more about why you were so upset. Still, even with you sitting calmly it wasn't making sense. None of it. So eventually, I stopped trying to make it fit into my own logic and just listened. I didn't reason or anything. I just sat there hearing your flight of ideas floating around that room. 

The lady in the next bed seemed to relax some.

So we had a heart to heart and eventually you were calm. You apologized some more and things seemed better.

As the afternoon progressed, I kept finding you out of your room. In the hallway near the vending machine. Near the elevator. And once all the way outside in the smoking area. Pacing around and talking loud. 

We had bonded so I walked right up to you and told you what I was thinking. "I don't want you to use. I don't. You are scaring me being out here like this."

"I know, Miss Manning. I'm not gon' do anything. It's just cigarettes," you said.

But I knew that this part was out of your control. Your body was just a marionette on a string and crack cocaine had the whole puppet show staged and blocked. 

Act 1 - The elevators, Act 2 - Something else.

"I'm leaving for the day. We still have work to do on you. Don't go, okay?" I said it that way because I feared your puppeteer would have you dance right down the street and around that corner. I had to at least try.

"Okay, Miss Manning. Okay," you replied. I could tell you wanted to mean it.

So I waved good bye to you and shook your hand tight. And when I did, I noticed the burns on your thumb from holding glass pipes. And that? It put a shiver through me because I knew that what caused it was a big mountain and me and my little bag of Internal Medicine tricks was the tiniest of mole hills.

But so what. I had to at least try.

This morning when I came to work, your room was cleaned out. The bed was made and ready for a new patient. I hadn't discharged you. 

"Where'd he go?" I asked.

"He flew," someone answered. 

You flew.

So yeah. I guess the puppet show went on whether I liked it or not.

F-bomb

F-bomb

F-bomb

***

Now playing on my mental iPod. . . . I love this song so, so much.

A slow train wreck.

I was working on a lecture a few years back about crack cocaine and people's stories related to it. I met this gentleman who was dealing with a crack addiction in the Grady emergency department one day, and he was nice enough to let me interview him. "I want people to see the people and not just the addiction," I implored while doing my best to get his permission to tell his story to others.

"Knock yourself out," he replied with a confident smile. "Tell my story 'cause I'm not your average crackhead."*

(*note: I am not keen at all on the term "crackhead." I am using it in the context of this patient's words which are being shared with his permission.)

His story.

No, he wasn't your typical street drug addict. This man was a college graduate that had once held an excellent job with excellent benefits. Back then, his two kids were in private school, and he had a college-educated wife that he described as a "strong black woman" and "the shit" (in a good way.) This whole former life of his fit perfectly into a "four sides brick" and "built from the ground up" house complete with a terrace level and three car garage in an affluent Atlanta suburb .

He'd lost it all after getting "caught up" with crack three years before.

During the time of our interview, he was unstably housed between shelters, couch-crashing, rooming houses, and "lady friends." He was no longer in touch with his family and he described his ex-wife as "terrified of him." His parents were alive, but also "too shell-shocked to fool with him" and he was quick to let you know that he didn't blame them. "Crack is no joke," he said while shaking his head hard. "No joke."

He was handsome with a youngish face that couldn't have been more than forty five years old. He had a cropped mane of shiny prematurely gray curls with a mustache and eyebrows that had the exact same distribution of salt and pepper as that on his head. His teeth were surprisingly white, but the minute I looked at his hands I could see his story. Burns on his thumbs and finger tips. Fingernails with dirt so deeply lodged under them that they looked like some reverse version of a french manicure. Oh well, scary fingernails or not--he was charming for sure and even with the profanity, his buttery use of the English language was believably consistent with his report of graduating from "one of the best historically black colleges you've ever heard of."

Normally, I would have started asking things like, "What college?" or other random things to give myself a better idea of his other life. But this gentleman was sitting in the ER for reasons other than my interview and since he was both generous and loquacious about his personal truths I decided to get to the things I really wanted to know while the getting was good.

My main question was, How? How does an educated, successful, and good looking dude like you use crack cocaine even for the first time?

Sure, I've encountered countless fifty and sixty-somethings that were blindsided when someone took the ultra-pricey powder cocaine that they'd occasionally toot on holidays and birthdays, cooked it on a stove with baking soda, and made it go further by making it into "free base." The story is usually that they tried it way back when nobody knew how addictive it was. That was in the early and mid eighties, so their excuse was that they didn't know what hit them when they hit it.

There's also the younger people from horribly disadvantaged backgrounds that I've met who grew up seeing it so much that they became desensitized to it. Then, after existing in what was surely a living hell, decided to escape it on a five minute, five dollar rocket ship straight to the moon. Even if it meant ruining their life, depending on the day and the reality connected to it, just maybe there wasn't a whole lot to lose.

So, yes, I've seen those individuals and heard their stories and kind of got it how they ended up "caught up." And oft times, the majority of the people I meet who are under the stronghold of crack fall into those categories. But every now and then, I've met someone like this man--someone whose life I can very much identify with--which completely terrifies me.

So I asked him. How? How does someone like you even try crack for the first time? How does this happen? Is it like they say? Where you try it once and then from the very first second you are hooked? Like you spend your life chasing the first high? Is that true? But even if that is true, hadn't you heard that? Didn't you know better? How could this have happened to you? You are young enough to know that crack is bad news and old enough to have heard Mrs. Reagan wag her finger and tell you to "Just say no." How? How did this happen?

Yeah, it was a lot of questions. Thank goodness he was in the mood for questions since I was in the mood for answers.

"I was drinking and smoking weed one night," he recounted. "Vodka, tequila shots, all that. We were getting f--d up that night. It was me and a couple of my buddies. Smoking blunts, playing Spades, talking shit. You know how folks do when they getting it crunk." He chuckled. I kept listening, waiting for Act 2.

"So, then, my homeboy says, 'Man, you ever smoked a primo?' and I was like, 'What's that?' So anyways, he explain that this is like a blunt that has some cocaine in it. You know, and I was like, 'Cocaine? Aww, hell no!' I'm sayin' because I never had got nowhere near no cocaine. As for weed, I mean, sure we did that all in college and after, but cocaine? That was some other stuff."

"So you got hooked from the first time you tried it?"

"See, that's a myth, doc. That mess folks tell you where they say you hit the rock and next thing you know you're like a zombie?" He laughed out loud and this time rolled his eyes like the very suggestion was both naive and ridiculous. "Naaahh. That's not how it goes down. See, essentially, my man rolls this blunt with rocks in it. Seeing as I don't know nothing about cocaine, I don't even realize what is up."

"Why did you buddy even have crack? What was that about?"

"I'm sayin', doc. . .crack affects everyone differently. You know there's a whole, whole bunch of folks that go to work, go home, do their thing and use crack on the weekends. Some folks are just hardwired to be crackheads. Some can just do it on the humbug."

I nodded my head slowly, recalling this lady I'd encountered once who worked in the post office for twenty years but had used crack "once or twice a week" for the last ten. "So your dude was one of those people who used it on the humbug?"

"Yeah, he isn't really the type that's got the addict gene. But me? My family, we have that gene strong. We have all kinds of alcoholics folks with addictions in our family." I could relate to that part, too. "So yeah. . .my man rolls this primo and I'm f---d up already from the shots and I wasn't driving so I was like, 'F--k it, let's do it.' So we sitting around, like three or four of us, talking shit and hitting this blunt. And essentially, that was it."

"That was it? No ride to the moon or anything?"

"Nope. We even talked some shit about how we had all heard that crack rock makes you go crazy from the minute you hit it and all laughed about it. See, my man who rolled it and had it, after the fact, he was like, 'Y'all know that was rock' and we were all like, 'That was rock?'"

I sat there staring at him with my eyes squinted. I was waiting for the part where he lost his house, his wife, and his job. This sounded a lot less dramatic than what I'd imagined.

He went on. "You know what did happen, though?"

"What?" I quickly replied.

"The next day, I kept thinking about it. It was crazy. It was kind of like when you sneak off and have sex with a chick when you know you're married. Well, maybe not you, doc, but you know what I'm sayin'. You tell yourself you tripped and it was a one time thing but then you keep thinking about it. Like nonstop."

"Hmmm." I pressed my lips together and continued to let him have the floor.

"So after a while, I'm thinking about it so much that I think about casually asking my homeboy about it, but I don't want him thinking I am fiendin' for it or anything. . . .so. . .I say, 'F--k it, I'm just gonna get me some weed and roll through the hood and get a little five dollar rock to roll into my joint.'"

He went on to describe how his thoughts of his extramarital romp/drug habit became more and more frequent. He couldn't get it off of his mind, and once per week became twice per week. Twice per week became once per day. Once per day became without marijuana, and eventually in the end it was any chance he could with any pipe he could get his hands on.

"The whole time it was like watching a slow train wreck. It wasn't fast like people tell you. It was slow enough for me to say, 'What the f--k am I doing?! I can't believe I'm f--king doing this!' And the day I knew I was out there bad was when I withdrew the last $1500 from my savings account one Friday and had smoked it up by Sunday. It was so f--ked up."

Wow. This was so different than everything I'd ever heard about people getting mixed up with things like crack and methamphetamine. A slow train wreck? Wow.

"You look like you saw a ghost, doc!" he laughed. "Don't worry, I'm not contagious."

I stared at him and widened my eyes. "Honestly? Your story terrifies me because I have sons and they're no different than you. I mean. . .I'm no different than you. That--what you just told me--could have happened to anybody. Everybody's done something stupid at some point."

He rubbed his youthful face with his tell-tale hands and sighed hard. "You know, doc? All you have to do is make sure you talking to them about being careful with anything that messes with their thinking. Like, it's okay if they drink, but you might want to talk to them about getting pissy drunk." He narrowed his eyes and his face grew serious.  "Doc,  you have any addicts in your family?"

I nodded sheepishly. Do I?

"Damn. Then talk to them about that, too. Tell them that it's not the same for them, so know that. Before they even get in high school, tell them. Hell, tell them all about me and what happened to me. Tell them I been to rehab and jail and still can't shake it."

Wow.

I sat there silently taking it all in. Finally I took a deep breath and spoke. "I will. I will tell them exactly what you said, I promise. As soon as they get old enough, I really will."

"Yeah, you should. I think if I hadn't been so drunk and if I had been afraid of drugs a little more I might've not even f--ked with it. Who knows? But yeah, if your mind gets twisted from something totally legal, don't think you can't get caught up on some illegal shit."

Real talk, man.

So that was that. That was how. That was what went down and that's how a super successful gentleman finds himself kneeling down in the corner of an abandoned building and having no idea how to reach a single member of his family.

So. . .  what did I learn that day? A lot. I learned a whole lot.

Reflections from a Friday at Grady: This bitter earth

"This bitter earth
What fruit it bears
What good is love
That no one shares?
And if my life is like the dust
That hides the glow of a rose
What good am I ?
Heaven only knows

This bitter earth
Can be so cold
Today you're young
Too soon you're old
But while a voice
Within me cries
I'm sure someone
May answer my call
And this bitter earth
May not be so bitter after all."

Jazz legend Dinah Washington singing "This Bitter Earth"


________________________________________________________

Okay, so I guess I would be remiss if I didn't comment on something that happened to me at Grady. . .and sort of beyond Grady. . .last Friday. I was giving the lecture for Primary Care Grand Rounds (at Grady) and I. . .well. . .I started crying during my presentation. Yeah, you read that right. I started crying during my Grand Rounds lecture. Snot and all, and not a tissue within 50 feet of the podium. "Boo hoo crying" as my best friend Lisa D. calls it, and nope, no typo-- I was the speaker. Wow. Doesn't sound too grand, does it?

Listen--if you have read any part of this blog, you probably know that I have a lot of emotions when it comes to crack cocaine and the patients we care for at Grady who are affected by it. So it should come as no surprise to you that I decided to take a detour from our regular super-scientific talks and try something different, but related to crack cocaine. I guess my goal was to "humanize" our patients who use crack, and to paint them not as "crackheads" or these erratically-walking-down-the-street/washing-your-windshield/asking-you-for-money/weak-minded/fill-in-the-blank addicts. . .but as real people.

Of course, I did the regular background stuff of reading papers and doing literature searches. But the coolest part was the three weeks I spent walking around the hospital interviewing patients who used crack cocaine. Oh man. . . . .it was amazing the things people told me. And every person I talked to was so gracious. . .so open. I always thought I knew a bunch about street drugs and the dismal factors that lead to their use- but I did not know as much as I thought. I was excited about telling their stories.

Last Sunday, I was working on my slides and even though it was going well, I found myself hitting a wall. I decided to take a break and head to my vice of choice - Target. (Some have a drink to unwind, I go to Target.) While en route, my dad called me on my cell. (Not unusual, since I pretty much talk to my parents daily and subject them to a blow by blow of everything I do professionally.) Dad and I were chatting about my presentation, and I was doing my best to give him my vision of the whole thing. I hoped he'd give me something to help me with the roadblock I was hitting.

"You should talk to your Uncle Woody, " he suggested. "He will probably tell you a lot of useful stuff for your talk."

Uncle Woody is my dad's younger brother. One of the eleven children born to my grandmother and grandfather, one of seven sons, and one of the two children who graduated from a four year university.
Hmmmmm. I suppose I'd sort of known that my Uncle Woody was "on something", and I'd heard that he'd been incarcerated and hard on his luck over the years. I even knew that he'd stolen money from Dad at some point, too, yet even that I hadn't thought about much since Dad had forgiven him for it.

"Uncle Woody used crack?" I asked. The more I thought about it, the more I knew the answer. While he wasn't the only Uncle that had substance abuse issues, he was the only one who was always accused of having "sticky fingers" which is, as comedian Jamie Foxx says, "crack-ish."

"Oh, yeah, he definitely used crack," Dad said. I liked the gentle and understanding tone to his voice. It certainly did not sound the voice of a man who'd had his identity stolen, his credit annihilated, and even a criminal record created in his name all at the hands of the younger brother of whom he spoke.
"He's really open about it. I will call him and see if he'll talk to you about it. I'm sure he will."

After we hung up, I pulled into a parking space and just sat there for a moment thinking. I reflected upon my childhood memories of my Uncle Woody and smiled. He was so charming . . .and cool--I'm talking cool as a fan. . . . .and super good looking. One summer we were visiting Birmingham, Alabama when I was around ten years old. We stayed at his lovely home with his even lovelier wife, and I recall not wanting to leave. I remember the wall to wall carpet in his new home, the late model Cadillac he was driving, and even the way he smelled. He smelled like fancy cologne and success. His wife smelled even better, and in their bathroom they had a double vanity (which at age ten, I had never seen before.) Woody's wife had perfume with an atomizer sitting on the bathroom counter, and sprayed two sprays each behind my ten year old ears. I was elated. My Uncle Woody was the number one salesman at one of the largest Ford dealerships in Alabama, and it showed--his life was fabulous, and so was he.

Then, at some point, something went terribly wrong. We lived all the way in California, so my perception was distorted by the miles. I recall these vague reports of him. . . . "Woody lost his job" or "Woody's not with his wife anymore" or later on, "Woody will steal from you 'cause he's 'on something'." That went on for years. . .through my high school years, through college and beyond. The uber-successful uncle who had graduated from my college alma mater and who always smelled so good had become this blurry figure that I couldn't get my mind around. I began to wonder if my early memories of him were just a figment of my prepubescent imagination.

My cell phone vibrated in my pocket and startled me.
"Take this number down," Dad said firmly, "Woody is waiting for your call."
Robotically, I wrote the number down on a loose sheet of paper lying on the seat in my car. A few moments after I entered Target, I took a deep breath and called my uncle.

As soon as I heard his voice, there was something different about it. Always the life of the party, I was accustomed to his quick wit and tendency to entertain any person with whom he spoke. Today, it was appropriately serious. No lighthearted one-liners, no silent laugh track in the back ground or even the slightest hint of "shucking" or "jiving." It was a side of him that was as nebulous and foreign to me as the descriptions I'd heard of him over the years.

Two sentences into him telling me his story, I felt a pang in my heart that told me, Go sit down. Take this all in. This is real talk right here. He doesn't have to do this for you. Give him that respect. (Fortunately, most Target stores are now equipped with their very own Starbucks bistros.) I asked him to hold his thoughts for just a moment as I ordered a latte, sat down with a pen in hand and that same loose sheet of paper. I didn't want to miss a thing.


We launched into what turned out to be a pivotal discussion. Uncle Woody took me on his twenty plus year personal journey through the hell of crack cocaine (and alcohol) addiction. He told me how he was introduced to crack, how it made him feel, and when he knew he was "hooked." He described the deplorable living conditions he experienced at his worst, his deceitful means of acquiring money for drugs, and the self hatred that was perpetuated as a result. Eloquently, he shared of his meteoric rise to success as a young man followed by his plummet to rock bottom--all at the hands of drugs.

We talked about his life now, and his ongoing struggle with substance abuse. There was a childlike quality to it all. . . . almost like an attestation of some horrible abuse at the hands of a caregiver; filled with internal angst about whether or not it was all their own fault. He graciously (and courageously) agreed to let me tell his story, use his name, and even his picture.
"Anything I can do to help you teach people, Kimberly," my Uncle Woody said earnestly.

The entire time, I was somewhere between intrigue and tears. Like my dad and all of his side of the family, Uncle Woody is such a good story teller that the pendulum swung more towards the "intrigue" side. I hung onto his every word, inserting my gasps and "oh my goodness"es along the way. In the end, I guess I never really processed my feelings about it all. . . . . .

That is, until a little over three quarters into my lecture last Friday. I had incorporated all that Uncle Woody had shared with me into my slides, including a few of his notable quotes that I'd scribbled down feverishly in the Target Starbucks that day. The whole thing seemed to be going well. I told my patients' stories, and saved one of the very best for last-- Uncle Woody.

(Granddaddy, Grandmommy, Auntie Bunny, Mommy, Daddy, Uncle Woody, and Mudear
Mommy and Daddy's wedding day, July 23, 1966)

There I was, in my element. Talking and teaching. . . .totally my thing. Then I advanced the slide and there it was. It was a picture that included my Uncle Woody from July of 1966 (above). An image I'd seen a thousand times before, and a thousand more since I'd been preparing for this talk. It was from Mom and Dad's wedding day, and there stood 18 year old Woody in the wedding party. Mom with her angelic 19 year old face, Dad standing at military attention--with Uncle Woody to his immediate left. Next to Woody was my paternal grandmother, affectionately know to us as "Mudear." She looked so regal--standing beside her two college boys. Dad, the first to go to college, and then, Woody, who had graduated high school second in his class and who'd scored a full scholarship to play baseball at Tuskegee. I saw my maternal grandparents, Mom's older sister, Bunny. . . but at that moment, when it was projected on that screen, I saw that picture completely differently.

That was the Uncle Woody of my ten year old memories. If I closed my eyes, I could even smell his fancy cologne and hear his confident laugh. That laugh sounded so watered down and defeated in our recent conversation. I thought about how much courage it took for him to tell me his story especially since I know he knew how much my siblings and I once looked up to him.

The magnitude of it all smacked me across the face and punched me in the chest. What a parent wishes and prays for their child! Oh, how proud Mudear must have been during that time. . . .and how devastated she must have been to see her manchild's demise! Completely unexpectedly, I was immediately moved to tears at the very sight of the image--in front of the entire auditorium of attendees. I tried to speak but nothing came out. I cannot believe I am doing this during my Grand Rounds lecture. I cannot believe this. Get it together, Manning.

You could hear a pin drop. I waited a moment and did my best to continue. Okay, Kimberly. Please don't go into the "ugly cry" like when Halle won that Oscar. That's when it crosses from touching to weird. Don't go there. Come on, girlfriend, pull it together. For a few seconds I felt embarrassed, but something about the audience comforted me; their understanding eyes, their patient silence.

On Friday, the pendulum swiftly swung the other way with nearly one hundred onlookers. I processed my feelings about my uncle, my Grady patients, and my feelings about crack right then and there--whether I was ready or not. And in a strange way, it felt good to release those emotions (even if it was in front of five trillion people that I have to see on Monday.)

Dear Uncle Woody,

Thank you for not being too proud or afraid to tell me your story. Thanks to your honesty, a lot of people learned a lot that day, and I learned something about myself. I learned that I love you--and you know what? Not as much has changed in thirty years as I once believed.

Now, I respect you for completely different reasons.

With love from your niece,

Kimberly

Now that I think about it. . . . .thanks to my patients at Grady--and my Uncle Woody--my Grand Rounds talk was kind of therapeutic. . . .and pretty grand after all.

Everybody has a story. . . .

Ever drive down a major street in a large metropolitan city and witnessed someone erratically walking by with that dazed, drug-addicted look in their eyes? Or better yet, have you ever encountered someone who was giving you this long, drawn out story about how their car broke down, etc. and if only you could give them $5, it would be okay. . . .yet you know from the vacant look on their face that it is likely drugs? Yeah, well if you haven't then just take a trip to downtown Atlanta.

I see so, so many people whose lives have been ruined by drugs, particularly crack cocaine. The most disturbing part about it is that the majority of them look like me- black and female. It really, really sucks. . .and it can be really frustrating at times. But every now and then, I am reminded that every single one of the people I have met or cared for who uses crack cocaine has their very own story.

I was rounding recently and one of my patients, hospitalized for multiple things all of which were complicated by the fact that she was homeless and addicted to crack, had a sad look on her face that morning. When I asked her what was wrong, she gave me a half-hearted smile with a shoulder shrug and told me, "Today is my 30th birthday." Then I noticed this yellow legal pad on the tray table. She had scribbled down all about what she wished this day could be like instead and how much she wished her life could be different. We talked for a while, and I learned a lot about her. Then I thought about my 30th birthday. . . .a fabulous weekend laughing on South Beach with two of my good friends. . . .riding around in a convertible, basking in the Miami sun and sipping mojitos. . . .meeting my best friend, Lisa, in Atlanta afterward for even more celebrating. It was unforgettable.

As soon as I walked out of her room, I burst into tears. That happens to me more often than I should probably admit. (I keep waiting for this point in my career where I will become stoic and unaffected.) Crack cocaine is awful. It is a horrible, ruthless thief that robs young and gifted people of so much promise. And I see it every single day at work. Be glad if it has never occurred to you to try crack, and feel thankful if your family cherished you growing up. If that's your story, count yourself blessed. A lot of folks never even get a fighting chance- and if only they did, they might have gone on to do such great things. The late Keith Haring immortalized this truth in his art (pictured above), and Whitney Houston said it best in her latenight chat with Diane Sawyer- "Crack is wack." Talk about an understatement.


Anyways. . .the next time you see someone who clearly looks like they are "on something" just take a minute to ask yourself. . . "What's her story? How'd he end up like that? What are her talents? What did he want to be when he grew up?" And then, if that's your thing. . . .say a little prayer just for them. I know I do all the time. . . . . .


Like many of my unstably housed patients, this one went back to a downtown homeless shelter when she was discharged. . . . .where a large number of the folks there use crack. Damn.

*patient permission obtained to be subject of blog