Showing posts with label priorities. Show all posts
Showing posts with label priorities. Show all posts

Sunday, October 14, 2012

Player of the game.


 I told a medical student one Saturday morning on rounds: "Efficient and focused rounding is something that you should consider a teachable moment." She furrowed her brow a bit and nodded. "I mean that," I added.

"Because of duty hours, right? You have to get us out of the hospital." This was her response. And she meant that because she was one of the bright-eyed, bushy-tailed ones that would have been happy to stay and stay as long as anyone wanted.

"Yes and no. You have to work hard and efficiently while you're here so you can get out and have a life. When you have a life, you're able to come back and give more of your self when you're here."

"Makes sense."

"So today, we'll get ourselves organized, lay out a plan, and take good care of our patients. But we'll do it efficiently. That's the teachable moment. You got that?"

"Yes, ma'am."

And we did.




Outside of the hospital, a world of experiences and loved ones awaits us. Very important events and irreplaceable moments that must be aimed for and planned for to witness. Sure. Sometimes those plans can get derailed by unforeseen circumstances. But a lot of times, they won't.

In other words, how you play the game is important. Especially when you're a Grady doctor. Or a business owner like the BHE. Or any person with any job that requires so much of you and your time.

Yes. Life goes on outside of work. And if you don't pay attention and don't make a clear decision to try your best to be present, you can miss a lot.

A whole lot.


Like pee-wee football games on sparkling fall weekend afternoons. And then seeing your baby boy get awarded the "player of the game" medal.


Or catching a glimpse of the proud look on his face as the coach spoke of him.


Then noting him scanning the crowd to see where you are and if you heard it, too.



Only to feel like your heart will explode into a thousand pieces when he finally finds your face exactly where it was supposed to be . . . . and then looks at you like this.



Sure. Maybe trying to balance your personal life with work life will make it take you a little longer to conquer your professional world. And perhaps you'll even be forced to redefine what "conquering your professional world" even means to you.


But moments like these? Man. They make all of that absolutely worth it.

Yeah.

***
Happy Sunday.

Monday, December 20, 2010

Reflection on a Monday: The Snoopy Dance.

The Snoopy Dance


 "And I love how you came along
and made the world for me secure. . . 

It's deeper than you know--
You made me believe I'd found a love for my soul."

From Kindred and the Family Soul's "Just the Way You Are" 


 ______________________________________________________

Becoming a doctor is such a selfish walk. You declare a major in college and then you work super hard to make excellent grades. You align yourself with equally studious people (some of whom seem really cool on the exterior but are secretly as nerdy as you) and together you perpetuate the belief that you must, must, must study super, duper hard.

To get an A in Biology 101.
To get an A in Organic Chemistry.
To set the curve in Physics 102.

Then the MCAT rears it's ugly head. Because you want to go to the medical school of your choice, and because you'd prefer to not be explaining that, yes, I realize that I will graduate magna/summa cum laude yet I was having a bad day when I took the MCAT or although I was top of my major in pre-med I am not a strong standardized test taker therefore I am hoping this can be overlooked. So you purchase fat books and programs and bury your nose and your life into them.



And then you get into medical school.

Your parents/study partners/high school teachers/everybody remotely connected to your parents celebrates. And you do that dance that Snoopy used to do when he was super happy. You imagine yourself in a white coat dropping all kinds of diagnostic bombs like House, but without his drug problem. You envision your arms folded on rounds pontificating a clinical dilemma. You see the legions of patients whose lives will be better because of you, the one doctor who always listens/never rushes them/treats them with respect.

You arrive at your medical school -- and then. You meet a new posse of super driven folks; even more super driven than the people from your college/university. The stakes are higher. Everyone is going over $150,000 in debt, so failure is not an option. At all.

So you study like crazy. You have fun on the weekends after exams, yes, but always looming behind you is the need to achieve, achieve, achieve. So that you can have your pick at the next level. So that when you go for residency interviews, you aren't saying things like, yes, I did do well in medical school but I am just not a strong standardized test taker, or see, the preclinical curriculum was tough for me, but I came into my own when I started clinicals which is why I got all honors on my rotations including medicine and surgery.

You miss some things.
Even things you shouldn't have.
But you get so worried about achieving that it seems okay.
You fret a bit.
And on some days, you fret a lot.


Then, if you're lucky, you match in the residency of your choice. Your family celebrates. You want to do pirouettes and, if you aren't too cool at this point, you actually do them. Or even the Snoopy dance. On commencement day you see the proud look in your parents' eyes which, unbeknownst to you, has as much to do with the fact that you are now a doctor as it does the fact that you are a gainfully employed doctor to boot.

A doctor with a job.


You enter internship. And it starts all over again. New road dogs. New challenges. New hurdles to jump. Do I want to do a fellowship? Oh my, then I need to be the best thing since running water and Estee Lauder on every rotation. Especially the ones in the specialty of my choice.

And so.

After all this, at some point the dust settles and you finish your training. Suddenly you have a little more time and a little more money. You emerge from the cloud of me, me, me and realize that, oh yeah, there were other people who may or may not have been in medicine there along the way. Or they sort of were, except on an attentiveness scale of one to ten you were, at best, a solid five.

If you're lucky, somebody thumped your head early in this process and you had a wonderful partner to hug you tight and call you "hon" instead of doctor, doctor, doctor.  Or. You could be someone who had your head thumped early, yet fickle fate never brought prince or princess charming from out of the stacks of the library or from perusing the shelves in your favorite Starbucks study haunt to love you forever and ever.

So you worry. You wonder.  Wait, what's really important? Oh yeah, more than just me and my medical milestones.

Oh yeah.

***

Today is my husband Harry's birthday. And for this reason, I am reflecting on achieving what is really important. Whether you are a doctor. Or a nurse. Or any other kind of uber-achiever. Relationships with the people who matter most are what's most important. If you get a chance to narrow it down to one super-special person, hot damn. You've hit pay dirt.

Yeah.

For a while during and especially after my residency I worried about that.  All that hard work. All the studying and gunning to "get there" to the promised land of doctor-hood.  But my dust settled and I looked to my left and my right and with the exception of my (wonderful) immediate family, it was just me, myself, and I. Oh yeah, and my professionally framed medical degree.

I wanted a love for my soul.  But it hadn't happened and it wasn't happening.

Damn.

What frustrated me most was the fact that I couldn't just work at it and study for it to achieve it.  There was no intense review book for finding a love for my soul.  And for nerdy academic types, that was a hard pill to swallow.

After some (very) unappealing dates and some (majorly) dead end getting-to-know-yous, I decided something very simple: I couldn't force this particular milestone.  No amount of studying would get me there. Instead, I focused on myself, but in a different way. At thirty one, I made a pact with myself to not waste a single moment on any human being who had not gotten the memo on my awesome worth.  I didn't want to be seen on the arm of Mr. It's-not-you-it's-really-me when the love for my soul came walking by. So that's what I did. Oh yeah, I also decided to make every effort to just be content with me in the interim.

It was worth a try.


Two weeks later, I met Harry. And just like that, I felt a different reason to strive other than me. Because finally, after all of that studying and trying and worrying and praying and waiting and achieving, I'd found the pièce de résistance. The one I'd been hoping and praying for. I'd found a love for my soul.

And sure, it probably sounds nauseatingly cliché, but that's okay. Because love does that to you. Especially a love for your soul.


Now that's a reason to do the Snoopy dance.
***
A love for my soul that led to two bonus loves for my soul.


So this one's for you, Harry.

Thank you for being a love for my soul
and the best and most important achievement I never studied to attain.

~ K.M.
___________________________________________
Now playing on my mental iPod. . . .

Tuesday, May 11, 2010

Reflections from a new beginning: The Graduate

The Complete Package?
It is what it is. Or is it?

my medical school graduation photo, circa 1996
(Yup, that's me with ALL that hair.)

"When you know better, you do better."


~ Maya Angelou

___________________________________________________________

The last few days have served as the celebratory swan song of our graduating medical students. Parties, events, gatherings, ceremonies. . . .it's a very festive time. They had a wonderful black tie dinner celebration last week, and I was honored to make the students' short list of faculty invitees. I felt terrible when I had to decline--but it was Isaiah's birthday that day, and I knew that (even though he was going to have a big party just two days later) home was where I needed to be. And so I said something like:

"Thank you for the invitation, but regrettably, I have to decline."

Sure, I fleetingly considered going for "just a little while" but knew that "just a little while" would turn into "Dr. Manning, you have to meet my mother" and then me looking at my watch and saying "I guess I can stay for the awards portion" and inevitably, a sheepish text message to my husband saying "I'm so sorry, babe, but it would be rude for me to leave. Be home soon as I can. xoxo." I felt conflicted that I couldn't be two places at once, but as terrible as I felt, I didn't allow myself to feel terrible enough to miss tucking my son in on his 5th birthday. And when I pulled the covers over him and heard him say, "Thank you, Mommy. I feel so special," I knew I'd made the right decision.


Colleagues and fellow faculty/mommies/Grady doctors, Joyce D. and Lisa B. in their regalia
at Emory School of Medicine Commencement, May 10, 2010



Yesterday was the med school commencement ceremony at Emory. It was, believe it or not, the first one that I have attended since joining the faculty in 2001. Watching all the students march in with their regalia on and with their families close by was quite a sight. The whole thing brought back tons of memories. Seems like only yesterday that I was the one looking in the mirror trying to perfectly position my cap. . . . . I remember much of that day quite well because it was pivotal for more reasons than just the obvious. . . . .

Two graduations in two days. . . .

When I graduated from medical school on May 19, 1996, it had been an exciting weekend. My younger sister, JoLai, had commenced from law school the very day before, and our entire family drove as a swift, proud caravan from her festivities in Birmingham, Alabama to my ceremony in Nashville, Tennessee. It was awesome. I'm talking really awesome. Pride oozed from my parents that weekend. I mean. . . . imagine how they must have felt. . . .literally seeing their two youngest kids finish professional school less than 24 hours apart! The third and fourth of their four children to receive terminal degrees. They could not stop smiling. Seeing how proud they were is a child's dream; the image is forever etched in my mind.

My classmates and I vibrated with excitement as we lined up and awaited our big moment. We graduated in this huge sports arena, but despite this, as soon as we marched into the large space, naturally, we each craned our necks with hopes of finding our families standing somewhere in the wings. Most could not make out their own amidst the sea of onlookers. Lucky for me, I saw my loved ones the minute I took my first few steps onto the slick wooden floor. There they sat in a row: my youngest sister, JoLai, the newly conferred juris doctor, my brother William and his wife, Francoise, who'd taken a similar walk in 1991 when they received their doctorates in Veterinary Medicine, ultra-proud Mommy and Daddy, both looking like they would vomit from the excitement, my oldest childhood friend, Kim B., and last but not least, standing on her feet applauding was my eldest sister and 1994 law school graduate, Deanna. That collective sight was moving. Everything about that moment said one thing to me: Complete. It should have been one of the happiest moments of my life. So why, then, did I suddenly feel so sad?

It is what it is. . . . .

Just two years before, my older sister, Deanna, entered her own professional school graduation and scanned an auditorium for those same smiling faces. The scene was likely almost identical--all were present, hooping and hollering, cheering and high-fiving--all but one member of our family: me. In May of 1994, I was in my final days of preparation for the first installment of the USMLE (U.S. Medical Licensure Examination) and was terrified to do anything that would take me away from studying--even for a moment. That included spending the weekend before the test with my family at my sister's law school graduation.

Interestingly, from the moment I made that decision until the day I finished medical school, I never felt like it was wrong. I deeply believed that this "sacrifice" was a necessary evil, and told myself (and my family) repeatedly that I just "had to do what I had to do." I was strangely proud of my resolve, and felt validated when I got notification that I'd successfully passed this critically important exam. I "did what I had to do," and "it is what it is" I repeated to myself and others over and over again. Although I was pretty convincing to most, a couple of people questioned me--but I could not be moved (or guilted) into doubting my rightness. Sure, my sister was graduating from law school, and sure, it was only a 3 hour drive away, but this is medical school, man. Medical school. Hey, man, it is what it is.

It was not until I placed my foot on that auditorium floor, head held high, and the room swirling with the first few notes of "Pomp and Circumstance" that something clicked. It did more than clicked. It clocked me in the head. The more steps I took, the more that fuzzy snapshot of my celebratory family quickly sharpened. That's when I got it. . . .the fact that all of my loved ones had made whatever sacrifices necessary to be there. . . . Will and Fran taking off from their busy Veterinary practices, Dad, Mom, and Deanna all flying from California, and Kim B. driving from North Carolina. It was like someone swiftly punched me in the chest, knocking my wind out. I gasped. How could I have not gone to my sister's graduation? I began asking myself. How could I not given her the experience of "complete"?

Now it seemed like Deanna was clapping in slow motion. . . . silently cheering and then exaggeratedly pumping her fist the closer I got to her. I could feel myself being strangled by shame and regret the more I watched her; genuinely proud of me and somehow forgiving the debt of me snubbing her from the very moment she was affording me. What's wrong with you? How could you have thought that was a good idea?

I cried throughout my entire ceremony, and got it together only to make my walk across the stage to receive my diploma. There is one smiling photo that I have seen of myself from when I'd left the stage (which I can't seem to find), but it in no way represents how I was feeling. My classmates all thought (being the drama queen that I can sometimes be) that I was overcome with emotion about finally becoming a doctor. What none of them knew was that I was in the middle of an "ah hah moment" and that I was learning a very important lesson.

My conscience was exploding: How could you have not been there? How could you have done this to her? You robbed her of her "complete". . . . and why did you think so little of yourself that you would actually believe that you could not have been there with your family and have done well? How can she be standing there clapping for you when you did this to her?

The thoughts were suffocating. I wanted nothing more than to get out of that seat on that row in that room and to run as fast as I could to my sister . . . .pleading with her and telling her that I was wrong. Terribly, terribly wrong. I repeated in my head what I should have said two years before: I'm so sorry. I should have been there. You mean more than a test. Our family means more than a test.

Later that evening, that's exactly what I did. I told her how sorry I was, and despite my best efforts not to, I cried hard right there in front of her (yup, the ugly cry.) Her response let me know how deeply hurt she'd been by my decision, and how long she had been waiting to hear those two words.

"It was only 3 hours away, Deanna," I eeked out between sobs, "3 measly hours. I should have been there, sister. I'm so, so sorry. . . "

"You didn't know," she replied gently, "You didn't know."

"Please forgive me." Suddenly I remembered how puzzled she sounded when I matter-of-factly told her that I wasn't coming during a brief board review study break phone call back in 1994. The thought of it made me cry even harder. "Please forgive me," I repeated. "I was so wrong. But you are right, I didn't know."

"I love you, Kimberly. Of course I forgive you," she said, "and I appreciate your apology. Even two years later. You have no idea how much I really, really appreciate your apology." She could of just said, "It is what it is." I continue to be thankful that she didn't.

What I know for sure

Deanna was right. I didn't know then but now I do know. I now know that I am smart enough and whole enough to do well professionally without shortchanging the other, arguably most important aspects of my life. I know that sometimes you do have to say "regrettably, I can't attend" but that there are also times that you must say "I will be there no matter what." I now know that "it is what it is" is no excuse for missing a milestone. As my former chairman, Dr. Blinkhorn, once told me before I moved to Atlanta, "There are times when your personal life must be paramount. The older you get, the more that is the case. The ones who seem to get this early seem to do the best overall." He was so right.

My hope for my students and residents is that they indeed care for their patients with all their might and attack all there is to learn about medicine with zeal, but never at the expense of family and important relationships. It's a bit of an oxymoron considering medicine is often a selfless pursuit. . . . . but again, it is those who maintain self who are able to give the most.

So in the end, my memory of graduation from medical school is bittersweet. Fortunately, I can say that it is more sweet than bitter. Beyond me officially becoming a medical doctor, it was a new beginning. . . . .and indeed a graduation. The start of me learning that honoring thy patient starts with first honoring thyself. . . . .and that honoring thyself involves honoring those who make your picture complete.

Me and Deanna at JoLai's law school commencement, May 18, 1996

Being there: Our COMPLETE family during another proud milestone
Grand Opening of Will's new veterinary practice, July 4, 2008




"When you know better, you do better."

~ Maya Angelou