On my rounds one day, I was with a med student talking to these two women about their seriously ill parent. They were appropriately worried, tired, and understandably nervous. They asked a lot of questions. Tough and skeptical ones, too. And that was fine with me.
It was.
Then, in the middle of my sentence, one sister interrupted me suddenly. "Wait. Can I see your hand?" She turned over my right hand, gasped and then looked over at her sister. "You seethat?"
The other sister smiled and then nodded. "Soror," she said softly, shaking her head and releasing a big relieved sigh. We then embraced in a tight three-way hug. It was beautiful.
My student was so confused. I explained that we all shared the same sorority. "That's so neat!" my student said with a big smile. I could tell, though, that she was still perplexed.
"No, baby," the oldest sister said while tearing up. "This is more than just neat. See, we just found out that we got a doctor in our family seeing about our daddy. Right here at Grady. And when you're worried like we've been? That's a godsend."
And you know what? She was right.
Yeah.
***
Happy Saturday.
Now playing on my mental iPod. I heard this song in my head for the rest of the day, imagining how proud Deanna would be of me and how much she would have loved this photo. I love being a Delta. For me and so many others it's the gift that keeps on giving.
He was only 6 when she passed away. That said, I'm thankful for that part because memories are less fuzzy when they happen at this age and beyond. In his mind's eyes, she isn't some amorphous, fantastical legend. Deanna was a life force in his own and one that he remembers for himself.
For himself.
I took this photo yesterday evening upon Zachary's request. He'd just brought home a form for a fundraiser his school is doing for the American Heart Association. Diligently, he filled out the donation form and asked me to help him create a page. He even had me take a video of him to send to family--an unrehearsed quick take in his own words to help with his efforts.
"I want to raise money to help people with heart problems," he said. "And I want to do it for my Auntie Deanna."
He didn't sound morose or somber when he said that, either. Instead there was a glimmer in his eyes of such earnest innocence about this idea that it quickly sucked the wind from my chest and made my eyes sting. Zachary even set a goal that was more than the minimum. And sure, the kid in him was rather enamored by the array of plastic prizes offered for high fundraisers, but I believed him when he said that the impetus was helping to fight against the disease that robbed him of his precious auntie. Truly, I did.
Yep.
Okay, so I'd be remiss if I didn't include a link to his American Heart Association fundraising page. But please--don't feel any pressure. Warm wishes are also accepted and equally appreciated.
He doesn't like the way his nosed is smashed on this photo. But that was the part I loved the most. I think in my head I hear Louie Armstrong singing "A Kiss to Build a Dream On" when I look at this image. We get to be better friends with time, trials and tribulations. This picture shows that. I love my life with this man and hope we get to grow old together.
Isaiah's school didn't restart the new semester until today. When he's out of school and Zachary is in, he often goes to his old pre-school to serve as a "helper" for the day. He's so naturally patient with small children. It's a special quality he has.
Heidi, his former pre-school teacher turned very dear family friend of ours, snapped this yesterday as my boy read a book to a room full of 3 and 4 year olds. She lauded him for the emotion, enthusiasm and intonation during his reading. "I know what kids want to hear," he said to me with a confident nod.
I love that boy with my entire heart. This photo made my day.
Even though he's nine now, on some early mornings he still appears at my bedside wanting to get under the covers with me. "I just want my mama sometimes," he says as he snuggles his body into the crook of my own. And every time, I kiss the top of his head and whisper back, "That's okay, son. Because your mama wants you, too."
"I remember," she said, "the day when it crossed into something else. Into that freakish range where mothers hiss to their kids to stop staring. At first you think that, just maybe, it's an accident. Then you realize that it isn't. They're whispering and pointing at you."
I squinted my eyes and tried to imagine it. My patient, minding her own business and moving slowly through the aisles of a store. Maybe even doing something like picking up lightbulbs and hand towels in the home improvement section at Target. People walking by and doing those not-so-subtle double takes and her trying her best to not notice it. But she was right. This was more than just a little out of the range of normal. And though I wouldn't choose a word like "freakish" to describe it, I'd be lying if I said that it didn't somewhat fit the definition of that word. Even if it sounds mean to think that way.
Sigh.
Patients like her require special provisions. They bring in a special bed aptly or rather, horribly, referred to as a "big boy bed" to accommodate such a large body. It's hard not to hitch your breath and stare for a beat when you first see her and others of her body habitus. Legs easily larger than my husband's torso and a mid section that appears far to heavy to be supported even by those extremities. The adult in you tries not to see the large pannus lying flaccid over their thighs and fights those silly juvenile thoughts like, "What happens when it's time to go to the bathroom?" or, I'm even more embarrassed to admit, "How would she or he make love? " I timidly raise my hand and admit that I do have these fleeting thoughts. The adult in me flicks them away. But every time, they appear and require that flick.
Yeah.
This encounter with me certainly wasn't helping her self image. My patient had some shortness of breath and was, literally, too big to receive any of the diagnostic studies that we'd considered. She could not have a CT scan. Her circumference exceeded that of the scanner and her weight was more than 150 pounds beyond the limit of the table. A stress test or a even an echocardiogram would be so limited in accuracy that it was almost deemed futile and a waste of her money and time to pursue. And to make matters worse, even if a stress test did find even some equivocal result, the cardiac catheterization lab wouldn't be able to handle 650 pounds on their support structure either.
Nope.
Ever since I was a resident physician in Cleveland, Ohio back in the 1990's, this kind of issue has periodically come up. Without fail, no matter where you practice, some well-meaning person speaks of the urban legend of the city zoo being an option. And no, not with cackling mean-person sarcasm but with a full-on, dead serious expression. A medical student looks stunned and queries whether or not a patient can truly go to the zoo for such a thing at which point whomever is speaking affirms it as the gospel. All of it reminds me of those stories of funny names in newborn nurseries, like the woman who named her twins "Oranjello" and "Lemonjello" since that's what they fed her in labor and delivery before she had them. Somehow the mother of those twins has managed to live in Cleveland, Ohio, Nashville, Tennessee, and Atlanta, Georgia. That, or she doesn't exist.
The zoo thing, though, I must admit always intrigued me. So, a few years after I came to Atlanta, I called Zoo Atlanta on behalf of a patient of mine. He needed a cardiac catheterization and I wanted to actually sniff out this trail to see if it truly would lead somewhere. Several of my calls were met with chuckles. Even when I reached some nice tech in the Large Animal area, he notified me that the zoo veterinarians did have X-ray machines and even a cath lab made special for elephants and such, but that actually having human cardiologists come in to use them on humans wasn't something he was aware they did. After that I spoke to our cardiologists who calmly answered me (while staring incredulously) telling me that logistically, it would be too much.
"We couldn't really do interventions either, Kim."
"Like place a stent or something?"
"Yes. And even if there was something significant enough for bypass, that wouldn't be an option either. The anesthesia risk would just be too great," the cardiologist said.
"I appreciate you actually thinking this through," I recall mumbling.
"This is really a sad, Catch 22 of a situation. I hate when it comes up."
And that was just sort of where we left that. But some piece of me has always felt this weird mixture of better because I actually checked before and discouraged for the very same reason.
Yeah.
So the truth is that, there wasn't anything I could do other than talk to her and listen to her story. And since she'd navigated the last several years of her life as what some would deem a "freak" I just made up my mind to humanize her the best I could.
I noticed her light brown eyes that almost appeared amber, framed with sprawling black eyelashes. She had a dimple in her chin that I thought was cute, whether she was smiling or not. The right cheek had a beauty mark on it, the kind that many women wished for but she'd obviously been blessed with at birth. And her teeth were unusually straight, large and strong appearing. Even though she didn't smile so much.
And so. I listened to her story of the transition from "always a chunky kid" to "overweight" to "really obese" to "freakish." I didn't rush her either. I just sat and paid attention and focused on her lovely eyes, her beauty mark and that cleft in her chin wondering what I could possibly do.
"Those surgeries scare me," she finally said.
"Surgery is a big deal," I replied.
"Yeah. I just feel like it would be such a failure to get an operation just because you couldn't stop eating."
I twisted my mouth and paused before speaking. "Food relationships are complicated. I think of weight loss surgery as an option that is now available that wasn't before, you know? But yeah, surgery isn't something to treat lightly."
"My relationship with food has never been healthy."
"I understand." I wondered if I should say the next thing in my head, but then decided not to overthink it. "I say just look into it. Make a decision after you look into it, you know?"
"Guess I'd not have much to lose, right?" After she said that we both chuckled at the unintended pun.
"Um. . .you could also look into . . . okay. . have you ever heard of this organization called 'Overeaters Anonymous?'" I inwardly cringed when saying the name of it but felt she should consider it. I hoped she wasn't offended. But she shook her head and looked intrigued.
I told her about this 12 step organization that tackled food relationships much like other tried and true organizations helped patients deal with substance abuse issues. And we looked at the website right then and there on our cell phones and she promised me she'd check it out.
And that was that.
We discharged her a few hours after that. Honestly, there wasn't really any more tests I could order and, fortunately, she was doing well enough where most weren't indicated anyway after all was said and done. But I have found myself thinking of her. Pondering her world and that threshold of going from overweight into, to use her words, "freakish." And usually it just leaves me feeling kind of sad.
That is, until this morning when I allowed myself to reflect on what I remember the most about her. Her smile, her enviously stunning eyes, that beauty mark that Marilyn Monroe had nothing on, the tiny indentation in her chin and especially her fearless transparency in describing her life. I realized that this is what I see in my mind when I think of her. And I see that part in greater clarity than anything else.
And that? That leaves me feeling hopeful that at some point something will happen that allows the entire world to see that, too.
Do you ever have these moments where you want to fix everything? I mean, fix the things that could potentially be fixable if you and like a whole, whole, whole bunch of people galvanized to make it better?
Yeah. Like that.
I have feelings like that a lot. Sometimes it's a really big and nebulous thing. Other times, it's more concrete and smallish. That is, until I really start to flesh it out. So then I'm just sort of left with this problem that I think I may have some ideas to help with solving. But simultaneously this tiny undercurrent of angst because I'm not.
Sigh. This sounds rambly, doesn't it? Like, I'm sure someone is like, "She goes a bunch of weeks without blogging and this is what she posts?" Or maybe that's too self-important a position to take. Perhaps you, too, are busy and don't fully give a shit whether or not I blog every day or every month but still think this sounds cryptic and tangential.
Okay. Fair enough. I guess I'll give an example of my latest "thing" that I'm thinking about (in terms of problems that need solutions.) And since you already can see that I'm feeling rambly, I advise you to read at your own risk of utter confusion.
Yeah.
Okay. So check it: 1991 was the year I applied to medical school. I drove to Auburn, Alabama from Tuskegee, Alabama and took the MCAT on my 21st birthday. I remember that part well because on my way home, I stopped at the State Store and bought a pint of some kind of alcoholic beverage. Not so much because I wanted to get drunk, but more because I could buy a pint of something--using my legit state-issued over-twenty-one identification, that is. Anyways. Luckily, I did pretty well on it on that first go (the MCAT, not the pint of liquor.) That fall, I began hammering out my med school applications for what I hoped would be my future career.
Yup.
Now. 1991 was a hell of a lot different than 2016. See, back then, you literally "hammered" out applications--on a typewriter. Sure did. I typed my applications out and mailed them via snail mail. Yes. Via the United States Postal Service. Some human received my envelope, tore it open with a letter opener, and read it. They looked at my picture and read my personal statement. My letters were skimmed and my meaningful participation in student leadership was noted. And all of that was coupled with my academic performance and MCAT scores for a more complete picture of my potential as a medical student at their institution.
I got plenty of interviews. And though I was a good candidate in terms of merit, I wasn't necessarily out-of-this-world academically. But coupled with my total package of service and leadership? I was a very attractive potential med student--if I do say so myself.
Yep.
But this? This is totally, totally different than the way things are now. Now? Everything is electronically-based. Applications are just a few clicks away and one universal form goes everywhere. That means it's easier to to apply to more schools. And for the schools, it means way more applicants from way more places.
Now that? That part isn't really a big deal and is probably a good thing mostly. But what is tricky is that now that it's computer based coupled with more volume, that human-being-looking-at-the-real-you component is removed. Or, at least, super diminished. That is, unless you jump the first objective academic merits hurdle--then, and only then, will your chances of getting your stuff looked at become highest. Which makes it MUCH harder to get into medical school (or any super competitive school without a slam dunk GPA, MCAT and, just maybe, alma mater.
Oh--and let me clarify something on the alma mater part: A 3.9 GPA from anywhere? You're golden. A 3.5 is more complicated. That said, that 3.5 GPA will be looked at differently if it is from Princeton or Harvard. I mean, it just will. Does it mean you have to go to an Ivy League school to get into medical school? Definitely not. And would I trade my HBCU undergraduate experience for anything in the whole world? No way. But it's probably fair to say that certain schools might get a person more wiggle room than others in the numbers game.
Okay. So here's why I'm talking about this: There's not a month that goes by that I don't receive an email, in box message or call from a friend, a family member, a friend of a family member or even just some acquaintance-of-an-acquaintance asking me to speak with someone who is applying to medical school. Now. If they are young? Like a freshman or even a first semester sophomore? It's great. Really, it is. But usually, that isn't who the person is.
Nope.
Often it's someone who is a college senior or who has already graduated. Maybe they look like me, but not always. But what does seem to be very common is that there is this critical information that they needed long before the call was made to me that they never received. And that information is simple:
This ain't 1991.
It breaks my heart to hear someone say their GPA from non-sexy state university or teeny-tiny-college-that-we've-heard-of but-the-admissions-committee-hasn't was "pretty good" and that they "could've done better on the MCAT." So I ask, of course, what "pretty good" means. That's when I learn that usually that's anything from a 3.0 to a 3.4 cumulative grade point average. Which, I know, I know, to a lot of folks reading this sounds great. And to me, I'd agree that this would sound totally great--were this 1991.
But, it ain't. Nope.
See now? Now with it all computer based, the easy clicks that you used to apply with less difficulty are also happening on the admissions end. A few mouse clicks helps medical schools easily filter out the "pretty goods" from the academically exceptional ones. GPA under 3.5? Click. MCAT under 505? Click. So the fact that you were SGA president or a volunteer at the Humane Society or a dancer with the Alvin Ailey Dance theater before college? Sorry about that. Thanks to your academic numbers, I'll never see it. Or your lovely headshot that your mom helped you narrow down and select.
Nope.
So yeah. I find myself hearing these earnest young people and feeling like a damn dream killer. I listen and make a few suggestions but deep down what I really want to say is, "You need to go back to your freshman year and start over. You need to be pressed to get a great GPA from day one, especially if you went to a school that isn't the first ones people roll off of their tongues when listing the very top-tiered institutions of higher learning."
That brings me to this solution. The solution would be for a bunch of doctors to go to colleges--particularly some of our smaller ones --- and talk to freshman from the very start. We need to show up and give that speech that Debbie Allen gave the kids at the Performing Arts High School during their first days.
"You want to go to med school? Well med school costs. And right here is where you start paying. In sweat."
And honestly? I'm not even joking. That message needs to reach aspiring doctors waaaaaay before they cross into their junior or senior year of college. The caveat, of course, is if you already were knocking it out of the park all along. Then there isn't such an urgency.
But what's messed up is that a 3.4 GPA is really not bad at all, man. It isn't. But for medical school? It pretty much sucks. Unless, of course, you know someone somewhere who can help open a few doors or you have your sights set on less competitive schools. But remember--even those schools now have more applicants in their pool due to the click-click-click culture, remember? And a lot of folks are hungry, man. Hungry to get into medical school and now they are clicking the schools that in the past they didn't.
So yeah. Asking can you shadow a doctor in their office or in the hospital? Totally cool if you're in high school or you're an already high achieving college student. But for the person who hasn't been so serious all along? Don't bother. Following me or any other doctor around won't do much more than frustrate everyone.
Man. I feel so horrible for saying all of this. But it's true. Someone needs to yell it, scream it, tell it--it's true. And see, we need to either figure out how to re-humanize the application process or get the word out to everyone that there is no goof-off margin any more in college for those who wish to go to medical school. Additionally, even if you didn't goof off, unless you go hard from the very start academically, no one will ever get a chance to see your great qualities beyond that. It's jacked up but it's true.
So anyone with a kid starting college or who just got there that wants to go to professional school? Here's my PSA: Go hard from day ONE. Make connections. You must be exceptional in person and on paper. Or at least make enough meaningful connections with people who can advocate for you enough to get your application in front of someone who'll actually read it should it fall below the bar. But remember that, even with connections and prayers, being "just above average" academically could get you shut out of what you aspire to do.
And you know what? You won't even be able to take it personally. Because it won't be personal. In fact, it won't be personal at all. Nope.
Oh--and before someone says it--yes, I know that there is a story of someone somewhere after 1991 who overcame all of this and got into the very best med school in the whole world and did great. Just like someone somewhere dropped a quarter into a slot machine and won a million dollars. Just consider this some pragmatic real talk. And the earlier it reaches the right people, the better.
Yeah. I need to get this message out man. Because it ain't 1991 anymore. No ma'am and no sir.
Thanks for letting me ramble on this. I mean it. Oh, and sorry for the buzz kill.
"I want to savor it. I want to swirl it all around on a plate and sop it up. That's what I want to do with this life. Find the sweet parts in every bit of it."
I wrote this in a text message to someone. Ran across it today and decided to post it so that I could come back and read it again later.
parable: n. a usually short fictitious story that illustrates a moral or spiritual lesson
The house was beautiful. I mean, just looking at it from the outside you could tell that these people weren't hurting financially. At all. The lawn was professionally manicured and the garden had this intentional spray of blooms welcoming every visitor. And, if that wasn't enough, there was the solid concrete lion that sat at his regal perch right next to the brick walkway leading to an enormous pair of doors. It looked like something out of a fancy home magazine.
We rang the doorbell and the chime totally fit. I imagined some person striking a xylophone to announce our arrival. All of it elegant and flawless. I looked over at my husband and smiled. He smiled in return and added, "Daaaaag. This joint is nice." I nodded in agreement.
"Heeeeey!!!!" That's what we all said in unison when the door opened and we saw our friends standing in the vestibule. Technically, these weren't our super close-close friends and admittedly, this was our first time in their new home. But we were certainly friendly with them since they were friends-of-our-super-close-close-friends. And you know? It was all good from the jump. We felt comfortable right away.
I mean, how could we not in a house like this one?
Of course, we got a brief tour of the home and oohed and aaaahed at every detail. They'd worked hard and, like a lot of people we know, had come a long way. (Although they appeared to have come further than most.) This home was unbelievable. It was thoughtful of them to welcome us for the evening when they heard from our mutual pals that we'd be passing through town.
Yep.
That evening we had a delicious dinner and then sat around talking and laughing in their exquisite family room. The ceiling was two stories high and the walls were decorated with art from their travels all over the world. That said, we were super comfortable. Everything was so easy and laid back. The libations began flowing and the laughs got louder. We had a wonderful time.
Fortunately, no one had to drive anywhere. Our only destination was up the stairs to the bedrooms. Harry and I quickly buried ourselves in the heaping down comforters and fell fast asleep.
I'm not sure how long I was out before my unforgiving mother-of-two-babies bladder woke me. My head was still a little swimmy when I sat up on the edge of the bed and I had to remind myself of where I was. The heavy cloak of custom drapes was pulled tight. Even if there was daylight outside, it wouldn't have gotten into that room. I waved my hand in front of me but could barely see it. That room was pitch black.
There was a little nightlight on the stand next to me. I started to turn it on but knew that it might disturb Harry. That said, I couldn't see a damn thing in that room. I squinted my eye in the dark and tried to get my bearings on the direction of the bathroom. They'd pointed it out during the tour we'd had earlier but I still wasn't fully sure. I should turn on the light, I said to myself. But, again, I hated the idea of bothering my very light-sensitive husband from his slumber.
When I stood, the plush rug felt good on my bare toes. Even though I still felt a few of those champagne bubbles from earlier, I was mostly okay. I took a few steps toward the bathroom and felt like I was in a cave lined with high end carpet. The smell of lavender and jasmine wafted into my nose and though I had no idea from where it came, I imagined some elaborate candle collection on a nearby occasional table. Somewhere between the big inhalation I was taking and the door threshold, something sharp poked deeply into the ball of my foot.
"Ooooh aaah aaahh owie!" I whispered through clenched teeth. Whatever it was hurt bad enough to cause me to hop in place for a bit and then force me to walk on my heel only. I'm pretty sure I'd broken the skin but wasn't completely sure. By now, I had to pee so bad that I focused on that only.
I'm still not sure why I hadn't pulled out the slippers I'd packed. I guess it just seemed unnecessary in such a swanky house, you know?
Anyways.
Eventually, I got to what felt like a marble floor and heel-walked my way to the toilet. I tried to turn what I think was some sort of fancy dimmer light on in there but couldn't get it to work. I shrugged, flushed the commode and set back out into the darkness once more--still with my antalgic hobble and still with some slight giddiness from those generous glasses of Veuve-Clicquot. My eyes were now a little more adjusted so I could now at least see in front of me.
Suddenly, something flew across the floor in front of me. It ran straight over the top of my foot and disappeared into a dark corner. A massive cockroach? A small mouse? I wasn't sure. Either way, it startled the hell out of me--big time. To make matters worse, when I jumped, I stepped down on something slick and oily. Since my footing was already unsure, up went my legs straight into the air and WHAM! I landed on my back with a big thud. Not only did I knock the wind out of my chest, I also ended up knocking over some candles and lamps and causing a 3AM cacophony.
Whoops.
Lights came on and feet could be heard quickly thumping the floor in my direction. By the time I caught my breath and sat up, Harry and both of our friends were standing over me panting.
"Whoa! Are you okay, babe?" Harry said while reaching for my hand.
"I'm fine. I just slipped."
"Oh my God, girl!" My girlfriend looked at the bottom of my foot and then looked at the floor. She gasped and then looked at her husband. "Did you trip on something? What happened?"
"Uhhh. . .I'm not . . .uh. . . . I'm not sure. I think I slipped or was just. . .uhh. . .clumsy."
Right after I said that, out came that mammoth sized roach thing. It shot across the floor right next to my foot. Both of us ladies jumped behind the door while the guys ran after it with their shoes in hand. Harry's foot slid a little and he nearly fell, too.
We all winced when we heard a crackling sound under the smack of that shoe. I looked over at them and spoke. "Okay, maybe I'm kind of scary and just maybe that little guy is partially responsible for that spill I took."
"Little guy?" my girlfriend said. "Good heavens."
"Oh damn! It looks like this scented oil lamp thing leaked," her husband replied. He looked over at her and sighed. "Since no one had been in this bathroom, I admit I didn't even check again." Then he looked at me. "Damn, I'm sorry, KD. This is super embarrassing."
"Girl, you just missed the edge of that tub!" She clutched her chest and shook her head. "Kim, I had no idea there was oil in here or a leak in this thing. Good Lord. If I had known, I totally would have moved that thing or gotten rid of it altogether. And as for that bug? I don't even know what to say. You could've gotten really seriously injured. I'm so sorry."
"I'm fine. Bugs are stealthy and this is the south. And I also should have turned on the light."
"Your foot is bleeding. Looks like a cut on the side of it." Harry pointed at my right foot. I pulled it closer to inspect it.
"Oh man. Forgot about that. I actually stepped on something sticking from the carpet when I was walking to the bathroom. Felt like something hard plastic. But I thought it didn't break my skin."
"Girl, you are kidding me!" She reached down and picked up a piece of a broken Lego. "I'm going to fuss at those kids as soon as they get back from their grandparents' house."
"It's no big deal. I was kind of heel walking with this foot which is the one I stuck in the oil when our little friend showed up. Pretty much a Murphy's Law kind of thing. It's actually kind of funny."
"Not to me, Kim. I'm sorry, girl." Her usually olive skin was beet red. I felt terrible for her.
After that we were all awake. Our friends looked mortified no matter what we said. Over and over again they kept saying that they were sorry and had no idea that something was on the floor. Then they'd imagine that roach thing and fall silent. They handed me bandaids and towels and kept asking me if I was sure my foot didn't need stitches. I kept saying that it was no big deal and that sutures weren't necessary. I also said repeatedly that I wasn't upset.
Because I wasn't.
"Why didn't you just turn on the light?" Harry said to me later.
"I didn't want you to get upset since you were knocked out asleep," I replied. "I didn't want to wake you up." He rolled his eyes and shook his head.
"Babe. I love you. I wouldn't have cared if you turned on a light, crazy woman. Besides, you didn't even know this house."
"Gotcha. Seems silly now. I should've had on my house shoes, too. Then I probably wouldn't have freaked out so much or slipped."
"Kind of a shock to see a bug in that house, huh?"
"It just affirms what we always say--anybody who hasn't seen one of those things in their home in the south is either lying or they just moved in."
We both laughed.
"Next time, turn on the damn light and put on some house shoes, okay?"
"Duly noted."
The following morning we were standing in front of our friends' home as we prepared to go to our next destination. For whatever reason, they still seemed embarrassed. Just before getting into the car, I paused and spoke. "You know everyone has those bugs in their home, don't you?"
"You don't have to say that. I'm so embarrassed, girl. We try hard to keep our home clean."
"Ha. Seeing one in your clean, new crib made me feel better about the ones I've killed in my house. They should pay rent, those big ones. It's a bible belt thing. If you figure out a way to never, ever see one, though, let me know." I looked around at their home again. "This is still the swankiest house I've seen this decade."
She chuckled and reached out to hug me. "You guys are always welcomed."
"Great. We'll be back for sure. And y'all can come stay with us, too, although we aren't as neat."
"Deal."
****
December 1 was World AIDS Day. In honor of that day, I was asked to talk to a group of people in a pretty traditional church that following Sunday about the importance of getting tested for HIV. And then, whatever that test reveals, making responsible decisions with the results. And, yeah, I've done that before in churches and other large gatherings, too. Almost always it comes out preachy and uncomfortable. I can always see peoples' eyes glazing over and body language getting squirmy. Kind of like a teenager who's getting admonished by a parent about something or other that they'd rather not hear about.
Yeah. Like that.
So. I decided to try something new. Instead of lambasting them with scary statistics, I shifted gears to do something that I didn't think church folk would mind so much. This time, I kicked it bible-style with a parable. This parable.
I had their full attention, too. It was awesome.
Then I closed with this. (Or something close to it.)
It's funny how similar HIV is to visiting that house. Just as that house looked spotless, people can look that way, too. We drop our guard when an outward appearance seems to scream immaculate and impossible of tarnish. Slack also gets cut to people that we don't know well when they're connected to people we do know well. You assume nothing could possibly be wrong.
Right? Right.
But the truth is that you can never just look at anyone or anything and know anything for sure, can you? So the best thing any of us can do is get to know what you're dealing with first. That said, we're all imperfect. So even though we know better, we don't always make the right choices do we?
Given all of that, there are still some ways to prevent accidents even when we're too impatient to know all the details. First, avoiding anything that affects your judgment is a start. Like maybe not having alcohol might have given me the sense to turn on a light or put on some slippers. And, just maybe, I wouldn't have felt the urge to pee so badly. Or even at all.
If I'd just turned on a light and worn slippers, I could have seen where I was going. And avoided stepping on something that hurt me. With something on my feet, though the bug would have still alarmed me, I wouldn't have been limping and I probably wouldn't have slipped. Especially since I would have seen that puddle of oil from the get go.
Knowing your HIV status and the status of your partner is like turning on the light. No need to guess where you're stepping. Or depend upon somebody else to protect where you've stepped. Because even the shiniest, prettiest, newest, richest and cleanest things have surprises. And sometimes even they don't know about those surprises, do they?
I guess the other thing that stops us from turning on lights is fear of what someone else will say. Like, when I was scared of waking up my husband so bumbled about in darkness. But, of course, we all know that anyone who loves you wants you to turn on the light. As a matter of fact, if they really, really love you, they'll turn the light on for you. Yeah, they will.
Then there's our friends who wanted to disappear after that whole incident. We'd discovered some blemish in their world. But little did they know that everyone has something lurking in a floorboard, a crawl space or crevice that jumps out sometimes. The kind of things that you pay people to come and spray but that still somehow exist in spite of that. That is if you realize there's something that might require pest control maintenance.
Hmmmm.
I wanted our friends to know that seeing that bug and slipping on that floor and cutting my foot on that Lego made us admire them no less. We were still just as impressed with their accomplishments, glad about our growing friendship and eager to return. And eventually they believed us.
We need to do that with HIV.
Our friends got a good exterminator. And he told them that because they live in the south and amongst a lot of trees, that there'd always be some tiny amount of pests hiding in there. But nothing that would likely bother them or anyone else.
Nope.
So I guess HIV testing is like turning on a metaphorical light. And seeing a bug when you do isn't the end of the world. It isn't. You just need to know so that you can get into care. Then yes, you'll live with a tiny amount of virus, but it will be so undetectable that it won't bother you or anyone else.
You feel me?
The most elegant homes can have debris in them and an unwanted pest or two. Just like the most amazing people can have HIV. But a lot can be avoided by just turning on the light. Or putting on some house shoes. Or avoiding anything that clouds your judgement. Or makes you greatly feel the urge to go.
What's up in your house? What's up with the houses you sleep in? Do you know your way around? Would you be surprised by a sneaky wood roach or not shocked at all? Are you scared to turn on the lights? And if so, why is that? Is it that you're with someone who doesn't care whether or not you crash into something? Or someone who doesn't even know that there is something to crash into? Or even worse--both at the same time?
How well do you know your own house? What are you doing to protect it? Do you inspect it regularly? Do you allow someone else to make sure everything is okay? If not, why is that? What are you afraid of?
Remember: Knowing isn't the worst thing that could happen to you. Even if you find something. Not knowing always, always is. So turn on the light. Look around. And if you still aren't sure? Or if you're still too scared to turn the lights on?
For Christ's sake--put something on your damn feet.
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?
