Life in pictures: The days on and around Thanksgiving.

Yummy peppermint soy latte on Thanksgiving eve.

Red glitter is sentimental to me. This red glitter manicure makes me happy when I look at it for that reason.

Spending time reflecting on the lives of those who are no longer with us. Because remembering people has to be intentional. We had fun talking about C.J. and his life.

And of course, we talked about Auntie Deanna. We also reminisced on this:

"Super Turkey" -- the red glittered masterpiece that Deanna created with Zachary on the last night we all spent together. That red-glitered wattle led to a whoooole lot of red-glittered everything else.

Ha.

Again. For memories of special people to stay on the front burner, we have to remain intentional. This always feels good when we do it.

I look at these guys and feel like my heart just might explode sometimes.

Small Group Delta is officially done with their preclinical work. Next stop, the hospital wards. Wow, how the time flies!

These images make me so happy and remind me of why I'm so fortunate to be a small group advisor. I'm super, duper thankful for them.

Nothing like waking up and running strong for 13.1 miles on a Thanksgiving morning. Especially when two years ago, you could barely run more than 2 or 3 miles.

Yup.

I love that this is my second Atlanta Thanksgiving Day Half Marathon. It is a reminder of how blessed I am to have two legs that work, a heart that pumps and a soul that feels the magnitude of that.

Doing it with some of your best girlfriends? Bonus.

I felt strong when I smiled for this photo. Like I could do anything I put my mind, heart and soul into doing. Do you ever feel that way?

People kept running by me saying, "Way to go, Strong Mom!" I loved it because that's how I felt.

It is never official until the "Oh what a feeling" Toyota jump pic at the end. I'm now laughing because that reference shows my age.

This race yielded two medals. One for the half marathon and the other if you completed the "Triple Peach." Peachtree Road Race, Atlanta Ten Miler, and Atlanta Thanksgiving Half.

Run. Run. Run. And done. Cool right?

Another of my fit, fab friends getting her jump on. Loved this photo of Tamika W. and especially that she asked a stranger to take it. Ha. It made me so happy when I saw it.

My partner in running crime, Frieda AKA FreeFree.  We call ourselves "the beastie girls." Ha.

That name is quite fitting, actually.

Hair salon selfie. For no reason at all. Wait. There is a reason. I love my hair stylist and wanted to snap a picture of a happy time we were sharing that afternoon in her chair. I'm so thankful for Sakinah, her scissors and her beautiful spirit and smile.

Basketball practice with Zachary earlier this week. Basics first. I enjoy watching his determination with sports.

My brother was having fun with a new app he got on his phone on Thanksgiving. This creepy hybrid picture of my nephew and me was a result of those shenanigans.

I know what I'd look like as a guy now. Thanks, Will.

 Playdate nirvana: When the moms get along just as well as the kids. And look forward to hanging out with each other just as much. Wonderful time with my sisterfriend Nicole L. today.

Capri Suns for them. We opted for slightly different refreshments.

Beautiful inside and out. Love it when the heart makes room for new friends. Met Nicole a few years back while we sat around waiting for our boys to finish their golf lessons each Saturday. Not only did the boys hit golf balls, my Isaiah and her Alex really hit it off.

Lucky for me, Nicole and I did, too. I'm thankful for her.

Zachary insisted on giving me a massage after the half marathon. I let him.

With my mommy on Thanksgiving day. She wanted to put on lipstick but I told her she was beautiful as is. True statement, right?

And lastly this: The medal my sweet boy Isaiah added to my rack of race medals. "Hey mom," he said, "I like your new medal." It was before the Thanksgiving half marathon, so I wasn't sure what he meant.

So he told me to come and see for myself. And so I did.

Sigh.

This. This, this, this.

I have so much to be thankful for. The little-little things and the big things, too. All of it wonderful and all of it worth savoring. As my dear writer-friend Angella says so succinctly and beautifully:

"Love is the what."

Yeah.

***
Happy Thanksgiving-time.

The calm before the storm.

I could see it revving up. Her voice was growing louder and there wasn't any eye contact. Arms twitching in a tightly folded position, seated with crossed legs and a foot that kept rhythmically kicking. Whatever it was that was going on wasn't good.

Nope.

I wasn't involved actually. At that moment, I just happened to be down in the Emergency Department looking for a patient who'd already been wheeled upstairs. I'd popped over to one of the computers to check a few labs before hustling upstairs to find my sixty-something year-old man with heart failure.

She was propped on the edge of a gurney just a few feet away from where I was standing. A young doctor was speaking to her and a nurse was nearby doing industrious things that appeared to be in preparation for the patient to be discharged. And me, I could just see it. This patient did not look happy. But it was more than that. Her fuse appeared short.

Very short.

And so. Like someone rubber necking at a car wreck, I stood frozen and watching. Some perverse part of me wanting to be able to say, "See? I told you so" and needing proof of the outcome before I could.

Terrible, I know.

I could overhear bits and pieces of it. Mostly the issue seemed to be that she wanted a "head-to-toe CAT scan" which her doctor didn't seem to think was indicated. Her agenda wasn't being met and she wasn't too thrilled about that.

"What if I got cancer?" she said.

"Ma'am," he responded, "from what I've seen so far, we shouldn't expose you to all the radiation."

"I am fine with the radiation. I want you to check me all the way out for cancer. From head to toes with a CAT scan. It's my body. I know what I need."

And that young resident doctor just sighed and tried once again to take a different angle. None of which was working.

Now. You'd think that this wasn't really a big deal, right? But here is the part I could discern--partly from working at Grady for a long time but also just from something I felt in my gut: Her impulse control was on 'E.' And that meant 'E' as in empty.

"We're going to go ahead and discharge you now. I'm going to schedule you a follow up appointment in the Primary Care Center, okay?" That's what he said to her. Easy enough.

But that twitching foot started going faster. Her chest was heaving in and out and her eyes were flitting all about. She was sitting on the edge of that hallway bed and, from what I could see, was all alone. No loved one appeared to be pacing nearby.  It was just her. A young woman who appeared, really, to have not a single medical problem. But clearly something was wrong.

Very.

And so. It all began to swirl in slow motion. The nurse tried to hand her the after visit summary and her arms stayed tightly pressed to her torso. Her lip curled and her eyes rolled. Her nurse tried a little bit more, hand making karate chops to her flattened palm to reason with her one last time. All of it at a snail's pace. At least, from my perspective. The nurse then walked away, clearly exasperated but fighting to hold on to any threads of empathy. And that young woman swept her hand across the bed, flinging that discharge paper work to the floor. My breath hitched as everything went silent. In the pregnant pause, I watched them float down to the slick linoleum like feathers.

And then, someone hit fast forward.

First came the expletives. Loud, unruly and landing all over the emergency departments in awkward, awful splats. B-words and F-bombs screamed with reckless abandon, not to the individual caregivers per se, but to the system, the moment, the everything. And I just stood there like some terrible voyeur watching it all unfold. Wondering, wondering, wondering what had broken this young woman down so much that she'd unravel like this and lose every shred of impulse control?

What?

Was it a shitty existence at home? Screaming kids and no help or money? A horrible childhood that left her with so much noise between her ears that she couldn't quiet it no matter how hard she tried? Someone not nice awaiting her, with nasty words and swinging fists? Mental illness that was under treated? Or not even diagnosed?

Or.

Just a young woman who had none of those issues at all. Who just happened to be a bit nervous about her health and who was hoping for fool-proof means of making sure it was all clean?

Maybe.

And so. I tried making eye contact with her. Hoping to untrouble her waters from afar which is really a crazy and rather self important thing to believe I could do. But I did anyway. And, of course, it didn't work.

Eventually security came. Bear hugged her and lifted her feet above the ground. One of her shoes flew off and she was reduced to one bare kicking right foot and one sneaker-covered left one. They were nice-ish too her, despite her vitriol, but still they had to do their job. Which was to protect the other patients and the staff in the ER.

Sigh.

Now. I wish I could tell you that his ended with me walking over and hugging her. Me giving her a card to come to the clinic and her promising through tear-streaked cheeks to do just that. But it didn't. It ended ugly. Like, as angry as she was, there wasn't a way to do this in a dignified way. There just wasn't. So this was it. A lumpy ending that left everyone trapped in that awkward moment where you glance all around like you didn't see what just happened.

And that was that.

As I walked out of the ED, I started thinking. Thinking about that aura before the meltdown. Those folded arms, that tapping foot, that complex scowl. I replayed it and wondered what, if anything, could have been done to preemptively strike. To throw baking powder on the grease fire before it blows up the kitchen.

And no. I'm not criticizing my emergency medicine colleagues at all. Quite the contrary, actually. I guess I just wondered if, with that kind of knowledge, that kind of premonition if you will, what I would have done. And would it have even made a difference.

I guess the thing is. .  . . loss of impulse control is never normal if you ask me. Sometimes it's due to some mood altering substance, sure. It wears off and provides a sound explanation. But other times it is just life. Big fists punching or little tiny fists pummeling all at once. . .manifesting as nothing to lose.

Sigh.

I just want to be a better doctor and human being, man. I think we get these little prickles under our skin for a reason. Sometimes it's all because you need to haul ass and get out of the situation. But what if, in this line of work especially, it's a signal to rush in? To try your best to knock the door down before it gets blown off and hits you in the face?

Honestly, I don't know the answer to that. I don't. But that's what I'm thinking about tonight. And what I will likely be thinking about for a long time.

Yeah.

***
Happy Thanksgiving-eve.

The King's English.

I was thinking about my colleague George yesterday and something popped into my head. This remote memory of a piece of writing that George had sent me a few years ago. When I saw him the day before he sent it, I recall him saying,"I decided I'd channel my inner Kim Manning and write down my reflections." That last part was laced with sarcasm.  Full emphasis on the word reflections. Ha. I could tell from his crooked smile and the twinkle in his eyes when he said it that he was poking fun at me. But I could also tell he was serious, too. "It's just a few thoughts I've been having," he went on. "Like you, I love working at Grady. So I knew you'd appreciate it."

He was right.

Now. The big joke with me and many of my colleagues is that I'm such a tremendous electronic hoarder. I save emails upon emails and constantly appall people by the number of items in my inbox. (Greater than one thousand on any given day--gasp.)  I replayed that exchange with George and, being the electronic hoarder that I am, subsequently began hunting through my giant email hoard piles for that original message--fully believing I would find it.

Mmmm hmmmm.

Did I mention that it was sent roughly four to five years ago? In like 2009 or 2010? Um yeah. Well. Believe it or not, it wasn't out of the question for me to think I'd have it. (Don't judge me, please.) 

Man. Imagine how sad I was to find that, probably in one of my massive vow-to-do-better in-basket sweeps, (usually prompted by someone judging my in-basket number) I must have deleted it.

Booo.

That said, being the multi-level electronic hoarder that I am, I had one other Hail Mary idea still in my back pocket. Yes people. My electronic hoarding exceeds the confines of Emory Outlook.

Mmmm hmmmm.

And so. My Hail Mary plan was to search for the piece in my random hard drive files, fingers crossed that it had been sent as a separate Word attachment.

And guess what? It was sent as a separate Word document. And guess what? That document was in the hoard pile. (Next to a residency recommendation letter for a medical student who is probably a full professor by now.)

Ha.

Imagine the gift it was to me to read these words. Ah! Words my colleague had shared with me way back when. Words that now serve as a haunting opus. . .so defining of his commitment to Grady Hospital, to our underserved patients, to our learners and to the purpose-driven life George tried to live. It gave me chills to read them again.

As I did, I could hear his silky accent saying each line. Using, as we used to joke in clinic, "The King's English." All of this--these words, this melodic use of our language--represented his international background built by living everywhere from India to Kenya to Indiana to Atlanta.

"In Africa," he used to say, "when you learn English, you learn it in its purest form, Kim. It is the King's English. Full strength. Like heavy cream, not this skim milk you hear elsewhere, Kim." When he said that, his eyes were probably twinkling with that same serious-sarcasm and he was likely crookedly smiling once again.

Ha. That makes me chuckle because I can see it. And those who knew him, I'm sure, can too.

Ha.

The original Grady. George would like this photo and would likely know some random fact about it. Ha.

The version I found had minor edits that I'd made out of habit more than anything else. I think George had written this "just because" and don't recall him saying he intended to submit it to a journal for publication. After finding it, I considered sending it off to one, but didn't want to be forced to edit his words too much. I do recall him complimenting this blog several times so have taken license to share his words here.

My honest guess is that George would have been honored to have others read his reflections. I'm proud that he trusted me with them and that he'd taken a moment to "channel his inner Kim Manning."

Ha.

Perhaps after reading this, you will be as compelled as I was to channel more of your inner George Mathew. To find your sense of purpose and then walk into it boldly. Just like he did.

George in his element, with colleagues and learners caring for patients at Grady.

(And if all that sounds too heavy for you, just try using the King's English. He'd like that.)


Enjoy. And thank you for sharing, George. This and yourself.

Your colleague,

Kimberly

_______________________________________________

A Sense of Purpose


I saw him at the hospital curb waiting to cross the road on his way to clinic. He waved at me and after exchanging a few pleasantries, went on his way to the clinic. Watching him stride away, I saw in his steps a sense of purpose.

Pushing through the doors of the hospital, I ran into another of my colleagues. She chattered about the weather, the weekend and while walking with her to the clinic, I could sense she was looking forward to spending the day with her colleagues, residents and taking care of indigent patients, that she called  “a wonderful population."

Combined they had spent over 25 years at the county hospital and had no plans to leave. Every day, every year they had a renewed sense of purpose that only got stronger. A sense of purpose that they were going to be there for the care of society’s most vulnerable.

I count it fortunate to have worked in the county hospital environment. For the academic clinical internist, a county hospital is a satisfying mix of patient care, education and research. Bereft of a strong subspecialty presence, internists tend to thrive in that particular microcosm, whose environment tends to nourish the physician’s soul. Where one physician may see frustration and despair, the county hospital internist sees opportunities for improvement and hope.

Certain specialties have their own favored clinical setting .For the cardiologist and the cardiac surgeon there is the Heart Hospital, for the Orthopedic Surgeon an orthopedic hospital but for the academic clinical internist it is the teaching hospital--often a county hospital. A natural fit.

One of my favorite professors had such a strong sense of purpose, that after serving many years in a county hospital, he went to Africa to create one of Africa’s largest HIV networks. Some of his fellow colleagues followed him there, knowing that a common sense of purpose would unite them as they tackled one of mankind’s deadliest scourges.

Which brings me back to the topic -- "a sense of purpose." For the physician it is the sixth sense, a sense that guides and defines us as we try to take care of our fellow human beings. If ones sense of purpose is followed and not ignored, it can lead the physician down a path where the reward is not monetary or power but one of accomplishment and contentment.

Sadly, in today’s world, many physicians tend to lose this sense of purpose due to a variety of reasons. Most of the time it is the environment in which they choose to practice.  An environment that does not nurture one's sense of purpose will only dull it over time.

But when that sense of purpose is incubated in the right environment, the result is uplifting. A renewal of youth occurs on a periodic basis and the physician continues to enjoy medicine as much as he or she did when they started their first year of medical school. And when others with a similar sense of purpose work together in that same environment, spontaneous chemistry develops. It is highly contagious and results in a deeper and richer environment that most people and professions aspire to but few will ever attain. It is in the county hospital that the academic clinical internist can best hope to create that magic.

~ George Mathew, MD

Written by George Mathew, MD  (1971 - 2014)
Emory University School of Medicine
Grady Memorial Hospital
(Shared in 2010 with Dr. K. Manning and posted with very minor grammatical edits)

***

Happy Monday. Again. And shout out to all the electronic hoarders.  #validation

With Kelly A., one of George's small group students. We promise to take good care of them, George.

What gives YOU a sense of purpose? 

Are you doing it? If not, why?

First Person Chronicles, Chapter 3: Me and Mrs. Jones.

*with minor exceptions, all people included are fictional. The hypothetical experiences are based upon my own observations.

The Unit Clerk

"Miss? Where can I find some gauze and some scissors?"

I was actually on hold with radiology when I heard his voice. Just as I started to address him, someone came in on the line to answer my call. I held up one finger, looked up and smiled. Then I mouthed to him, "Give me just one second." He didn't seem to like that.

"I really need some gauze and scissors now," he repeated. That "now" had a huffiness to it that caused my brow to furrow. I mean, was someone bleeding to death as he stood there? Or had he just decided that his time was exponentially more important than my time--or even the time of the other person I was assisting? "Who is my nurse?" he demanded once more. "I mean, the nurse taking care of 15 bed one?"

At this point he made it clear to me that he was gong to keep hovering right there until I stopped everything to help him. Now I was on hold again with radiology as they looked to see where a patient was and whether transport had picked her up already. I took my chances and put them on hold with me, too.

"Mrs. Okeke." I had checked the board behind me that very clearly indicated who the RN was caring for his patient. The same board he could have looked at. I decided to be a bit passive aggressive when I said it by pointing at the white board.

"Who is that?" he countered without even trying to think more. Just then, Mrs. Okeke walked up.

"This is Mrs. Okeke, " told him while gesturing in her direction. "Okeke, this doctor needs some help with 15 bed one."

He immediately butted in. "I need some gauze and some scissors."

That's it, that's all. No "good morning." No "excuse me, can you help me." No nothing.  Mrs. Okeke just walked off toward the PIXIS to get him what he needed. And that was that.

Just then I remembered radiology and tried to return back to the call I was placing. Before I could, someone else approached the station. "My daddy is cold. Don't Grady have more than just one blanket they give people?" For a moment I wasn't sure who this young woman was speaking to. But then, after a few seconds, it clicked for me that she couldn't be speaking to anyone else but me, the unit clerk.

"Ma'am?" That's all I could think to say. She was clearly frustrated. I needed to prepare myself.

"My daddy is seventy five years old and he in there with just one blanket. He's cold! Can't he have more cover?"

"I don't think that should be a problem. Let me call someone for you."

And with that, she just walked away. No "thank you," no "preciate you," no nothing.

"Is it time yet for me to get something for pain? I'm in pain." This was Mr. Marshall who, every few hours, was at the unit clerk's station asking this same question. His IV pole was right next to him and he still had on his hospital gown. Like always.

Sometimes he started out super, syrupy sweet, complimenting my hair and my skin and then asking me to call his nurse. Other times he was volatile, banking his adhesive taped hand on the counter and gnashing his teeth in my direction. But most of the time, he was somewhere in the middle. Too exhausted to put on a show or rather,  just forgetting. "It's only been about two hours, sir."

"Well, can you call my nurse to come and see me? I'm in pain," he said. His face twisted up and he slumped his shoulders before slinking back toward his room with the IV pole in tow.

Sigh.

I put my hand on the receiver of the phone once more and prepared to call radiology back. Then came that booming voice overhead and those sirens.

"CODE BLUE, SEVEN A. CODE BLUE, SEVEN ALPHA!"

I had noticed a little bit of commotion down on the tail end of the long hall but didn't realize that it was a code situation. Mrs. Okeke came bursting out of room 15 and all of the other nurses began running toward room 26. The rude resident with the gauze ran out next and seconds a later, more doctors of various levels came pouring out of the stairwells and hallways into the corridor.

"Where is it!?" one yelled in my direction.

"26!" I responded.

The entire area outside of the door of room 26 was swarmed with people. Some walking in, some walking out. Some yelling, some looking terrified. And me, I just braced myself and waited for all of the orders that would surely be coming my way.

Whether the patient made it or not.

See, for the clerk? A code means entering orders and making calls. Where those orders and calls go depends upon the outcome. Either way, people often come out of those crazy situations flinging orders like frisbees at your head.

No "please," no "thank you," no nothing.

Which, I guess, I can maybe allow if someone has died. I mean, maybe.

I look at my census to see who is in room 26. Oh no! Sweet Mr. Shaughnessy! Oh no.

I wasn't sure of all the medical parts of what was going one with him. All I knew was that he was homeless, had some psych problems and some kind of medical issue that had made him a real, real long term player. He didn't come out of his room much during the day. Only in the evenings, when things were more quiet. And when he did, he was kind to me. Really and truly kind.

His hair was always matted and he smelled a little bit whenever he came out to the desk. His teeth were all cracked and blackened and his beard so nappy that it resembled taco meat pasted to his face and neck. But that part didn't faze me so much. It didn't. I loved the way he always remembered my name and how, despite his circumstances, seemed to be able to find a glimmer of light everything. I know for sure that he knew my name because every time he approached the counter in the late afternoons or evenings he'd sway from side to side while holding his IV pole like a microphone. Then he'd croon in a really low voice,  "Meeeeee aaaaaaand Mrs.-Mrs. Joooooooones. . . we got a thaaaaaaaaaang . . goin' on. . . . "

And each time I'd just laugh and laugh. Some might have thought he was being fresh, given the nature of that song. But not me. To me it felt like a hug and a big pile of all the "thank yous" and "good mornings" that I hadn't received all day long.

I closed my eyes and said a little prayer for him.

"My daddy stil didn't get no blanket," the same woman said to me. My eyes flung open and I stood up.

"Let me help you," I said. Quickly, I headed over to the laundry cart and slipped a clean blanket out of the stack. "Here you are, ma'am." She took the blanket and marched away, mumbling under her breath something not-so-flattering.

No "thank you," no "preciate you," no nothing.

The phone was ringing when I returned to my desk and from the corner of my eye, I could still see the people milling around room 26.

"Unit 7A, Ms. Jones speaking,"I answered. The person on the other end was a family member of a patient. A seemingly angry one who wanted to know what was going on with a loved one.  Carefully, I did what we are instructed to do, determine who the person is and contact the nurse. But with the code going on, I'd just have to take a message.

"Who am I speaking to?" the person demanded to know.

"I'm Ms. Jones. The unit clerk."

"Well. I need to speak to a doctor or a nurse. Right now."

"Um, okay. Well ma'am, we have an emergency on the floor right now and her nurse is occupied. I can have her call you right back. You said you're her daughter, correct?"

"I'm like a daughter to her, yes. I need to know what's going on right now. I'll just hold."

Like a daughter? I leaned back in the chair and rolled my eyes a little while the receiver was away from my face.

"Ma'am, I will have the nurse or doctor call you back once we get the permission of the patient. Thank you for your understanding."

"This is some bullshit!" the lady on the other end said. And then she hung up. On me.

Sigh.

I looked back down the hall and hoped poor Mr. Shaughnessy was okay. I wished that call had been for him and wondered who would arrange a funeral for him if he passed. I decided that I would go if there was one. To his funeral.

Suddenly, everyone came walking out of the room toward the unit station. Mrs. Okeke was reaching into her pocket for meds that she was obviously about to pass before and the rest of the staff all seemed to be returning to what they were doing. The doctors, even the rude-gauze-and-scissors dude, all walked right by my desk with these nondescript looks on their faces. I couldn't tell from looking at anyone whether or not Mr. Shaughnessy had made it.

So much energy. No answers. No nothing. Chaos one minute, business the next.

I closed my eyes once more and said another little prayer for Mr. S.

"Good morning, Ms. Jones."

That nice greeting--by name--startled me. I looked up and saw the smiling face of what appeared to be a young doctor. I tried to place her--I think she'd been a medical student here first and had stayed on as a doctor. I could usually tell by the length of the white coat which, right now, I couldn't go by since all she was wearing was a set of blue scrubs.

"How are you doing today?" she asked me still smiling. I noticed the tiny freckles spread across her nose and the color of her eyes. Some shade of greenish-blue.  I smiled back.

"Good. Crazy morning."

"Yes, indeed," she replied. "You look a little distracted. Are you okay today, Ms. Jones?"

I felt bad for not knowing her name. But the fact that she'd made up her mind to not only learn my name but use it, spoke volumes of who she was. Though I couldn't place her name, I recalled the team she was on as a student where her attending, Dr. Winawer, always spoke to me in front of all of them. I think she'd learned from that example. Which I appreciated.

"The patient who coded has been here a while. He's such a nice man. I was just feeling a little worried, that's all."

The freckle-faced intern reached out her hand for me and touched my arm. "That's so kind of you," she said softly. "Well, I'm on the ICU team this month. And I want you to know that I'll be taking care of Mr. Shaughnessy up stairs, okay? We got his pulse back and it looks like the nurses called the code so quickly and started compressions so fast that it made a difference. Of course, he's sick. But we will take good care of him, I promise." I could tell that she meant that.

"I'm so glad."

She nodded and began to walk backward toward the room again. Then she stopped and said, "Oh, I almost forgot and I've been meaning to ask. Did your daughter make the dance team?"

I was confused for a moment and then remembered telling Dr. Winawer about my daughter trying out for her high school dance line last year. She was a student and was there and remembered. Which immediately made me feel like crying and laughing at the same time. "She is the captain this year. Her and another girl."

The freckle-faced intern gave me a big thumbs up and shuffled back over to room 26. And that was that.

"Is it time for my pain medicine yet? Is it?!"

It was Mr. Marshall again. This time he was angry. He slammed his hands on the counter in front of me.

"I'm sorry you're in pain, sir. But it's only been a few moments since the last time you were here."

"CALL MY NURSE!" he snarled.

I didn't say another word. I just sat still for a moment. From the corner of my eye, I noticed the bed being wheeled out with Mr. Shaughnessy on it. Someone was bagging him while the freckle-faced intern was holding his the rail of the bed helping guide it. When she passed me, she gave me another thumbs up. "Bye Ms. Jones!" she said. "Thanks for your help!"

As they disappeared down the hall, I realized that I hadn't done anything for her. But that she seemed to appreciate the fact that I stood ready to.

Sigh.

That little bit, that tiny humanistic nod from that intern did my heart good and had given me the charge I needed.  I looked up at Mr. Marshall and softened my expression. "Good morning, again," I said, "Let me see if I can somehow help, okay?"

And he nodded his head and let that angry fire quiet down. Instead of getting his nurse, I put my hand on his back and walked him back to his room. I told him it would be okay and that I'd make sure his nurse knew he was in pain. And that? That seemed to be enough.

Surprisingly enough, it was and all he really wanted after all.

Two lines were ringing when I got back to the desk. One of which was radiology asking why I'd hung up on them. Another resident doctor was asking for something without making eye contact with me.

"Who is O-KEEK?" she asked while looking a bit annoyed.

"Mrs. O-KAY-KAY is right there. Would you like me to get her attention for you?"

That annoyed resident just walked off while muttering what I think just maybe was a thank you. Maybe. She obviously hadn't been on Dr. Winawer's team. Oh well.

Also a patient who was recently discharged was standing at the counter with a prescription that she couldn't afford to fill. I wasn't sure how to fix that, but figured I could at least say I was sorry and get the doctor. Which seemed to make a difference.

I paused for a moment, just long enough to hear Mr. Shaughnessy with his crackly voice singing quietly in my ear and then I smiled, thinking about the care I know for sure that the freckle-faced intern would give him. I knew he was in good hands.

Why?

Because she noticed me. And if she noticed me, then she'll notice him. And to me, noticing people is like telling them they matter. And that you care.  Which, if you ask me, is more important than just about anything else when you're working in a hospital like Grady.

I returned to my work--answering phones and answering questions. Some people were nice to me and some weren't. But me? I made up in my mind to notice them all no matter what. . . .

. . even if they hadn't yet made it up in theirs to notice me.

***
Happy Monday. Will make up for Sunday with two today. Stay tuned.


Now playing on my mental iPod. . . . for all of the wonderful unit clerks at Grady who deserve to always, always be noticed. 

First person chronicles, Chapter I: Urban legends.

It isn't like they say it is, you know. Like, this whole urban legend of it being like someone stuffing you into a cannon and exploding you straight out into the sky is actually just that. Legend. I think the folks who never tried it before are the ones that make those kinds of stories up.

Like just yesterday when I was on the MARTA train and heard some older lady talking about how people who smoke rock do it because they're always trying to chase that very first high. "It's like they go crazy, " she told her friend. Then she went on and on with more bullshit that I'm sure she didn't know first hand. And it was sort of pissing me off the way she kept talking with so much authority like she was the damn Surgeon General on street drugs or something. I started to lean over that plastic orange seat and give her an earful. Like a mean, cussing, one. But instead I just stared straight ahead and spoke loud enough for her to hear me.

"That--what you just said--ain't really true."

She swung her head from side to side like it's no way possible I was speaking to her. So I repeated myself. "That's not the truth what you saying. Obviously, you ain't never got high."

And would you believe that old lady was so stunned that she didn't even bother to respond to what I said? I guess she looked at me and made up her mind not to fool with me. Like a person riding in one of those open door buggies in a wild animal park where you ain't s'posed to feed or touch the wild animals. But me? I ain't no wild animal. Regardless of what I look like, I'm not.

I'm really just a regular person. A regular person who got caught up.

You might define regular as going to college and being filled with what everybody thinks is promise. Well. I didn't go to college but I did finish high school. I had me a good job with some benefits, too. That said, I could still be regular without all that. To me, regular mean you got your head screwed on and you have a damn clue. I did have a clue, too. I did. And I still do.  It's just that over time, I got caught up. And now I'm like I am now.

Anyways.

I had just got off the MARTA that day when I started to feel I was losing my breath every time I tried to walk. I'd walk for like a few feet then have to stop. Then my chest started tightening up. I knew enough to get back on and ride down to the Georgia State station right by Grady. With what I'd smoked that morning, I wasn't sure what this all meant but I wasn't gonna wait forever to find out.

Most of what they said flew over my head. I guess they think I had a light heart attack and all of it they relate to me smoking. So they talk at me and scold me and all that like that's all it would take. And me, I just sort of tune it all out because it's almost as annoying as that old lady on the MARTA.

There was one person I liked, though. This little medical student who works with my doctors came in my room every day asking me all about my life.. Like, she wanted to know about the first time I ever used crack and like, what all was going on when it happened. She seemed like she for real wanted to know, too. Then she made a reference to that same thing everybody is always saying that ain't true about running behind that first big rush.

"That's not how it is," I told her.

Her eyes got all big like saucers. Then she said, "Tell me, then. What is it like?"

I sat and thought on it for a few seconds then I asked her a question. "You ever had sex with somebody that you know you ain't got not business having sex with?"

Lawd. What did I ask that for? That child turned fifty shades of crimson when I said that. And I swear I wasn't trying to embarrass her. I was just trying to find an analogy that fit and, hell, she looked grown. At least, grown enough to be in medical school which means she already went to college before that.

"Look," I went on without making her answer, "it's kind of like the first few times you have sex with somebody. Especially somebody that you ain't got no business getting with. The first time, it's mostly that you are caught up in the moment or curious. It's not necessarily great but you find yourself thinking about what you did. Next thing you know, you made up your mind to try it again. 'Fore you know it, you can't stop yourself."

"So . . .  no crazy fireworks? Or like a really intense first high?"

"Naaaah. That's that bullshit people always feeding the world about crack. It ruins your life slowly. Like somebody ripping pages out of a book or pulling hairs from out of your head. Take you a minute to notice, you know? But once you do? Man."

She got that. It made sense to her and I could see her wheels turning.

That medical student sat and talked to me for two whole hours. She made me feel better than anybody else on that team. Maybe since she was't busy or maybe it was just that she knew how to not seem busy that I liked her.

She came back and told me that I didn't have a full on heart attack. The heart doctors had thought about having me do the test that checks to see if you have blockages in your heart vessels. But then when they heard I was still using crack, they shifted the plan. At least that's what I think.

Now, I get to go home. Which, at the moment, I'm not so sure what that's gonna be. And even that, not knowing where you really live, isn't like what people think. But that's another story for another day.

So anyways. My point in all of this was really just for you to know that the only way to know about the  real deal stuff happening with real patients is to just ask them. And if you want to know the real parts of the things that are mostly urban legends, it's best to ask the legends themselves. You find out some cool shit that way.

I'm just saying.

***
Happy Thursday.

21 Days of Storytelling.

This random selfie in my Deanna original scarf makes me happy.

Work has been crazy. Busy, yes. But also just emotionally taxing, man.

Sigh.

I can tell it's been getting to me because I have all these half written blog posts in my queue that haven't been finished. Almost like a bunch of sandwiches with two bites out of them. But, like nourishment with food, writing feeds my soul. Yes, it does.

And so. Here is my challenge to myself. For the next 21 days, I'm going to write something each day. A story, poetry, something. Work my literary muscle out. And the point? Well. I guess the point is to write. Write, man. All in an effort to replenish me in that way that only writing can.

Yes. Yes!

I feel tired. Which makes the challenge even better. I also want to be brave, too. And . . .I don't know. . .just willing to try things in my writing. Or flesh out quirky thoughts, man. That's also stifled me a bit as of late. You know? I'm just thinking. It doesn't have to be that heavy, man. Writing is like running. The best way to run is to run. The best way to run well is to keep running.

And so it is with writing. So . . .no more over-thinking it. This is a nudge to just do it.

Just Do It. Ha.

Now that I think of it, even though I'm a runner now, I've never gotten that runner's high that everyone keeps talking about. But the writer's high? Man, oh man. That I HAVE felt. I've had moments that seemed just like a sky rocket in flight and an afternoon delight all rolled into one. Where I couldn't stop myself.

Nope.

And so. Tonight I will sleep. I will write in my dreams and stick post it notes all around my heart. Then, at some point, I will write. And by "at some point" I mean starting tomorrow. I'll do my best to stick with it for 21 days.

Why? Because that's what feels right in my universe. And not writing feels awry.

Yeah.

***
Happy late-night Wednesday mostly Thursday. Kinda excited.

Oh yeah. Forgot to tell you guys this rad thing. Or wait, did I? I can't remember. On August 10 I wrote an essay about how losing Deanna to heart disease changed me as a physician. I submitted it to JAMA (The Journal of the American Medical Association) on August 11--Deanna's birthday. Well. It was accepted for publication and guess when the manuscript went live on line? November 16. One day after the two year mark of her passing--and in the Cardiovascular Disease special issue, no less.

You know what? I'm proud. And I know she is, too.

Regrettably, the full text version is only available with subscription to JAMA or access through a university library. But I knew y'all would want to hear about this either way.

***
Now playing on my mental iPod. . . . .