Enough already.

They called her name and everyone jumped to their feet. The applause was thunderous. All of those synchronous hands clapping so loudly that it almost drowned it out.

Almost.

She rose from her seat carefully. Halfway stunned and halfway excited. Someone beside her patted her on the shoulder.  A close friend wrapped her in an affectionate headlock and said in that way that only a true friend can:

"SO proud of you, dude."

Those words from that friend were so sure and affirming. It made her feel like a winner. Like all of this was something that she actually might be worthy of and had earned. But then, there it was again. That tiny naysayer in her ear.

"It's only because you're likable, you know. Nice. Friendly. That's why. There are others who are so much smarter, you know. So much better than you."

That's what that voice was saying. Like it couldn't let her be fully happy about this accomplishment. Or at least think for even two seconds that she was deserving.

When she walked to the podium they handed her a plaque. That made it even more real. She stood there staring at the pressed wooden board with the engraved metal plate.

RESIDENT TEACHER OF THE YEAR 

1999 - 2000

Just below that was her name. Her name. Out of all those people. Her name.Someone turned her shoulders toward a camera and nudged her in between the Chairman and the Program Director.

"Smile everyone . . ."

The photographer pulled her face away from the viewfinder and cocked her head sideways. "Come on, a real smile, doctor!" So she went ahead and smiled. Big and wide and happy and proud. And that felt good.

But then, just like that, there it was again.

"You're actually just more easy to remember than anything else. If you weren't of color and female, they'd not even remember who you were, you know. You do know that don't you? I mean, don't get me wrong. You're pretty good and all. But man, you better hope they don't find out that you're not nearly as great as they all think you are."

And just like that, a wrinkle of worry rippled across her brow again. She fought against it as she returned to her table. Eyes landing on person after person who smiled up at her with twinkling eyes and congratulatory gestures. All the while, fighting an internal war between perception and some distorted idea of reality. What was true?

A chief residency and a couple of years later, she was back in a similar place. This time at a new hospital with new faces and new experiences.  Second year on faculty, standing in the back of a conference room with half of a mouthful of a turkey sandwich, her name got called again.

Wait, huh?

And just like that, she could feel that tiny war trying to start once again. That relentless battle against any and every accolade, compliment, or triumph.

Again. Again? Damn.

Later that evening, she was home alone staring at herself in the bathroom mirror. She felt those words rising up to pick her apart.

"It's all a popularity contest, you know. All of it. It has little to do with your real impact as a teacher or anything like that. It's all popularity."

And she stood there looking back at her reflection and felt tears stinging in her eyes. But no, these tears were not tears of defeat. They were the kind that form when someone is loading up ammo and preparing to fight against an enemy. A giant Goliath.

This time she fought back. Not with audible words or swinging fists, but still, she fought with her conscious thoughts.

"I'm proud of myself."

"You're not what they think."

"I am not what they think. I am more than that."

"It's a popularity contest."

"Maybe something I have done has been popular with a learner."

"It's because you're black and female."

"It's in spite of that."

"So many other people are smarter and better than you."

"There is only one me."

"You aren't so perfect."

"I am quite imperfect. And I'm okay with that."

"You're not all that."

"I am enough."

The real fight started then. And it continues.

Yes it does.

***

image credit

A few years ago, I sat in a room with one of our female chief residents. The day she was asked to be chief, it was a no-brainer to everyone. .  . . except her. The first time I heard her say that with a chuckle to a group, it was met with an immediate barrage of counter-comments. But me, I put it on a post-it note in my head for later. This day during her chief year when I sat in that room with her was that "later."

On this day, I could tell that she was flying on one wing. I asked her what was wrong and she shrugged. So I asked her again, this time in a quiet room.

"I just don't feel as great as everyone thinks I am," she whispered through muffled sobs. "It's like all of it is some kind of fluke. . . some kind of facade, you know? I keep waiting for someone to come along and discover the truth."

"And what is the truth?" I asked.

"The truth? The truth is that people just like me for whatever reason. But otherwise I'm not at all what they think."

"No, you aren't what they think. You're more than they think."

"It's really just a popularity contest."

"Maybe your work product has been popular with our learners."

"But I'm not everything that. . . ."

"You are enough."  

That is quite close to exactly what I said that day. I must have struck a nerve because she just wept and wept.

Those answers came fast because they had become a part of my own war cry. But they can evoke some tears because it stirs up something inside of you when you decide that you're going to believe them.

Initially I worried about sharing that story. The part about me, the part about that chief resident . . all of it. As for the me-part, I felt nervous about revealing that amount of insecurity. But part of me believes that I'm not alone in feeling this way sometimes, so I know that by admitting to it, it helps me--and perhaps someone else--move past it. As for the her-part, I feared she or someone else would know who it was. But then I realized that nearly every female former chief resident I've known or woman for that matter who's reading this has probably felt some version of this. The other thing is that this has not only happened to me one time with one female chief resident. So really? It could have been anyone. Hell, it could have been me.

At one point it was me.

But, for the most part, it's not me any more. Nope.

Lord knows that I'm not perfect. I can be a bit feisty. I procrastinate like crazy. 99.9% of my schedule, my life, and my everything can only be explained by me despite how much administrative and BHE support I have. But you know what? Despite all that, I'm alright with me.

I try hard to do things with intention. Far more than I did or even knew how to do way back as a resident. Now I know more than just those negative things. I know that I'm a creative thinker. I'm a good communicator and I'm good with people. I genuinely care about the people in my life and try to show them I do through my actions. But mostly that's no longer me because I fight. I fight to channel that nervous little middle-schooler inside of me that once coached herself to believe that something she had to offer was special. Uniquely special. And then, with all my might, I try to bring the best version of me available.

And only I can do that.

Yeah.

I read a note from a young female medical student advisee last week. It was so kind and heartfelt that it instantly made me cry something eerily close to the ugly cry. I was so moved. This one person had carefully outlined what she personally felt about the impact I'd had on her. No. It didn't involve anyone else. Just this one student and her own experience and impression. That's it. The part that made me cry was how specific it was; somebody got it. Somebody got what I was trying to do.

Yes! I am enough! Man. That note helped me to fight some more against that pesky enemy. I am enough. Me works. Me is okay.

So (along with some profuse gratitude) I responded to her kind words with a few of my own:

"Remember that you are the only you the world has and you've worked hard to be where you are. I'm so proud of you, and you deserve all that has come your way.You are wonderful and special and enough. I am better for knowing you. Hold on tight--the best is yet to come."

Enough.

No. This isn't only applicable to female physicians or chief residents or medical students. This is a word for every single woman, mother, sister, daughter, wife, friend, girlfriend, ex-wife, teen, or person who has heard that heinous little enemy within spewing those venomous words of self hatred and self loathing in her ear. And sure, such things happen to men, too, but for whatever reason there is some way that women are uniquely wired to tear themselves apart when no one is looking. So yes, my sisters. This is a word for all of y'all. And me, too.

So I say to you what I say to myself in the mirror nearly every single day: 

"Enough already. Enough. Already."

Then, with bare-knuckled intention and butterflies in my stomach, I fight. Dammit, I fight.

And you know what? These days I'm winning.

***

Happy Tuesday-almost-Wednesday. Maybe it's time to retake the "NO SELF HATERATION PLEDGE" again as a reminder not to hate on ourselves and to leave all hating to the professional haters out there. Matter of fact, I think I'll jump on it in May. Or at least a part of May. Who's in?

Oh! And with that suggestion, of course I must play the "NO SELF HATE" anthem. Remember this? Love. This. Song. It is SO going to be playing on my mental iPod all week. (If you see me and I look like I have extra swag, that's why.)

See one. Teach one.

I snapped this picture with my iPhone on rounds last month. That's Elicia S., an awesome fourth year medical student, standing there explaining a complicated plan to our patient. I was so proud of her and how much command she had of the room and what she was doing.  I also love the way our newly minted second-almost-third year student, Yasmin A., was watching her.

Sigh.

This? This is medical education at its finest. At the bedside. As a team. Learning and caring and explaining and growing. This image embodies how our team rolled last month. Time and energy went into building our students' and interns' confidence in talking to the patients more than talking to anyone else. The patients. Not just me, the attending. The patients. 

Explain what's wrong. Answer their questions. Feel a little "put on the spot." It's okay, though, because we are all at the bedside with you. And we are all in this thing together. You're damn right we are.

I was just hiding in the shadows observing that day. It was the last day on service for me and now the learners were in an amazing groove. And Elicia. Look at her standing all tall. Can't you just see the respect she is showing for that patient? And look at Yasmin. Watching. Learning. Growing right along with her. And man my chest was all poked out like a mama bird or better yet what my dear friend the profesora in Pittsburgh calls the "mama gallina." So I lifted my phone and covertly snapped this shot--one that wouldn't include our patient, of course, but would capture what I was seeing.

Because what I was seeing was awesome.

Bwwawwwk. Bwawwk. (Pardon me, that's just me having a mama gallina moment.)

And this? This is medical education at its finest. Yes, it is.

There's this old saying in medicine that goes "See one. Do one. Teach one." But you know? I'm thinking that maybe we need to focus less on the "do one" part and more on the other two. I looked at this picture over and over again last night while working on a campaign for our Academy of Medical Educators.

See one. Teach one. 

That was the thought that immediately popped into my head. If you see one, teach one. Period.

That goes for everyone. Patients. Students. Colleagues. Everyone. Pay attention. Watch someone teach and learn something. Listen to the patients and learn something. No matter how old you are or young they are. Or vice versa. It's all just a reminder to never miss an opportunity to teach the ones you see. All of them, even if it's something tiny like "that Ivory soap is actually making your skin drier" -- that's better than nothing.

So that's why this tzujj-ed up iPhone snapshot is one of the centerpieces of our Academy of Medical Educators. Because of what it captures. It captures the best of what we should be doing as medical educators. Yes, it does.

And no. We don't always get it right. I am the first to admit that. But sometimes? We do. We so do.

See one. Teach one. 

Man. If we can just master those two, seems like do one will take care of itself. Don't you think?

Yeah.

***
Happy Tuesday.

The Singing Guy.

"Music makes the people come together."

~ Madonna

As promised--"The Singing Guy"singing his original song "Just Do It For Love." (By the way, he did give his permission for this video of his song to be shared.)

Mom and Sister Moon, the ocean view is for you!

Wow. The world is so full of talented people, isn't it? My friend, Lisa R., just said on her blog the other day: "I love people."  Man. Me, too.

* (Excuse the shaky camera person who may or may not have been under the influence of Jamaican rum.)

***
Do something for love this week. Happy Monday.

Three times is the charm.

 "In your world of noise

or in your quiet place

whatever you say

whatever you do

just do it for love."

~ The Singing Guy, Jamaica 2011

________________________________________

This weekend I cried. Three times, actually.

For some people this is a lot of crying. For others, it is no big deal at all. I guess I'd say for me that three times in one weekend is certainly no record, but it is a respectable amount of crying. Or not-so-respectable depending upon who you ask.

None of them were ugly cries. In fact, all three were the kind that remind me of sun showers. Light. Fleeting. Mostly pleasant.

The first cry was on Friday evening. The BHE and I had had a very dumb spat the night before. Nothing earth shattering, but we weren't agreeing so eventually just went to bed agreeing to disagree. We don't fight dirty. We decided very early in our relationship to not carry arguments and brooding into new days, especially if they weren't extremely important issues. This wasn't. But I am human and my feelings were a little hurt. Because we have now had nearly ten years of practice with not holding grudges and keeping things moving, I was on to other things the following day and not the least bit upset any more.

But then I received this text from Harry on Friday evening:

"About yesterday: I'm sorry and I love you."

And that was it. He had broken the rule of not unearthing spats with this simple apology. Reading and re-reading that text message made me cry. My husband is a tough guy. He is the antithesis of touchy-feely but regardless of that he cares about how I feel enough to make love a verb. For me, that means a lot.

My reply:

"Me too."


I cried again on Saturday morning. Zachary is officially five and a half and tells me this often. "Mama! I am five and a half!!"  And I laugh and say, "Yes, sir, you sure are."

Sometimes it's a reading-a-magazine-uh-huh-okay laugh. Other days it's a wistful laugh because Zachary is the caboose on our baby train. Yesterday morning when he made this announcement for the umpteenth time, it was definitely the latter.

This time he showed me his loose tooth when he said it.

And then this:

Something about that made me cry. I was happy for him, yes. But it put a pang in my heart to know that he was really moving further and further away from being my baby.

Not enough for me to allow my husband to impregnate me or anything. (Relax, Mom.)

But still. It choked me up. All of it. Him. It. That.

Saturday evening I cried once more. Harry and I attended the wedding of one my favorite former Grady doctor-girlfriends. She married another former Grady doctor on a beautiful spring evening. It had rained all week but yesterday for her wedding? It was perfect.

She looked perfect, too. So happy. So content. So beautiful. He did, too.

And interestingly, I didn't cry when I saw her walk out with her dad. Instead I cried randomly at the reception while glancing at her from across the room. Because she was happy and whole and full and complete. I was so glad for her. So glad for them.

I love it when I attend weddings and get that feeling. That feeling that isn't there at all weddings but that lets you know that it's right. Very, very right. You feel it. You know it. It has nothing to do with flowers or food or cake or expense. It is this feature that can't be purchased but is the main ingredient for a wedding to be right. No matter how modest or swanky the celebration.

And you know it when you feel it.

So I felt it at this wedding. Which made me cry.

Those kinds of weddings also feel like a bit of vow renewal for my own marriage. So that part was nice, too.

Oh yeah--and a bunch of my favorite people sat together at one table. Including my friend Stacy H. and the two infectious disease doctors with the infectious love that I wrote about over a year ago. Seeing them made me go back to my post on their wedding to relive it all. I smiled and laughed out loud all over again.

Perfect.

So yeah. We were all together at one very special table.

Table 'G' for Grady.

At Table G with my fellow Grady doctor, Stacy H.

So this weekend, I cried three times. All for love. You know? I'm thinking that old saying might be right. Three times was indeed the charm.

"Me, too."

But four is okay, too.

***
Happy Sunday.

P.S. I tried to post my video of The Singing Guy singing that song but it wouldn't work. Grrr! I'll work on it and get it on here somehow (because that's what's playing on my mental iPod!)

Complexities.

image credit

I was sitting at the nurses' station typing my notes and minding my own business. It was smack in the middle of the afternoon so there were scattered residents, students and ward teams around the area. Some were rounding. Some were teaching. A few others were just hanging around tying up loose ends from the morning.

And me? I was just in my own world typing my notes into the computer. My own team was on call so I was left to do my work while they stamped out disease in other parts of the hospital. I looked at my ratty checklist and methodically marked off my boxes with each note.  I was completely in that getter-done mode; I was in that zone that others automatically know to not disturb.

"You need to go be with her ass then!"

This was what jolted me out of my note-writing groove. My head whipped up and I saw her standing there. A young woman with a hand on her hip and an elbow resting on the counter. In that hand she had a bedazzled cellphone pressed up against her ear tightly. Almost as tight as the expression on her face.

When I looked at her we locked eyes. It was my way of telling her that she was not speaking in an "inside voice" at all. And that, seeing that this was a hospital and all, she needed to.

She rolled her eyes away from me and dug back into that conversation.

"See now you 'bout to piss me off. That b---ch called your phone and I saw it. You think I'm stupid. I ain't stupid."

Her voice was loud. Too loud to be standing where she was standing and saying what she was saying. I looked up at her again. Trying my hardest to communicate with her through my searing eye contact.

Another eye roll.

"I tell you what! Tell that b---ch to come within two feet of me so she can see what I got for her. Naw. . y'all both got me f--d up!"

That f-bomb grabbed the attention of everyone within earshot. She ignored the glares and snickers and kept on going. More f-bombs and even the n-word. Repetitive. Loud. Unfiltered.

And embarrassing.

There were easily twenty people who heard her. And of those twenty people, I was the only one there who looked like her.

Here I was sitting there in my white coat and professional attire trying my best. After walking around and seeing patients who smiled so deeply and with such pride to see me, their doctor, standing before them. Touching the hands of Grady elders and pulling my shoulders back a little more because I know that I am representing many of them, too. By doing things that were never even options for them to do.

Yes. This is something I have strapped to my back while working at Grady. This responsibility to provide a different kind of insight into black people. Through my actions and the things that I at least try to do. And on many days? I feel like it's working. I feel like somebody is looking and listening and thinking, "Hmm, this was not my impression of black people, but now perhaps it is." Or instead of that,  just some kind of realization that we are far more alike than we are different.

And then this. This young woman with a frighteningly unnatural hair color stomping her feet and hollering into a cell phone. And as if it couldn't get any worse, when I got up from the nurses' station and walked around the counter I saw that she was gripping the hand of a very confused-looking toddler.

Yes.

I thought about approaching her and saying something. But initially decided against it since the last thing I wanted was to let those twenty people witness two black women arguing in the hallway at Grady. So I walked by and cast my eyes in her direction once more. She kept on with tearing that person on the other end of the phone a new you-know-what--despite me or anyone else hearing.

I walked down the hall and then paused. Before I could talk myself out of it, I did an about face, forward marched right up to her and then stopped. I softly touched her shoulder and also softened my voice.

"Would you be okay with stepping into the family waiting area? Some of the patients can hear you and your conversation sounds pretty personal."

I braced myself for her to say something back but she didn't. Instead she huffed away and into the corridor toward the family area. Still swearing. Still loud. And still with that baby in tow.

And everyone just sort of stood there watching but instinctively not saying anything because I think they knew not to. Perhaps they knew me well enough to know how I was feeling. Or maybe her behavior was so inappropriate that the moment was far too awkward to even comment upon.

I don't know.

I do know that this is one of the things that makes being black so complicated. There is sometimes this self hatred that creeps up if you aren't careful. This thing where folks who have been given opportunities and guidance and parenting grow further and further away from those who don't. Chris Rock once built an entire stand-up routine on this notion. Which in some ways was very funny, but in the deepest ways was not. At all.

Especially since the whole world was laughing, too.

Over time I have learned that there a lot of folks that don't like black people. Regrettably, more of those folks than many realize happen to be black, too. Just ask Chris Rock.

So I thought about that moment a lot after it happened. I reflected on that toddler standing next to her as those expletives flew off of her tongue with out the tiniest concern for those pre-school ears or any other ears. Then I wondered whose hand she had held as a toddler and what she had heard.

Probably something identical.

It sucks that history tries so hard to repeat itself. And it sucks exponentially more that without a whole bunch of fight, that it almost always wins.

So we have to fight. But fight for all of us. Not just our own kids in our own houses.

After writing my notes, I headed to the elevators. I pushed the button to go down and sighed. It startled me when I looked over to my right and saw her still sitting in the family waiting area. Off the phone now and wiping her daughter's face with a wet wipe. An ironically mundane scene after what I'd witnessed earlier. I took a deep breath and approached her.

"Hey little sister . . .I didn't mean to get in your business like that. . .I just. . . yeah, it just sounded . . . . .personal."

"Tha's okay, " she replied. Her voice was surprisingly pleasant. "I just got a lot going on. Sorry I was loud."

And I stared at her and wished that I could sit right next to her and talk to her for four more hours. About why she was even in that conversation and what it could mean to her daughter to hear and see things that could rob of her innocence. I wanted to hold her hands and tell her that she was beautiful and full of promise. And that we are no different except that I was born to William and Cheryl Draper and she was born to whomever she was born to. But, still,  that we were one and the same and that we needed to fight. Together. That's what I wanted to tell her.

But I didn't. Instead I just smiled and said, "I hope everything works out for you. I really do, little sister." And I really did call her "little sister" because that helped me to see her that way instead of hating her.

Because hating her would be hating me.

Yeah.

You know what? I love being who I am. But sometimes? Sometimes it's kind of hard.

***
Happy Saturday.

Now playing on my mental iPod. . . . the great Frankie Beverly singing "We are one." Because we are.

I break the rules.

image credit

Recently I had the distinct pleasure of putting together and running an elective workshop for fourth year medical students on narrative writing in medicine. 14 students signed up for this session and we had three luscious hours to explore and discuss and . . .yes. . .write! I used that word "luscious" on purpose because that's exactly what it was to me--luscious--which by definition means richly satisfying to the senses or mind.

Loved. It.

So we started off with a discussion about why it's important for physicians to consider writing as a means of reflection. We chatted about how it connects us to the awesome responsibility we've accepted of caring for human beings and their families, and how it prompts us to pay attention. I shared a power point presentation with a few things from the medical literature about narrative writing and ways to get works published in our medical journals. That slide set also included some of my own approaches to writing, which isn't necessarily evidence-based. I guess it was just sort of my-own-experience-based.

Someone in the group asked me, "So were you an English major, Dr. M? A journalism major or something like that?"

And the answer to that was the honest-to-goodness truth: No. I'm just a person who has always loved to tell stories. . . . and also one who always loved to write.

Wait. Always? Hmmm. Let me clarify what's meant by "always."

By always, I guess I mean that remotely I had crappy journals and diaries stuffed in the side of my bed as a kid and a few times I wrote something that a teacher commented on for being not-too-horrible. Then as more time passed, I found myself sitting at computers writing for no reason. About this, that and also the other. So this is what I mean by always. But as far as some formal, hoity-toity training in writing. . .the answer is no.


This makes me a renegade writer of sorts. Kind of like some untrained person who shows up at a Broadway audition and just starts doing their own little pirouettes in a corner that they practiced in front of their bedroom mirror. But who someone sort of likes so they somehow makes the cast of a show or two.

Yeah. Like that.

We chatted about my blog and the other places that I write. That got me thinking about writing here and how intensely therapeutic it has been for me. There are days that I can't wait to open my laptop and just write. Write and write and write. With reckless abandon, without rules, without word count restrictions. To just get it out of my head and somewhere else and for it to be okay to have fragments for emphasis or silly sidebars and sayings like "awww hells naw!" or "the hairy eyeball" or to even refer to someone as the "teenage mutant target checkout chick."

So anyways. That three hours was luscious indeed. We spent some time using our words to paint pictures. I gave them a few scenarios and asked them to describe them with words. And they did. Wow they did. We shared those pieces and dissected them for the most decadent parts, too. Then they all took about fifteen minutes to write a longer narrative. Yes. Fifteen minutes--which I know doesn't sound like much but surprisingly can yield some substantial thoughts. We shared those pieces, too, and it was jaw-droppingly amazing and perfect and good.

Yes. Yes!

I walked away from that session so full and so encouraged. I was excited about writing and teaching and talking about writing, too. The students were so gracious with their ideas and so engaged with the process that I was like a rabid dog for more. (Do rabid dogs want more of things? Hmm.) Anyways. What was so good about this session was that all 14 of the students truly wanted to be there. They had chosen the elective and wanted to write. It wasn't being forced upon them like some lukewarm porridge; it was exactly what they'd selected off of the menu.

Ant during our writing elective, 2012, which she picked from the menu.

This made me wonder what more I could do with narrative writing for our learners. So over the last few days, I've toyed around with some ideas and have started researching some things to flesh those ideas out. That research led me to this article that had been published in the New York Times by a highly respected writer named Elmore Leonard. Leonard wrote this oft quoted piece (which later became a book) called  "Easy on the Adverbs, Exclamation Points and Hooptedoodle." It's his ten rules for writers which, if you hit a quick Google search, seems to be one of the closest things to the Gospel on Writing out there.

Anty-WHO. I read the article and had a major ah hah moment. Or better yet a rut roh moment. I break the vast majority of his rules quite often. Except for the last one. I think. Or at least I hope.

So first, let me share his rules and my take on how they apply to me as a writer. In a way this is a bit of a top ten. Well sort of. The bold is his rule as published. The part after is my thoughts on it. Capisce?

Okay. . .and away we go.

1.  Never open a book with weather.

Okay. I've not written a book, but I think there have been times that I've talked about the weather right off the rip. Oh well. Sometimes weather matters, man. It totally does.

 2.  Avoid prologues.

Again. I haven't written a book. But according to him, prologues can be annoying. Hmmm. I guess. Sometimes they annoy me, sometimes they don't. The thing for me is simple: Every book gets about 75 pages. In fact I have read the first 75 pages of  just about 75 books. Without ever finishing. If you haven't grabbed me in 75 pages--or 75 words if it's a blog post--then I will probably get distracted and do something else. The prologue counts in that. So if it's an interesting 75 pages, I'm cool with that. Prologue and forward included.

3.  Never use a verb other than "said" to carry dialogue.

Dude. I profusely break this rule. In my head sometimes people yell things or whisper things or mumble things. And sometimes they just said it, but that rule? I break a whole, whole, whole lot.

4.  Never use an adverb to modify the verb "said”…he admonished gravely.

Hmmm. This is good advice. . .I think. I am trying to go easy on the adverbs. But you know?  I'm not against them if it adds to the image. I guess I break this rule, too.

5.  Keep your exclamation points under control. You are allowed no more than two or three per 100,000 words of prose. 

 Say WHAAAAT!?

Ha. I don't think I'm super exclamation-pointy. But I am also not against some caps or some exclamation points here and there if it paints the picture. See? I break this rule, too.

6.  Never use the words "suddenly" or "all hell broke loose."

When I read that rule, suddenly all hell broke loose. Yep. I've broken that rule, too.


7.  Use regional dialect, patois, sparingly.

Rut roh. I break this one constantly. Especially telling stories from Grady. Sigh. This guy would hate my writing. Hate it, I tell you.

8.  Avoid detailed descriptions of characters.

Okay. Elmore Leonard would not make it through 75 words of anything I have ever written. My favorite thing to do is describe people. My absolute favorite. Another rule--broken.

9.  Don't go into great detail describing places and things.

See number 8. Sigh.

10. Try to leave out the part that readers tend to skip.

My fellow Grady doctor Neil W. is my guru for helping me here. He's good for striking a whole paragraph out of something I'm submitting for publication without me even knowing he did it. I probably break this rule on my blog. But oh well. Elmore Leonard would never have made it beyond one post so it's not like he'd notice.

 My most important rule is one that sums up the 10.  If it sounds like writing, I rewrite it.


Yes!  A rule that I actually follow!! (Whoops, too many exclamation points, sorry.)  I try hard to make my writing sound like dialogue or a real conversation. I want you to feel like you were there. So even if I break all of the other rules, if it feels like we're chatting over coffee or a yummy red wine, I have succeeded.

 * Excerpted from the New York Times article, “Easy on the Adverbs, Exclamation Points and Especially Hooptedoodle”


So. I am thinking of trying to put together of Council of Physician Storytellers at Emory. Don't you think that would be cool? A council of health providers as writers. . . .students, residents, faculty, and just people who want and need to write. But see? Now I'm all wondering about these rules and such. Man. I hope suddenly all hell doesn't break loose. Heh.


*rubbing forehead with the heel of my hand*


Man. This rule business makes it all feel so hard. Uggghhh.

Okay, seriously? Here's what I'm mostly thinking of telling folks should this pipe dream of a Council of Physician Storytellers become a reality. . . . I'm thinking of telling them just like that creepy, pock-marked dude told Danny Zuko before the car race scene in Grease:



The Rules Are, There Ain't No Rules


"The rules are--there ain't no rules."


Well, except for one. If it sounds too much like writing, then rewrite it. 


Yeah.


***
Happy Friday. 


How do you do with these rules? What do you think about them or rules in general? Weight in.


This is how I was feeling after our three hour writing workshop--giddy like these guys. Now playing on my mental iPod. . . .

Some soles to keep.

*details, names, etc. changed to protect anonymity

min·is·try n. pl. min·is·tries 1. a. One that serves as a means; an instrumentality.

____________________________________________

"Excuse me, I'm looking for the social worker on call?"

The clerk in the emergency department looked up from her multitasking and raised her eyebrows ever so slightly. Holding up one finger in my direction, she placed the call she was handling on hold and pushed a button to take another.

"Blue Zone!" she announced not exactly cheerfully, but not rudely either. "The attending is Dr. Heron but she's with a patient. Uh huh. Okay. Sure, please hold!" Methodically, she mashed the hold button and repeated this same process with two more calls.  I patiently waited for her and watched her hands on those buttons. Each of her fingernails was adorned with a long, curving acrylic coating and intricate decorations. The index finger responsible for that hold button was painted a different color altogether and was glistening with some kind of rhinestone design. Not to be overshadowed by those nails, she wore a fancy ring on every one of her fingers, including her thumbs. She caught me studying her hands and smiled.

"I'm sorry, baby. Now what was you saying?"

"Yes, I was just wondering--whoops, I mean, hey there, I'm Dr. Manning from the Medicine service. You doin' alright today?"

"Girrrrl, it's on like Donkey Kong down here, but you know how it is in the ER!" She let out a quick chuckle and as soon as she did, I noticed that one of her front teeth was completely overlaid with gold with the exception of an 'L' initial cut-out. I immediately liked her. "What you need, baby?"

"I was wondering if you could tell me where the social worker on call is? I need to find a patient some shoes."

That may have sounded like an odd thing to request, but she didn't even flinch. At Grady, this isn't unusual at all. "She down here somewhere. I can page her, but the box is in the social work office. I heard they was kind of low, though."

"Low on shoes?"

"Yeah. It's a man or a woman? They ain't hardly got no man's shoes. At least not in no size that nobody wear. Girl, you know Grady like a ministry, though, so like any ministry we do what we can!" She sighed and splayed her hands out; she looked a little like an ornate version of Edward Scissorhands. I stuck that statement on a post-it note in my mind for later. Grady is like a ministry. Hmmm. With any kind of ministry, you give and serve yes, but everyone knows you always get something intangible yet valuable in return. Grady is like a ministry. I liked that concept. "Yeah, but go on to the social work office and see what they got. I'm sure you can find something up in that box!"  She smiled quickly and raised her eyebrows to punctuate that this was the end of her being able to help me. Diligently she went right back to answering those blinking call buttons just like before.

"Thank you, ma'am," I said while moving away from the counter. She raised her arm and pointed in the direction of the social work office with that same rhinestone pointer. In that moment I thought to myself that perhaps there was a method to her madness in those nail designs--this especially fancy one had extra jobs so needed extra attention.

I stepped into the social work office and found another woman behind a desk. "Good morning. I'm Dr. Manning from the Medicine service and I was coming to try to find some shoes for one of my patients?"

She had a phone balanced on her shoulder and nodded to me silently. Next she pointed toward a weathered cardboard box sitting in the corner. It was only halfway full, but toward the top I could see that it had a collection of shoes inside.

These shoes were for a patient on my ward team, Mr. Shane. He was homeless due to a combination of severe mental illness, a stronghold of substance abuse, and poor resources. On this admission, he'd come to us for a persistent cough and an abnormal X-ray. Mr. Shane also happened to have advanced AIDS, so his subtle lung and radiograph findings made it necessary for us to exclude tuberculosis in the hospital, which fortunately for him, we did.

That morning was a Saturday and it was just my resident and me. I had agreed to manage the discharge for Mr. Shane and was nearly finished when I saw him lacing up a pair of sneakers so worn that I thought they'd disintegrate in his hands.

"Are these your only shoes, sir?" I'd asked that morning.

"They all I got. But it's better than nothing," he replied.

On this particular morning, I wasn't so sad to be at work because the weather was awful. A cold rain pelted the side of the hospital all morning long and I knew for certain that Mr. Shane's shoes would be no match for it. He had no interest in going to a shelter no matter how hard we'd tried to convince him. Though mentally ill, he was decisional. I knew he would choose to be discharged to the street.

"Maybe I can try to find you some shoes," I offered. "What size do you wear?"

Mr. Shane looked at me and shrugged. He truly had no idea. I stared at his sneakers and tried to guess-timate for him. "A ten maybe?"

"I 'on't even know. But 'preciate you for looking. I'll take whatever you got."

So I stared at him for a beat and then looked past him at that window behind his head. A dreary frame of a  bitter and wintry day was what I saw; I resolved to try to find him some shoes.

That's how I ended up hunting around for that box of shoes in the social work office on a rainy Saturday.

I paused for a moment and thought about his feet again. Then I dug my hand straight into that half-full box of donated shoes. That clerk in the ER was right. Nearly seventy-five percent of them were ladies shoes--loafers, moccasins, and even a pointy toed pair of heels. I sifted through all of the shoes, putting the men's ones aside and finally had four pairs to select from. One appeared to be no larger than a seven. Another had a hole on the sole so immediately was tossed back into the box. The remaining two included a pair of hightop sneakers that had to be a size thirteen at the least. The last was an overworn pair of wingtips. I turned them over and looked at the bottoms of the soles which appeared to have been redone at some point. I also noted the size: ten.

"I'll take these with me," I announced to the lady behind the social work desk who nodded once more from her receiver-on-shoulder position and held a thumbs up in my direction.

Off I went with wingtips in hand. As I reached the elevator I held the shoes up and inspected them. Fancy white and black shoes that would likely pair nicely with a zoot suit. But in this instance, they would have to work with one half of a warm-up suit and multicolored crew neck sweater reminiscent of Dr. Huxtable himself.

When I reached Mr. Shane's room, his bed was empty. I checked the bathroom and craned my head out of the door into the hall. A nurse standing nearby saw me looking for him and offered some information.

"He was ready to go so he was discharged already."

"Dang!" I said with probably a little too much emotion. "I had just gotten him some shoes!" I held up the wingtips for her to see.

"You got him some shoes alright!" the nurse teased. I flushed a bit because just then I remembered that those shoes just happened to be a dapper pair of Stacy Adams specials.

"Oh yeah. Swanky, right?"

"They're something," she replied with a shake of her head and the can of Boost she was about to give her next patient.

I stood there for a moment in his doorway. Wondering what to do with the shoes. I decided to take them back to the box they came from.

The emergency department is on the ground level by the hospital entrances. Instead of going straight to the ED, I took a chance and made a detour--walking outside near McDonald's--just in case Mr. Shane might be out there. By the time I stepped through the automatic doors, I immediately wished I'd had more than just my thin white coat. Even though the rain had subsided, it was still cold. Surprisingly, though, there were still a significant number of people walking around in front of the hospital.

I scanned the area. Then from the corner of my eye, I saw him. Mr Shane standing under the covered walkway just  before the entrance to the McDonald's next to the hospital. And yes. There is a McDonald's next to Grady hospital, but I have also worked in hospitals with Pizza Huts and Mickey Dees and Starbucks on the inside -- not even next door like this. So anyways--there he was, chatting with a man who also had a Grady armband. Talking all animated with a Happy Meal hamburger in one hand and an unlit cigarette in the other.

"Mr. Shane?" For some reason I hid the shoes behind my back. That nurse's teasing had left me a bit self conscious of those wingtips so I didn't want to embarrass him.

Mr. Shane smiled at me big and wide. He wasn't the least bit embarrassed by his decaying, fractured teeth. That's when I knew that he'd be the last one fazed by someone's opinion of some zoot suit shoes.

"Hey doc! What you doing out here?" He said that as if I hadn't just left him ten minutes before to go get some shoes.

I extended my arm toward him, wingtips in hand. "I was going to get you some shoes, remember?" I glanced down at his feet and those unbelievably ripped up Converse All-Stars. They were filleted open from the big toe all the way to the pinky toe exposing the royal blue hospital-issued socks he'd left in.

He froze and didn't say anything. Mr. Shane narrowed his eyes and leaned his head forward to get a better look at what I had to offer him. I couldn't read his expression so I just sort of stood there with my hand out not knowing what to do.

What was I thinking? Why didn't I just get the size thirteen high tops? Or better yet--why didn't' I just go back to the box in the social work office instead of hunting him down outside of McDonald's?

"Damn, doc."  That's all he said. He didn't even reach for the shoes when he said it either. So at this point I felt my face getting hot and heard a little voice in my head saying, Just go, will you?

Then, Mr. Shane abruptly plopped his bottom straight down onto the wet concrete and began pulling off his Converse. There was light in his eyes and a child-like animation in his movements. Within two seconds, he had thrown those sneakers to the side and was reaching for the wingtips. "Damn, doc!" he repeated, this time with great enthusiasm. "People always be saying they gon' come back and they don't get around to it or they just don't. Especially when iss Saturday. So I just went on and left 'cause I ain't think you was gon' make it back up there."

He got both shoes onto his feet and stood up. Next he stomped his feet and paced back and forth. "Awww yeah, doc! These is cold!" And from the big smile on his face, I knew for certain that "cold" was a good thing.

"Do they fit?" I asked in that rhetorical way that people ask about gifts that someone has just opened and appears to be loving.

"They fit perfect!" He kept pacing around and this time added a little point of his finger and "cool-brother" swag to it. That made me laugh out loud.

My daddy calls that the "Sunday stroll." The walk to do when you've got on your Sunday best or, as my dad says, when you're "clean as a Safeway chitlin." It warmed my heart to see Mr. Shane doing his Sunday stroll right there in front of Mickey Dees.

I reached down to pick up his Converse and gestured to a nearby wastebasket. "Can I pitch these?"

"Aww, naw. I need to save those. Just in case, you know, like somebody try to steal these from me."

And just like that I was jolted straight out of the warm and fuzzy of that moment into the harsh reality of Mr. Shane's real, true existence. He was still smiling as he took them from me and stuffed them into the white plastic bag on the ground next to him that he'd been issued for his belongings at discharge.

"I sho 'preciate you, doc. For real."  I looked in his eyes and smiled. He meant every word of that.

"Alright then, Mr. Shane. Take care of yourself, okay? And see about staying in a shelter tonight so you can get yourself all the way better."

"Okay, doc," he replied while still looking at his feet. He looked up at me with a twinkle in his eye, "For real, I'm gon' try."

"Okay." I reached out and shook his hand hard. I closed my fingers tightly around his and pressed them into his leathery skin. I wanted him to know that I wasn't afraid to touch him. I also wanted him to know that the doctors at Grady will come back to you. And they'll even find you and bring you some shoes in front of McDonald's if they can.

I turned around and walked away and, for some reason, no longer felt as cold as I had before.

As I reached the door, I glanced back over my shoulder at Mr. Shane standing under that breezeway. He was laughing out loud and holding that unlit cigarette and the hamburger in one hand. And despite the fact that all he owned was in a plastic bag at his feet and the fact that he might very well be standing in the very shelter of his choice for that night, in his face and laugh I saw some peace. It gave me some, too.

Imagine that.

Though not an unusual day for Grady, I'll always hold that memory close for years to come. That day, I made someone smile by giving them  a old pair of resoled wingtips. And in return? I got some soul to keep.

"Girl, you know Grady is like a ministry. . . ."

Yes, girl. It sure is.

***
Happy Wednesday.

Have you ever read this book? If not, you should.

Top Ten: Monday Night Randomness.

Hey good people!  It's Monday-almost-Tuesday and even though I don't have much to write about today my hands are on the keys like they have a mind of their own. Those who write know how it is. Sometimes you just have to write. I guess those who read have something similar but with reading, yes? Maybe? Hmmm. I guess.

Yawn.

Hmm. What to talk about?  Hey! How about a top ten? Don't mind if I do.

Top ten . .top ten. . .uhhh. . .hmmm. What witty thing can we discuss? Gosh. I'm feeling so random and silly right now. Hey! Let's just do this:

TOP TEN SUPER RANDOM THINGS I'M PONDERING 

ON A MONDAY LATE AT NIGHT.

And let me just give this disclaimer, people. On a scale of one to ten, this is likely to be a one point five as far as importance. You will likely learn absolutely nothing of great use to your life. In fact, at this very moment I don't know what this is going to be. (That's how it goes down when your hands just leap onto the keyboard and start going crazy with randoms.)

In other words, read at your own risk. If you're new and heard that this blog was really deep and thought-provoking, please peep my archives to the right which at times do get deep and thought-provoking.

Here we go.


#10  The Real Hot-Mess Housewives of Atlanta

O.M. expletive G.

I made the mistake of watching the reunion show for the popular Bravo series last night which, seriously? I . . .just. . .uhh. . .yeah. Man. . .let me tell you. . .I'm all for some fun and some shenanigans. But this? Wow. Two words: Train. Wreck.

Oh heck.  Let me just say what I was really feeling last night and what I said to the BHE:

"Dude. Is it me or is this a lightweight disgrace to the race?"

Before he could answer, Nene Leakes went off into a finger-snapping tirade to another cast member about how, "I'm RICH, BOO!" She was also rolling her eyes so hard that they were about to roll out of her head. As a matter of fact, she said "boo" no less than seven hundred and sixty two times. And poor Andy Cohen sitting in the middle of it all. Well, I take that back. Andy Cohen is the executive producer for all the Real Hot-Mess shows, so he was actually going CHA-CHING with every "boo" and every neck roll.

Okay, for real. I keep saying, "This is the very last time I will ever watch this mess."

This time I mean it. I'm done. Yes. Dunzo.

(Like as soon as I see part two and part three. Because I think somebody get's their wig pulled off or their weave pulled out. )

Then, I'm done. For real.

#9  "Mars Needs Moms. "

And Disney needs movie ideas. Obviously.

I watched this movie "Mars Needs Moms" with my kids on Saturday on cable. Essentially, Martians come to Earth and kidnap moms to suck all the mom-ness out of them to give to Martian moms. The story surrounds a boy who is mad at his mom, gives her some lip, and then finds that she's getting snatched up by Martians when he comes to apologize to her. Crazy, right?

It's an animated film, but am I tripping or is that a creepy concept? Obviously, the mom gets rescued but early into it, Zachary looks at me and says, "This is not a nice movie, Mama."  And he kept climbing all on top of me and clutching my neck while it was on.

Eventually it got kind of silly so the kids were fine. But old man Isaiah says toward the end, "Why would somebody think kids would want to watch a movie where moms get taken away? That's terrible."

Turns out that Isaiah would have been a good focus group. The movie didn't do too well and interestingly, when it was in theaters the boys had no desire to see it. They only agreed to see it Saturday because it was coming on on a cable channel.

"Hey kids! Let's kidnap your mom and have her nearly die trying to get back to you! No--wait. . . but it's okay. . . we're going to animate it with that creepy real-looking animation so it will look real but not BE real. And it's from the Disney studios so it won't be as bad of a concept as it sounds. . .hey. . .wait. . .where are y'all going? Why are y'all crying?"

Verdict:  FAIL.

#8  Mad love for Rihanna.

Rihanna. I'm kind of disappointed in Rihanna. Which stinks because I'm a fan of her music.

Unless you were under a rock, you saw the dreadful photos of the young singer after her then boyfriend and fellow artist, Chris Brown, tried to put her head through a car window a couple of years ago. Leaving her all kinds of black and blue. Horrible, I tell you. Just heartbreaking.

I guess he had mad love for her, alright. Dang. That just made me mad typing it.

Grrrr.

Well. I was listening to this catchy song on the radio the other day while getting ready for work. Harry likes the radio and I don't so of course this was while hanging out with him. So I hear this song. And yes, it's kind of catchy. So I bop my head and snap my fingers.

Actually the song is a bit risqué and nothing I'd allow my kids to hear. . . but catchy nonetheless. So I say to Harry, who's up with the latest music (unlike his NPR and podcasty wife), "Hey, who is this singing? It's kind of catchy."

"That's your girl," he replied. Which seems to be his standard cryptic answer for ANY person that I have EVER mentioned at any point in my entire life. If I say their name, they automatically become "my girl" or "my boy." Particularly if it's someone I don't care for.

But I digress.

Well, that catchy song? It's with Chris Brown. Yes. Yes! The same Chris Brown who tried to open a car door with her face not even two years ago. Singing about some sort of tryst or party that they'd like to have together -- with some non-G-rated activities planned.

As soon as I heard his voice, I froze and looked at Harry. Then I was like, "WHAT THE WHAT???"

And of course, Harry says, "Yep. Crazy, right? That's your boy singing with her."

And let me clarify. Chris Brown? My boy?  Not. Even. 

And Rihanna singing with him on a top ten hit now? That is WACK. WACK, I tell you.

That's all I'll say on that for now.

#7  They are young. We are not.



This song came on when we were at the beach and seriously? My tweenaged nieces and their tweenaged buddies all sang every single word at the top of their lungs. As a matter of fact, my eight year-old niece was right there with them.

But here's the thing. I had Never. Heard. This. Song. In. My. Life.

How apropos that it's called "We are young." Because realizing that a song popular enough for them ALL to know every single lyric yet totally unfamiliar to me is telling. Telling me that I am crossing into a new level of grown. Or old. Depending upon who you ask.


#6  Hold up. Rihanna, you did what?

I have to go back to this Rihanna thing once more. I'm saying, Rihanna! A duet? With Chris Brown? Seriously? Seriously?!!

Man. What a crappy message to send when you have that major platform and the attention of so many kids. Boo hiss. Dang. You get punched in the grill, the whole world sees it, and you even talk to Diane Sawyer about it. Then you . . .wait huh? You come out with a club-banger (oh, not a real club but a song that is in heavy rotation in clubs) with your . . .Ike Turner?

Chile please.

See? This is when I miss the Oprah Show. She needs to go on Oprah so Maya Angelou can ambush her as a surprise guest, rolling up on her all wise-like and saying something deep like, "My beloved little sistaaaaaaa. . . . . when you know better, you do better." Or something like that.

Rihanna. Rihanna! This is a FAIL. Boo hiss. Hiss boo.

Okay. Now I'm done with that, for real.

#5  Good times.

These goofy pictures with Zachary make me happy.  He loves to hop on my lap when I'm working or writing so whenever he does, I stop and play with him (if it's not his bedtime.) Or we do this. Take silly pictures with the "Photobooth" thingy on the MacBook Pro.

Love that kid.

#4  Off the fizzy drink!

Hey! This is almost the end of my third month off of soda. Yep. Gave up my once to twice daily Diet Coke habit because I kept reading things about how it adversely affects your waistline. And no, studies don't suggest that they cause obesity, but there is good data that shows that people who drink diet drinks have bigger waistlines. I would tell you what percent more, but it would break your heart if you love Diet Coke as much as I do.

As for me and my experiment? It has translated to five pounds lost without trying or changing anything. I do think not having soda has made me drink more water and just maybe has desensitized my "sweet tooth" a bit. Allegedly, artificial sweeteners send wacky messages to your satiety center and they also make you crave sweets more. Allegedly.

Regardless of all that, the five pounds I lost aren't alleged. I'm just saying.

#3  Mary don't you weep. 


Should I even go here? Oh heck. Why not. This post couldn't get more random than it already is anyway.

The crazy Mary J. Blige Burger King commercial. Have you seen this?



I just. . .uhh. . . .yeah. No. It didn't strike me as racist or whatever a whole bunch of people said when they saw it. I mean. She's the Queen of Hip Hop Soul for crying out loud. And she's using some hip hop soul to endorse crispy chicken wrapped in a tortilla with fresh lettuce. Dang. Lighten up, people!

But it's such. . .a bad commercial, man. Whose idea was that? Aaaahhhh. . .Mary.

*snicker*

No. Not racist or degrading or any of that to me. Just. . . it just struck me as. . . weird . . .and like . .huh? Hold up. . .is that Mary J. Blige standing on top of a table in Burger King? Wait. Is this Saturday Night Live? Am I getting punked?

Let me hit rewind and watch it one more time. Am I the only one who saw that?

I admit. I love her but. . . .this is sort of a fail for Mary. We've got to talk to that publicist of hers. Quick.

BUT. Burger King did not punch Mary J. Blige in the head and give her two black eyes the day before the Grammys. So as far as I'm concerned, get your chicken wrap jingle on Mary. But don't be mad when I laugh because for whatever reason you popping up out of that table his L-O-L funny no matter how many times I watch it.

(And yes. I've seen the spoofs which, to me, weren't nearly as funny as the original and that, unlike the original, bordered on offensive to me.)

#2  People change.

Hand over heart, not even exaggerating. My friend Lesley M. has been helped in the Target checkout line at least three times by Teenage Mutant Target Checkout Chick. And y'all!! Allegedly she has bordered on friendly! Yes!!!

I have had TMTCC about two or three times since our original run in. The last time, she actually asked me how I was doing. After I fainted and then got back up, I told her I was fine.

There is hope for this world, I tell you! Hope!!

#1 And hey! Speaking of Target.

Here's a little flash mob action for you. In TARGET, no less. Shout out to David M. for hipping me to this one.

Y'all! How did the universe know to combine two of my favorite things? Target and. . . a flash mob? Cannot. Even. I just. Can't.



You're welcome.

***
Now that I've thoroughly wasted your time and brain cells. . .  . Welcome to Tuesday!

That's all I've got. What do y'all have?

Sometimes we get it right.

Isaiah sat and worked on this all by himself yesterday. In the morning when he woke up, after soccer, and after his bath--determined to finish. Not one stitch of help from any person other than him. He sat there quietly with his finger on each step and followed those heinous little Lego directions with those teensie-weensie pieces until he finished.

And he did finish.

It was important to him to do this one all alone, with no help, and no lost pieces. And if you've ever seen the new generation of Legos, those pieces can be smaller than a newborn baby's pinky fingernail--for real. 

The look on his face when he finished -- so priceless. I said, "That's awesome, Isaiah! You must be really proud of yourself!"

And he said, "I am VERY proud of myself!!!"

Yes sir, that's my baby.

Can't you just see it on his face? How proud he is of himself?

I was proud of him, too. And something about that moment made me feel proud of myself for being his mom. You know? Sometimes. . . sometimes we get it right.

***
Happy Monday