Belated Music Lyric Monday: Love Letters

Love Letters.

The sky may be starless
The night may be moonless
But deep in my heart
I know that you love me
You love me, because you told me so

Love letters straight from your heart
Keep us so near while we`re apart
I`m not alone in the night
When I can have all the love you write

I memorize every line
I kiss the name that you sign
And darling, then I read again
Right from the start
Love letters straight from your heart

I memorize every line
I kiss the name that you sign
And darling, then I read again
Right from the start
Love letters straight from your heart

~ As sung by both Nat "King" Cole and Ketty Lester

***

Beautiful lyrics as per Poopdeck's request. His birthday was a perfect excuse for a belated music lyric Monday post. Even if my FP said that Nat King Cole wasn't so cute, we could all agree that the man sure could sing. Hearing this song made me think of her, too. 

The version Poopdeck loves is the Ketty Lester version--I just added this to the post since he (and Tounces) let me know that hers was "THE" version. Ah hem. My bad. Nat's version was the one I found first and since it made me think of my FP I figured I'd keep it there, too.

I wasn't familiar with this song or the lyrics. Now it is playing on my mental iPod for sure. I love you, Poopdeck. You know I do, because I told you so and will continue to until I no longer have breath.

Hope your birthday was perfect.

xo, Dr. KD

All good.

(photo and exchange shared with patient's permission)

Heard that one of my F.P. all-stars was in the clinic the other day. Stopped by to see him before he left.

Me:  "Sir! Heeeeyyy!!! What you know good?"

Him:  "Hey sugar! I'm soooo happy to see you!"

Me:  "Sir! You know how happy I always am to see you, too."

Him: *smiling*

Me:  *smiling right back*

Him:  "You looking good. Like you happy in your life."

Me:  "I am, sir. I am."

Him:  *face gets serious* "You know? That's all you can ask for, right? Jest to be happy."

Me:  *silence*

Him:  *starting to cry*  "I'm very happy in my life, Miss Manning. Very happy."

Me:  *tearing up*  "Why does that make you cry, sir?"

Him:  "Because it ain't promised to you. 'Specially when you get to my age."

Me:  *silence*

Him:  "So it make me cry some to think about my life. It ain't been easy. But it's been good."

Me:  "It still is good."

Him:  *now full on crying*  "Yes, ma'am. It's all good." *points to the sky* "Cawse it's all God."

Me: *silence*

Him:  *wipes cheeks and sighs* "Love you, doc."

Me:   "You know what, sir? I love you, too. I really do."

Him:  *crying again*

Hug him tight before leaving the room. Gently step outside of the door.

*deep breath*


"You know what, sir? I love you, too. I really do."

I said that because it's true. I really do love him, too. And I really am happy. And no, it's not promised that you will be at any age.

 *Now crying, too.*


This? This is Grady. And it's all good.

***
Happy Friday.

Now playing on my mental iPod. . . . Mary Mary sings "Be Happy".


P.S. Every time I look at his sweet picture I want to cry. I really do. 

Connection.

Who said that every wish

Would be heard and answered

When wished on the morning star?

Somebody thought of that

And someone believed it

And look what it's done so far

What's so amazing

That keeps us star gazing

What so we think we might see

Someday we'll find it

That rainbow connection

The lovers, the dreamers, and me

~ Kermit the Frog in "The Rainbow Connection"

_______________________________________

Of course the news was bad. Ever since I was a medical student this was always the old adage: "The nicest patients have the worst diagnoses."

And you were nice. More than nice, really. You were funny and witty and smart and likable. Everything that portends a poor prognosis. 

I met you during the honeymoon period before things were confirmed. You patted your bed and told me to sit down next to you which is exactly what I did. You said things that made me laugh out loud. And you knew your medical history like the back of your hand and barely came up for breath when telling me every single detail of it.

"Was that too long?" you asked me.

"Uuuuhhhhhh. . .I mean. . . it was. . . uhhh. . .thorough." 

Then we both erupted into big, fluffy hearty laughs at the same time. The kind that float out into hallways and summon others inside. When I asked the next question, I narrowed my eyes and said, "Alright, this time give me the Cliff Notes version."  

You furrowed your brown and wagged your finger at me lightheartedly. Again came those big, fluffy, and contagious laughs all over again. Because you were cool like that. Serious about what was going on with your body but cool enough to pat your bed and welcome me into your space. And to make our encounter one that welcomed this kind of humor.

"I feel so much better," you told me. 

"I'm so glad you do!"  And I meant that. I wasn't there when you were first admitted, so I never saw you at your worst. As much as you stole my heart in just ten minutes, I'm so glad I didn't have to see you that way.

Now, you did look good. Good enough to discharge from the hospital, even. 

But. There was still a cloud looming over our heads. Even if you did feel like a  champ, your original symptoms and findings made no sense. Unless, of course, it was the very worst thing possible. I hoped so bad it wasn't that. I crossed my fingers because you looked so good. Too good for that word that nobody wanted to dare say but would eventually prove to explain your entire hospitalization.

Cancer.

When I came to see you again, you had already been given the diagnosis. This time I was rounding with the medical students and before going in your room, I told them, "The diagnosis has already been discussed. I just want to go and visit, you know? To just. . .I don't know. . .check in." I stammered a little more because there wasn't some big teachable moment or physical finding I had to share. This was just me going to see a new friend who'd just heard some heavy news. A new friend who happened to be a patient on our hospital census.

When I got in the room, you were your same self but a little less spunky. Our exchange was as easy as the day before, and something about that made my heart hurt. 

"I feel like you have some piece of information or like something is going on," you said. "You look like you got something to tell me. You got some more bad news you haven't told me yet?"

And I just stood there staring back at you. You had already recounted everything that every other doctor had told you already. You knew the diagnosis and broke it down far more than I'd ever heard any patient break down anything. So, no. I had no more news. Or anything for that matter.

"No, I have no news."  My voice became tiny and watered down. "I. . I just really felt. . . touched by you yesterday. I loved meeting you and talking to you and laughing with you. I guess I kind of felt like we connected."

You sat up in your bed and smiled. "I felt that way, too."

I smiled and added, "So, really, I just wanted to come and see how you were today. With all that's going on, you know? I just wanted to come and see about you."

"I appreciate that," you said.

You patted your bed once more and again welcomed me in. This time with your better half in the chair right beside you who, of course, was just as nice as you.

"Alright, Manning. Now since we connected and all. . .I hope you use some of your connections to get me up out of this hospital!" 

And we laughed. Hearty, fluffy, and so contagious that the students joined right in. 

And we talked. And connected just like we did before.

Ever since I was a medical student this was always the old adage: "The nicest patients have the worst diagnoses." 

Damn. You never stood a chance.

***

Happy Late-Friday-Early-Saturday.

Now playing on my mental iPod. . . my favorite song about connections. . . 

And Justice for all.

Oh, just wanted to follow up. Here's a picture of Isaiah this morning with the replacement Jake Justice. Getting the replacement Jake wasn't so easy either. Oh, did I tell you? Turns out the dude has been discontinued. Discontinued!  Well hallelujah for used and collectors items on Amazon. Lawdy Miss Claudie! First the Green Lantern situation and now Jake Justice gets axed from the Rescue Heroes?!  Seriously? Seriously.

Dang. 

Don't worry. I didn't tell Isaiah about the diss-continuation. Besides, I'm told that there's been some sort of crazy ethnic remix on Spiderman and trust me--that'll be confusing enough.

***
Happy Sunday.

The last word.

Annals of Internal Medicine, July 5, 2011

There was the most wonderful soul I had the chance to care for in the winter of 2010.  He was one of the loveliest human beings I've ever encountered, and he touched me deeply in my soul. Definitely an F.P. all-star of legendary proportions.

Anyways.  Although he passed away  from complications of cancer shortly after I cared for him, he left an indelible imprint on my heart.

My patient had immigrated to the states from Guatemala several years before and as it turns out, had earned both an M.D. and a Ph.D. in his home country.  He never had the chance to continue practicing in the states, but still. . . he was kind of a big deal.

I called him "Doctor." Because that's who he was--even though he wasn't in practice here--he was still a doctor. Two times over.  Doctor was the best. I'm talking the best of the best. He was wise and brave. . . .and scholarly. Would you believe that before he died he said, "I wished I could have had just one more publication in a medical journal."  Say what?

His health wouldn't allow him to write but I asked Doctor if I could write about him someday. He obliged.

Later on, I did write about him. Then I contacted his family and asked their permission to submit what I'd written for publication. I was so happy when they obliged.

So I aimed high and I sent it to the most high profile Internal Medicine journal I could. Hell, why not? And something beautiful happened next. . . .

The journal obliged, too.


And so. "The Lucky One" --the story of my experience caring for my dear, dear F.P., has officially been published. Right there in the most recent issue of The Annals of Internal Medicine.

Talk about feeling over the moon.

Man, I just know he is somewhere smiling. I just know he is. . . because this publication was his publication. And me? All I did was show up. 

***
Thank you, Doctor.

P.S.  The link to the story only gives an excerpt. Unfortunately I can't reproduce it full text right now, but will get a link to it as soon as it's authorized. If you have access or know any nerdy internists, just ask them to let you see their July 5 copy of the Annals and check out the "On Being a Doctor" section!

Homegoing celebration.

a homegoing celebration

I feel like going on

I feel like going on

Though trials may come

on every hand. . .

I feel like going on.

_________________________________________________

Today was the homegoing celebration for my F.P.


"Homegoing celebration" is the term my people often use to describe what most refer to as a funeral service or a memorial. Instead of the traditional heavy, dark clouds of grief and muffled sobs that funerals usually bring to mind, it's a bit different than that.  It's often hopeful. . .  uplifting. . .and though painful, yes.  . . .almost always celebratory. The shouts are audacious and when the tears do come, they are often so unrestrained that to someone less familiar with black culture, it could be a lot.

I always liked the term "homegoing" instead of funeral. 

Unfortunately, I wasn't able to be there for her homegoing, but my heart was on the front pew.  I know that if she touched me like she did in that brief period then her service was packed from wall to wall with more people than anyone can count.  I just know it. So yes, in my heart I was there.

Last night, I went by the funeral home to pay respects at the viewing of her body.  My fellow Grady doctor, Neil W., met me there and together we signed the book and reflected on this remarkable human being. We read her life story and felt the energy and the love in that place.  Three of her family friends were there, too, and they asked us who we were. When we shared that we were Grady doctors who had the honor to care for her, they cried and nodded.

"Of course her doctors are here. Because she was the kind of person that would make you want to be here," one woman said.  And we all nodded, too.

We stood there in a circle. . .sharing and reflecting and remembering and celebrating.  Neil told one of the sisters from her church that he has never met a more peaceful human being. I shared that I'd known her for only a brief time, but it felt like an eternity. Another lady said that she always made her feel like she was better than she gave herself credit for--but eventually she started to believe thanks to Mrs. Z.  It was awesome. Four black women and one Jewish guy from Long Island holding hands and touching and agreeing--- all in the context of love. We all hugged each other tight and it felt good.

Yes, Mrs. Zebedee. You were right. You were so very right.

Thank you for everything.  . . .

Now . . . you go ahead and get some rest. It's okay. Go on home.

I am hearing this on my mental iPod today. . .feeling your peace in my heart and celebrating your homegoing. I love the joy and peace in his voice that reminds me so much of you. . . .

I know you loved this song. Today, I'm playing it for you.


***
Happy Saturday.

Hair Raising Tales Part 3: The F.P.

*names and details changed although written with patient's permission.

The long (hair) good-bye.

The history behind the F.P. thing.

I have this little thing that I do on rounds each day. I've done it ever since I was an intern and how or why I started this ritual, I do not know. But I do it and I've done it going on fifteen years now. Every day I knight one of my patients as my "F.P." --shorthand for favorite patient.

When I first started doing this, I kept it to myself. On rounds, I'd simply place an asterisk in the upper right hand corner of the patient's tracking card--which meant that the patient was in the F.P. running. When rounds ended, I'd place the card of my F.P. on top. Again, why I did this? Eh. Beats me. I guess it just made the whole process of meeting and caring for folks a little more fun.

The other funny part about the F.P. thing is that there has never really been any kind of rhyme or reason to what deems someone F.P.-worthy. Sometimes it's something obvious like being wonderfully pleasant for no reason. Other times my F.P. might be delightfully wrapped in a cocoon of mild senile dementia interrupted by wisdom so crisp that if defies belief. And then there are the days where my F.P. is mindblowingly contrary and cantankerous, doing anything from kicking the whole team out of the room to tossing f-bombs around like confetti to refusing any and every therapeutic thing offered.Yep. Those folks challenge me so much that they're paradoxically endearing to me.

When I became an attending, I got a little more open about my F.P. ritual. So much so that by the midpoint of every ward month, members of my team often preface their patient presentations with this preamble: "This patient is totally going to be your F.P. today, Dr. M." By the end of the month, they are knighting their own F.P.s. And I just love it.

Which reminds me--I'll never forget the day that I hugged my student, Joelle, in the hallway as she cried over her patient who'd taken an unexpected turn for the worse. With a red nose and leaky eyes she sniffled quietly and said, "He was my F.P., Dr. Manning." Hearing that made me cry, too.

Every now and then, I meet a patient who is just so special that their F.P. status transcends a one day designation. These patients achieve a title that I developed somewhere during my senior year of residency--"F.P. All-Stars." I guess being an F.P. All-Star is like being in one of those airline platinum clubs where you immediately trump all others upon arrival. Work in a hospital long enough and you can form quite the collection of F.P.s. Not to mention F.P. All-Stars.

Anywho.

On Friday I was at the end of my solo rounds. I'd allowed the team to disperse after seeing our new admissions, especially since I knew the senior resident had already work rounded with the team on all of our pre-existing patients. At this point, I had been going around seeing the rest of our service of patients, reiterating the points that had already been made earlier that morning by the team. I love moments like this--they give me time to really connect with my patients in that way that I used to during internship. And enjoy my F.P.s even more. Especially ones like Mrs. Zebedee.

Mrs. Zebedee.

I'd intentionally saved Mrs. Zebedee for last. She was not only my F.P. on this day, but an F.P. All-Star. Even though she was pretty sick, seeing her was such a treat. Her attitude is always so calming and sure that it immediately washes me with a peace that is hard to explain. On this day, it wasn't terribly busy, so I'd carved out a little extra time at the end of my rounds just for enjoying her presence. I couldn't wait.

A fairly aggressive cancer was what had her hospitalized this time--the same one that caused our paths to meet in the past. The team had already told me that Mrs. Z. was doing okay today and that she was still tolerating her chemotherapy like a champ. My plan was to confirm this through a quick examination and a few questions then, depending upon how she was feeling, let her dictate what would happen next. A chat perhaps? A hand squeeze followed by a request to close her window shade? The ball was in her court. No daycare clock ticking or meetings looming over my head. This time was hers.

I approached her room, pausing to press down the sign hanging on the outside that had come partially untaped. It read "Neutropenic Precautions"--indicating that the chemo had wiped her white blood cells down to nearly nothing. This meant anyone with so much as a sniffle should steer clear of her and avoid bringing anything that could put her at risk of infection. After a soft rap on her door, I entered and just as predicted, was greeted with a big, warm smile.

"Hey, pretty lady," I greeted her.

"Hey, baby," she replied while sitting up in preparation for my examination.

I asked her my obligatory questions and searched her chest and back with my cold stethoscope. After a careful inspection of her skin for rashes or pressure ulcers and that ever intrusive abdominal examination, I recounted what she'd already heard from my resident and interns. She nodded in acknowledgment.

"You look good." I studied her smooth brown skin that didn't even have a hint of a wrinkle. Deep dimples sunk like valleys into her cheeks as she smiled in response to the compliment. Then she patted her covered head and then furrowed her brow.

"My hair," she said, pausing to clear her throat. "My hair is coming out."

I pulled a chair and sat down as close to her bed as I could. From the corner of my eye, I could see a picture of her beaming with those signature dimples and the thing she was most known for--her thick mane of jet black hair. As a hairstylist for many years, she was the master of doing the thing that every black woman has wanted at least once in their life--growing long hair. Hearing that she was officially losing hers immediately put a lump in my throat.

"How is it--I mean--are you. . .okay?" Great. That came out stupid sounding.

She slid her hand from her forehead, wiping off the satin bonnet that had been hiding her scalp. Instead of a clean ball of fuzz, I saw patchy areas of complete hair loss interspersed with islands of intact hair now clipped close to her scalp.

"I expected it to be different," she answered me while staring somewhere distant. "It's not. . . like I thought."

"What did you think?"

"I thought I'd feel more devastated. But surprisingly, I don't. It feels a little like a rebirth, you know? It's funny. Seems to bother everybody else more than it bothers me."

I narrowed my eyes and leaned forward. Propping my foot up on the edge of the bed, I rested my elbow on my knee and my chin in my palm. I wanted her to know that I wasn't in a hurry and that I was there to listen.

She went on. "I went ahead and clipped it on down. Once it started coming out, I figured I'd help it on along."

"Hmmm," I murmured not knowing what else to say. "How do you like it?" Right after saying that I immediately pressed my lips together out of fear that I'd said something stupid again, but she didn't seem bothered.

"Well," she said while cocking her head sideways to find her words, "I hadn't really ever had my head shaved before so I never knew what my head looked like. And you know what I'm thinking?"

"What's that?"

"I'm thinking my head is kinda cute." We both laughed as she struck a playful pose in her bed.

"You go, girl!"

"Girl, I woulda cut this mess off sooner if I'd known underneath all this I was Halle Berry!" She chuckled again, but this time more gentle. Her face became serious. "The hard part was yesterday. . ."

"What happened yesterday?"

"My daughter. She was trying to put my hair into a pony tail for me and every time she brushed it, a whole handful came out. I think it really upset her."

I thought about what she was saying and tried to imagine that exact scenario between my own mother and me. A quick wave of angst came over me as I found myself reminded of my own parents' mortality. "Did y'all. . .talk about it?" I asked. I didn't know what else to say.

She sighed hard and rubbed her head again. "Naaah. She wasn't ready."

"Has she seen you since you cut it down?"

"No. And I'm not going to even tell her unless she asks me to remove my bonnet. It's funny. Now this child's hair has been all the way to her tailbone one year and then fried, dyed and laid to the side another year and then she came home once with it buzzed down with clippers just like a boy--but me, her mama, has had the same hair for her whole life. I just think it was a lot."

"Wow," I whispered. When looked at from that perspective that sounded like a lot.

"When people love you, it becomes your reason for living. Like, before when I was younger? You know, I was worried about me. But now, I'm concerned about me because they love me and I love them. It wasn't like that when I was younger. 'Cause I didn't know love like I know it now, you know?"

I just sat there staring at her with these images swirling in my head:

Finally, I nodded my head and closed my eyes. "Yes, I do know." Because I did. I understood exactly what she meant.

"Don't get me wrong," she went on, "I care about myself and I want to get well for me, too. But, see, as you get older, if you're lucky everything you do is in the context of love. Everything."

I felt myself getting choked up so decided to stay silent. I took in her words carefully, scribbling notes in my head and across my heart for later.

She touched her head again slowly. "So, this hair? It didn't hurt me to lose it until I saw the look on my daughter's face. Now that? That hurt." She stared out of the window for a moment and I followed her eyes to the giant Coca Cola billboard with Atlanta traffic underneath. Eventually she sighed and looked back in my direction, shaking her head quickly and putting back on her signature dimpled smile.

"Everything you do is in the context of love," I repeated her wise words back to her. Staring skyward, I nodded slowly and let those words marinate. Then I added, "I like that. I will remember that."

Because I did like that. And I will remember that.

She reached out and squeezed my hand. "You are sweet," she said.

"And you are wise."

I hugged her and told her to get some rest. She hugged me back and said, "God bless you, baby. And all the doctors here at Grady." She hugged me like she meant it and she said that like she meant it, too. Because she did. I could tell.


"God bless you, too, Mrs. Z." I headed across the room toward the door.

She watched me walk past her bed and then said, "Love you."

I paused for a second, peered my head back inside and said, "You, too, Mrs. Z."

Because in that moment, that's exactly what I was feeling, too. And I felt lucky that I did.

"If you're lucky, everything you do is in the context of love."

~ Mrs. Zebedee

May we all be so lucky. And may your life be filled with your own collection of All-Stars, too.

****
Happy Tuesday.