Life in Pictures: Good Stuff.

Here are some images from the past few days of my life that make me happy.

Like to see 'em? Here they go!

Isaiah had just made his second goal in their soccer game on Sunday. He was running that field like a big boy and I couldn't help but feel a little choked up. Seems like yesterday that he was picking up autumn leaves on the opposite end of the field. While the game was in play.

Uhh yeah.

There was big boy plotting and discussion taking place on that field, too. Like plots on who to pass to and who on that other team seems a little like they might cheat. (Yes, I overheard that part.)

Most of all, he was having fun. And I was proud.

Next.

Mehndi and Maya.

I was working in clinic yesterday with Maya V., a resident that I adore. She had just attended a traditional Indian wedding and had the decorative mehndi designs on her hands and forearms to prove it. For those who are unfamiliar, mehndi painting wears off over a few days or so and is something celebratory and festive in Indian and other South Asian cultures.

What I like is that it opened up this rich discussion about culture. India is not a small place. So like all not-small places, being from from one part of India is almost a world apart from some other parts in terms of traditions. The mehndi painting is shared by many states, but Maya talked a lot to me about weddings and marriage and all sorts of things related to different Indian cultures.

I also like that her painted hands led her patients to learn a bit more about her, too. It's a beautiful thing when we let each other into our worlds.

Next:

This is Zachary after one of his last football games. His team remains undefeated after six games. They were in their huddle and he was feeling good.

Now. This look on his face would suggest otherwise wouldn't it? Let me tell you what had just happened.

Zachary had asked me if I would mind not yelling out his Mama-pet-name during his game or any other public place. That nickname is "Toogie-Woogie." Which I have shortened up to just "Toogie" or "Toog." I think it was originally "Shuga-Wuga" but since my mom is Shugsie, it evolved to something else.

Well.

Didn't I mention that the team is 6 - 0? I was excited y'all! So in the post-game huddle when the coach gave Zachary a shout out, I pumped my fist and yelled out, "Yaaaay, TOOGIE!"

Epic. Fail.

Fortunately, none of his friends caught on that I was talking about him.

Oh, and this:

Turns out that I was considered as one of Atlanta's  "Top 25 Influential African-American Physicians" this year. Who knew?

You can see that the red dress that I wore to the ball last March (the one that coincided with the anime cartoon convention) got a little re-wearing.

Kind of funny -- this function was at the same hotel as the one above. But don't think that didn't stop me from putting that same dress right back on.

Mmm hmmm. Sure did.

The BHE was hanging that tux, do you hear me? Chile please. You can't even get the full glory from this photo but let me just say that the man has broad shoulders made for tailored suits.

Mmm hmmm.

Now THIS man is not the BHE, at least not mine. He is Dr. Maupin and he was President of my medical school when I was but a wee little medical student. He was being honored with a lifetime achievement award. It was really cool to be there with him and for him to remember me as a former "pesky little medical student in student leadership."

I was the one who always set up meetings to ask "why come this, sir?" or "can we have money for that, sir?"

And look at me now. Ha!

I do admit that I was tempted to still ask him "why come this, sir?" or "can I have money for that, sir?"  What can I say? I'm still pretty pesky.

Here's some more:

I had concession stand duty for football last week after our game.

And the bars in the concession booth are perfect because it sort of feels like. .  um. . . jail.

(Whoops. Did I say that out loud?)

Especially when your family chucks you a deuce and leaves you there to take your lumps. Oh well. Every football family has to do their time. In our house that translated to me since I'm not one of the coaches standing out there getting bitten by mosquitoes all the time.

Yup.

Oooohhhh. . . and what about this?

"Oreo Truffles" made for me with love by two dear medical students, Jenna M. and Katy A.

Lawd.

Talk about a party-in-yo-mouth. I was sure to snap this picture prior to inhaling the box. Which Harry, Isaiah, and I most certainly did. Isaiah even slapped me. And that was okay because these little balls of deliciousness were slap-yo-mama good.

What about Zachary? Oh. Zachary is not a sweets fan. Bizarre, yes. The kid just doesn't do too many sweets beyond frozen yogurt. He does like hard candy, but cakes, pies, truffles and such? Naaah. He doesn't do "rich."

Which reminds me of these images from last year when he turned five. He didn't want the cupcakes so we just sang to him with me holding a "five" candle lit in front of him. He blew it out and let the other kids have cupcakes.

Who does that?

But I digress.

And lastly, this:

My nephew, David, after my brother went with him to get his drivers' permit. This could quite possibly be one of my favorite pictures of all time. It just says so much. Doesn't my brother, Will, look so proud? And I promise you, it feels like yesterday that he and Poopdeck were sitting in that same position.

Little does poor David know that, just like his father, he will be toting his younger sisters hither and thither to Girl Scouts, drama, cheer practice, etcetera, etcetera  from the second he gets his official license until the day he moves far, far away. Bless his heart.

Shhh. Don't tell him, though. Heh heh.

This picture was taken on September 22. Exactly fourteen years to the day after David took his first steps, which I was there to witness -- back when I was just a pesky little medical resident.


Life is good.

***
Happy Tuesday, y'all.

Music Lyric Monday: Do You Remember

Here is your lyrical offering for the day:

Do You Remember

"I wish I could turn back the hands of time
I wish I could go back and rewind
the wrong I've said and done
to hurt you, babe
we all make mistakes
they tend to change the outcome of things

You're always on my mind
I think about you all the time now

Do you remember the days?
When we'd go for walks and play little games?
Remember those times like it was yesterday
I wish things were the same

Do you remember the days?
When we'd sit and talk about everything?
It's not I ever meant to bring you any pain--
I'm sorry, baby

Life's too short
to hold on to grudges
Gotta learn how to let go
to things that's really not important

See, we'll have misunderstandings
and live in the past
but with the wrong that has happened
you've gotta have forgiveness
and with patience
kindness
happiness
life is so worth living
with the love you're giving

And we can make it right
we can start all over
I apologize
for all the tears you've cried

Do you remember the days?
When we'd go for walks and play little games?
Remember those times like it was yesterday
I wish things were the same

Do you remember the days?
When we'd sit and talk about everything?
It's not I ever meant to bring you any pain--
I'm sorry, baby

I'm sorry, mother (I'm sorry, father)
I'm sorry, sister (I'm sorry, brother)
and to my best friend I never meant to hurt you

Can we get back to the way things used to be?
I want to get back to the way things used to be

It used to be--

Can we get back to the way it used to be?

Can we get back?

I'm sorry!
The things that I said
I don't want to say no more!
Forgive me!
The things that I've done
I'm willing to say were wrong!

It's time to change
Sat around hurting for much too long
I miss you
and this is the reason that I sing this song to you!

Do you remember the days?
When we'd go for walks and play little games?
Remember those times like it was yesterday
I wish things were the same

Do you remember the days?
When we'd sit and talk about everything?
It's not I ever meant to bring you any pain--

I'm sorry, baby."


~  lyrics by Kindred the Family Soul
  

 
***

Someone who reads this blog said to me the other day, "Wow, you sure have a broad taste in music!" 

Ha.

I can't say that I'm just so worldly that I have all of these swanky travels that helped me to get this way. Nope. But I do think that statement is true. I do have a pretty wide variety of music types that I like.

Here's why.

I like music that speaks to my soul. I like things in general that speak to my soul. Sometimes it's a mandolin crying out from REM or even from The Cicada Ladies. Other times it's an old school rap with a baseline so rumbly that it makes me wrinkle my face and bop my head hard enough to dislocate a cervical vertebra. Many times, though, it's lyrics. Words and poetry that speak to my life and the lives of those around me.

And lots of music can do that. Lots.

I decided that I'll start writing out some lyrics every Monday to a song that has spoken to me at some point in my life. I think stripping the lyrics away from the music, the voices, the all-of-it helps to dissect out the art and the message. Instead of feeling like it's a bunch of rap noise or country and western mumbo-jumbo or fill-in-the-blanks with whatever genre of music you DON'T listen to AT ALL . . . .reading the lyrics or carefully listening to them can change your entire perspective.

This song above was one I listened to many, many times when my brother and I had drifted apart. I would drive down the street and just weep and weep. Those words spoke to my soul in a way that my mouth could never seem to speak to his. Now when I hear those words or read them, I feel so glad inside that this isn't where I am. Now they sound like a testimony and words that perhaps I could share with someone else who is in a similar situation.

That's what I love about having a mental iPod. The music is always with me. The lessons and the messages, too.

I think of this particular song as one for people who can't seem to navigate great divides but should. Family. Really, really important people. Those words scream "truce!" And with family and like-family people, sometimes that's the only way it can happen. Sometimes it's not words. Just actions like a tight hug or a warm response when extended an olive branch.

But all relationships don't warrant this.

Sometimes the season for a relationship has ended. I had two separate people who are close to me struggle with the redefinition of friendships last week. Awkwardness and hurt feelings at where things are now and that stinging realization that the season has come to an end. That fighting for it is now futile.

And no, I'm not talking about someone in a romantic relationship. And I'm also not talking about immediate family members because under most circumstances (unless they abused or neglected you) they are worth fighting for. If the caveat applies however, that's far more complicated than the lyrics to a song can help a person sort through.

Anyway.

I thought of this song when I was rereading the post from my mother's birthday the other day. My brother and I are in a very, very good place. We got back to the way things used to be. And I'm so glad.

These words might speak to someone today. Do they?

They will always speak to me.

***
 Now playing. . . .hear it.

Top Ten: The ones I keep coming back to.

When I woke up Saturday morning, I did the normal early Saturday things. I made some coffee and pulled together some breakfast . The television came on and I listened to the boom-boom-pow of Saturday cartoons. Mean-mommy me puts the kibosh on television and electronics Monday through Friday so Saturday mornings are pretty much dedicated to both. I'm cool with that since I simultaneously find it a perfect time to nestle down at the kitchen table in front of my own "electronics."

The laptop opens. On a lot of mornings I wake up knowing what I want to write about. My hands are itching for the keys and I can't wait to go into my own world of writing. There are other days where instead of writing I just sit and read. Usually it's a combination of other blogs and, dare I even admit it? My own blog. It probably sounds a bit narcissistic but I hope not.

I've said many times over that the reason I started writing my blog was so that I could read it. It's been an archive of moments and lessons that I wanted to keep. Writing them down makes those stories and memories come alive. . . and stay alive. On the days I need to a pick-me-up or when I just need a swift kick in the pants, I find the stories that help me to do that. Sometimes I just want a good hearty laugh or a luscious ugly cry. I have my go-to posts for that, too.

Even pictures I've posted here remind me of things. Like these MacBook photobooth shots of Zachary and me are from this day when we were watching the video to REM's "Losing My Religion." The song had been playing on my mental iPod and I'd written a post that had this song at the end. Zachary came and sat on my lap (as he often does when I'm writing) and went into a trance while hearing that mandolin wailing and seeing the REM frontman Michael Stipe flapping his arms all about dancing.

"Play it again," he kept saying. So I would. And I did. And we talked about it and asked each other what we thought was happening in the video. I ended up writing about that, too. And if I want to relive that tiny little moment with my son, I can.

So I do that often. Sit and read. Sometimes it's a post that I remember every single detail about. Other times when I'm reading it, it feels like I'm reading it for the very first time. Many, many times I'm moved to tears by your thoughtful comments. I reflect on the unexpected community that has come to rally around these ideas and how many of those same people welcome me onto their own porches to sit and read and think and reflect.

I love it. I really do. It makes the world feel smaller and less lonely. It makes me feel -- no know -- that we are so much more alike than different. You show me that. I show myself that, too. So for that reason this is therapy, really. Anything that makes you more okay with yourself and the world you live in counts as therapy if you ask me.

Anywho.

This morning, I've been just sitting here at my kitchen table with a hot cup of coffee doing just that. Rereading and reliving. Doing that gave me an idea.Thought I'd try my hand at creating a top ten of the posts I go back to the most--and why. Quickly I ran through a list in my head and realized that it would surely exceed ten. I figured I could still call it top ten still to rope y'all in. Bwwwaaaaah! Ha! Haaaaah!

Ah hem. I wrote a little top ten (okay fifteen) about it!

Like to hear it? Here it go!

THE TOP TEN (OKAY FIFTEEN)  BLOG POSTS THAT I RETURN TO REREAD, RE-REFLECT UPON, AND RELIVE ON THE LITTLE BLOG THAT COULD (AKA THIS-HERE BLOG.)

And let me just give the disclaimer that I am already feeling some tinge of anxiety at the idea of trying to do this. It sort of feels like I'm picking out a favorite child out of many or like I'm thanking people on a stage and am about to forget someone very, very important.

Very corny, I know.

You're probably thinking, what about the archive list on the right side of the blog? Why not put them there? Well, first of all, I don't update that too often. Second, I can't say it fully reflects the ones I go back to the most often. And third, oh. There is no third. Yes there is! I thought it would be a fun exercise to reflect on my reflections.

Even cornier, I know.

Hey! For those newer here, it could provide some insight. For those who've been down since I had less than ten followers, it might feel like a walk through an old neighborhood. And for those who are bored to death by all of this and see it similar to a rerun or when Tyra Banks does the hodgepodge episode on Top Model, please, please come on back here later, ya hear?

Warning: This will take some time to digest. Especially if you are new here. Take your time, bookmark it and come back to have another bite. Those who read here often, you'll remember most of these so no pressure for YOU to reread just because I do.

Wow. These disclaimers and warnings are getting neurotic.

And away we go!

#15  OH NO,  I SAID TOO MUCH.

*note that the pictures all link to the post of reference.

This was the post I was referring to above. Though I've written specifically about that song, Losing My Religion, the original post where I linked that song was about a patient asking me if I believed in God. I loved the discussion that followed in the comments.

My student-friend-mentee Cathy M. posted this weekend about her thoughts on keeping her faith-cards close to her chest. I know that people all along the faith spectrum are a part of this community. Believers in humankind only to those who said "L'shanah tovah!" often in the past few days to ones who fasted during one of the hottest months of Ramadan ever all the way to the ones who specifically believe in Jesus (and even that is a whoooole 'nother humongous spectrum.)

Anyways, I dipped my toe into that topic. I wondered if the post was too much or if it would offend somebody. As I was writing, I kept hearing Stipe on a loop. . .bleating into my ear. . . "Oh no, I said too much. . ."

What I learned was that I didn't. I go back to that post to feel this community and to also think about faith questions in the work place. Now I know that it's okay to do that and it's not really too much if you respect the space of others while owning your own.

#14 LA PROFESORA.

This was the post written after I'd visited the University of Pittsburgh Medical Center as a visiting professor. I go to that entry often because it makes me thing about friendship between women. My friend Shanta Z. was the one who invited me up there and is such an amazing friend and colleague. I loved my visit there and continue to be glad that I wrote about that experience very shortly after it happened.

I often refer to Shanta as "the profesora in Pittsburgh." She is a wonderful champion for medical students and residents, a strong leader, and someone who gets me. She also inspired a poem that I posted a few months ago about teaching medical students and residents that I read often. Her mantra is "back to the bedside." I hear it in my own head every single time I am attending on the ward.


#13  PANIC! AT THE NICU.

First of all, I always smile at my witty play on words with that title. Then that smile becomes a laugh when realize that my most faithful readers like my mama have no idea who the band "Panic! At the Disco" is so it actually isn't so witty at all.

That story was one that I had wanted to get out of my head and into written form for years. It felt so very therapeutic to write it and it continues to feel that way when I read it. The comments moved me to tears in ways that are hard to describe. What's funny is . . .if there was ever a post that I wrote for me, it was that one. I needed to process that experience. What I learned is that others needed to process some related feelings, too.

And I'm glad.

#12  THE BEST MATCH DAY EVER.

This was the post written after Small Group Alpha (my first group of medical student advisees) had their residency Match Day in March of 2011. It was probably one of the proudest moments of my entire career. In fact, I'm sure of it. On days that I feel overwhelmed by teaching and mentoring medical students, I go to this post. It recharges me and gets me shadow-boxing again because the reward is so, so great.

And since I mentioned Small Group Alpha and their Match Day, that always leads to me rereading the fun day I had with Ant, the sole survivor of SG Alpha, on her last day of medical school. That was special, too.

#11 ONE MOMENT IN TIME

Well. I can't read this one too often because I end up thinking about that whole journey with a previously anonymous medical student. That leads to an ugly cry like no other. Like, super-duper-somebody-slap-me-to-get-a-hold-of-myself ugly.

But when I am in the right mindset, I read that post. I love that entire story because it is a testimony and reminds me that good things can happen if we pay attention to one another. So many people paid attention. The pieces came together and the result was . . . .  literally, a dream come true.

If you put "one moment in time" in the search engine or click that label, you can read the entire story.

#10  WHEN HARRY MET KIMBERLY: YOU HAD ME AT OHIO.

Oh, how do I love thee? Let me, like, count the ways!

Aaaah. You guys know how much I love the BHE. Oh, that man. He is just . . . the best husband ever. Don't believe me? How about even more pictures to make you gag on how much I have a crush on this man!

The post about when Harry met Kimberly (witty again and bet Mom does get this play on words!) I don't know what was going on with me that day--oh yeah! Yes, I do. It was Harry's birthday, I think. Anyway, I put fingertips to laptop and wrote about the entire story of the day the we met. Whenever I am having a Harry love-fest (which is often, often, often) I read this for a smile.

I was never, ever lucky in love. Like, ever. So reading that makes me feel encouraged that every single dream can just be one moment away. It makes me hope that someone reading believes that, too.

I also like knowing that my boys will be able to read that story one day. The real, true story of "how I met your mother."

If you are interested in gagging repeatedly, please go straight to "The BHE" as a label. I do that often and fall in love all over again. It sort of embarrasses him that I so effusively profess my love for him here. But it mostly touches him.

#9  TEENAGE MUTANT TARGET CHECKOUT CHICK.

Man. This post just makes me laugh out loud. Every single time I read it. No matter what.

Part of it is imagining my sister JoLai or my friend Psonya saying, "Aww hell naaaw!" while reading it. Or knowing how much it would tickle my friend Lesley M. She always shares the funniest ones with her husband who, like her, is an avid reader. Something about that makes me feel proud of the funny ones.

For whatever reason when this happened, I thought of all of you! I couldn't wait to write about it and hear your thoughts. It felt like I was standing on the corner talking to my homegirls about some mundane ridiculousness--and all of you were those homegirls. Ha. Sure, it had nothing to do with medicine but seeing as forty two percent of my life is spent in Target, it seemed reasonable to write about it.

I can't tell you how many times I've revisited this post just for a pick-me-up on heavy days. Laughter is an excellent panacea for icky days.

#8  I WON'T COMPLAIN.

Something about this image I found of a young Bob Dylan singing in the deepest parts of the south during the epicenter of the civil rights movement moved me this morning. It also made me think of what was probably one of the greatest and most memorable moments I have ever experienced at Grady Hospital.

This is the post about that moment. I reread it often. I think it's my Poopdeck's favorite post of all time. (Poopdeck is my dad, but most of you know that already.)

Most of the stories I significantly modify to protect anonymity. The reason I love that story is because not one single drop of the details were changed in any way. I reported it exactly as it happened and, since it didn't involve patient care, it was okay to do so.

I loved this moment. It embodied every drop of every thing I love about Grady and underscores my complete awe and respect for the Grady elders.

That picture was one that I thought would make my friend Sister Moon smile. She (and the rest of our blog community-of-writers) is one of the best parts of starting this blog. We have really all become friends and it's so wonderful.

I mean that.

#7  LITTLE MAMA.

This post about a young mother crossing the street was supposed to be nothing but an exercise in simple observation. What I learned is that this can make for some of the most powerful imagery. I reread this post often. I recall closing my eyes and trying to think of words to bring that moment to life.  Funny. I had no idea where I was going with it. Once I reached a destination I was surprised at the emotion it evoked. It wasn't supposed to be that kind of post.

But it was.

#6  I THINK I KNOW YOU.

I just reread this post again this morning and it made me cry. I wrote this after running into an old acquaintance in the hospital. Someone I'd known from college whose life had taken a few sharp turns that landed him in a clinic room at Grady Hospital.

I loved the way he owned his space. Despite the obstacles or the little voice it was obvious that he was alright with himself. It immediately made me feel comfortable and made me want to emulate that quality.

More than anything, I learned that you don't know anyone like you think you do. Pretty much ever.


#5  THE HAIR POSTS.

Okay. Not all of them. But a few of them.

The F.P.

The first is the one about my favorite patient (F.P.) whose hair was coming out after chemotherapy. She was an amazing human being and one that I think of very, very often. I didn't know her for long but she had a tremendous impact on me. The very last thing she ever said to me was, "Love you." I will always remember that and hold it close.

Though not her real name, I gave her the name Mrs. Zebedee in the story. I'm not sure what made me pick that name but it's probably no accident that I chose a biblical one for her.  In the bible, "Zebedee" was the father of James and John. I imagine that he was quite wise. My Mrs. Zebedee was, too.

FOX-y Lady

This was the one about a patient calling to the hospital after an appearance I'd had on our local FOX affiliate. Hilarious.

The Hair Mane-ifesto

My homage to black hair and all that goes into it. What prompted me to do this? Well. Blame it on the Surgeon General of the United States. Sister-Doctor Benjamin said that sisters not exercising because of their hair concerns is a public health issue. While I neither support or refute this statement, I will say that I get why some women might be deterred by sweating if they have hair of the kinky-curly variety. Once I started writing about it, I couldn't stop.

One of my good friends (who does not happen to have hair of the kinky-curly variety) said that it was "truly educational and eye-opening." Something about that makes me wish I had a book cover to put that on the backside of.

Ever wondered about black hair? Read that post.

#4  WE LOVE HER MORE.

This was the post written after my mother's sixty fifth birthday. It was a day of new beginnings. I was reminded of what is truly, truly important. I have read that post and watched the video clip of my brother and I more times than I can even count.

Ever had misunderstandings with family members? Read that post and be reminded that life is too short to let them fester.

#3 THE NOD.

A modified version of this post is now published in JAMA. It is accompanied by an author reading. If you go to www.jama.com and either search or click on the multimedia page, you'll find an author reading of the full text version.

 I get "the nod" from people at least ten times every day.


#2  MY SO-CALLED LIFE OUTSIDE OF GRADY

This is exemplified through this small handful of posts about things that happened away from Grady. Technically, Teenage Mutant Target Checkout Chick and the one about my mom's birthday should be there, but they deserved their own place since I read them so very often. I know I'm cheating by not listing an individual post. But oh well, what can you do? I truly do read these often, so I figured I'd share.

The Puppy Mafia.

This entire saga makes me laugh out loud. But the very first installment makes me laugh the most. It's so ridiculous yet so true. I am laughing just thinking about it. So ridiculous and very much the embodiment of "my so-called life outside Grady."

The Lady in the Airport.

I kid you not, that's what happened. I go to this post for a hearty chuckle. And a reminder to have a little bit of chutzpah and cojones.

The Unexpected Isaiah Car Conversations on Race Relations.

This post was about a surprisingly heavy conversation that I had with Isaiah in the car one day--all revolving around The Green Lantern.

And this one was about the day that Isaiah relayed what a friend had told him about black people.


#1 -- ACUTE-ON-CHRONIC PARENTAL PRIDE

This post was written right after I had the surprise of winning the Evangeline Papageorge Teaching Award at The Emory University School of Medicine Commencement this year. I really, really considered not writing about it. But then I realized how bummed I'd be if I wanted to come back to that moment someday and had neglected to write about it while it was fresh.

I'm so glad that I did.

Every time I look at that last picture of my father, I cry. It makes me remember how I felt when I saw him standing there patting his eyes in that chapel. It reminds me of how acutely proud I made my mother and my father that day -- on top of their already chronic pride.



Whelp. Now that I have sufficiently eaten up your entire day, you may return to your regularly scheduled life. Ha ha ha.

There are others that I reread but I realized that I had to narrow it down. Remember, this blog is therapy and like Toni Morrison said after writing The Bluest Eye-- it was written "so I could read it." And I guess the point is. . . .I actually do.

Which makes me wonder--do any of the other blogger-writers out there do this? Or am I just a cornball who reads her own writing? I always hear artists and television/movie personalities saying they don't listen to their own music for leisure and that they've only watched their own movies/TV shows once. Is that just the cool thing to say or is that, like, how it really is with most people?

Hmmmm.

Sometimes I read things on my friends' blogs and wish I could remember the title or label so that I could go back to it. That may or may not be me nudging you to do a version of this, too.

My mom says that she is going to make a guest post here with her top ten posts from her daughter's blog. And by her daughter I mean me. Stay tuned for that. It could be as soon as next week or next year. I've learned not to rush the sixty-five year old version of my mama. You shouldn't either. Just saying.

Antywho.

I'd love to know which posts, if any, have resonated the most with you. Do you like the student posts? The mommy-hood ones? The patient stories? The ridiculous Target encounters? I'm curious. Feel free to delurk to share. Or just share. Think of it like feedback on Amazon.

But without the mean comments and star system.

***
Happy Weekend, my friends. And thank you so, so much for returning over and over to read the little blog that could aka this-here blog.

Trials and errors.

I was talking to a patient the recently. The conversation was easy and fluid, just like doctors like discussions with patients to be. A blood pressure was too high so we needed to do something about it. Two medicines needed to become three. Because even though she was taking the two, her blood pressure was still uncontrolled.

I listened to the amazingly competent resident physician as he unfolded her medical history in front of me like a linen napkin. Stage two essential hypertension. Currently on a thiazide diuretic. Next came a calcium channel blocker. Now he wanted to add another medication because the pressure was still too high.

He gave me a clear explanation for his choices of medications. That resident cited all sorts of clinical trials with funny acronyms that spell out words like ACCOMPLISH and MERIT-hf and provided evidence for why each potential drug combination was or was not the best for this patient. I marveled at how well he knew the fine points of so many intricate medical studies and how effortlessly he applied them to his practice.

Honestly? He was all over that plan. So much so that I had nothing much to add. Who could argue with clinical trials?

"Is she taking all of her medicines?" I had to ask at least a couple of questions.

"Yes. She's very motivated and is taking them all. She brought her bottles in and everything."

Then he assured me that she was taking her medications, exercising, and watching her salt intake. So a third medicine it would be.

Admittedly, this resident had memorized more medical evidence than I had. I knew the rules and what to do, but when it came to calling out the names of each study and those fine details like, "3100 adult white males were randomized to this medicine versus placebo." Me? I tend to mostly know the impact of the study and what it means to patient care.

But I'm always super impressed by others who can recite the details.

So after my less-than-probing queries, we went to see the patient.

I exchanged pleasantries and explained that we were concerned about her blood pressure. That's when we launched into that easy-like-Sunday-morning chat about her hypertension and she seemed quite amenable to all of the things we were saying. I then thanked her for bringing in her pill bottles and asked if she'd minded showing them to me again.

"That's no problem," she answered and pulled out her medications as prescribed during our last visit and also during a recent  ER visit.

He was right. This lady seemed to have it together. Greying hair in a tight chignon. A careful application of lipstick. And a fancy blouse with ruffles along the front. All accessorized with a warm demeanor--the very best kind of "together."

My resident launched into a discussion about our plan to add another medicine. How she should take it. What side effects to look out for. All of that.

I kind of zoned out while he was talking. I read the labels on her bottles and made sure they matched the amounts recorded in her chart. Everything was spot on and the resident was nearly done with the encounter.

That's when I let my eyes do what they habitually do. Check the fill date and estimate the number of pills remaining in the bottle.

Fill date: July 20, 2012.
Quantity dispensed: Thirty pills for each prescription.
Amount in each bottle: Easily twenty.

Rut roh.

"Is this the last bottle you had filled?" I asked her.

"Yes ma'am."

I twirled the bottle over in my hand and pressed my lips together. My brow knitted and then unknitted; I didn't want to alarm her. "Do you ever . . . .sometimes. . . forget pills?"

"No, ma'am. I take my pills every day." She kept her eyes carefully fixed on my own.

"Okay. I was just wondering because this bottle should have run out at last month around the eighteenth of August. Are you sure you always remember?"

She dropped her head and sighed. "I be forgetting. A lot."

I looked up at the resident and then back at the patient.

"You do? Did you take them today?"

And she shrugged.

We probed some more and found out that this "really together" patient with the stage 2 hypertension mostly took her medicines on a "as needed" basis. Because on the other days she often forgot. The day her head hurt, yes. If her urine was dark yellow, definitely. And in those next moments we uncovered a surprising amount of things that she didn't understand about her medical problems and couldn't remember in her life. It became clear that she had some pretty significant cognitive impairment.

"I live by myself. I don't be wanting to bother nobody and don't want nobody thinking something wrong with me."

"Something like what?" I asked.

"Like the old-timers setting in. You know. My daddy, he got the old-timers disease real bad before he passed on. It started with him forgetting stuff."

Aaah. She was afraid that she, too, might be developing some Alzheimer's dementia.

So we talked some more and arranged for her to see our neurologists in the "Memory Clinic" -- a session devoted to early cognitive impairment. The resident doctor spoke to her son on the phone who agreed to regularly check in on her and to get other family members to help him. Lastly, we spoke with our social worker and pharmacist to arrange some other interventions to assist her in managing her health.

It wasn't clear what this all meant. Was she on her way to developing severe dementia? Had those daily crossword puzzles and sudoku grids betrayed her? We didn't exactly know. All of this had been masked so well.

Finally we discharged her home with the same exact medications with which she'd arrived. Two medications instead of three.

"I'm going to worry about her," the resident told me. "I know I am."

"Me, too," I whispered.

He shook his head and stared out of a nearby window. "You do all this reading, you know? But for some things there's just no textbook."

And I got what he meant by that. He was right. Sometimes medicine isn't about knowing the clinical trials  off the top of your head. Sometimes it's just about trials and errors.

Yeah.

But the other part that isn't in the books is that it also involves worrying. . .  long after the patient has left your sight and just before your head hits the pillow.

***

Random goodness.

"What is it you think you see when you see me?"

~ Mary Mary

_____________________________

Well.

I can't say I have the energy to type the story that's in the queue of my mind. Promise to get to that soon. In the meantime, here's a little bit of random goodness.

Let me start with this:

I was in clinic on Monday and a patient that I have been seeing for several years came in to be seen. I mostly see patients with the residents and for this patient, we'd together seen two trainees from internship to board eligible graduation. Now seeing her third resident primary care doctor, we felt like the seasoned camp counselors returning year after year as constants in an ever-changing system. Instead of the doctors showing this patient all of the ropes, she knew Grady so well now that she schooled them.

It had been a while since i'd seen her. As a matter of fact, it had been well over six months considering all of her medical problems were under such great control. On this day, everything was still in great shape, so the encounter was easy and familiar. After the resident saw her, I came in and socialized more than anything else. I examined her briefly and then jumped straight to the pleasantries. It was great.

But then, she reached into her purse and handed me something. It appeared to be some kind of card and I could tell she wanted me open it right then and there.

So I did.

A birthday card. With my actual date of birth on it. My mouth fell open.

"I remembered from one year that I was here in clinic and it was your birthday. I always remembered that it was on September 7 after that."

I was speechless.

"I wanted to bring it sooner but I knew this appointment was coming up. So happy belated birthday, Dr. Manning."

But by the time she said that, I was getting choked up. Reading this card with my date of birth on the front that this patient with all of her medical problems and life issues had remembered.

Here is what it said:

"You're such a cheerful giver, Dr. Manning. You give of your spirit. Thank you for blessing me with that gift."

Come on, y'all. Now you know what happened next. And if you think I didn't do it right there in front of her, you haven't been reading this blog very long. Yep. Cried right then and there. Didn't even try to front like I wasn't moved to tears.

She gave me a meaningful hug, hand tight on my back. And I was tired that day, too. So reading that card and feeling her hand pressing between my shoulder blades made my soul just open right up.

She pulled back from the hug and looked at me. With a chuckle, she said, "You know? This isn't the first time I've seen you cry, Dr. Manning. And I love that about you."

And well. What do you say to that? Especially on a day when you're tired and you really, really needed something like that?

"Thank you. You have no idea what this means to me."

"I do. This is why when I saw that card, I knew I had to get it for you. "

And that was that.

Can I just say this? I have done some cool things in my career. Like, I've been on really high profile television shows talking medicine and taught some amazing students and have received some really unbelievable awards, too.  And hand over heart, I appreciate every last experience and accolade. But these moments? These one-on-one pivotal moments with real people are the ones that tell me the most about who I am and what I've accomplished.

Yeah.

Someone at Grady Hospital felt like I was a cheerful giver--of my spirit. My spirit, y'all. This? This is making me cry right now because this is what I want to do in my life more than anything else.

Whew. Let me lighten things up with a change of subject.

The hair salon was great today. Nobody was selling peach cobblers or talking about Mrs. Obama, but two of my good friends had appointments today so that was awesome. And we weren't expecting it, so that made it even better.

Joy, one of my besties and college sorority line-sisters, was there. We caught up and agreed that we should coordinate our appointments more often.  That's Joy on the left.

Isn't she gorgeous?

Yolanda, my med school classmate, was there with her daughter, Ryan, who is turning six next week. Ryan had the appointment--not Yolanda.

Yolanda and me, both medicine nerds

Her first press and curl? Chile please!


This is a milestone, people. We all applauded Ryan as her little afro puffs slowly took on another form. And this is not saying that we have any issues with afro puffs. Or the darling braids and twists she normally wears. No, we do not. I'm just saying that there's something about getting your hair straightened as a kid that feels like a big deal. I know you couldn't tell me NOTHING (yes, I meant to say nothing instead of "anything") when I got my hair pressed out as a kid.

Don't believe me? Here's one of my very first press and curls. Clearly that sidewalk in front of our house was a runway. And clearly I was FIERCE. (Can't you see me smizing?) JoLai was ready to take up the runway next.

You betta work, honey! (That's Top Model lingo for those unfamiliar.)

Whaaaat?

There's her mom, Yolanda, standing in the background. I took out my phone and said, "Girl! This is a milestone! Why ain't you snapping pictures?"

And yes. I said "ain't" and not "aren't" because that's just me being honest.

I can say for certain that I did NOT have an iPad to keep me company when I got my first press and curl. Furthermore, I was not in a salon but in a kitchen. And I was not sitting in a fancy chair but on three to five phone books.

I'm just saying.

You can't really see it in this light, but one thing that hasn't changed:

You couldn't tell Ryan NOTHING when she strutted out of there. That baby almost broke her neck from swinging her hair. And yes, the parking lot was a runway.

Sashay, Shante! You beta work, Ryan!

That made me think of this, listen to this, and pause from this post to "sashay, Shante!"



First press and curl? Been there. Sho nuff done that.

What else?

Walked to campus today for my meetings. How gorgeous was it? A fall teaser of a day, I tell you.

I snapped these shots while strolling along and humming a song.

Here's another shot from another meeting I had downtown. I just liked the view.

Purty, huh?

What else do I have? Oh this:

Isaiah had a family tree project due this week. He really worked hard on it and got into the whole process. I loved seeing his face light up with ideas. When I'd try to redirect him, he'd say, "It's my project, Mom." To which I'd say, "That it is."

He was very proud of his finished product.

"This is awesome, Mom, right?"

"That it is."

***
Happy Wednesday-pretty much-Thursday.

Now playing on my mental iPod. . . .

Oke-rees.

oke-rees

You know how I love the elders. Lord knows I do.

Sigh.

Today I was leaving Kroger and this sweet elderly gentleman in front of me in line commenced to strike up a conversation. The man was surely about to knock 90 down if he hadn't already and he definitely put some fear in my heart as he pulled out his car keys to approach his car. Because he was about to drive.

Mmmm hmmm.

I made the mistake of smiling at him too warmly because that opened up the floor for him to get his full, unfiltered and unabbreviated chit-chat on.

I wan't you to know: I am currently typing this while beheaded. Because that man TALKED. MY. HEAD. OFF.

Do you hear me?

I walked out toward my car at approximately 6 PM. And I just got home five minutes ago. For real. Okay, maybe I got home a little bit sooner than that but, for real, he was skipping from topic to topic like rocks on a lake.

Lawd.

"Do you eat oke-rees? I like your cross neck-a-lace. I see you got that Er-bama on your car. Are you in college? My son had double majors when he went to college. Is that a stick shift? Some folks can't even drive a stick shift. Do you drive stick shifts? Seem like prune juice don't work like it use-ta. Was your peaches sweet this season? I puts oke-rees in my black-eyed peas. You eat peas? What you put in 'em? I like a piece a salt pork. Seem like pork get a bad rap. You know they letcha buy wine on a Sunday now? That's a shame. I like your cross neck-a-lace. Why you got Er-bama on your car and a cross neck-a-lace? I saw two ladies in broad day light kissing on the mouth. You have children? My wife deceased but she liked H.W. Bush. I liked him okay. Seem like a damn shame to get some beer on a Sunday. This is Georgia, you know? I got a grandson in college. He real smart but otherwise he ain't no count. Did you know them oke-rees was on sale? Do you eat oke-rees? My son he'll eat anything but some oke-rees. Seem like it's getting dark already. Hey. . .what you think of that Er-bama anyway? He's alright with them girls kissing each other you know--smack dab on the mouth! And them was some pretty little ladies, too. Broad day light. Did you know that it's poisons in them fabric softener sheets you got there?"

LAWD.

He WOULD. NOT. STOP.

I. COULD. NOT. GET. AWAY.

Multiply that paragraph by seven hundred and you have the number of tangents he went on.

Seriously.

I love the elders. Lord knows I do. But this one. . . . sigh. . . bless his heart. WOW he was chatty. I feel so bad that I had to just finally walk away in the middle of his sentence. Literally. So terrible, I know.

What would y'all have done? I'm real scared that he still might be out there talking. . . .