Grandson.

“Where are your people from? Maybe Mississippi or an island?” 

- India.Arie, “Brown Skin”

______________________________

Grady elevator, July 4.

Him: “Hey doc.”
Me: “Hey there, sir.”

*silence*

Him: “Hey doc? Where you from?”
Me: “Me? I’m from California.”
Him: “No I meant like, where you FROM FROM.”
Me: “Ummmm. Born in Compton. Raised in Inglewood.” *holds up hand gesture* “West syeeeeeed.”

*laughter*

Him: *squints eyes* “But where your peoples from?”
Me: “Alabama.”
Him: “Alabama? So you just regular black? I was thinking you was something else.”

Me: *shrugs and smiles* “Nope.”
Him: *still pondering my ancestry*

Me: “So tell me, friend. Where’re you from?”
Him: “Straight out the A. Vine City.”
Me: “Gotcha. Is that where you’re FROM FROM? Like, your peoples, too?”
Him: “Yep. I’m just a regular ass n*** from Atlanta.”

*silence*

Me: “So, why are you at Grady today on Firecracker day?”
Him: “To see my grandmama. She been real sick.”
Me: “I’m sorry to hear that. Are y’all close?”
Him: “She my heart.” *eyes glistening so looks down* “I see her every day.”
Me: “I bet she’s so glad to see you everyday.”
Him *nods and keeps looking down*

After that, I asked his name and told him mine. I told him that I thought his grandmama was a very lucky woman to have a special grandson who came to see her every single day. And then I reached my floor and the doors opened. I stepped out but then turned back to face him with my hand on the door.

Me: “Hey grandson? Can you do me and your grandmama a favor?”
Him: *looks up* “Yes, ma’am.”
Me: “Please don’t ever, ever refer to yourself as a ‘regular ass n***’ again, okay? Like, ever. Because you’re not.”
Him: *staring at me while I stand in the doorway as elevator buzzer starts going off*
Me: “Alright then, grandson. Go see ‘bout your heart. She waiting on you.”
Him: “Alright then, doc.”
Me: *smiling*
Him: *smiling back*

Both of us: *fist bump*

I love this place.❤️🏥

***
#slowtojudge #hewasspecial #peopleoftenaskwhereimfromfrom #butonlymyownpeopleask #itscooltho #totallycoolwithme #dialoguestarter #amazinggrady #loveisthewhat #alwaysandinallways

Baby Daddy.

Him: "You got kids, Miss Manning?"
Me: "Yep. Two sons."
Him: "They grown? Like my age?"
Me: "Nah. Thirteen and eleven."
Him: *eyes widen* "Damn. Doctors be waiting to have they kids."
Me: "Ha. Some do. Some don't."

*silence*

Me: "You excited about being a dad?"
Him: "Very. But it scare me, too."
Me: "What part?"
Him: "Getting it right."

*silence*

Him: "Miss Manning? You think if you didn't have no good daddy, you can be one to your kid?"
Me: "I think there's a lot of good daddies who are the first good daddies in their family."
Him: "Kind of like the first to go to college, huh?"

*silence*

Him: "I just hope I got what it take to be a good daddy."
Me: "You do. You got love. And love is the what, man."
Him: "Take more than love."
Me: "It's a start though. That and showing up."
Him: "I can show up and love her. I can do that."
Me: "Good stuff, man."

*silence*

Him: "That's what your daddy did, huh?"
Me: "What?"
Him: "Showed up. And loved you. I can tell."
Me: *silence*


He changed the subject after that and just watched the TV. And I just sat there on the chair next to him. At first, I wanted to cry. But then I decided to go ahead and give thanks for the amazing father this young man will become.

Because he will. I claimed it.

Yeah.

***
#whynothim #hegotnext #loveisthewhat #amazinggrady #iprayformypatients #gooddadsrule #hewasrightaboutmine

Divine intervention.

A fist has hit your face. A strong hand has gripped your arm hard. Spit has flown from lips as they spewed forth words cursing you. And you took it day after day, year after year. Now your body is sick and growing older. The energy it took to be a crouching tiger from this hidden dragon is needed for other things. Except this is all you know. Or all that you've known for most of your adult life.

"God called me to this place. I am trusting Him." That is what you said to me when I asked about all of this. You explained it with such simplicity. Like, this was your lot in life. Your destiny of lumps that you would just have to take.

Like you had been taking for all this time.

When I explained that I worried about this and said I didn't believe love should hurt like this, your eyes filled with tears. When I told you that I knew it was complicated but we wanted to protect you, they fell. Onto your cheeks and in splashes on your blue hospital-issue gown.

We sat in silence for a bit. Then you squeezed my hand tight and said, "I'll be okay. I've made it this far. I will be okay. God's got me." You smiled. And when you did I saw your cheek quivering. But you nodded hard and sure. So brave and full of fight. You meant those words.

You did.

"No." That's all I said. Then I closed my hand tight over yours, shook my head and clamped down hard. "No."

And you understood what I meant. That this idea of you fighting this old fight and this new fight at the same time was not going to happen. Even if it was super complex and lumpy and scary. We can't unhear it. I can't unknow it.

I can't.

I gave you a hug before walking out of your room. And you hugged me right back. You sure did.
I didn't say anything more after that. But I hope that hug conveyed what was on my heart.

I recognize that you are scared and respect that you believe that God has called you to this place. But I need you to remember something, okay? Just maybe He called me to this place, too.

I will do my best to fight with you. I will.


Yeah.

***
Happy Monday.

Rules of Intern Year.

10 Rules of Intern Year

1. Show up.

2. Do your best.

3. Listen to the nurses. 

4. Don’t lie.

5. Put the patient first. 

6. Do fun stuff when you’re off.

7. Cry when you need to. 

8. Laugh out loud when you need to.

9. Eat lunch and take the stairs. 

10. Care like it’s yo’ mama.

July 1. One day down, 364 to go. You’ve got this, interns. And we’ve got you. Let’s get it! 👊🏽🏥 #gohardest #bespecial #carelikeitsyomama #youarereadierthanyouthink

Stick together.

"I was next!"

"No you weren't!"

"Why are you cheating?"

"I'm not cheating!"

"You are!"

Their voices escalated from down the hall. I sunk my face into my hand and groaned. I wasn't in the mood.

"Mom!"  I took a big drag of air and tried to ignore it. It was repeated with more urgency. "MOM!

Next came a cacophony of clattering plastic. I'd attempted to sit at my kitchen table doing nothing enough times to know the exact sound of a PlayStation video hand control device falling to a hardwood floor. I squeezed my eyes tight and pressed my lips together.  Next came the feet stomping in my direction.

"Mom? Isaiah was supposed to --"

"No. No, he's exaggerating," Isaiah protested before his brother could finish his sentence.

I swung my head from side to side between them. Zachary was now blinking back mad tears and fuming. Isaiah held the plastic controller behind his back so that Zack couldn't reach it. They were at a stand still. And I hadn't even uttered a word of mediation.

And wasn't going to.

Clasping my hands in front of my face, I looked straight ahead into the space between them. "Listen," I said. "You will argue sometimes. You'll frustrate one another, too. But no matter what, I just need you to always remember what I say about brothers." Both boys stared at the floor, still fuming. I cleared my throat hard, "What do brothers do?"

The answer came as a mumble. They'd uttered that response so many times that me asking to have their words repeated had far more to do with me just wanting them to speak up than not hearing. I pressed them in a firm voice. "What do brothers do?"

"Stick together," they replied in low unison.

"Solve this. You solve it. And if you don't, nobody gets to play." I turned back to my computer and let them know I was done. Because I was.

Last week at Grady, I took care of a man with an advanced cancer. He was up in age. His parents had passed several years back. The ex-wife he'd had remotely was no longer in is life and they'd never had children. He'd had a few strokes that left him with labile cognitive function. And his health issues were significant and active enough to warrant somebody thinking about him and advocating for him.

Yeah. That's what he needed.

Again--there was no spouse. No common law boo wringing hands at the bedside in woeful misery. No parents filled with that unconditional parental love and no aunties or uncles who'd doted on him since he was a child. All there was was one person: His brother.

Now. This man's brother was a grown man with a full life. He had a wife and adult kids and grandkids, too. He had a business that he ran and a church where he deaconed and a square of lawn in front of both his house and his church that called for him to mow it on a weekly basis. But the other thing he had was a brother.

Sure did.

He'd come in with a work uniform on. Soiled with a full day's work and with this little hint of masculine mustiness that would waft into my nostrils whenever he moved. Sometimes he'd wipe his forehead with handkerchief or just the back of his hand. Or rub his eyes with the heels of his palm. But no matter what, you could count on him seeing about his brother.

Yep.

Brother was only the next-of-kin for my patient. And since some days my patient was with it but on most other days he wasn't, we needed someone to step in. We did. And let me tell you--Brother was there.

"I'm sorry to keep putting so much on you," I said to him the other day.

"It's okay. I just hate I can't get up here no sooner. My wife would've come for me but 'cept she got some hip troubles and ain't driving right now. So I can't get here 'til I get off."

"I understand."

"He look a little better to me today." Now he was dabbing that same hankie on his brother's brow.

"He always seems to perk up when you come in." I realized that may have sounded negative so I corrected myself. "He does look to be a little better."

We sat and talked some more. Brother asked hard questions and I answered to the best of my ability. We discussed next steps and what he thought would best honor his brother's wishes. This was a day that my patient wasn't flying on both wings mentally. That was happening more and more frequently.

Brother signed a few papers and placed the pen down in front of him. A big yawn escaped his lips, causing his body to let out a tiny shudder at the end.

"I can tell you're tired."

"It's okay. That's my brother."

I squinted my eyes at him and twisted my mouth. "I have sons."

"Yeah?"

"Yes, sir. Two of them. Sixteen months apart."

"They fight?" Brother laughed at his question. "I know they do. You always do when you close in age like that."

I laughed. "Pretty much."

"See, our mama always told us this: 'Take care of your family, take care of your mama and your daddy, and take care of each other. I don't care what you got going on. You stay connected to your peoples.' So I hear my mama straight in my ear sometimes. I be tired but I come on down here."

"I love that."

"I'm all he got."

I didn't know what to say do that so I said nothing. Then I finally said, "He's blessed."

"We both blessed."

We sat in silence for a few moments. Brother stood up and put his soiled trucker's hat back on his head. This time he addressed my patient. "Okay then, Junior. We'll see you tomorrow, okay?"

"Okay," my patient replied. Brother reached down to give him a tiny hug in the bed. Then he gave one more of those big yawns. He waved goodbye to me and before I knew it he was gone.

The whole way home I thought about them. I thought about a mother infusing this idea into her children of staying united. Letting no weapon formed against them as siblings prosper.

Ever.

That night over dinner, I shared with my boys about this story. With privacy protected, I explained that my sick patient had no one to look out for him in this whole world except his brother. And that his brother worked all day long and came anyway.

"I'd come for you." Zack looked at his brother. His face was serious.

"Me, too. I'd come for you, too."

And that was that.

I felt a tiny heave in my chest. Followed by a shiver like the one Brother had. Something about my boys saying those affirmations to one another had given me chills.

Yeah.

I've probably had to ask that same rhetorical question about what brothers do some fifty times since then. But after watching those two men fulfill that duty to one another, I knew that it was an important seed to keep on planting.

I'm learning day by day that connectedness requires intention. It involves forgiveness and redemption and resilience and commitment. And it especially calls for us to fight for the relationships we value the most.

The mama who raised those two men did something right. She made love and loyalty a rule. And no--sometimes it doesn't work. But what I do know is that the kind of sacrifice I witnessed between those two brothers didn't just happen overnight.

No it did not.

Do brothers fight? Sure. And will brothers get on one another's nerves? For sure. But as for me and my house? They will stick together--and stay connected. If I can help it, at least.

"I don't care what you got going on. You stay connected to your peoples." 

Damn right.

***
Happy Tuesday.

On Anthony Bourdain.

“Life is complicated. It’s filled with nuance. It’s unsatisfying. If I believe in anything, it is doubt. The root cause of all life’s problems is looking for a simple fucking answer.”

- Anthony Bourdain (1956 - 2018)

I remember watching this dude on TV and thinking, “Damn. He seems cooler than the other side of the pillow.” I dug the way he treated people the same regardless of their position. He listened to the short order cook in a Bangkok dive with just as much interest as he did Barack Obama. I always thought that was dope.

Yeah.

I met him once during those years when I used to do segments with CNN. He was good and famous by then. And though I don’t watch a ton of television, I’d seen his show more than enough times to know that fan-girling over him wouldn't be necessary. I was waiting for my segment and he walked through the room where I was. When he saw me, he was exactly the non-diva that I imagined he'd be. He paused, shook my hand and said, “Hey. Anthony.” And I nodded and said my name in return. He looked to be in a hurry but I said I liked the show. Because I did like the show. He stopped, looked at me, smiled and said, “Hey thanks.” Then he pointed at my hair and said, “Joining the silver fox club, huh? Welcome!” We both laughed and he walked out. And that was the time I met Anthony Bourdain.

Yep.

That was like 5 years ago. I had just started letting my grey hair come in so him pointing it out was pretty damn observant. And he wasn’t being even remotely fresh. He just saw me. And acknowledged me. Which was cool.

Turns out I was right. That dude really was cooler than the other side of the pillow. I’m glad he noticed people and lived so voraciously. I’m glad he got to break bread with people all over the world and that he looked at me not through me when I encountered him that day. I’m sad to hear of his death.

It's cliché to say things like, "No matter how rich or fulfilled you seem, that won't make you happy." So I won't say that. Instead I'll just say that I'm thankful that Mr. Bourdain--I mean, "Anthony"-- shared so much of his world and this world with so many people. And though he lost his life to suicide, I think his life included a lot of joy. I've learned from living and watching and listening that we all have parts unknown. Happiness is an everchanging spectrum. Sometimes light and darkness dwell together. It isn't just one or the other.

And it's complicated.

Thinking of every person I know who has ever been affected by suicide. I know this has been a tough week. You’re all in my thoughts, okay? I mean that.


***
Happy Friday. And rest well, my fellow silver fox.

Zone of Development.

Funny thing about life. We want to be comfortable in it. Like, we want things to mostly be predictable and painless. Low on stress and curveballs, right? And while it may seem like the next predictable sentence is some reference to how it isn't that way at all--that's not what I'm thinking. I'm actually thinking that many times it is like that. Comfortable. Predictable. A rolling ball down a straight path without even the tiniest hint of anything to break the inertia.

Yeah.

At first, that feels good. Kind of like when you run and get to a pace that feels manageable. You get out and you do it. Until, at some point, it feels less satisfying. And as a result something has to shift. Maybe you will do hill work. Maybe you will start running faster and aim for a better time. Or just maybe you will stop running altogether. Why? Because being comfortable is overrated man.

For reals.

I heard this guy once talk about how the most fulfilling place to be is in what he referred to as a "zone of development." This is the place where you don't know how to do everything and some piece is a wild card. Your are working up to it, broadening your fund of knowledge and skillset, shaking things up. Contrast this to your comfort zone--where all is predictable and mostly easy.

Yeah.

I think the older you get, the easier it is to land in comfort zones. I find myself wondering if there is an age where this is nirvana--being in a perpetual comfort zone. While I'm not sure if that's true, I know that if it is, I'm not old enough for it yet. Not for long period s of time.

So yeah. Here lately, I have been thinking of this. Feeling ready to push envelopes and thrust myself into some zone of development. Lucky for me, that can all be done at Grady and with my current employer. But it will call for me asserting myself and learning some new things. I think I'm ready to do that, too.

Yup.

I'm ready to move intentionally into a zone of development. Do I know what will happen there? Nope. But what I do know is that this is where growth lies. And what I also know about where growth is?  Peace and fulfillment are somewhere nearby.

Yeah.

***
Happy Tuesday.

Affirmative actions.

Best moment of my week at Grady:

Yesterday I encountered a young man at Grady who spoke to me by name.

"Hi Dr. Manning!" he said. Even though I wasn't sure where I'd known him from, I smiled big and responded in kind. He went on. "I know you don't remember me. But I just want you to know that I just matched in Emergency Medicine and am about to graduate from medical school at Morehouse School of Medicine!"

"That's fantastic!" I replied. "Where are you going?" He told me and I congratulated him. Genuinely, too. Because matching into a residency program is a big effing deal and a huge accomplishment. And since he stood there still smiling, I repeated myself. "That's really, really awesome."

And I said that because it was. But then he jogged my memory about how we'd met:

About 5 years ago, I was making rounds at Grady one afternoon. This young man was working as a one-to-one patient safety sitter (not for the faint at heart at ALL) and, since his patient was fast asleep, he'd brought along books to study to make the most of his time. I was seeing the patient in the next bed over and couldn't help but notice how fervently he was scanning the text in front of him. This kid meant business.

"What are you studying?" I asked him.

"Ma'am? Oh, studying for the MCAT," he replied.

And honestly? I mostly remember was that I liked his hustle and the tenacity in his eyes. So I told him just that. Then I extended my hand and introduced myself because I knew what it meant for him to be a black man sitting in that chair studying for a med school entry exam with a black doctor standing in front of him.

I really did.

This was 2013--within the year that Deanna had passed. My intention with people changed when she died. Even the tiniest moments I think about, wonder about . . like, "Hmmm. . .. what am I supposed to be doing with this one moment in time with this person?" Heavy, I know. But this was my paradigm shift. And so. I know exactly what happened next: I gave him a word of encouragement and told him that I was sure he would become a doctor. And that big smile on his face showed me that he believed me.

Then I took his picture so that I would remember that moment in time. And I am so glad that I did.
Yep.

You know what? When I ran into him, I didn't remember him. But you know what? He remembered me. He also remembered that I encouraged him, too. Then he reminded me that I had taken his picture that day. Sure did. And I knew then and there exactly who he was and could see the moment crystal clear.

Here is what I know for sure:

Life is but a twinkling of an eye. Every little sliver of time that we get is an opportunity. And sure--from this 2013 photo, it's clear that this young man was already well on his way to succeeding. But I love knowing that God placed me in his path that day and that I noticed him. I really am. I could have walked right by and not seen him at all.

My goal is to see people. Like, for real see them. I loved this moment and the affirmation it brought to us both about the power of letting our lights shine.

Yeah.
***
#idontmakethisstuffup #bestjobever #thisisgrady #choosekindness #hegraduatesinmay #howdopeisthat #whoareyoumissing #speakaword #wordshavepower #morehouseMD #meharryMD #lookatGod #iseeyou

The Gospel.

I was told one thing. That your aortic heart valve was narrow and tight and that, just maybe, one day very soon you would need that valve replaced.

Aortic stenosis. That's what I was told. With clear certainty and not so much as an eye twitch or a blink. From his lips to my ears like it was the gospel. Aortic stenosis.

I entered the room alone. Armed with the gospel that I had been told about you. Aortic stenosis. I spoke to you for a few moments and talked about what was going on. "What is your understanding of what is happening with your heart valve?"

"The blood rush over it in a way that's not normal. They heart valves don't open and close like they s'posed to."

I nodded because, for the most part, that was true. It was. And I went into a description of what it all meant. Your tight and narrow heart valve. I said the words over and over again. "Aortic stenosis" this. "Aortic stenosis" that. You looked a little bit confused but when I asked if you understood you said, "I think so."

I think so.

Next I pulled my stethoscope from my pocket. Slipping the rubber tips into my ears, I looked at you and smiled. You smiled back. Then I gave the diaphragm a vigorous rub with my palm remembering that a Grady elder had told me once: "Even though it don't do much to warm it up, something 'bout seeing you try make me feel good."

So I did that. And I do that. Most times, I do.

I close my eyes and place the instrument on your chest. I follow the map of listening areas taught to me as a medical student and quietly listen for the tell tale sounds of aortic stenosis:

First a soft sssssssshhhh. Then it grows louder to a SSSSSHHHHH. Falling down quickly to the that soft hush again.

I know it when I hear it now. And so, instead of fighting to discern what it is, I am armed with experience. You patiently allow me to confirm what we both already know. My breathing slows. My hand glides with the stethoscope over your skin.

You are so cooperative and kind, I wish I wasn't alone and that a student could be beside me. To hear and learn right next to me. Aortic stenosis.

My eyes open.

Wait huh?

I am hearing sounds, yes. But they are NOT the ones I expect. I squint my eyes and listen harder (as if this changes what the ears hear.) "Can you hold your breath?" I ask. And you do.

Same thing.

A soft whoosh followed by what sounded like a deep sigh between heart sounds. Again and again I listen. And again and again, I hear the same thing.

Shit.

"They told you your heart valve was small? Like tight and stiff?"

"They told me something. I don't know if it sounded like that."

"What about a leaky valve? Did somebody say that?"

"I don't know, Miss Manning. Y'all be saying so much sometimes."

And you're right. We do.

You don't have aortic stenosis. And while you do have an issue with your aortic valve, it isn't that. And though I am not a cardiologist, I can say that right now it doesn't look like you need surgery either.

You were gracious when I told you I was wrong. You shrugged and laughed a little. Like none of it was a big deal.

While my face burned hot like coals.

This happened a while ago. But what it taught me was that, like all gospels, I need to listen for myself, examine for myself and interpret for myself. Because even though a lot of times there is no discrepancy. . .sometimes there is. When telling someone life impacting information, it's good to have at least checked for yourself before talking.

Whew. Preach, pastor.

I also learned that there is a lot we say that gets missed. Yeah, so I work at doing a better job in that area, too. Explaining until you know so. Not just think so.

Yeah.

Last I checked, you hadn't had your aortic valve replaced. You were still doing well and seeing the cardiologists regularly. Today I am hoping and praying that you know exactly why. This is what I am hoping. And that the gospel you hear is the gospel indeed.

Yeah.
***

Get (TF) out.

I used my softest voice. Tender and earnest. Made sure my body movements were slow, gentle and nonthreatening. You'd been through so much already. And even though your distrust and refusal to cooperate with nearly every doctor who'd stepped into your room was so unwavering, I knew that NOT seeing you wasn't an option.

"You'll probably get kicked out," someone said.
"We'll see," I replied.

And so I went.

"Hi there."
Your eyes flung open, suspicious and glaring. "Who are you?"
"My name is Dr. Manning. I'm the senior doctor that's going to be taking care of you."

You stared. Didn't say anything.

"How do you feel?"

Still nothing.

I asked two more questions and you shut me down. "I don't know you," you said. "You could be anybody."
"I could," I responded. "But I'm not. I'm your doctor."

The next things you said made no sense. They flew out of your mouth and splashed against the walls and floors. I tried to grab them up and make sense of them. But I could not.

I could not.

"May I examine you?"
"No."
"No?"
"Hell no."

I didn't know what to say so stayed silent.

"Can I--"
"Get out." That's what you said. Then you said it again. "Get the fuck OUT."

Which is what I did. As you turned up the television, rolled on your side and refused to look at me.

Two hours and some change later I came back. This time you were nice. Like, super nice. Like none of that had ever happened. You complimented my hair and my shoes. Then said it was really nice meeting me. Then you asked me for some strawberry Boost and a ginger ale. And the name of where I got my boots.

The interface between medical illness and psychiatric illness is one of the hardest parts of my job. They wrestle each other to the ground and when they aren't on the ground they play a hellacious game of tug-o-war. It sucks. A lot of days it really does.

But I signed up for this. And you? You signed up for nothing. So I'll keep coming back. Again and again I will.

Before I left, I placed three things on the bedside tray table in your room:

A ginger ale.
A strawberry Boost.
And a piece of paper that said, "Frye. But they sell them on Amazon or eBay for cheaper."

Yeah.

***

Happy Monday.