Reflections of a Grady Doctor after a Bedtime Story: The Gospel According to Shel Silverstein

"If you are a dreamer come in
If you are a dreamer, a wisher, a liar
A hoper, a pray-er, a magic-bean-buyer
If you're a pretender come sit by my fire
For we have some flax golden tales to spin
Come in!
Come in!"

~ Shel Silverstein

_____________________________________________________________

I was sitting on the couch with my laptop on my lap, and thinking. . . .I want to write. I need to write. But there's a problem: I have nothing on the tip of my tongue or fingertips to write about. I felt my engine stalling. . . .

(Hmm. . . . could this be the aftermath of me now being 40? Let's hope not.)

I put down the MacBook and decided to wait it out. Vegged out on the couch with the kids watching "Astroboy" on cable. As soon as the credits rolled, I marched them to their bedroom.

"Just one book, pu-leeeeease?"

I thought of my friend and fellow Grady doctor, Lesley M., who agreed with her husband that they'd never say no to a request for a book to be read--an agreement that I also adopted. (Eh hem. . ."never" sounded like a good idea at the time, Lesley and Rich. . . . ) So anyways. . . .tonight, I broke out "The Giving Tree" by Shel Silverstein. The book is part sullen/part deep/part thought-provoking/part sleep-inducing. (And okay, just a wee bit depressing. . .but depressing in a good way. . . ) Anyways. . .it held the kids captive as always.

". . .and the tree was happy."

I snapped the book shut in an unspoken "The End."

"Read it again!"

"Yeah, Mom, puleeeeaaaase?"

"No, you little coco-pugs. Bedtime."

Once I finally got them settled in/tucked in, I found myself reflecting on the book we'd just read, and I thought about how much of my childhood was punctuated by Shel Silverstein's writings.

Hmmm.

Turns out that Shel was a pretty insightful dude. Next thing I knew I was looking through some of his classic children's poems and stories and. . .

Ah hah.

A "light in the attic" came on. . .just like that. Something to write about indeed. Why? Oh it's simple. Life as a Grady doctor totally overlaps with the gospel according to Shel Silverstein. Totally.

Wait.

Before I go on--could you possibly be one of those rare people who didn't grow up on Shel Silverstein masterpieces such as "Where the Sidewalk Ends" and "Lafcadio?" I will give the disclaimer that my mother is a retired elementary school teacher AND a ridiculously avid reader of all things literary. . . .but I'm saying. . .didn't everyone grow up being mesmerized by the late Shel Silverstein and his grainy black and white illustrations? If you, by some strange chance, did not then please excuse me while I turn my back, clutch my chest and . . .

::GASP::

Seriously? Seriously. A childhood without Shel Silverstein is a questionable childhood at best. (No offense to yours.)

Alright. . .so where was I? Oh yeah, the gospel according to Silverstein. Care to join?

*(All of the following quotes are the works of Shel Silverstein.)

***

"How many slams in an old screen door?
Depends how loud you shut it.
How many slices in a bread?
Depends how thin you cut it.
How much good inside a day?
Depends how good you live 'em.
How much love inside a friend?
Depends how much you give 'em."

Going in circles. . . .

There was this patient I had once who goes down in history as one of my most memorable Grady elders ever. No matter what I asked him, he had some circuitous comeback or pontificating response that never quite qualified as an answer. I thought my questions were simple enough, but I'd find myself in this crazy loop of Mr. Miyagi commentary that never seemed to have a real endpoint. Now y'all know how much I respect the Grady elders, so it's not like I could just throw my hands up and say, "Would you just answer the question already?!?" Instead, I just had to endure. . . .

"Hey there, sir. How are you feelin' this morning?"

"I'm still kickin' just not high, doctor."

"Oh. . .okay. Are you alright today?"

"Oh, now I'm always gon' be alright, now. 'Cawse I know a man who died on a cross and rose on the thoid day. . ."

"Yes, sir." (Grady rule #1: Never interrupt any Grady elder who makes reference to any part of the Holy Trinity.) I pause and wait for him to finish. "Soooo. . . .how are you doing, sir?"

"I don't know, doc. I ain't no count." Starts rubbing his abdomen. Belches.

"Uhhh, okay." (No count = not good or not well. Thanks, Dad for teaching me such lingo.) "Is your stomach hurting?"

"Sometimes it boils on me, but tha's okay. 'Cawse I ain't no ways tired."

"Yes, sir." ("No ways tired" = words in an old Negro spiritual. Grady rule #2: Old spirituals are also not to be interrupted.) I wait a few beats before asking again, "Sir, I'm just trying to get an idea of how you're feeling today. .to make sure I'm not missing anything. . . so your belly. . .how is it compared to yesterday?"

"Every day that I wek up and see a new day is better than yesterday. You see, 'cawse I know a man. . . " ("I know a man" = Elder reference to Jesus. Back to Grady rule #1.)

This cryptic circuit went on every morning for two full weeks for, like, thirty minutes an encounter. To this day, I'm still not sure whether or not he felt bad or good. Seriously, it was never clear to me. Either way, I came to enjoy our morning chats, even if I had no idea what to chart afterward.

***

"I cannot go to school today"

Said little Peggy Ann McKay.
"I have the measles and the mumps,

A gash, a rash and purple bumps.

My mouth is wet, my throat is dry.

I'm going blind in my right eye.

My tonsils are as big as rocks,

I've counted sixteen chicken pox.

And there's one more - that's seventeen,

And don't you think my face looks green?

My leg is cut, my eyes are blue,

It might be the instamatic flu.

I cough and sneeze and gasp and choke,

I'm sure that my left leg is broke.

My hip hurts when I move my chin,

My belly button's caving in.

My back is wrenched,
my ankle's sprained,

My 'pendix pains each time it rains.

My toes are cold, my toes are numb,

I have a sliver in my thumb. My neck is stiff, my voice is weak,

I hardly whisper when I speak.

My tongue is filling up my mouth,

I think my hair is falling out.

My elbow's bent, my spine ain't straight,

My temperature is one-o-eight.

My brain is shrunk, I cannot hear,

There's a hole inside my ear.

I have a hangnail, and my heart is ...

What? What's that? What's that you say?

You say today is .............. Saturday?

G'bye, I'm going out to play!"

Mourning sickness. . . . .

There was once this resident rotating with me on wards who was about 15 weeks pregnant. She confided in me early in her pregnancy, and also did not hesitate to let me know how obstructive pregnancy was to anything more than the most basic patient care. (She didn't seem impressed by the two pregnancies I worked through on wards. . .)

Me: "How 'bout you give us a lecture on hyponatremia?"

Her: "Oh, my legs get tired when I stand at the board."

Me: "You can sit if you'd like."

Her: "But I get out of breath from all that talking."

Me: "Okay, then you can just make us a handout."

Her: "I have terrible carpal tunnel already."

Me: "Uhhh, okay."

Her: "Hey, Dr. Manning?"

Me: "Yes?"

Her: "Don't forget I have Saturday off. . . ."

Me: "Yes, I remember. Is everything okay?"

"Oh, yeah! I'm doing a triathlon!"

Um yeah.

****

"There is a voice inside of you
That whispers all day long,
'I feel this is right for me,

I know that this is wrong.'

No teacher, preacher, parent, friend

Or wise man can decide

What's right for you--just listen to

The voice that speaks inside."

The Hard Choices. . . . .

I was once talking to one of my most favorite former-Grady-doctors ever. She was struggling with a decision to continue working at Grady, or take a different job. Now y'all know how much I love me some Grady Hospital--but the job opportunity in question seemed like a really great fit for her. She was so conflicted! I sat and listened as she rattled off all the pros and cons of each. As badly as I wanted her to stay and be a Grady doctor with me, it really sounded like her decision was already made before she even knew it.

"But I don't know what to do," she said tearfully. "I love Grady, but. . ."

"Listen to your spirit," I replied. "What's your spirit telling you?"

She started crying. Hard. I just sat there watching her from the other side of my desk. Hunched over with her face in her hands, weeping.

"There's your answer, and don't worry. It's always hard to say goodbye to someone or something you love. Just know that more love awaits you."

Just know that more love awaits you? Whew. I have no idea where all that Jedi Master deep-ness came from, but thank goodness it came when it did. Too bad I wasn't on a Shel Silverstein kick. I could have just whipped out "Where the Sidewalk Ends" and had her read that poem. See? I'm saying. Shel was dope.

***

"Sandra’s seen a leprechaun,
Eddie touched a troll,

Laurie danced with witches once,

Charlie found some goblins gold.

Donald heard a mermaid sing,
Susy spied an elf,

But all the magic I have known

I've had to make myself."

Magic in the hospital. . . .

When I was a medical student, I never seemed to be the one that ever saw the exotic cases of anything. Nobody ever seemed to seize in front of me or exsanguinate before my beady little eyes. Every heart murmur I heard was an "innocent" one and even when I thought a patient had a mass in the roof of his mouth one day, even that turned out to be a "normal variant." Dang.

One day in the cafeteria, third year medicine clerkship circa 1994:

"I admitted a lady with acute intermittent porphyria last night!"

"Oh yeah? Well, I helped code a man in heart failure from wet Beri-Beri!"

"What did you see, Kim?"

"Errrr. . . .I saw a lady who ate at the all-you-can-eat shrimp feast at Cap'n D's and got the gouch in her big toe."

::crickets::

(Okay. . .although seeing gout (a.k.a. "the gouch") is not like seeing a leprechuan, I've since learned that since common things are common, seeing all of those "bread and butter" cases in med school was a good thing.)

***

"Tell me I'm clever,

Tell me I'm kind,

Tell me I'm talented,

Tell me I'm cute,

Tell me I'm sensitive,

Graceful and Wise

Tell me I'm perfect--

But tell me the TRUTH."

Feedback. . . . .

(This is what I'm subconsciously thinking when I solicit feedback from my husband . . .and from your blog comments. . . .hee hee. . . .wait, did I just say that?)

****

"Said the little boy, "Sometimes I drop my spoon."

Said the old man, "I do that too."

The little boy whispered, "I wet my pants."

I do that too," laughed the little old man.

Said the little boy, "I often cry."

The old man nodded, "So do I."

But worst of all," said the boy, "it seems

Grown-ups don't pay attention to me."

And he felt the warmth of a wrinkled old hand.

I know what you mean," said the little old man."

Kindred spirits. . . . . . .

This little ditty reminds me of why it's so beautiful to have medical students in the hospital. They have the most time to give, and their undivided attention can be such a blessing to sick patients. I remember being completely ignored by my attending during my 3rd year clerkship in Internal Medicine--so much so, that I was convinced that I would never, ever do Medicine. I initially thought I'd be a surgeon. . . . .until I discovered that I loved the post-op patients and consults on the surgical service, but not the OR. (Turns out that you need to like the OR if you want to do Surgery. . .picky, picky!)

I later learned that even though some of my attendings back then wouldn't know me if I walked up and smacked them across the face. . . .my patients knew me and appreciated my presence. Sometimes the patient and the medical student have more in common than they realize. I tell the students of how pivotal their role is to scared patients. I also tell them that you need that patient just as much as that patient needs you.

****

It was missing a piece.

And it was not happy.

So it set off in search

of its missing piece.

And as it rolled

it sang this song - "Oh I'm lookin' for my missin' piece

I'm lookin' for my missin' piece

Hi-dee-ho, here I go,

Lookin' for my missin' piece."

A perfect fit. . . . .

This book by Shel Silverstein-- "The Missing Piece"-- makes me think of my life before Harry and the boys. I can't say that I was really unhappy, per se--but something was missing. The ending of the book makes me happy because it reminds me of when I first met Harry. I guess the way I remember it is kind of like this. . . . I was just a-singing and a-rolling along like the circle missing the piece. Hi-dee-ho, here I go. So glad I found my missin' pieces!

Found: my pieces that I love to pieces

***

"Would you like to hear

of the terrible night
when I bravely fought the---

No?

Alright."

The late night storyteller. . . . .

Bwwah hah hah! This essentially describes one of the reasons I started this blog in the first place. Harry a.k.a. "the person who originally had to hear every one of my Grady reflections before this blog." My poor, poor husband. He'd lay in bed at night listening to me rambling on and on with my intricately detailed Grady tales. . . . .

"And then, you won't believe what happened next, babe!"

Snort. "Uh. . . huh? I can't believe that, babe."

"I didn't say anything yet, Harry." Snort.

Snort. That was the sound of Harry dozing off with the tiny snore that he would swear up and down was not, do you hear me? Not a snore but a wide awake snort.

"I'm listening, babe. I am listening."

"Okay, well then. . the nurse comes up to me and my team and says. . " Snort.

Starting this blog sort of let Harry off of the hook. Sort of. (Okay, I do still tell him quite a few of my stories, and okay I admit, sometimes make him listen to me read him my blog posts aloud. . . .)

So on behalf of Harry and me-- thank you for reading. . . .and for coming in and sitting by my fire. For truly, my friend, we have some flax golden tales to spin indeed. :)

***

If you didn't (gasp) grow up on Shel Silverstein. . . .and even if you don't have children. . . .please. . .
don't go another day without the gospel according to Silverstein. . . .