Hello rain.

*written with permission of individuals mentioned

It's raining today

It's raining today

Hello rain, hello rain. . .

I want to go outside and play

I want to go outside

Hello rain, hello rain. . .

Raindrops fall

Raindrops falling down

Everywhere

All around

from "Hello Rain"

(a great song by Marcia Berman that I sang with Isaiah at the bus stop this morning)

_____________________________________________________________________

Today it was pouring down rain in Atlanta all day long. The sky was this confluent shade of murky gray and the relentless downpour came in the kind of sheets that renders even the best umbrellas useless.

Bleccch.

This was definitely not a day that makes folks who rely upon public transportation or parking meters clamor to come to the hospital. Who can blame them? I didn't exactly want to be at work today either.


That is until I saw one of best things ever. . . . .

I saw this lovely Grady elder who was well into her nineties. . . .accompanied by her daughter who was well into her seventies. . . .and her granddaughter who was well into her forties. All wedged into a tiny clinic room together.

In the waiting room was. . . .her great-granddaughter who was in her twenties. . . .holding her child. . .the patient's great-great-granddaughter. All at Grady together on a torrential Monday just for Mother's appointment.

Wow.

"Did ya'll have special plans today?" I asked, "Is that why everyone is here?"

"Nope," replied Daughter with a smile and a shrug. "We just here with Mother."

"Yep," said Granddaughter and winked at Mother sitting over to the side in her wheelchair.

Mother simply beamed while they looked at her--almost child-like. I can't recall the last time I saw anyone look at another human being so lovingly. The love in that room was . . . . inexplicable.

I studied Mother carefully. She was bundled up in layers; someone had obviously put great care into making sure she didn't get soaked. Her snowy hair was in a network of neatly connected plaits and her weathered hands rest quietly on her bony legs. She gazed back at her doting descendants, her once brown eyes appeared almost blue from the cholesterol haze outlining each aging iris.

Aaaah, but my how they still sparkled.

"You okay, Mother?" Grandaughter queried while adjusting the jacket that sat on her grandmother's shoulders. Daughter immediately joined in and began fussing over something else that didn't need fussing over.

Mother smiled and spread her trembling hands out toward each of them. Both women quickly clasped them into their own. She looked from side to side at both of her "girls" proudly and then shook her head.

"Sometimes I say, 'Lawd, I sho' musta done somethin' right,'" she finally spoke, tightening her grip around their hands.

I looked at them all huddled there together and immediately felt like crying. . . . .

Instead I asked them if I could take a picture of their hands to remember them and this moment.

(Generational Blessings: Photo taken today and shared with permission of Mother, Daughter and Granddaughter)

Sigh.


This picture embodies everything that I love about working in this public hospital. I get the privilege of meeting people like this every day. Caring for an indigent patient population has its challenges, yes. But the moments like these far outweigh the frustrating ones. No question--we see poverty and we see some really unfortunate pathology as a result. . . . .oh, but the love we see. Money can't buy anything better.

Sometimes when I'm at Grady, I think the same thing as Mother:

I must've done something right.

image credit

I'm so glad I came to work today.

.

Reflection on a Sunday: This Woman's Liberation

"Who gon' check me, boo?" (insert finger snap here)

__________________________________________

"I can pay my own light bill baby
Pump my own gas in my own car
I can buy my own shoe collection
I've been blessed thus far. . . ."

from Jill Scott's "The Fact is (I need you)"

 ___________________________________________________________
I was watching television the other day and saw one of these Atlanta "real" housewives rolling her neck and her eyes and tightly folding her arms. She was explaining to her pseudo-friend all the things she could do "for her damn self."  This was in the context of how she didn't want any man or partner "bringing her down" -- and she subsequently listed all the things that any partner would need to bring (or not bring) to the table.

"Girl, he got to come cor-rect not at all!"  (insert finger snap here.)

Then there was a litany of more things that men have done that were disappointing and even more that she could do for her (damn) self. (Don't forget the finger snap.)

Hmmmm.

That got me to thinking about independence and vulnerability, and whether the two are mutually exclusive. It also reminded me of something that happened recently at our house with Harry, the boys and me. . . . .

image credit

The background and the story

I live in a rather wooded area in Atlanta.  Mature trees are all throughout the neighborhood. . . and that means chipmunks and squirrels--like all over the place.

Okay, listen. I'm originally from the L.A. area (and not that "inland empire" or whatever they started calling those far-out areas once I moved away.) Anyways. . . .specifically, I'm from a part of Los Angeles County called Inglewood. Now, if you know anything about Inglewood, you know that it ain't wooded. In fact, there is this interesting set up where for every house you get exactly one square of lawn in front, interrupted by a concrete sidewalk then followed by a narrow landing strip of grass separating it from the street. On that strip of lawn is one tree, strategically placed in front of each house. I'm convinced that some obsessive-compulsive architect painstakingly made sure that every tree was perfectly centered and that no greedy arborist planted two trees anywhere instead of the one that they allocated back in 1940-whatever-year-they-built-that-neighborhood.

And so. I say all that to say this: I didn't grow up with too many chipmunks. (Stay with me, I'm going somewhere with this. . .)

Fast forward to now. The chipmunks in my intown Atlanta neighborhood, and specifically around my yard, have gone bananas. They are e-ver-y-where.  Every. Where.  Scurrying across the driveway. Scooting across the kids playground. Playing in the bushes out front. Dipping and dodging along the sides of the house.  And for the most part, it's really cute. In that Chip and Dale slash Alvin and the Chipmunks kind of way.

At least it was for the first few years.  Now, it seems we have entered "The Squeak-uel."

My local "Alvin" and two of his little brothers have decided that they don't like hanging out in the elements when the weather changes.  No, no no. . . . don't worry. . . they haven't come into my house. But they have figured out a way to clear a tiny corner of my (waaay too old) garage door. So that's what they do. And there's three of them. Just like Alvin and his pesky little brothers.

So what's the big deal, you say?

Now, let's just think about this for a second. A chipmunk scurries across your garage as you go down to handle some laundry. Chipmunks are curiously close in size to. . . .um yeah. . . .other rodents. You know--the big, bucktoothed kind that live on subway tracks? Umm yeah.

Getting a little less cute, right? 

I'd say. So the very first time I caught one of those jokers in my peripheral vision, I almost had a heart attack.  Literally. Early one morning, I was carrying a big basket of laundry up the stairs (yes, our laundry room is in our garage) when I saw something dart by. . . what the. . . .and then something else right behind it.  OM (expletive) G.  I dropped that basket, sprinted up the stairs, and nearly mowed the door down trying to get into the house to wake Harry up. A rat? Awww hell nawww!!!

"Harry!! Harry!! It's a rat! No! Two rats! Like rat-rats!! In the garage!! I'm never going down there again!! Ever! In my whole entire life!!!"

"Are you sure?" he asked while yawning. This lack of urgency was not what I was looking for.


Am I sure?  What?  Dude. Didn't he hear me? I just saw Templeton and his brother in our garage. What kind of monkeyshine is this?

"Sure??" I exclaimed, "Sure?? What do you mean,  'am I sure??' Dude! You need to go down there right now!"

Isaiah chimes in nonchalantly while walking in from his bedroom. "Dad, I think she's talking about the Alvin and the Simon that always run under the garage door. They're chipmunks, Mom, not rats like Templeton in Charlotte's Web." He climbed up on the bed with his dad and nestled himself under the covers.

Harry cosigned. "Yeah, there's like these three chipmunks that sometimes hang out in the garage when it's raining and since the weather started changing. I doubt you saw a rat, babe. Did it have a long tail?"

Did it have a what?  I thought I would faint. Oh lawd. I just stared at Harry like he was crazy.

He repeated himself. "A tail, babe. Did the things you saw have tails?"

I thought for a moment and was very thankful that I did not know the answer to that question.

"A tail?? I DON'T KNOW!!! They were running too fast!! But trust me, it was definitely a freakin' rodent that was too big to be a mouse, though. That I know."

"Relax, baby. It's definitely not a rat. The garbage bag down there would have holes in it if it was."

O.M. (%#!) G!!! 

"HOLES? In the GARBAGE? Oh my LAWD have mercy, Harry!! You are really, really killing me!!!"

Harry erupted in laughter, burying his face into the pillow. Isaiah mimicked him in that way kids laugh when adults laugh. It was kind of amusing, I suppose, but I was serious.

"Babe! Don't laugh! I'm for real!" I pressed, doing my best not to let them make me break.

Suddenly Isaiah jumped up with an all-business expression and said, "Mommy, don't worry, okay? We'll go check it out. Right, Daddy?"  He hopped off of the bed and waved his hand toward Harry. "Come on, Dad."

"Me, too! Okay, Mommy?" a pajama clad Zachary announced as he sped into the room. Harry shrugged and slid his feet into his Crocs, succumbing to his overly dramatic better half.

So down they went.  One fearless husband and two fearless-in-training little boys all behind one giant flashlight.  Oh yeah, with one terrified-slash-grossed out mommy peeking through a little crack in the door.

"There he is!" I heard Isaiah exclaim to Harry. I immediately jumped back from the door and screamed. Isaiah looked back up at me and added, "Yep, it's just Alvin, Mom!"

I cracked open the door a bit further and kept watching as they completed an obligatory search of the garage. I could see them flashing the light in crevices, behind the washer and dryer, and in any other possible hiding place. I loved how brave the boys were, lifting boxes and pointing in places for Harry to flash the light. Five minutes later, they all came back up the stairs with the final verdict:

Alvin and the Chipmunks.

Harry pushed my ajar door open, wrapped his arms around me and smirked. He furrowed his brow and gave me a very serious expression. "Definitely chipmunks, babe. They aren't scavengers like rats, so nothing to worry about. I see a small opening at the bottom of the garage that I'll block so they'll stop running in there scaring you, okay?"  He kissed me hard on the cheek and laughed. "Unless you want me to trap them and drown them instead." He chuckled again and got away just before I could punch him.

Deputy Isaiah, who now had the giant flashlight, shined it in my direction and declared in a most authoritative voice, "All clear, Mom."

Zachary echoed, "Yeah, all clear, okay Mommy?"

"Thanks, gents. I appreciate it."  I knelt down and pulled them both close to me. They both treated me to hard cheek kisses, just like the one their dad had just planted on me a few moments before.

::Sigh::

All clear, indeed.

***

 Harry and Zachary walking out of church this morning

Today I'm reflecting on the blessing of being okay with needing other people. Sometimes it's for life or death things, but other times it's for something as mundane as killing a spider or opening a jar without banging it on the counter. Either way, acknowledging that you can't go at it all alone is huge.

 I'm not talking about "not going at it alone"in the sense of needing a divine presence into your life (which I do think is quite important, for the record.) I guess I'm talking more about being open to the possibility that just maybe some of those things that you can do "for your damn self" (insert finger snap here) just might come out better with someone else helping. Or at least rooting for you.
 
Honestly? I consider myself pretty independent. Still--there are some things that I'd prefer to never, ever do . . . . such as investigating the identity of a rodent in the garage or flashing a light into a crawl space in a nearly 100 year old house. . . .umm yeah.

I'd even say that I believe that I'm a great mom, a rather proficient doctor and an overall decent human being. I think I'm good at several things and am pretty sure that I could live comfortably on my own salary, thank you very much. But the other thing I know for sure is this: I am better in this life with Harry as my partner. Period.

I know. Some folks don't have the option of a partner right now, and I realize that. But some folks with partners find it really hard to relinquish some of their bad-ass-ness long enough to admit they need help. Watching that "housewife" talking on television that day made me sad. It also made me see how easy it is to place up walls that make us emotionally unavailable to the potential ones waiting in the wings. . .or the ones living right under the same roof. Take it from a formerly single girl who once took great pride in all that she could do "for her damn self." (Insert finger snap here.)

Yeah.

Harry takes the boys for haircuts every two weeks, pulls the garbage to the curb, pressure-washes the deck with some scary contraption every spring and scouts out alleged varmints in our garage. Sure, he can't make a cup of coffee, seems to have an aversion to helping me sort the recycling, has been to the supermarket all of 5 times in the last 5 years, becomes paralyzed during NFL Sundays, and always throws my bath towel on the floor when the kids splash in the tub.

But.

He wrestles on the floor with the kids six out of seven days per week until they're exhausted, cleans a kitchen like no other, is always down for taking the kids to the latest animated movie, and (along with his two little helpers) always carries in the groceries.  Real talk? We need each other. Bad.


Take home point: Vulnerability allows for authentic independence. And realizing that was this woman's liberation.

 Isaiah and Harry playing Laser-Tag 

(with the same expressions they had when checking out the garage)

"I can even stain and polyurethane

But some things don't change. . .

. . I need you, yeah."

- from Jill Scott 
(the same artist who sings my internal iPod anthem)

Jill Scott sings the song currently playing on my internal iPod. .  .all about needing. . .what a beautiful message!

Needing someone. . . . I highly recommend it. :)

Terms of endearment.

*names, details, etc. changed. . . .yadda, yadda, yadda. . .

 "You need anything, sweetie?"

"Mrs. Jasper?  Mrs. Charlesetta Jasper?" I overheard a nurse calling from the door  dividing the clinic from the waiting room.  Shortly after, a very snappily dressed Grady ultra-elder shuffled her way to the door with all of her weight leaning on her four pronged cane.  The nurse stepped backward and leaned her back on to the door to create more space for the patient. "You're gonna come right on through here, sweetie," she said while pointing toward the triage room.                                               

Mrs. Jasper pushed and stepped along with her cane, but inadvertently bypassed the triage door.  "No, no, sweetie. . . .over here," the nurse gently instructed her.

"Oh. . .I thought we was gon' go strett to the room," replied Mrs. Jasper in a wobbly voice.

"No, love, we're going right in here." The nurse gestured to the entrance and helped her into a chair to get her vital signs measured.

"Thank you," spoke Mrs. Jasper.

"Yes, ma'am, no problem." Mrs. Jasper smiled warmly and stuck out her left arm for the blood pressure cuff.

A few hours later, I walked downstairs to the gift shop to grab a quick diet Coke.  I was immediately greeted by Shanika, one of the cashiers.  "Hey, Dr. Manning!  How you doing?"

"I am so sleepy!" I replied with an exaggerated shake of my head. "I need a diet Coke fix!"

"And your granola bar, too?"  We both paused for a moment and shared a laugh, acknowledging how completely predictable these pitstops have become for me. 

"You doing alright, Miss Shanika?" I smalltalked as I rummaged through the refrigerator. I have this dumb practice of placing my hand on several drinks in an effort to choose the coldest one (probably one of the most completely asinine things I do on a daily basis.)

"I'm fine, baby," she answered with a broad smile. I liked her confidence and decided that the gleaming gold in her front tooth was fitting. I smile in return. Next, I sift through the granola bars and predictably choose the same "Peanut Butter" one. Finally, I hand it, along with the winning cola to Shanika.

I studied the cursive tattoos across her forearms and her long, curved acrylic nails as she rang up my two items.  She caught my eye and flashed that glowing smile once more.

"You want a bag, baby?" she asked.

"Naaah, I'm fine."

"Alright then, baby," she said pushing my purchase over toward me. "It's  good seeing you as always." Shanika dropped my change into my hand and nodded.

"Thanks, Miss Shanika!"

"Okay, babe."

I twisted open the bottle, took a few swigs and scurried back to the clinic.

As I headed up the stairs I found myself reflecting on words like "sweetie", "love", and "baby."  I recognize in that moment that Miss Shanika, who was easily fifteen years my junior, and the nurse who spoke to Mrs. Jasper, who could have been her granddaughter, both freely used the terms.

I asked myself if hearing Shanika call me "baby" offended me, and quickly admitted to myself that, for some reason, it did not. It's not like she is my close friend, or even someone who is old enough to be anything other than my "baby" sister. Maybe I should have been put off. Yet the "baby" that she kept using to address me sort of rolled off her tongue in a way that felt . . .I don't know. . .endearing. 

I thought about Mrs. Jasper. I could still see her appreciative smile, and decided that maybe she didn't mind her "sweeties" and "loves" so much either.

Or did she?

I still remember that time when I had my first pelvic exam, and the doctor kept calling me "sweetie" and "honey."  I hated it.  It made me feel creepy and patronized, even though I was only sixteen and a half and not yet fully aware that what I was feeling was even called "patronized."  Since then, subconsciously more than likely, I've never been a huge fan or user of those terms of "endearment" for my own patients.

But I'm still guilty.

Confession: I totally change my intonation when speaking to my Grady elders, and especially the Grady ultra-elders like Mrs. Jasper.  I ramp up my Southern hospitality and especially my "ma'am's" and "sirs." I even fine tune my "beg pardons?" and my "Good mornings." Now that I think of it. . . I have also convinced myself that tacking a "Miss" in front of someone's name when I don't know them or I'm younger than them makes me more respectful. . . but is it really? Couldn't that be bothersome, too?  And somehow it's like it just happens without me even thinking of it, just as I'm sure that nurse gave little thought to her pet names for Mrs. Jasper.  Without the "sweeties", yes, but could the musical quality of my voice be equally as. . .what do you call it. . . patronizing?


Hmmm.  

My friend Lesley M's kids attend a school where they call their teachers by their first names. Some deep thought has clearly gone into that decision, and that award-winning school is just as much in the bible belt as Grady Hospital.  But for some reason, I cringe when my kids roll up on adults and call them by any name that isn't preceded by a "Ms", "Mr.", an "Auntie" or an "Uncle." (And it ain't like I'm an award-winning child educator like that school. . . hello?) I wonder how their school would feel about "sweetie."


"Sweetie"
"Love"
"Baby"
"Honey"
"Dearheart"

Is it okay if you mean well and are deferential? How about if you're syrupy sweet and with a masterful southern twang?  Would mixing it in with "ma'am" or stirring it up with"sir" make it more okay? And is there some accepted age differential that must be present to make it cool? Like, if you can qualify for Medicare, do you have carte blanche to use these words, or if you're old enough to pay a mortgage and the recipient isn't--does that make it alright?

I mean, that gynecologist that left me with feelings of violation back in 1987 was quite senior to me--yet the thought of his words and actions still make me bristle to this day. (Just bristled.)

Hmmm.  (This time with a head scratch and a slow head nod.)

I'll throw this one out to y'all.  . . . . and this time, comment--okay sweetie?

Sigh.

A much-needed nap interrupted: The worst and yet the best.

Cool thing I read today:

"The worst things about being a parent
are still better than the best things about every thing else."

~ Will Arnett, actor and husband of SNL funny-lady Amy Poehler

"So I could read it."

Lame, I know: my #1 follower

Author and Nobel laureate Toni Morrison didn't start writing until she was almost 40 years old. The first book she ever published, The Bluest Eye, is one of my favorite books of all time.  When somebody asked her why, after all that time, she'd decided to write that book she said, "So I could read it."

I heard that.

A medical student recently asked me, "What prompted you to start writing this blog?"

Hmmmm.

Okay. . . it's true that I write this blog to honor patients, their stories, and to underscore the ups and downs of fighting for work/life balance. No question. But now when I think about Ms. Morrison's words, I realize what I should have said:

"So I could read it."

I think that's also part of the answer to the question I hear the most frequently: "How do you find the time to do this?"  We find the time for the things that are important to us. And this has become important to me, so I have to find it somewhere. Nestled between that moment when I first wake up to those first few seconds that the kids break the morning silence. Or intertwined in those few hours after the last Dr. Seuss book and falling asleep with a book in my hand. Even if it means not watching much television. Or talking on the phone a little less. I have to find the time to do this.

So I can read it.

Nope. I'm no Toni Morrison, but I sure relate to her impetus to write. Reading my own stories has made me a better doctor, a better teacher, a better mommy, a better wife, but most of all, a better friend to myself. It's given me a golden opportunity to visit with me regularly and often, sometimes laughing out loud over an early morning cup of joe or "ugly crying" into the crook of my own elbow late at night until I'm out of breath and tissue.

Yeah.

It's an honor to know that anyone has spent even a moment of their day reading what I've written. Seriously. And I'm the first to admit that sharing these thoughts and hearing affirmations nudges me to keep at it.  But deep down, I admit: sometimes I can't wait to finish a story. . . .just so I can read it. And learn from it.

Lame, I know.

My friend and fellow Grady doctor, Neil W., calls me a "free-style" writer. Kind of like those rappers who rhyme off the top of their heads without scribbling or erasing my words off of a notebook multiple times before performing for a crowd. He's right. Most times, I just have to get it out so I just type, type, type. . . and (thanks to my mom, the queen of "girl, you have two typos in that post and 'eachother' is NOT one word for the millionth time,'") my "free-style" approach works. .  .and has made this a surprisingly painless form of self-exploration. Taking the time out to do this is a gift I give to myself, my #1 reader.

That's been one of the most surprising perks of doing this. I've gotten so much closer to me.

(Lame again, I know.)

I now believe that everyone should have some kind of activity that allows them time to befriend themselves. In doing so, you quickly find that you are the friend who is always willing to try that new restaurant, to hear the same stories about what your kids are up to over and over again, and not mind being tapped into late at night for last-minute advice (on the same damn issue--again.)

I'm not sure what you do to befriend yourself. . . . .

But I hope it's something. For me, it's writing. About everything and about nothing. And these days I'm thankful for this electronic labor of love that has forced me to take pause in this hectic life and spend a little time hanging out with someone who has finally become my BFF--me. 

****

What do you do to connect with you?

***

Here is a neat essay on finding the time to do something meaningful like writing, shared with me by my blog-friend Lisa R. (Thanks, Mama-smacksy! )

This is the remix.

At the end of proctoring a clinical skills/physical examination test last week, I told two medical students this during the feedback session:

"Whatever you do, do it with as much zeal and as much confidence as you can muster. If you've prepared, there's no reason to shrink and hide in the shadows. In fact, no one wants you to do that. Don't be afraid to infuse your own style into it. Make it your own."

I noticed that they'd both done a wonderful job preparing for the exam. They knew every single thing that they were supposed to know. Interestingly, though, these students and several other learners I've encountered over the years were . . .how can I put it. . . self-deprecating to a fault. Apologetic, even. Yet they had no reason to be! I did my best to punctuate that session with a "you go, girl!" moment, just to make my point.

It took me a while to reach that point of being used to hearing my own voice in medicine.  I remember being stunned and overly celebratory whenever something came out right. One day during my 4th year of medical school, my classmate Jada M.R. and I were having dinner with this accomplished black female attending. We had just gotten our USMLE 2 scores, and were over the moon because we had done well. She looked at us with disdain as we chattered about how elated we were. Then she told us these pivotal words:

"Why are you so surprised when you do well? That's a shame. You need to tell yourself that your preparation is enough, and that you are the bomb--over and over again. Until you believe it."

  Of course we graduated. We worked hard. We prepared. We deserved to.

(with Jada at graduation in 1996)

I've held those words close to my chest ever since. I tell myself those things often, and I tell my husband and children the same every single day.

Today I'm reflecting on the importance of self-confidence. Sometimes you just have to get in the corner and shadow box for a few minutes to pump yourself up, even when you're feeling unsure. And no matter how nervous it makes you, sometimes you just have to get off of the ropes and start swinging as hard as you can. There's so much that holds us back just because we're too afraid to say, "Let me in, coach!"

So.

To everyone out there who is trying their hardest to do something with zeal and with confidence and with non-shrinking-ness and with an infusion of their very own--albeit different--style. . . . this is your nudge to get those shoulders back and that chin up and do just that. This is your nudge to ask the coach to let you in. And to inspire you, I bring you the perfect example of zeal--courtesy of the "king-of-dancing-like-no-one-is-watching" himself--my four-year-old son, Zachary:

"Hey Diddle Diddle, The Country and Western Remix" by Zachary M.

(Digitally remastered at Manning Home Studios, 11/5/2010)

 (He also has an extended version of this remix that he sang in front of his class Friday--and a B-side version of "Hickory Dickory Dock" that is equally reminiscent of Waylon and Willie coming soon to iTunes. . . .)

Now if that ain't zeal, tell me what is?

Life. Make it your own, people. Don't hold back. Expect to do well. . . .

. . . and don't be afraid to do an unexpected remix.

Reflections of a Former Chief Resident: The Ultimate Excuse

(Art by Shel Silverstein)

____________________________________________

"I cannot go to school today," 
said little Peggy Ann McKay,

"I have the measles and the mumps, 
a gash, a rash and purple bumps. . .

What? What's that you say? 
You say today is. . . .Saturday?

G'bye! I'm goin' out to play!"

~ from Shel Silverstein's "Where the Sidewalk Ends"

____________________________________________________

Back in the day when I was a chief resident, I used to hear all kinds of excuses. Most of the time, they were legitimate, but every now and then, they'd border on completely crazy. For those who don't realize exactly how the chief residents' facial expressions look on the other end of the phone when you call in (or call back after being "drafted" for a Jeopardy call) with "awww HELL naw"-worthy excuses. . . .I'll show you. . .it looks a little something like this:

"Awww HELL naww!!"

Case in point, right now, I'm reflecting on this phone call I received early on a Saturday morning circa 2001:

"Heeeeyyy Kiiiiiimmmm." (read with very dramatically raspy and quasi-sickly voice)

"Hey. What's up?" (read with superdry voice to squelch dramatically exaggerated and quasi-sickly energy.)

"I feel like I'm about to get a migraine. . .ooooohhhh. . . . so I can't come to work."

"ABOUT to get a migraine?"

"Yeeeeaaaaah. . . "

"Umm, so DO you have the migraine or not?"

"Not yet, but I know what it feels like when it is about to happen."

"Umm, so why don't you, like, take some medication now and come a couple of hours late?"

"I think it could make me drowsy."

"Does it usually? I mean, like, make you drowsy?"

"Not always, but sometimes. . . . I'm just not sure about taking ICU call today. . . . or in 4 days. . ."

"AWWWW HELLL naw!"

As time has marched on, I have heard some more winners--one of my all time favorites being the one where the resident "accidentally" took two Benadryl allergy pills like, right before she was supposed to come in, and was just too drowsy to drive in to take call. . aww HELL naww!

Or. . .no, THIS is the best one. . . the one where this intern had terrible, terrible stomach cramps so terrible that he couldn't even make it out of the bed to even consider trying to come to Grady, yet I actually frickin' saw him with my own two peepers standing near the stairwell in the parking garage looking tearful while having some kind of heavy duty, love affair-looking discussion with another (female) resident.

Really? Wait -- did this dude just call off "brokenhearted?" Aww hell naw!

Listen. I don't mean to be insensitive. I, too, had my share of early morning internship tears over a wobbly love mix cassette tape (yes, I meant to say "cassette tape.") But I never called off for it. Nor did I insult my attending by making a call from what sounded like death's front door or at least an infirmary--when I was in the building!

So when he called in quasi-sick I said, "Uuuuhh, didn't I just, like, see you? Like here-here at Grady? Like here two seconds ago in the parking garage?"

And would you believe that he said, "Nuh uh, Dr. Manning, that wasn't me."

Wasn't you? Wait--is this dude trying to play me?

(throwing hands in the air and kicking over a chair) AWWWW HEY-UULLLL NAW!!

Now, let me just say for the record: The vast majority of the medical students and residents with whom I've worked have been absolutely spot on and professional with regard to disclosing the rare situations when they must miss work. But for those who just can't seem to get their excuses together, I offer you an alternative. Yes, against my better judgment, I will share with you what I have learned to be the one thing I could hear that would not lead to the hairy eyeball.

Yes, today I bring you. . . . .wait for it. . .wait for it. . . .

The Ultimate Excuse.

Now. Let's just be clear here. I don't recommend making excuses for absences. I suggest telling the truth up front, as it is always the easiest thing to remember. However, if you are going to fabricate something. . please. . . don't insult our intelligence. (Or as Harry says, "What do you think my name is? Boo Boo the Fool?")

For all of my non-doctor, non-medical student readers, The Ultimate Excuse works for you, too. I must add that my knowledge of The Ultimate Excuse is not because I have personally used it. It's instead because I've heard so many "Awww hell naaaw!"- worthy excuses spanning from my chief residency in 2001 to my current role as a residency program director that I feel 99% sure that I have damn near heard them all.

What makes an excuse The Ultimate Excuse, you ask? It's simple. The Ultimate Excuse must be:

Believable.

Kind of unfortunate (enough to make people feel a little sorry for you.)

Self-limiting (meaning it will improve without a doctor or hospitalization.)

and, gender-neutral.

Most important, however, for an excuse to be The Ultimate Excuse, it must have one main quality--it MUST be something that NO ONE WILL ASK YOU MORE QUESTIONS ABOUT. Period.

Now with doctors, this is tricky. I mean, what kind of illness can you tell a doctor that you have that won't garner more queries?

"I have a horrible headache so I can't come in to take call."

"Is it a stabbing headache? A dull throb? Any visual changes?"

"Ummm. . . . ."

"Let me see what I have here in my purse. . . .great! Just found a sumatriptan in here. . . . this will work wonders. . . .see you in twenty minutes!"

"Damn."

And so. This is why you need to know about The Ultimate Excuse. Just in case you need to keep it behind a glass box that you can break open and use in case of emergency.

Oh yeah . . . The Ultimate Excuse also works wonders for legitimate problems taking you out of work, too. You know. . .the ones that could be slightly embarrassing like hemorrhoid surgery or mid-week laser hair removal for a female goatee. This calls for a zippy one-liner that welcomes no further comments. (Even from a nosy person like me.)

Is the suspense killing you? Let me give you a musical hint. . . .

This anonymous juvenile songwriter in my neighborhood put it so eloquently:

"Put yo' hand on yo' hip

Put yo' foot on the floor

Make a fifty yard dash

to the bathroom door. . .

People think it's funny
but it's really kinda runny. . ."

Yep. You guessed it. Diarrhea.

Diarrhea. . . . . aka The Ultimate Excuse.

Don't believe me? Try it this on for size:

"I can't come in today because I woke up early this morning with. . . horrible diarrhea. Man. . .like every 5 minutes! It's . . . .uh oh. . .hold on for a second. . . "

Genius, I tell you.

No one wants to know more details.

No one wants to discuss it upon your return.

No one wants to come by to see you.

No one wants to explore its legitimacy.

Period.

This is why I maintain that diarrhea is, hands down, The Ultimate Excuse.

And it's so versatile, too! It works equally well for:

Not wanting someone's bad ass kid to come over for a play date.

Not allowing someone in your house because it is a mess.

Not talking on the phone to someone you'd prefer not to speak with who keeps calling you.

A solid explanation as to why you missed the Tupperware Party, Silpada Party, Pampered Chef Party, insert any kind of retail party that you would prefer not to attend.

(Gasp. . .cannot believe I said that part out loud. This is hypothetical, people. I am not saying that any of this is from experience.. . . ahem.)

Hmmm. Though I have never attempted this. . . .Ladies, The Ultimate Excuse would likely work perfectly on those evenings that you are feeling. . .say. . . . .less than amorous. . . .(I'm just saying)

Aaahh yes. . . .Diarrhea--The Ultimate Excuse that shuts everyone up.

You never have to worry about those pesky exploratory questions:

"Is it runny? Watery? Gooey? Voluminous? Explosive? Malodorous?"

or follow up questions like:

"How is your diarrhea today? No longer runny? Watery? Gooey? Explosive?"

Instead, all you get (accompanied by zero eye-contact and barely even a hug) is this:

"Heeeyyy. . .errr. . . welcome back. . . . uuuhhhh. . . did you watch the Housewives last night? That NeNe is something else, right?"

"I was sick, remember?"

"Errr. . .oh yeah. . .ummm. . .would you. . .uhhh. . . like some hand sanitizer?"

***

See what I mean?

(You're welcome.)

_________________________

*Disclaimer:

The Ultimate Excuse is not for casual use. You can only have but so much diarrhea in a one year period. Overuse of The Ultimate Excuse will guar-OWN-tee you the following reaction from your chief resident, program director, boss or spouse at some point:

"AWWWW HEY-UULLLL-to-da-NAAWWWWW!"

It's a love thing.

image credit

I could never hide the feelings
That come over me
When you're near me
I know that's how it's supposed to be
My heart is telling me. . . .

It's a love thing. . . .yeah.

from The Whispers "It's a Love Thing"

______________________________________________________

This past Monday was the most "fall" of the fall days I'd seen so far this year. The kind of air that's so crisp that it shoots straight up your nostrils and opens your nasal passages like strong peppermint. And the colors. . .grass, so gloriously green. . .the sky, so breathtakingly blue. . . and the leaves. . .oh, those beautiful leaves! With each gust of wind, they rise up to meet you. . . swirling around your feet and head in a palette so rich that it can only be compared to that moment when black and white Dorothy landed in technicolor Oz. . . . . .the kind of beauty that makes you know for sure that there has to be a God somewhere that had something to do with it.

Yeah, kind of like that.

This past Monday was one of those kinds of autumn days.

I took in its beauty as I parked my car in the space that this official-looking woman in a long skirt and dark clothing pointed to for my car. "That's fine right there," she said. I nodded and turned the steering wheel in that direction. Right behind me in her car was my friend and fellow Grady doctor, Stacy H. I watched her straighten up her wheels to get them as close to the edge as of the curb as she could. In the passenger seat beside her was Joanne, one of our Grady administrative assistants. I slid on my coat as I watched her step out of Stacy's van and onto the grassy shoulder. Joanne offered me a half-hearted smile. Stacy did the same.

We walked in silence for a few seconds; our feet in synchronous reluctance. No one knew what to say.

"God sure smiled on this day, didn't He?" I finally uttered. It came out kind of awkward.

"Yeah. . . " Joanne politely replied. Stacy just glanced at me and tried to smile again. This time her eyes were glistening with tears.

We reached the top of the grassy knoll where scores of people huddled solemnly below and around a green tent. A rabbi spoke in a hushed and calming voice. This was in stark contrast to the unabashed singing and bellowing ministers I was used to in my own culture. The traditional African-American "homegoing celebration" would probably feel like being in a foreign land for the many in attendance. But as I silently listened to unfamiliar prayers spoken in Hebrew--one similarity rang true: This was not something any of us wanted to do.

I clutched my chest and drew in a deep breath when my friend and fellow Grady doctor took the podium. Her arm was locked tightly in her sister's; her face a solid mask of pain.

"I want to thank each of you for being here. Our mother was an amazing woman, a devoted wife, and a committed mother. . . ."

Her voice began to break, but she quickly regained her composure. Sniffles rose and fell amongst the mourners. She was strong and brave to stand there. She even said a few funny things about her mother that made those who knew her mother smile.

Watching her grieve hurt me deep in my soul. I wanted to push through the crowd and tell her how sorry I was. I wanted to cry with her and to hold her hand; the doctor in me hoping that those things might be therapeutic. But what do you say to a child who just eulogized her only remaining parent? How tightly can you hold her hand to make her not feel afraid and alone? That thought made me cry.

Suddenly, while I was weeping into a tattered piece of napkin, something happened. It was as if God Himself tapped me on my shoulder and whispered in my ear, "Don't be sad. Take this in. No, not just the fall colors and the cool weather. This. Take this in."

And that's what I did.

Here's what I saw:

First, what I saw was a crystal clear autumn day. But then I saw nearly one hundred people standing shoulder to shoulder in honor of my friend's mother. I saw hands. Some holding the person beside them, some wringing shredding tissues, and a few masculine ones securely placed on the yarmulkes that mother nature repeatedly tried to blow off of their heads. I saw several medical students shivering outside of a tent in dark suits; one of whom had very, very recently had a baby. I saw Grady doctors young and old, current and former, patting tears from their eyes or hiding them behind dark shades. There were childhood friends flanking the family fiercely, and there in the center of it were the two sisters. Two sisters, one an attorney and the other a doctor, both of whom sat in those very seats eleven years before when they lost their beloved father. Two sisters who, since that time, had become two wives and two mothers each of their own two children. But that thought--it was too much. That made me cry more.

I felt that soft tap on my shoulder again. "Look again. Don't you see it? If you did, you'd not be sad."

Just then, I saw it . . . .I really saw it. And just like that, I stopped crying.

Here's what I saw when I looked again:

I saw children who grew up to be whole. I saw kids who became true friends to others and decent human beings--a sparkling testimony of the very best any parent can ever hope and pray for in a lifetime. In that moment, I saw what happens when two young people meet each other, fall in love, get married and then have two children that they parent with all of their might. I witnessed what happens when a man and a woman carefully hand down traditions and teach their children to embrace their culture and faith.

What I saw wasn't a black thing or a white thing or a Jewish thing or a Christian thing. This was a love thing. And in that love thing, I witnessed the perfect outcome of what happens when a mother's eyes and a father's eyes light up whenever their children walk into the room.

Those children become the kind of people that others love. The kind of people that draw countless friends out to stand with them in quiet solidarity in the middle of a cool autumn business day with virtually no notice. Some because they personally knew your parent. But many others who only knew the love they instilled in you, their children--so for you, they had to be there. Which really means they were there for them after all.

I thanked God for revealing that to me, and as soon as I had the chance, I hugged my friend and whispered in her ear the very words that had just been given to me:


"You represent the very best your parents had to offer this world. Your life is their greatest opus and the swan song for them that never ends. Always remember that."


I felt her trembling body burying muffled sobs into my shoulder, yet somehow it felt strangely peaceful. Just then, something else was revealed to me in that moment: As doctors, we don't just need to take care of our patients. We need to take care of each other, too.

I put that on a mental post-it note so that I wouldn't forget it..

When I walked back to my car, I could feel the temperature outside getting a bit warmer. I lifted my chin and let the November sun caress my cheeks. My tears had all dried and something in my heart felt celebratory. I squinted at the intense sunlight and paused. I promised myself to keep this moment as a reminder of what "love things" can achieve.


Yeah. God had smiled on this day indeed. And there was nothing awkward about it.

________________________

*for AB and AB, may your swan song never end and your love thing never die . . . .

The Last Word.

Two weeks ago, my son Isaiah demanded that I do a few things while in the car with Zachary and him "from now on." :

1. Not talk on my cell phone, even with an "ear-bug."
2. Not make them listen to NPR with me.
3. Especially not make them listen to "Fresh Air" on NPR . . . .which they giggle at profusely when the host says "I'm your host, Terry Gross"--like she's really gross or something.
4. And since I won't be doing 1 through 3, talk to them instead. (Unless, of course, I want to pop in a DVD and let them watch TV or play on my iPad, which negates 1 through 3 and allows me to do the default "whatever you feel like doing, Mom.")

It's actually worked out quite well so far. First of all, it's a wonderful way to grow your kids' vocabulary and to see what's going on with them. Second of all, it's a great time for bonding. Kind of like the kitchen table, but without the kitchen or the table.

Here is our unabridged conversation that took place on the way home two days ago. Brought to you straight from the back seat of Mommy's thinly veiled attempt at avoiding the mini-van a.k.a. the Volvo SUV (which equally screams "soccer mom" . . .sigh. . .I know, I know.)

Isaiah:  "Hey Mom?"

Me:  "Yes, Poops?"

Isaiah: "Mom, why did you want to be a doctor when you grew up?"

Me:  "Hmmm. I think I wanted to be a doctor because I wanted to help people."

Isaiah:  "But you can help people even if you aren't a doctor."

Me: "Okay, sick people."


Isaiah:  "You don't have to be a doctor to help sick people."


Me: "But you can't tell them what's wrong or give them special medicines if you aren't a doctor."

Isaiah:  "Remember that time when I told you that Zachary had a fever and you said, No he doesn't, and I said, Yes he does? I knew what was wrong with Zachary and I am not even a doctor.

Me: "But you couldn't give him special medicines, though."

Isaiah:  "You couldn't either, Mom. You called our pediatrician, remember?"

Me: "That's because it's not good for me to be you and Zachy's doctor."


Isaiah:  "Then why be a doctor in the first place?"

Me: "Because being a doctor is . . . . cool."

Isaiah: "Well, it's not so cool if you still have to take your kids to the doctor after learning all that stuff."

Silence

Zachary: "Mommy?  I'll be a doctor, okay? Does that make you happy?"

Me: "Zachary, I want you to be what makes you happy. Wait, I mean what makes you happy and gainfully employed enough to live by yourself in your own house and not with me."

Zachary:  "Okay then I don't want to be a doctor I want to be a ninja."

Me:  "Do ninjas get a paycheck?"

Zachary: "Ninja turtles do."

Me: "Cool beans, dude. Works for me."


Silence

Isaiah: (brow furrowed) "You know, Mom. . . .If I were a. . . painter, I would definitely paint my own house. Definitely. Seems like it would be dumb to learn how to be a painter but have to call in another painter to paint. . . .especially if you are real, real busy. "

Me: (in mirror to myself)  "What the . . .?"

Isaiah:  (folds arms and smirks) "That's what I think about that, Mom."

Silence

 (Terry, I don't think you're gross.)

Terry  Gross through my VERY LOUD radio:  "You're listening to Fresh Air, and I'm your host, Terry Gross. . . . "

Well, that's what yo' mama thinks about THAT.

Kick Buttowski.

Trick or treat for us went a little something like this:

"Trick or Treat. . . .or pay the price, suckaaaaa. . .waaaaaaaaaaahhhhh. . . .bssshhhh! Bssshhhh!" (Sound effect of waaaay too violent pretending. . .)

This is what went on from house to house....to house..


Ummm. . .did I fail to mention? One of the homes where this took place was that of the DEAN of the SCHOOL of MEDICINE. (100% truth.)

Picture it:

Ding dong!

Dean: "Well, hello there!"

My child: "Trick o' Treat! Or pay the price. . . "

Me: "Whooaaa. . .uh. . well, hello there sir. . . . .uhhhh. . ."

My child: (with round off kicks on Dean's front porch) "Waaaaaahhhh! Bshsshhhh! Bssshhhh!"

Dean: (just smiling, no words as small black child threatens safety of his family)

Dean's wife: (with expression that I can't fully put my finger on) "Ooohh, now aren't you just so energetic!"

::sigh::

Ummm. . . . yeah. Know anyone hiring?

****

Hope y'all had a fun one, too!