Top Ten: Mentor-ific Part #1

Telemachus and Mentor

One of the first things people tell you when you take a faculty position in medical education is this: "Get yourself a mentor."  It doesn't matter if you're a clinician educator, a clinician researcher or both. At some point somebody is going to catch you at the coffee maker and ask you all nonchalantly:

"So. . . .who's mentoring you?"

This is the point where you break out in a cold sweat. Unless, of course, you have a clear idea in your head exactly who that person is.  Maybe you're so savvy that it's more than one person, even. But if you are like many fairly junior folks. . . .that answer isn't as clear as you'd like for it to be.

Here's why. Many institutions help you identify a mentor right of the rip. Someone looks at you and your accomplishments and serves as a professional "match.com" for you and your future.  The problem is. . . as well meaning as these arrangements are, ofttimes it doesn't result in "eharmony."

And so. You give that name that was given to you whenever someone asks, but secretly you kind of recoil because there hasn't been the kind of magic you'd been hoping for.

Um yeah.

I know that some professional person somewhere is reading this thinking, "Yes! Yes! Yes!"  Yes, because it's true.

Hold up.  A few of you might be like, "What do you mean mentor? Like why must I have one of those? Is it like having a guru? Because if it's that, I'll pass, thanks."

Alright, so check it. Back in the Greek mythology day, Odysseus (as in the dude behind "The Odyssey") had this right hand man named Mentor (yes, this was the dude's real name.) Anyways, Odysseus had some big things going on and by big things I mean The Trojan War. Odysseus, being the responsible dude he was, was concerned about who would hold things down for him in his absence. And see? Remember when I said that all women need good women friends and all men need good men friends in their corners? Fortunately, The Odysseus had that in his running mate Mentor.

This just reminded me of my hospitalized patient who introduced me to his best friend who was visiting at the bedside one day. He said to me, "Hey Miss Manning, this man right here is my 'A-alike!'"

And of course, I asked this patient who happened to be a New York transplant, "He's your 'A-alike?'"

In unison they both laughed out loud and said, "Yeah, 'cause we B-alike and we C-alike."

Yes, I digress but the point of telling you that was. . .uhh. . .nothing really.

Ha.

Okay, so Odysseus had a son who was the apple of his eye named Telemachus, and he needed somebody to keep an eye on his boy while he was away. Even though Telemachus wasn't like a baby or anything, this was necessary because his father was kind of a big deal. So, in a way, Mentor was kind of like having secret service for the Obama girls but like, before the secret service was invented.

You still with me? Good.

So the story goes on, a lot of stuff goes down, but the bottom line is that Odysseus' A-alike Mentor held down the fort big time and proved to be a great guide to Telemachus. When it was all over, Telemachus probably said, "''Preciate you" to Mentor and Mentor, like any good mentor, just smiled all proud-like and replied by saying something poignant like, "Ah, my lad. . . . when you succeed, I succeed."

Anyways. This is where that whole word comes from in the English language. The gnarly thing about the story of Mentor is that he wasn't just a babysitter. He was wise counsel, a cheer section, a coach, and a trusted confidant. And although Telemachus had a good father who could serve in that capacity most of the time, it ended up being good to have someone else in that role as well.

So I say all this to say. . .I think good mentors help us to get close to our full potential. We all need good mentors to nudge us, advise us and sometimes taze us into doing what we need to do. The most effective mentors coach, inspire and lead by example. It took me a minute (a Grady miiiii-nute) to recognize and identify my mentors in medical education. And man, am I glad that I finally did!

Haven't found one yet? Or don't realize who yours are? Never fear because today, in the first installment of my Mentor-ific series, I bring you:


The Top Ten Ways to know a GREAT mentor when you see one.
Use this to help guide you to the promised man or wo-man.  (Not in the romantic sense but in the mentor sense, alright?)

Drumroll please. . . . . .

#10  --  R-E-S-P-E-C-T

A mentor that's right for you is someone that you respect. Now, this is trickier than you might imagine. Just because someone is a rock star professionally doesn't mean that you'll fully respect them. Perhaps you don't like the way he or she speaks to his or her administrative assistant or even they never leave work to be with their family.  Whatever it  is, if there's a disconnect with your ability to feel genuine respect for the person, it's probably not a good fit.

#9  --   PRODUCTIVE

It's kind of ideal to have a mentor who has actually done some of the things that you aspire to do. Don't confuse that for EXACTLY the things that you want to do.

Case in point:  My main professional mentor is Neil W., who happens to have some interests that don't exactly mirror my own. But. He is a highly accomplished teacher on the local, national and even international levels. His teaching style is quite different than my own, too. And that's fine. Because he is very, very productive and helps me to push harder both through his encouragement and his example. Plus he's a kick ass teacher, which I always aspire to be. I respect that. It works.


#8 --  AVAILABLE

Doesn't matter how amazing of a fit a person is for you if they don't have time for you. Some folks are well-meaning but ridiculously busy. Too busy to reply to your emails or your phone calls. And if that's the case? Regrettably, it's probably not a good fit.

There are some times when the mentee falls short and isn't assertive or prepared enough. This might leave said busy potential mentor less than enthusiastic about making time for them. But when it's not that, then at some point you just have to cut your losses and keep it moving.

Yes you are published in the highest tiered rock star journals and you present at the biggest deal conferences every year. But you won't call me back so . . . . oh well.

#7 -- WISE

A great mentor has been around the block enough to have gained some wisdom here and there. Sometimes you need to turn to your mentor for insight on what to do when those paths diverge in a yellow wood. It helps if they don't have to use an 8-ball to give you some advice.

#6 -- EXAMPLE

Those I identify as mentors are people who I consider role models. Not just professionally, either. I like knowing that, yes, you work hard but that you also go on vacation with your family or take a cooking class with your husband on Tuesdays after work. No, you don't need to be perfect. Just working to achieve some sort of balance, you know? It also helps if you're nice.

By the way--I gave a speech once called "Let your life be a mentor."  It was about how even when folks don't know you personally, they can be mentored by your example and the lessons in your life. I am mentored, for example, by Angella L. on many things. She is a mom and professional and a wife and when I read her writings, I get guidance. That's just a little bit of food for thought.

#5 -- UNSELFISH

I'm sure Mentor had a whole bunch of things he needed to do while Odysseus was gone to the war. Even though it is technically a myth and was technically waaaaaay back when, I know for sure that not that much has changed in the world since then. Real talk? Time is a precious thing.  This is why many people would much rather write a check toward food for the homeless than going to a shelter and actually feeding them. Time. Energy. Commitment. 

It takes an unselfish person to spend time focusing energy on someone other than themselves. Exceptional mentors are willing to sacrifice their time, ideas, and energy to bring out the best in you.

Oh,  and don't be fooled. Sometimes productive mentees find themselves working with people who seem unselfish. Ask yourself a question: Would this person still be as interested in working with me if they weren't last author on all of my papers in their field or if I wasn't completing the manuscripts that were sitting on their desk for the last five years? If the answer isn't an immediate absolutely yes, then know that the relationship could be difficult to sustain.

#4 --  INSPIRATION

Mentors come in all shapes and sizes.  Some serve as "coaches" -- kind of like what surgeon Atul Gawande, M.D. wrote about in his lovely piece called "Personal Best" in The New Yorker. They stand on the sidelines watching you and telling you how to improve your technique. They come up with ideas that you never thought of, point out strengths and weaknesses that never occur to you, and. . . .they just. . . .they just invigorate you.

One of my mentors who serves in this capacity is a Grady doctor named Carlos D.  Carlos is quite possibly the busiest, most hard-working person I know. But he does all of the things he does with such zeal, man. He teaches with zeal. Treats patients with zeal. And even responds to my most simple text messages with a spunk that often makes me laugh out loud.  I learn so much from watching him and listening to him. And though he is not my mentor in the formal sense I count him as one because he makes me better.

There's a whole movement about peer-mentoring that I have to mention here, too. Many of my peers in medicine hype me up so much! I watch them teach or talk or do what they do and I feel invigorated. Ready to try something new.  That list is long. But I count these people as the swirling moons around me that serve in a mentoring role, too.


#3  -- NO COMPETE CLAUSE

Your mentor should NOT be in competition with you. Period.

#2 -- FUN

Mentor-mentee relationships can be time consuming. It sure can be painful to spend all that time with someone who's a stick in the mud.  When I meet with my mentor Neil W. we spend at least 70% of the time laughing out loud. It's productive, yes. But always fun.

Okay, except for the last chapter we wrote together. That wasn't fun. But he did laugh at all of my jokes regarding how un-fun I found that whole process. And the reason he insisted I do it was because he thought it would help me professionally. (He also helped a WHOLE lot with the hard parts which takes me back to number 5.)

#1  -- GENUINE INTEREST IN YOU.

Not what you can do. Not how fast you write. Not how willing you are to work long hours. And not just what you can do to make them look good.

You.

They remember that your son is turning five and they fly back from wherever they were to be at his birthday party because it's important to you. (Yes, I remembered that, Neil.)  They want to hear your ideas and have the patience to help you flesh them out. They take the time to look at your unique qualities and try hard to come up with the best ways to utilize them.  They know when to push you and when to back off because they've taken the time to get to know you.

In other words, they care. About you. You.  Even if you don't have great comic timing. Even if you got a 'B' on the medicine clerkship or if you didn't get awarded that big grant from the NIH. They still make room for you in their schedule and start that meeting off with simple things like:

"How are you? How was Harry's birthday? Are the kids out of school yet? Have you ever eaten at Antico Pizza?"

And then they get down to business. I think everyone knows that there is a very fine line between business and pleasure. It sure helps when it gets blurred.



Oh and mentoring isn't just a doctor thing or medicine thing either.  Many of my mentors coach me in life and motherhood and everythinghood as well. And. Many people mentor you without even knowing it. Kind of cool, isn't it?

Bottom line? The best mentors get it. And they get you. 

That's all I've got today.

(Stay tuned for more on my mentor Neil W. in the next installment. Ha ha ha. . .)

***
Happy Hump Day, y'all.



Now playing on your mental iPod. . .  If you're lucky, your mentor just might teach you how to Dougie. . . but don't count on it. Don't worry, this is not a requirement.

See one. Do one. Teach one.

 *some details changed to protect anonymity and all that stuff. . .you know the deal, people.

 "See one. Do one. Teach one."

~ Anonymous

Hands shaking inside of tight sterile gloves. Eyes with laser focus on the landmarks. All but a tiny square of skin on the small of the patient's back is blanketed in blue sheets. That exposed area, now rubbed sterile with surgical-grade antiseptic, awaits those hands.

"Your position is perfect. This is exactly correct."

The upper level resident is coaching; he is using those words of encouragement that surely were used for him. Though technically a novice at being a supervising physician, he is obviously a natural.  I smiled as I observed the entire thing--his back straight and confident and his words commensurate with his posture. I liked the way he glided between giving attention to the medical student whilst offering continuous concern to the patient.  Of course. The patient.

"How are you doing, ma'am? Are you okay? Just let us know if you are feeling pain, okay?"

And gently she'd respond, "I'm fine."

Like clockwork the student mimicked this, checking on her patient's well-being despite her trembling hands. This was the first lumbar puncture she would perform.  And perhaps, for her supervising resident not even six months out of internship, this was one of his first experiences guiding someone junior to him through it.

"Make a wheal under the skin," she spoke aloud. She wanted to be sure she followed the proper steps.

"Exactly," he affirmed.  She continued anesthetizing the narrow space that awaited the spinal needle as he nodded in confirmation.

Then, as if planned and blocked by a director, they peered over the sterile field and spoke in unison:

"You doin' okay over there?"

She paused for her patient's answer before she continued--just as she'd been taught.

"Okay, so now you may feel some pressure. I'm about to insert the spinal needle, okay?"

"Okay," the patient nonchalantly replied.  She looked cherubic all curled into a fetal position.  Mostly because she seemed content with all of this poking and prodding. Words like "T-cells" and "viral load" and "spinal tap" weren't foreign at all to this patient.  She'd been there and done that, and didn't seem to mind at all when, with full disclosure, the student admitted that this would be her first time doing this procedure.

"That's okay with me," the patient said with a genuine smile.  "You have to learn at some point."

And despite the fact that no person ever really wants to sign up for a lumbar puncture, let alone one performed for the first time by a medical student, there was a peacefulness about it all that immediately told me it would go just fine.

"Bevel up."  She continued to narrate her actions as her supervisor stood close; this time she was referring to the mouth of the spinal needle.  I liked the way he nudged her along, peppering in relevant questions along the way.

"You alright, ma'am?"

"Fantastic."

She inched the long spinal needle through her man-made welt while carefully sliding the stylus out periodically to inspect for a flash of spinal fluid.

Advance.
Look.
Advance.
Look.

"Watch your hand, don't lose your position."

"I'm meeting some resistance. Do you think it's bone?"

"The intervertebral space is narrow. You just need to reposition you hand and make sure she's not rotating forward or backward."

"Okay." She took a deep breath. I loved the determination in her face.

"We're almost done with the hard part, okay, ma'am? How are you doing?" her supervisor asked.

"Just fine. I'm okay."

"Pain?" she asked earnestly. The student really wanted to know and seemed to deeply care about her patient's comfort.

"No, I can barely feel anything," the patient replied.

"Okay, let me know if you do, okay?"

"I will."

Advance.
Look.
Advance.
Look.
Advance.

She swung her head in the resident's direction, eyes widening behind the clear plastic eyeshield. First a few drops of blood and then. . .

Drip.
Drip.
Drip.
Drip.

Eureka.

"Now we're just going to take the samples of the spinal fluid, okay?  We're in with the needle and the spinal fluid is coming on out now."  I could hear the tremble in her voice; part relief and part elation. Her first time doing a lumbar puncture.  And she'd succeeded.  On the first time she succeeded. (Which is more than I can say about my first L.P.)

Next they collected the specimens; the resident downshifting his gears and morphing into her trusty assistant.  Diligently he handed her the numbered bottles and methodically cleaned up the sharps.

Throughout all of this, I sat quietly on a nearby chair; close enough to see everything, to chime in if necessary, and to assist if required. . . . but still far enough to let my resident lead. The residents call it "micro-managing" when attendings breathe down their throats and cramp their leadership style. I didn't want to be that person, so I crossed my legs and watched; I even answered my resident's pages for him. Sure, at one point I felt myself itching to gown up and snap on a pair of size 6 1/2 sterile gloves just for old times' sake. . .but I fought the urge staying glued to that seat and resisting that temptation.

"See one. Do one. Teach one."

That's a common saying in medical education. Classically, that's been the order of things, particularly procedures, in everyone's medical upbringing. You stand by passively those first few times. Then at some point you get the chutzpah to try it yourself, but only if the planets align and you have a supervisory resident that feels ready to both relinquish the operator position and guide you through it.  Finally, you become that person who's done this enough to remove someone else' training wheels and walk behind their bicycle.

But on this day, I recognized a shift in this unspoken law of learning in the clinical setting.  I have already seen one, done one, and taught one many times over. This time, I watched this with different eyes. I had the golden opportunity as a clinician educator to see one . . . one who finally had the chance to do one while having her tremulous hands held by a newly minted resident. . . . ready and able to confidently teach one.  Gives a whole new meaning to that old adage--it had now gone full circle.


They dismantled the giant blue force field separating them from outside germs and also eye contact with their patient.  At this point, I'd stepped out of the room, but I didn't need to be there to know what would happen next.  They would ensure the patient was comfortable and provide some anticipatory guidance about laying supine to avoid a spinal headache. They'd ask if the patient wanted her window shades opened or closed, her room light on or off, and her television muted or with sound.  And then they'd promise to share the results as soon as they were available.  And as soon as they did appear on the computer screen a few hours later, without question, they'd be standing at her bedside going into the nitty-gritty of each and every detail.

Or rather she, the medical student, would go back and do all of these things alone.  Why? Because, at some point, this is what she'd seen someone else do. At least, this is what I've chosen to believe. . . .

"See one. Do one. Teach one." 

Medicine and learning . . .all in a continuous cycle. . . .simultaneously wonderful and terrifying. . . . . yeah.

***
Happy Friday.

 It's official. She did one.

The Last Leaf Has Fallen.

J. Willis Hurst, MD  

(Sunrise 1920 ~ Sunset 2011)

Today is a sad day for the medical community and especially at Emory.  After a long life and influential career of caring for patients and teaching us how to do the same, the iconic clinician-teacher, Dr. J. Willis Hurst, has passed away.  

As a teaching internist at Emory, I am proud to be among those who carry on his ideas and remember his influence as we teach the residents in the very Internal Medicine program named for him--The J. Willis Hurst Internal Medicine Residency Program. I feel fortunate to have been at Emory during his time on faculty, and even more fortunate to help carry the torch that he worked so hard to keep lit in us all.

This morning I am quietly reflecting on Dr. Hurst and his legacy in patient-centered care and medical education. I am sharing a few of his own words, followed by some quotes that he personally found influential. 

"The truth has always been difficult to identify.
Unfortunately, there is every reason to believe that
the future identification of the truth will be even
more difficult than it has been in the past. This is
because there are currently more nonscientific
forces that clutter the mind than there have been in
the past. There is also evidence that such forces will
be accelerated in the future. Accordingly, the identification
of the truth is destined to become the
physician’s greatest problem."

~ J. Willis Hurst

***

A few of his favorites:

"I am a part of all that I have met."

~ Alfred Lord Tennyson, 1842

***

"We may affirm absolutely that nothing great in
the world has been accomplished without passion."

~ Georg Wilhelm Friedrich Hegel, 1832

 ***

"Be not the first to whom the new are tried,
Nor yet the last to lay the old aside."

~ Alexander Pope, 1711

*** 

"Your compassion for your patients—trying
to do the best for them—must be the major motivating
force in your effort to remain competent."

~ Dwight C. McGoon

***

"Press on; nothing in the world can take the place
of persistence. 

Talent will not; nothing is more common
than unsuccessful individuals with talent. 

Genius will not; 

unrewarded genius is almost a proverb.
Education will not; 

the world is full of educated derelicts. 

Persistence and determination alone are
omnipotent."

~ President Calvin Coolidge

***

"Like love, talent is useful only in its expenditure,
and it is never exhausted."

~ E.P. Tuttle, Sr.

***

"Clay lies still, but blood’s a rover;
Breath’s a ware that will not keep.
Up, lad: when the journey’s over
There’ll be time enough to sleep."

~ Alfred Edward Housman, 1896

***

Rest in peace, sir. And rest knowing that your legacy never will.

***

Hurst, JW. Quotations on the Wall. Annals of Internal Medicine. 1999;131:551-554.

Each one. Teach one.

*Details changed significantly to protect anonymity.

Grady Resident's Clinic, July 2011


"Hi, ma'am. I'm Dr. Manning and I'm the senior doctor working with your doctor today."

"Good morning."

"Good morning to you, too. I heard that you had a rash giving you trouble today, right?" She nodded emphatically and rolled her eyes upward. Without me asking, she opened up her gown to show the angry eruption on her chest wall. I slid on a pair of gloves and asked, "Does this hurt?"

"Like hell," the patient quickly replied. "No, like hell-fire."

With the newly minted intern right beside me, I carefully inspected the flaming crop of dewdrop-appearing bumps spread like a linear stripe just below her right collar bone. "Tell me. . . how did this start?" I looked over at the intern whose brow was furrowed and inquisitive. Then I added, "I know you told your doctor all of this already, but I just wanted to hear a little more for myself if that's okay." I turned my head to make eye contact with both the intern and the patient; this was my unspoken way of getting permission to be redundant.

"First . . . .it felt like. . . .like something burned me. Crazy sounding I know. . . but that's how it felt."

"Ummm hmmmm." I folded my arms and kept listening.

"Then yesterday night I looked and this was what was there. Still burning like the dickens, but now with this ugly rash."

I raised my eyebrows and nodded slowly. "You know what, Ms. Fulsome? You do a great job describing what's going on with you. That was really helpful, thanks. If it's okay with you, we're going to just shop-talk for a few seconds, and we promise to explain everything we're talking about. Feel free to interrupt, okay?" She smiled in acknowledgment and helped us as we closed her gown. Next I faced the intern. "Thoughts?"

The intern licked her lips and pressed them tightly together before speaking. Although we'd met in passing a few times when she was a student, this was our first time working together in a clinical setting. Her brand new lab coat issued during intern orientation was blindingly white; her lack of experience had not yet caused it to be otherwise. Her earnest eyes were unspoiled, just like her white coat. . . . but she seemed nervous.

"No pressure, okay?" I offered. "Look. . . I really just want to hear what's on your mind. When we were outside you mentioned a few thoughts, and I was wondering if any other things had come to mind since we came in here together."

"I guess my first thought was pretty off then." She laughed nervously and then continued. "I was thinking that maybe. . . maybe she came in contact with something? Maybe poison oak or poison ivy? Especially since it is so linear?"

"Good point. Contact dermatitis from poison ivy can definitely give you blisters and you're right, it's one of the only things that gives you straight lines." I gently re-exposed the rash while being careful to keep Ms. Fulsome's breast from being exposed with the other. "This looks less like straight lines per se. . . and more like . . . . blisters on a red base. . . . but limited to one area. Kind of sparing other areas, you know?"

"I see what you're saying."

"What else could this be other than contact dermatitis?"

She sighed and licked her lips again. I could tell that the answer was right there but that, for whatever reason, she was afraid to be wrong. The silence was growing uncomfortable. Now she was biting her cheek, obviously deciding whether or not to say something.

I kept telling myself that this was only the third week of internship for them, and that I needed to be mindful of that. I didn't want to apply too much pressure.

Then, this happened.

Ms. Fulsome finally chimed in. "Doctor? What about the other thing we talked about? Remember when you asked me what I thought this was? And then you started teaching me about that?"

"Oh. . . you mean. . . . shingles?"

"Yeah, the shingles. Dr. Manning, she asked me what I thought and I said, 'I wonder if it's shingles?' and she said, 'You know, it could be shingles, it really could. . . but your immune system isn't weak.' Then she taught me a whole bunch about it. But I still was thinking the shingles."

Wow. Ms. Fulsome for the win.

The intern looked at me and discounted their great idea. "She isn't diabetic and she's had several negative HIV tests. My first thought as soon as I saw it was that it could be Herpes Zoster (shingles) but since she isn't immunocompromised I thought against it."

I smiled wide. "Your first thought was right. Both of you."


"Really?" the intern asked incredulously. Ms. Fulsome made a hand gesture that said, "BOOM!" (which I totally and completely loved.)

"Yes, really. This is classic. Ms. Fulsome gives a perfect history, and lots of people with strong immune systems get Zoster or shingles. Have you been under any stress, Ms. Fulsome?"

"Stress? Well, I got three grown people living up in my house that should be living in they're own houses. Them and their kids. They my grandkids, I know, and I love them like crazy. . . .but I'd say having all those mouths at your table and hands pulling on your refrigerator can definitely give you stress." She released a hearty chuckle. "And two of them grands is teenage boys. You know how they eat!"

"I heard that!" I laughed, imagining two Paul Bunyan-sized teens scarfing down food at her table.
Next I pulled off my gloves and tossed them like a ball into the waste basket. "Whelp, it looks like you both were right the first time. This is sho' nuff shingles."

After that, we chatted with Ms. F about the anti-viral medication that she'd need to take and gave her some information about reactivation of the chicken pox virus--aka Herpes Zoster. Once things were wrapped up, we stepped out of the room, pulled the white "discharge" flag and waved good bye to our patient.

The minute we left the room, the intern hung her head. Her morose facial expression completely caught me off guard.

"Oh my gosh! What's wrong?" I queried. She almost looked tearful; her face was a solid mask of defeat and her shoulders rounded and dejected.

"Zoster! Of course. Of course it was zoster. Pain first. Then the rash. In a dermatome distribution." She smacked her hand to her forehead. "I should have known that." Then she whispered with a sigh in a very tiny voice:

"I'm sorry."

dermatomes

Sorry? Oh, hell naw!

Like the touchy-feely mama that I am, I put my arm around her shoulder. "Sorry? Come on, now. That's why we all work together. That's why we are here with you. How do you think I learned? How do you think I still learn?" She shrugged and kept staring down as we walked back to the physician's room like teammates who just lost the big game.

Finally, I halted in front of her and placed both of my hands squarely on her shoulders. "Listen to me, and hear what I'm saying," I firmly spoke while staring into her glassy eyes. "You will never, ever know everything. Never, ever, do you hear me? You did something really great. You asked Ms. Fulsome what SHE thought it was. And you know what? She was right. You respected her enough to ask." Now, she was gazing back at me, riveted and almost scared by the tone of my voice. I went on. "Look. The more patients you see and the more you listen, the more you'll know, period. With experience you'll see things like this and know in a snap exactly what it is." I snapped my fingers for emphasis. "But some days? You won't. You'll be clueless, you will. So you admit it. You look things up. You get another opinion. You ask for help. You ask the patient more questions and get their input. And you learn."

"Yes, ma'am," she whispered.

"I say, 'I don't know for sure' about something every single day. But I just try hard to be curious enough to be bothered by not knowing. That way I'll look it up."

For the first time, she looked a little reassured. Suddenly, an easy smile broke out over her face; her eyes more confident and with a new determination. "You know what, Dr. Manning? I bet I will never miss Zoster now. Not ever."

You know what? I'd bet she's right.

Sigh. I love this job.
***
Happy Tuesday.