Here is what I learned about the beach. You can do some of your best thinking there. Especially if you have the right drinks.
Guess what? If you have to pee from all the drinks, you don't even have to go that far either. Papa says it's okay to go in the ocean because where do you think the fish go. Just not number 2.
Love,
Isaiah, age 5 and Zachary, age 3 and three fourths
P.S. Please tell the mayor of Atlanta-in-Georgia that we need a beach. But not a lake-beach but a real-ocean one, okay? Thank you. Okay bye.
P.P.S. Where do the fish go number 2? Papa said to ask you. Now this time bye okay.
Today we ate at a place where they let you eat what you want. Like pizza and macaroni and ice cream. Except you can eat it in any order that you want. Like first, ice cream with sprinkles, and then maybe one broccoli, and then some pizza. Or maybe no broccoli.
Papa says it's all going to the same place and that there is no such thing as a spoiled appetite. Okay, bye.
Love,
Isaiah, age 5 and Zachary, age 3 and three fourths.
When I was a brand-spanking-new intern, I remember taking a call that was so scary that it nearly caused me PTSD. This fearless senior resident was supervising me and thank God she was because the way people were coding all over the place felt exactly like stepping on landmines. My senior resident was the "Black Hawk Down"/Army Ranger of residents; she had already secured a spot in a Pulmonary/Critical Care fellowship, and was virtually like a mini-ICU attending. To that, all I can say is hallelujah.
Hallelujah, because the ICU scared me. Every single page that came through was about something really, really serious. No "can you write for a stool softener, please?" or "can I get a verbal for some pain medicine?" calls. Nope. Every beep was for the hell that was breaking loose in some part of the unit--and let me tell you--hell was sho' nuff breaking all the way loose. I am so glad that I was being covered by someone who knew what the hell to do.
As I already mentioned. . . .since this was the intensive care unit, for the most part, all calls were "real calls." ICU nurses are, by definition, "bad ass" and generally don't go bothering folks with simple things (unless of course they hate you.) These nurses were not only knowledgeable, but excellent teachers for new interns. So, despite my panic, between the unit nurses and my hard core resident, I had great support.
Hell kept breaking loose for most of the night and eventually slowed down some. The unit was full, and my resident told me that this "was a good thing because now we couldn't get anyone new." I decided to believe her, relaxing my new-kid-in-school expression and even laughing at a few jokes.
I guess I got a little too relaxed.
All that easygoing laughter must have made me look more confident than I was. That's the only explanation for what could have possibly given my mini-ICU attending/senior the unwarranted faith in me to nonchalantly shrug her shoulders and say to me, "I'm gonna go and get me a few winks since I have clinic tomorrow. I'll be back in two hours and then you can go get a couple of hours before rounds. You hold down the fort, okay?"
Say whaaaat?
Dude. It was 2 a.m.! That meant I had at least five hours of potential hell-breaking-loose-ness remaining!
Awww hell naww!
This resident was responsible and hard working, and I know that she would have NEVER left me if she didn't think I'd be able to manage things. But the thing is, I didn't agree with her. I was NOT ready for prime time. And being alone in the ICU at 2 a.m. was sho' nuff prime time. I offered her a sick smile but tried my hardest to look easy-breezy. Behind the cool expression was somebody screaming and waving her hands like a wild woman, "MAMA! DON'T LEAVE ME MAMA! I DON'T KNOW NOTHIN' 'BOUT BIRTHIN' NO BABIES!!" (Well, not exactly that but you get the picture.) She didn't catch on. "Call if you need me, okay?"And before I could say a single word, she had disappeared through the automatic doors. Just like that.
(This is really a picture of me circa 1996.)
Lawd. Lawd. Lawd.
I remember standing in one place, kind of like some city dweller plopped in the middle of the Amazonian rain forest at night. That, or that terrified kid who video taped himself in that creepy Blair Witch Project movie. I was scared to move, speak, or breathe. All I did was pray in my head, "Please let nothing happen, please let nothing happen." I felt my stomach rumbling and my pulse quickening. I repeated my pleading prayer. "Lord, please let nothing happen. Please let me not hurt anybody. Please let nothing happen."
(This is really an ICU intern.)
And for like ten minutes, nothing happened.
I sat in the nearest chair gripping my sign out cards. I jumped every time I heard a beep or an alarm on one of the vents. For a little while, I even held my breath. And eventually decided to put my head down on the nurses' station. Exactly one second after I laid my head down my pager went off. Before I could even dial the number, I overheard Ida, one of the ICU nurses, yelling for me to come.
"Doc! Doc! Are any of you guys still over there?"
The urgency in her voice made me feel sick. I knew this was going to be something and not nothing. I wanted so bad for it to be nothing. So bad.
I scuttled over to Ida and, in my most confident voice, asked what was going on. To answer me, she handed me a strip of paper with an EKG tracing on it. Intermittent runs of ventricular tachycardia---the kind of heart rhythm that precedes a cardiac arrest. I sifted through my brain for a logical approach to what was surely about to be a problem.
Mr. Jones was the 71 year old patient in question, and had just turned the corner after a near-death experience with multilobar pneumonia. He'd been intubated for nearly a week, and had just been extubated earlier that day. According to my sign out notes, he was now in a step down bed and was "doing just fine with nothing to do." Nobody said anything about V. Tach.
Damn.
My brand-spanking-new intern brain wasn't on auto pilot yet. I took a deep breath and thought for a second. Electrolyte abnormalities? Was his potassium high or his calcium low or his magnesium low? Was he hypoxic? Were his medications some how screwed up?
Ida must have read my mind. She'd been an ICU nurse for waaaay longer than I'd been an anything so before I could say a word, she rattled off answers my short list of thoughts.
"Lytes are all normal--potassium is 4.1, calcium and mag are stone cold normal. Tolerating the 40% ventimask just fine and oxygenating at 95%. Renal function is also fine." I swallowed hard as I listened to all of that. Shit! Now what? Ida went on. "We were going to transfer him to the floor earlier today, but the attending decided to just watch him overnight to be safe since he'd had such a tenuous course. That was a pretty nasty pneumonia he had, you know?"
I nodded while staring at Mr. Jones. He didn't look good. His face had a grayish cast over it and his brow was covered with sweat. The whites of his eyes looked unusually white, enhancing what I am sure was an expression of fear. A sinking feeling rooted in my stomach and suddenly I recognized something that my senior had been trying to teach me for the past few weeks--the sense of impending doom.
Impending doom. That gut feeling that tells you that things are not right. It's how you know who is sick and who is sick-sick. This man was sick-sick.
"Mr. Jones? Sir, are you okay?" I asked. Which was a dumb thing to ask because he obviously wasn't okay at all.
His response was a widening of his eyes and an anxious pant. I looked at Ida.
"Come on, buddy. We're okay." She tried to prop him up with some pillows and readjusted the pulse oximeter on his finger. She pushed a button to recycle his blood pressure. "Doc, I sent off some cardiac enzymes and checked a twelve lead EKG on him already. Other than a few premature beats it looked okay."
The cuff slowly deflated and eventually displayed an error sign across the LED screen. Ida grabbed a manual blood pressure cuff before I could register what that meant and began attempting to check his blood pressure. All of a sudden, she pulled her stethoscope out of her ears and growled, "Dammit! We don't have a pulse!"
Famous last words. We. Don't. Have. A. Pulse.
No. WE don't have a pulse. Nor do we have a spine. I am 100% sure that, had I had time to eat dinner that evening, I would have evacuated my bowels right then and there. This wasn't supposed to happen. I wasn't supposed to be the one leading a code on Mr. Jones. He was supposed to wait until my resident was awake to have his v. tach and his no pulse.
"We need some help in here!" Ida bellowed to her fellow nurses. They quickly ran to her side.
Things started moving fast all around me. Ida quickly let down the head of his bed so that his feet were elevated. This position, called the Trendelenburg, assured blood flow to the brain when patients became hypotensive. Before I knew it, the room was filled with ICU nurses, industriously positioning themselves to save Mr. Jones' life.
good ol' Trendelenburg.
But the problem was, there were no other doctors.
Crap. Crap. Crap.
See, here's the thing. The ICU nurses already knew what to do. They had paddles nearby and were assessing his cardiac rhythm. They were doing chest compressions. They were drawing up meds and handing me gloves. The respiratory therapist pushed a mask over the now somnolent patient's face and began bagging in oxygen. And me? I just stood there with my gloves on. Paralyzed with fear. Terrified to say or do the wrong thing.
Ida saw the terror in my eyes and whispered in my ear, "Come on, baby. You can do this. We got you, baby. Just think it through. We got you."
And you know what? They did have me. They really did. I carefully walked through the stepwise interventions in the Advanced Cardiac Life Support protocols as experienced nurses helped me through it. They gave me gentle suggestions and firm "uh uh, baby's" when things weren't going in the right direction. It was like walking a tight rope with pillows all around you.
Finally, we regained a rhythm for Mr. Jones and they Anesthesia team reintubated him. Shortly after, my resident came in and helped with the rest of his stabilization. We confirmed his ventilator settings with the respiratory therapists and reviewed the stat lab results that had just come back. After a few more tweaks, he had turned the corner. "Strong work, Kim!" my resident said while suturing down an arterial line in Mr. Jones' wrist. "You saved Mr. Jones' life."
I saved Mr. Jones' life? Uuuhh, I don't think so.
I glanced over at Ida who was now across the room giving report to the nurse on the next shift. She smiled and gave me a thumbs up. I tried to profusely thank her before she left that morning, but she disappeared before I could.
And so.
Mr. Jones' lived. The sun came up a few hours later. I gathered information on my patients for that upcoming morning. And rounds happened at 7 am.
That morning on rounds, my resident told our attending, "Kim saved Mr. Jones' life last night!"
To which I admitted, "The nurses were amazing. Especially Ida."
Because they were amazing. And, no, I can't exactly say that I saved Mr. Jones' life that night. We did. Together. . . .
Yeah.
As I remember it, that night an R.N. saved my life.
***
Shout out to all the nurses who save patients--and doctors--every single day. 'Preciate you.
Now playing on my mental iPod. . . . .(insert "RN" for "DJ"). . .
Did you know that Auntie JoLai has a car that the whole top comes off of? She asked if we want to "drop the top" and then that's what she did. Took the whole top off and it was just air and sun on our heads. But we had some sunblock so it was okay. Mommy? Did you know? This is something people do in California. They drop the top. Why don't you drop the top, Mommy? You should. Because this is very cool.
The happy side: My med students at my house last week. Love having them there.
"You can't do it like that Love will show you where it's at What you put up you'll surely get back 'cause there's no other way if you play you'll pay
Back and forth . . . . "
~ Cameo's "Back and Forth"
______________________________________
Left and right. Right and left. The pendulum of life continues to swing. The "ugly cry" on one end, the "Snoopy dance" on the other. . . . .all existing in a continuum. . . fluid like waves but less predictable.
So like surfers on waves, you do your best to just go with the flow. You grab your board and you boogie. It's all you can do. . . . . .
Here are ten things that happened this week in the swinging pendulum of joy, pain, sunshine and rain in my life.
Harry was out of town last week. He spent good and quality time with his mother, and I stayed here.
Him plus my boys being away was novel for like one day, but got old real quick. When he got home, he sent me a text that said, "I'M BACK IN THE ATL, BABY!" I was in the middle of my work day and it made me so happy. The minute I got home, I hugged him tight and told him how much I love him. Then we got some fish tacos from La Fonda and drank the remaining half of a bottle of cheap Riesling in the refrigerator. After that we cracked jokes on each other and ate pumpkin seeds on the couch, followed by both of us promptly falling asleep on the $2.99 budget list pay-per-view movie.
My kind of date.
#9 - Stolen.
There was this stunning girl I knew in college with the purest, greenest eyes I have ever seen on a real person. Her eyes were piercing against a creamy olive complexion--kind of like that Afghan girl on that famous National Geographic cover from back in the day. In addition to those green eyes (that left others green with envy), she had a mane full of dark, shiny curls--and this was before all those hair weaves became mainstream. . . . .
We weren't close friends, but at our small college--by definition--everyone was considered your "friend" if they were there while you were there. She and I finished high school and started the same year. Later we pledged "rival" sororities--she became an AKA and I pledged Delta. But honestly? At Tuskegee those rivalries were light like whipped cream because regardless of the letters on our t-shirts we were all like family. That's just how folks roll at Tuskegee.
I saw her last month for the first time in ages. She had cut her signature long and naturally curly locks into a bold and spunky bob. I barely recognized her at first--but the minute she cast those green eyes in my direction, I knew exactly who she was. "Hey girl!" we greeted each other in unison. Then we laughed and hugged and caught up.
"How many kids do you have?"
"I have two, too!"
We meant to exchange numbers, but never got around to it.
Early this week, she lost her life in a murder-suicide. Right here in Atlanta. Not even five miles away from where I saw her that last time. Her husband was ill and depressed and obviously in a very, very dark place. Ill and depressed. Yes, this is what I tell myself when it comes to things like that. To leave your children motherless and fatherless, you have to be in a very scary, dark, ill place. Fortunately, her kids were okay because he took them to a safe place first. Then he did it. The unthinkable. Just like that.
I was not her close friend, but I knew her enough to be sad. And I am sad. Sad for her family. I'm sad about her mother and her father having to bury their own child and sad that they have to imagine their baby girl with fear in her eyes in her last moments. I'm sad that they will probably have to find words to explain something to their grandkids that is lose-lose no matter how it's spun, and for the crippling anger and grief they must be feeling. I am sad for her husband's parents and sad for the aftermath that things like this can bring. Most of all, I'm sad for her children--one whose face and haunting eyes resemble hers so much it's eerie. And the other who is so young that she may struggle with remembering the fine details for herself.
Yeah, I'm sad because I knew her and hugged her tight and genuine just last month. I am her age and I showed her two kids on my iPhone that day, too and said mundane things like, "Yeah, girl, they're a handfull!" just like she did.
See, all of this is lose-lose. Too much to reconcile and try to get your mind around. Too too much of the pendulum swinging the wrong way.
But.
When I saw her that day in June, she looked peaceful and fresh and beautiful and happy. I hope this is her legacy. I do.
#8 -- Me and Free-Free.
My friend and former Grady doctor Frieda J. was a resident when I joined the faculty back in 2001. The following year, she was chief resident at Grady and spent a few more years on the faculty. We became fast friends and remained as such after marriage, two pregnancies each, and her her departure to the private practice world.
I always called her "Free-Free." Mostly because she thinks it's funny, so it stuck.
On Sunday I came to visit her at her new house in Buckhead. Lovely! Even lovelier was Free-Free and how happy she was. Yes. Happy-happy, whole-whole, and free-free. We escaped to a nearby Thai fusion restaurant for dinner and drinks and laughs. We caught up on all of the things that girlfriends catch up on and it was wonderful.
It really was.
#7 -- Broken.
What do you do when your heart says "yes, please" and someone alerts you that their heart is now saying "no, thank you?" What if that person initially said "yes" in front of every single person you care for, but mostly in front of you and God, but now after all that their heart is saying "no?"
Okay. . . maybe not even "no". . . maybe just "I'm not sure." What do you do when there are other someone's involved and affected by that decision? What if more of your life has been spent with your heart saying "yes" to this person than not, and just what if you have no idea how to redefine your every day since this is really all you've known since forever?
I don't know the answer to those questions. My friends who are dealing with those questions don't have good answers either. . . . other than this:
You just wake up and you take a shower and you slug it out. You remember the little people who are innocent in the confusion and slug it out harder. And if it's your thing to pray, you do that, too. You talk to friends who you trust who hug you and listen without judging and who hold your hand and wish you weren't going through it. Then you wake up and do it again.
These women are resilient like women can be. But human still, with hearts that can break if not handled with care. Broken hearts suck. Broken people and broken lives suck more.
#6 -- Of Mice and (Wo)men.
What did I do?
I pulled into my driveway on Wednesday around 8:25 AM after coming back from the Fox studio. Harry was in Cleveland on vacation still and was likely fast asleep. But see, when I pull in my driveway I see what looked like a mouse. No, I said a MOUSE. Some kind of field mouse or whatever, but a MOUSE no less, and it was all shivering and sickly-looking.
Awww HELL naww.
You KNOW what I did. Claro que si! I called the BHE and woke him up. In Cleveland. (Clearly, there was plenty he could do from Cleveland, Ohio about a field mouse in Atlanta. Clearly.)
Me: "Babe!"
BHE: "Ummm hmmm" (groggy, froggy voice.)
Me: "Babe! There's a sick looking mouse in our driveway by the bushes."
BHE: "And?"
Me: "What should I do???"
BHE: "Nothing."
Me: "But what if it goes into our garage?"
BHE: "Have you seen a mouse in the garage before?"
Me: "No. But he could crawl into the garage."
BHE: "I thought he was sickly."
Me: "What if he has rabies and attacks me?"
BHE: "A rabid field mouse?"
Me: "It's a mammal! Should I call the pest control? To get him?"
BHE: "To get a field mouse sitting next to a field in our driveway? Outside? No, baby. No, you should not."
Me: "But what if he gets in the house?"
BHE: "Do you think he's going to climb TWELVE stairs to get in the house from the garage?"
Me: "He might. You never know. Especially if he has rabies."
BHE: *snoring*
Me: "BABE!!!"
BHE: "What, what, what."
Me: "You aren't worried about him ATTACKING me? ATTACKING your WIFE?"
BHE: "No, I'm not worried about a sickly FIELD mouse hanging out near a big-ass FIELD in your driveway attacking you. No, I am not. Not at 8:20 in the morning while I'm all the way in Cleveland."
Me: "Babe? Oh shoot! I think he hobbled somewhere. . .should I--"
BHE: "Goodbye, crazy girl . . . "
And that was the end of that. If something happens to me, y'all know who did it. I'm just sayin'.
I looked at this over and over again. My kids are having such a wonderful time with their grandfather. And I am missing them terribly but loving the idea of them doing things like this.
They were at the beach for more than five hours that day. That makes me so happy because there aren't beaches in Atlanta. Or their PaPa.
#3 -- "Music makes the people. . . come together." ~ Madonna
Remember my patient that I used to download music to play for her on my iPhone on rounds? Nat King Cole and Sam Cooke? My friend and fellow Grady doctor, Shelly-Ann F. sent me an email to let me know that she had peacefully slipped away in hospice the other day.
Yesterday I listened to Sam Cooke and Nat King Cole quietly in my office and wept. I let my mascara run into ugly raccoon swirls and sighed hard and heard each word and each melody. I listened hard for her and felt thankful that this was a piece of unrelated yet important information that I learned about her while caring for her. Then I wiped my eyes and smiled because I realized that when I listened like that I could see her face. Oh, her face! She was in such awe of how that little device could grab her favorite songs straight out of thin air and two minutes later play it for her just like magic.
Those moments of sharing that music with her were magic. . . .and caring for her felt magical, too. Yes, it did.
#2 -- Baby love.
If you don't feel madly in love with him, you are not normal.
Jackson is my godson and he was born on the day after Christmas. Whenever my best friend brings him over, I steal him for the whole time. I see him often, but the last few times it was obvious that he knew me. He really knew me. He smiled at me and looked at me and reached for me like he knew who I was.
Seriously? Seriously.
The only thing more beautiful and perfect than him is watching Lisa mother him. She is perfect at it and even though she has always been beautiful, motherhood has cast a glow over her that is hard to explain.
I am so happy for her. And so, so happy for me that I get to be in her life and Jackson's, too.
#1 -- Going back to Cali.
It makes me sad to think of Camp Pa Pa coming to an end. Sure, there's a whole week left, but I know how much my dad and the kids are enjoying it. But especially my Poopdeck (my dad.)
Kids bring such an energy to houses, don't they? They yell and sing and stamp their feet and pull out toys and spill gooey things on tables. They play with Play-do and forget they were playing with it and cry when it turns all dry and crusty. They mess with your ice dispenser and splash too much in the tub and accidentally put banana peels in toyboxes, too. Houses come alive when kids are in them; they float like that house did on "Up" -- except the kids are the balloons.
My dad always has this look on his face that pains me when he takes us to the airport. It's like happy and sad at the same time. But mostly happy, thank goodness.
While I'm in L.A., I'll be there for my little sister, JoLai's 40th birthday party. Yay. We're ten months apart (which is a kind of a long story in itself, but one that I'm glad exists.) I am delighted that I get to see her and celebrate with her because she is some kind of wonderful.
I think Zachy looks like Auntie JoLai, don't you?
No offense to any other person that I know or love, but seriously? She could quite possibly be one of the very best people I know. There is not a more selfless person. There is not a more fun, hip, cool, easygoing, non-quirky, loyal and giving person, either. Plus, she loves everyone--so much so that I call her "the friend hoarder"--because like those folks on those shows, she doesn't get rid of anyone. Even the oldest friends stay neatly stacked all over her heart--while she keeps bringing new ones home. (That's a whole post in itself. . . . ha ha ha. . . .)
But for real, y'all.You know what? Anyone reading this who knows her is nodding their head right this second because it's true. JoLai is the friend/sister/daughter/granddaughter/auntie you wish every person could have. Really. The kind of person that if you didn't have her in your life, you'd wish you did.
Harry and I have this joke about JoLai--
"If anybody falls out with JoLai or has some kind of problem with JoLai, then BY DEFINITION they are AUTOMATICALLY the problem."
Harry even goes so far to say that he doesn't want anything to do with anyone who has some kind of beef with JoLai. I think the exact words he used to describe such a person were "automatic a--hole."
Ha.
The good news is that, with very few oddball exceptions, no one fits that description.
***
So that's it. That's my week. Ten swings of the pendulum. The ups, the downs, the laughs, the smiles, the tears, the stillness. . . . .
All a part of the continuum. . . .the back and forth of love and life.
Resident: "Hey Dr. M, have you been doing anything fun since your kids are in California?"
Me: "As a matter of fact, I went to see Sade on Tuesday! She was awesome!"
Resident: *crickets*
Me: "Wait. Please tell me you aren't looking at me like that because you don't know who Sade is!"
Resident: *crickets*
Me: "You don't know who SADE is? SADE? SHAAAHH- DAAAAYYY???? Seriously?" (but really wanting to say, "AWWW HELL NAAWWW!!!")
Resident: *crickets*
Me: "This will be reflected in your evaluation."
Resident: "SHAH-DAY? Is that what you're saying? Spell that."
Me: "F-I-R-E-D."
Sade, Atlanta Performance July 2011
On Tuesday, the B.H.E. took me to see the wonderfully talented Sade in concert. Her voice was like a perfect piece of dark chocolate--velvety smooth yet textured, uniformly sweet yet peppered with a little bite. The best part of it all was that she sang all of the songs that I like and know the lyrics to. And even better than that? She and her band Sweetback (who is a-freakin'-mazing, by the way) performed each track in the exact arrangement as their original recordings.
That made me super happy because nothing annoys me more than going to a concert to hear one of my favorite artists perform my favorite songs only to find that some wise ass has remixed every slow favorite into some funky, uptempo techno version and reconfigured all the fast tracks into wrist-slashing ballads.
Talk about annoying.
My sister, JoLai, who goes to waaaaay more concerts than me once asked, "Why not just listen to the album if that's all you want anyway?" To which I snarkily remarked, "Come on--everyone wants to sing along. Just give the people what they came for!"
Sade got the memo.
And yes. This is exactly what Miss Sade got on that stage and did, do you hear me? She gave the people what they came for. That and more.
Like chocolate, I felt myself melting into the seat, lulled by her voice and the horns. I closed my eyes as she sang "Smooth Operator" and remembered when my 9th grade Geometry teacher, Mr. C, had this big poster of her on the wall next to a parallelogram. I recalled us asking him who she was, and him smiling all big and giddy-like as he pushed the button on a boombox behind his desk.
That was the very first time I'd ever heard Sade.
"Smooth Operator." Ah yes. That song took me back. And track after track, other songs did the same. We went through my first heartbreak from tenth grade with "Is it a crime" and then the undying love I professed to the same boy at the end of twelfth grade with "Nothing Can Come Between Us."
Of course we'd be together forever and ever--even with me going across the country to college. Because this guy? This guy who was my first love in high school? He was the one. For sure and for definitely. And so I sang Sade all the way from California to Alabama on a forty hour drive--loud--because nothing could come between us. He was the one after all, right?
"It's about faith. . . . it's about trust. . . .yeah, yeah. . "
It's about faith my foot. That same boy had me singing "Love is Stronger Than Pride" just a few months later in the cafeteria. That sucka.
The good news is that reliving this not-so-good memory was fleeting. I was happy just a few tracks later. Yes. Filled with the warm nostalgia of yet another puppy-love when she sang "I Couldn't Love You More."
Lawd.
I played this incessantly while cutting out pictures of diamond rings from fashion magazines and annoying the crap out of my roommate every time I hit "rewind." Yes. Because this dude? The one from my freshman year of medical school? Oh baby. This guy? Now he was absolutely the one. No question.
Uuuhhh, yeah. Thank goodness she had the track "Bullet Proof Soul" on the same LP, 'cause I needed it.
Time marched on and my crappy luck in love continued. I served as a most excellent professional bridesmaid several times over, smiling pretty and accumulating dresses. Although my girlfriends all had "Kiss of Life" on the brain, I was stuck on "Please Send Me Someone to Love."
Good ol' Sade.
I finally finished residency and Sade stayed right with me. After the move to Atlanta, my longing for that "real love" chapter to begin grew stronger than ever. On the days that I felt sorriest for myself, I could count on Sade to have the perfect soundtrack for my doldrums. "King of Sorrow?" Seriously? Most depressing song ever. (Yet perfect background music for the blues, I tell you.)
"I want to cook you a soup that warms your soul but nothing would change, nothing will change at all It's just a day that brings it all about Just another day, nothing's any good."
or better yet
"I'm crying everyone's tears I have already paid for all my future sins. . ."
Damn, Sade. Everyone's tears? Really? (And if that wasn't enough of a downer, I'd just play "Somebody Already Broke My Heart" from the same CD.)
Finally, my heart could rejoice as I relived the first days after I met Harry through her sultry performances of "Lovers Rock" and "By Your Side." She sang it perfectly. No--better than perfectly. She gave the people what they came for.
It brought me to tears.
The show ended with her locking arms with all of the members of her band, walking to the edge of the stage and taking a bow--together. I immediately liked her twenty times more after that gesture.
See, this is what I love about the Sade pendulum . . . .and the music pendulum in general. It takes you through the extremes of emotion. . .running through open orchards with you on the best of days and snuggling under down comforters with you as tear-soaked tissue crumbles in your hand. Music makes you laugh and cry. But best of all, it stirs up memories rich and deep and takes you on a journey through time.
On Tuesday, we took a journey. And I'm so glad we did.
Encore!!
Oh yeah.
Just as everyone was leaving, she re-emerged for an encore performance wearing a stunning scarlet dress with matching ruby lips. The song?
"Cherish the Day."
Perfect.
*** Now playing on my mental iPod--one of many Sade songs that makes me think of Harry (aka the BHE) because of this line. . . "You're the one. . .the one I swim to in a storm. . . like a lovers rock."
and this one, too. . . because it defines who I want to be to those who I love with this line. . ."I will show you. . you're so much better than you know."
and this one because, yes, it is kind of morose. . . but it held my hand when I felt lonely. And sometimes the right song is the only one who can do that for you.
*Details changed significantly to protect anonymity.
Grady Resident's Clinic, July 2011
"Hi, ma'am. I'm Dr. Manning and I'm the senior doctor working with your doctor today."
"Good morning."
"Good morning to you, too. I heard that you had a rash giving you trouble today, right?" She nodded emphatically and rolled her eyes upward. Without me asking, she opened up her gown to show the angry eruption on her chest wall. I slid on a pair of gloves and asked, "Does this hurt?"
"Like hell," the patient quickly replied. "No, like hell-fire."
With the newly minted intern right beside me, I carefully inspected the flaming crop of dewdrop-appearing bumps spread like a linear stripe just below her right collar bone. "Tell me. . . how did this start?" I looked over at the intern whose brow was furrowed and inquisitive. Then I added, "I know you told your doctor all of this already, but I just wanted to hear a little more for myself if that's okay." I turned my head to make eye contact with both the intern and the patient; this was my unspoken way of getting permission to be redundant.
"First . . . .it felt like. . . .like something burned me. Crazy sounding I know. . . but that's how it felt."
"Ummm hmmmm." I folded my arms and kept listening.
"Then yesterday night I looked and this was what was there. Still burning like the dickens, but now with this ugly rash."
I raised my eyebrows and nodded slowly. "You know what, Ms. Fulsome? You do a great job describing what's going on with you. That was really helpful, thanks. If it's okay with you, we're going to just shop-talk for a few seconds, and we promise to explain everything we're talking about. Feel free to interrupt, okay?" She smiled in acknowledgment and helped us as we closed her gown. Next I faced the intern. "Thoughts?"
The intern licked her lips and pressed them tightly together before speaking. Although we'd met in passing a few times when she was a student, this was our first time working together in a clinical setting. Her brand new lab coat issued during intern orientation was blindingly white; her lack of experience had not yet caused it to be otherwise. Her earnest eyes were unspoiled, just like her white coat. . . . but she seemed nervous.
"No pressure, okay?" I offered. "Look. . . I really just want to hear what's on your mind. When we were outside you mentioned a few thoughts, and I was wondering if any other things had come to mind since we came in here together."
"I guess my first thought was pretty off then." She laughed nervously and then continued. "I was thinking that maybe. . . maybe she came in contact with something? Maybe poison oak or poison ivy? Especially since it is so linear?"
"Good point. Contact dermatitis from poison ivy can definitely give you blisters and you're right, it's one of the only things that gives you straight lines." I gently re-exposed the rash while being careful to keep Ms. Fulsome's breast from being exposed with the other. "This looks less like straight lines per se. . . and more like . . . . blisters on a red base. . . . but limited to one area. Kind of sparing other areas, you know?"
"I see what you're saying."
"What else could this be other than contact dermatitis?"
She sighed and licked her lips again. I could tell that the answer was right there but that, for whatever reason, she was afraid to be wrong. The silence was growing uncomfortable. Now she was biting her cheek, obviously deciding whether or not to say something.
I kept telling myself that this was only the third week of internship for them, and that I needed to be mindful of that. I didn't want to apply too much pressure.
Then, this happened.
Ms. Fulsome finally chimed in. "Doctor? What about the other thing we talked about? Remember when you asked me what I thought this was? And then you started teaching me about that?"
"Oh. . . you mean. . . . shingles?"
"Yeah, the shingles. Dr. Manning, she asked me what I thought and I said, 'I wonder if it's shingles?' and she said, 'You know, it could be shingles, it really could. . . but your immune system isn't weak.' Then she taught me a whole bunch about it. But I still was thinking the shingles."
Wow. Ms. Fulsome for the win.
The intern looked at me and discounted their great idea. "She isn't diabetic and she's had several negative HIV tests. My first thought as soon as I saw it was that it could be Herpes Zoster (shingles) but since she isn't immunocompromised I thought against it."
I smiled wide. "Your first thought was right. Both of you."
"Really?" the intern asked incredulously. Ms. Fulsome made a hand gesture that said, "BOOM!" (which I totally and completely loved.)
"Yes, really. This is classic. Ms. Fulsome gives a perfect history, and lots of people with strong immune systems get Zoster or shingles. Have you been under any stress, Ms. Fulsome?"
"Stress? Well, I got three grown people living up in my house that should be living in they're own houses. Them and their kids. They my grandkids, I know, and I love them like crazy. . . .but I'd say having all those mouths at your table and hands pulling on your refrigerator can definitely give you stress." She released a hearty chuckle. "And two of them grands is teenage boys. You know how they eat!"
"I heard that!" I laughed, imagining two Paul Bunyan-sized teens scarfing down food at her table. Next I pulled off my gloves and tossed them like a ball into the waste basket. "Whelp, it looks like you both were right the first time. This is sho' nuff shingles."
After that, we chatted with Ms. F about the anti-viral medication that she'd need to take and gave her some information about reactivation of the chicken pox virus--aka Herpes Zoster. Once things were wrapped up, we stepped out of the room, pulled the white "discharge" flag and waved good bye to our patient.
The minute we left the room, the intern hung her head. Her morose facial expression completely caught me off guard.
"Oh my gosh! What's wrong?" I queried. She almost looked tearful; her face was a solid mask of defeat and her shoulders rounded and dejected.
"Zoster! Of course. Of course it was zoster. Pain first. Then the rash. In a dermatome distribution." She smacked her hand to her forehead. "I should have known that." Then she whispered with a sigh in a very tiny voice:
"I'm sorry."
dermatomes
Sorry? Oh, hell naw!
Like the touchy-feely mama that I am, I put my arm around her shoulder. "Sorry? Come on, now. That's why we all work together. That's why we are here with you. How do you think I learned? How do you think I still learn?" She shrugged and kept staring down as we walked back to the physician's room like teammates who just lost the big game.
Finally, I halted in front of her and placed both of my hands squarely on her shoulders. "Listen to me, and hear what I'm saying," I firmly spoke while staring into her glassy eyes. "You will never, ever know everything. Never, ever, do you hear me? You did something really great. You asked Ms. Fulsome what SHE thought it was. And you know what? She was right. You respected her enough to ask." Now, she was gazing back at me, riveted and almost scared by the tone of my voice. I went on. "Look. The more patients you see and the more you listen, the more you'll know, period. With experience you'll see things like this and know in a snap exactly what it is." I snapped my fingers for emphasis. "But some days? You won't. You'll be clueless, you will. So you admit it. You look things up. You get another opinion. You ask for help. You ask the patient more questions and get their input. And you learn."
"Yes, ma'am," she whispered.
"I say, 'I don't know for sure' about something every single day. But I just try hard to be curious enough to be bothered by not knowing. That way I'll look it up."
For the first time, she looked a little reassured. Suddenly, an easy smile broke out over her face; her eyes more confident and with a new determination. "You know what, Dr. Manning? I bet I will never miss Zoster now. Not ever."
Early this morning over coffee, I looked at this picture. . . . .
. . . . .and fell in love all over again.
I have a lot of stuff to do today. New interns in the medical clinic. Deadlines to work on. A manuscript to start. Evaluations to complete. . . . .
But that's not what's on my mind right now. This is.
This. This is what I'm reflecting on this morning. Over hot coffee and yogurt with fruit on the bottom, I am reflecting on this. . . .
Yeah.
This morning, I'm savoring the love that I longed for and was never sure could be. 'Cause before this, see, I wasn't lucky in love.
No, not at all.
So . . . . . instead of fretting the day ahead. . . . .instead I'm sitting at my kitchen table looking at pictures of people and places and blessings. . . . .remembering and marveling and feeling thankful. And that's it.
Nothing deeper than that.
***
Happy Monday.
". . . for His compassions never fail. They are new every morning; great is your faithfulness." ~ Lamentations 3:22-23
Honestly? I write this blog to share the human aspects of medicine + teaching + work/life balance with others and myself -- and to honor the public hospital and her patients--but never at the expense of patient privacy or dignity.
Thanks for stopping by! :)
"One writes out of one thing only--one's own experience. Everything depends of how relentlessly one forces from this experience the last drop, sweet or bitter, it can possibly give."
~ James Baldwin (1924 - 1987)
"Do it for the story." ~ Antoinette Nguyen, MD, MPH
Details, names, time frames, etc. are always changed to protect anonymity. This may or may not be an amalgamation of true,quasi-true, or completely fictional events. But the lessons? They are always real and never, ever fictional. Got that?
