Near misses.

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It was more than just a snow storm. It was this yucky mixture of snowy-slushy-sleety yuck significant enough to make it too dangerous to fly a 747.

"We are so sorry to inform you that your flight has been cancelled."

Not postponed. Not "hold up, let us check on a few things like de-icing concoctions and such." No. Just cancelled. It all sounded so final.

I sat on that hardish-softish chair in the Northwest Airlines terminal like a kid who'd lost her parents. Not really knowing what to do next or where to go next so just remaining still until some authority figure came along. Problem was, I wasn't a child--I was mostly grown. Twenty-five years old, to be exact. And wondering what in the hell I was supposed to do about being stranded at 9pm on a weeknight in Cleveland, Ohio.

That day had gone fairly well until that point. In fact, it was more than okay. I was in my fourth year of medical school and had just completed two days of residency interviews at two different programs in Cleveland. At the time I was doing an elective rotation at a hospital in Michigan that month. Though most people advised against it, how could I not schedule a couple of my other Midwest interviews while I was there? Lucky for me, my supervisors were super nice that month. They encouraged me to take those interviews in Ohio and didn't even flinch when I took them up on that offer.

The distance between this particular set of Ohio interviews and the temporary housing I had near that Michigan hospital that month was actually drivable. A little over three hours in good weather and maybe longer in this wintry mess, but nonetheless drivable. Unfortunately, that wasn't really an option. For starters, I didn't have a car with me that month since the hospital was in walking distance from the housing. Additionally, I needed this to be as quick a trip as possible. I felt obligated to hurry back since I'd already be missing two days of clinical duties in a row. That's what made this sudden flight cancellation even more uncool. That and the fact that I was too broke to even fathom a plan B.

Ugggh.

But then--thank the heavens--something happened. A voice comes over the crackly loud speaker announcing that a bus would be arriving in the next hour to drive us back to Michigan. Our bags would be coming out on the baggage claim at which point we would have them loaded on to a Greyhound-esque bus. At no additional cost.

Hallelujah.

And so. One hour was really like two hours. And in that snowy-slushy-sleety mess, the drive ended up being more like 4 and a half hours. It was so nasty out there that I couldn't allow myself to sleep. I guess I just couldn't totally relax with such treacherous conditions.

Anyways. The bus was full to capacity. Shortly after I sat down, a very pleasant gentleman sat beside me. He was holding a little wrapped box and sat it on his lap. After about forty five minutes, I guess he could tell that I wasn't planning to sleep. And so the chatting began.

Of course, it always starts teeny-tiny. That's what I call the smallest of small talk. Universally vanilla observations about how sucky it is to have a flight cancelled but how quasi-good it is to at least have an outdated Greyhound as an option to get you to your destination. Next came questions about who's from where and so on and so forth. And that was all fine and well. But that part lasts for only about an hour tops. After a while, the talk gets a little deeper.

He learned that I was a medical student. I learned that he was a single father. And the more we sat, the more questions he asked. He was so very nice about it, too. Like super, syrupy Mister Rogers friendly with a laugh that sounded like a laugh track. And you know? Something about it all felt contrived. And kind of weirded me out.

I pretty much stopped at "I'm a medical student doing a rotation at Michigan." I kept my answers very nonspecific beyond that. But Mr. Pleasant just kept on chitting and chatting about any and everything you can imagine. Especially his intricate plans for his daughter that got foiled by all of this mess. And, again, he was mostly friendly so on a scale of one to ten he was only getting on my nerves about a three. But his questions kept vacillating into wanting to know more about me and my plan for getting back to the hospital. "It's going to be 3:30 AM," he said with a look of concern, "and the roads will be awful."

I quietly suggested that I'd sleep in the airport if need be. Although I was still very worried about what this would mean to my supervising attending. I guess it was obvious.

"Well. I'd be more than happy to drive you there," he offered. "I was supposed to be home early to give this gift to my daughter. I was going to drive to her mother's house first but now it's too late. I am actually in that direction so I'm happy to take you so you won't have to sleep in the airport terminal."

He smiled at me after he said that. A nearby light from a passing truck rolled over his face like a spotlight. I could see his large yellowish teeth and the gleaming shine on top of his pale balding head. All of it still pleasant, but somehow just overly so. I couldn't put my finger on it.

"That's okay. I am sure I'll manage."

And for the next two hours, he would make more over-pleasant small talk followed by yet another offer to drive me back to my destination.

"No cabs will be running, you do realize."

"It's okay."

And then he asked the magic question. "Aren't they expecting you at the hospital?"

And when he said that, for the first time, I considered his offer. Because, yes, they were expecting me. They'd been kind enough to let me dip out for two days and returning after lunch the following day would not be holding up my end of the deal.

"Um." That was all I could say. Because I was still thinking.

"Let me swing you by there. I'll feel like I'm investing in the future of medicine." He smiled again and I noticed how the bottom row of his teeth showed, too. My eyes then darted down to the little gift wrapped box he had on his lap. I imagined his daughter staring through the window all night only to be devastated when her mother told her that he wouldn't make it there after all. This guy was a good guy. I mean, he had to be.

"You know what? Okay."

He looked a little surprised and giddy at the same time. "Okay, you'll let me drive you?"

"I need to get back. So I'd really appreciate it and would be glad to pay you for gas."

"Oh, it would be my pleasure. That isn't necessary."

Then I guess he felt like some door had been opened. He became super familiar telling me all about everything from his dog to his daughter to his divorce to his hobbies. He went on and on all while smiling with those big yellow chiclet teeth and large forehead with its stray wisps of hair sprouting out. All of it periodically giving me this urge to change seats, yet simultaneously forcing me to try convincing myself that he was simply a good, albeit awkward, samaritan.

The bus arrived finally. Mr. Pleasant let me out onto the aisle first and asked if I needed help. And, again, it was weird. Not really fresh or anything. Just this strangely unnatural way that was slippery and hard to put a finger on.

He kept saying my name, too. Kimberly this. Kimberly that. Let me help you, Kimberly. Is your bag over there, Kimberly? Kimberly, Kimberly, Kimberly. And instinctively, I kept my things with me and kept mumbling "that's okay" each time he offered to assist. Because for some reason, I didn't want him to touch any of my belongings.

"I'm right over in this lot. We can walk right over or, if you'd like, I can take our bags and pick you up from here." That big smile again with top and bottom rows showing. I glanced toward those barren lots scattered with their snow covered cars. Dark. Personless. Lonely. And kind of scary.

"Um."

"It's no problem." He began to reach for my bag. "I'll swing right back for you. I know my daughter is so disappointed that I wasn't able to see her. You'd like her. She's a great kid. Here, it's not to heavy. Let me just pop it in the back of my car."

But once he touched by bag handle, I kept holding it. "Uhh. . .I need to, um, go to a pay phone and call my dad to let him know I made it to Michigan safe."

"Okey dokey, Kimberly. I'll take the bag and get the car and you make your call. Okay, Kimberly?"

Kimberly, Kimberly, Kimberly. 

"Um. . . . I'll just hold my bags with me, I'm fine. Thanks." I turned and began to head into the terminal toward the bank of phones. I paused for a moment when I noted each one of them was occupied by other passengers from my original flight.

"It's so late. I'm happy to stop you by another pay phone since those might be tied up for a while. I wish I had one of those cell phones! When my daughter gets older, I'm going to pay whatever it costs for her to have one of those things." I noticed his smile once more.

And right then and there, some kind of alarm sounded. Something deep inside of me told me that spending even another second with this man was not in my best interest.

Run. . run! My little voice screamed this time. And it refused to be ignored. Run! Get away! This is a bad idea. A very, very bad idea. Leave. Run. Get away. You'll get where you need to be. Trust me.

And that was all I needed to make up my mind to get the hell away.

"You know what? It's okay. I'm good on the ride, okay? Thanks again." And I turned and left without saying another word. Or allowing him to say Kimberly, Kimberly, Kimberly anything.

He didn't follow me. At least not that I know of. And I didn't even look back to see if he was even thinking about it.

That happened nearly twenty years ago. But you know? I replay that day in my head often. I wonder what would have happened to me if I had headed out with that stranger and if I'd ignored that little voice inside of me. I wonder if that walk toward that lot or that ride in his car would have been my last. Or at least the last time anyone heard from me. And every time I think back through it, I feel this deep, deep sense of relief. Yes. Relief. Like a person who jumped out of a car right before it blew up or ran out of a burning building seconds before it collapsed to the ground. Something about it has always felt like a near miss. From something really, really awful. What? I do not know.

And yes. He could have very well been a kind and balding man with big yellow teeth and a laugh-track laugh. One who intended to drive me straight to where I needed to go without stopping once. Except to let me use the pay phone to call my dad. But something deep down inside of me has always told me otherwise. I'm not sure why. Nor am I sure why it took me so long to follow my gut. But desperation can do that to us, I guess. Yeah, I guess.

I felt a little twinge that something was awry at first. But I ignored it. Then it felt like a brush on my arm. Finally it rose to a nudge on my shoulder. Subtle, but still there. And I am so, so glad I responded to that feeling.

I've said before that I believe that this innate sense of "fight or flight" is something that shouldn't be ignored. I will always believe that it saved my life that night. Honestly, I will.

I did call my dad. I didn't tell him about the man with the chiclet teeth and shiny forehead. I just told him I was okay. Then I told him that I had one of my sorority pledge sisters there in town and that I had just found her number in the phone book. And Dad said for me to call her but then call him back collect. To let him know I was okay, yes, but also to let him know that it worked out.

And I did call her. My line sister Chelsea. Cold-called her, no less. And she was home. And, even though she hadn't heard from me in a long, long time, she got out of her bed and came to get me. At O-dark thirty, she did. And she was pleasant about it, too. But normal pleasant. Not laugh-track, chiclet smiling pleasant. Which felt right.

Some part of me also believes that Chelsea being where she was at that time and even being listed in the phone book wasn't on accident. And that our connection through Delta Sigma Theta and Tuskegee University could have possibly all been just for that moment. That life-saving moment. Yes. Some part of me will always believe that, too.

I called my Dad collect, just as promised. And then, when I was safe in my dorm, I called him once more to--yet again-- alert him that I was well. Which, thank God, I was.

Hmmm. I'm not really sure why I felt the need to tell that story. Maybe someone needed to read it as much as I needed to tell it. Or maybe. . . . just maybe. . .  I just needed to be reminded to pay attention.

Yeah.

***
Happy Saturday.

Now playing on my mental iPod. . . . one of my favorite songs from one of my favorite movies of all time. It gives me goosebumps and brings me to tears every single time. . . .just like the goosebumps and tears that come when I imagine what could have happened that night had I not listened to my spirit.

Dat'll do.

*Names, details, and all that stuff that folks worry about have been modified.

Piedmont Park on a Saturday, Atlanta

Last patient of the day on a sunny afternoon. This was back when our Urgent Care center was open on weekends and, no matter how much you love Grady Hospital, being there on a sparkling Saturday is not exactly ideal. So yeah, that's where I was but on this day I was trucking. Running three rooms, working seamlessly with the nurses, and stamping out disease one urgent complaint at a time.

I'd grabbed his chart and read the complaint. "Recurrent hemorrhoids and constipation." Age: twenty-something.

Now. If you are a doctor who has ever worked in a super-busy clinic--especially a super-busy inner-city clinic--you can totally understand why those two words "hemorrhoids and constipation" would make me do the happy dance. Especially at 4:45 P.M. on a weekend when I really wanted to be in Piedmont Park.

I nodded my head smugly and pointed at my colleague who was feverishly charting on his second to last patient of the day. "Yeaaaaah baby!"

"What? A toothache?" he asked. We both knew that a toothache was the motherlode of complaints that were in-and-out for us. As internists, there wasn't much more that we could do other than getting the patient to an area dentist or oral surgeon. Antibiotics in the interim and pain control could be written on a script quicker than you could say "Rumpelstiltskin." Next best thing? Hemorrhoids. Especially recurrent ones.

"Hemorrhoids. And constipation. Recurrent." I smiled a big wide smile.

He squinted his eyes at me and groaned. "I have someone with a headache and a pretty elevated blood pressure. At four forty-five. Awesome." He held up the other chart in his hand. "And this patient needs some stat labs."

"Ouch."

"I know, right? So much for finishing up early. But I guess we signed up for this, right?"

"Claro que si," I replied while sifting through the computer to see if my young patient had any old lab work. "No labs or prior visits to the Gradys." I stood up, propped hands on the desk and leaned over toward the window like a tripod. I was looking forward to feeling that sun on my face.

"Rub it in, why don't you!" my colleague teased. I raised my eyebrows and smiled again. Then he offered me a playful warning. "Hey Kim. . . . . nothing is ever as straightforward as it seems."

"Especially at four forty-five on a Saturday!"  I pushed the door open and chuckled again. Quickly I made my way to my last patient of the day.

After a knock on the door I stepped in and introduced myself. "Hey there, sir! My name is Dr. Manning and I'll be seeing you today. You are . . .Mr. Cole?"

"Yes ma'am," he replied while firmly shaking my hand. That handshake was deliberate and masculine. "It's okay if you call me Quentin, though."

"Is that your preference?"

"Sure. That's cool. I mean, yes ma'am, that's what I'm most comfortable with."

I liked the way he autocorrected himself when speaking to me. Almost like he could hear some grandmama in his ear saying, Is that how you speak to people? The Grady elders call that home-training. I could tell he had plenty of it -- from his neatly groomed hair and clothes to the straightness of his spine as he sat. No slack jeans or mumbling voice. He clearly had some quality home-training.

"Okay, Quentin. So . . .are you a student here in Atlanta?"  I couldn't help but ask since he was wearing a t-shirt with big block letters from his university on it. The baseball cap and drawstring nylon bag in the same color palette gave it away. That and his young face. "I see you representing your school with all the paraphernalia!"

He nodded proudly. "Yes ma'am. Proud of it, too!"

"Good stuff," I continued. "What are you studying?"

"Finance. And I'm on an athletic scholarship. Football."

"Nice."  And I said that because I meant that. It was nice that this kid with the home-training was in an excellent four-year institution on a scholarship. I looked back down at his chart and was reminded of his chief complaint. I knew it would be more awkward for him than it was for me  so I did my best to keep things light but formal. "So I see that you have a problem that isn't a new one for you. How about you tell me what's going on?"

"It's kind of embarrassing. But yeah, it's hemorrhoids. And since they are kind of uncomfortable, I think I've been avoiding doing. . . .you know. . . number two."

"Got it." I jotted that down and glanced back up. "Hemorrhoids are so super common. They can be pretty uncomfortable, too."

"Yes, ma'am." He seemed to appreciate that normalizing statement.

"You've had hemorrhoids in the past?"

"Yes, ma'am."

I stared at him for a beat and thought about why a twenty-something year old man would have recurrent hemorrhoids. Most of the time they come from straining--pushing out hard bowel movements, pushing out big babies and pushing through some heavy lifting. Heavy lifting? Aaaah. Yes.

"Do you lift a lot of weights for football? Like squats and stuff like that?" I knew that answer before he could even open his mouth. His percentage of body fat wasn't the kind you get from recreational work outs. He had that two-a-day practice kind of definition clear down to his calf muscles.

"Yes ma'am," he chuckled, seemingly relieved that we had an easy explanation for all of this.

I was relieved, too. Relieved that this was as straightforward as I'd hoped it would be, but also that I was sitting in front of a really charming young person who knew how to talk to other adults. His caramel complexion was almost identical to my own and his facial features even looked like those of people related to me. Something about that made me well with pride. I was glad to be seeing him.

"Is this similar to when you had hemorrhoids before?"

"Pretty much. They hurt a little more last time. Now they're mostly irritating." A wave of embarrassment came over his face. "I'm sorry. This is so weird to be talking about."

"Totally understand."

"I was hoping to get some of the foam and the medicine they gave me last time."

"That shouldn't be an issue."  I wrote down a few more things and then asked him some more obligatory questions. Like, what are you allergic to and do you smoke? Are you sexually active and have you tried any kind of drug? Do you drink and what medical problems besides this have you had in the past? His answers were predictable. No allergies, yuck to smoking, yes ma'am to sex and no ma'am to drugs. A little bit of asthma that he thinks he grew out of. Otherwise uneventful. Yes, this was all very straightforward.

Hallelujah.

I also asked a little bit more about the constipation and reviewed his diet. Typical crappy college fare, full of refined sugars and fats with a paucity of fiber. Duh.

Next was the physical examination. Habitually, I started with his eyes and oropharynx which didn't yield much of anything. Ears had not even a trace of wax and other than being hidden inside of an uber-ripped container his lungs, heart, and abdomen were pristine.  And then I paused.

Shit. He needs a rectal exam.

I could see his face pleading with me. It was saying, Please, ma'am. Just take my word for this. Please don't ask me to drop trow right here, right now. And you know? I strongly, strongly considered obliging him.

First of all, it meant I'd need to get a nurse to stand in as a chaperone. Since it was late in the shift, we were low on nurses so that would make the whole thing take longer. And seriously? This guy was a good historian with good home-training. Why wouldn't he just tell me like it was? Everything else about him had been easy-peasy. Was it really necessary for me to make this poor guy show this lady doctor his nether region?

I started coming up with arguments in my head. Telling myself that if this were some swanky private practice that this whole encounter could have been a call in to the nurse and that, sure, a prescription could be phoned directly to his local CVS. Or Rite Aid. Or whatever he so chooses.

But that isn't what this was. It was an urgent care visit. With a complaint involving the rectum. What kind of doctor would see someone for a complaint in an ear and not look at it? Grrrr. I could hear my dad in my ear. He calls that being a "dat'll do" kind of person. The kind that cuts corners just because they think they can.  I knew I had to look.

"Well let me just step out and grab a nurse, okay? Go ahead and undress from the waist down and cover your lap with this sheet. I'll be right back."

"Excuse me, Dr. Manning--umm. . . . is it possible to just make the prescription? My mom was saying that sometimes if you've had a problem before like this one -- especially a sensitive thing -- that I should ask."

I held my hand on the doorknob and paused. Good ol' Mama.

"She was saying, like, that her doctor if she has a yeast something she called it. . . . the doctor just calls it in or even takes her word for it. So she won't have to do that whole other part and get checked out all over again when they know what it is."

Damn. This was tempting.

Dat'll do. Dat'll do. Poopdeck wouldn't get out of my ear.

"This will be super quick. It's way easier than doing a pelvic exam. It'll take two seconds, okay? I'm only looking just to be thorough. I'll be right back."

I stepped out of the room before he (or me) could try to convince me otherwise. A few moments later I was back with Charlotte, one of our nurses. She offered a quiet introduction with only a smile and head nod.  Her job was just to be there and nothing else.

I instructed Quinten to put one foot on the step and to lean his body forward on the exam table. I kept reassuring him that this would be "super-quick" so that I could "quickly confirm that his hemorrhoid didn't need to be drained." He wasn't miserable enough to need emergent incision and drainage, but I felt the need to justify this mortifying position I had him in.

I rolled over on my stool to grab the neck of the positionable light and then flicked it on. "These are just my hands looking," I announced. Quentin's voice was quiet and far away as he mumble back an obligatory "Yes ma'am." I gently applied pressure outward to open the cleft and better visualize what was certainly going to be the tell-tale garden variety external hemorrhoid.  Just as I did, the bright light gave me clear view of the source of his complaint.

Or rather sources.

I'd been talking the whole time but now I was quiet. I looked carefully to make certain I was seeing correctly. And I was. Shit.

"Quentin? You said this was a little different than your hemorrhoids before?"

"Uhhh, sort of. I mean just. . .they didn't hurt as much."

"Um, okay." I inspected some more. "So, okay. How long has this been bothering you again?"

"On and off for like some months."

"Did the doctor who gave you the foam and numbing medicine last time do this kind of examination?"

"Like what you're doing?"

"Yes. Like what I'm doing right now."  This was awkward. Talking to someone who had their back--and their backside--to you. But this wasn't what I was expecting. I needed more history.

"No. It was my pediatrician while I was home for the summer. When he heard about me being constipated and the weight lifting he gave me the medicines and they kind of helped."

"Okay. Thanks for clarifying that, Quentin."  I went ahead and examined the rest of his genital region and then stepped on the other side of the curtain that Charlotte had pulled. "Go ahead and get dressed and we can talk about the plan."

"Yes ma'am." Of course. Yes, ma'am.

Charlotte was so busy that she was down the hall and into another task before I could even get out of the room. Moments later I stepped back inside to talk to Quentin about what I'd seen.

So what did I see? Well. It certainly wasn't a hemorrhoid. Instead, found a large collection of perirectal warts coalescing right at the entry. Some were pedunculated and red--I could see how this could be irritating to him.

I was mad at myself. First, I'd strongly considered not examining his rectum. Second, I didn't take a full sexual history. I"d gotten so caught up in making him a bread and butter case that I'd sized him up and forced him into my own story line. I was too experienced for this. To me, this was more the move of an overtired trainee. Not a full fledged attending physician.

Dat'll do. Dat'll do. 

"Quentin," I started carefully, "I didn't see hemorrhoids on your examination. I saw some pretty large genital warts at the opening of your rectum."

His eyes widened and his mouth fell open. "What?"

"It makes sense why you've felt this way. I think the medicines you took before quieted down the irritation but it probably wasn't ever a hemorrhoid."

"How did I. . . I mean, what does this mean?"

"I probably need to have a specialist see you. I can make a referral to help with that. I think since they're kind of big, they may want to remove them, like, surgically."

"Will that mean they're gone for good?"

I sighed because that was a damn good question. "Honestly? These often come back."

"Really?"  Now his eyes were glistening with tears.

"Quentin?" I softened my voice. "I should have asked you this earlier. You told me that you are sexually active. . . but are your partners female, male . . . or both?"

"Female," he promptly responded.

"Condoms? Do you use them?"

"Mostly. I mean, I've slipped a few times but mostly yes."

"Have you. . . .like. . . ever maybe tried sex with someone who wasn't a female?" It felt so lame to ask again but this diagnosis suggested unprotected anal receptive intercourse. We needed to get this out on the table before I could get to any problem-specific patient education.

"I tried it, yeah. Like only a few times, though."

"Okay. There really isn't an issue with whether or not your partners are only girls or only guys or girls and guys. The issue is mostly whether you use condoms. I think maybe one of the times that your partner didn't use a condom. . . .you might have gotten these warts around your bottom."

"Damn it! Really?" Now tears were falling down his cheeks. "So anybody who sees this on me will know, right? Like know that I've done that before?"

"Quentin, look. I know this is a lot and those kinds of questions are really complicated, you know? But to be honest, this can be as private as you keep it. There's probably more to all of this, I'm sure. Like, how you feel about all of  this and even how you feel about who you are."

"Yes, ma'am."

"My impression of you when I first met you is that you seem like a really respectful young man who obviously has been hitting the gym and the books." He offered me a tiny smile. "This is kind of crappy news to get on a weekend, but you're here, you know, and now you'll get the care you need."

"Yes, ma'am." He sighed hard and pressed the heels of his palms into his eyes.

"It's going to be okay, Quentin. Okay?"

He nodded and tried to believe me.

I wanted to say dat'll do and end it there but I knew I had to consent him for an HIV test, further screen him for other sexually transmitted infections, talk about safer sexual practices and arrange some referrals. He was gracious with all of it, and mostly he looked kind of relieved. Almost like I'd rubbed a genie out of it's bottle whose contents had been under pressure.

After all of this was said and done, the encounter was still pretty fast. I was out of the hospital by five thirty and yukking it up with a girlfriend over frosty margaritas on a patio overlooking Piedmont Park by five forty-five.

Yep.

I never saw Quentin again. I did see that his HIV antibody was negative and there were indications from his chart that surgical follow up was obtained. Otherwise, I'm not sure what ever became of him.

My guess is that he's somewhere working in finance and doing great things. I hope that he's being true to himself and not just saying "yes, ma'am" and "no, sir" because he thinks that's what everyone wants to hear.

But mostly I hope he's happy.

I never, ever forgot the lesson he taught me in not sizing people up with sweeping generalizations and also about fighting the temptation to cut corners. It's all so easy to fall prey to, you know? He also reminded me of how hard it is to be your authentic self in this world. Sometimes life nudges us to walk the seemingly easiest path when doing that really makes things less so.

Dat'll do. Dat'll do. 

No ma'am, no sir, it will not.

***

Beyond belief.

image credit

"One day I'll fly away

Leave your love to yesterday

What more can your love do for me?

When will love be through with me?

Why live life from dream to dream. . .

. . and dread the day that dreaming ends?"

~ "One Day I'll Fly Away"
lyrics by Will Jennings, music by Joe Sample

(now hearing this version on my mental iPod)

____________________________________________________________

My rounds were quiet and peaceful that day. The interns had the day off, and the resident was putting out fires on other floors. This time for you would not be divided by medical student queries or carefully guided tours of your physical findings (with your permission of course.) I was all yours that day.

It was a weekend day, so there weren't even any meetings to race over to be late to or conference calls to dial into or students shuffling their feet in front of my office door or urgent emails to return. The kids were somewhere climbing jungle gyms or splashing in puddles or licking syrup off of their hands with their dad who had kindly sent a text that simply said, "We're fine." So that meant that, on this day, I was all yours.

This day, I saw you in morning light so bright that it made me take pause. Despite the overcast sky and its imminent plans to deliver a torrential downpour, somehow the rays that were stubborn enough to come out any way managed to find you. Your hands were idle, folded over your abdomen; your eyes tired and fearful. It had been a rough night; the pain had been at almost a 'ten' until finally you told someone and ultimately received a higher dose of pain medication.

"I hate to be a bother," you tell me.

"But you aren't a bother," I quickly reply. "If you are in pain, I have failed you."

"Okay." Your face washes over with a blanket of childlike comfort, but not your eyes. I can still see fear. Cancer is something to be afraid of. Especially this one.

I glance over at the window sill. Not a single card or flower. No photos of you posing with loved ones during the honeymoon that preceded this diagnosis and no worried significant other abruptly rising from the bedside chair upon my approach to examine you. It was just you. And today, just me.

"Are you? In pain, I mean?"

"No. I am okay."

"Good."

I carefully pull back your cover and examine your cachectic body. My stethoscope rocking over your ribs; their perfect outlines like some kind of skeletal relief sculpture. Your lungs sound surprisingly clear on this day, and outside of the mild tenderness around your feeding tube, your sunken abdomen is equally unremarkable. I inspect your legs for any asymmetry; your backside for redness from the pressure of lying in bed more than standing up and making it.


No, your exam is not normal. But for this day, it looks pretty close. With the exception of your fearful eyes, it is normal enough to plan your discharge.

"There is so much to coordinate," I say softly. "Our plan will be to get all of this done for you and discharge you first thing in the morning. How does that sound?"

"That sounds good."

"What questions do you have for me?"

Your smile is warm and genuine. Your bony cheeks and wasted temples perfectly framing your every expression. "I think you answered them all."

I reach down and put my hand on your soft cheek. "Are you sure? Is there anything you need?"

You smile again and shake your head. "I'm okay."

"Okay."

I step back from the bed and delicately arrange the covers over your tiny shoulders. I fluff the pillow and tuck another blanket around your neck; enveloping you in as much safety as I can.

"I'll see you later, okay?" I say after finishing my fuss over the bed.

You nod and smile once more.

I walk away from your bed and that morning light. . . . around the thick pink curtain dividing it from the other side of the room where the neighboring bed was empty. Suddenly, I abruptly stop in my tracks. The next thought I continue to replay because it was so memorable. It was simple and clear--like the single chime of a tiny bell--and enough to halt me in place:

Maybe I should go and just sit with you. And hold your hand and maybe even. . . . pray with you. Or better yet just be with you a little longer.

The Grady elders might call this "The Lord puttin' something on your heart." And they call listening to such a thing "being obedient." Others might call it something else or even be uncomfortable thinking about it. Regardless of what you call it, it was something. Something strong yet fleeting that I somehow allowed to come and then go in the blink of an eye.

I lean back around the curtain and into your light again.

"Ma'am?"

You raise eyebrows and turn in my direction.

"Umm. . . you. . . make sure you remember what I said about the pain medicine, okay?"

"I will," you murmur quietly. "I will."

And with that. . . . I leave. Thinking I can do it tomorrow. Letting go of that moment in time on my solitary rounds.


Early the next morning, the intern covering the team on call left a message on my voicemail. You were found pulseless. They worked on you as hard as they could to bring you back. But unfortunately, they could not.

No! I must be hearing wrong!

I remembered your pleading eyes and those words put on my heart. I replayed the message and immediately felt my pulse quickening and my eyes welling.

No! It wasn't time yet!

But actually, it was. That morning, I stood listless in a hot shower crying and crying. Not because I could have saved you. And not because I could have cured you, either. But because I didn't listen. And regardless of what you believe or who you pray or don't pray to, sometimes you get a little nudge that tries to give you a message. This time, your eyes tried to tell me. And even after your eyes tried, something else tried, too. But I missed my cue.

Now I know. That day, I was supposed to be the cards on your window sill and the flowers on your tray. And even though you weren't in pain, in a way I did fail you. I should have yielded to that tug, that magnetic force that was pulling me back to you. And I'm sorry. I'm so, so sorry I didn't.

But.

Today, I will dry my eyes and honor you. And for you, I will never ignore that whisper laid upon my heart again. Because that time was your time. And on that day it was just you and just me. So next time, for you, I will be obedient.

***