Zone of Development.

Funny thing about life. We want to be comfortable in it. Like, we want things to mostly be predictable and painless. Low on stress and curveballs, right? And while it may seem like the next predictable sentence is some reference to how it isn't that way at all--that's not what I'm thinking. I'm actually thinking that many times it is like that. Comfortable. Predictable. A rolling ball down a straight path without even the tiniest hint of anything to break the inertia.

Yeah.

At first, that feels good. Kind of like when you run and get to a pace that feels manageable. You get out and you do it. Until, at some point, it feels less satisfying. And as a result something has to shift. Maybe you will do hill work. Maybe you will start running faster and aim for a better time. Or just maybe you will stop running altogether. Why? Because being comfortable is overrated man.

For reals.

I heard this guy once talk about how the most fulfilling place to be is in what he referred to as a "zone of development." This is the place where you don't know how to do everything and some piece is a wild card. Your are working up to it, broadening your fund of knowledge and skillset, shaking things up. Contrast this to your comfort zone--where all is predictable and mostly easy.

Yeah.

I think the older you get, the easier it is to land in comfort zones. I find myself wondering if there is an age where this is nirvana--being in a perpetual comfort zone. While I'm not sure if that's true, I know that if it is, I'm not old enough for it yet. Not for long period s of time.

So yeah. Here lately, I have been thinking of this. Feeling ready to push envelopes and thrust myself into some zone of development. Lucky for me, that can all be done at Grady and with my current employer. But it will call for me asserting myself and learning some new things. I think I'm ready to do that, too.

Yup.

I'm ready to move intentionally into a zone of development. Do I know what will happen there? Nope. But what I do know is that this is where growth lies. And what I also know about where growth is?  Peace and fulfillment are somewhere nearby.

Yeah.

***
Happy Tuesday.

A.D. (After Deanna)

"The only advice I can give someone about when you lose someone like that is you won't ever get over it. And the more you know that and embrace it, the better off you are."

~ Billy Bob Thornton

________________________________________________________

The Day before Ides of November, Year 5

It's been five years since the day before she left us. For me, they all kind of run together but there's always something about November 14 that stands out. That was the day before things shifted. Now? I will always see my adult life as November 14, 2012 and before-- and then everything after that collectively as A.D. -- After Deanna.

A giant line was drawn in the sand of my life that day. All that was before that day seems like it was so simple, man. Even when it wasn't simple. See, what was simple was that you could trust the day to be what it was. Happy would be happy. Sad would be sad. Lumpy would be lumpy. But it was what it was, you know? I mean, you could walk into that day or that month or that week believing that this is what it will be. And trust it to be just that.

And up until then, I mostly felt that way. I did.

But then came November of 2012. It started off so seemingly normal. The sky bursting with this extraordinary blue and the leaves on the Japanese maple evolving into the most painstakingly beautiful shade of bright red that it seemed like they weren't even real. Just two weekends before the day she departed we sat together on the bleachers screaming and cheering at a pee wee football game. Deanna had painted a poster for Zachary's team by hand and he was so, so proud of that. So proud that he refused to let the team run through it because he didn't want it to tear.

Ha.

My text exchanges the days before were about Thanksgiving week. I had to work for part of it. She had the week off. She offered to help me out with the kids but only up until Wednesday because she had plans to attend the Turkey Day Classic football game in Alabama that day. She loved our alma mater Tuskegee so her being unavailable to me so that she could be available to Tuskegee made sense to me. All of that was cool with me. Yeah, man. It was.

I have read those text messages no less than 1,000 times. I scroll back as far as I can and remember the innocence of that time. How my fear of bad things like sisters suddenly dying were mostly hypothetical and outlandish and not the kinds of things that could affect me in real life. That is, until they actually did affect me in real life.

So that November of 2012 was pivotal. It shifted my view on life and the world I live in and what is promised to me. What is sure is right now. Not even today but now. And so what happens after something like this is that you start to really, really look at your now with different eyes.

Does this even make sense?

For those who have lived through one of these moments, you already know. You know that you can start a Tuesday thinking it will be just the day after Monday and nothing else. But once you experience one of these knock the wind from your chest moments? You know not to fully and completely trust Tuesday. Or Wednesday. Or any day completely. Negative sounding, I know. But that's not how I mean for it to sound. I'm just saying now I understand that there's always some piece of what will happen next in a day that is impossible to predict. So you learn to keep a tiny piece of yourself "woke" just in case that day pulls a fast one on you. And no. That doesn't mean live in fear or don't appreciate it. I guess, to me, it instead means savor the piece of it that is before you. The slice right in front of you sitting on your plate. Savor it. Dig into it with your fork and close your eyes when you take that bite. Yes. Taste every bit of it that you can. Because something could shift and make it where you can't.

Sigh. Rambling, I know.

I think what I am realizing is that every day could be the day before November 15. Which, in a way, makes me both happy and a bit scared at the same time. But mostly happy.

Here's why:

The day before Deanna died was just about as perfect as a day could get.  I had given a lecture that afternoon at Grady that she'd helped me with. It was something that called for courage because it was so different than most standard medical lectures. And, at first, we had some glitches in the AV equipment. But then it worked out and went wonderfully. So great that I have given that lecture several times and even in several different states. I called Deanna in the middle of that day and told her how great it was. How really, really great it was. And, like always, she said that she knew it would be. That was one piece of that day. Later on, she picked up our kids and when I came home she was doing crafts with them on the dining room table. There was glitter everywhere and everyone was so happy. I'd come in with a handful of groceries and started making some dinner. Spaghetti. 

"Join us for dinner?" I asked.

"Sure, why not?" she replied. 

And I cooked while they kept on sprinkling that glitter. She listened as I rehashed every single detail of my lecture and the kids screamed and made as much noise as possible. Harry came in and all of us just laughed and talked and ate and hugged until well after 9PM. And I remember thinking how awesome it all was. How happy I felt that we lived in the same city and how grateful I was that she was there to help me with my kids. I even recalled that moment just a few weeks before crying while telling her all of this. Sitting at the kitchen table weeping and saying how truly, truly, truly grateful I was that she was there to help me because I needed it. I needed her to help me raise my kids and to be brave. And she would just smile and say, "You do need me. You're a mess. But you got me so it's good." 

Then we'd just laugh and laugh. 

I am laughing and crying while typing this because she was so right. I was and am a mess. And I still need her. I do. The cool thing is that, while I know she isn't here in the flesh, I know I still have her. I can hear her when I close my eyes and sit very still. Her strong opinions, her unfiltered advice, her favorite pet name for people she loved "Pookie." And, as crazy as it might sound, the parts of me that are a mess without her are a price I'm willing to pay to honor her. 

Sigh.

Man, oh man. I had no idea that the day after the great glitter and spaghetti night that she'd be physically gone. Just like most people who live through such a thing feel, you know? But there is such a tremendous comfort in remembering how wonderful that November 14 was for us. That she would think to stay late on a school night even though she had to work and that we laughed out loud and did the most ordinary extraordinary things. I love that I was given the gift of discernment in that moment, too. Like, that I knew to think "this is a great day and a special moment" right then and there while it was happening. That was a gift, man. A real gift. Which is a very, very good thing to hold in my heart A.D.

It is.

And so. Now I'm really into trying to do that more. I want to  feel my life and experience it all in high definition. I want to see it and touch it and savor it. Each hug, each laugh, each kiss. Fill it all up with the people who bring me joy and not anxiety. And permit myself to be okay with not giving that precious space in time to those who don't. Because I'm never fully sure if this is the day before a day like November 15. And some piece of me is always praying that, since I never can know what is coming around the corner, that I will live with enough intention to have very few regrets. I'll know I loved hard and was wide awake for it all. 

And I get it that the intensity of it all probably sounds exhausting. And no. I'm assure you that I don't get it right a lot of the time. But you know what? Damn, do I try.

Damn, do I try as hard as I can.

I miss my sister every single day. And I hope that I always will. 

Yeah.

***

Be intentional with your days, okay?

This resonated with me. I get his melancholy and don't see it as a bad thing. Some piece of me will always be sad and I'm okay with that. It's okay.

Twenty for twenty: Number 4.

Overdrive.

If I won the lottery--like the big, bad, super-inflated, multimillion dollar PowerBall? Let me tell you exactly what I'd do:

1. Get some sheets in the highest count attainable.
2. Get my currently periodic housekeeper to make my home her main and only gig.
3. Get a driver.
4. Make sure the driver is down for driving 24-7-365-52.
5. Get one of those cars with internet access so that I can do stuff like blog while riding.
6. Philanthropize like a BOSS.
7. Have a cook.
8. Pay off my house and my student loans (yes, I still have some.)
9. Keep my minivan

Oh, and of course, keep working at Grady.

I need to emphasize numbers 3 through 5. I really, really, really don't like driving. Outside of that? My life is rich enough, man. Like, I'm pretty sure I wouldn't do too much different if I suddenly hit a windfall of moolah on a random Wednesday. But the thing you could bet your life upon is that somebody other than me would be driving.

Everywhere.

So, this is on my mind because in the past few days I've driven WAY more than I want to. I mean, I really don't want to ever at all. But when I do, I'd like it to be as limited as possible.

Anywho.

Yesterday, I was rounding and my patient kicked me out as soon as I walked in. He said, "I'm not happy. Y'all are making me leave and I don't even have no shoes, man. This is some bullshit."

And so. I tried to tell him that we'd go find him some shoes in the social work office but he announced that he had to pee and that I needed to get out. And that was that. But before I left, I did ask him what size he wore. Which was a twelve.

Yep.

Well. Turns out that the BHE is a size twelve and since he is from the midwest where sneakers get retired after just one speck of dirt gets on them, I knew EXACTLY where to get this man a fresh pair of kicks.

Yep.

It was Labor Day so I knew the BHE was off. I tried to get him to bring the shoes but he was hanging out with the kids and the dog away from home.

Grrr.

So you know what I did. At lunch time I drove my butt home. To get the shoes for the man who kicked me out of his room. And can I just say this? Bringing those shoes back to that brother made it worth driving across town, man. It was.

"Got you some shoes."

"Who shoes is those?"

"Yours."

"Them shoes look like new."

"Yeah. They come from a dude from Cleveland."

"Awww shit. Them cats from Cleveland, Detroit and Chicago? They crazy 'bout some shoes getting dirty."

"You know it."

"Damn. This is a good look, doc. What size they is?"

"Twelve."

"No shit?"

"Nope."

"And they mine?"

"All yours."

"Damn."

"Can I examine you now?"

"Lady, you can make me do jumping jacks for all I care. Man. These shoes is great."

"I brought a pair of socks, too."

He just stared at me on that one. And looked almost like he wanted to cry. I've learned that socks are a big deal when you don't have stable housing. For reals.

So yeah. I drove for that.

Then there was today. I was at Grady in the morning rounding. And I had seen all but one patient but that patient belonged to the med student. It was noon and the students and residents were supposed to go to Grand Rounds. I didn't want to delay them going but I also had this one more patient. There was an easy solution: See the patient while the team went to Grand Rounds.

Oh, did I mention? Today I had to be at Emory at 1PM to teach my first year med students. So I'd need to either see the patient alone and not give the student a chance to present his patient to me (a big deal when you're a student) or go to Emory and come back explicitly to let the student have the chance to present his patient.

Sigh.

Yeah. So you already know what I did. I went to Emory. Came back to hear the student discuss the patient. And then? Did I mention? I had to go back toward Emory to meet my third year students. Oh, and I had to get Isaiah from school, too.

Now.

That student knew that I valued him when he saw me walking back into Grady to hear his presentation. That was worth a lot to me. But dude. That was a lot of driving. A lot, man. I really need a driver. For reals.

Yeah. So I've been in overdrive this week, man. But all of it is give and take, I guess. And if I could do it all over again, I'd do it the same.

That's it. Oh, that and the fact that I have nightmares about someone forcing me to drive Uber for the rest of my life. Like, full on nightmares.

I think that's it. Yeah.

****

The Mandolin.

Me and Isaiah this morning

That's me in the corner. 

That's me in the spotlight.

- R.E.M. , Losing My Religion

Today I was sitting in church by myself. Isaiah had joined me this morning but he'd gone on to his middle school service and I to the adult one.

Which was fine with me.

Summer is weird for schedules. At least it is in my family. So a lot of our regular routine relaxes a bit. Harry had a late evening so was breathing heavily and not stirring even though I was moving all around the room. I decided to let sleeping husbands lie. Zachary was as still as a statue--not even the fake, smirking one that appears on most school days--when I tried to rouse him from sleep. I left him be as well. Isaiah was up and said he wanted to come with. "Wait for me," he said quickly pulling on his sneakers. "I'm gonna come, too."

Which was also fine with me.

He's getting older. Twelve now. Full of his own ideas, some of which are still adolescent half-baked, but still very good ones. Views and attitudes. Somewhere along the way he has decided that he likes attending church. Which feels really good since it's of his own volition. The fact that we can wear whatever we want, bring a cup of coffee or a water bottle right into the sanctuary, or even chew a stick of gum without admonishment doesn't hurt either.

Anyway.

I was sitting in church this morning. I'd chosen a corner seat, the first on the aisle. The kind of seat that makes you swing your legs to the side or stand up every time someone comes up. And probably, it's one of those things that, if you really, truly were to ponder it, is kind of selfish. But I just kind of felt like sitting on the end this morning. Which, as it turns out, was fine, too. Summer-schedule weirdness apparently isn't just limited to the Manning family. The church services are generally less full this time of year so no smiling usher-person came over to wave gently in my direction asking that I slide down.

I was glad.

So, I guess all of that had me in a peaceful place. The week had been full. I wanted a peaceful moment of fellowship. And, while I know that not everyone is a believer in God or a follower of any organized religion, I do think we can all agree to knowing that feeling of just wanting a peaceful moment. One not tainted by someone moving you from the place where you want to sit or forcing you awake and guilting you into doing something that, just maybe, you kind of aren't in the mood to do. So yeah. That's where I was.

Peaceful.

That's when I heard it. Hauntingly beautiful. Painstakingly tender. Like a rub on the shoulder when you feel sad or a very, very tight hug when you feel super happy. The room had fallen quiet, as often churches do when lights go down and doors close. But instead of someone talking or singing, it was just this sound, this melody.

I looked up from my corner seat. And there was this light falling upon this one man, head down and eyes closed, playing a mandolin. His head was waving rhythmically, almost choreiform and trancelike. Lost in the sound of his instrument.

Yeah.

I could see the other musicians on the stage, too, but that soft, bluish spotlight was on him. Eventually the rest of the lights filled in to reveal the rest of the band and they began singing. But for some reason, I couldn't hear them. All I could hear was him. And that mandolin.

Hauntingly beautiful. Painstakingly tender.

Like the flash of lightning, my eyes filled with gigantic pools of tears. They spilled over my lashes and onto my cheeks. It all caught me off guard. It did.

But that mandolin. So tender, so beautiful . . . it reached straight into my chest and clutched at my heart. Squeezing it tight and bursting from it every single moment of my week, of my life. And let me be clear: Life is good, it is. But it is, like always, full and complex. It is.

The more he played that mandolin, the more I cried. Tear after tear. Eventually, I just stopped wiping them away and just surrendered to it. All of it.

I'm taking care some very sick people at Grady right now. Sick in ways that I cannot really fix. And all of that feels so dark, you know? But then, right in the middle of all of that, are these enormous bursts of light that shine like sunbeams. People saying and doing unexpectedly amazing things. Some of them patients. Some of them not patients at all but just a part of the teams who signed up to care for them.

This one lady on my team was so sick that she could barely catch her breath when we came to see her. We were seeing her as a team and I felt guilty asking her to answer my questions or even sit up with such short wind and pain. But she did and I was able to assess what was happening with her from that. So I talked to her about the plans and answered our questions. And that was that.

Then, just as we prepared to go, she pointed at my medical student Joav and said to him, "Hey, you're the only guy on this team. How's it feel being surrounded by all of these ladies?" And we all just sort of chuckled as Joav made a small talk comment back. So we left the room and that was that.

But that wasn't really just that. See, on this team, I am working with a med student who is a transgender woman. She, along with all of us, is navigating a territory that is, to put it mildly, new to a lot of people around her. And with new or unknown things, people say and do things that catch you off guard. Some of them extremely hurtful. But some hauntingly beautiful. Painstakingly tender.

Kind of like that man randomly playing a mandolin in my church today.

Or like a lady gasping for air who points out the obvious. The obvious being that there was only one man on our team.

Yeah, that.

So I saw my student Holly's eyes when listening to that mandolin. That flicker that went across them when that patient spoke those words. And, to quote Holly, a lot of trans women will never look like Laverne Cox. They won't have the "pretty" advantage or mysterious ambiguity that some others enjoy. But still. That woman--that woman who pulled her oxygen mask to the side to say what she said--didn't seem to care about all of that. Yeah, so that was part of what made me cry.

And then there was my patient who, while fighting for her life, shared on rounds with me that her biggest concern was getting some diapers to her auntie's house for her baby. That was her big, big worry. She said her baby probably has a washcloth on her. And then she started crying because, honestly, there just wasn't any sort of solution.

To get diapers, that is.

And me, I was just thinking about her medical problems, you know? How serious and life threatening they were and just how totally first world, in comparison, that getting a box of pampers was.

Except that it wasn't first world to her. It wasn't. To her, it was just her world.

So I thought of that, too. With each cord of that mandolin wailing into the heavens, I did. That brought more tears.

This week, at least three different nights, I woke up and felt something right in front of me in my bed. It was my youngest son, Zachary--ten and a half years old and up to my shoulder, no less. But somehow finding himself under his mama's bosom just like when he was a little toddler. So savvy that he even figured out how to do it without even waking me up.

Yeah.

And so I asked him, "What's up with you coming into my bed, son? Big ol' boy in my bed!" And mostly I laugh about it since it was as unusual as it was funny.

"I don't know, Mom," he replied. "Something just told me that you needed to feel my love this week. Plus I just sort of wanted my mom. So I got in your bed."

And he was right. So very right. Which was also something I thought about as that mandolin played.

Hauntingly beautiful. Painstakingly tender. My growing, athletic and outwardly tough baby boy. Who somehow hasn't lost that inner compass to his mama's heart.

When he was about five or six, he tried to get in bed with me late one night. It had been a long time since that had happened so it startled me. I lifted up my blanket for him, and he started crying when I let him under the comforter next to me. I asked him why he was weeping and he said, "I'm getting big so I thought you'd say no. But sometimes I just want my mom."

To which I replied, "Remember this: Your mom always wants you, too."

Sigh.

I decided right then and there that I love the mandolin. Which probably I should have already known since one of my favorite songs of all time is "Losing My Religion" by R.E.M.  The irony of that song, to me, is that listening to it is always a bit of a religious experience for me.

Yeah.

The rest of the service was amazing. I learned some stuff and was given some good ideas to reflect upon from the sermon. Nobody sat directly beside me or coughed or smacked gum or kicked the back of my seat. They didn't try hugging me when I was crying or intrude upon my mandolin-induced emotional outburst with words of consolation or inquiry. And I'm super glad, too, because I wanted none of that. I just wanted peace on the corner seat. Which was exactly what I got.

On the way out of church, I chatted with Isaiah about a whole bunch of nothing. He told me about what they did in middle school church and I did my best to explain the mandolin making me cry. "I love the sound of the mandolin," I told him. "It makes my heart fill up when I hear it." And since Isaiah said he didn't know what a mandolin was, when we got into the car, I immediately played R.E.M. for him from my iPhone and pointed out the mandolin parts.

He just sort of shrugged and said, "Uh, okay, Mom." Then looked at his phone.

Which was also fine with me.

So yeah. Today, that was me in the corner. Not necessarily in the spotlight. But  as filled with emotion as that man in the spotlight playing that mandolin.

Hauntingly beautiful. Painstakingly tender. Like darkness and light existing together. The light always wins.

"Hey, Isaiah, get that paper and that empty bag off of the back seat for me," I said as we got out of car at home. He did as I asked of him and then walked toward the garbage can to toss the stuff in the trash.

"What'd you get from Target yesterday?"

"Some diapers," I replied. "And some wipes."

The garage door went up and Isaiah just sort of scowled at me. Then he just shook his head, deciding not to bite. "Diapers and wipes. . . . Uh, okay, Mom."

That was all he said before trotting up the stairs two by two and out of sight.

And you know what? That was fine with me, too.

Yeah.

***
Happy Sunday.

Now playing on my mental iPod. . . . the song that me and my friend Mary Moon have connected over and that, just maybe, had something to do with her own baby playing a mandolin. (That might be in my own head, though.)

Sixteen years.

We wear the mask that grins and lies, 

It hides our cheeks and shades our eyes,— 

This debt we pay to human guile; 

With torn and bleeding hearts we smile, 

And mouth with myriad subtleties. 

Why should the world be over-wise, 

In counting all our tears and sighs? 

Nay, let them only see us, while 

       We wear the mask. 

We smile, but, O great Christ, our cries 

To thee from tortured souls arise. 

We sing, but oh the clay is vile 

Beneath our feet, and long the mile; 

But let the world dream otherwise, 

       We wear the mask!

- Paul Laurence Dunbar

We are drawn to Grady for its complexity. The people riding along in the struggle bus just hoping and praying to be seen. Seen by someone who cares for real and not just because caring seems like the cool thing to do this year. We want to be that person. We want to be the one who swoops in and helps. 

Because this is what we do at Grady, right?

July 1 marked my 16th year as a Grady doctor. And in 16 years I've seen a lot. I've grown a lot, too. There are stories that I've heard that would break your heart into a million tiny pieces. Laughter garnered from my patients that would split your side in two and make you vow to cover your ears at all funny things for the rest of your days. 

But. 

Here is what I have especially learned: Those drawn into the doors of this place know not fully what she will offer to them. She changes you. Makes you believe in humanity again and recognize the similarities we share instead of the polarizing differences. Without asking for it, she gives you that. Freely. And those who are most eager for her lessons get the most frequent and most heaping helpings of them. 

They do.

I saw something beautiful today. A patient felt broken. Sad and like their world had not really, truly been worth living. And no, not suicidal but more in this downward spiral. Life looked bleak. And, when I listened, it reminded me of the man who once told me that he felt like bugs were crawling all over his body. Once I leaned in and looked closer to him? He was right. There were bugs crawling all over his body. So sometimes? A bleak outlook on life is exactly what it is. 

Bleak.

But here is the thing about Grady. From some of the hardest, coldest concrete lives, there is still life. And from it, if you stay long enough, you see a leaf shoots out of it. And then a tiny bud. It blooms into a rose. Fragrant, beautiful. And something about seeing that restores hope in the person who watered it, not believing for sure that it would ever become the flower it was designed to be. 

Yeah.

So that? That is what I saw today. A patient was going through it. And that patient was honest about it. Said, "It is what it is--messed up." Family who mostly isn't fully supportive. And the person who was supportive not living long enough to stay in your corner, pat your back and send you back into the ring when you get your mouth piece knocked out. 

That is where we thought we came in. Us. The Grady doctors. With our listening ears and our hearts on our sleeves and our hearts that have just a little extra space inside for the least of these. Because, you know, that's what we do. Thinking all along that it's them who need us. 

Except when you do this you learn. Especially after sixteen years. You learn that, really, people are all a little bit broken somewhere. Us included. And that kindness is kindness and empathy is empathy and that all of it is therapeutic whether you have several letters after your name and student loans on your credit report or not. Every one of us could use that balm for our weary souls in the form of another human being looking in your direction and offering affirmation. Especially when it's genuine. 

I saw that happen today. At Grady, I did.

The patient was seen by a medical student on my team. And under that student's care that patient felt connected and safe. So, to this student, that patient shared a truth that had never been shared. A scary truth that doesn't perfectly fit into the box of "how to be" in the bible belt. And that student sat on a chair and held that patient's hand. 

She sure did.

She listened and nodded and created a safer space than the patient had ever known. A student did this. Yes, a medical student. And it made this tremendous difference that will, I'm sure, lead to better outcome for this patient. I believe that it will.

So I come back in with the team to see the patient. And I do the things an attending physician is supposed to do,  you know? I ask a few questions. I repeat a few parts of the story. I hold the patient's hand and let them know I am an extension of the care they've already received. And if the care hasn't been good? I am the place where that ends. Except, in this instance, it had been good. It had. 

Yeah.

So I go over everything and it is good. This person who'd felt broken was feeling better. Motivated to fight hard as hell to get to the other side of complicated. And a lot of it had to do with this medical student who'd quietly slipped into that room with a tiny pad of paper and a very big heart. Peeled off the mask that the patient had worn for over half of a century. And it was as a amazing as it sounds. 

It was.

But then something happened. That patient turned toward that student. Looked into her eyes and spoke words stronger than any healing salve in your grandmama's medicine cabinet. Trained those big brown eyes on hers and spoke of gratitude. But that isn't all that happened. 

No, it is not.

See, this student also knew of the pain of wearing masks. That patient let it be known that this student and her transparency had provided the wings this patient would need to fly. And it was stated concretely, too. In front of that whole team. Me, the resident, the others on the team. And that patient said that because it was exactly what was deep down inside of their heart. 

Sure was.

"Thank you for giving me the courage to speak the truth. I don't have to pretend I'm a mistake or the wrong person. I'm so proud of you," the patient said to that student. "You are so brave. And I admire you so much for that. Seeing you be so strong makes me feel stronger, too."

That is what that patient said. That. 

Let me tell you--this? This was a magical moment. And another perfect reminder that we think we sign up to do the healing. Here we come in with our little bag of medicine tricks, believing that we have the panacea to whatever ails you. Or at least the brains to talk about it all. 

But.

Like I said before we, too, are broken. We come to Grady for one thing. But we stay or keep coming back for something altogether different. Healing. Our healing. Opportunities to remove our own masks and walk upright. Souls being soothed by humankind and reminded of the very best of who we can be. 

Grady gives that a thousandfold. Maybe even more 'fold than that.

I know I'm totally rambling. I know. 

Anyways.

Today was the very best of Grady Hospital personified. Underscoring yet again that the most important things we can give to our patients are never learned in medical school. We don't come needing to learn that critical piece--humanism. Instead, it is simply our job to fight to keep it intact. I think that what our patients most need from us are exactly the same things we need from other human beings, too. And when we both agree to remove those masks and share freely? It is a beautiful thing, man. It so very is. 

That is what I saw today at Grady. And what I've witnessed for the last sixteen years. 

And I'm thankful for that. Super, duper thankful.

Yeah.

***
Happy Monday. And here's to sixteen more. 

Thank you, Grady for giving me sixteen fantastic years and for saving a piece of my life every day, too. And thank you to that brave medical student for being you. You know who you are.

The Mom Report Card.

"We gon' be alright." 

- Kendrick Lamar

Some days? Man. I feel like the worst mom ever. 

Wait.

That might come across more dramatic than I intended. I mean, obviously not the actual worst in the history of crappy moms. Like, not as bad as that woman I recall seeing on some photo on-line who was taking some really inappropriate selfie snapshots in her bathroom mirror clad in pretty much nothing. . . .  but neglected to note the reflection of her infant child sitting on the tile floor behind her-- in what appeared to be a very full diaper.

Yeah. So maybe not the worst.

But seriously though? There are some days that I just feel like I'm flying on one wing as a mother. And as if my shortcomings will ultimately lead to the same unfortunate demise of a plane trying to operate with only one wing.

Yeah.

Okay, so honestly? Most days, I don't feel this way. But man. When I do? I like really do. I'll be doing something like hurrying to get the kids somewhere. And then my poor planning mixed with their lack of urgency explodes into me barking orders and eventually just setting the house alarm forcing them out of the house. Sometimes holding socks and shoes in their hands. Okay, a lot of times even.

See? I told you it wasn't pretty.

So then we get in the car and someone says a smart ass comment. Or declares that they forgot something quasi-essential to their future success as a student and it becomes abundantly clear that, given our tardiness already, that they'll just be shit out of luck for the day. And I find myself communicating all of this to my kids minus the word "shit" but with enough surly snark to count just as much as the aforementioned expletive.

Yeah. So that's how it goes on some days. And without fail, when the last kid is dropped off, my shoulders slump and I let out a big, defeated sigh. Followed by saying (many times out loud): "You so suck." Then, like always, I start running down my grades on my Mom progress report determining that I just might be at risk for academic mom probation.

Case in point:

Breakfast: Wait. You didn't eat breakfast? Shit. I thought you popped down a waffle, dude. Ugh.

Lunch: Not organic. At least one item with too much sugar.  Or conversely something so healthy that my kid won't eat it at all.

House: Lived in looking. Not hotel neat. Unless somebody other than mom does the clean up job.

Laundry: In dire need of doing. With simultaneous need for done things to be folded. Or moved from the couch after being half folded. Or just so badly in need of doing that everyone is to the point of beach towels being used for regular Tuesday evening showers. Eek.

Homework: Asked about but not confirmed on school website that day. So hoping it's exactly what the kid said it is. A form needs to be signed that I did sign but we left on the kitchen table after I kicked everyone out with the house alarm.

Dinner: You asked for breakfast for dinner. And I said yes. Twice in one week.

Night time reading: Me listening to Audible and you reading whatever I told you to read. Then you bargaining video game time with reading time. And eventually you listening to my Audible book with me, even if an occasional F-bomb is in it.

And so on.

So I go through all of this until I come up with a Mom grade point average which, on days like this, is not EVEN passing. Like, at all. Nope.

So yeah. A few weeks ago that's how I was feeling. Like the mom on mom-probation for poor performance in several subjects.

Yup.

So when this happens, I do my best to chuck myself under the chin. I say stuff to myself like, "They know they are loved. It will all balance out in the end." Then I close my eyes and imagine them slapping knees and laughing as grown up men about how their mom used to flip on the alarm and force them out of the front door in 60 seconds or less. But in the most loving way, of course.

Ha.

I'm not a perfect mom by a long shot. I'm not. And while I do think that I do a great job of loving my children and letting them know how much I love being their mom, on my beat-myself-up days, I tell myself that the best moms do that and feed their kids gluten-free, grass-fed, cage-free, organic food dinners and set timers for video game time. They plan camps like 5 years in advance for the summer instead of 5 days and they don't throw their kids out of the front door under the duress of a beeping ADT alarm. See, man. Those great mamas do all of this. 

And then they do some hot yoga after all of that.

I was exceptionally sucky the other day. I'd made the mistake of starting "Born a Crime" by Trevor Noah on Audible while walking Willow one morning. Oh my goodness. . . the combination of his witty candor and that mesmerizing South African accent of his drew me all the way in. Like. . . . all the way in, man.

Sigh.

My kids would be asking me stuff and I'd yank out one ear bud, raise an eyebrow and try my best not to look impatient. But since my kids know how I get when I get into a crack-equivalent Audible narration that this is just par for the course. Mom will do 90% of everything with iPhone earbuds in until finally that creepy music pipes in that says, "This has been a production of Audible."

I even set the house alarm while listening to Trevor Noah this morning. "You got 60 seconds, dudes. Chop chop," I said. I wish I could say that wasn't true. See? Those really good moms would never do something like that. The only person who gets a mom upgrade when I'm on an Audible binge is Willow because he almost always can count on a longer walk. Otherwise everyone else? Not so much. Ha.

Anywho.

I am really just rambling mostly about how this motherhood thing isn't for sissies, man. It's no joke. Especially when you intermittently suck as a mom.

Ha.

Now. Before you go worrying about me, know that I generally think well of myself. And though my marks in the mom class are not always passing, I have an extensive history of figuring out how to round out my grade in the end. So I'm hoping big time that this is what happens with these two little dudes living under this roof with the BHE and me.

Which reminds me of something else that happened recently. Like to hear it? Here it go.

So check it: A few months ago, I was in one of my mom-probation slumps. While I wasn't Audible binging or Netflix binging, I was busy with work and generally ready for the kids to be out of school. Most of my head butting was with Isaiah and somehow it almost always went down when it was just us two in the car. He's now twelve and growing smarter and smarter by the year. But not just smart. Smart and a smart-ass at the same time.

Now.

Because this kid has always been an old soul with a cantankerous streak like an old man in a barber shop, he likes to push my buttons. Questions things that are generally worth questioning but does so at the most inopportune times. Furthermore, he calls me out on things that are 100% true which, when I'm running late or already feeling a bit low, I could do without.

Ugggh.

So on this one day, Isaiah began pointing out that I need to work on not being distracted behind the wheel. Then he started talking about how just because I'm not texting doesn't mean I'm not distracted. And since he's like an old man, I come right back at him like he's not even a kid. Or rather, like I'm not even an adult. Yeah. More like that. It's pretty funny, actually.

"Mom. Checking your eyelash make up stuff at a red light is still a distraction."

"It's called mascara."

"Well checking it makes people honk at you. That guy was honking because you needed to go."

"I did go."

"Once he honked."

"Horn honking is rude, man. Where I'm from? You don't go honking your horn for no reason."

"He had a reason. You were looking in that visor mirror checking picking black stuff off your eyelashes. Which looks not so good anyway so I'm not sure why you do it."

"Do me a favor. Let's ride in silence."

"That's not a favor."

"You're killing me."

"I want you not to be looking in the mirror so you won't be killing me."

I scowl in the mirror. He smirks back. And eventually the whole cycle restarts with another surly exchange.  So yeah. This went on for probably the last few weeks of school. And each day we'd bicker about the most unimportant things of all time. Then, I'd ask him a question about something he needed to have done and from there, would end up shifting from petty tween with him to fussing, nagging mom.

Yeah.

After enough days like this, you start feeling like you're dropping the mom ball, man. My sweet baby that wanted to hug and cuddle me was now groaning in my direction and ducking my hugs. I told myself that this was age appropriate although some piece of me had always hoped that tween-age behavior would somehow skip my boys.

So yeah. That was going on and I was feeling tired. Tired of no longer being sweet and awesome mom. I liked being her. Man, I did.

This one day, I pulled into Isaiah's school on two wheels to pick him up at the last minute from after school care. I scurried up the path to the gym and another mom decided she'd chat with me--even though I was clearly in a hurry.

"Did you see the 6th grade art project?"

"Um, no. I need to see it." Another reminder of my poor mom grades. Because clearly she'd seen it.

"You should stop on the way out to see it," she said.

"Uhh. . . yeah, I'll be sure to check it out." I started walking to the door. But she spoke again.

"It's pretty amazing. Especially Isaiah's part. Did he tell you about his part?"

Another 'F' on my record. "I'm trying to remember." Except I wasn't trying to remember. I'd heard him mention the 6th grade art project and how he'd decided what he'd do. I asked if he needed anything and he said no. So that was it.

I did at least know that the project was this giant tapestry made up of tiles drawn by kids in the class. That compliment given of Isaiah's part didn't shock me considering he's a pretty creative dude. But her persistence was a bit off putting. "You should really consider stopping in the main building to see it before you leave today."

That was the last thing she said.

When Isaiah got into the car, I asked him about the project. "What'd you do?" I queried.

And he shrugged a surly twelve year old shrug, yawned and leaned his head against the window.

Grrrr.

I whipped my minivan around and made my way out of the parking lot. That woman imploring me to look at the art display niggled at me. Finally I pulled right next to the door and told Isaiah I wanted to run in to see the project.

"Coming with?" I asked.

"Nah. I'm good," he replied.

And so. I punch in the door code and hustle inside. Immediately I see this big quilt-like thing covering part of the cafeteria wall. It's made up of several squares each drawn by a different pair of hands.

"Oh. Okay, I get it," I said out loud. I said that because the project was a tribute to Influential African American Women in US History. This very liberal parent at my child's very liberal school was encouraging me, a black woman, to revel in this special celebration of sisters lovingly put together by my son's entire grade. Like, urgently.

Well that was nice.

I stood there looking. Lip jutted out and nodding. Ode to black women movers and shakers, huh? Cool. So yeah, I guess it's fair to say it did make my heart feel warm knowing that this activity is what his entire class was working on and thinking about and talking about. And that his school had deemed this the kind of thing worthy of their attention.

Not to mention it wasn't even February, man.

So I'm checking it out. It was an impressively diverse group of women, too. From several eras which was pretty darn awesome. Sojourner Truth. Phillis Wheatley. Michelle Obama. Marian Wright Edelman. Shirley Chisholm. Nikki Giovanni. Simone Biles. Oprah Winfrey. Lena Horne. Barbara Jordan. Debbie Allen. Misty Copeland. Maya Angelou and. . . . wait. . .who?

So there it was. Plain as day. My name. Kimberly Manning. Listed among the Harriet Tubmans and the Ruby Dees. My name. Chosen by my child as his Influential African American Woman in US history.

Wearing a damn superhero cape, no less. Seriously? Seriously.

Yeah, man.

I stood there in silent disbelief for at least two or three minutes. Then I slipped back into my car and started the ignition. Isaiah was now dozing off in the back seat.

"Son?" He opened his eyes and didn't move. His eyebrows went up to let me know he heard me. "Son?"

"Yes, ma'am." His voice was flat, purely obligatory. He knows his mother well enough to recognize that that second "son" meant to open his mouth and answer with words.

"I saw your drawing. For the project. That was amazing." I immediately started to cry.

"Oh my gosh, Mom. Are you seriously crying?"

"Of all the people though. I guess. . .I don't know. . . you picked me?"

He shrugged. "They said for us to pick an Influential African American Woman in US History. So I told my teacher that my mom is a doctor who writes and teaches. And that she's super influential to a lot of people." I just stared through the rear view mirror. Then he added, "Or at least she is to me."

After that, he just let his eyelids fall closed again and didn't say much else. Which was fine with me because I was trying my best not to let him hear me full-on ugly crying while driving the whole way home.

Yeah.

So listen. . . .  there are some days that I feel like a complete mom failure. And definitely in the runner-up finalists for the worst mom ever. But then. . . something happens that makes me feel like I just nailed the final exam and brought my grade all the way back up to a solid A, man.

This? This was one of those times.

Am I a perfect mom? Nope. But if this . . .this is who my kid envisions when he takes out a box of colored pencils to describe his mother and whom he perceives to be an influential black woman? Then I just might pass this Mom class after all.

Maybe even with honors.


Yeah.

***

On Moonlight.

"You can't be what you can't see."

~ Anonymous.

I do not mind seeing you in hair salons or in chic shopping malls. Laughing louder than the rest with exaggerated hand gestures and a language all your own. Occasionally addressing your closest friends by the word used to describe a female dog even though they are neither female or canine. Hips swinging just a little more than usual, eyebrows telling the world that you don't conform to any gender. Or you do but you want to define what that looks like. No. I don't mind that at all.

But.

I do mind that this--even if it is authentically you--gets amplified into this larger-than-life caricature that elbows all of the other facets of those like you to the shadows. That I do mind.

When I was sixteen, I lived in Inglewood, California. I was what rapper L.L. Cool J would have referred to as an "around the way" girl with two pairs of bamboo earrings in my ears, easy subject verb disagreement, and neck rolling to get my point across often times than not. I remember standing behind the counter at my job as a cashier at Foot Locker in the now extinct Hawthorne Mall chewing a gigantic wad of Hubba Bubba, poking the register with my elaborately decorated acrylic nails and greeting each customer with the same three words: "How you doing?"

No. Not "how ARE you doing" or "how're you doing" but exactly what I just said. And this wasn't because I was trying to be something or create some version of me. This was just who I was at that time. And that was fine.

But I was also a lot of other things. And so were my friends. Some were nothing like me, voices with the singsongy twang of the Valley due to their lives on opposite sides of town. Others were far more unabashedly urban than me, the varsity cheerleader Foot Locker cashier, and that was cool, too. My best friend was studious, outgoing and neither of these things. And all of us represented what young, coming-of-age black girls looked like.

Yeah.

So I found myself reflecting on this after going to see a movie the other day. This independent film that had gotten a lot of critical acclaim but that, for the most part, has ridden slightly below the radar of the mainstream. A friend had seen it and loved it and thought I would, too. I had a few hours off on Monday, so we met up to see it together. Even though we saw a daytime matinee, this movie "Moonlight" left my soul mixed with the same melancholy one feels when standing under a gleaming full moon.

Yeah.

And let me be clear: There was so, so much to take in from this movie. But I guess the thing that keeps floating to the surface of my thoughts is how beautifully you were portrayed.

Yes, you.

No one was snapping in a Z formation. Not one individual called another friend "bitch" in jest or pronounced the word "yes" with a soft A followed by a loud cackle. And no, there is nothing wrong with that, you know? I mean, if that is you. But this movie, this sublime piece of work, put the other pieces of the dream that makes up who you are on a gigantic screen for all to see. For me to see.

And seeing stuff makes you less afraid and confused, you know? Yes. That.

The friend I saw the movie with is like you. A same-gender loving black man with thoughts and feelings and a life time of experiences that has shaped him into who he is. And seeing it with him, perhaps, made my breath hitch even more. I realized that I thought I saw him for all these years. But I hadn't fully. And am still working to see him.

This? This movie helped me with that. It showed the complexities of growing up in a world that isn't always filled with love. Navigating a shitty environment while also struggling to find and own who you are. And no. It wasn't a "gay movie." It wasn't. It was an exquisite portrayal of a sliver of life. A piece that has been there all along but that we don't get to see. Even those of us that call ourselves looking hard with eyes wide open.

Yeah.

My Wet 'n' Wild .99 cent lipstick, door-knocker earrings and biker shorts probably did fit some cartoonish idea of the 1980's black girl back then. Spike Lee put us on mainstream screens with all of that, just like (some of us) were in real life and that felt good. But right next to lolly pop licking neighborhood girls were the Ruby Dees and the other grown ass black women splashed upon those movie screens. All the different versions of us. We were also on small screens as Claire Huxtable or collegiates like Lisa Bonet and her friends on "A Different World." Not only did we get to see them, so did the world.

So did the world.

At first, I was sort of speechless when "Moonlight" ended. My soul was stirring but I didn't know how to feel. I walked to the restroom afterward and came out still drying my hands on a paper towel. My friend David M. was standing there chatting with the movie theater manager, Chuckie, who also happened to be a same-gender loving black man. I smiled at them both.

"Well? What did you think of the movie?" Chuckie asked.

I parted my lips to speak and suddenly felt like I'd been punched in my chest. My eyes welled up with tears and I started full on crying. Hard. It was actually rather embarrassing.

"Why are you crying, hon?" Chuckie's tone was gentle. He really wanted to know. All I could do was shrug.

David knows me so just sort of watched and waited. I then saw a tear trickle down his cheek but never asked why it was there. I tried to express myself but knew I wasn't making much sense. I just knew that my heart was feeling overwhelmed with emotion and . . I don't know. . .awareness, maybe? I don't know.

But not because it was a "gay movie" and that I'm so damn renaissance that now--oh yes, NOW--I'm all open-minded and down with the cause. Because that would reduce this to something akin to someone staring on the outside looking through the glass of a piece of art in the Louvre. Looking and staring but not touching or being a part of the painting.

See, David and Chuckie are just two people. Two very different people. And just like the protagonist, Chiron, in the movie "Moonlight" was one person, like them he had a story--his own story--and feelings, too. And not just like them--like me, too.

Sigh. I bet none of this is making sense. But what I am trying to unpack here is that Barry Jenkins, the man who brought this to the screen, unfolded an aspect of life that doesn't get shown like this. Joy, pain, sunshine and rain--the same kind we all feel and try hard as hell to sort out when we are young and confused about any and everything. And beautifully turns a mirror on all of us, you know?

Yes, that.

I think that's what made me cry. It dawned on me that we all want the same things--as children and as adults. To matter and to be cherished. That looks different ways to different people. But it is as necessary as air and water. Regardless of who you are.

Seeing that movie in a bona fide theater was a step in the direction of cherishing the narrative that so many live. More than the wise-cracking hair stylist talking shit with the marcel curling irons in his hand or the kid strutting down the street to jeers at a parade.

Kind of like how on "A Different World" I could identify with spunky Jada Pinkett's braid-wearing, lip-curling, shit-talking character right along with all of those cocoa-complexioned college girls on the same show trying to navigate young adulthood. I was all of them. And sometimes none of them. But it gave me value to see them all. But little did others know that it helped them to value me, too.  Because it helped those other people to not be afraid of me and my essence when coming into my presence. Or feel disappointed or confused when I don't fit the singular idea of what the media portrays me to be.

And see, that's what this movie did so bravely and beautifully. For me, that's what it did.

Does this make sense? I hope so.

And so. Today, I'm still basking in the afterglow of seeing "Moonlight." And today, I am reflecting on just this one teeny-tiny aspect of the many, many things I've been left to think about after seeing it.

Here's what I know for sure: I am better for seeing it. Because seeing it helped me see more of myself. Which ultimately helps me see more of you.

Yeah.

***
Happy Hump Day. And thanks, David, for trusting me to see it with you.

Now playing on my mental iPod. . .this was me. . .but not all of me. Then or now. 

The Bad News Bearers.

The original 1976 Bad News Bears--one of our favorite movies as kids.

"The bad news is that 50 people died in a hotel fire. 

The good news is that we got exclusive coverage."

- Jessica Savitch

We were all sitting outside on the brick wall between classes she walked up. Her eyes were dancing, flitting from side to side. She licked her lips and brushed her hair out of the way from her mouth. "Did you guys hear about Dawn?" Her eyebrows went up when she said that part, waiting for our reply. You could tell from the looks on our faces, we didn't know this news. But there was one thing we did know. She was going to tell us.

Yup.

"She didn't pass the boards, man. Again." Her face fell into this dramatic frown. And honestly, I was so young back then that I didn't recognize that this was a pattern.

We all reacted. "Damn, that sucks," one person said. "Awww, wow. I hate hearing that," another said. And she kind of nodded and took it in. Stirring the pot with a few more tidbits like the fact that she might not graduate at all and that, to make matters worse, her boyfriend was out around town cheating on her while she was already down.

Mmmm hmmmm.

And now, when I look back, I see it. The very edge of her mouth turned up a bit and her voice quickened in exhilaration. Why? I'll tell you. This classmate was one of those people that liked sharing bad news. Like some piece of it almost made her euphoric.

Yup.

There was this guy I knew in residency who was similar to this. He loved to casually drop bombs in the cafeteria about how someone screwed something up on call or didn't get a job or overslept and got called by the chief residents. Every second of it made him high. So he hit that pipe repeatedly.

Yup.

Oh yeah. And then in my recent life, there was this person that kept kept kept texting me updates about this really, really, really awful thing that was happening to a mutual friend. Wanting to discuss it over and over again or clarify the shittiest parts in case I'd missed them or tried to see some silver lining. All of it made me anxious. Not to mention like some bolt of lightening would strike my phone every time I texted back some sort of nondescript response like "Whoa" or "OMG that sucks" or "Dang."

Yeah.

So what I realized is that peoples' woes are favorite pastimes for some folks to follow. The crappier the news the better, too. Whether the person intentionally feels giddy telling it on the mountain or not. I call them the "bad news bearers."

Yeah. That.

I guess I'm thinking of them today because of my last few days at work. Nearly every day, I am charged with pulling up a chair and telling some unfortunate news. Like, I tell people the kind of stuff that will thrust them hard and fast into a new normal that they didn't even know or want to be signed up for.

Nope.

And see, me? My job is to bust into the room and, in the most empathic way I can, shit on someone's entire existence. You know? I have yet to get used to it. And one thing I can say for sure is that I never enjoy it.

This got me thinking about people who dig hearing of someone's hard time and who love telling someone else about it even more. And let me be clear: It's not like I genuinely believe that people do this on purpose or feel this way intentionally. I guess I just sort of think of it as how they're wired.

Maybe? Maybe not.

I hate being the bearer of bad news. Little bad and big bad, I don't like it. Like, over the weekend I had a patient who was really, really ready to go home. And one of his lab tests was very abnormal and just too abnormal for him to go home and me be able to sleep soundly. I needed to watch him another day.

My team had told him he was leaving. And he thought he was, too. So I go in the room and tell him otherwise. That I'm just too concerned to not watch this value one more day. That I needed him in house to make certain nothing life threatening was brewing. And honestly? This was little bad news. Not big bad news. Like, he had family support and a way to manage. But still. I hated telling him that his body wasn't all the way ready to go and that he had to remain in the hospital.

Yeah.

And then there's the big bad news. Like the person to whom I tried my best to explain the difference between regular chemotherapy and palliative chemotherapy. Me realizing that eventually that puzzled expression would be replaced by something much worse. It sucks to be the person who slams the door on the "what ifs" and hypothetical versions of something. My heart does not feel paradoxically happy or glad that I get to be the one who is doing it.

Nope.

I feel similarly about real life bad news. I learned of someone who is at the start of a divorce proceeding. It will be a shocking to people to hear it, too. I heard it from that very someone who told me of her situation. "It's not a secret at this point," she said. And her voice was stoic and brave. It was.

Now this? This was some bad news. But my thoughts wandered back to those town cryers who took pleasure in spreading this kind of news followed by feigned concern. Which reminds me--I pretty much left one of my favorite Facebook groups after someone shared all about another person's unfortunate marital issues which garnered all sorts of comments and postulations peppered with those "praying for you" lines that, I guess, serve as the olive branch after a sucker punch.

Yeah.

And listen. I am human so of course I do have some amount of nosiness and mischief in me. I mean, I do like to know what's going on around me to some degree. But. Rehashing and re-rehashing peoples' fucked up situations? It's not fun to me. Especially as I get older. Especially as I get older, man. Because getting older has this way of giving everyone a chance to sit in the bad news hot seat at some point. So, nah. I don't feel delight when I get the scoop about someone being down on their luck. Not even those people that I don't particularly like or who most would say had it coming.

Yeah, I said it. I'm silently rooting for the assholes, too. Ha.

Divorce. Losing a job. Failing a board exam. Infidelity. Getting in trouble with the law. Not being able to get pregnant. These are the sorts of effed up things? I'm happy to let someone else tell the world. They are the things that, short of unpacking in private with my best friend or husband,  I try my best leave to someone else.

Because bad news sucks. And I hate being the bad news bearer.

Metastatic cancer. Life altering health concerns. Medications like steroids that will alter your appearance. And, perhaps, an extremity that needs to be amputated to save your life. These are the kinds of things I have no choice but to tell. And so. I do.

And I hate every second of it.

Every.
Last.
One.

Yeah.

"If you're gonna bring me something, bring me something I can use.

Don't nobody bring me no bad news."

- Evilene, the wicked witch from "The Wiz"

#exactly

***
Happy Day-before-election-day

And who knew that they remade The Bad News Bears movie with one of my favorite humans ever Billy Bob Thornton? OMG. So gonna find that on Netflix and chill with it very soon.



And just because Deanna would call it blasphemy to only put the remake clip, here's a clip from the original movie, which was one of our absolute faves as kids. I think Deanna, Will, JoLai and I saw this now less than seven hundred trillion times.  



And obvi, I have to include this from our other favorite kid movie The Wiz--"Don't nobody bring me no bad news." 

Being bothered.

There is this lady. This lady that I see every day at a point in my day. Pretty much at the same time. Like, if I walk the direction I need to walk to get where I need to get, I will see her. See her in the path of where I am going. That is, if I take the way that is fastest to get where I need to go. Which is mostly what I do.

Yep.

So every day, there she is. Doing what she does while I go where I go. But then, whenever I get closer she eases in my direction. Comes nearby and says a cheerful hello, like always. Includes some open ended questions that call for me to open it into a conversation. And then, if I don't run any form of interference, she will pause to chat. A little bit about this. A little bit about that. And a little bit about the other, too.

Yeah.

All of it takes no more than 2 minutes, really. And sometimes less than that if all she wants his a hello and a hug. She is a hugger. One who puts her whole body into those hugs, too. Both arms, torso to torso, and pressing into you. Complete with the "mmmmm-mmmm!" sound effects. Yes, she does that.

She does.

But. There are some days. Like, some days where I feel like I'm super busy and feeling harried. Or where I'm late.  Like, where I really just want to get to where I am trying to get without stopping to chit or chat or hey or hug. Even for a moment. Telling myself that I am just "focused" today and want to just stay on my task. Whatever that task may be.

And so. On those days, my walk is more brisk. My body language is fast and deliberately standoffish. I typed and deleted that last sentence twice. That word "standoffish" made me cringe. Especially when connected to me. I had to add it back because it is true of what happens. That is what I do. Like,  on those days, I do this thing to demonstrate that I don't want to be interrupted. Not even for a hug.

Nope.

So on those days, she will call to me in her singsongy voice as I whisk past going wherever I need to go. She simply calls out a "hello" that floats out into the vacuous hallway then swirls down to the ground like some kind of lonely feather. My salutation in return shoots out and hits it like a fast ball. Quick, pressured. Making it clear that it would be this one pitch. And that's it.

Yeah.

Doing that always feels bad. I mean, because it's not nice really. I'm old enough to know that. So on a lot of days, I just take this really circuitous route to the place I need to go that doesn't take me past the place where I would pass her. But fickle fate somehow always reroutes her path to overlie my own at some point. It does. So then, I'm back to where I was. Either cooling my jets or deciding to turn them on high.

Sigh.

I am not proud of this. I'm writing about this because I am just thinking this morning. I'm thinking about those two minutes (or less) that I so stingily clasp in my hand. My decision to withhold some piece of me, albeit a fleeting piece, because I just sort of don't feel like being bothered. And you know? I am really not sure why I don't want to be bothered by this very sweet individual on some days.

There is this melancholia about her. Like this piece of her that I can tell needs a human interaction as much as she can get it. And I think it's even worse that I am not always forthcoming with it since I know that. Like some sort of middle school mean girl who has decided not to be your friend. On certain days.

Maybe the sadness in her eyes overwhelms me. Makes me feel like what I give needs to be all or none. And like the all isn't necessarily my job since I work a job where I have to give that kind of all all the time.

I don't know.

I know about pieces of her world. Even though I don't have a lot of contact with her, there is the stuff she has told me. And, no, I don't know what her full world is like away from the place where I pass her each day. But what I am processing this morning is this realization that I am a tiny sliver of her world.

I am.

There's probably some complicated piece of my psyche that this underscores. And I don't know what that is since I'm not a psychiatrist. But what I do know is that I love people. And I want to be a good person.

So today, I've made up my mind. To be bothered. And interrupted. By her.

And before you say that, from what you read on this here blog, I seem very good about being bothered, I will say that on some accounts I am. Like, I am very, very good about say, a stranger, in the Grady hallway hitting my pause button because they are lost. Or that wayward medical student who wants to pick my brain. But this? This is different. This interruption is like that movie Groundhog Day. I know what's going to happen. Yet I find myself using some energy to redefine the outcome and order of events.

I'm not really even sure why.

Withholding kindness isn't cool. Even if on other days you give an extra heaping helping of it, it's not.  And so. I am going to work on that. With her. With me. Because two minutes is nothing. Except for when it's something.

Yeah.

***
Happy Sunday

Jeopardy.

my situation on June 23, 2016. Literally.

jeop·ard·y

ˈjepərdē/

noun

1. danger of loss, harm, or failure.

Two weeks ago, I did something that I have never done in my entire medical career. Had I come close to it before? Yes. And is it something I probably should have done a few times in the past? Definitely.

So . . .  what was it that happened, you ask? Well, I'll tell you. Um, yeah. . . I'll tell you even though, after twenty full years of not doing this, it's pretty hard to actually confess. I. . I. . .sigh. Okay. . .I. . .I . . . I .  . whew.

I. Called. In. Sick.

*squeezes eyes closed and turns head so you won't look at me*

Yup.

It was the week of our interns' orientation in the hospital. Those first few days had gone just fine and at the end of the hustle-bustle of a particularly crazy afternoon, I popped by a casual eatery to grab a late lunch. And that part was fine, too.

Yep.

It wasn't until about an hour and a half later that I began feeling this cramping sensation in my midsection. My tumbly became rumbly and before I knew it, I was in and out of the restroom doing what the Grady elders (and my daddy) refer to as "running off." Somehow I managed to get a long enough window to get over to get the kids from their camps but admit that I sprinted from my car to the front door.

Thank goodness I did.

And you know? The running off part I could mostly deal with. I mean, I was hydrating and such and told myself that if there wasn't anything in my gut, the "running off" would eventually "run out." But then came the nausea. And then came the vomiting.

Uggh.

And so. I pretty much spent the next several hours trying to decide which end of my body to aim at the commode. I tried all those home remedies like ginger ale and the non-home remedies, too, like antiemetics and antidiarrheals. But mostly, this was something that was just going to have to run it's course. Literally.

I didn't catch a wink of sleep until about 4:30 that next morning. My alarm went off at 6am and I just sort of stared at it for a few beats before silencing it. Finally, I sat up on the end of the bed and prepared to treat the day like any other Thursday. I grabbed a t-shirt and a pair of sweats, pulled on some socks and shoes and prepared to walk Willow. And that was fine, too.

Well, I take that back. It actually would have been fine if I wasn't lightheaded from my certain dehydration and on the verge of vomiting the remains of the Canada Dry ginger ale and the electrolyte drink that I'd carefully sipped all night. After only two steps toward the door, I felt my belly churning again. But still, I grabbed the leash (and my tummy at the same time) and took Willow for what I am sure was the least gratifying dog walk ever.

You know? I didn't even think to wake Harry and ask him to take the dog out instead. Even though I knew he would have, I didn't. Then, when I came back inside, I stood staring at the medicine cabinet and trying to decide which concoction would allow me the best chance at not barfing all over a patient. Or passing out on them.

Yeah.

But somewhere in the middle of all of that, I spoke out loud even though no one but me was awake. "I  really, really feel like shit." Which, I am sure, is exactly what I said. Followed by a dry heave.

And right then and there, I had an ah hah moment. I recalled all of the times I've told countless residents that self care is essential. Even though, particularly when it has come to personal illness, I've never given my health priority over going to work.

Nope.

It dawned on me that if I were advising any of my students or residents, I would tell them to immediately contact a supervisor in order to afford that supervisor as much time as possible to cover the clinical duties. And then I'd tell them to drink, drink, drink fluids like crazy and get in bed under the covers and get some legit rest. And/or seek medical attention if it is even more serious.

But for myself? Chile please.

So with my dog at my feet wagging his tail and me hunched over the kitchen sink on one elbow out of fear of projectile vomit, I made up my mind to do the unthinkable. Yes. I decided to call in sick.

Um, because I was. Sick, that is.

Now. I tried as hard as I could to recall a time ever in my career that I'd done that but came up with nothing. And I think I came up with nothing because that adequately represents how many times I've decided to stay in my household infirmary versus crappily do my job while ill. And how many times I acknowledged that I was too unwell to work.

I blame jeopardy. Confused? Okay. Let me explain.

At nearly every residency training program, there is this back up schedule that is designed precisely for moments such as these. And you know? Nearly every residency training program calls it by the same name: JEOPARDY.

Yup.

So when one is sick, they call the chief resident or schedulers or whomever--and that individual refers to the "jeopardy schedule" and notifies some unlucky soul who, up until that moment, was basking in an awesomely easy assignment. Only to be thrust into the firing line of some essential patient care situation such as the intensive care unit, hospital service, or something else even more hellacious. And yeah, it's exactly as sucky as it sounds when you get called.

Yup.

Similar to, say, jury duty, everyone knows that the jeopardy schedule is everybody's necessary civic duty. That is, in the resident community. But, just like jury duty, it isn't one of those things anybody is particularly pumped up about getting notified about. But physician jeopardy is more complicated than that.

Totally.

When I was a resident, we had this longstanding culture of bravado when it came to toughing it out through illness on the job. And I can't say that it was because our program leadership wasn't supportive of our personal needs. It was just this thing that sort of happened, you know? Most of the time they had no idea.

Nope.

Well, I take that back. They were supportive when a person actually endorsed being ill as a reason to call off. But because they came up in the same system, I can't ever remember anyone insisting that someone leave back then. Go lie down for a few moments? Sure. But full on leave and cause another resident to be called in? Never.

Oh, and before I go further, I will say that there is always this teeny, tiny subset of individuals that call jeopardy 200% more than anyone else in their entire program. Most notable was this girl who had taken two benadryl on accident and called in because she was afraid she'd be drowsy. (Me countering her with the half life of benadryl, which she'd consumed 4 hours before, didn't seem to make a difference.)

Anyways. The vast majority of my resident colleagues worked when ill. Furthermore, there was this esprit de corps between us that caused us to rally around the sick guy and fill in the gaps. (Forget the fact that everyone was getting exposed to whatever illness the person had.)

Uhhh, yeah.

A few times stand out in particular. One was my junior year when I was taking call in the cardiac care unit (CCU.) I came down with fever, chills and a terrible headache. My neck was tight and I had some nausea and diarrhea, too. It was the summer and I had just come off of the pediatric inpatient service where kids with aseptic meningitis from enteroviruses was rampant. I even had a tell-tale viral exanthem (rash) to go with my constellation of symptoms. And you know? I was 99.9% sure that viral meningitis was exactly what was going on with me.

Maybe even surer than that.

I called one of my classmates (who was also on call) and asked him to come examine me in the nurses station which he did. "Dude. You probably got viral meninge. You gonna go to the ER and let a second month intern do a spinal tap on you?" He bit into the room temperature honey bun he was eating and laughed at his own joke.

"No way, dude. Did you see my rash?" I asked while pulling up my sleeve.

"Cool," he replied. "So what are you gonna do?"

"I think if I take some Motrin, I can make it through the night."

"Yeah, probably so."

And I am not kidding you. This is what happened. I took the call, fever, stiff neck and all.

Super stupid. Especially since it could have been something far more serious.

That same friend called me the following year (when we were both on call again) to check him out in a call room. He'd developed some shaking chills and a nasty, rattly cough rather suddenly. When I got there, he was breathing super fast. "Dude! Holy shit. You look like you're about to code."

"I feel like I'm about to code."

I listened to his lungs. "Yikes. You've got signs of consolidation. This looks like a bad pneumonia. And that history, man! You might have pneumococcus, I think."

"Hmmm. Cool. Think I can tough it out?"

"You're breathing pretty fast, bud. Let's go to the PICU nurses station and pop a pulse oximiter on you to see if you're hypoxic." Which is exactly what we did.

Guess what his oxygen saturation was? 82% (96-100% is normal.) Craziness.

Let me tell you. This guy? He looked sick-sick. It was NOT a soft call. At all. That said, I am convinced that were it not for the whole needing oxygen thing, he would have slugged it out through that call with his pneumonia.

Yup.

Would you believe that he got admitted to the hospital that very night? And you know? We were so entrenched in that culture that I can remember like yesterday cracking jokes in his room about him spreading TB to the interns and telling him that I was totally going to present him in morning report the next day.

Which he found funny, too. That is, when he wasn't nearly about to code.

Uh, yeah.

I blame this word "jeopardy." The actual definition means "danger of loss, harm or failure." I can't think of anyone who has ever wanted to be the one responsible for putting someone in that situation--that is, one involving jeopardy. Especially another overtired resident who finally, finally, finally is on a lighter work assignment.

But see, that word just underscores the culture. It sounds heinous, punitive even. And to tap into it literally puts another person in peril, if you follow the definition. And I think that's a part of the problem, frankly.

The one time I called jeopardy as a resident was when my father had a massive heart attack requiring emergency surgery. And you know what? I actually took call all night before taking a flight out, now that I think about it. We also have a jeopardy schedule (also called "jeopardy") in my current faculty position and you know what? The one time I called jeopardy with this group then was on November 15, 2012--the night my sister Deanna passed away.

Yup.

So yeah. I am reflecting on all of this and realizing that doctors who neglect themselves really aren't the best physicians at all.  Coming to work while truly ill puts patients in danger, can make things worse and it probably increases the chance of an error happening.

Now. Do I think folks should be calling off for sniffles or allergies? No. Do I think taking two benadryl should allow a rain delay at best but not a full on call off? Damn right. But do I believe that a vomiting, diarrhea-ing, teeth-chattering person should have another able physician working in their place? Definitely.

If you ask me (though no one did) the first step is changing the name. Instead of calling it "JEOPARDY" it might be better to refer to it as "FAMLY EMERGENCY/ILLNESS PATIENT CARE BACK UP." This way, those who need it will understand when it is to be called. And those who get called will feel okay with being called in.

We could even call it "FEIBU" (pronouced FAY-BOO?) for short. As a reminder that this is for FAMILY EMERGENCIES and ILLNESS when back up is needed. And that FAMILY EMERGENCIES and ILLNESS happen and aren't a sign of weakness at all. 

Mmmm hmmmm.

Oh, and the times that folks get pulled in because of human scheduling glitches NOT due to the needs of a colleague dealing with a FAMILY EMERGENCY or ILLNESS? Well. Keep right on calling those times  "jeopardy."

Ha.

So yeah. I acknowledged that I was ill and called off the other day. My colleague Stacie S. was great and made sure I didn't have to feel guilty. And my other colleague Alanna S. was super kind about picking up my slack in the resident clinic that morning. And you know? I think if my patients knew of my decision, they would have appreciated my choice to call off, too.

And so. I drank fluids and rested in my bed all day. That photo is proof that I was exactly where I was supposed to be, too. I went through a whole lot of hand sanitizer and considered going to get a bolus of IV fluids at one point. But the next morning, I felt a thousand percent better which taught me a mighty lesson.

And you know the best part? Not a single patient was harmed or put in jeopardy--thanks to my decision to first put the oxygen on myself.

Yeah.

***
Happy Sunday.

Now playing on my mental iPod. . . .