I was counseling someone recently about healthy food choices. This wasn't actually a patient--it was an acquaintance who had been feeling a little bummed about weight management issues.
"I don't know what it is that makes it so hard for me to eat right. I mean. . .I try. . .but then I fall right back off again."
That conversation went similarly to discussions I have with patients. Next came my suggestions about portion control, healthy choices, filling up on lean proteins and vegetables, and easing up on the bread and carbs. The same ol' same ol'.
Yawn.
Since then I've been thinking about food and our relationships with food. Because everyone has a relationship with food. Some people enjoy their meals, but mostly look at it as nourishment. Sure, they indulge here and there. But for people with this kind of relationship with food, it's more of a "hookup" with no strings attached and they don't "catch feelings."
Let me quickly sidebar you on that for a second--this idea of "catching feelings." I still remember this one night when I was sitting on the porch of my dorm talking about boys with a group of girls. One of them had been "hanging out" with this guy who (totally) had a girlfriend (which now that I am reflecting on it makes me laugh out loud at this idea of folks thinking they were betrothed to anyone back then.) Anyways. Like I was saying, this girl and this (spoken for) guy were "hanging out." (read: being intimate/lovey dovey even though he had a girlfriend.) However, there was a bit of a problem, Houston--she liked him for real. But him? Oh, this was just casual and he was just "hanging out" on the "low-low." (There was lots of good slang in 1989, too.)
Now check it--seeing as dude was already attached to someone, he broke off their little situation stating that they couldn't "hang out" anymore seeing as she was "catching feelings" and all. Yeah, that's right. "Catching feelings." That surprising (or not-so-surprising) side effect of spending time with someone or something such that you find yourself wanting more, please. So him? He was "just chillin'." And her? She was trying out his last name and picking out china patterns--rookie mistake.
Dang.
See? I am thinking that this is how food is for some people. Like, no matter how hard some of us try. . . . at first it's just "hanging out" and then, despite our best efforts, we "catch feelings." We try diets and "lifestyle modifications" but as soon as food gives us an inch, we look up and now we've taken a mile. . . making those same rookie mistakes.
And why is that any way?
Harry and I have very different feelings about food. For him, food has more love wrapped up inside of it than it does for me. He is incredibly disciplined in all areas of his life--but whenever we get on one of our "Team Manning" health kicks. . . .I can tell that it affects us differently. Like. . .it's almost. . .I don't know. . oppressive for him to eat egg whites and lean turkey for breakfast. Yes, I meant to use that word--oppressive.
Part of this has to do with how our mothers cooked (and still cook.) My mom mostly cooked because we needed to eat. (No offense to my mother.) I don't recall hearing her agonizing over what to serve on a Sunday or mapping out a big Thanksgiving for fifty folks. We always had delicious, hearty meals--yes. But with the exception of her (amazing) specialties--yeast rolls and homemade dressing--most of those things could be done fairly painlessly.
At least this was my impression.
My mother-in-law on the other hand? Fuggeddaboudit. When she comes to town, there is only one single thing we argue about--how much food she makes. Cakes. Pies. And not just cakes and pies. Several of them. Case in point--nobody ate the sheet cake I bought from Publix for Isaiah's second birthday because sweet Nana had also made. . .wait for it. . . TWELVE sweet potato pies, TWO red velvet cakes, and ONE key lime cake. Oh, and a big, giant vat of banana pudding.
Um, yeah.
In Harry's house growing up, Sunday meals start on Saturday. Chopping up things and soaking things and seasoning things. Sunday morning early the house is already filled with amazing scents wafting into the nostrils of sleepy little ones. Homemade biscuits with butter pats on each one bake as she grates cheddar for macaroni and cheese. Bacon is sizzling in a frying pan and eggs are being scrambled with some of that same cheddar cheese folded in. Oh, and do you want some hashed browns, too? Sure, baby, here you go. Real buttermilk cornbread getting poured into a cast iron skillet and brisket slow cooks all the while. Just like you like it.
After 24 hours of preparation and cooking. . . .the meal is but a memory by 5pm. But the love could be tasted in every bite. . . and seen in the entire spread. Three meats, more sides than could be counted and of course, some sho'nuff dessert to top it off. The night ends with a house full of happy folks in comfort food comas.
See?
So how do you tell folks who grow up with this to wake up to some steel cut oats and a dry ass piece of grilled chicken breast and steamed broccoli? How do you say, "Chill on the butter" or "choose the berries for dessert?" Like. . .how?
There's also folks who catch feelings for food later in life. The love affair starts on the "low low" in college or after some pivotal time in your life. Maybe it's wrapped tightly inside of another relationship like with that of a bff or a summer romance. The food becomes a part of the celebration of happiness and most activities start to center around it. Ever seen a newly wed like six months after the wedding with a few new curves? A lot of us have been there. . . all that love leads to some extra butter pats on biscuits in the morning. . .and some extra junk in that theoretical trunk.
Anyways.
Look, man. I have no answers here. All I know is that food is real complex. And I need to be thinking a little more carefully about that when counseling my patients in the future.
Because some people caught feelings for food a long time ago. Or at some point. So asking them to scale it back to just "hanging out" from a full on love affair is more than just a notion.
Yeah.
That's all I got today.
***
Happy Monday.
What's your relationship with food? Do y'all casually "hang out" or have you "caught feelings?"
**Warning: Totally nonmedical and random post ahead.**
organized hoarding
Have y'all ever seen one of those shows about the people who hoard stuff? You know. . .the ones with things stacked all the way up to the ceiling and who constantly shop and bring new stuff INTO their house without ever taking anything out?
Well, have you?
Dumb question. . .of course you have. Even if you had every intention of turning the channel, you know you've watched and gasped and OMG'd at those shows before. You stared at the television like it was some kind of dreadful train wreck rubbernecking at the tiny little walkways between those enormous stacks of clothes, trash, or just stuff. Oh, and if you haven't seen one of those shows? It only means you don't have cable--which is a whole different subject for a whole different time.
Anyways.
Since most of you have seen the hoarding shows, you know that there's a few different types of hoarding people. There's the shop-til-you-drop ones who keep buying clothes or knick-knacks until they overtake the entire house. Then there are the folks who, for whatever reason, simply don't throw any trash out. Garbage and old food stacks all over and leads to an overwhelming stench that neighbors eventually smell and call the authorities about. Of course there are the pet hoarders--and these episodes are seriously so disturbing that I won't even describe any of it further.
So at this point I'm sure you are wondering--what the HELL is the point of this post anyway?
Stay with me. I'm going somewhere.
So here's a question--isn't there a little mini-hoarder in us all? I mean. . . look. . . I'll come clean right here and now and tell you that I am definitely an email hoarder. Baby, I have emails from President Obama back when he was still Senator Obama. And worse? I think I even have a few emails saved from before I was married. Bananas, I know.
See, like the folks on those television shows, I had a traumatic event that triggered my electronic hoarding problem. Once someone swore to me that they hadn't promised me something that I was sure they had over email.
I dug and dug through my emails and finally--hallelujah--found that lonely little message. Clear as day, the dude said, "Sure, Kim! Would be glad to do it!"
BWAAHH-HAAH-HAAAAAH!
So quietly. . .I have not deleted a single email since 2006. Okay, maybe that's an exaggeration. But seriously? I don't think my inbox has been at zero since, like, 2007. (I ain't lyin'.)
But I digress. . . .
That brings me to the subject of this post. . . my sister, JoLai. JoLai. Oh, my dear, dear sister JoLai.
Let's see. JoLai? Um, she's pretty much awesome. In fact, to help you fully understand how great she is, I will share with you this quote from Harry regarding JoLai:
"Anyone who has a problem or an issue with JoLai is an automatic asshole."
(What can I say? The dude is rough around the edges.)
Anyways, this is because JoLai is the easiest person to get along with of all time. And for this reason, she is a friend to everyone. She is also the person that I have now affectionately dubbed. . . wait for it. . .wait for it. . . .
"THE FRIEND HOARDER."
Because she is! She so, so is! I mean it when I tell you this. . . .my sister hoards friends. It's officially hoarding because JoLai brings friends in and never gets rid of them. She's not a "trashy" hoarder. . .she's more like that photo above. . .where everything is neatly organized and categorized. Yeah, that's how she hoards her friends. As a matter of fact, she'll keep your friends, too--even the ones that you lose touch with. Crazy!
Yeah man.
So check it. . . most of it has to do with just how likable she is. I mean, seriously--JoLai is like this person who curiously has achieved the most perfect mix ever of coolness, nerdiness, fun-to-hang-out-with-ness, sports-lover-ness, cultural competency-ness, thoughtfulness, malleable-ness and magnetic personality-ness such that anyone and everyone who gets to know her at some point wants to keep her as a friend. Forever. No, I'm not exaggerating. The friendships are always reciprocated. Forever.
She's the one who takes me for those fancy L.A. pedicures.
Hold up.
Let's be clear here. It's not like JoLai is stalking people and forcing herself upon them. Not at all. She simply has this way of keeping her finger on everyone's pulse and knowing how even the most remote people from the most RANDOM times in our lives are doing. And not in that cursory way, either. She really has spoken to them and really knows. How. They are. Doing.
Case in point:
Last month, JoLai had a big 40th birthday bash. It was in her backyard, and was complete with the most awesome deejay ever, a taco truck (very popular in Los Angeles by the way) and even a bartender. It was relaxed and fun and . . . .seriously? FULL of people from literally every stage of our lives.
Kind of like Facebook on steroids.
JoLai and college pal, Marla--who flew in from Houston.
Let's start with the deejay. When I was in 9th grade, I had a crush on this guy from this family/kid organization we were in called Jack and Jill. Although my crush never became anything, I'd occasionally run into him over the years because he became a fairly popular deejay while we were growing up. But the last time I saw him? Like. . . uhh. . .let's see. . . 1992 maybe?
Okay, so turns out that the deejay thing eventually became his livelihood, and he is totally an "it guy" for parties in and around L.A. I overheard my sister saying that "the deejay" would be arriving to set up--and then she said this guy's name--DeVoux--which isn't a name like "Keith" or "Jeff."
I was floored. "DeVoux? As in from like 9th grade Jack and Jill DeVoux?" I asked incredulously.
"Oh, yeah! That's my buddy!" she said.
Anyways. . . . .unlike me, she remained friends with him over the years. . .and of course he was her deejay. Of course he was.
A few weeks ago, JoLai was at a different party and sent me this picture:
Does that make you crazy? Possibly.
Ummm, yes. That would be Cee-Lo Green. As in "the EFF YOU song" Grammy-winning guy. Turns out that she was at a party with a friend of hers who. . . uuuhhhh. . . was also from our 1980-something Jack and Jill days. Well this old friend just happens to be a stylist to the stars, and JoLai, of course, has not only stayed in touch with her, but is a good friend, too. So naturally she invited JoLai, the least starstruck and least pretentious person ever, to hang out with her and all of the freakin' members of that hit show "The Voice" for their wrap party.
JoLai and Shawn B., stylist to the stars (and friend from J and J back in the day!)
Of course she did.
Her and the (mutual) friend that I, literally, had not seen or spoken to since like eleventh grade.
Speaking of which. Let me get back to the blasts-from-the-pasts that I saw at her party. . . . . a girl from kindergarten, a bunch of kids from the magnet school we were bussed to in 5th to 8th grade, girls from our cheerleading squad, my high school sweetheart--LITERALLY (aka "Cute Boy"), her best friends from elementary and high school, a bunch of people that went to college with us, law school friends of hers, work colleagues. . . . you name it, they were there. And. She was still down with them. And you know what? They were down with her, too.
JoLai with bff since 9th grade, Stacy. Still goin' strong.
Wait, y'all--even my homegirl Bernetta from across the street that used to double dutch with me all day and braid our hair and put tinfoil on the ends.
It was bananas. Bananas!
The girl has remained friends with E-VER-Y-one.
Now seeing as I am the only human being who isn't on Facebook, all of this was just way too exciting for me. And seeing as I am no where near as good as she is about maintaining contact with people from certain seasons past, all night it was like this for me:
Me and Carla--my Varsity Cheer pal from the Class of '88!
Dude. It was like some kind of crazy time warp. For reals.
And as nice as it was to see me, her older sister, every person I saw said, "Oh, you know I couldn't miss JoJo's party!"
Seriously? Seriously.
I mean. . . yes. I have some old friends. But not like JoLai. With one very tiny and completely understandable exception, I cannot think of a single person that she has "drifted apart" from or completely fallen out with. It's amazing.
Man. Y'all had to see this party. I wish I could put it into words better. And for real, this is not because of Facebook, either. JoLai was hoarding friends long before there was a Facebook or MySpace in existence. Ask her about anyone--ANYONE--and she will know their whereabouts.
"What ever happened to ol' boy that use to go with ol' girl?"
"Oh, they just had triplets! Let me show you the picture!"
"What about ol' dude from seventh grade who used to wear those thick glasses?"
"Oh, him? He texted me this morning and said he was so sad he couldn't come. I had forgotten that his daughter's Bat Mitzvah is this weekend. Remind me to get her something, okay?"
His daughter's Bat Mitzvah? Like really? This is no exaggeration.
There have been some instances where drama just makes it impossible for me to keep up with folks. Yet. . .somehow. . .in all of this. . .she averts drama. Like you'd think that with all of these friends stacked up all over her heart that she'd be having to coddle them or deal with their quirks, right? Wrong. For whatever reason, people put their quirks on ice for JoLai. They keep all their crazy at home and give her the best version of themselves. (Me included.)
She's just that person that if you weren't friends with. . .you'd sure wish you were. But the best part is this--you'd never have to stand on the sidelines wanting to be her friend. She'd welcome you into the game long before it even got to that point. That's just how she rolls.
Honestly, I used to marvel at her ability to maintain ties with people so much that it became envy. Eventually (and quickly) I got over that and just realized that this is just who she is. And though I do hold on tight to my fair share of people, there are admittedly some that I honestly couldn't name if my life depended upon it. Some of whom were once every day fixtures during different stages of my life. Eh. This may be represent pathology or some quirk of my own, but oh well.
So. . . there you have it. The story of why I call JoLai the "friend hoarder." And the explanation for why I'm not on Facebook. . . because who needs a Facebook account when you have a JoLai?
JoLai. . . the best friend ever.
If it sounds remarkable, that's because it is. Oh. And if she sounds remarkable, too? It's because she is. Damn, she is.
JoLai and our homegirl, Kelly W. The baby sister of my childhood best friend!
All grown up!
Bernetta -- head of the original neighborhood drillteam and hair salon
Friends since 4th grade. Oh, and she lives in D.C.--not L.A.
My very first real boyfriend--in the dark jacket. (Still friends with Jo.)
First cousin flew in from Dallas--had to be there for JoLai, too.
This was before it really got crowded!
JoLai's BFF Stacy on left and that's DJ DeVoux on the right.
Far left, a friend I haven't seen in literally 25 years. Center, the infamous Bernetta.
Everyone loves Jo!
Including our cousin, Brian, who had to be there, too.
Work friends were there, too.
Old friend Inga from fifth grade on the left, new friend Claudine on the right.
More old friends had to be there for JoLai.
I'm still tripping off of seeing this guy!
(JoLai only knows cute guys.)
Oh, and this cute guy? That would be her man. See, told you.
This night a deejay (who happens to be a friend) saved her life. . .
She sure has a lot of gorgeous friends, right?
Here with our big sis, Deanna!
(She's also an awesome auntie!)
Ah hah.
While looking at these pictures, I just figured it out. JoLai brings out the best in people and makes them like themselves more. This is why she draws people to her light. And this is why once they get to her light, they don't want to go home.
Ah hah.
***
Happy Sunday.
Now playing on my mental iPod. . . . .TLC's "What about your friends?" (a question that no one will EVER ask JoLai. . . )
Lately I've found myself saying at work on multiple occasions, "Damn, I love this place!"
This week, I bring you ten lovable takes from my life at Grady Hospital . . . because this place never fails to bring that boom boom pow.
Ten Takes from one week at the Gradys
#10 -- You must remember this. . . .
. . . a kiss is still a kiss. A sigh is just a sigh. . . the fundamentals all apply as time goes by. . . .
Alright. So I'm walking out of Grady the other day and I see a woman exiting with two plastic bags full of personal belongings. She'd just been discharged from the hospital more than likely and just as she made her way outside, a man--obviously coming for her--began walking quickly toward her.
"I was coming up there to get you, baby!"
"They let me out early, honey!"
So check it--these people were no less than sixty-something years old. Matter of fact, seeing as "black don't crack" they might have even been knocking on the eighties. Either way, it was obvious that they had some serious love for one another and were happy to see each other.
And so. Nosy me keeps watching.
Finally, he reaches her. First he just cups her face in his hands and I catch a glimpse of a warped band on his left ring finger. And her? She is smiling like a fourteen year old girl . . .I tell you the truth. Then he says, "Heeeeey, baby." All soft and throaty. Really in a tone just for her, but since I was being nosy, I heard it, too. And she responds by just smiling more. After that, he plants one on her. . . .pressing his lips against hers in that slow-ish, deliberate-ish way that older folks sometimes do.
It was so sweet.
But then something happened. That dry-lipped "welcome home, baby" kiss morphed into something else. Mr. Happy turned his head to the side and went in for the kill. Y'all! Mrs. Happy dropped her two bags and wrapped her ample arms around his shoulders. I could see her grandmother-ring with multiple birthstones on one hand and a weathered wedding band set on the other.
Aaaaah, yes. This was a husband and wife. . .and probably somebody's Maw-Maw and Paw-Paw.
Sigh.
And do you know what they did next? They made out. No, for real. They said "to hell with y'all" and went for it. Yes. They stood there making out--like for real open mouth kissing and all that--right there in the Grady vestibule. The kind of PDA that makes someone shout out to a couple of twenty-somethings to "get a room!"
But in this instance? It was endearing. And . . . hell. . kind of inspiring.
I hope Harry and I are still kissing like that when we get up in age.
#9 -- Baby, baby, baby
me and my baby boy
In the Grady elevator on Thursday:
"Hey Miss Manning!"
"Hey to you, too!"
"I ain't seen you in a minute. I see you got all that baby weight off you."
Don't know what to say to that.
"I think last time I seent you you had just had your baby or was pregnant. Around Christmas? When did you have the baby, like six, seven months back?"
Don't know what to say to that.
"Is the baby sleeping for you yet? What you have a girl or a boy this time?"
"Uuuuhh, a boy." Which technically is true.
"Okay, then! You almost there Miss Manning. You lookin' good."
Walks off of the elevator, all cheery and happy.
Still don't know what to say to that.
#8 -- That's what's up.
Talking to a patient on rounds the other day:
"Word life, you don't need a ring to be my wife. . " ~ Method Man
My patient was sitting with his common-law wife as we discussed details of his medical history and hospitalization. He was animated and so funny. She was totally chill. Look up "chill" in the dictionary, and she'd be there. Not chill-y. Just chill. I liked them immediately.
"So, do you ever smoke sir?"
"I ain't gon' lie, Doc. I do."
"How long does a pack last you?"
"Uuuuhhhh, two or three days, maybe?"
Eye roll from Lady Chill. I laughed out loud and asked, "More than that?"
A coy smile and an eyebrow raise.
"Alright, alright! I smoke like a pack every day."
"What about your medications? I know you ran out this time, but are you good about taking them otherwise?"
"Oh, yeaaaah. Definitely. I don't never be missin' my medicine. Never."
Cough into her hand. Another sly smile and this time one eyebrow up in his direction.
"Whaaaat, ba'y?" he chuckled while looking at her lovingly. "Ba'y, for real. I do be takin' my pills!"
She folded her arms and giggled in her chest with her lips closed. Not a word, but she was sure telling on him.
"Not such an angel about the medicines?" I query her. She turned over her palms and shrugged while cutting her eyes playfully in his direction.
"See, Doc, you know what they call that? They call that 'dry snitchin'.'" They both laughed in unison.
"Dry snitchin'?"
"Yeah, Doc. Tha's when you be tellin' on somebody with your eyes and yo' facial expressions. Givin' it away without openin' your mouth. Tha's the dry snitchin'. Ba'y, why you dry snitchin' on me?"
She smiled wide this time showing a glistening gold tooth. . . and looked so amused with him. It really was a loving interaction.
"She's dry snitchin' because she obviously cares a lot about you," I responded.
"Oh yeah, now I know tha's true, for real. This lady right here--" He gestured at her with his thumb. "She hold me down, you hear me? Man, like Mary J. and Method Man . . .for real. This chick? She hold me the f--k down. I mean, we ain't legally married, but we married, you feel me?" He looked over at her and softened his eyes. She returned the gesture and didn't seem to mind at all being referred to as "this chick." Which made me not mind either. And yes. I got the "Mary J. and Method Man" reference.
That's what's up.
And so I say exactly what I'm thinking. "That's what's up, right there."
Because no matter who you are, love is love. So yeah, man. I do feel you.
"Back when I was nothin'
You made a brother feel like he was somethin'
That's why I'm with you 'til this day, boo, no frontin' "
~ Method Man featuring Mary J. Blige in "All I Need"
#7 -- How excellent.
Kevin is a medical student on my team this month. It's so obvious that he cares for people in the deepest parts of his soul and I know for certain that he is going to be an exceptional physician some day. Because he is early in his clinical training, the trajectory of his growth is straight to the sky. It's amazing how much I've seen him grow in just ten days.
Amazing.
On Wednesday, I sat with him and gave him detailed feedback on his patient presentations. We had a great chat and he asked excellent questions. I could tell he was eager to apply the concrete suggestions I'd offered to him.
On Thursday, he did just that. He stood tall and confident and prepared. . .and then gave this kick ass oral presentation of an extraordinarily complicated patient warranting zero interruptions. He peppered in teaching points and it was great. Really great.
The best part was that I could see and feel how proud he was of himself.
I gave him a fist bump and told him exactly what I was thinking. "Excellent. Now that? That was excellent."
#6 -- It's the Real Thing.
As my patient was getting discharged last week:
"Is there anything else I can do for you before I go?"
"You know what? I would give anything for a Co-cola. Just a nice cold Co-Cola in the red can. Ha ha ha. . .naaw, but otherwise I'm okay."
I smiled when I heard that request. It made me think of Harry who says often that there is nothing comparable to a "good strong Coca Cola in the RED can." Not that Diet crap that everyone else is drinking.
I thought for a moment about his reasons for being in the hospital and asked myself what it would hurt for him to have a good ol' Coca Cola Classic before leaving. My answer? Nothing.
I excused myself, walked straight over to the vending machine and bought him one. In the red can.
#5 -- This is it.
I saw a patient the other day that had me perplexed. Nate, the fourth year medical student working with me, however, was not perplexed. It was his patient and he had put a great deal of thought into the diagnosis and management.
"I think this is what it is," he said. Then he explained why he felt that way.
"But what about that?" I countered. "The thing that makes me unsure about this is the amount of pain and the appearance. This doesn't always look like this in my experience. I'm wondering about that."
"From what I read, Dr. M, this can totally have this appearance. I mean, that is a consideration, but this is what we were thinking was the most likely explanation."
We talked some more about this and even involved some consultants. I examined the patient three or four times throughout the day to see how it would evolve. The specialists came to see the patient and using all of their expertise they came up with a final diagnosis.
Assessment: THIS (not THAT)
Recommendations: KEEP DOING WHAT THE MED STUDENT WAS DOING. OH, AND YOU CAN DISCONTINUE YOUR EMPIRIC TREATMENT FOR THAT BECAUSE IT AIN'T THAT, IT'S THIS.
Umm, yeah.
#4 -- Oh, lightin' up.
Outside of Grady in the "Smoking area" man has a cig in between his fingers and is looking around. . . .
"Hey -- 'scuse me, Doc. You got a match?"
Seriously?
"A match? No, sir."
"You got a lighter?"
"A lighter. Uh. . .no."
"Damn!"
Damn.
#3 -- Drive bys.
We were rounding the other day and standing in the hallway outside of a patient room. There were about seven of us on this day and we were all standing in a huddle. As one of the interns is presenting his patient, all of a sudden this man rolls up in a manual wheel chair to the edge of our pack. It's obvious that he needs to pass by.
"'scuse me!"
We part like the Red Sea and let him through. Our focus goes back to hearing about the patient. Less than a minute later, I'm listening to the elements of the physical examination and another interruption comes mid-sentence. I look over and there is Dude once again, this time on the other side of us.
"'Scuse me!"
Our circle fragments again to let him through and then rejoins. On to the lab data. X-ray results, laboratory interpretations, and EKG tracings. My intern prepares to put it all together in the assessment and plan. Then--I am not kidding--Dude rolls up again.
"Beg pardon!"
Yes. He wants to go by. And we let him. Again. Finally, after hearing the assessment and plan, we all start making teaching points and discussing what else needs to be done.
But the thing is, I'm having trouble concentrating because I know that Dude is just bound to roll up on us again. After a few moments, he doesn't so I relax and regroup. Just as I start talking, I feel something against my leg.
And, y'all know me, I looked skyward and laughed as I stepped aside.
Later on, I heard him say to a nurse who asked where he was going, "Man, I just be rollin'. That's just me!"
Hearing that made me smile for some reason. Because sometimes? All I want to do is roll, too.
#2 -- I got that Boom Boom Pow.
"Tell her it's okay to eat the breast of the chicken. That's the white meat and it's healthy. Tell her, Miss Manning!"
"White meat is leaner. Especially if it's skinless."
"Boom! Told you! Told you I could eat the breast and the wing!"
"Wings are actually a little higher in fat. But you are right, the breast is a good selection."
"Boom! Told you!" This male patient pointed triumphantly at his wife, who clearly had questioned his food choices. She folded her arms hard and curled her lips.
"Uuuuhhh, doctor?" she started in this very sassy and animated tone. "Tell me this--what if that breast of chicken is as big as his head and is fried at Popeye's? Is that a 'good selection?'"
I look at him with a one eyed wince. "Uuuhh, yeah. Not so much."
She held up her tattooed arms and pointed her fingers like two guns blazing. "BOOM! Told you Mr. Popeye's Fried-Chicken-even-though-you-got-heart-problems! Don't try to PLAY me!" Their laughter rang out into the hallway.
He looked at me sheepishly. "No?" A playful smile creeped up the side of his mouth.
I could still hear her playfully chastising him as I left the room . . . . .
For some reason, I couldn't stop playing "Boom Boom Pow" by the Black Eyed Peas on my mental iPod for the rest of the afternoon.
#1 -- Grady, baby!
***OMG. Best moment of the week!***
"Wow. You sure have a lot of ink. How many tattoos do you have?"
"Damn, doc. I 'on't even know. I got so many! They all tell they own story, though."
"Which one is your favorite? Or is it hard to choose?"
"Naw, it ain't hard to choose, Doc. This one right here is my favorite of all."
(shared on this blog with patient's consent)
Aaaaah.
"Grady baby." I said the words displayed proudly on his arm. Awesome.
"Yeah, man. Grady baby. . . for life."
Yeah, man. Me, too.
***
Happy Weekend.
Now playing on my mental iPod. . . Mary J. and Method Man singing about "holding someone down."
That first day you went off on me and everyone else.
"I'm in pain!" you yelled in no particular direction.
"I will work on your pain," I said back to you, my voice decidedly softer than yours.
"Yeah, right." That's what you retorted. Phtooo. Take that.
The next day I ask you, "How do you feel?"
Again you light me up, this time threatening to kick me out altogether. "Worse! Worse! I'm in pain! Y'all got my medicines all confused and I'm still in pain!"
And see, you have a reason to be in pain. This is not some "soft call" where you have a little ache in your back or a visit from Arthur-itis. No, this pain is legit. And this analgesia you're calling out for is warranted.
I take your venom and withstand your anger because I know it's really at the pain and not me. And, seeing as you're a born-at-Grady elder who happens to be old enough to remember the segregated "Gradys", then that gives you license to go off whenever you feel ready.
"Okay, let me compare your home medications to what we are doing here," I reply. "Were your home medications helping at all?"
"They were working better than what y'all doing! This don't even seem like it's as much as what I was getting at home and I thought I was s'posed to be getting my pain medicines worked out. This is some bullshit."
"Sir. . .I'm sorry. Please. . .let me look at--"
"Get out, please. Just get out. I need some rest. I'm tired and my body is hurting. Just go."
"Okay. I'm going to put you back on your home medicines and then move up from there. Okay, I'll leave now."
"And turn my television that YOU shut off back on 'fore you go."
"Yes, sir."
"And get that bright ass light, too."
I click it off on the way out and leave with my tail between my legs.
As a team we carefully reconcile your home medicines with your hospital medicines. Looks like we were a few milligrams under what you'd been getting, and we bring it all to speed by changing the orders.
The third day I come in to see you and your back is to me.
"Hey there, sir. I'm making my rounds and I'm here to see about you."
No answer.
"How are you feeling?"
"Terrible."
"Terrible?"
"Terrible."
"The medicines aren't taking the edge off?"
"It helped a little bit, but now I feel sick to my stomach. My bowels are loose, too." Your voice is quiet and defeated. This is different. . . and it scares me.
"We put you back on what you were getting at home and--"
"I know that. Soon as you said that yesterday I started. But now all I feel is sick."
"I'm sorry. . . what do you mean by 'as soon as I said that?' Do you mean the nurses told you it was a new dose?"
"What?"
"The medicines. You said you started as soon as I said something? That part confused me. Just wanted to get clear."
You reach under the bed and pull out a plastic Kroger bag full of pills. "No, I'm talking about my home medicines that you said to get back on. These here."
Wait, huh?
"Sir. . .wait. You're taking. . .hold up. . . you're taking these . . . and the ones we're prescribing in the hospital?"
"I did what you said." You point straight at me. You are talking about ME. Not my intern. Not my resident.
"What I said? You mean you are opening these bottles and taking these pills in the hospital?"
"Just the pain pills. Just those like you was talking about." You pull out a bottle and show me. "I took two of these here."
I look and then read the bottle. You have just shown me some Reglan to help with digestion. This is not a pain medicine at all. "This is what you took, sir?"
"Yes, I took my pain pills from home. That's what you said!" Your voice is rising higher and cracking a bit. Your repeat yourself. "You said to get back on my pills from home!"
Briefly, I'm relieved that you didn't take double the amount of narcotic pain medicine, but that is only fleeting. I squeeze my eyes and rub my forehead with the heel of my hand and sigh. "Sirrrr. . ." My voice sounds scolding, even though I don't mean for it to sound that way. "Noooo. . .noooo. . . .you're never supposed to take your pills from home when you're in the hospital. This could really--"
That was it. That was the straw that broke the camel's back.
Your face melted into frustration and tears began shooting out of your crinkled eyes. You shriek out, "I DON'T KNOW!!! I DON'T KNOW!!! I DON'T UNDERSTAND THIS! I DON'T UNDERSTAND THESE MEDICINES!!!" Your body is limp and your shoulders slump. And you weep. An exhausted, exasperated, tired weep. "I'm tired of the pain. I just want to stop my body from hurting. This illness going all through my body. . . I know it ain't a cure but they said. . . you said you would help my pain. Please, please. . . .help me."
Your hands are shaking and your lips are quivering. Each word is punctuated by your throaty cry. That cry sounded like it had been bottled up for all seven of your decades and I had just rubbed it out just like some kind of genie. It rose out into the hallway, first slithering around my head and strangling my neck.
I stood there dumbfounded. My face felt like it was on fire and my eyes blinked like some kind of involuntary tick to fight back the rapidly forming tears. I dared not talk. I had done enough.
I reached down and patted the bed, looking at you for permission to sit beside you. You nod, still crying. . . now trickling off into restrained manly crying instead.
And so I sat next to you in silence. I held your hand and wiped your cheek with some paper towel since it was the only thing sitting on your tray table. Then, when you were ready, we started over. Going through each medicine one by one. . . opening the bottles, pouring out each pill, and making it more concrete.
You told me that sometimes it's hard to see the words on the pill bottles and that even when you can, sometimes it's hard to read them depending on the words involved. I tell you I should have asked that and I apologize for what feels like the one hundred-trillionth time.
Then, eventually we get somewhere. I excuse myself with your permission and share this with the other members of our team. The intern, the resident, the pharmacist, the students. I let them see how ashamed I feel and how much it hurt my heart to see you cry. Yes, you. A grown man. Their faces look sorry, too, and I say nothing to blow it over or shrug it off because you being confused and in pain and frustrated just isn't acceptable. So together, we vow to do better.
And so we do.
On the fourth day you were smiling. A big beautiful, nearly toothless smile. . . lighting up the room and even the hallway.
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?
