"Funny the way it is, when you think about it
Somebody's going hungry and someone else is eating out
Funny the way it is, not right or wrong
Somebody's heart is broken and it becomes your favorite song. . . "
from Dave Matthews Band "Funny the Way it is"
On rounds at Grady one Sunday. . . .
Him: "Miss Manning, I really need you to let me leave the hospital for 'bout five. . .six hours. I promise, I'm gon' come back."
Me: "I don't think it's a good idea. You have too much going on, sir, and something could happen."
Him: "Awwww, ain't nothin' gon' happen. I promise, I said I'm gon' be back."
Me: (considering his drug history) "Hmmmm. . .I really don't think it's such a good idea. Our recommendation is that you stay here to complete your treatment."
Him: "But I must, MUST go. Just for a few hours. Then, like I said, I'm gon' be right back."
Me: "I'm confused. What could possibly be so important that you must leave while being this sick? Maybe we can help you with whatever it is."
Him: "My grandmama sick and she play the organ on Sunday at our church. Some weeks she play and other weeks I play. This her week, and she sick. I need to go play the organ for my church today."
Me: "Really?"
Him: "Yeah, Miss Manning, I promise to God."
Me: "I think it's great that you are looking out for your grandmama and also that you are thinking of your church congregation. But I think they would all want you to stay, too. I bet they would understand that you are too ill to be the stand in."
Him: "But I'm a man of my word. I always told my grandmama that I will step in if it's her week and she can't do it. I gots to go. But, like I said, I'm gon' be right, right back."
Me: (looking at him with hair all over his head, appearing to not have shaved/bathed/groomed for at least 3 months before this hospitalization, and imagining him in a suit playing a lively organ for a Pentacostal church somewhere---uhh. . .no.) "I'm sorry, sir. You would have to leave against our advice."
Him: "But then I wouldn't get no 'scriptions."
Me: "We could probably get you the insulin prescription. Otherwise, it would be against our advice for you to go."
Him: "Insulin? I don't want that. I need my pain medicine, man."
Me: "So stay here with us, sir."
Him: "But I got to, got to go. I'm sayin', though, I promise I'm gon' be right, right, right back."
Me: "No can do, sir."
Him: "But my grandmama and my church is counting on me!"
Me: (thinking of my own church, my down south African-American roots I have in common with this patient, and hoping that my inclination that he really is anxious to use drugs is completely off base) "Sir?"
Him: (looking extremely anxious and now putting on his run down shoes) "Miss Manning, I got to go. I got to go for real before it get too late. Man, my mama sick and my church don't have nobody to play."
Me: "Your mama or your grandmama?"
Him: (stops and thinks for a minute) "Uhhh, my ma- I mean my. . .man, I got to GO!"
Me: "Everyone at your church will be looking for you. Wow, you must have a close knit church."
Him: "Yeah, I do."
Me: "What's your pastor's name and what's the name of your church-home?"
Him: (totally caught off guard) "Huh?"
Me: "Who's your pastor?"
Him: silent
Note: Let me speak on behalf of black people who regularly attend church anywhere in the U.S. but ESPECIALLY in the South. (I feel I have full authority to do so as 1) a black person who 2.) regularly attends church in the South.) If we don't know anybody else's name, we know the name of our pastor. Matter of fact, we know the pastor's name, his (or her) middle initial, the first lady's name, and her favorite color. We might not be able to keep track of all the books in the bible, but our pastor? Chile please!
Ask any black person who attends church this question and it goes like this:
"Do you have a church-home?"
("church-home" is one of my favorite down south references to church membership in the African-American community)
"I attend New Mount Hope Calvary Sermon-on-the-Mount Rhema First Fruits Alpha Omega Missionary Full Gospel Baptist Church where Reverend Dr. Jo-SI-ah Oba-DI-ah MacGriffin is the senior pastor!" (No exaggeration whatsoever.)
("church-home" is one of my favorite down south references to church membership in the African-American community)
"I attend New Mount Hope Calvary Sermon-on-the-Mount Rhema First Fruits Alpha Omega Missionary Full Gospel Baptist Church where Reverend Dr. Jo-SI-ah Oba-DI-ah MacGriffin is the senior pastor!" (No exaggeration whatsoever.)
Back to my patient. . . .
Me: "I really want to know. . . what's your pastor's name? Surely you know your pastor's name."
Him: "Uuuuhhhh, it's mostly my mama's church and I just be playin' the organ. I don't even be talking to nobody all like that." (He was sinking fast.)
Me: (with light chuckle + hairy eyeball) "Come on Mr. Johnson! You mean to tell me that a brother who must, must, must leave the hospital to go play organ at his church can't even tell me the pastor's full name? Now I know something is fishy."
Him: Sigh
Me: "Look, sir. You are an adult with decision making ability. If you decide to leave, that is your choice. I would not recommend it. Mr. Johnson, I'm worried that your condition could get worse. Sir, I'm also going to be honest and tell you that I'm worried about you leaving here and maybe even using again. . . . .and I don't want you to. I don't. I don't want you to go."
Him: (No longer making eye contact with me) "But, doctor. . . . .I. . .I got to go. I just got to."
Me: "No, you don't, Mr. Johnson. You don't."
Him: (Now looking at me) "But you don't understand, doctor. I do."
And that was that. The patient left against our advice. Remember when I said these conversations start out funny and end not-so-funny? Makes me think of something I've heard the elders say over the years in response to something some might think is funny at first, but really isn't:
"Ha Ha hell."
How funny was it that Mr. Johnson told this colorful tale of urgently needing to play an organ at a church. Problem is that he couldn't recall the church's name or that of its pastor--a fatal flaw in his story that got him busted in a probable fib. Ha Ha. He also has a life threatening condition, is homeless and despite that, left the hospital against medical advice likely to seek something in the streets that he doesn't need. And he will likely be back against his will and maybe without a pulse. Ha Ha hell.
I've thought of Mr. Johnson a lot since he left. While I admit that I was amused by the shakiness of his lie, I'm still saddened by the magnetic pull of something so much greater than the desire to be healthy and safe. I can't prove that it was crack cocaine, but I have been working here long enough to suspect that it was. . . . . .
I wish so bad that I could believe that he really was going to his church. I really do.
Link to Dave Matthews Band's "Funny The Way it Is"
oh lord, working in the VA....addiction is our specialty and it always breaks my heart... had a similar experience with my patient just last night. So sad :(
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