Fun, fearless, oozy, and sticky.

You just gotta love a good save on a sign. Oh yeah, baby.

There are these two women I know named Katie B. and Carol R. And both of them are what the Grady elders would call "just good folks." And me? I'd agree with that and also just say that both of them are just amazing. Amazing in the sense that they both have that rare gift of genuine selflessness. The kind that gives behind scenes but always makes others feel important right out in the open. And this? It's a quality I strive to have but that, admittedly, does not seem to come as natural to me as it does to them.

I first met them both at what was originally Isaiah's school. Katie out front directing traffic and children and keeping the peace in her Katie way and then later Carol when the heavens opened up and made her Isaiah's teacher. And sure, I've met many, many wonderful people through the boys' schools, but I admit that these two just sort of had this lingering effect on me that made me want to keep them in my pocket for good. And you know? They've allowed me to do just that.

So before I tell you about what I did with them this weekend, I will first just need to tell you a little more of what makes them special. And that list is long so I will have to give my own Cliff Notes version. They are so good at noticing others that I want to do the same for them.

Yeah.

Okay, so Carol. She has known joy and pain. And I also know that she has known sunshine and rain. That I know for sure.  And what I will say without saying too much is that she knows first hand that extreme and unnatural pain known only by people like my parents and others who have lived through the unspeakable. But despite the pain and the rain, the joy and sunshine are what always seem to ooze out of her. And like all things that ooze . . . her oozy joy sticks to other things and people and is hard to get off of you once it gets on you. She is one of the people (besides my sweet Sissy Deanna) who taught me to (try to) lighten up more when it came to my children, especially Isaiah,  and to enjoy them more. As a teacher, she has always been honest about every aspect of who my kids are, but supportive in this way that reminds me not to sweat the small stuff. And damn I've appreciated that. Damn, I have.

You know? I loved her immediately after meeting her. I mean that. Like, she looked at me and Isaiah on that first day and shook our hands and her oozy-sticky-joy just stuck to us. And you know? Even my son Isaiah knew what an amazing teacher he had in her because one day--not even six months ago and more than two years after being in her class--he was thinking about the days that he gave her a hard time. And you know? That boy started crying. With the most serious face ever he told me, "Mom, she was so, so good to me. She was so, so kind every day and sometimes, Mom, I wasn't so kind back." And he started crying these big, fat, wet tears when he said it and I didn't even stop him because she was kind to him. And I think her kindness is what was making him cry. At least that's the effect kindness always has on me.

Anyways. That Carol R. is superkind and amazing. And just "good folks."

Then there is Katie (also known on this blog as Coach B.) Oh Katie. Whenever I think of her I think of those awards given out in like, I think, Glamour or Cosmo or one of those popular womens' magazines to a small group of "FUN, FEARLESS FEMALES."  Because even if she never goes near those magazines, she is certainly that. Fun and majorly fearless. At least, that's how she seems to me.

So I came to know Katie initially as an acquaintance in the carpool lane. Our relationship was limited to hand waves and big smiles and that was that. So really, then, I didn't know her. But when Zachary started school, he attended afterschool care there since Isaiah's aftercare wouldn't take pre-K kids. Which, yes, I'm crazy for doing but yes, that year I picked up my boys from separate places even though they attended the same school.

Uhhh, yeah.

But it was a godsend that Zachary had to go there because Katie was there. And not only Katie--Carol, too. They actually run the afterschool program so this gave me a chance to get to know both of them a little better. But there was something about those moments with Katie that I will always remember. We'd chat for a few moments as I waited on Zach and they would always be so rich and special. It was then that I learned of her daughter (a Grady nurse!) and her engagement to a very, very special and good man and also that I heard all the details of the greatly anticipated arrival of her first grandchild. And every time she shared on her family her entire face lit up in this way that made me feel like I knew them. Or at least that made me want to know them.

I've mentioned it before but will mention it again--one day I got stuck in some hellacious traffic on the way to pick up the boys. And I was literally almost a half of an hour late. Now. If you know anything about childcare you know that for every minute you are late, it's usually like fifty trillion dollars. And you get this hairy eyeball to boot. I guess I don't blame them since the folks who run childcare places have lives, too, and they need to make the punishment grave enough to get parents hustling.

Yeah.

So anyways. I was so, so mortified. I was. I kept calling the centers and letting them know I was running late and going as fast as I could but half of the time the phones went to voicemail or someone just answered and said, "Okay. Got it." Which, to me, was code for "Just come on already." So finally, finally, finally I pull up to the barren driveway where all the parents and employees have since come and gone. I tear into the building huffing and puffing and feeling like the worst mom ever. And what do I see? Katie. Calmly sitting on a chair next to my baby boy reading him a book. And reading in this soothing voice that was the antithesis of me and my frantic phonecall apologies.

"I'm so, so, so, so sorry!!!!" I panted. And then I started sifting into my purse to pay for the overage right then and there.

Katie looked up--still so calm and kind--and smiled. This warm, gentle smile that literally spoke to me without words. Her expression said, "Peace be still." Or "Namaste." Or something. Either way I immediately felt less anxious. I did. But the best part was that my child did, too.

Sigh.

And can I just say that I wanted to cry at that moment? I mean, I did. And you know? I have. I've reflected on that moment so many times and quietly wept. Really for the same reasons Isaiah was crying when thinking about Carol R. and how sweet she always has been to him no matter what. The kindness. That kind of kindness just gets you in the heart and makes you cry.

Yeah.

Do you know she wouldn't accept my money? Coach B. saw how freaked out I was and told me to take a deep breath and that all was well. And I hugged her neck tight and vowed to myself to never, ever forget how much I appreciated her making up her mind to be so kind to me that day. And every day. Because she was kind and is kind to me and my kids without fail each time.

Good folks, man.

Oh! And Katie is totally Team S.J.G.R. all the way and even ran the half marathon on Thanksgiving with us. Yes! She kept reminding us that she is "a lot older" than us even though we'd all kill for her legs. Hello? So yes, she was out there running strong with that same warm smile of hers. And that was super awesome, too.

Yeah. So that's them. And yes, there is a lot more to them but this would be longer than it already is. So I will limit it there.

 And now, this.

This weekend. Yes, on Saturday. We joined them at the Men's Shelter that Katie directs (yes, directs!) for the annual Christmas dinner. All of the kids in Carol's class (Zachary has her this year--yay!) and a few others who have stayed in her oozy-sticky grasp decorated and then served a fine meal to the men. And thanks to Katie and Carol and a host of others, the men were given some other things that will surely make their lives a little easier if only for a few days.

Oh and before I even say one more word: Here is where you can find Katie's awesome blog "A View from the Sidewalk: Concrete Reflections" about her experiences at the Men's Shelter. So please--check it out.

Where was I. Oh. The evening. Saturday. At the Men's Shelter.  Yes!

Yeah, man.

It was a magical evening. It was magical because of the truly amazing wonder powers of Katie and Carol and how they've taught scores and scores of children how not to be afraid of regular people. See, it isn't set up in the way where the kids and volunteers are on one side and the gentlemen on the other. No. Everyone was intermingled and chatting and laughing. The men even sang carols and the kids just twirled and danced right along with them. Sure did.

Oh! Katie arranged for Santa Claus to come which was a HUGE hit with all except the Manning boys. Uggh. Those boys seem to take great issue with imposter Santas. Mmm hmmm.

 

Here's what was going on behind the scenes with the Manning boys when Santa walked in and as all the *other* kids were stampeding him.

Me:  "Hey boys! Do you want to go and say hi to Santa?"

Zachary:  (twists face so hard in the such a bitter-beer expression that his left eye winks shut) "Maaaaaaan. That's totally not even the real Santa. So totally not even."

Me: "Zachary! Duh. It's his representative."

Zachary:  "That's what you say every year. But I don't want to talk to the fake Santa. Or his 'presentative."

Me:  "But he talks to the real Santa. Like directly."

Zachary:  *twists face up again and then sucks teeth. Then walks away.* 

Me:  *looking around for the other child* "Isaiah! What about you? Do you want to go over and see Santa?"

Isaiah:  "Um, no thanks. I'm pretty certain that's not the actual Santa. This is a very, very busy time for the real Santa and I'm sure he wouldn't be here. Not now he wouldn't. That's just a man who dressed like Santa. And don't say it's his representative. Because I don't believe in Santa representatives." 

Me:  "What about a helper?"

Isaiah:  "Uhhh, yeah right, Mom. That's just a dude with a beard. But I like that he has that real beard. It's not the kind people just put on so that's cool. Do you think he grows it just for Christmas? Or does he keep it in the summer, too."

Me:  *sigh*

See? As far as my kids are concerned, they absolutely still believe in REAL Santa. But the mall Santa and the shelter Santa representatives? Fuggeddaboudit. The Manning boys say they can kick rocks. Ha ha ha. I'm sorry, y'all.

And you must admit that it doesn't get any better than this Santa. Hell, I wanted to run over and hug him. As a matter of fact, I'm pretty sure that I did.

What else? Oh! The BHE was there and so was Grandma Shugsie. Carol asked the BHE to man the fort at the downstairs front entrance where they issued the gifts and admitted folks. And I tell you it was a perfect job for him. You had to be tough and have a perfect hairy eyeball to unleash when necessary. Oh, and don't get it twisted. That fun, fearless Katie is TOUGH, TOUGH, TOUGH and if she hadn't been keeping things flowing with Carol, she'd have been down there herself.

Which reminds me: Now I see what makes her daughter Jessie such a perfect Grady nurse. That toughness is definitely in the DNA. Ha.

Oh and guess what else? And on top of all of this, my sis-in-law Fran was there with three of the four Draper kids which made this totally awesome-er. In her very Fran way, she was working hard, hard, hard the whole time.  I also  loved that my big ol' varsity baseball playing nephew David was right there, too. Awesome, awesome, awesome.

See? And I really think all of these people came as much to serve as they did out of their love for Katie and Carol. Those two truly amazing women who have already chosen to shape lives as educators and who on top of all of that give of their time and effort at this shelter long after the Christmas bells stop ringing and it's no longer sexy to be there.

Yes. I said "sexy."

So I'm rambling, I know. But really the point is just that I am so much better for knowing these two women. And their kindness not only to me but to my family and so many others is just something to ramble about. It is. And it might sound weird to say this but I feel very proud to be a part of their lives. I do.

So today I am reflecting on Katie and Carol. Two completely different women who have uniquely touched my life. And especially during the most wonderful time of the year I want to package up my appreciation in the form of this blog post to tell them so.

Katie -- thank you for your fun and fearless example. You rock. You do. And Carol -- thank you for your oozy-sticky web of goodness and joy. I will always remember -- even when it seems like I don't  -- the many legitimate reasons you could use to hang your head and  not spread your joy the way you do.

You women? You're just truly amazing and especially you're just good folks. And to quote the Grady elders once more, I'll say what I could have said in far less words:

'Preciate you.

Yeah.

***
Happy Monday. And here is another shameless plug to link to Katie's blog in case you missed it earlier. . . . plus an image of what happens at the Mens' Shelter after the party and every night thanks to people like them.

Here's a couple of old posts that include these two truly amazing women and also one with another year we went to the shelter.  Hope you enjoy these as much as I enjoyed revisiting them.

Little shifts: The post when I realized how much I'd miss seeing Katie (aka Coach B.) after we stopped attending the school-based aftercare. And when I remembered how gracious she was that day I was late.

Twelve steps: The post after Carol helped me to learn to enjoy my child instead of worrying so much.

Stuff:  One of my favorites, actually. This is the post from the first time we came to the Men's Shelter with Carol and Katie.

And bonus: The post with my kids last year with the Mall Santa. This post made me LOL today!

Worry-wonder.

image credit

There are some patients that we discharge from the hospital and it feels so right. Like, there is a family member at the bedside who has appeared with a fresh set of clothes, a coat and a fleece hat for their loved one. The balloons and cards that they and the rest of the doting family had sent fill their arms as the nurse helps the patient into a wheelchair. Out they go. Mylar balloons floating behind them like some kind of flag signaling to all that this part is over. The patient is well enough to go home. And that there is a home to go to.

And when that happens? I don't worry so much. I can't say I don't worry at all but perhaps "worry" isn't the best word. "Wonder" might be good because I do find myself wondering about how they're doing and if they're okay. I open the electronic chart and "chart stalk" to make sure appointments have been kept and medications have been picked up. And the ones who have that kind of support usually quickly allay my concerns with just one glance at the record.

I wish they all had that kind of support.

There was the sweetest man that I cared for a few months ago. His stunning eyes were like two symmetric pieces of amber; I always gasped a little when he looked at me. His skin was a warm chocolate hue and his strong teeth seemed divinely protected from the harsh life he lived. And it was a harsh life. A combination of substance abuse and mental illness had likely peeled him away from his family and, at this point, rendered him without any stable housing.

"How are you today?" I asked him on the last day.

"Me? I am good. Good doctor."  Then he smiled and widened his eyes. I gasped.

"Things look a lot better. I mean, with your health. So we can let you go home today." I winced when I said that part. I cleared my throat and made the correction. "We will be able to discharge you from the hospital."

"That is okay with me."

His voice was staccato. His native tongue wasn't English but he'd been here long enough to have full mastery of it. Admittedly, that part perplexed me the most. It was unusual to see an immigrant person without the balloon-toting brigade. When I saw his name and then met him for the first time I assumed that regardless of how debilitating his mental illness and addiction was, they'd be filling the room sooner than later. Speaking in hushed voices in languages that I don't understand but that would provide me, the doctor, great comfort at the time of discharge.

But they never came for him.

"Where is your family?" It was a simple enough question. I wanted to know. Because this was unusual. It was. And nothing against American families at all. It's just an observation that people who aren't born-and-bred mainland Americans seem to have some kind of family support regardless of the gravity of the issue or amount of their financial resources.

"My family? No family."  And he smiled after he said that. This smile that was either knowing and telling or just completely inappropriate due to the depth of his mental illness. I wasn't sure.

"None? At all? I mean, are they here but you just don't talk to them? Do they want to talk to you?"

"No family."

"Is there something about that question that you want to talk about? Like about your family?"

He shook his head, still smiling.

"Are you hearing voices today?"

"I always hear the voices."

"Are they saying bad things to you?"

"No."

I looked at the notes I had written on him. According to social worker, we had arranged for him to go to a nearby shelter after he'd declined a personal care home. I twisted my mouth and sighed. I knew I'd add him to the queue of those that I worry-wonder about and not just wonder about.

"Why don't you want to go to the personal care home?"

He shrugged. "I just can go to the shelter, no problem. No problem I can go to the shelter."

And what could I say to that? I was the fourth member of the team who'd asked him that same question and, like them, was met with the same answer.

And so. We discharged him. Out of the hospital with a seven day supply of his medications and out to a nearby shelter. A ride was provided to be sure he'd make it there and that was that.

Of course, I chart stalked him. When he didn't get his medications, I tried the number he provided and it didn't work. A medical student on my team even called the shelter but he'd since left. So I just kept watching to see what was happening electronically. And surprisingly, there wasn't much activity in the chart.

That was a few months ago. After doing six ward stints in the past six months, my worry-wonder list has grown long. It gets reorganized by acuity and height of stakes so I found him eking down on the list. Admittedly, I hadn't thought of him in several weeks. Plus life goes on, you know? And I am not sure what my worry-wonder capacity is. Even though I think that Grady doctors get added storage when it comes to this.

At least that's what I think.

Yeah, so life goes on. Like life with children and husbands and work and other patients and commitments, too. And on Friday that commitment ended up being a holiday party with a group of children and friends from our old pre-school. I was riding in the car with the kids and they were chattering non-stop about school and video games and sports. And me, I just sat in front periodically saying, "Uh huh, uh huh, oh yeah?" And all was well.

Dusk had fallen and I could feel that the temperature was dropping. The cabin of the car felt cool as we drew nearer to the intown neighborhood where the party was being held. I turned on my seat warmers and also the heat as I slowed down at a red light.

"That man seems mad!"

"What man?"

"That man right there," Isaiah clarified. "He's like he's in an argument but with nobody there."

"Maybe he's just pretending," Zachary replied.

Just then, the man in discussion began waving his arms wildly. He was pointing at the passing cars and then swinging to look over his shoulder, only to start swinging fists in the air. And honestly? He was on the corner and technically harming no one. But it was clear from what I saw that in his mind there was a war going on and he was fighting it as hard as he could.

We sat in silence watching him until the light changed. And just before I pulled off he began to cross the street, still talking, pointing and shadow boxing. I lightly tapped the brake to allow him to pass by the front of my car. And he did.

But just as he did, he turned his head in the direction of my car. And I can't say he looked at me because really, he didn't seem to be looking anywhere. But what I did see was that he was smiling this dichotomous grin that didn't match his aggressive hand gestures. Then the headlights captured his eyes and right then I knew. They were amber.

I gasped.

It was him. My patient from my worry-wonder list. Clearly decompensated with his schizophrenia or very, very high. Or perhaps both. I don't know. But not near any of the shelters and likely not going to one since it was after the 5PM check in time for most of them and since he more than likely was still using.

And that? That sucks. Like, really, really, really sucks.

That's a weird part of this job. The worry-wonder list. You see people and try your best to help but sometimes the enormity of it all is just . . . .yeah. As I drove on and he slipped from my sight, I wondered if there was something, anything right then that I could have done. Like immediately, you know? And since I didn't know what that was, I just said a little prayer for him right then and there and added him back to my worry-wonder list in a higher position. Which maybe was helpful or maybe wasn't helpful at all but at least was a start.

Sigh.

So today I worry-wonder. Which is something I do often. I worry-wonder if he is somewhere safe and if he is okay. I worry-wonder if he became hypothermic and was brought to Grady. (Per the record today, no.) Then I worry-wonder if he came to Grady anyway but couldn't talk so got entered as a John Doe or something like that. And I also worry-wonder if that doting family is somewhere crying and praying and wishing they could find him and blanket him with love and mylar balloons.

I have none of those answers. But I want to believe that there is something good that comes from worry-wondering about people. At least, when you work at a place like Grady Hospital there is. That's what I believe.

Yeah.

***
Happy Sunday.

Team S.J.G.R. Thursday Huddle: Cut. It. Out.

Sigh.  I'm feeling kind of salty today. I just finished clinic and seriously no less than four people told me with the straightest of faces of how they are cooking with sea salt only. "Yeah. I only use sea salt. Only!"

0_o

Dude. If I had a dollar for every patient or person who said to me that they are using "only sea salt" in their food as some kind of healthy alternative to "regular ol' Morton's salt" I'd be one rich woman. I am so mad at whoever has told the whole United States of America that somehow sea salt is curiously healthier and less sodium-y than traditional salt. Lies, I say! 

Here's what else I say:

Cut. It. Out.

Here's  the realness:  By weight, sea salt and regular ol' salt have the same amount of sodium. And sodium is what we want to limit when managing blood pressure and fluid status. Sorry to make you . .errr. . .salty.

So what is the deal with everybody saying sea salt is all healthy and stuff? I'll tell you. Basically sea salt comes from evaporated salt water. There's less processing so the texture and color is different. Regular table salt from minerals mined underground so a lot more has to go down to get it ready for your friendly neighborhood Kroger or Publix. But still. None of that process has ANYTHING to do with the sodium content. As far as your heart health is concerned, it can't tell the difference between your expensive sea salt bought out of the natural food section or the regular old kind that comes taped together with some pepper. 

So please. Don't say that to your doctor. And when your family members say that at the holidays with a big ol' proud smile on their face, drop your eyelids half mast and tell them in your flattest voice:

Cut. It. Out.

And while I'm at it. . . .

Smoothies!

Unless you want to be wearing a body smoother all day everyday, you might want to drink smoothies with care. Sigh. I'm not saying they aren't good for you. In fact, if you make a smoothie yourself at home and don't add a crap-ton of yogurt or sugary frozen fruit, it's mostly fine. But you betta recognize that even though fruit is good for you, it has calories. And a lot of calories means weight gain.

So check it. Most folks eat one banana at a time. But in a smoothie? Folks might drop two bananas, some yogurt, some blueberries, some strawberries and waaaay more than they'd normally consume. And all of it has calories. Yep. 

And worse-worse-worse is those uber expensive pre-packaged smoothies. They have SOOO much sugar and calories. So much. So read the labels. And think about how many calories is in that smoothie you're drinking. Unless you are partial to pureed kale and celery with one granny smith apple in it, I mostly say:

Cut. It. Out.

Next up? Energy bars.

With a cool 240 calories per bar, I hope you skipped lunch before you ate one of these puppies. I am all for an energy bar now and then. But only in the place of a meal or after a super hard work out or run. Looking to lose weight? I'd suggest a lower calorie snack or even a piece of whole fruit. Just ran ten miles? Okay, then fine. Enjoy your energy bar. ONE of them. Otherwise?

Cut. It. Out.

We get fit in the gym. We lose weight in the kitchen. And when we know better, we do better. Real talk for the team. Including me. 

Say word!

***

Happy Thursday.

Hump Day Ridiculousness that made me want to talk to Deanna SO BAD!

Did y'all see this? No. Not hear about it or read about it. Did you actually SEE this? This crazy video of the imposter dude who was doing the fake play-play sign language on stage at the memorial of Nelson Mandela? OM-OM-OM-GEEEEEE!

Now this? This hot ass mess made me want to call Deanna so bad that I almost lost my mind. She would had so many choice things to say about this foolishness. Ha ha. So many. I can just hear her now.

Ha ha ha ha.

Okay. I know, I know. It's not funny. It's not, y'all. See, 'cause clearly I'm mature enough to see that it's a highly offensive slight to those who were counting on a true sign language interpreter to navigate that live historic moment. I get that and fully acknowledge that.

I also get that it's especially not funny when you just hear of it on NPR or read it on a news page. Seeing it, though? Seeing this and keeping a straight face takes a level of seriousness that I have to say I'm still working toward. Even if I can fully accept the inappropriateness of it.

But see Deanna?

Chile please. Deanna would have been screaming in laughter. Then she would have said that reacting to that man having the audacity to do the same three rudimentary hand motions for three hours (with a STRAIGHT FACE y'all!) is a mutually exclusive event from paying homage to the amazing life of Mr. Mandela. Which should give us all the official authority to LOL. Better yet -- carte blanche to ROTFLMAO (which was actually in one of the last texts she sent me about something equally ridiculous.)

Did that man really do that? Like did he REALLY throw up three gang signs that look like they're from my neighborhood growing up while standing next to the most important people in the world while memorializing a man compared to Ghandi AND Jesus himself? What the WHAT?!

Hold up. I have to watch it again to make sure it really happened.



*screaming and reaching for my cell phone to call Dee*

Oh Deanna! Why can't I call you on this one? Aaaaahh!!! Your reaction would be so priceless. But the good news is that I can hear it as clear as I could tell that that sign language was some bull-jive. OM -expletive- G was it. And that straight face! Seriously? Seriously.

And do you know he had the nerve to say it was some kind of Zulu sign language? Which makes me want to call Deanna even more. Lawd. Lawd. Lawd.

So what would Dee have said? Oh, that's easy. The clip would be embedded on her Facebook page or in a quick text to her sibs with this caption:

"Now this? Tell me this isn't the most gangsta thing you've ever seen in your life! This is some funny azz sh@%!"

Wait! Nooooo! Don't get mad at me. That's what DEANNA would have said! Deanna. Not me, of course. Because me, I'm super mature so wasn't laughing when I saw this. I *cough* wasn't. 

>_<

Okay. This officially trumps when Bert took a shot of Jack Daniels in the pulpit at Deanna's Memorial Service. Or at least it's a tie.

The one and only Bert D. who made the shot heard all around the world.

Whew.

On that note, I'm going to bed. But not before I call JoLai so that we can LOL about what Deanna would say about this. ROTFLOAO even.

Lawd, lawd, lawd. . . . what the . . . sigh.

See? Strong memories of the people you love sustain you when they're gone. It's not all sad--it's not. So make memories and savor the silly so that you can pull it out when you need it. Kind of like "on demand."

Yeah. Like that.

***
Hump DAAAAAAAY! (Some other ridiculousness that I could hear her saying while walking into my front door on a Wednesday. Ha ha ha ha.)

Life in pictures: Let it shine.

Everyday I try to take a moment to pause and savor my life. And when I do, I feel happy. No matter what. Because regardless of the joy, pain, sunshine, or rain that is there, I wouldn't trade this little life of mine for anything.

For anything.

***
Happy Tuesday.

Now playing on my mental iPod. Always loved this scene because I feel exuberant like this on most days. . . ha ha ha ha.

Team S.J.G.R. REALNESS 101: The Sledgehammer.

"I want to be. . .  your sledgehammer."

~ Peter Gabriel

Oh just damn. I hate to come at you like a sledgehammer on this overcast Sunday, but that's how the realness usually comes, right? Hard like a sledgehammer and shattering everything to bits. And so. Here we go.

Feel free to stop here if you aren't ready for it.

So check it. There was this study that came out in the Annals of Internal Medicine (which is a super legit and high impact journal) very recently.  And sure, this is a study that, no, won't say anything that is rocket science to any of you, but that will nudge everyone a little further out of hypothetical la-la land when it comes to health and wellness.

At least it did for me.

Oh, my bad. You forgot about "hypothetical la-la land?" Okay. Well let me just remind you. And remember--any message for you is a message for me. Which means that you aren't the only one who needed this reminder. I do, too.

So hypothetical la-la land. That's the place where all of the things that happen from unhealthy practices and states of being somehow leapfrog us and land on someone else. Like Tony Soprano or some other person who isn't you or isn't connected to you. But see, since we are all members or at least peripheral members of Team S.J.G.R. we all know that at some point SHIT JUST GETS REAL. Hypothetical becomes a legit part of your world and not some far off thing that only happens to other people.

Or just "older people."

Yeah, I said it. So we will just go right ahead and put it out there that, for me, S.J.G.R. when my beautiful, talented, wonderful and hilarious sister Deanna Draper left this world as we know it on November 15, 2012 from a heart attack. Yes. A heart attack. The number one causer of death and disability in the U.S. that, somehow, I still sort of saw as something that was happening in hypothetical la-la land only.

Or mostly to "older people."

Yeah, I said it again. No, I never in seventy million years expected my sister who was only 20 MONTHS older than me to leave my house on a boring Wednesday night, text me with emoticons that she got home safe, and then never hear from her again. Because stuff like that happens in People Magazine or The Atlanta Journal Constitution or during the church announcements. Not in MY family. And certainly not in yours, I'm sure. I'm sure.

So when I read this study, it punched me in my mouth hard. It said, "Yeah, yeah, this is stuff you already know but like, for real, here it is with data in your FACE." Which is kind of different than thinking you know something. At least to me it is.

So here is basically the gist of the study:

There is no such thing as healthy obesity.

Sigh. Let me say that again--but in the way that less kind people and media are wording it:  You can't be "fat but fit." I mean, not really you can't.

And before I go into more of this study and unpack on all of it, let me be very, very clear.  I don't like the term "fat" used to describe people. I think it's hurtful and callous and mostly unhelpful. It's even more damaging when we use that word with reference to ourselves. Which happens far too much and is extraordinarily poisonous. And that? That could be it's own blog post. Hmmm. It probably already is somewhere but I just forgot about it.

Wait? Where was I? Oh, terminology. Yeah. So, instead I will use the term "obesity" or "overweight" to refer to being well over an ideal body mass index. Or over your ideal body weight. You with me? Good.

Okay, so check it. First a little background information: There've been some studies that have looked head to head at obese people who are "metabolically healthy" and also their "metabolically unhealthy" couch potato counterparts. Wait. That came out wrong. Okay, so those aren't necessarily their counterparts. They're just people. So yeah, researchers have compared these two groups in the past and found that -- duh -- it's better if you're overweight and metabolically healthy. There's also been a few small studies that looked at metabolically healthy obese people and metabolically unhealthy normal weight people,  too. That data mostly says that it's always better to be metabolically healthy no matter how much you weigh.

Now. Let's define "metabolically healthy."  Per most studies and my points today, that refers to people who don't have high blood pressure, issues with glucose control, and cholesterol -- or who have these things yet are consistently, irrefutably WELL CONTROLLED. And by "issues with glucose control" that's just a way to say that they didn't have diabetes or "pre-diabetes."

Here's what they weren't talking about. They weren't talking about how much the obese person is working out or how much weight they can bench press or squat. Although we do know that there are definite major health benefits and improvement to life expectancy for folks of any weight who do exercise regularly. So that doesn't mean that this isn't good. It just means that there has to be more.

Whew. I know. This is kind of confusing so far. But stay with me, y'all. I'm going somewhere.

Okay. So this study in the Annals of Internal Medicine -- a big meta-analysis of several studies -- broke down what I think a lot of us kind of know but have wanted to ignore.

But first the good-ish news:

• Being metabolically healthy and obese is better than being metabolically unhealthy and obese. 
• Even if you are of a normal weight, being metabolically unhealthy reduces life expectancy. Which means just being skinny can't be the endpoint either.

So it is critical to work hard to control blood pressure, blood glucose and cholesterol.

But here is the real talk part:

Even if you are metabolically healthy, if you are overweight or obese, you have a significantly higher chance of dying or having heart-related problems than if you are of metabolically healthy and of a normal weight.

Significantly, so.

So what does this even mean?  It means that SHIT JUST GOT REAL with our health and wellness goals, that's what it means.

Let's make this not hypothetical, shall we? Okay. I am the first to admit that this study would punch my mouth even harder if I'd struggled with my weight as much as some others in my family. I know I haven't so yeah, yeah it's easy for me to say this. But the thing is. . . .I am a member of a family where people started out slim and ended up not slim. And I'm also connected to and deeply love some people who are overweight that read this blog. So really, this message is for all of us. And, no, it's not just some slim internist wagging her smug skinny finger at everybody else.

You got that?

But even more real is this. I know for certain that my sister Deanna was not hypertensive and she didn't have diabetes. What I don't know is her cholesterol level. I had taken her blood pressure myself before and recall being surprised at how perfect it was. Now admittedly she wasn't in a doctor's care but the truth is that she very well could have been exactly what was described in this study: An obese person who was, by definition, metabolically healthy. Yep.

Perhaps that piqued my interest even more when I read this study because I felt myself saying, "Damn. That was my sister." And no, I don't know for sure if it was but the fact that it could have been or that it likely is for someone reading this, I knew we needed to unpack this and get the realness out of it.

So what is the realness out of it?

I'll tell you. Obese or overweight CANNOT be the endpoint. It can't. So even if you are 250 pounds  and have been "big boned-ed" or heavy for your ENTIRE LIFE, your endpoint cannot and should not be like, 180 or 175.  It shouldn't be if you want to increase your life expectancy and reduce the chances of heart-related problems.

Which I will KEEP saying is the NUMBER ONE CAUSE of death and DISABILITY in this country. And please--don't forget AND DISABILITY because while death royally sucks, severe disability can suck equally hard depending upon what that disability is and how it affects the quality of your life (or that of those who love you.)

So the realness is that we acknowledge that going from 250 down to 175 is awesome and a HUGE step in the right direction. But then we clean out the pantry and empty out the refrigerator and go harder. 175 can't be where the confetti settles. It can't.

I like to think of weight loss and fitness goals as having those people cheering for us at the "cheer stations" during running events. Think of hitting one milestone as the folks cheering at the mile five marker and later at the ten mile marker. It's way awesome and deserves some cowbell and major hand claps but it doesn't welcome you to leave the course. You feel me?

And what about when you run through the finish? What about when you reach a healthy weight and manage to do attain some metabolically healthy state to boot? Do you get to just sit on the curb and eat a banana? (Which is what I do after most races, ha.)

The answer? No. You do what any good runner does. You congratulate yourself and then sign up for another race. That's the only way to keep yourself training and running.

Yep.

Is this discouraging? I hope not. It shouldn't be. It should instead just be a jolt of realness. One that makes us look at the people and lives we love and vow to do what we can to remain a part of it. To put down excuses and fear and prove our little naysaying voices wrong, wrong, wrong.

Yeah. You hear them. Those little voices. They come in so many forms. Nice. Mean. Complacent. So stealthy, those little voices are. Recognize any of these?

"Girl, you just thick. You always gonna have junk in your trunk. It's good that you exercise though. Shoot! A lot of big people don't even do that. Don't worry about the weight!"

"Your man likes a woman with meat on her bones." 

"You work out WAY MORE than any of those skinny-minnies. You are healthy at this size! You ain't a couch potato like such-and-such is."

"You'll never be at a normal weight. Never have been, never will be."

"Everybody in your family is big. You will be, too. Deal with it."

"Your medical problems won't allow you to lose weight right now."

"You quit smoking that's why you gained weight."

"You just (fill in the blank) that's why you are this size." 

"People in my family live to be old. My grandmama-granddaddy-great uncle-great auntie was heavy set and lived to be ninety-nine and a half. Mmmm hmmmm."

"Man! You just ran a half marathon! You are healthy so don't worry about trying to look like something your body isn't. You just big-boned-ed, that's all!"

And you know what? That's all fine and good but is, unfortunately, bullshit. Bullshit if you want to reduce your risk of death or heart-related disease. And do what you can to be here with the people you love.

And I said "do what you can" because we certainly all know that sometimes the bell just effing tolls and it's nothing we can do about it. But you know? If right now somebody is telling you that there IS something that you could POTENTIALLY do, what the hell do you have to lose by trying?

Overweight CANNOT be the endpoint. It just can't. And, no, I'm not saying hate yourself. I'm saying be real with yourself, though. I sure am. I'm saying be real about how your weight directly affects your life expectancy and risk of cardiovascular disease.

So recall:  We LOSE WEIGHT by putting down the fork. That doesn't happen (really) from exercise. Does it help? Absolutely. And it especially improves the metabolic state to move you toward being "metabolically healthy." But as far as truly losing a sustainable amount of weight? That happens in the KITCHEN and at the dinner table with healthy choices.

Yep.

And that's doable. "NO" is sayable and doable. No starts at the grocery store and when perusing a menu. It doesn't have to be oppressive to all around you, either. It's passing on the egg nog because  it simply isn't 750 calories worth of delicious. It's a small glass of egg nog because you LOVE egg nog but no to the sweet potato pie because you can have a taste of one but not both. 

And NO you can't eat and drink both and then plan to "walk thirty extra minutes" on the treadmill. Because we LOSE WEIGHT by controlling what goes in our mouths. Period and END OF STORY. So disconnect the weight loss and constructive changes after naughty meals to exercise. Connect them to the next meal or the other things that are allowed during that same meal.

Whew.

I know some folks won't agree with that and say, "Of course you lose weight when you exercise." And to that I say yes, it does create a calorie deficit but not the kind of calorie deficit that putting down the fork or rather, choosing the right food and portions does. This is the reason why at every single race I've been in I am getting lapped and dusted by hard core distance runners who are still significantly overweight or obese. Which underscores my point: You CANNOT outrun, outjump or out-pilate a big ass until you fix your food intake.

This is suck a freakin' buzz kill at the holidays, right? I mean someone is just eating the last of the deliciously yummy latkes slathered in sour cream and apple sauce while someone else is perfecting their pecan pies and pound cakes for the next holiday party. But remember, what this calls for is AWARENESS not oppression. Have a latke. But have ONE. Put some greek yogurt on it instead or pass on the creamy topping. Enjoy your piece of pie. But modify the other food choices to counteract that calorie bolus.

Oh, and the same goes for alcohol which tends to come out even more during festive times. Because they have calories, too.

So the take home points are as follows:

1. When obese, we can't be our healthiest. 
2. Obese or overweight shouldn't be where the endpoint lies.
3. Exercise improves our cardiovascular health not matter what our size is.
4. We lose weight in the kitchen. 
5. We get fit in the gym.
6. This shit is not hypothetical.
7. Being awesome and loving your curves does not prevent heart disease.
8. You can do this.
9. We can do this.
10. Somebody is counting on us to at least try. Because your example can be a multigenerational catalyst and a message to your kids on "how to be."

Let's leave hypothetical la-la land for good. And recognize the realness for what it is. It's there whether you are celebrating with your family or not. And acknowledging the realness for what it is -- and not something hypothetical --  could quite possibly give us even more celebrations with our loved ones for years to come.

This message is as much for me as it is for you. So please--let me be your sledgehammer. Because I got love for you. . . and the realness? No matter what that little voice tells you -- it don't stop.  Plus I want YOU to be somebody's sledgehammer, too, through your strong example. And you can.

And you will. I just know it.

"Oh let me be -- your sledgehammer.

This will be my testimony."

~ Peter Gabriel

***
Happy Sunday. Say word!

Now playing on my mental iPod. . . . .a cool song (and one of the coolest videos ever) that probably was about the horizontal mumbo-jumbo more than it was Team S.J.G.R.  and cardiovascular health but lyrics are always open for our interpretation, right? Thanks, Mr. Peter Gabriel for this excellent soundtrack today. Rock out and enjoy.