Early morning Haiku on a Day Off: Already Awesome.

An early morning

Complete with superheroes

is already great.

High Off Your Happy.

"Are you going to celebratory Grand Rounds tomorrow?" I asked my friend and fellow Grady doctor, Lesley M., one day a few months ago.

"Yep. I'll be there," she responded. Then she added matter-of-factly, "I was actually nominated for an award, so I guess it would be poor form to not be there."

"Um. . . yeah!"

"Sit together?"

"It's a date."
___________________________________________________

Every year, our Department of Medicine has this special Grand Rounds dedicated to celebrating the service, teaching, and mentoring of our faculty at Emory. The biggest awards of the year are doled out during this hour, one of which is called "The Outstanding Clinician Generalist of the Year Award." This one goes to the person the committee deems as the best general internist in all of the Department of Medicine (which happens to be a pretty darn big department.)

This year, my friend, Lesley M. was nominated for that coveted award. I had the distinct pleasure of sitting directly beside her at the program.

Now.

Let me give you some background on Lesley M. We both joined the faculty the same year, and have been great friends ever since. She could possibly be one of my favorite human beings.

Not only is she kind, smart, witty, and empathic, she's a great friend and an even greater mommy-slash-wife. She laughs at my dumbest jokes, and doesn't mind if I retell her a story that she's already heard before. She doesn't mind when I want to have lunch at Whole Foods instead of a shmancy restaurant, and agrees that the right pair of shoes can make you happy. And. She read my blog back when there were only two followers.

Oh yeah, and even though she's not the commenting type, she always says little things to me in the hallway to let me know that she's still reading.

Two Grady doctors

On top of all of those things, she is also an absolutely amazing clinician. Really. She effortlessly drops her knowledge like a stealth bomber; without a stitch of fanfare. She simply does her thing in her Lesley way, and that's that. And. She has a heart of pure gold that she cracks open like an egg right on top of every single patient under her care. Her easy confidence makes you want to be her patient, her friend, or both.

I think your favorite people should have a few qualities that you aspire to have yourself. If that's the case, Lesley M. is exactly what you want in a friend-slash-colleague. It made me happy to know that someone else thought she was just as great as I do (since I was not the one behind her nomination.)

And so.

We sat in the auditorium side by side. Lesley M. quietly perused the program; looking very calm-cool-collected in her very Lesley way. This unique mixture of genuine humility peppered with just the right amount of self-awareness to accept that she is a damn good doctor--so her. In my heart, she was already the winner. But still. I felt butterflies as we waited for the awards ceremony.

One of our senior faculty members was given the honor of announcing the recipient of this particular award. Instead of just ripping open the envelope and saying, "And the winner is. . . ." he instead chose to eloquently torture us and build up the suspense.

"Ever since she joined the faculty. . ."

Okay. It's a woman. It's a woman, okay.

". . .she has consistently delivered exceptional care to a population of patients that at times had been forgotten. . ."

Lesley totally does that. She was one of the founders of our Liver Clinic, devoted to treating patients with Hepatitis C. OMG. I hope it's her. I hope it's her.

". . .Under her leadership, the clinic she helped to start at Grady Hospital over five years ago is now one of the busiest in the primary care center and also the subject of thriving research. . . ."

Wow. It's her. It has to be Lesley.

The rest of his words swirled around the room like a complimentary ribbon floating behind an airplane. Then, suddenly, I was overcome with emotion. The more accolades he delivered, the more my eyes welled up with tears. Lesley says that I was doing "the pretty cry" -- but it took a lot of restraint and imagery of funny things to keep me from taking it somewhere else.

". . .It is with great pleasure that I announce this year's recipient of the coveted Outstanding Clinician Generalist Award. . .Dr. Lesley M."

By this point, I was losing the battle of snot and mascara. (You know, that point where you discover that the side of your palm isn't absorbent of tears and mucous? Yeah, that.) Lesley tells me that this was one of her favorite parts which she was careful to include when describing, in great detail, the entire moment to her husband, Rich.

Oh, and did I mention that the School of Medicine photographer kept snapping photographs of me crying and wiping snot through the entire announcement?

Ummm. . .yeah.

***

Today I am reflecting on how wonderful it feels to be a spectator when someone wins. Especially when you care about them, but even when all you know about them is that they're deserving. Celebrating the triumph of someone else is a special kind of high that happens to be one of the few habit-forming ones that this doctor would recommend. It's a great high. And best of all, the more you get of it, the more it makes you want to be better.

For this reason, I make it a point to nominate people for awards at least once per year (although Erica B. beat me to the punch on this one), and also do my best to be the one in the audience who completely embarrasses them with my hooping, hollering, and over-exuberant fist bumps. I've said it five trillion times before, and I'll say it again: Flowers are for the living, man. And if you think getting your own bouquet gives you the warm fuzzies, try giving one some time. Trust me. The minute you do, you'll know exactly what I mean.


L'chaim!*

So here's to you, Lesley M. . . . . . here's to the "pretty cry," and here's to the joy of seeing you win. Even though it ruined a perfectly good application of drug-store mascara, it was worth it. 100% worth it.


Take home point: The thing about celebrating someone's win is this--it immediately becomes win-win. Got it?

I'm saying: Lesley M. is the mother of the second grade child who took it upon

himself to create the above masterpiece: "The Dalai Lego."

Who does this??? By definition, his mom has to be awesome, right?

________________________________________________________________________
*Hebrew lesson courtesy of several of my favorite Grady doctorfriends, including Lesley M. :)

A Long Time Coming.

"It's been a long. . .a long time coming. .

but I know. . .a change is gonna come. . "

~ Sam Cooke's "A Change is Gonna Come"

__________________________________________________

Walking on the side of Grady yesterday, next to the McDonald's entrance:

A Grady elder smiles at me near the steps as I enter the hospital. A tall man--at least 6 foot 3--wearing a newsboy cap, a plaid shirt and a pair of weathered chinos. His salt and pepper hair is neatly cropped around a gleaming strip of scalp that hadn't seen hair for some time.

He has The Atlanta Journal Constitution tucked neatly below his right armpit, and manages to keep it secure as he tips his hat to me with his right hand. Picking up his pace to share my brisk footing, he catches up with me.

"Didn't I see you on TV last night? On CNN?"

"Yes, sir, you did."

Looks at me and smiles wide and proud. I like the twinkle in his eye. "I thought that was you! You know what? You did very well, young lady. You really did."

"Thank you. I really appreciate hearing that, sir. I really do." I decide to stop walking and face him. I want him to know that I mean that. I was nervous and scared, and hearing that feedback from someone other than my parents means a lot. He looks back at me with an expression that I struggle to explain so won't even attempt to explain. His face becomes serious.

"Do you have any idea what it mean to somebody like me to see you talking on that news show last night? Do you?" He pats his chest for emphasis.

Silence. I don't know how to answer that.

"It mean the world, young lady. The world. I wanted to cry when I saw you. I said to my wife, 'Come here! She work at Grady! I see her all the time right there at Grady. Right there at Grady Hospital!'"

I think for a moment and try to see if I can get my mind around what it was that he was feeling. I estimate his age--at least seventy-five--and note the Southern twang in his voice that gives away that he was brought up in these parts. I ponder the headlines in The Atlanta Journal Constitution that he has seen and lived in his lifetime and feel a wave of indebtedness.

I clasp my hands together and nod to him in deference. It's all I can think to do.

The tall Grady elder looks me in my eyes, tenderly and carefully. His telling eyes are glassy, almost pleading.

"We so proud of you, Miss Manning . . .so proud. And we rooting for you, okay? We rooting for you."

Rooting? For me?

Now, I want to cry, too.

Tickled Pink.

Today at Grady:

I meet this lovely Grady elder who was dressed head to toe in pink. Pink hat, pink shirt, pink warm-up suit, and even pink socks and sneakers. She was definitely doing the "pink thing."

"Hi, I'm Dr. Manning. How are you today?"

"I'm blessed and highly favored, baby."

I can't resist commenting. "You sure are pretty in pink today!"

"You know why, don't you? It's the breast cancer month!"

"That's right, ma'am. It sure is."

"October."

"Right."

"You see my earrings? My pin? They have the pink ribbon." Points these items out. Then, pulls up her sleeve. "My watch is pink, too."

"Wow."

"I'm even wearing some pink undies!" She slaps her leg and cackles in this very animated way. Almost like a scripted, blocked, and pre-planned knee slap. But I know this is just her. A content Grady senior, tickled pink to be telling me about her pink britches in honor of "the breast cancer month."

"Well! You are just a pink lady today, aren't you?"

I smile. She smiles back, but a bigger, better one than mine. I decide to remember that smile for later.

"Ma'am?"

"Yes, baby?"

"Are you . . . .a breast cancer survivor?"

"Nine years and counting, baby. Nine years and counting." She sits up taller. She smooths out her warm-up suit. "Never had nothin' on no mammograms. And then just like that they saw a spot that they thought might be nothin'. But my doctor at Gradys said, 'Let's just be sure.' It was cancer, but I took all my treatments and it's gone. It's all gone going on ten years."

"Amazing."

"I'm happy."

"Me, too, ma'am."

"I'm happy that I lived to tell. 'Cawse I have a testimony."

I look at her leathery brown face framed with coarse white curls exploding from the beneath her pink cap. I imagine her marching proudly at a breast cancer walk in that very outfit but with a pink boa, too. I see her amongst a throng of other survivors and the people who love them. I allow that last part to resonate and put it on a mental post-it note. I decide that it's good for the soul to hear somebody's testimony. Especially when they lived to tell.

"Wow. You are blessed."

"And highly favored, too, baby. Don't forget that part."

I smile. She smiles again. Still bigger and better than my smile. I decide to remember that one, too.

Loose Interpretations.

*patient names, details, and identifiers changed. . .but the message is the same.

image credit

There was this exercise I participated in once at some workshop at a medical meeting where we wrote narratives in patients' voices. Kind of like your interpretation of what they might be thinking or feeling.

It was pretty powerful. Man. What a great way to really connect to how a patient might feel and really humanize them. I revisit that little process every now and then to, as my advisee Antoinette and I always say to each other, "keep it human." Most times I just carry out the dialogue in my head, but other times I'll actually put it on paper.

By the way. . .even if you're not a doctor, you should try this sometime. Hospitals aren't the only places where empathy is needed. . . . . .

 photo credit

Mrs. Xie.

There was this sweet octagenarian woman from rural China who had been an inpatient on my hospital service once upon a time. She couldn't speak more than two or three words of English, so would only smile at most things said to her during her entire stay. I hated being unable to communicate with her, but she never seemed to let it ruffle her feathers. She always seemed to have such a sweet and gracious disposition. It pained me to see the confusion in her weathered eyes each time we entered the room. She deserved to be heard.

This trip was on her "bucket list". Family had fulfilled a lifelong dream of hers to visit to the U.S. and she was elated.

That is until she got sick. Headaches on and off. Pain in her leg and really, really high blood pressure. We admitted her for management of a hypertensive emergency, and to further explore the pain in her leg. Years of smoking had done a number on her arteries which decided to give up on sending blood to her right leg. A complete blockage at the femoral artery, right in the groin area, left her with a tender, mottled leg--all the way down to the toe.

To make matters worse, she spoke a Chinese dialect that few people (read: nobody) in the hospital had in common with her. These are the times that you kind of wish you lived in a city like New York or San Francisco, for real. (Interesting sidebar: My friend and former Grady doctor, Natalie L., works at Bellevue Hospital in NYC and they have an entire Chinese-language-speaking medical and psychiatric ward!) But we were in Atlanta, not New York City. Bummer.

We pointed at the sign for interpreter services.

"Mandarin?" Smile.

"Cantonese?" Smile.

It wasn't one of the ones on our in-house interpreter list. Or what if this was a literacy issue? This sucked.

One of the inpatient pharmacists, Val, came to help me out. Val is Chinese and was fortunate enough to learn both Mandarin and Cantonese as a child. In a pinch, she's always gracious about stepping in to interpret for me, despite her busy schedule. If the issue was that my patient could speak but not read Mandarin or Cantonese, this would be money.

Val spoke to the patient. The patient spoke back to her in a wobbly voice that, no matter what language you speak, seemed difficult to follow. Val looked at me and shrugged. Her eyes were apologetic.

"I'm sorry, Dr. Manning. This is some kind of dialect that I just can't make out. Her last name is a Mandarin last name so I thought she'd at least speak some Mandarin. But honestly, it's not unusual for older people from certain areas to only speak dialects other than Mandarin or Cantonese. Sorry I can't help."

Dang.

To make matters even worse than the worse that I mentioned before, she was sick-sick. That leg pain of hers turned out to be severe peripheral arterial disease. Her right leg was getting no blood supply and the clock was ticking. She needed surgery ASAP to either open up those blocked blood vessels or if that didn't work, an amputation.

But she was almost eighty nine years old. Would she want such aggressive treatment? How did she feel about the possibility of an amputation? Not getting surgery would be life threatening. Getting surgery could also be life threatening. Sometimes when people are sick-sick and well into their eighties, they don't mind life threatening situations. But for her, we didn't know any of that. And that sucked.

She had two family members that worked full time. They would come when they weren't at work (which wasn't often.) They owned a small business and had no choice but go to work each day. Most of the time, the patient was there alone. So there she was. . . . in this mystery land with a mystery language while fighting a mystery illness. I can only imagine how she must have felt. . .. .

6:08 a.m.

Can't sleep.  The television next to me is too loud.  I also think I need to move my bowels. I haven't had one in three days. My leg feels like a tooth that aches.

Lady with brown skin comes in smiling at me. She keeps nodding her head over and over again. I think I do understand that word, "MAM."  Always with two words I know in English: "yes" and "no." I think "mam" means thank you? Or please?

Brown lady shows me a pillow. But I think the pillow here is too itchy. Or something. That television. It is too loud.

"Mam." Thank you for offering, I really want to say, but this thank you will have to do.  I smile and shake my head. I don't want another pillow. I think she understands what I said.

My stomach is hurting. I need to have a bowel movement. Maybe this medicine is making it worse? I don't know. And my foot hurts, but just on my toe.  I move the cover over it softly because it hurts. Ouch.

Brown Lady is smiling at me again. Maybe she is a nurse? What is the word for nurse in English? I don't know. How do I say "excuse me" in English?  Is it "please?"  Oh man. I am not sure.

"Please."

Brown Nurse Lady just looks at me and smiles.  I squeeze my stomach. I want her to know I need to move my bowels and that my toe hurts. I think this medicine is making it worse. Helps my pain, hurts my bowels.

Brown Nurse Lady looks at me and smiles again. She says words that I do not understand that sound like that loud television next to me.

"Don't worry, they will be coming around shortly with the breakfast trays."

What? Does this mean she understood what I was saying with my hands? I hope so. I nod my head and say "thank you."

"YESMAM." I say. That is, Yes, thank you.

She leaves.  Television still too loud in bed next to me.  I don't even see a patient in there. I think they took her to a test. Maybe nice Brown Nurse Lady will come back and turn off the television for me.  Push the call button. Picture of a nurse lights up and a voice follows.

"How can I help you, Ms. ZEEE?"

Voice comes in saying words I do not know. Except the last part ZEEE which, I'm thinking she thinks is how I pronounce Xie. She speaks again. I still don't understand.

"How can I help you?"

"PLEASE?" Excuse me?

"Ma'am?"

Why is she saying thank you? Never mind.

I hear some voices. Laughing. Speaking in English and I still don't know what they are saying. Voices get closer.

Someone greets me. Then they go to town examining me.

"Mrs. ZYE. . . . "  They said a bunch of other stuff after that that made no sense to me. And they mispronounced my name. Again.

Hands near my groin. Pushing hard with gloved hands. Gloves off. Push again with fingertips. Now on the back of my leg. The top of my foot. Feeling for pulse? They look worried. Doctor in a short jacket runs out and comes back with device to look for my hiding pulse. They squirt clear jelly on my foot and move that thing around. Doctor in short jacket keeps looking scared. Doctor in long coat helps, but nobody can catch my pulse.

They look at each other and talk to each other. They look afraid which makes me afraid. Somebody tries to talk to me but all I can do is smile. I am grateful that they want to take care of me. But I wish I understood.

They wave good bye and prepare to leave.

"MAM." I say. Thank you. Want to ask about my bowel movement, but don't know how.

Brown Nurse Lady comes back. Still smiling. I point at the TV that is still too loud.

"PLEASE," I say to get her attention. Excuse me.

She comes over to me, smiles and squeezes my hand. I like this lady and also like her hair. I want to touch it, but I don't.

She turns my TV on. Not that loud one that isn't getting watched off. NO!  I don't want my television on. I want hers off. I hate the laughing sound from those recorded laughing voices. Why do they have that? Now I get to hear it double.

"PLEASE," I say. I point again. This time she turns it up a little louder.

My stomach hurts. Can I have something for that? She puts something inside the IV. I fall asleep.

I awaken to more hands groping my pulses. Everyone is wearing green uniforms like pajamas. Talking, pointing, nodding to each other. But not to me.

"She needs to go to the OR tonight," one of them said.

"Where is the family? How can we consent her?"

"Wait, is she a full code?"

"How is her cognitive function? Is she decisional?"

I have no idea what they are saying. But I am grateful.

"MAM," I say. Thank you.

Later on my nephew and his wife are there when I wake up. I am so happy. I feel like I've been locked in a tomb and they just arrived with the key. Now they can turn off that television and listen to me.

My foot is hurting like a really, really bad tooth. Tip of my toe looks a funny color to me. The team with the short jacket Doctor and the Green Pajama doctors are all there together. Everyone looks worried. Now I am worried.

Green doctors say a whole, whole bunch of words. Nephew looks to me and says,

You need surgery. There is no blood going to your right leg. So you need surgery. Or you will die.

Surgery? This is something I'm not sure about. I ask can he call my daughter. I know she is in China but I want to talk to her about this.

No, you need surgery, he says. It is an emergency. They said right now or you will die.

Feel sad about dying and not speaking to my daughter first. But otherwise, would rather make a peaceful transition than have surgery. I think my daughter would not object.

I tell my nephew. I don't want this right now. I want to speak to my daughter.

There is no time for that, he says. It is life or death.

They all talk some more. They all look at me.

"MAM," I say.  I am grateful that they are spending so much energy. But my life has been good. I want no leg pain, but surgery, I don't think I want this either. I want to tell my daughter. Can't we call her in China?

It's an emergency, my nephew says. If you were back home, then okay. But I cannot let you die here. You need the surgery. It is an emergency.

So that is that. I am afraid. I am nervous. I want to speak with my daughter. Had not seen this nephew since he was a little boy. Would rather speak to my daughter.

But I am grateful that they want me to feel better, though.

More medicine in the IV and I drift off.

Knuckles on my chest. Pushing in harder and harder.

"Ma'am. . .Ma'am?"

Why is she thanking me?

My eyes flutter open and I see young, young looking doctor with short jacket like that other one. Looks very  new at this. Feel very nervous at the sight of her. Younger than my youngest grandchild.

She says, "SHIH? SHIYE?"

She wants to say my name correctly. She is trying. I like her already. Close enough. I smile. She smiles back.

Short coat green doctor then takes out her phone from her pocket. Makes a phone call. More words I don't understand. Then she hands the phone to me.

I hear a voice through the phone. First I don't understand. Mandarin and then some kind of Cantonese. Then. I understand!

Her friend worked in something he calls Peace Corps. He told me about my leg. I told him that I did not want surgery. I want to call my daughter and tell her. He asked if I understood it could take my life. I tell him my life has been perfect. I ask him can we call my daughter. He says he is only a medical student, but will see if he can help.

Asks a few other questions, but these are silly. Where are you? What day is it? What is your full name? I tell them all of this. Phone-a-friend tells me that they will call me back. Short coat green pajamas young, young doctor leaves really fast.

Comes back with all of the Green Team. Takes out phone again and now it is a speaker. Phone-a-friend asks me the same questions over the speaker phone. I say the same answers. And also, Can I call my daughter? In China?

I also ask him how to say "thank you" in English.

It isn't "MAM."

12:35 a.m.

On a flight back to Beijing "at my own risk" and "against medical advice." Daughter flying to Beijing to meet me. No surgery. Just pain medicine. And pain is there but manageable. But that's okay because  Nice Stewardess keeps checking on me the whole time. She can only speak Mandarin and English, but she is nice and I appreciate the attention. I feel safe.

She puts a cover over me as I feel myself drifting to sleep. Before I do, I look up into her eyes and smile.

"THANK A-YOU," I say.  

 "Yes, ma'am," she replied.

 This time, nothing was lost in translation.

Kind of a big deal.

Zachary: The one who has never chosen to sit it out (even as an 18 month old.)

 "If you have the chance to sit it out or dance,

I hope you dance. . . .I hope you dance."

~ from Lee Ann Womack's "I Hope You Dance"

 ____________________________________________________________

This is what the church folk down South and the Grady elders call a "praise report."

 Okay. I was on the fence about sharing this in this way. But I have to share this because it's something that I sort of put on the vision board  I started over a year and a half ago. (I secretly buried it in an earlier post, but was cryptic about it.)

I debated back and forth, about mentioning it here. Would it be weird to unabashedly tell this on the mountain? Would it be a little too self-important?

So that's where I was. Say something or not? Hmmm.

But then I remembered these words that I have posted on my office door at Grady:

Our deepest fear is not that we are inadequate.

Our deepest fear is that we are powerful beyond measure.

It is our light not our darkness that most frightens us.

We ask ourselves, who am I to be brilliant, gorgeous,
talented and fabulous?

Actually, who are you not to be?

You are a child of God.

Your playing small does not serve the world.

There's nothing enlightened about shrinking so that other

people won't feel insecure around you.

We were born to make manifest the glory of
God that is within us.

It's not just in some of us; it's in everyone.

And as we let our own light shine,
we unconsciously give other people
permission to do the same.

As we are liberated from our own fear,
Our presence automatically liberates others.

—Marianne Williamson

I read this every day when I come to work. And I always have to reread that middle stanza. It reminds me to let my light shine.

Reflecting on this helped me to be okay with admitting to myself that. . . well. . . .this shout-out was kind of a big deal. (At least to me.) I'm happy. I'm flattered. I'm inspired. And. . .dare I say it? I'm. . .kinda proud of myself. There. I said it.

::Gasp::

Must we always have the "kinda" there to water down a "yay me" celebration? Why can't I just be more like that Zachary and his brother? Is there anything more audacious than the confidence of little kids? Talk about dancing like no one's watching. This shot says it all:

Zachary aka The Great Poodowski: our hallway circa 7pm tonight.

To quote Isaiah:  "'Yaaay me' does not mean I'm saying 'Booooo you!'"

Words to live by, man.


Wait . . .so how in the world did this go down?

Essentially, a really cool freelance writer named Madonna Behen (her name is even cool, right?) randomly found and read my blog. I thought her first email was a gag. Anyway, she was just surfing the net for a story she was doing on medical bloggers and found the little blog that could (aka the one you're reading now.) Actually, she found it linked from another much more popular blog (one with double digit comments on nearly every post and quadruple digit followers.) Oh did I mention that this is my measure for blog-royalty? But I digress. . . .

Oh yeah. . . .so anyways, that's how it went down. The little blog that could (aka the one you're reading) ends up nestled right in there with some blog royalty. In Oprah Magazine, no less. Bananas.

"So random."

Funny. All week I've been referring to this as "random." But is anything really random? I don't really think so.

Hmmm.

I find it interesting that the cover asks, "What's your true calling?"


I started this blog on August 8, 2009. Shortly after that, I wrote this:

"Do you ever do something and feel intensely like it's totally what you were born to do? Do you? I sure hope you do. Because that's how I feel about my life as a clinician-educator at Grady Hospital. I really do." *

*(Being born to love Harry and the cocopugs goes without saying!)

Assessment: Wow.

Plan:  Dream bigger.

Hope:  That we all dance instead of sitting it out. Shall we?
 
________________________________________________________________

P.S. Was equally thrilled to get honorable mentions this week on two of my FBE's (favorite blogs ever): Smacksy and The Startup Wife. Wow. Maybe I should redefine my personal definition of "blog-royalty." :) 

One is enough.

*names, details, etc. changed. . . .you know what's up.

"Baby, I can fly like a bird. . .

When you touch me with your eyes.

Flying through the skies, I've never felt the same

But I am not a bird

I am not a plane

I'm Superman."

from "Superman" by Barbra Streisand

____________________________________________________________________

Sometimes I wish I was a superhero. Better yet, two superheroes. Like one with super powers to do things like write long prescriptions in a single bound, and another to wipe snot from my kids' noses and console crying patients. But I know I'm not a cloned superhero. I'm just one person with two feet, two arms, and one brain. I work with what I've got.

I do still wish that sometimes, though.

Yesterday morning was crazy-busy. Our clinic session, which is supposed to end at noon but rarely does, kept chugging along despite our efforts to hustle. On Thursdays at Grady, our General Medicine division meets for a lecture or general business. Today, one of my friends was the presenter. I really wanted to make the meeting.

Fortunately, we have a system where a colleague comes to cover the noon hour while others make the meeting. We all take our lumps on this coverage schedule, but there's this unspoken rule that a few of us have where if it's crazy-busy, you stick around and help. At least to tie up loose ends.

There seemed to be a lot of loose ends yesterday. But still. I really wanted to make that meeting.

The more I'd kept trying to get out of the Residents Clinic though, the more things kept popping up. Like:

"Dr. Manning, somebody told this patient just to come down here and get a flu shot. She was in another clinic already. I know they have flu shots up there. That's ridiculous. I explained that you can't just walk in like that."

I look at patient: a doe-eyed woman on the brink of me deeming her a "Grady elder." I recognize her as one of our regular clinic patients. Hmmm. I make a quick glance at the clock: already past the 12:00 start time of our meeting. Uggghh.

"Okay. Well, tell me this. . . . what would we need to do to give her a flu shot here?"

The nurse looked at me and, I'm pretty sure, gave me the hairy eyeball. Dang.

"She could just go back to the specialty clinic where she was," she counters. I nod in acknowledgment.

"I mean. . . she's our patient," I say, "Yeah, she should have gotten a flu shot up there, but can we actually do it now that she's here?" I look at the patient and add, "I'm glad you know how important it is to get your flu shot."

The busy (and seriously, awesome on most days) nurse just sighs and says, "Fine, Dr. Manning. We'll just check her in." She muttered something under her breath as she walked off, but that was okay. I have a good working relationship with this nurse, so knew that she was just frazzled from the morning, just like me.

Okay. Now I can go.

A patient in a room calls me by name. "Miss Manning!"

I look. I don't know her. I walk over and raise my eyebrows. "Hey Miss Manning. . . .I see you on Fox 5 and you give some good information."

A compliment. Right now, I'll take it. "Thank you very much, ma'am. I appreciate that."

"Can I ask you a question?"

Despite the protests from my growling stomach, I oblige. "Sure."

"Do it mean you might have breast cancer if you had to repeat your mammogram?"

Loaded question. Great. I can't do it. Not this. Not now. "Did you see a doctor this morning? I'm sure they can review that with you, because it really depends on a what the mammogram showed."

She looks tearful. Ugghh. "I am waiting until my doctor come at one. I just got checked in. But I was. . . .worried. . . 'cause. . . I just been worried about the result and what it say. I ain't been sleeping 'cause I been so worried, waiting for this appointment." Tearful evolves to quiet crying with eye-patting.

Damn.

I get her name off of the chart and address her as such. "Ms. Campbell, give me a minute and I will pull up your mammogram result. Your doctor will go into it more with you, but I can check to make sure it's up."

"Thanks."

I go to the computer. Telling myself that this is crazy. Could be stepping into a bomb. Why are you getting involved? Her doctor will be here in 45 minutes. Tell her to wait. But I don't. I look. And thank goodness, it is just a simple need for "compression views" in a woman with large breasts. Repeat mammogram free of signs of cancer. Radiologist recommends follow up in one year. Cool.

I tell Ms. Campbell. I tell her that her doctor will examine her and explain more. But don't worry. She is so happy she cries. And hugs me.

It's 12:35 p.m.

Now I'm really trying to go. Then, I see one of our newest faculty members looking perplexed. She is stuck in the clinic still trying to sort things out that aren't user-friendly to a new person. "You okay?" I ask. (note: this is a rhetorical question. answer should be "I'm fine!")

"Ummm. I'm trying to admit someone to the hospital. . . but I'm not sure what to do next."

Damn.

We work together, we get the patient admitted. It's now 12:43.

That superhero clone of me would really come in handy now. One could be at my friend and former Grady doctor, Christina P.'s, presentation at 12:05 at the latest. The other could have stayed behind to help. But I'm not a superhero with a clone. So this will have to do.

I do still wish that sometimes though.

I approach the double doors leading to the exit of the clinic, and I see Nurse C. talking and smiling with the patient from earlier in one of the clinic rooms. She had just administered the flu shot to the patient, despite the hassle of another late check-in. She caught my eye and winked at me. It was her way of saying, "We're cool." I appreciated that gesture.

Once out of the clinic, I scurry down the hall and toward the stairwell. My stomach is hitting high notes, wondering what's up with the lack of food. I'm walking 60 mph and simultaneously looking at my iPhone to make sure I didn't miss any emails. As I am sure you can imagine, I nearly mow down this patient making his way to the elevator.

I had dropped my coat and phone with the collision, but fortunately, he seemed okay. I apologize for not paying attention, and we both bend down to collect my belongings together. Just then, I realize that I know this patient.

"Mr. McCoy?"

"Heeeey, Kimberly!!!!" He let out a hearty laugh and gave me a big hug.

Mr. McCoy was a patient on my team a while back. He was, hands down, one of my F.P.'s of all time. (F.P. = favorite patient.) When he was on our hospital service, he'd passed out from what we discovered to be severe problems with his aortic valve. He needed that valve replaced.

Problem was he actively used crack. And was homeless. And didn't take his medications. There was some fear that he wouldn't follow up or take the required lifelong blood-thinner after valve replacement surgery. Despite all this, he had the best attitude of any patient I'd ever seen. He said, "I can do this, Miss Kimberly. I know I can." Seeing him on this day made me realize that I never found out exactly what happened with him. I left the service before a verdict was rendered on his valve operation.

"You doing alright, Miss Kimberly?" He handed my coat back to me, and smiled.

Mr. McCoy asked me on the first day we met if he could call me Kimberly. Funny. I'd never been asked by a patient permission to be called by my first name. At that point, he was already my F.P. for that day so I obliged. Kimberly or "Miss Kimberly" it was.

"I'm doing great, sir! But how are you? What ever happened with you?"

He gave me the biggest, warmest smile ever and then pulled his shirt apart like Superman. A well-healed vertical incision went straight down his sternum. That's when I knew that he'd had the valve replaced. He looked good, too. Healthy. Well groomed. Robust.

"Baby girl, I'm like a new man!" We both laughed. "I got my surgery. . .now Kimberly, I told 'em, 'Give me a pretty scar, 'cause I got to have a pretty chest!'" Awesome.

I stand there looking at him. Later and later for the last few minutes of the meeting. Will probably even miss out on the lunch. But this was worth it. I was really happy to see Mr. McCoy. I feel myself beginning to fret, hoping he is off the crack. He was insightful.

"I'm off that mess, Kimberly. I put it down. I even got a place to stay, too. No job yet, but my brother got me doing little jobs here and there with him. I go to Coumadin Clinic and the heart doctors. They said I'm a good patient. But I told 'em that Miss Kimberly already said that 'cause I was her favorite patient." Ha. True indeed.

"Wow. That has made my day, Mr. McCoy. I'm so happy I saw you."

"And I'm so happy I saw you, too, Kimberly. But you look like you lost a few pounds. I hope you eating."

(Is it bad that I wanted to hug him again for accusing me of weight loss?) I decide to let it be a compliment considering ninety percent of all comments I get in Grady Hospital regarding my weight are the converse of Mr. McCoy's.

"Naaah, just watching what I eat. It's so good to have seen you, and I am so proud of you, sir."

"I'm proud of me, too." Love that response.

"And you know what, Mr. McCoy? You are still one of my F.P. all-stars. That means you will always be a favorite patient of mine."

"Babygirl, I knew that already!" His hearty laughter rang down the hallway. "But for real, Miss Kimberly, I want you to know. . . .you my favorite, too."

Aaaaahh.

I gave him a big hug and waved goodbye to him.

12:53 p.m.

When I reached the faculty office building, I had already missed all of the meeting, including Christina's presentation. But I was able to give her that hug.

As I scarf down what remained of lunch, I now know one thing for sure: I had been exactly where I was supposed to be at the time I was supposed to be there. I also know that if I'd had a clone, she would have missed out on seeing Nurse C. wink, on allaying the concerns of an anxious stranger, and of course, being there to witness Mr. McCoy open his shirt like Superman.

Nope, I am not a bird, and I am not a plane. But I do feel kind of like Superman sometimes.

I decide that one of me is enough.

Get Yo'self Free.

Isaiah and I were running late getting out to the bus this morning. I hate it that I'm constantly rushing. . .rushing me. . . rushing him. . .uggh. . . rushing to the hospital. . .rushing to pick up the kids. . . and starting it all over by rushing to the bus. . . yeah.

I keep saying I'm going to do better, but unfortunately, this was yet another day of just that: The rush-rush.

I'd say that at least 50% of the time, I'm rushing. And during that 50% of the time when I'm rushing, depending upon how late I am, I'm all business. Time to hustle. No time for "hee hee ha ha," I tell the kids. But especially Isaiah when we need to get out to that bus. There will be consequences and repercussions if we miss that bus, I say. Like me wanting to punch myself in the head in the carpool line. This morning was a rush-rush morning. Lost track of time and realized I was behind the 8-ball. Let's go, bud. No time for "hee hee ha ha."

7 minutes to get to the stop. Time is ticking. Let's move and groove, I tell Isaiah. Out the door, hustling. Isaiah unfazed by the rush-rush (as always) and equally unfazed by the request for "no hee hee ha ha."  He, in fact, 100% refuses to participate in my 50%-of-the-time rush-rush and is almost always down for some "hee hee ha ha." This was one of those mornings.

We were clearly on different pages.

"Bud, let's hustle."

"Hee hee ha ha."

Awesome.

But fortunately, without fail, Isaiah has a way of breaking me out of my "all business rush-rush" mode, even when I don't think it's possible. Usually, he achieves this by saying something unexpectedly hilarious. Even early in the morning, he can come up with a winner. Even when I'm ultra-harried and feeling like "no hee hee ha ha" he manages to flip the script. Completely. Today was no different.

It started when we ran out the front door, making every effort to do the rush-rush, yet at the same time trying to do so very quietly  (so as not to wake up the Great Poodowski.)  As I closed the door, and said "Sssshhhhh!! Inside voices since people are still sleeping!" -- here is the first thing Mr. Hee Hee Ha Ha/I have no "inside voice" said:

Tip-toe-ing exaggeratedly down the front steps in the silliest way ever. . . .

"You know, Mom, we could . . . .  Just slip out the back, Jack!"

::hee hee::

I looked at him, smiled and shook my head. The next part, in concert with the beat of our feet heading toward the bus stop (kind of like those little-drummer-boy-sounding drums at the beginning of that song) went something like this:

"Just slip out the back, Jack! Make a new plan, Stan! No need to be coy, Roy! Just listen to me. . . "

::giggle, giggle, snort, snort, hee hee, ha ha::

"Or Mommy, I can . . . .just hop on the bus, Gus!"

::snort, giggle::

Throws head back for this part and really rocks out: "No need to discuss MUUUUUUCCCCCCHHHH! Just drop of the key, Lee."

Then, in a super-quiet voice, and with a super silly pseudo-serious face, he looks at me and says,

"And get yo'seeeelf free."

Wow.

Now you tell me: How can you not hee hee ha ha to something like that coming from a five-year old? Answer: You can't.

***

Okay, so while I must admit that I'm not looking for fifty ways  (or even one way) to leave Harry (aka "my lover"), this did remind me to slow down. . . .to ease up on the "all business" and to allow a little more "hee hee ha ha."

And get myself free. :)



 FAQ: Why on earth was your five-year-old child singing a Simon and Garfunkel tune on the way to the bus stop? 

Answer: Okay, okay .  . . me and the boys sing a silly version of this called, "50 ways to Leave Your Brother." (Wait, is that bad?) Anyways. . . . it started when Zachary didn't want to leave the park one day, and it worked like the Pied Piper to get him to the car. (It also works wonders to end a temper tantrum. . .) 

Paul Simon would be proud. 

(Hee hee ha ha.)

This One Time at the Gradys. . . . .*

~ names, details, etc. changed. . .you know what's up. 

photo credit

 This one time, at the Gradys. . . . .

An excellent young resident physician was talking to one of our ninety-something year-old Grady elders at the end of her hospitalization. Upon the request of his attending physician, the resident broached the subject of advanced directives with the patient. . . . .

"I just wanted to be sure that we were correct about your wishes.  If something was to happen to you where you had trouble with your heart or breathing, you would want life support?"

"I definitely, definitely want life support."

 "Okay. . .  . .I was just wondering. . . . you know. . . .Sometimes when a person has been fortunate enough to live to be in their nineties like you, they prefer that nothing heroic be done. That things just be let be."

"Oh, Lord, No! Don't never just let me be. I want the life support. Definitely."

Resident doctor clears throat. Looks uneasy. "My concern is that it could make matters worse. Depending on the circumstances, it might not help at all."

"I can't see why it wouldn't help. If they got to me right away, seem like it would be alright. Plus I done outlived everybody. Most of my kids. My husband. My sisters and brothers. Got a bunch of grands and great-grands, but they ain't no count. It's just me. So definitely. I need life support."

"I am not suggesting that nobody would help you in an emergency or if you were sick. Not at all. I am just saying that especially considering what you just told me, some doctors might recommend that you don't accept life support."

"Well, them doctors would be some fools."

Resident doctor sits there. Just staring. Doesn't know what to say. Patient speaks again.

"Hell, I don't want to be like Juanita that used to play bingo with me. She fell and didn't nobody come for her for three whole days. That ain't happening to me. No suh! I want the life support."

::ding::

Lightbulb moment.  Ah hah.  "Ummm. .  . . Mrs. Flournoy. . .what do you mean exactly when you say 'life support?'"

"You know. . . .that thang you put 'round your neck that you can mash to call somebody if you fall down by yourself or need some help."

Aaaaahhhhhh.

"You mean 'Life Alert?'"

"Whatever the hell y'all call it. I want that thang I can mash if I fall or something. Juanita's hip was broke in two places and nobody came for three whole days. She was in her nineties, too."

"Oh, okay."

"You need the life support when don't nobody come to see about you that much. Now my sister, Willie? Her kids and 'specially her grandkids, they see about her every day. But mine? They ain't no count."

"Mrs. Flournoy?"

"Yes?"

"What if you came to the hospital or were at home and your heart stopped or you stopped breathing? Would you want the doctors to do CPR, like pushing on your chest, giving you medicines, and connecting you to machines to help you stay alive?"

"Awww hell naw. I don't want none of that. When the Lord call for me, don't y'all get all up in His way. That's what happened to one of the ladies on the Mothers Board with me at church. They had to pull the plug. I ain't even got nobody left to come and pull the plug!"  She threw her head back and laughed.

"So. . .wait. . . .you would not want those things I mentioned?"

"I DO want the life support. I don't want y'all holding me here if God trying to take me home. Matter of fact, it get boring sometimes going to all these funerals." She chuckled again.

"Wow. I could only imagine. But I bet you've seen a lot in your lifetime, though."

"Oh yeah. I remember when there was a Black Grady and a White Grady. One side for if you was colored, and the other part was only for white folks. They had air conditioning on one side but not the other side. Yep. Colored Grady and White Grady. That's why we still call it 'The Gradys.'"

The resident nods in respect of the history lesson. Looks like he might be imagining how one must have felt to be on the non-airconditioned side during the summer. Especially in Georgia.

Mrs. Flournoy is oblivious to his deep thoughts. "You know what else?"

"What's that, Mrs. Flournoy?"

"They have it so where you can RE-wind your television or pause it while you watching it. If you got the special cable like my sister Willie got at her house, you can just pause it and see about a pot on your stove."

"Yes, ma'am. . .that is pretty neat."

"Especially if you got people seeing about you. See my sister, her kids and grands, they got her the special cable TV. I only see it when I go by her house. See, 'cawse Willie, she got her kids and 'specially her grands to see about her. But mine, they ain't no count."

"Hmm."

"All these young folks is worried about is what they got going on, and not what nobody else got going on. You know what I'm saying?"

"Yes, ma'am. Unfortunately, I'm embarrassed to admit that I know exactly what you're saying."

Oh my gosh. Are we a generation of "no-count" grands and great-great grands? I sure hope not.

***

Grady elders = The truth.  I'm just saying.
________________________________________
*Story courtesy of my friend and fellow Grady doctor, Danielle J.  :)

I Do Declare!

Beware:

Touchy-feely blog post ahead. If such things cause you to dry heave, you may be excused to peruse the archives until this is over. (Kind of like sitting on a bench in the mall while your wife tries on peep-toe pumps and pencil skirts.)

Vision. . .

At risk of sounding 100% lame, I will ask this question:

Do you have a vision board? (What in the world is a "vision board?!") Aaaahh, thought you'd never ask. . .

Okay. . . so it's like this concept where you take all of your biggest dreams for your life (and that of those you love) and put them out there into the universe. It's what the Grady elders refer to as "claiming a victory"-- daring to utter your aspirations loud enough to be heard. . .declaring your dreams as tangible and doable and achievable instead of mousy little whispers in your head. . . . .

Yeah.

So two years ago, I spent an entire evening alone at home, working on a vision board. I'd just seen an episode of Oprah where Jenny McCarthy had written this book on life with a child on the spectrum of autism, and she showed her vision board from a few years before. It may sound lame, but I was inspired. I decided to do one, too. (Okay, okay, I'll admit that I was also inspired by the big stack of magazines that I needed to recycle that day. . .)

Getting my vision into focus. . . . .

First, my dreams were small and predictable. Get fit. Flatten my tummy. Cook more. Yadda Ya. Then something happened. I got more chutzpah in my vision. It's really good that I was alone because it made me bolder in what I listed. (My sister had a "Vision Board Party" with good friends that she completely trusted, though. That's a consideration--might even be fun to do with your spouse, partner or kids. . . .but I digress. . .)

Anyhoo. . .Where was I? Oh yeah. I included bold declarations about my kids. About my marriage. About my career. And a lot of fantastical things just about me. And you know what? By making a vision board, I put myself on the list, which was a pretty cool exercise considering my career and my family are usually fighting hard to bump everything else off of it.

"Start a blog."

That's one of the things I wrote. While cutting and glue-ing captions, it came to me: I want to write. I love to write. And I want to write more and better. The way to write better or run better or do anything with more skill, is to do just that: it. Over and over and over again.

And so I did.

"Get Oprah to read my blog."

That's on there, too. Ha ha. Who knows? She just might be one of my 88 followers, secretly hiding under some funky avatar. . . .See? That's the cool thing about a vision board. It's your vision. And no one can argue with your vision.

You know. . .there are things on my vision board that have absolutely come to pass. Sho nuff. Errr. There are also things that are still works in progress--like the cook more declaration, the run a half marathon plan. . . . And. There's also a couple of items that I've changed my mind about. . . for example:

That horrid P-90X workout!

Sidebar: Harry says I did the P-7X. Ha. 90 days of extreme exercise in front of my TV sounded like a good idea at the time. . . . uhhh. . .yeah. Excellent laugh-out-loud image: Me trying to do a chin up. Nuff said.


Okay. So why am I telling you this? Because I think everyone should have their version of a vision board. Something that boldly says that you can do anything. Not just the things that are inevitable, either. It has to be almost laughable at times and even slightly embarrassing. The kind of thing that someone else would look at and say, "You cannot be serious." But you are serious. Serious as a heart attack. (And that's serious--trust me, I'm a doctor.) My vision board holds my feet to the fire to work towards being:

• my best mom
• my best wife
• my best teacher
• my best doctor
• my best writer
• my best dreamer
• my best me

For the most part, it has done just that. Even better is this: I keep adding things as I dream them for myself and the ones I love. In fact, something happened recently that inspired my husband to say, "Hey! That was on your vision board, babe!"

Say what?

more of my vision board

For the record, although he is good for a random mushy comment here and there, Harry is the least touchy-feely person ever born. So this is huge, people. HUGE. (Perhaps a Cleveland thing? Hmmm. . . ) However. Somehow God saw fit to put him with touchy-feely me, which just might explain the fact that
a.) He actually knew I even had a vision board, and
b.) He'd actually gone so far as to read said vision board. (Thump. Excuse me--I fainted for a second.)

Okay.

If you are the introspective, touchy-feely type (be it publicly or privately). . . .I recommend making a vision board. I really, really do. Instead of focusing on things like (depending upon who you are, of course):

• 7 out of 10 black women will never marry
• The chance of getting pregnant from month to month when you are of advanced maternal age is less than 10%
• 50% of marriages will end in divorce
• A scary percentage of black males (read: my sons, my husband) will be arrested/incarcerated in their lifetime

It instead helps you focus on things like:

• My single friends will marry the man of their dreams when the time is right.
• (this person) will get pregnant despite the odds. Note: (this person) is pregnant and due quite soon.
• We WILL shake a tailfeather at our 50th wedding anniversary. . .and be cognitively unimpaired, thank you very much.
• Isaiah and Zachary and (these men) will contribute great things to the world and never know incarceration or the correctional system.

It's almost like a really bodacious prayer. If it's God's will, cool. And if it isn't? Even if I'm disappointed about it, ultimately, that part is cool, too.

Now, if you aren't the touchy-feely type--especially if you're new to this blog-- forgive me for this whole thing. I promise that more satisfying--though equally touchy-feely--posts can be found under my "favorites" scroll.



Scale of one to ten on lameness? Maybe a ten. But my vision board has helped me to be even more alright with me. How could it not? It includes this personal charge:

"Stop caring so much about what others think about you.

Start caring more about how others think of themselves."

Just added to my vision board: Make vision boards with Isaiah and Zachary.

Now: Back to our regularly scheduled programming. :)