Sunlight bathing the room. Him, sitting quietly with light beaming around him. A halo, even.
I approach softly. He doesn't move.
Edematous legs off of the edge of the bed. Head tilted upward with closed eyes.
I pause. Then wait.
Still, he doesn't move.
Intentionally, I nudge his tray table, hoping to let him know I'm there.
His head turns sideways and I see only a silhouette of his profile. As I come closer to him, I can see that he is smiling. He pats the bed beside him, welcoming me in.
I ask him how he he's doing and listen as he tells me. Next I examine his body and talk to him about the results of his tests. The news is not great news. We don't have all the answers but it seems serious. And I want him to know that this is what we are discussing in physician-only rooms tucked on the halls away from where he is. Even without all of the details, I want him in on what we're in on. I do and he gets it.
His body stills again and just then I notice rosary beads in his hands. Head bowed, eyes again closed. His head suddenly turns in my direction, startling me. I smile awkwardly, feeling like I just stepped in on someone who'd believed they had privacy.
"You know what?"
"What's that, sir?"
"If He brang you to it, He'll brang you through it." Releasing a weak chuckle, he continues. "But, see, only He know what route you gon' take."
I stand in silence, taking time to scrawl that on the graffiti wall in my head for later. The section on "good words."
"Yeah. So I'm jest sitting here praying that through it mean throughwith it."
"Yes, sir." My voice is barely audible.
Again those hands clasp around the rosary beads and this time I see his mouth moving without sounds coming out. His eyes are now skyward, opening for bit and closing for a bit, and then doing it again. First, I wait without speaking. Next, I stand up; I place my hand on his shoulder for a moment, push down and squeeze.
Without another word, I tiptoe away. Leaving him to pray his way through the thing that he was brought to.
And yes.
Those are my patient's real hands holding his real rosary beads and, yes, this was a real part of my day today.
This intrepid faith is and always will be one of the very best parts of Grady.
Yes, it will.
***
Another part of today. . . .
This is from one other piece of my day today at Grady. It's an image of my colleague and fellow Grady doctor Stacie S. connecting with a patient. I was looking for one of my patients on my afternoon rounds who'd left the first bed in the same room. I didn't find my patient but I did get there just in time to witness this moment.
Aaah. It moved me deep in my soul.
See, I have known Stacie since she was an Emory medical student. She trained with us for residency and I even spent an entire month as her attending on the Grady wards some years back.
And now here she is. An attending physician, too. All grown up. Respecting and caring and simply being there with a patient. Now role modeling for me without even realizing it.
No defibrillator paddles out for a high-paced code sequence or sterile gloves on for an exciting procedure.
No medical students watching with the same short white coat that she once wore on these very halls. No residents standing by to make mental note of and then jot down her empathic behaviors into an evaluation form for later.
Nope.
None of those "sexy" parts of medicine that you see on television dramas or that people imagine when filling out medical school applications. Just one doctor with one patient -- caught caring. This was humanism as its best.
Watching Stacie in that moment made my heart swell. It made me feel so proud of her and, yes, proud of us for being a part of her upbringing in medicine. Proud that we didn't take this--this critically important piece of being a doctor--away from her through irresponsible role modeling on our part. This piece that cannot be found in books but that can somehow be lost along the way if we aren't careful.
This moment--captured with the quick snap of an iPhone in the late afternoon--affirmed me today. Damn, it did. It made me want to try harder and do better and pay things forward. Because this is the result when you do. Or when we all do together.
Can't believe I'm crying. . . again.
But I am because all of this is Grady. . .snippets of humanity behind sliding curtains and inside beating hearts. The parts that are filled with grace and simplicity--and that don't get shown on the 11 o' clock news.
You asked. You did! You hit me with your best shots and fired away. You sure did. And keeping true to my promise, I have answers. In the interest of you not reading a five thousand word soliloquy, I will limit this volume to ten. . .well sort-of ten. . . . of the questions I received and I promise to include the others in a Volume 2.
Volume 2!
Did you get that? How cool is it that I received enough questions to even do a Volume 2? And, perchance, a Volume 3 even? Hush yo' mouth.
(Pardon me while I do a happy dance for feeling so accepted by y'all!)
Okay I'm back. So here we go with Volume 1 of your best shots. . . .
Hey! I wrote a little top ten about it! Like to hear it? Here it go!
#10 Why Grady?
Question: What originally attracted you to Grady?
I did my residency at a county hospital and loved it. Although the experience during training with indigent patients in Cleveland, Ohio challenged me immensely, when others felt overwhelmed, I felt right at home. Though there was tremendous poverty where I was working, I began to learn about other public teaching hospitals with even greater need. When I finished my chief year, I knew I wanted to go to a larger metropolitan area to work in one of the fire breathing dragons; I set my sights on the legendary public hospitals.
What did that mean? It meant:
Grady in Atlanta (my very first choice) Bellevue in New York City Jackson Memorial in Miami Parkland in Dallas Charity in New Orleans Cook County in Chicago Ben Taub in Houston
I was over the moon when I got an interview at Grady. I nearly fainted when I received an offer. I'd always wanted to come to Grady because I knew I would feel at home when I got there.
And I have from the moment I arrived.
#9 Don't forget the lyrics.
Question: All those lyrics you use to begin a post -- do you know them by heart or do you have to check them?
While I do know a scary-large amount of the lyrics to a scary-large number of the songs I use to accompany posts, I always, always double check them and also fill in the gaps of what I don't know. It's so funny when I realize that I've been butchering the lyrics to a song for over two decades!
The musical accompaniment is hands down one of my favorite parts of finalizing the post. That and the title. Sometimes I know the title from the very start. Other times I start with one in mind, write the post, and something better comes to mind.
But you were asking about music and lyrics, weren't you? Oh yeaaaah.
So back to that. . . hand over heart, no kidding-- when I include songs playing on my "mental iPod" they really are. I usually start writing the post and then the song pops into my head. That's when I'll add the lyrics and sometimes thread it through the story. I choose songs that I am familiar with, not just ones that pop up on random searches. As you can see I have a wide and scarily random array of musical tastes. It works for pairing with blog posts, though!
#8 The Funny Section.
Questions: What do you think of sectional sofas? And what's with the minivan fascination? You are too fly for that!
This is SO random--I love it! I think sectionals are freakin' awesome. No. They won't win you first place on "Design Star" but if you are looking for a hard core nap, a sectional is what's up. My sister JoLai has a gigantic denim sectional in her den that is both swanky and ridiculously comfortable. I took a nap on that sucker the last time I was home in L.A. that was so good that I needed to be defibrillated to wake up.
So what do I think of sectionals? I think that if my built in the 1920's house had more space, I'd have one.
Disclaimer: This is coming from a woman who wants a minivan.
And about the minivan fascination. . . .ah hem. Two words: AUTOMATIC DOORS. Period. End of story. Say what you want to say, wrinkle your noses and give me the hairy eyeball all you like. I am very close to complete little kid-mommy nirvana which is defined as:
Little Kid Mommy Nirvana Criteria 1. Can pump their own legs on swings. Which means Mommy can read e-reader and shoot breeze with girlfriends whose children also can pump own legs on swings. 2. Can buckle own seat belts. 3. Can prepare own bowl of cereal. 4. Can swim in deep water unassisted. 5. Is fully conversant. 6. Can read stuff. Not all stuff. 7. Is fully, all-the-way potty trained to the point of being able to sleep over at a friend's house without an oopsy. 8. Can leap into and out of my car in a single bound as I sit calmly in PARK with both hands daintily wrapped around an insulated NPR mug pausing only to (also daintily) press the AUTOMATIC DOOR button with my manicured fingernail.
Yes!
I have seven out of the eight right now. By 2013, I fully anticipate marking off the eighth one. And to the nice person who asked this question and who suggested that I am "too fly" for the minivan, you MUST know that I have a master plan. This involves me getting so ridiculously fit that (in those rare instances) when I saunter (yes, saunter) out of my tricked out swagger-wagon, the dudes in the valet and the haters waiting for their sedans will be forced to drop their mouths open and say, "I cannot BELIEVE that she has children!" To which I will respond with a CHIRP-CHIRP of my alarm and a sultry glance as the TWO-SIDED automatic doors flush under the swanky vacuum closure mechanism.
My inspiration:
"Where my MOTHER-FATHERS at???"
Oh! And the haters waiting for their sedans are hating ONE because they have a $700 car note and TWO because despite that, their kids have STILL spilled Cheez-its, Gold Fish and Pirates Booty into the cracks of their butter soft leather interior.
SUCK-AAAAS!
That reminds me of one of my favorite old school Prince songs now playing on my mental iPod. . . . Now. . .picture me with my AUTOMATIC DUAL SIDED SLIDING DOORS and ridiculously fit body as you listen to this song. And please, don't hate . . .because you know what that means, right? It means you totally have minivan-envy.
Mmm hmmm. Don't hate. Participate.
#7 Going back to Cali? I don't think so.
"Her bikini small
Heels tall
She says she likes the ocean."
~ LL Cool J in "Going Back to Cali"
Question: Do you ever miss Los Angeles and if you do, what do you miss (other than family?)
Since I can't say that I miss my daddy and my sister, that's hard. I love how Atlanta is full of trees and has less concrete than Los Angeles. Even after I've visited home, I never wish I lived there. But there are some things that I absolutely miss besides the family. Those things are:
The ocean!
The Mexican food!
The Asian food!
The swanky-ness
The laid back-ness
The WEATHER.
But mostly I miss my sister and my dad. JoLai and I are only ten months apart. It stinks living so far from her after spending a large part of my life in the same room as her. It's awesome having her there to visit though. And my dad to expose my kids to L.A., too.
That said. . . .as for me ever going back to Cali? Uuuhhh, I don't think so.
(Peep this old school LL Cool J playing on my mental iPod to get the pop reference.)
#6 Ah hah moment.
Question: At what age did you know you wanted to be a doctor and what inspired this calling?
Calling? Uhhh, I wouldn't say it was that.
I honestly don't know what age I was when I decided I wanted to become a doctor. My mom tells some family lore about my sister JoLai's eye doctor dubbing me empathic at a very early age. Allegedly, he said I'd make a good doctor because I really seemed to care a lot about all that my baby sister was going through with her eyes. Maybe that dude planted the doctor seed (unless Tounces just made that up.)
For all we know, he saw her at the visit with me in tow and muttered that it was "tragic" that she had two kids only ten months apart. And she heard "empathic." (Juuuust kidding, Tounces.)
Either way, it worked out.
Seriously though? In 9th grade I took a science class and was good at it. Math was a struggle but science and people were always my thing. That combination made me feel like I could have a future as a physician. I never had a major ah hah moment. I just wanted to find a career that would make me happy. Since science always seemed to feel organic to me, I never doubted myself when I went into college with my sights set on getting into medical school.
So the truth is that I can't say that it was a true "calling." Instead I was fortunate enough to grow up in an environment where the idea of being a doctor seemed fully attainable to me. Lots about what I do is unconventional in terms of your standard doctors. I mean. . .crying in front of people? Who does that?
Answer: Me. Still working on that tear-drying mechanism. Ha ha ha.
But seriously? This career has been wonderful. I love the relationships the most--it's my favorite part of being a doctor and a clinician-educator.
#5 The Wanted Ads.
Question: As a Program Director, what about an applicant, besides their numbers, would persuade you to hire them? In other words, for those of us who don't necessarily have the best numbers, what part of our application should we emphasize the most in order to catch a Program Director's eye? How do we put our best foot forward?
It always depends upon what one means by "the best numbers." Does that mean board scores only or grades, too? That matters.
Honestly? The best thing that any applicant can do is to shine in the clinical setting. If you do, then you will gain allies and advocates. For those with less than shiny scores, etc. having a respected person speak up on your behalf makes a difference. So what does "shine" mean? It means being uber-professional. It means working hard and being a team player. It means communicating well with patients and nurses and colleagues. Your work product has to be impeccable and you have to strive to be better every day. If someone reaches out to another program director or writes these qualities into a letter, it helps.
Also remember that there are some very, very good programs out there that may not be attached to big names. Don't underestimate those places.
My biggest advice is to get some allies and a solid mentor at your institution who's willing to fight for you. Oh, and always, always, always LOOK professional. Always. White coat--clean. Clothes -- neat. It makes a TREMENDOUS difference.
#4 Eeewww. And Aaaaaah.
Question: Are there any medical procedures that gross you out? Also who do you think is the most handsome movie star right now?
I don't like feet. Especially ones that are maggot-infested or with toe jam that looks and smells exactly like feta cheese. Yes, I have experienced both.
Okay. That isn't a procedure but for real? I nearly fainted when I saw a man with trench foot way back when. Hadn't removed his shoes in over three months. And his feet were wet. So, yes. I almost fainted.
In fact, I almost fainted just now whenI typed that.
Oh yeah! Here's something! Post-delivery vaginal tears! Wow. Now that? That 100% sealed the deal on me NEVER doing Ob/Gyn. Like, ever. Especially when I saw a fourth degree laceration. (You don't even want to know.) And wouldn't you know when I was a med student all of the WORST vaginal delivery related tears happened on MY call nights? My classmates used to be all jealous of me for all the action I was getting and my attending would be all like, "Hey, Student Dr. Draper! You want to suture?"
And I used to be all like:
0_0 "Uhhh, yeah. . . I'm good."
(Just go ahead and Google "fourth degree laceration" if you want to have nightmares.)
*thump*
That time I really did faint.
Hmmm. . . .
And the most handsome actor? Right now? Hmmm.
Love me some Brad Cooper. Especially the He's Just Not That Into You version. I thought Justin Timberlake was adorable in Friends with Benefits. Yes. I said Justin Timberlake.And though it isn't "right now" I still find the I am Legend version of Will Smith to be SMOKING. To the point that Harry calls me into the living room when it's playing on HBO just so I can see the chin-up scene.
And, though obscure, I looooove the dude who played Beyonce's love interest in the "Halo" video (his name escapes me, I know he's an actor on a TV show now). Michael something-or-other. Dig that dude. But mostly because of how he looks at her in that video. I look at it and think, "Now see? This is why I am not an actress-singer-entertainer because I could not EVEN be playing opposite that dude looking all up in my face like that." They'd be all like "Okay, cut! Uuuuhhh . . .Cut! HEY! CUUUUTTTT!!!!"
Peep it here.
Lawd.
#3 Hard hitting.
Questions: Are there reeeeeally Dr. McDreamy types at your hospital? Has a patient ever laid a pick up line on you? What's the strangest thing a patient has ever asked you? What kind of doctor are you?
McDreamys? Uuuhhh, not that I look at that way. I'm sure somebody somewhere is feeling McDreamy about one of my colleagues. I did once hear a nurse using some very flattering words to describe my friend and fellow Grady doctor Neil W. And my mama thinks he's "really, really handsome." Does that count?
Oh and have I ever told you about how steaming mad Grey's Anatomy used to make me because of all of the inappropriate resident-faculty relationships? Don't worry, I'm over it now. But seriously? We are so not moving in with our interns and hunching in broom closets.
Strangest question: My iPhone rang and my patient had a visitor who asked if he could have it. As in, my cell phone. I was like, "Ummm, yeah, that's a no."
I also love when people ask me "what am I?" followed by "are you regular black or from somewhere?" I am still not certain what "regular black" is. And please note that it is only my own people who ask me this.
0_o
What kind of doctor am I? I'm a general internist by trade. I'm board certified in both Internal Medicine and Pediatrics but no longer practice Peds. Unless you count me closing a teeny weeny laceration on my friend's daughter's head recently using her OWN hair. Yes! I tied pieces of her hair together to close a small lac and it was WAY cool. They didn't have to go to the ER and everyone was looking at me all like "five points for Gryffindor." For real, they were.
#2 Balancing acts.
Question: Some of my friends and I were talking about life with our husbands post kids. Some of us are really struggling with maintaining crazy work lives and our kids yet managing a relationship with our husbands. You and the BHE seem to have it together. Were there any low points? How did you break through it?
Well, first of all nobody ever has it as together as anyone thinks. The BHE and I are always a work in progress. I can tell you that there have been times when we've been flying on one wing but fortunately we've always pushed through. I'm certainly no expert but I will tell you a few things that I think of and try to live by.
First, I heard a woman who'd been married for many years tell me early in my marriage:
"Always keep your husband first. Always. Work at that relationship harder than the one with your kids. If you do, the kids will always be alright."
I always remembered that. So I work hard to be Harry's wife and not just the mom of his kids. I do things that make me feel desirable and feminine. I take off my pink fleece Paul Frank pants and put on something else sometimes. I exercise and consider the things he finds attractive. And a lot of times, I wear things he likes. Yes, I wear and do the things I like, but I want to be my husband's ideal. This means not letting things go. Or at least trying not to. And. Even when I am very, very tired (which is often) I make no excuses not to be intimate with him.
Yes. You read that part right.
When I go to work, I throw myself into it. And then I go home. When I'm home, I try to be present. I spend time talking to Harry without the kids interrupting. I stay up a little later sometimes just to do that. Even when I'm tired.
We also read this book called The Five Love Languages which really made a huge difference in our marriage. I know it sounds cheesy, but we speak each other's love languages. We really do. The BHE's love language is "words of affirmation." Mine is "acts of service." So pretty much, I tell him what an awesome husband he is and he washes some dishes. Afterward we are both in the mood for amor! Ha!
Most of all, I really do make our relationship the one of highest priority in our house. Yep. Before the kids. And no, I am not like that lady who wrote that NY Times article about how she loves her husband more than her kids. But I do get the sentiment and think that kids sometimes take the place of spouses a bit too often. Sorry, but Isaiah and Zachary cannot do for me what the BHE can.
And I think that woman who said if WE are okay then the kids will always be alright was right on the money. She sure was.
That same lady also said "Girrrrl, you got to keep it HOT."
Ha.
#1 Book worming-my-way
Question: I would like to know how your book is coming along.
My book. How's it coming along? Errrrr. Yeah. It hasn't been. Every time I try to write on it, I either feel overwhelmed or I feel pulled away from writing here. But here's the good news. After reading that surprisingly craptacularly written NY Times Bestseller "Fifty Shades of Grey" I am ready to at least try.
So to answer your anonymous question, Lisa from Smacksy, I have pretty much been a LA-HOOZER on the book writing front. But your question has nudged me. In a good way.
Related question: Have you thought about putting a collection of these stories into a book?
Definitely yes. I did speak to a literary agent and did some research on the whole thing and found out that anthology books are very hard sells. No one seems to want to publish them for some reason. And they want nearly all of the stories to be original, which means I couldn't use the ones that have been here already. People that are already big time authors can get away with it but no new kids on the block like me.
I guess I could self-publish and sell them out of the back of my mini-van. Hmm. There's a thought.
**
Bonus: What's something random that you've always wanted to do but haven't?
A TED Talk. I'm obsessed with them. The thought of doing one terrifies and excites me simultaneously. Added that to my vision board recently and it gave me palpitations when I did.
***
Happy Wednesday.*
*(And stay tuned for Volume 2 in the future because I saved the other questions. And, perchance, Volume 3!)
Wow. It's been three years that I've been writing this blog and frankly? I can't believe that I've stayed with it for this long. I know that I have because of all of you. You've been a community of thinkers and feelers and learners right along with me and that's made me want to write and share here.
So thanks for that. For real.
A while ago someone asked me to write a post called "ask the gradydoctor." Not in the ask me my medical opinion on things sense (which I don't do here) but instead an opportunity for members of this community to ask. . . .hmmm. . . . any burning (read: random) questions that they may have. When I first heard that request, I said, "Meh." (Insert shoulder shrug here.)
Then. Another person asked me this recently and then surprisingly, another. So with that in mind and the fact that I'm at the three year mark, here we go.
Why the three year mark? Well. Didn't you know that three is a magic number? At least according to School House Rock (which we rock out to in the Volvo five out of seven days per week) it is.
Is it normal that it's 2012 and the kids and I can sing every single word to this and every other School House Rock jam? Sure can. Oh! And is it normal that I tear up on the part of "Three is a Magic Number" that says "a man and a woman had a little baby. . .there were three in the family. . .that's a magic number" since it makes me think of the day we brought Isaiah home from the hospital?
*sniffle*
Le sigh.
It also taught my boys to count by threes. Anty-who. Yeah, I digress. But if you read here often you know that I do digress a lot.
So where was I? Oh yeah. The "ask the gradydoctor" thing.
Okay. First, let me say this. Having a post called "ask the gradydoctor" sounds rather obnoxious, so instead I'm just going to call it "Hit me with your best shot, volume 1." If I'm lucky, there will be more volumes.
Here's how it will work:
In the comment section of this post, simply ask your question. I won't publish the questions, instead I will just include some of them in a post with the answers. Feel free to be anonymous, even if you normally have a log in--or not.
What else?
Oh. What to ask? I don't know. Random stuff is awesome to me, medical student situations/advice, mental iPod music, what I think about Jennifer Anniston's recent engagement, whether or not jeggings are for everyone, why I want a minivan. . . .whatever. As long as it's appropriate (and I am hoping most of us know how to define that.) Since the queries won't be published, you don't have to be inhibited by that part, either.
Now.
This could be a total bust and if it is, I will fully blame the three people who encouraged me to do this. Ha ha. If it goes better than expected, then I can spread the answers into separate posts.
Alrighty. Hit me with your best shots. Fire away.
Maaaan, I need to go round. Deuces.
*** Now playing on my mental iPod. . . . Ms. Pat Benatar. (You're welcome.)
I went to see a patient on my inpatient roster the other day who, for the most part, was doing pretty well. Her active medical issue was one that we were managing in tandem with one of the specialty services and by "tandem" I mean that the specialists were calling all of the nitty-gritty shots and we were on the execution of those shots. And though this may sound a bit odd, none of this is unusual for a hospital service. At all.
So anyways. I go to see my patient and toward the end of the encounter she asks me a series of questions about her active problem. The initial questions were easy for me to answer, but her follow up queries were rather specific and slightly beyond my expertise. So I admitted that and promised to speak with the specialists and get right back to her. That seemed to satisfy her so she shook my hand, nestled down under her hospital blankets and then instructed me to un-mute her television (which I had asked to mute upon my arrival.) Pretty uneventful visit.
"Light on or off?" I asked.
"Off!" she announced in her overly loud voice. That made me smile. She was up in age and her hearing was starting to dwindle. She'd refused to be fitted for hearing aids on multiple occasions for two reasons: partly cost which her primary doctor had managed to find ways to overcome but the other reason presented a hurdle that couldn't be jumped--"Look like when you got a hearing aid in you jest look like ya' OLD." So instead she opted for talking loud and having others to speak up. And that was working for her.
I flipped down the switch and stepped outside of her room. I didn't want to forget her questions so I immediately pulled an index card from my pocket and leaned against the wall outside of her room to jot them all down. The ambient noises of the hospital were all around me. The rolling cart of the cafeteria food, the ringing chimes at the front desk of patients calling their nurses, the phones ringing, and somewhere far down the hall what sounded like an elderly man moaning repeatedly. Just then, among those sounds I heard one that exceeded them all in decibel level.
"Hey there, BOO!"
It was my patient on the inside of that room. I was still beyond the threshold of her door and could hear her booming voice speaking over the phone.
"YEEAAAAH. The doctor was jest in here. I thank this one you ain't met yet. Her name Kimberly something-or-other."
That made me chuckle. I love how patients grab pieces of names and hold on to the parts that stick for them. For her, I wasn't Dr. Manning--I was Miss Kimberly. It certainly wasn't the first time I'd heard that and I was certain that it wouldn't be the last.
"I don't know which one she is. I THANK she might be the intern though cawse she kinda didn't look like she knew what she was doing toward the end. But she was nice. Reeeal nice."
I covered my mouth to keep her from hearing me laughing.
"Naawww. She had some grey hair a little bit but I thank it might be the early-grey. Boo, 'member when mama had that friend who wadn't no more than twenty-five with all that grey in his head? So yeah, she prob'ly is the intern. I don't know. I jest know her name Miss Kimberly and she said she gon' ask somebody else, you know, what the answers was to my questions I had."
I could not stop eavesdropping. I was loving every minute of it.
"Mmmm hmmm. She nice though. She a nice little intern. She said she'll be back when she speak to the supervisor-doctor who know all about my kind of health problem. The experts. Naaaww. I said she the intern not the expert."
Love. It.
So eventually her conversation moves to something else and I move to actual work instead of cupping my ear to her door like a kid sister. I run into my colleagues from the specialty service and relay her questions. They provide me with concise answers that I agree to take back to her and that they agreed to readdress when they see her on rounds.
Later that afternoon, I come into her room to see her. She is watching television and is now out of bed in a bedside chair. I tell her that I have some answers to her questions, and commence to share them with her.
"Thanks, Miss Kimberly. I 'preciate you for getting all that information!" she said in that still-loud voice. I was getting used to it now so it was cool.
"No problem. Sorry I didn't know the answers earlier!"
"That's okay, sugar. How much mo' time you got in school for you finish up?"
I smiled because I knew this was about to be fun. "Well. Actually I'm the senior doctor on the team and I've been out of school for some time."
"YOU? YOU the senior doctor?"
"Yes, ma'am. The attending physician. Does that surprise you?"
Here we go. Now I was beaming because this was a Grady elder and I knew that she was going to keep it ONE HUNDRED. (That's Harry's way way of saying 100% real.)
"Surprise me?Yeah, it do. When I seent you earlier look like you was the intern or something. Like you was new at all this."
I let out a chuckle that couldn't be stifled and then cleared my throat. "Sometimes I do feel new at all of this."
"Mmmm hmmm. Look like you ain't knew what you was doing so I thought you was still training. But you said you the senior doctor? I told my sister that you got some grey in your hair so I didn't know if you was the early-grey or whether you was older. You know there's this friend my mama had that wadn't no more than twenty-five and he had a head full of grey."
Aaaaah. Love it. "Is that right?"
"Mmmm hmmm. Sho' did."
"I'm almost forty-two. I have kind of a lot for forty-two."
"You look a lot younger. Then when you was saying you didn't know my answers to my questions I put that together to mean you was young and still doing your clericals."
"Clinicals?"
"Pardon?"
"Nothing."
"Alright then, Miss Kimberly. Go on unmute this TV, hear? I'll be seeing you a little later. I'm gon' see what these judges talking about today. I like the judge shows."
"Do you have any other questions I can answer?"
"Yeah. Can you get my light and pull my door flush?"
"Sure. Is that your question?"
She was already watching Judge Joe Brown.
"Alright then, ma'am."
"Okay then, Miss Kimberly." She took her eyes off of the television for a moment and flashed an edentulous grin. Her eyes went back to the screen mounted on the wall again.
I waved my hand and reached for the door.
"And Kimberly? Good luck with your studies, hear?"
I glanced over my shoulder and smiled. "Yes, ma'am," I answered with a gentle nod.
I told her she wins "best hairstyle of the entire week." That made her laugh out loud in between passing meds and caring for her patients. I also told her that she probably brightens up her patients' days when they see that she will be their nurse. Thinking that the same love and meticulousness that went into that perfectly round afro will go into them, too.
And you know what? It does. I've worked with her and know for sure that it does.
Now this? This, too, is Grady.
***
Happy Sunday.
Now playing on my mental iPod. . . .with love for the nurses who put love into everything they do.
*Every one of the amazing and beautiful images of Grady Hospital in this post were taken by my dear Emory student-friend, Cathy M.
When trying to express oneself,
it's frankly quite absurd, To leaf through lengthy lexicons
to find the perfect word. A little spontaneity keeps conversation keen, You need to find a way to say
precisely what you mean...
~ Mary Poppinsin "Supercalifragilisticexpialidocious"
____________
Yesterday was kind of crazy. Busy in the busiest of ways, but not necessarily in the bad kind of way. Which I am sure is a description that makes absolutely no sense . . .but it was one of those days that's hard to corral into just one adjective, you know? Either way. I like having days like these. When they end, even though I'm exhausted both physically and mentally, I close my eyes and fall asleep with my mind swirling like steam off of hot cocoa. Good swirls. With soft ribbons of ideas and thoughts and reflections that lull me to sleep just like a mug of cocoa would at bedtime.
Yeah. Kind of like that.
So. . . here are a few of my favorite parts from that day.
Yesterday.
I was running late in the morning for my eight o'clock teaching session at the School of Medicine which had me kind of frazzled. Emory is a "pedestrian campus" so what that really means is that when you park there, you need to factor in two extra hours of walking to wherever it is you have to go. Okay. I exaggerate but there is no convenient, in-out type parking. So even if you're on time to get there, the parking will shoot you in the foot.
But me, I'm married to the BHE who took the kids to school and then pulled right into the driveway like a knight in shining armor. Out came his gleaming smart phone where he texted his wife saying, "Want me to drop you off?"
And I said, "Yes!" Even though I would have to figure out my way home or need to walk back, he knew I was late enough to need that offer to take me to school and drop me in the front just like it was the carpool lane.
So he did. And that seven minutes I got to spend with him was just as wonderful as he is. I appreciated him shaving fifteen minutes off of my commute. I appreciate him just being who he is even more.
Teaching Small Group Gamma was awesome and worth my morning hustle bustle. We were doing cases on sickle cell anemia and they were engaged and prepared and learning. It was good. Really good. Lately, I've been sharing stories with them about real patients affected by the diseases they're learning about to add an element of humanism and reality to the concepts. Yesterday, I read them a story about this patient with sickle cell anemia.
And they listened and paid attention. We honored that patient and respected that terrible disease. And that part was good, too.
When I was leaving, Erica U., one of the Gammites, offered to drop me off at home. So we walked and talked on the long stroll across the pedestrian campus to her car. We talked about school-things and not-school things, too. And then we rode to my house and as we did, I realized that every single one of my student advisees would know exactly how to get to my home without me telling them. That made me smile.
Erica let me out in the driveway and waved good-bye. I appreciated the lift. I appreciated the E.T. (Erica Time) even more.
That part was good.
*Here Cathy used this cool effect from an app called "Glaze." Makes photos look like paintings. Way cool.
Next: Jumped out of her car and then into my own and headed to Grady for rounds with my team. The team was on call so things were already rocking and rolling when I got there. My resident, Aaron G., is hardworking, responsible and smart. That's a good feeling to have when you have to teach in one place while your patients are in another. Things were in order, as I knew they would be.
After meeting with the team for a bit, I set off alone to catch up with some of the old patients as they admitted new ones. I was strolling through the hall on my way to a room and heard my name.
"Dr. Manning? Heeeeey! I thought that was you when I looked down the hall!"
I knew that voice before I turned around. It was the husband of the patient I'd seen on Monday--the one whose bubble I'd burst. His Fred Sanford voice was unmistakable and the big smile on his face was in stark contrast to the last time I'd seen them.
"Heeeeeey sugar!" He walked right up and kissed me on my cheek. "What you doing up here in the main hospital?" His light and jovial attitude surprised me. Especially as yucky as we'd left things on Monday. I shifted nervously on my feet, not knowing what to expect next.
"Oh, I take care of patients up here, too. What are y'all doing here?"
"She getting the PALL-A-TIVE chemos today. She feeling good, though. Reeeal, real good. I was jest trying to sort out her 'pertments cawse she was 'sposed to see a doctor today but we in here so we missed the visit. I don't want to be a no show."
Wow. With all they had going on, he was concerned about inconveniencing someone by them not showing up for a clinic appointment? Wow.
"Who was she supposed to see today?" I asked.
And so he told me who the doctor was and it was someone I knew. I offered to call and he was quite appreciative. After making that call, I popped into her room and told her hello. She was as warm and welcoming as he, and I can't even begin to tell you how that felt. Wait, yes I can. It felt like . . .like. . redemption.
Like redemption. Yeah.
How is exquisite is this photo Cathy took from a hospital window? It even captures the original Grady Hospital--red building below.
Later that afternoon I saw one of my favorite nurses, Ms. Dawonde, and she gave me the biggest, tightest hug ever. And then she told everyone on the floor that she has known me since I first got to Grady. Which is absolutely true. That felt good, too.
Sure did.
We had a family meeting planned that afternoon and with the new patients coming in, things were really crazy. We decided to divide and conquer--Aaron and the interns would admit our new peeps, and me and the PA student, Meredith, would go and conduct the family meeting.
That family meeting was hard. Hard because it really and truly felt like some kind of deja vu from what I'd gone through Monday when speaking to that same lovely couple about that horrible train speeding through her body. This train was out of the station, too.
A roomful of people stood by and listened as we had this discussion and I tried my hardest to factor in love's myopic view as I spoke to them all. Love's myopic view. . . .the disconnect between what we see through loving eyes and what is. The image of who our loved ones are or who we are painted by love and memories. Unshakable images that are based upon hearts and feelings and never, ever logic.
Yeah. So I thought about that and acknowledged that but that didn't make the topic any less heavy. At. All. But you know? It's good that I considered this because in the epicenter of all of that heavy discussion, there came one point where my patient said to me:
"I know I got this cancer. I know it's all through my body and everything, too. And how you looking at me, you looking at me like you can see all of that going on in me. Like you sad for me 'cause you know something bad is gon' happen. But let me tell you how I feel. Even with all that happening--and I know it's happening--somehow, some way I still feel like. . .really in my heart. . .I feel is like I'm in the greatest of health." She repeated herself for emphasis. "The greatest of health! My wind is short and I get tired. But I jest don't see no sick person when I look at myself. I don't! I just don't! I see myself healthy. In the greatest of health."
And she patted her bosom and stared at me with such an intensity that it moved me deep down in my soul. It also made every single one of her family members cry big, fat wet tears down cheeks of all ages. Because that? That was a collision of harsh reality and love's myopic view right there in that room.
And what do you say to that? Tell me. What?
That room was filled to the brim with people. Loving family who wanted to know what all of this stuff we were saying meant. Really meant. And this time, I still told the truth but as carefully as I could. Treading softly and respectfully. . . and in full recognition of love's myopic view. They cried and listened and asked. At one point, I'm (only slightly) ashamed to admit that I cried, too. Right in front of that entire roomful of people. Sure did.
And all of it, even though it was sad, was in some kind of way good, too.
I also felt thankful for running into that couple from Monday because that taught me that tincture of time is a mighty, mighty thing. Especially in situations like this.
Yes, it is.
Oh! I heard the best story on rounds. A daughter was in the hospital visiting her father who was our patient. She told me that the day that she was born, her father went to the newborn nursery and said, "Don't tell me which one is mine. I will know her when I see her." And she said this while mimicking her father's very thick accent from their mother tongue. So she walked across the room pacing like a person inspecting babies in a nursery. Furrowing her brow in the most animated way and rubbing her chin for effect. And finally she stopped. Froze over the pillow on the bed and just stared. She reached down, lifted that pillow and said, "This is her. She is mine." She lost herself in that story and, for a moment, I was a fly on the wall in that hospital far, far away in another continent. Yes, I was lost, too.
Her father was unable to speak, but he reached for her hand, grabbed hold of it and squeezed it as tight as he could. A squeeze that said those same words:
"This is her. She is mine."
And that? That was awesome. Not just awesome in the "like, totally" way but truly awe-inspiring. Divine even. I was so glad I was there for that moment. Man, I was.
My resident asked me to go and see one of the sicker of our new patients. Our entire team went to her bedside and listened to her and carefully examined her body. We did what we could to make certain that she was as comfortable as possible and not afraid.
The comfortable part seemed more successful than the afraid part.
We weren't certain what was wrong with her but we had some strong suspicions. So after we left her room we gathered and talked as a team and put all of our brain power together to get to a diagnosis for our patient. I sat at a computer and the searched the literature as Aaron looked something up on his iPhone. And this was good because the hierarchy was flattened. We were not the attending and the resident and the interns and the medical student. Instead we were one team with one unified goal to get to the right answer and ultimately the right management for this very ill patient. This meant that suggestions from any member of that team was fair game. Fair game because this patient was acutely, acutely ill and big dog-little dog tactics weren't the best use of our collective ability.
And let me just say that there are times to be the big dog--there are. But this was not one of those times. So this moment where we all so fervently thought and tried on the behalf of this patient was good. Really, really good.
Cathy's unique eye caught this image of Grady from the parking garage.
I was leaving the hospital and on my way out, I ran into my friend Lorenzo D. (known to this blog as the ultimate medicine nerd.) He saw me in the hallway and asked if I could give him a lift since his car was in the shop. I immediately said yes, partly because he's my friend and other-partly because doing so felt like a great way to pay the universe forward for me needing the same earlier.
So we rode in the car and I learned that Lorenzo, too, is on the wards right now. And we talked about our day and the things we'd seen and learned and taught. I picked his brain about my ill patient and asked what he thought. He's one of the smartest people I know so I was pretty happy when his thoughts were similar to our team's. I was also glad to hear his way of articulating those thoughts particularly since he has a way of expressing himself that always makes me feel like I'm learning. Probably because I am.
Anywho. That part of my day was good, too.
When I reached Isaiah and Zachary, they were both in high spirits. Zachary literally leaped into my arms and Isaiah told me that his day was "supercalifragilisticexpialidocious." I looked at his brown eyes and then thought about my day. My day that, up until that moment, was indescribable. I laughed out loud saying, "You know what, Brother? My day was, too. My day was supercalifragilisticexpialidocious!"
Then all three of us went to Yogli Mogli for frozen yogurt and sang that song in our very best Mary Poppins voices for the rest of the evening.
"Supercalifragilisticexpialidoctious. . . um diddle-diddle-diddle-um-diddle-eye. . . "
And that? Perhaps that part was the very best part of my entire day.
***
Happy Saturday.
Now playing on a loop on my mental iPod thanks to Isaiah. . . .
and also this just because I'm in Atlanta and I love me some old school Andre 3000 and I like the play on supercalifragilisticexpialidocious from this vintage OutKast song. . . .
Cathy M.
And of course, a huge thank you is in order to Cathy M. who allowed me to share all of her beautiful photographs of Grady Hospital. Don't you just love how she has managed to capture these images between medical student moments? These photos warm my heart. There are many more lovely images and reflections on her blog. (She also does acro-yoga which makes her very, very cool.)
"Girrrrrrl, you betta be glad you ain't closer to MY age! Shooot. If I was jest a few years younger I'd be chasing you like a Monday after the weekend!"
Well.
It's good to know that I've still got it.
And can I please say that there was more than "just a few" years between us?
And that his "old lady" was sitting RIGHT beside him?
Mmmm hmmm.
Sigh. I love this place.
***
Happy Thursday. First day of wards. . . and away we go!
"I slipped in some high heels and twisted my ankle!"
"Man!"
*pausing to look at her pedicure*
"Whoa. Now that's an awesome nail polish job. Daaaaaang."
"Mmm hmm. And don't you know I had just got my feet done before this happened?"
*Hard head shake and eyes getting narrow for emphasis*
"They was wrapping my foot with the cast in the ER and I was like: 'HEY! HEY! HEY! WATCH THEM TOES HOMEBOY! WATCH THEM TOES!'"
Loved. It.
This I understood considering the fact that there's nothing worse than a premature pedicure smudge. (Especially if you just got them gunmetal shellacked.)
So I gave her the world's most exaggerated neck roll and lip curl--and even gave her a finger snap to let her know that I was with her.
And she got what I was saying so in response she reached over that table and gave me a big, hard extra-high high five. Then we threw our heads back and laughed so hard that my side and my head both started hurting.
All of it was awesome.
It's funny. This happened yesterday, too. And even though I cried on the way home from work yesterday, I thought of this on that same commute . . . . .and laughed, too.
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?
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