Top Ten: How YOU doin'?

Back on the wards and man! Don't even know where to start. How about a top ten?

Don't mind if I do.

I bring you. . .

THE TOP TEN MOMENTS ON THE WARDS 

IN THE FIRST THREE DAYS OF MARCH

And no. I have not taken the time to really edit this, so forgive any typos in advance. (Got that, Shug?)

#10  --   All the single ladies?

So on the first day of wards, I step onto the A elevators heading down from the floor. The doors open and there's four or five youngish dudes standing inside. Well, not even just youngish. They were young, for real. So anyways, I join the young dudes and am immediately reminded that just maybe I still have my mojo (if being looked up and down with a creepy smirk counts as having your mojo.)

Yeah, so finally one of the dudes hits me with the Wendy Williams "how YOU doin'?" and I sort of giggle and nod in reply.



So we ride. And they creepy-smirk. Finally we reach the ground level and the doors part.

And guess what? Do you know all four of those young dudes stepped off right in front of me? Maaaaan, in my head, I was like, Can a sister get even a little bit of chivalry?

So I say to them, "Maaan, can a sister get even a little bit of chivalry?"

To which the how-YOU-doin' dude says, "Get a little bit of WHO?"

And I was like, "How are all y'all just gonna step off the elevator first? What happened to 'ladies first?'"

So the spokesperson dude looks at me incredulously for two seconds and laughs. Then he says, "You MARRIED!"

And I'm like, "What the heck does that have to do with y'all letting me off of the elevator first?"

We all laughed but they stuck to their guns. Another dude, not even the how-YOU-doin' one says the same thing again, "Yeah, you MARRIED!"

"Wait. . . . so if you're married then. . . you . . .no longer get ladies first?"

"Tha's what your husband is for."

This was the reply. And seriously? They meant it.

So. . . .the point of me telling you this? Uh, zero. It was just funny.


#9  - Ro-sham-bo!

This morning on rounds we asked our young patient this:

"What questions do you have for us?"

And he said, "I don't have any."

That wasn't surprising. Even though he wasn't even legal yet, with his chronic medical problem he knew the ins and outs of how such hospitalizations work. Then he added:

"Wait, yes I do. I have one question."

"What's that?" I asked.

"Do you know how to play 'rock, paper, scissors?'"

"Do I?"

Our patient smiled for the first time at that point. A big, bright smile that peeled back his lips and showed all of his teeth and a whole lot of his gums, too. That smile brightened up that room.

"Alright, let's see who wins!" he announced while squirming to sit upright in bed. I loved how boyish and playful he was about it, too.

And so we started. Me, the patient, the resident, and the intern. Playing rock-paper-scissors which I hadn't played since Isaiah was a newborn and Harry and I were trying to determine who had to wake up next.

"Rock-Paper-Scissors. . . . Shoot!"

The best part: Our patient won. Best out of three.


#8  -  Sugar pie honey bunch (but not like that.)

Patient was lying in bed this morning. She's been very, very short of breath so we wanted to limit her talking. I saw her alone on rounds today. She was resting on her back with her eyes closed which she opened only for a moment when she greeted me.

"Hey, sugar."

"Hey," I replied. "How you doin' today?"

"Good, sugar."

"Your breathing?"

"If I stay still, it's okay, sugar."

"Okay. Can I listen to you?"

"That's fine, sugar pie."

Sugar pie. Sigh.

I listened to her chest and back. Felt her tummy and made sure she was okay. When I got ready to leave, she opened her eyes again.

"You beautiful."  She smiled at me and squeezed the hand I was already holding.

"You are, too."

She closed her eyes again and looked like she was falling asleep. Then suddenly they flung open.

"I wasn't trying to sound funny. Like. . .I meant you beautiful like inside and out. Not like you beautiful like I'm trying to date you."

Wait, huh?

I smiled and then laughed because that was the last thing I thought this grandmother was saying so it was funny.

"Nawww, I never thought that. I got what you meant."

"Oh okay, sugar. 'Cawse, you know, I didn't want you thinking I was trying to be all like 'how YOU doin'?'" She gave a weak laugh and then coughed.

Not. Kidding. That's what she said.

And okay, the dude on the elevator didn't really say it like Wendy Williams but her? She really did.


#7  You smell me?

A man gets on the elevator with me on Thursday.

"Damn! Somebody in here smell good!"

Then. He commences to sniff person after person on the lift. And I am thinking we should have moved away or something but for whatever dumb reason we all just withstood his sniffing.

Verdict:

"Doc, you smell pretty good, but I thank it's her right here that I smellt when I got in here. She smell the best."  Then he looks over at this other lady and says--I kid you not--"now baby you might need you some more Sure."  And he threw his head back and laughed. Then he leaned back over, sniffed her near again, and shook his head."Wheeeeew. Yeah, baby. You got to do somethin' bout that!"

0_0

Wait. Seriously? Seriously.



#6  Tell me how you really feel.

"Good morning!"

"NO!"

"Beg pardon?"

"Get out!"

"Get out?"

"Get out!"

"I need to examine you."

"No!"

"But--"

"I said NO!"

"Okay. Is there anything that I can do for you before leave?"

"Let that door hit you where the good Lord split you."

Well alrighty then.



#5  You probably think this song is about you.

"Can I go home today?"

"I'm pretty sure. We just need to confirm one more thing, okay?"

"Hmmph."

"What's wrong?"

"Manning said I could go. Manning! She's the boss. Call her so I can speak with her about me leaving. You need to call Manning."

"I'm Manning."

"You Manning?"

"Yes, ma'am."

"Oh, damn. I thought I could trick you into getting me on out. I thought you was a intern."

"Thought I was an intern?"

"Yeah, you looked kinda younger."

"And for this reason, I will totally be expediting your discharge."



#4  --  What's in a name?


"You're all set to be discharged!"

"Great!"

"Do you have someone to pick you up?"

"Yes. My lover is picking me up."

"Your lover?"

"Mmm hmmm. My lover."

*all of us laughing together*

"Your lover?" I repeat. "That sounds awesome."

"And baby if you knew my lover like I know my lover you'd know that he really is awesome."

*gives me two exaggerated winks*

Love. This. Place.

#3  --  The Hard Questions on the way home.

Isaiah:  "How was your day, Mom?"

Me:  "Kind of rough. One of my patients is pretty sick. She might die."

Isaiah:  "Die?"

Me:  "Well she has a bad illness, so yeah, she might."

Isaiah:  "Did you give her some medicine?"

Me:  "We've tried but for this kind of illness it won't work."

Isaiah:  "Mommy?"

Me:  "Yes?"

Isaiah:  "Are you sure you know what you're doing?"

Damn.


#2  --   Full Circle.

Small Group Alpha - First year of medical school 2007

Me with Dr. Wetmore, Dr. Nguyen, and Dr. Carlisle in 2011

One of my interns this month is a student from my original small group -- "Small Group Alpha."  I've known him since his very first day of medical school.  Yesterday on rounds, every time he presented his patients or every single time I referred to him as "Dr. Wetmore"  I sort of wanted to cry.


#1  --  I do not speak Spanish.

I have come to accept this. Louder and slower does not turn English into Spanish. Neither does saying "como se dice en Espanol" before every single thing you say.  And so. I have vowed to call a Spanish interpreter whenever I have any situation at all where the patient does not have full mastery of English. No using the eight year-old in the room or the clerk on 7A.

On Friday, I went with the interpreter to see a patient and his family. And I did what the interpreters have taught me to do--speak exactly as I would normally speak with pauses for them to interpret.  I held my patient's hand, looked him in his eyes, and even cracked jokes. The interpreter slowly faded into the background (which is their goal) and I connected with my non-English speaking patient and his family. It was awesome.

It doesn't sound so deep does it? But it was. It truly was. I realized how many patients I haven't connected with due to a language barrier. It felt so good to wait those few moments for someone to stand in and allow us that connection.

Claro que si.

***
Happy Sabado y mucho mas.

Needs assessment.

*Names and details changed to protect anonymity. . . .you know what's up.

Tell me more! Tell me more!

Grady Wards Fall 2011:

Finished up my history and physical exam of this ninety-something year old Grady elder and decided to make a little small talk.

"Mrs. Porter, are you from Atlanta?"

"Sho' is. Born and raised right here. Well, really more like Avondale, but you know tha's still Atlanta."

"Definitely."

"Been comin' to Gradys all my life. You know, back then Avondale was all colored."

"Is that right?"

"Sho' was. But it always was nice, you know?"

"Yes, ma'am. Avondale is still a pretty cool neighborhood if you ask me."

"Mmm hmmm.  It do pretty good."

"Children? Did you have any children?"

"All my kids they dead."

Thought about the fact that people who live to see their ninth decade may have to face the dreadful possibility of outliving their kinfolk. Put that on a post-it in my head to revisit later.

"I'm sorry to hear that, Mrs. Porter.  So. . .how many children did you have, ma'am?"

"Well. . .outta my own womb I had seb'm.  But then there was two more that I raised like they was mine so altogether tha's nine."

Took down the post-it and tried hard to get my head around outliving nine children. Realized I couldn't so put it back on the wall in my head for later.

"Wow.  That's amazing. Were the other two nieces or nephews? Or younger brothers and sisters maybe?"

"Oh, naw. They was from my husband. See, he had to chil'ren that wadn't with me in between them seb'm we had."

Wait, huh?

"Your husband had two children while. . . .uhh. . .okay."

Wasn't sure what to say next.

"Yeah. Two of our kids less than six months apart."  She laughed out loud like this was real, real funny.

At this point just sitting there confused. She kept on talking.

"See, when he was in the army, he had one baby by one lady and after the service he had another from this ol' nasty woman. You know them mamas wadn't no count so I went on and raised them myself. Sho' did. See, back then, womenfolk didn't get all bent outta shape 'bout stuff like that. Fightin' over they men and such. Naw. We jest welcomed 'em on in and took care of 'em like they was ours."

Please believe it--she was 100% serious. Do you hear me?

"You know 'cause a man got needs. And you know, depending on wha's goin' on with you and yo' body and such. . you know, like if you with-child and feelin' sick or still got the baby on the ninny a' somethin' like that you know? You ain't always up for no rompin' round.  But what can you do? A man got needs, baby."  Said this with a nonchalant shrug.

Loving. This. Story.

0_0

"Mmmm hmmm. They was some good kids, them two. Even if they didn't come out my own womb they was mine jest like all the other ones was. But they mamas?  Now tha's another story."

"So . . . you didn't really mind that your husband had babies with someone else even though you were married?"

"What you gon' do? Once the baby on the way what you gon' do but love it?"

I wasn't thinking about what I could do to the baby. Instead I thought of choice places to squarely stick my foot on said husband's body. Tried to get with what she said.  Hmmm. Okay, awww hell naw. Next I fixed my facial expression once it dawned on me that I was giving Mrs. P the hairy eyeball.

-_0

"Mmm hmmm. 'Cause see, a man got needs. And if you ain't up to meetin' his needs then tha's what happened 'fore they had all these ways to stop you from getting with-child. Nowadays I guess it ain't such an issue."

0_o

"Mmmm hmm. What other questions you won't to know?"

Smiling big and wide.  "That's all I really wanted to know for now."

"Okay, baby.  Now get on out my room so I can get me some sleep, hear?"

"Yes, ma'am."

And that was the end of that.

Sandy got that memo.

Moral of the story:


Ladies! Quit your belly-achin'! A man has needs. Needs, I tell you! 


*Uuuhhh, be right back.*

***
Happy Tuesday.


I have a feeling Sandy wasn't leaving her situation up to chance. . . I'm just sayin'.

Lost.

I was walking through the hall way during the noon hour at Grady last week. It was my week to teach our resident physicians' Clinic Conference, and I was reviewing my teaching points in my head. My assigned topic was "Hearing Loss"--which I'd admittedly protested doing since I couldn't think of any way to make the topic fun. So . . .in between dreading the topic and a last minute internal rehearsal aimed at "tzuj-ing" up the subject. . . . I did what I always do while navigating the Grady corridors--observe the sights and sounds.

And so I walked and in my head (and occasionally to people) I talked. . . .

Okay, residents. Hearing loss falls into two categories: conductive hearing loss and sensorineural hearing loss. (Yawn)

"Hey there, doc! You doing alright?"

I make eye contact with the cheerful woman pushing a walker in front of her that had just greeted me. I wasn't sure if I knew her from the clinic or the ward, but it didn't matter. Her smile made me smile. "I'm doing great, ma'am? You doin' alright?"

"Blessed and highly favored! But I'm looking for the Dermatology clinic! You know where that is?"

I pointed to the elevator beside us. "Up one flight, and make a left. You can't miss it."

"'Preciate you!" she announced while stepping inside. I waited for the doors to close before heading on.

Can't miss it, I told myself in an effort to be okay with not joining her to make certain.

Conference was about to start, so I let it go and keep walking, my heels like drums on the linoleum.

::click, click, click, click::

Conductive hearing loss involves the external ear and the middle ear. Can you think of some causes of conductive hearing loss? What if you looked in someone's ear and saw what looked like a hunk of feta cheese on their tympanic membrane? Right! A cholesteatoma. Who knows what that is?

"'Scuse me, doctor. Do you know how I can get to the cancer center?"

A frail appearing Grady elder stands in front of me while holding a piece of paper with an appointment on it. His face is gaunt with sunken in temples. His clothes appear two sizes too big. "May I see your appointment, sir?"

He handed me the paper and I quickly scanned it for where he was supposed to be going. Radiation Oncology for a radiation treatment.

"Sir, let's get you over to the information desk. This appointment is for you to get radiation. Did they talk to you about that?"

"Yeah, ma'am. They talked about so much. Mostly my wife keep up with 'em and she know her way 'round Gradys. She under the weather, so I got dropped off."

I thought about the fact that Radiation Oncology was actually outside of the building altogether. I also registered the fact that he was holding a paper in his hand that said just that but, for whatever reason, didn't realize it. I imagined the hassle that this was about to be for him and felt myself badly wanting to take him there myself.

But it was five minutes before my lecture was to start. The best I could do was point him to information. As we reached the info booth, I immediately speak on his behalf to the woman behind the glass.

"I need you to help me with something. This gentleman has an appointment with Rad Onc, and was dropped off here. This is kind of a disaster because he's not anywhere near the Rad Onc building. Please tell me there's something that can be done to help get him there."

And just like that, the woman smiled at me wide and warm and genuine and said, "No problem. We got this." She picked up a phone preparing to dial someone somewhere, but first stopped and spoke to the patient, "Hey there, sir! You doin' alright, sir?"

I like the way real true Southerners tack "sir" onto things when speaking, and especially when speaking to sho' nuff elders. It's a habit that I've admittedly adopted. "Alright then, sir," I said while shaking his skeletal hand. "Looks like you're in good hands!"

I wave and nod as I ease toward the hall near the conference room where I'm scheduled to give my talk. The nice lady at the information desk winks and nods while balancing the phone on her shoulder. We got this.

I went back to reviewing my "chalk talk" on (yawn) hearing loss in my head and drumming the floor for the last few yards before I reached the room.

::click,click,click,click::

Who remembers how to use a tuning fork? Don't worry. I always forget, too. I have an easy way for you to remember how to tell whether you are dealing with conductive hearing loss or sensorineural hearing loss without you being intimidated by this tuning fork!

"What the f&% are you doing? Let's f&%-ing go!"

When I look up, I immediately make eye contact with this stunningly beautiful young woman with piercing green eyes contrasting her cocoa complexion.The nineteenish - twenty-one year old tops guy who was speaking to her in that venomous tone had already passed me and was easily fifteen feet ahead of her now. All I could see was his backside--low slung designer jeans, a hooded sweatshirt, and plaid underwear popping out in between. I paused with my hand on the door of the conference room.

I did my best to hug my little sister with my eyes.

She gazed back at me, almost like a regal gazelle who just noticed a tiger moving in the brush. Her slim fingers clutched her cellphone as she shuffled her feet reluctantly. I offered her a half hearted smile as she passed, which she tried her best to ignore.

"What the f%&$! Come on, dumb-ass!!" bellowed her "friend" from the lobby.

Dumb-ass? Wow.

There were people everywhere. And you know what? He not only yelled these things without any consideration for how this might make her feel, but it also didn't seem to even cross his mind that there were children under the sound of his voice, too. And Grady elders--including my friend who had gotten lost on the way to get radiation.

I try my hardest to think of a reason why young man would think this was okay, and then I try harder to find one to explain why such a lovely girl would be with him. But I knew why--and it was an unfortunate truth that I preferred not to think about.

They were lost, too.

"Here I come!" she finally replied, with an emphasis on 'come' that she somehow seemed to think would sound to all of us like she was defending herself. Her anemic and defeated body language spoke otherwise.

I followed her silhouette down the hall and then noticed it disappear into the sea of other Grady people. My hand was frozen on the door handle as I fell into a trance wondering who among them were lost, too.

In that moment I hope that what I can offer is enough sometimes because on this day, it doesn't seem like it. I start feeling lost myself.

Suddenly, I felt someone pushing against the door. "Dr. Manning? We thought you got lost out there!"

I look at the resident on the opposite side of the entrance and beyond him to the several other learners seated in the conference room facing the clean dry erase board.

Lost?

Yeah, seems to be going around.

"Here I come," I respond, "Here I come."



- Posted using BlogPress from my iPad

Reflection on a Tuesday: I Heard THAT!!

Zachary concerto #1,442: Why can't we be friends?

Things I heard yesterday:

• Isaiah trying to whistle as I got him ready for school. It sounded like someone blowing out birthday candles to a tune, but he didn't seem to mind.
• The school bus blowing the horn for the five kids or so at the next stop after ours. None of them were out there yet.
• Zachary talking to me in his "sleepy guy" voice. The one that includes no real words. Just strange mumbling and random singing.
  
• My friend, mentor, and fellow Grady doctor, Neil W., talking about Alzheimer's Dementia on television before I went to work. Cool.
  
• My mom saying, "EXCELLENT!" when I asked her how she was doing this morning during a morning-commute phone chat.
  
• Two men in front of Grady laughing so hard that they looked like they would be sick.
• A lady talking on her phone in the Grady elevator as if no one was on the elevator except her. Like not even talking in the hushed-elevator-tone where you try not to say anything until you reach your floor. "Mmmm hmmm! Yeaaaaah, girl. . .I'm still here! Girrrrrl, you lyin'!! No she di'in't!!!" Funny.
• An environmental services worker who asked me, "You don't even look that thick in person as you do on Fox 5. See, I told somebody you was really regular-size! What you weigh? 'Bout 150?" (All while pushing an automatic floor waxing machine.) Huh?
• A patient I saw on rounds who was gasping for air from an asthma exacerbation, but not one so severe that she couldn't ask me, "Ex-ex-ex-cuse-cuse (pant, pant, wheeze, wheeze) me-me, doc-doc. . .where-where-where (pant, pant) do you-you-you get your hair-hair d-d-done?" Huh?
• A patient telling me that today's date is December the fifteenth, nineteen hundred and sixty eight. (But he did know that the president was 'Bama.") Huh?
• A sleeping elder wake up during my exam of her belly to say, "God bless you, baby."
• My cell phone playing an embarrassing ringtone on accident in the sleeping elder's room. Whoops.
  
• Dr. del Rio teaching the resident conference and me wondering in my head how he fits so much in his brain.
• A man with an oxygen tank asking somebody for a light (for his cigarette.) Huh?
• 3 and 3/4 year old Zachary in his car seat singing a loop of the same eight bars from this old R and B song for the whole commute: "Why can't weeee be friends? Why can't weeee be friends?" Huh?
• Isaiah crying when I wouldn't let him play "Angry Birds" on my iPad before homework.
• Harry waking me up off of the couch to do the second half of "bath-time."
• The kids reciting The Lord's Prayer. And, as always, Zachary starting it off with, "Our podder, art'n hebben, hoddobeedahname", and Isaiah ending it with two to three extra "ever and evers" before saying "Amen."
  
• The television when the episode of "The Closer" that I'd DVR'd ended. I'd fallen asleep on the starting credits and woke up when the DVR went back to the menu channel.
  
• The kids making their sleep sounds when I looked in on them: Isaiah with occasional teeth-grinding and Zachary with the weird tongue sucking/lip smacking thing.
• Those bizarre sound effects (a bird making kung fu sounds, swearing (?), and a pig snorting and laughing at you?) on that addictive little "Angry Birds" app. Couldn't help but play it in bed before falling asleep.
• Me and a mini-snore mid-game that woke me up--and Harry saying, "You need to go to bed."
• Me replying, "I heard that!"

_____________________________________________________________
The horribly addictive "Angry Birds" application. . . . . don't even go there. . . . trust me!

(my favorite TV appearance by Grady doctor, Neil W.--
the one where he brought his baby son on the set!)