Life in Pictures: Goings on.

From my first week on the wards. Had just rescued someone who was locked in the stairwell. For whatever reason, that's always funny to me. Mostly because that person has many times been me.

Medicine nerds unite! Nothing like a field trip down to to the lab to look at slides under the teaching scopes. My resident knew this would give me palpitations of joy, so he snapped this image and sent it to his attending.

My dynamite third year student, Alex R. She's excellent with patients and a real self starter. I'm really enjoying working with her. Oh, and she's also a California girl, like me which only makes me like her more.

Friday night lights! The girls were all back together again. Tanya S. was passing through the states on her way back to Africa where she now lives. Aaah! What a treat! It was like we never missed a beat.

I had just come from Grady to meet up with them. Still in my glasses and work clothes, but so what? I was with three of my original Ruths. I never feel under or overdressed when I'm with these girls. Our laughs are easy and genuine. Acceptance is never the exception--it's the rule.

I have no idea what Marra was showing Tanya in this picture. Probably something naughty hence this diabolical laugh after she caught me snapping a photo of it.

I told them to hide me in my work dress. Ha. Joy gladly obliged and took it as an opportunity to strike a pose in her gingham checked shirt.

We were instructed to look "fierce" here. We look more forced than fierce. Ha.

Dang. My glitter-sparklies are showing up pretty strong on that snap.

Huggies! (That's what Zachary says in the morning or late at night when he wants a hug. Ha.) Now I say that all the time to my friends.

Was great to see Tanya. But bittersweet to know she'd be on another continent in just a few days.

The boys at church today. It was "move up Sunday." The kids get promoted to the next grade classroom for children's church. They build a lot of pomp and circumstance around it which kids really dig.

We all had brunch/lunch at Mardi Gras Cafe afterwards. It's become our post-church ritual now. It's amazing to see how much the BHE has grown that place. Today before we ate, Isaiah said a lovely prayer of thanks for the food but also for his Daddy's thriving restaurant.

Did you know? Harry had never owned a restaurant in his life nor had he ever been in this business. But what he does know is hard work and people. That man is the real deal, I tell you. I'm so in awe of him. He's amazing.

That's him in the background in the yellow shirt. He's been avoiding my paparazzi lately. Ha.

Look at this! Parking spot #33 at the hair salon. That's my lucky number, you know.

Yup.

z

My resident this month, Cameron L., teaching the medical students and the interns. I had just walked into the team room where I found him in the throws of some serious knowledge-dropping. He also wears real bow ties nearly every day except on call.  Sorry I didn't get a snap of it--this was a call day.

He's my kind of resident.

Team H hallway selfie. Cameron was in clinic so when the bow tie is away, the kids all play. (Yes, we were still taking excellent care of our patients, thank you very much.)

We believe in communication on our team. Compassionate and transparent communication. That's what Mayur M. was doing here. He's awesome.

This is what it looks like when your attending physician communicates with you via text. And when 90% of the texts are business but 10% completely random things designed to get everyone to lighten up.

I'm sure you can guess which of those two types Alex and Kevin were reading here. What can I say? This work gets heavy so you've got to lighten up, man.

Are you ready for some footbaaaaaall? Oh yeah!

Hey, did I tell you that Zack made the travel team? Maybe I did. But if I didn't, he did. And yes, his mother most CERTAINLY did buy him a balloon to commemorate this accomplishment. Most certainly did.

Like that boy said to me a few weeks back: "Effort is between you and you."

His effort paid off. And how awesome is that quote? (It's from Ray Lewis, his football hero.)

Here is Zachary mean-mugging after his football game on Saturday. He's starting as a corner back. Exciting stuff. AND we are 3-0 so far. Woot!

 This is Isaiah after I busted him drinking a Sprite at the Omega picnic. He froze like a statue and acted like I couldn't see him. That funny little man.

More of the boys at Harry's fraternity family picnic. I am wondering at what age they will realize that they are actually NOT members of their father and grandfather's fraternity?

Ha.
 

Here with Uncle Keith. He's the BHE's line brother and Zachary's godfather.

I love that my boys are such good friends.

This fun day in the pool last weekend went swimmingly well. That's Isaiah with that funny face and the two handsome little sweeties flanking me are the boys' twin godbrothers, Parker and Peyton.

Had a very lovely "brunch bunch" with these two awesome Emory M2 students, Robbie G. and Will T. I took them to one of my favorite neighborhood spots, Murphy's. I'm so glad they did most of the talking. I got to listen (and inhale my chilaquiles.) Yum!

We are penciled in for another brunch bunch in a few months. This one was so much fun we agreed that we must do it again.

Blue toes at football practice.

Throw your hands in the air and wave 'em like you just don't care. . . . .if you're a big time second grader on the second grade hall!

Never too cool to come give huggies to your favorite first grade teacher, though.

Huggies!

Dinner with Las Jefes. It never gets old being with these girls. Grady doctors through and through.

There is always permission to speak freely. That's the best part.

This was after a five minute visit to a patient turned into a one hour visit. Let's just say she was rather . . errr. . .chatty.

And this. A yummy bowl of green gazpacho at the counter of Ria's Bluebird. Ria, the beloved owner, passed away in 2013 from a heart attack. She was in her forties. I didn't know her personally. But her story and the hole she left behind reminds me of my Deanna. Plus her food is great and her restaurant is adorable. I imagine her hanging out with my sister and talking shit. That makes me like coming here, usually alone.

The price is nice, too. I had a pancake on the side and it only came to 8 bucks. Shweet.

And lastly this. A snap taken on my office photobooth. I was missing my sister and feeling melancholy. Not really crying on the outside, but sort of on the inside I was. So I captured it in an image.

Why? I'm not sure.

My emotions are complex when I'm missing Deanna. I can see it here. So I guess I sort of like that I can.

That's all I've got.

Are you living your life like it's golden? I hope so. I know it looks exhausting but it's not. I'm just alive. And I'm so, so glad.

Yeah.

***
Happy Sunday. Tomorrow is Deanna's birthday and the first day of school. Perfect, right?

Fifty-some-odd years.

It was slipped into the presentation by the intern during her presentation. He and his wife had been married for over fifty years. Longer than any of the members of their care team had been alive.

"What is the secret to being married for fifty-some-odd years?" I asked in front of our entire team. It was the end of the encounter, so I just had to ask.

He looked up from his hospital bed and responded matter-of-factly. "Well. You have to put up with each others' mess. Pretty much. That's it."

"That's it? That's the secret?"

Then she chimed in. "There are a lot of good days. But there's gon' be some bad days, too. But that's okay long as you both trying."

"Hmmm."

He let out a moist cough and then followed up after his wife with a few more words. "See, I made a vow. We both did. And when you both stick with what you promised, you don't need no secret."

"That's a good word, sir."

"It's jest the truth is all."

"And nothing but the truth, sir."

His wife looked me in the eye and gave me a hard nod of her head; it was her way of cosigning this gospel according to them and their fifty-some-odd years of marriage. Yes, it was.

And this? This is Grady. And I know I say it over and over and over again--but I'm just glad to be here bearing witness to this gospel every day.

***
Happy Saturday.

Thank you. Thank you very much.

 This has been my self-authored writing mantra:

Write it down. Get it out. Out of your head and onto some paper. Or onto a keyboard and then into a computer.  Or something or somewhere. Just out. Out. Whatever it is. However it seems. Good. Bad. Random. Joyful. Painful. Process it. Explore it. Excavate it. Deconstruct it. Reconstruct it. Get it. Learn it. Honor it. Feel it. Master it. Hold it. Release it. Celebrate it. Love it. Forgive it. Be it. Live it.

Or do none of those things.

But whatever you do, just write.

For five years, that is what I have done. I have laughed myself sick. I have cried from the most primal places in my soul. I've pushed my mind to better understand my world, my thoughts, my day, and, as a result, myself. I have.

 And you.

You've been with me. You've held my hand when I felt afraid. You've laughed with me instead of at me when I danced like no one was watching. And, on most days, you've even jumped out there and danced, too. You have.

For five years. And here is the God's honest truth:

I am forever changed. For the better. I am. I am. I am.

Like Toni Morrison said after she penned her masterpiece "The Bluest Eye". . . Why did she write it? So that she could read it. Yes. That. I've let myself adopt this philosophy, too.

But.

Were it not for you, this community of thinkers and feelers, reading these words and reflecting with me, I know that it wouldn't have been the same. So this isn't just my lonely place to write words for my own eyes. I know it isn't.

I mean, when my sister passed away? And I turned to this place to explode my overwhelming grief? When I was searching and searching for a way to walk into a new normal? You listened. You came and you read. And it was you who loaned me your wings on those days when I was flying on one. You gave me the courage to honor my sister and this journey in my own way and also a place to chronicle a time that I knew was pivotal. You did.

But you have also celebrated with me. Every step of the way. You've listened to my medical nerd stories and random observations. Allowed me to indulge you with the back seat shenanigans of my children, a husband so gagworthily called "The B.H.E." (that I'm perpetually crushing on), and even went for the ride to my crazy visits to grocery stores and Target.

Yes, you have. And it's been about so much more than Grady Hospital. But you've been okay with that.

You even read about The Puppy Mafia. Ha!

And so. Maybe I started writing here so that I could read it. But because of what you've given me, I know that a piece of me also keeps coming here so that we can read it.

It has been a dream, my friends. It has. And this idea of you--you busy people--reading these words over and over and over again? It will always be a big deal to me.

Always.

So thank you. Thank you very much.  As the Grady elders say, "I 'preciate you."

I mean that.

Sincerely,

Kimberly
aka gradydoctor

***
Happy 5 year anniversary, Reflections of a Grady Doctor!

Random stuff I heard at Grady this week.

"Something smell like incense. Is that you?"

"What? Uhhh, I hope not."

***

"Describe your pain to me."

"It feel like when a roach bite you."

"Uuhhhh. . . do roaches. . .uhh. . .bite?"

"DO ROACHES BITE? HELLLLL YEAH A ROACH WILL BITE YO' AZZ!"

"Oh, okay."

(Do roaches bite?)


***

"You got little ankles to have such a big butt."

"Um, thanks?"

***

"Is there anything more disgusting than a bedpan? You tell me!"

"Uhhh. . ."

"See? I told you."


***

"Sir, you need to take your antipsychotic."

"Risperdal is for SISSIES!"

***

"Why you standing there looking at me with that stupid look on your face?"

"Ummmm, not sure how to answer that."

***

"Percocet is the TRUTH, baby."

***

"Awwwww yeah! Black cat, I see you crossing me!"

"Ummm, hello sir. You okay today?"

"Come on over here so I can show you, shuga!"

***

"Tha's your real hair?"

"Who me? Is this my real hair?"

"Yeah."

"Uhhh, is it possible to have hair this short that isn't really mine?"

"You ain't never seen the 27-piece weave?"

"The who?"

"Girl, Google it."

(I did.)

***

"Hol-laaaaaaa!"

(from a Grady elder to the nurses on the ward while being wheeled out to the discharge waiting area.)

***

I love this place.

***
Happy Thursday.

Nothing to lose.

"The most dangerous creation in any society is the man who has nothing to lose." 

~ James Baldwin (1924 - 1987)

You were shivering and covered with goose flesh. A slick film of sweat enveloped your skin and stayed that way no matter how many times you tried to wipe it away. Food particles floated on top of the murky liquid in your emesis basin, sloshing back and forth on your lap with every tremble of your rebellious body. You looked up at me with eyelids at half mast; you tried to speak but could only moan. With your torso still quaking you finally got a few words out: "I-I-I-I fee-fee-feel like I'm gonna d-d-die." And the look on your face when you said it made me believe you.

Damn. This wasn't what was intended. You were supposed to make it over to your friend who said he had some money. Once you got the money, things would be fine. You'd get what you needed before feeling like this set in. But you stepped off of that bus and walked those four blocks just as you said you would. Problem is, when you knocked on that flimsy screen door, the person who came to greet you wasn't your friend.

"He ain't here," the other person said. You could feel the urgency welling up inside of you. Your head cocked sideways as you studied the person on the other side of that screen. He had you by at least fifty pounds but that didn't stop you from making a quick assessment about whether or not you could take him down.

"He supposed to have some money for me. Did he leave it?"

The other person just laughed out loud when you said that. Then, intuitively he stopped and said, "Don't even think about getting froggy and trying to leap on nobody neither 'cause it won't end pretty for you." That urgency turned to desperation when he slammed the wooden door shut in front of that screen. You started to knock, begging for something, anything he might have in there but the minute you heard that loud click you stepped away. Was it a deadbolt or a glock? You weren't sticking around to find out. 

Light became dusk. And dusk became dark. That urgency and desperation evolved into physical sickness. Innards threatening to hurl and bones feeling like each one was being broken from the inside out. And this? This wasn't what was intended.

Calmly, I took your medical history. I asked you about your story and listened as you told me what happened through your chattering teeth and glistening face. But honestly? The explosion of red confetti dots covering your left hand and forearm explained it all. Well, not all of it. But at least it explained your immediate clinical picture.

"How did this happen?" I asked.

Somehow you got what I meant by that question. You knew that I wanted to know how this happened. All of this. You spending your days roaming around and hoping to get what you need to not feel like you feel now. At what point you even stepped into the threshold of this shitty existence. And I am thinking of that adjective to describe it because this just could not have been what was intended for you life.

"I got in an accident. A bad one. They gave me some pain pills and they gave me a couple of refills. Next thing I knew, I was hooked."

"Dang." You offered me up this lopsided shrug when I said that and something about that gesture made me sad. I squinted my eyes as I tried to sift my brain to get the course of events. Then it clicked and I nodded slowly. "First the pills . . .then. . I guess you turned to heroin because it was easier to get?"

"That and way, way cheaper. It hits you harder, too." You winced between sentences and then went on. "Nobody get on this stuff like they did in the old days. Just about everybody I know that shoot up or snort heroin started off on pills. First they was prescribed by a doctor and then all hell broke loose. Like I don't know nobody that just chose heroin to get blowed right off the rip. No way. It's just the way to keep from getting sick."

I just stared at you when you told me that part. My body filled up with these complex emotions that were hard to get my mind around. Pissed that the medical profession was now a new part of an old problem. Intrigued by this suggestion that shooting up heroin just for the sake of getting high was as played out as Tab soda. Pills had become the Coke Zero, and for many it was on accident. In other words, it wasn't what was intended. By the patients or by their doctors when they acquiesced and gave "just a little" of "something strong."

"So you don't know folks who just decide to give it a shot? I mean, no pun intended."

"Naaah. Not really. Not no more. Maybe some really stupid rich kids. But most folks I know start with pills. For real. The needles don't come until they go broke from buying pills. Then, as for the other drugs, once you all caught up in the life, you just in it. So you'll try whatever, you know? Meth, heroin, speedballs, all that."

Again, I said nothing. I mean, what could I say? Instead I just sat there pondering this quote from James Baldwin because that's what that last sentence made me think about.


"The most dangerous creation of any society is the man who has nothing to lose."

~ James Baldwin

Let me tell you. Some of the deepest truths I've learned about addiction have come from simply listening to the voices of my patients. Patients who have lived it or who are living through it. People like my Uncle Woody or like my patient who explained to me the real truth about how a crack addiction develops. And every time it is nothing like what I'd seen on television or heard through urban lore; the common thread being that this--the wretched monkey now perched upon their backs--was never, ever what was intended.

No it was not.

The sad truth is that there was little we could do for you without resources. I couldn't carefully place you into the open arms of an inpatient rehab facility nor could I hospitalize you until I could. Instead, the ball was placed into your court forcing you in your broken state to dribble down a full court and shoot.

You left before I could wish you luck. That ball before you turned out to be an airball. Your sheets were empty before I could even get back down to you.

I guess in my Pollyanna-ness I imagined this brief encounter as something more pivotal than it was. I pictured us plotting your comeback and me running into you somewhere looking robust and strong someday. And I swear to you, I believed that this could be your story. I did.

But as of today? This wasn't what was intended. The magnetic pull of your own back alley hospitals was greater than me and my scattered words of encouragement. In your mind, you had nothing to lose at this point--and maybe you were right.

I guess I just wish I could have convinced you of all you had to gain.

***
Hump Day, it is.

And now I'm crying because writing this made me think of a Grady angel who left in August of 2009--and now is making me hope this one won't be joining her in August of 2014.

Addiction sucks, man.

Grady, baby.

On the way into rounds yesterday morning at Grady.

Recap of rounds at Grady


Someone smoked but now they have a bad cancer. One that can't be cured because it is too advanced.

Someone has a weak heart muscle that is too damaged to even respond to our standard medicines. We are trying something non-standard and hoping it will work.

Someone loves to drink sweet tea but can't eat by mouth anymore. Which left me thinking about things like coffee and red wine, both of which bring me joy when I take them by mouth.

Someone has a chronic illness but has no family to "see about" them. No balloons or cards will be there because there is no person anxious for them to get out of the hospital.

Someone drank a lot of alcohol and is now in intensive care. Maybe they will quit but maybe they won't be able to do it just yet.

But.

Someone proudly told me that she was a "Grady baby"--the proud distinction of those born in this hospital.

Someone was smiling with gleaming gold teeth while giving me fist bumps.

Someone was laughing, loud and hearty for no reason other than just exuberance.

Someone was singing, too. Not really able to even carry a tune, but still with a song on his lips.

And someone held my hand today and said, "Thank you, Miss Manning." No. Not Dr. Manning, but Miss Manning. Another proud distinction unique to Grady that you'd have to be here to understand.


Joy, pain, sunshine and rain. Each of these a reality and all of them necessary pieces of this dream called Grady.

***
Happy Monday. I am on wards and this is Grady, baby.

Good Random Morning.

"When you look good, you feel good. When you feel good, you play good. 

When you play good, they pay good."  

~ Deion Sanders

You know I want to write about our event last night, but my head is still spinning from the excitement. Let me just say instead that it was a smashing success. Each of them, all of it just great. More on that very soon, okay?

My hands and mind need to be on this keyboard writing. About what? No real definite thing. So you all know what that means, right? You guessed it. A post of random stuff on my mind. Usually of first world, non-monumental unimportance.

That's always my disclaimer. Ha.

I'm starting wards today. The service is pretty big to begin with which means there are a lot of patients. We're admitting today, too, which somewhat adds a bit of insult to the injury. That is, if you think of it that way. I remember when I was a resident and my fellow resident and I decided that we'd take a positive view on getting smashed with tons of patients. It was initially this silly joke but eventually it got into our heads and made us less surly and jaded about being busy, sleep-deprived residents.

"How many new friends have you made tonight?" I'd ask with my biggest, fakest grin.

"I've made ten so far!" Maria would reply in an overly giddy way.

"Awesome! I've made only 9 new friends but two of them are the equivalent of four friends. So technically I'm winning since those two are like. . .superfriends."

"Oooohhh! I want to have some super friends, toooooo! But wait. I think I have at least one. One of my friends threw some grits at me today. I'll have to talk to him about the ground rules for our new friendship!"

"Well. At least it wasn't feces."

"Uhhh, yeah. That's such a good point, my dear amigo!"

That's when our pagers would both go off. "TIME TO MAKE MORE FRIENDS! WAHOOOOO!"

Maria started all of this. She'd show up post call to morning report with stickers all over her scrubs and a tepid cup of coffee in a styrofoam cup. If the night was rough, she'd put her right fist in the air and announce, "I WON! I MADE THE MOST FRIENDS OUT OF EVERYONE LAST NIGHT!"

Then she'd go to the podium and present them to our critical bunch of chiefs, attendings and fellow house officers. And that was that.

After a while, both of us DID start seeing new patients and encounters as opportunities. Chances to meet new human beings and to become affected by their stories. A way to learn something or grow, too. Seeing them as "friends" turned us into patient advocates--even more than we expected. What started as a coping mechanism changed us into better doctors.

So my point of that reflection is just that I am about to meet a crap ton of new friends today. And from what I see, some are superfriends.  (I'm still hoping no one throws grits or feces, though.)

Ha.

What else?

So the student I was coaching for the Medical Student Teaching competition is this wonderful young woman named Kelly A. Our coaching sessions were rigorous and fun and full of whip-cracking excitement. Hands down, that part of the experience was possibly one of the best teaching experiences I've ever had.

Okay, so check it. We discussed everything in preparation for her lecture. Once we got through the logistical stuff like slides and transitions and teaching points, I moved to something that I doubt the other coaches were asking.

"So what are you wearing?" I asked.

"Wearing?" Kelly's eyebrows raised in that "beg pardon" kind of way. But she'd worked with me on wards so knew that she'd probably heard me correctly.

"Yes. Wearing. Whenever I give a big talk, I am very cognizant of what I have on. I wear my power color. Or at least one of my power colors."

"Really?"

"Oh yeah. Red. Red is my go-to power color. Almost always I feel my best in something red. I feel strong and fierce. If not red then definitely some strong pop of color for sure. That--and a good heel. A nice pair of heels makes me feel ready to bring it every time."

"Hmmm. I'll have to think on that. But I will think about it. I will."

Power color ready before a speaking engagement

And she did. We did our dress rehearsal earlier this week and she showed up in her power color--purple. She looked strong and confident and able, too. I could tell. She admitted that she's more of a "flats girl" than a "heels girl" and I said, "You have to do what makes YOU feel best." And she agreed with that.

That dress rehearsal session was great. She gave that talk nearly eight times in a row for me and incorporated all of my tiny criticisms into each version. At the end, we ended up on the power outfit discussion again.

"You look great. And strong!"

"I feel good," she said.

Last night at the event, Kelly made my chest swell so full that I nearly skyrocketed out of that auditorium. She arrived in her power purple and an added surprise--you guessed it--a pair of heels.

"I practiced my talk in them!" she said with a bright smile. "And I felt strong. I can see what you mean so I went with the heel." We both laughed and high-fived. I was in my power red pumps so, as the emcee, was definitely practicing what I preached.

For some reason, that heels thing from Kelly made me happier than it would have made most people. Especially when I saw her get up there and do her thing. She was strong and she was fierce. And sure, it was about far more than the heels. It was just her. She owned her space, man.

Yep.

I like this quote from the flamboyant former football star Deion Sanders:

"When you look good, you feel good. When you feel good, you play good. When you play good, they pay good." 

Ha. I can't say that my power red pumps or power red dresses are necessarily getting me raises, but I can say the rest of that quote resonates with me.

My hair is the same way, actually. Remember the time I melted down on Harry because I needed to get my hair cut? Yeah. I'm with Deion. Look good, feel good.

Here's something funny:

In my car the other day the kids had this conversation. . .

Isaiah:  "When I grow up, I think I'm going to name my son after me or after dad."

Zachary: "Oh. Well when I grow up, I think I'm going to just name my kids whatever my wife says."

Ha ha ha ha ha. Those kids are hee-larious.

Lastly:

Speaking of superfriends. . . . I have a few real life friends now that were originally virtual ones through my blog. The other day on the way to football practice for Zachary, I had this super rich conversation with Psonya, one of those friends. We talked about important life things, too. And at some point, it dawned on me that this--us being friends--is just another of the many blessings that has come with this blog. It's really kind of amazing.

Whelp.

My friends and superfriends await me on the wards. I hope you all look good, feel good, and play good today. That's my plan.

Welcome to August.

***
Happy Friday.