Transitions of care.

"Why live a life from dream to dream

and dread the day that dreaming ends?"

~ Joe Sample

________________________________________

"Tomorrow is March 16. That means that another senior doctor will be taking over for me. I wanted to be sure you knew that since I've been seeing you every day."

"Really? You leaving me, Dr. Kim?"  You feigned a pout but then as it faded I caught something else in your expression. Less playful, more serious. It was hard to put my finger on.

You are young. You'd been very ill this hospitalization with something that would be chronic and life-altering. Over those last two weeks, you'd been through a lot. You appreciated my pictures on the dry erase board detailing exactly what was happening with your body. It didn't bother you when I erased the pain scale for which that hanging board was originally intended (even though the nurses weren't so keen on it.)

Yeah. This had been quite a ride.

"You know? I'm kind of sad about it," I said.  I sat on a chair across from you and twisted my mouth sideways. "You've been my F.P., man."

That made you release a weak chuckle. "Ha. F.P. What's that--favorite patient?" I nodded and you did the same from your bed. "Ha ha. That's what's up, doc."

That was what was up and it was true. Completely true without a single drop of exaggeration.

"How are you?"

"Real talk? I don't even know how I am. This shit is a lot. Like a whole lot."

"Yeah." That was real talk because all of this is a lot.

You looked at my face and seemed to want to counter that with something positive. This was your way; it didn't surprise me. "You kind of made it not as bad. The way you explained stuff. But I think because of that your whole team been real good about coming in and talking to me to make sure I know what the plan is. They do a real good job of that." The side corner of your mouth turned up when you said that.

"Well, that's good, sir, because all of them will likely be with you until you get discharged."

You smiled. "Oh, so you're the only one bouncing on me?"

"That's why they pay me the big bucks."  I leaned down on my knee and rested my chin in my palm. Our eyes locked for a beat and we both smiled.

"People need to know what's going on. Like sometimes? You just lay here feeling scared that they saying one thing in front of you but a whole 'nother thing outside, you know? That's scary."

I was still leaning forward when you said that and chose to remain silent to see if you had more to say.

"I think that's why I was always so happy to see you. I knew you were gon' keep it real."

"What made you know that?" I wanted to know.

"That one day when they did that one test and things had gotten worse? You came in and broke that shit down. Like, you wasn't mean about it but you was like, 'This is your body and you need to know what all of this mean.' And in my heart, I knew something was bad happening but before then I felt like nobody was really saying it all the way. That's the first day you was drawing pictures on that board." You laughed at that. "And that nurse came in here going off when you left."

That made me smile, too. I sort of didn't know what to say, so I just said the first thing to pop into my head. "You deserve to know everything."

"I agree," you quickly replied.

I waited a few more seconds and then added, "You know? There've been times when I felt like I jumped the gun on explaining too much. Like it hurt and didn't help. So . . .you know? I appreciate those words. I do."

You nodded hard and that was my affirmation that you meant what you said.

I stood up to leave. "Alright then, friend."

"Okay, then, Dr. Kim." You put out your fist and I knew the drill. This was our fist bump of departure which, with your youth and your illness, seemed perfect.

I spun on my heel and started out of the room. Just as I reached for the light switch to turn it back off, you spoke once more. "Dr. Kim?"

"Sir?"

"Do you mind stopping by to see about me? Or at least keeping tabs on me from the computer? That would make me feel a lot better."

I cocked my head sideways and let that request settle in. "You know what? You didn't even have to ask."

"I know," you said softly, "I know."


***
Happy Tuesday.

Now playing on my mental iPod. . . . Thank you, Mr. Sample and Ms. Crawford for ministering to my soul this early Tuesday morning. Please listen to these fluttery, smoky vocals and spectacular piano accompaniment.

No pressure.

This week in clinic:

Me:  "Okay, so our plan today is going to involve adding a medication to get your blood pressure down."

Her:  "I'll pass on that. I have some natural remedies I'm gon' try instead."

Me:  "I think natural things are very helpful. My concern is that we've agreed to do that on the last two visits. I think we're at the point where we need to go ahead and do something a bit more aggressive."

Her:  "Mustard and vinegar bring blood pressure down. I bet you ain't never knew that, did you?"

Me:  "I actually have heard that."

Her:  "Well, I'm going to do that and also some other things."

Me:  "How 'bout if we start the medicine and you do those things? Then if it comes down low, we can take the medication away."

Her:  "What you think I look like? Boo-boo the fool?"

Me:  "Pardon?"

Her:  "You know damn well y'all don't take away no blood pressure pills!"

Me:  "Yuh huh. I mean, yes. Sometimes. Yeah, we do sometimes."

Her:  "Mmmm hmmm. Yeah, right."

Me:  "Mustard? And vinegar?  Aaaah. You're killing me."

Her:  "Naw. That's you that's trying to kill somebody."

Me:  0_0

Her:  "I'm gon' meditate."

Me:  "What's that?"

Her:  "I'm said I'm gon' meditate. That helps your pressure, you know."

Me:  "How about meditate right after you take this low dose water pill?"

Her:  "Nope. Then I'd have to pee."

Me:  *sigh*

Her:  "It's true!"

Me:  "Okay. My recommendation is that we start something this time. It doesn't have to even be a water pill."

Her:  "I hear you. But still, no."

Me:  "Did you get the colonoscopy appointment?"

Her:  "Naw. I don't want that neither. They put a camera in your rectum to do that."

Me:  *Sigh*

Her:  "Why y'all steady trying to do something to somebody? Push pills and probe thangs up in folk?"

Me:  *Sigh*

Her:  "I don't want all that. None of it. I'll go buy me something herbal to cleanse my bowels."

Me:  "That's not the same. This tells us if you have a polyp or something like an early cancer."

Her:  "Cancer? Naw. Y'all ain't searching around in me and bringing something in there. I'm fine."

Me:  "Okay. Then tell me--what do you want?"

Her:  "To be healthy!"

Me:  "That's what I want. But you keep trying to stop me."

Her:  "Just 'cause I like natural stuff? Chile please."

Me:  "Okay. So you don't want the blood pressure medicine, the cholesterol medicine, or a colonoscopy, correct?"

Her:  "Correct."

Me:  "So that's it?"

Her:  "I reckon so."

Me:  "So I'm confused. What did we even do today?"

Her:  "We stopped somebody from getting poisoned and getting a camera stuck in her behind that's what."

Me:  "Can I at least give you the prescription so that you can meditate on it?"

Her:  "That sound okay."

Me:  "Great."

Her:  "But that colonoscopy? Tell 'em they can stick it in the same place they trying to stick it in me."

Me:  "Gotcha."


This is Grady. And I love this place.

***
Happy Monday.

Goodfellows.

Last Thursday

Rock steady, baby
That's what I feel now
 Let's call the song exactly what it is
Step'n'move your hips with a feeling from side to side
Sit yourself down in your car and take a ride
While you're moving, rock steady
Rock steady, baby

~ Aretha Franklin

_______________________________________________

Sigh. 

So much excitement this past week. As if match day weren't enough, last week also included one of my favorite events of the year -- The Fellows Teaching Competition!

What's that, you ask? Okay. Let me explain from the beginning. . . .

First, since a lot of non-medical people read this blog, let's just digress with a recap of who all of our usual suspects are in teaching hospitals, shall we? Yes, we shall. Okay. So you already know that I have finished my training and I supervise medical students and residents as an ATTENDING physician, right? I also know that most of you recognize that those who are still working toward earning medical degrees are our MEDICAL STUDENTS. We number them by year--M1 through M4--first year through fourth year, respectively. You with me? I figured you were and that you're yawning right about now. But stay with me because this is the part where I think people who aren't in medicine get confused.

And a few people in medicine, too. Uhh. . .yeah.

Okay, so check it. Our academic calendar runs from July through June. Most medical students graduate in May and then start their post-graduate training in late June. Sometime during your third and fourth year of medical school, you declare your chosen career path and that's what you then interview for as a senior student. Match day is the day where you find out, through some crazy computerized game of card shuffling, where you will be spending the next several years shaping yourself into a sho' nuff and bona fide member of whatever specialty you want to do.

Whew.

So that FIRST year when you first start in late June fresh out of med school commencement, you are an INTERN. That lasts for the academic year until the following July when the next crop of bright-eyed bushy-tailed neophytes arrives. After that, you become a RESIDENT. This pretty much lasts until you finish your training. And just in case you weren't confused, let me quickly rectify that by telling you that we collectively refer to all of those people, interns and residents, as "residents." I think it's because the official verbiage from the graduate medical education governing body uses the word "resident" to describe specialty trainees. And guess what? We also refer to them all as "house staff," too. That dates back to the times when residents lived in the hospital which, hallelujah, I never personally experienced. (At least not in an official capacity.)

Yeah, but there's more so stay with me. In most specialties, a program selects a few standout residents to serve an additional year as a CHIEF RESIDENT. This is usually an honor given to a select few who stay on beyond the final year of training to serve in a year of administration and teaching. The caveat is that in some surgical fields and training programs, the Chief Resident is any person in their final year. (But hell, getting to your final year of a surgical residency is often an honor given to a select few all the same.)

Alright. We still cool? Good. Okay. So let's just say you have chosen to train in the best specialty ever--Internal Medicine. You've done your first year (internship) and also your last two years as an upper level resident. At that point, you are eligible to take your specialty boards, hang your shingle and start to practice. But you also have another option, which many people take. You can go and get some ADDITIONAL training in a subspecialty so that you can narrow your expertise to one area.

Such as:

• Cardiology
• Infectious Diseases
• Hematology and Oncology
• Endocrinology
• Pulmonary and Critical Care
• Rheumatology
• Geriatrics
• Hospital Medicine
• Nephrology
• Gastroenterology

Or something else if you happened to train in a specialty that isn't the best specialty in the world.

Mmm hmmm.

So IN ADDITION to our teaching hospitals being filled to the brim with house staff and medical students, we also have a whole cohort of wonderful trainees who have finished their residencies but are now getting an additional three + years training as specialists. We call these folks FELLOWS.

Whew. I know that was an awful lot to put you through just to set up what I'm about to tell you. But you know? I think all of your medical folks need to bookmark this post for your loved ones so that you won't have to keep fielding these kinds of questions:

"So, are you still in medical school?"

"No, ma'am. I'm doing a fellowship in Rheumatology."

"In who?"

"Rheumatology. We see people with things like lupus and bad arthritis."

"So are you a full-fledged doctor that can write a prescription?"

"Yes, ma'am."

"So when do you graduate?"

"Next year."

"Damn, ain't you over thirty?"

"Beg Pardon?"

"Medical school sure do seem like it last a long time these days."


 And I know that somebody somewhere is nodding their head HARD to this because they just had this very discussion with someone last week.

Mmm hmmm.

So what was my point of all this? Oh. The fellows. Yes! The fellows. Okay. So our fellows are such a huge part of patient care in the hospital. But not only that--they do a TON of the clinical teaching. That said, fellows don't often get much . . . how can I say it. . . shine. . . for all they do. Those guys work very, very hard and provide so much to us yet there aren't many opportunities to shine a light on them. Last year, with the help of a great committee, we set out to change that.

Enter the "Demonstration of Teaching Excellence" aka "The Fellows Teaching Competition."

So, a few years ago, I was asked to serve as a judge for a similar event held by the Department of Pediatrics at Emory. They'd been holding their fellows teaching competition for quite a few years and when I participated as a judge that year, I fell in love with the idea. Later that academic year, I pitched a similar event to our Department of Medicine leadership and they gave the green light. Because the Internal Medicine Department has a lot more people and trainees, we set out to build on their wonderful ideas to make it a HUGE signature event.

And the best part? Our unsung heroes--our FELLOWS--would be at the center of the attention. Yes!

Last year was our first year doing it and man! It was a smashing success. People had no idea what it would be but our fellows made it into something special. So special that it became a "don't miss" event just one year later. So yeah, this was our second year and all I can say is . . .wow. It was unbelievably awesome. Recognize that I'm a medicine nerd, so these kinds of things excite me in ways that aren't really normal.

Yeah. So the official name of ours is "The J.Willis Hurst Demonstration of Teaching Excellence: A Teaching Competition Between Fellows." Nine of our subspecialty divisions get to nominate one of their fellows to represent them in the competition. We make it very clear that it is a distinct honor to even be asked to participate and, truthfully, everyone sees it this way. Kind of like being asked to be chief resident. Kind of.

Anywho. The fellows are allowed only eight minutes to present a topic of their choice. The focus is on delivery, intonation, enthusiasm, use of learning materials and all of the things that set good teachers apart from exceptional ones. Because the focus is teaching methods, there is no question and answer period--just applause. Now how sweet is that?

We select a panel of esteemed judges from across our Department of Medicine and also one from another Department. (This year it was my buddy Jaffar K. from Neurology.) That group also includes one medical student and one of our Chief Residents--because these learners are important judges, too.

After a MAJOR PR blast to the whole of Emory (sorry, y'all--I just get excited), last Thursday our nine fellows showed up and BROUGHT it to a full house. Really. A full house! Here's my favorite of our email blasts featuring Cardiology fellow and former Chief Resident, Akram I., who was a super good sport.

I was so excited, y'all. When we pitched this to our leadership, the exact vision was an event that would celebrate teaching in a packed room buzzing with excitement. That's precisely what it was. There were division chiefs, program directors, fellows, house staff and students of all levels. And all of them were buzzing with enthusiasm about excellent teaching--and all focused on our fellows.

Yay!

It's so cool to see something come together. Our fellows were amazing--both last year and this year. Oh, and I almost forgot--the part that I'm most proud of is that the judges name one winner who gets a substantial cash prize. I love that our Department of Medicine put our money where our mouth was. Last year our winner was Eddie S. from Infectious Diseases and this year it was Randy H. from Pulmonary and Critical Care. But the real winners were all of us who came to the event because we learned SO much.

And to all you medicine nerds out there reading this, let me just go ahead and read your minds: YES, it was EXACTLY as awesome as it sounds and YES, you would have TOTALLY enjoyed it had you been there. And YES, you should TOTALLY try to do something like this at your institution and YES, we are TOTALLY going to write it up for publication so that more institutions will.

Eddie S., 2012 winner

Randy H., 2013 winner

What can I say? The flyer worked so nice, we used it twice. Ahem. (Don't judge, people. I was on wards.)

Anyways. Another neat thing was to see the innovative tools the fellows used for their presentations. Last year's winner, Eddie S., was the lone person to use a presenting tool called Prezi, and it was fun to see how many more people used that interface this year. Also lot of them used videos and sound and all sorts of cool things. And they did all of that in just EIGHT MINUTES.

EIGHT. MINUTES.

And would you believe that NOT ONE of them went over time? Not a one. Man. Imagine if all lectures could be limited to eight minutes? Hmmmm.

So at the end, our committee members snuck off to a secret location, tallied up the scores and named the winner on the spot. People were cheering and the energy was awesome. And all of the fellows who were in it and even there felt that spotlight and some love, too. Yup.

So shout out to our fellows. And also a HUGE shout out to our awesome planning committee that included what is quite possibly the most easygoing bunch of busy clinician-educators in our entire institution. Yay for drama-free and non-"extra" people to work with! And double-yay for people coming through and doing what they say they will which is what a great planning committee is all about.

You know? The whole thing was social, too, which was also a bonus. It was fun to see students talking to full professors and residents hob-nobbing with division chiefs. So much to talk about and discuss (especially since we wouldn't allow any questions. . .ha!) But seriously. . .all of it was full of the very best spirit and the climate for learning was like the clearest, most perfect spring day you could ever imagine.

Yeah.

The thing is this: "Not enough time" is never an excuse to ignore learners and not teach. Whether you're in a teaching hospital like me or just talking to a patient in the clinic. Once you make up your mind to do it, it can happen a lot faster than we realize. I've even started giving my ward teams fifteen minute chalk talks instead of 45 minute or 1 hour sessions. I learned from organizing that event that lots of rich teaching can happen in a more condensed period with some preparation.

Yup.

So that's the other super cool thing that happened last week. And yes, all of this went down while I had a ward team, kid responsibilities and butterflies in my stomach about the match. But more than that, it was also another one of those things that makes me love my job so much. I'm surrounded by lots of really cool, smart people who love sharing ideas and realizing visions. And that's a really cool place to be in.

A rock steady one, even.

Man. I know I've said it a million times before . . . but me? I'm just glad to be here.

***
Happy Monday.

Now playing on my mental iPod. . . ."Rock Steady" by Aretha Franklin -- the theme song for our intro video for the 2nd Annual Fellows Teaching Competition. These are our awesome fellows who demonstrated their teaching excellence. Enjoy!

Fellows Teaching 2013 - Rock Steady from Emory Medicine on Vimeo.

Match Day '13: Leave it all on the field.

I remember the first day I met each of them. Shaking their hands hard and asking them questions like, "What is the proper pronunciation of your name?" or "What's your favorite food?" Yep. Those icebreaker questions opened doors to relationships.

They sure did.

We sat in classrooms dissecting clinical cases and exploring algorithms on whiteboards. Then, later we stood shoulder to shoulder on hospital wards. They asked things that challenged me and made me go home to read. They often had the answers to the things I'd forgotten or never knew and they helped us to create this collegial, safe learning environment that brought out the best in us all.

And sometimes--a lot of times--they simply made me laugh.

Yep.

All of this unfolded over the course of years. Text messages asking for urgent meetings. Us hashing out details of professional and personal lives and hoping that our solutions worked. Making phone calls and sending emails and even offering some tough love on the days that it was necessary. Yep. A lot went into it.

A lot.

This year for match week, I was unusually emotional. Almost embarrassingly so. I know--it's hard to imagine me being even more emotional than I usually am, but just try because that would give you some idea of where I was this past Friday. I think part of it is because I see life with different eyes now. Since Deanna passed away, now more than ever I recognize how important it is to love and live with zeal. It's the only way to have no regrets. And yes, I do think that I live my life with purpose, but I think that kind of loss rips the covers off of your bed and leaves you more emotionally naked and exposed. You see things with a different clarity. Love comes more into focus.

At least that's what I think.

I was proud of my students Friday. And you know what? I admit that I was proud of me, too. Proud that as I watched them ripping open those envelopes and erupting into loud cheers and happy tears. Proud that I had given of myself fully to the ones entrusted to me. And I was hyperaware of it all as it was happening. Almost like it was in slow motion.

Even going into the day as my nerves began to stand on end, I spoke to one of those students to try to offset some of my crazy onto him. Instead, he spoke words that helped me to take a deep breath and relax. Those words were: "Dr. M, I'm going to be happy no matter what. I know for sure that I gave my very best and that my advisor fought for me with all of her might. I know that. We truly left no stone unturned. I'm okay knowing that we left it all on the field."

We left it all on the field.

That's it. That's why I felt so emotional. I left it all on the field. I knew for certain that this year, more than ever, I had gone hard. Harder than I felt I ever had before. Many of my students did the same, so we wouldn't have to struggle with the "if I coulda-woulda-shouldas." No. Not this year. So match day was the day when, after running and gunning as hard as we possibly could, that the score was posted high on a board for all of the world to witness.

And this year? That score was a winning one.

This time was a little different than it was with Small Group Alpha. All but one of them graduated in four years and opened envelopes on match day in 2011. But this year, three of my eight in SG Beta are taking detours to do things like earning Masters degrees or becoming famous as researchers. So yesterday, we applauded five from our family and felt tiny butterflies forming for the same experience next year with the remaining three.

Additionally, I have what I affectionately call my "accessory small group." These are the students who aren't in my officially assigned bunch that have captured my heart and my time in ways that made them, too, part of my tears yesterday. They underscore what my grandmother once told me years ago:  "The heart makes room."

Yeah, it does.

And so. With my hand on my very proud bosom and my eyes still glistening with happy tears, I'd like to introduce you to a few very special people who allowed me to celebrate in their successes on Match Day 2013 . . . .

First, from my beloved Small Group Beta

Marla W. ~ Urology, University of Florida

Driven. Insightful. Professional. Conscientious.

****

Mark G.: Integrated Plastic Surgery, UCLA

Bright. Determined. Worldly. Chic.

****

Doris K. :  Emergency Medicine, University of Chicago

Consistent. Malleable. Supportive. Smart.

****

Jenna M.: Anesthesiology, Western Pennsylvania Hospital

Thoughtful. Exuberant. Faithful. Brave.

****

Dan W.:  Internal Medicine, Penn

Confident. Remarkable. Trustworthy. Unselfish.

***

And now, a couple of others from my "accessory small group" who've also stolen my heart. . .

Kevin S.: Internal Medicine-Primary Care, Brigham and Women's Hospital (Harvard)

Leader. Selfless. Gracious. Unforgettable.

***

Bryan O.: Internal Medicine, Oregon Health and Science Center

Talented. Kindhearted. Hardworking. Earnest.

****

There are definitely some more students that I could include here but won't since this is already getting long. That and the fact that I don't have pictures of them handy, either. But that said, those students know who they are. Know that I am equally proud of you, too. 

And all of the rest of you, who aren't quite at this stage yet? Know that I'm just excited for you because I know that "you got next." I promise to have my waterproof mascara ready for you, too.

What a wonderful day it was. Yes. We left it all on the field. 

And we won.

That's all I got for now.

***

Happy Sunday.

And the world's alright with me.

When the day that lies ahead of me

seems impossible to face

and someone else instead of me

always seems to know the way

Then I look at you

and the world's alright with me

Just one look at you

and I know it's gonna be

A lovely day

~ Bill Withers

___________________________________

Match day was today and I swear it just never gets old. I have a lot to say about it but I still get all quivery in the lips when I try. So let me just share this picture I took with Dan W. from Small Group Beta right after he got his first choice of programs. This photo speaks volumes of this lovely day.

Waterproof mascara? Check.
Red nose? Check.
Shades to cover leaky eyes? Check.
Cups that runneth over? Check, check, check.

More to come, I promise.

Best. Job. Ever.

***
Happy Match Day.

Now playing on my mental iPod. . . . and crying all over again.



Overheard today at Match Day:

Student: "Have you seen Dr. Manning?"

Other student: "Yeah, I just saw her in the crowd a moment ago."

Student: "Was she crying?"

Other student: "Dude. Was she?"

Student: "Wow. That's love."

Exactly.

Back to the future.

 

When I was a medical student and an intern, the only way to see an x-ray was to schlep downstairs to the radiology suite in the basement. On lit boards marked up with wax pencils, you could find your patient's films--if you were lucky and they hadn't been filed already. Otherwise you were at the mercy of the lady in the file room, which could be hit or miss. 

Especially if you were a medical student or an intern.

Now? X-rays, CT scans, MRIs and more can be found on rolling flat screen computer monitors. Yes. Right outside of patient rooms and even from the comfort of your HIPAA-compliant computer at home. Imagine that.

I snapped this picture on rounds yesterday. My fourth year medical student, Patrick M., had pulled up the image of his patient's chest radiograph and was teaching the team about what he saw. 

In just two more days, Patrick will find out where he matched for residency in his chosen career . . . . Radiology. While it is too late for me to convince him to be an internist, it did warm my heart to see him using the technology of his era to teach us all something. It kind of felt like a little glimpse into the future while simultaneously living inside of it. 

Does that even make sense? Sigh. I don't know. 

But here's what I do know:  A lot has changed since I was in training. Yet everything has stayed the exact same. There are patients. They are people. We are healthcare providers. We are people. We do our best--using what we have at the time, technology or otherwise--to help. 

And on the best days, when all of those things come together. . . .we do.

***

Happy Wednesday.

Work. Play. Love.

This past seven days in my life. . . . .

Zachary's new favorite photo expression. He thinks it makes him look like he has a mustache.

Anand B. from SG Gamma on the Grady Wards looking all bona fide and grown up. Hard to believe he's on his Medicine Clerkship. Something about this photo makes me slightly teary.

 

Teachable moments behind masks.

Usain Bolt? Watch out for the Zack Attack. Who now runs track.

 

My friends Akima and Marc had this sweet bundle of joy in December. He's the kind of baby that makes your ovaries hurt for another baby. 

Temporarily. Ahem.

 

A little vino is sometimes keen-o.

 

Naps are so underrated. Especially the couch variety under my sissy's Delta blanket. It still smells like her which I love. It feels like a hug from her when I'm under it.

I love this snapshot of Marc, Akima, Ryan and Christian. They're a beautiful family, aren't they?

 

"Chipping is my specialty."  He's actually kind of right.

 

 Curtis, my resident, getting his upper level swag on with Jennifer, my intern.

Jay L., medical student, counsels a patient. He did a great job.

 

One of my favorite places: The hair salon! We had a great time this day. I was laughing at someone giving their opinion on Kim Kardashian's unfortunate choices of maternity clothes.

 

This is what happens when your child discovers how to take "selfies." (Check Zach's expression.)

One of my BFFs, Joy, had a house party over the weekend. Fun, fun, fun!

 

I had just had lunch at the Metro Deli in the Sweet Auburn Market by Grady. Mimi and Fred, who own the deli, had just given me this scarf that Fred brought back on his recent trip back to their home country, Ethiopia. "Now you really look Ethiopian," she said. I took that as a compliment because East African people are beautiful.

 

I ran into Miss Regina, the lady in the elevator. As I was--wait for it--getting off of the elevator. She no longer works at Grady. But she is doing well. 

She told me right at this moment, "The things you wrote about me that day blessed me and encouraged me." Her telling me that did the same for me. Yup.

 

Shoe-tying. It's a hard job but somebody's got to do it. (And it ain't gonna be me, son.)

Hop on Pop had just ended in our California King. Pop aka The BHE was pooped but obviously those boys weren't. And Zachary still has the smooshy-mustache-man face. Hilarious.

The sign is up at Mardi Gras Cafe! Don't forget to check it out. Business is going well so far. Thanks to those who have been there. Harry says he's enjoyed meeting readers of my blog. He can tell them because they refer to him as "The BHE."  Ha. Keep on coming. Baby needs a new pair of shoes.

 

Status post rounds this afternoon with Jay and Eric, my two medical students on service. We had a great time together and I was so glad they joined me. My students have great energy this month and it inspires me to try harder.

______________________________________________

You work. You play. You love. And if you're lucky, you do them all at the same time.

Me? I'm lucky.

And my life is good.

***
Happy Tuesday.

P.S. Missed my sissy a lot this week. But in little waves that felt mostly okay. I haven't been able to remove her name from my speed dial favorites on my cell phone. I probably never will.