"I was just noticing your rings. One of them looks like a championship ring. You played sports?"
"Oh naw, these rings ain't come from me, although I did play sports growing up."
"What did you play?"
"Oh Lord, child, I played everythang. Tha's 'fore we had tv to watch and video games and all that stuff. When I was coming up, after you did your chores, you got out there and just played. Anythang, ev'rythang.."
I remembered that he was over eighty years old and brought up in South Georgia. The likelihood of someone giving out sports rings during his hey day was pretty low.
"That's awesome," I said as I leaned my chin into my palm, "I mean, really great." I couldnt resist getting the story behind his hand adornments. He was wearing them so proudly--I just had to ask."So then . . . . .where'd the rings come from?"
"My kids."
His kids? Hmmmmm.
Earlier in the visit, I'd already asked him if he had any children, and I was pretty sure he'd said no. Maybe I heard him wrong.
"Oh, I'm sorry, I thought you told me that you didn't have any children."
The second the last word of that sentence came out, I froze. . . .realizing that an eighty-something year old Grady elder could very well have survived his kids. I immediately felt like a loser.
"None biologic, but several in my neighborhood been like they was my own."
Whew.
"I coached 'em, helped 'em with they running and all that. Several of 'em didn't have no daddies around and I jest always felt God was calling me to step in and help where I could."
"Wow."
"Yep. Then one of 'em gave me this rang here when they won the states, and another gave me this one here after he graduated cawse up 'til right before he didn't think he would. But he did, and you know he went to college, too?"
Here we go.
I felt that familiar sting in the whites of my eyes. Man! What is it about the Grady elders that always sends me to the tippy-tip edge of crying? I thought of something distant and emotionless for a few seconds to keep me from doing what instinctively I knew I would if I wasn't careful.
"That's beautiful, sir." I sighed and stared at his hands. I placed my hand on his and smiled. "Just beautiful. . . . ." I paused and then added, "I bet you had a lot to do with him going to college."
He smiled wide and proud, the crow's feet in the corners of his eyes exploding like fireworks. He cocked his head sideways as if he was thinking for a moment and then looked back at me while nodding slowly.
"You know, doc. . . . they say, 'It take a village'. I like knowin' I was part of somebody's village."
Part of somebody's village?
::sigh::
Little did he know that today he was a part of mine, too.
I was walking through the hall way during the noon hour at Grady last week. It was my week to teach our resident physicians' Clinic Conference, and I was reviewing my teaching points in my head. My assigned topic was "Hearing Loss"--which I'd admittedly protested doing since I couldn't think of any way to make the topic fun. So . . .in between dreading the topic and a last minute internal rehearsal aimed at "tzuj-ing" up the subject. . . . I did what I always do while navigating the Grady corridors--observe the sights and sounds.
And so I walked and in my head (and occasionally to people) I talked. . . .
Okay, residents. Hearing loss falls into two categories: conductive hearing loss and sensorineural hearing loss. (Yawn)
"Hey there, doc! You doing alright?"
I make eye contact with the cheerful woman pushing a walker in front of her that had just greeted me. I wasn't sure if I knew her from the clinic or the ward, but it didn't matter. Her smile made me smile. "I'm doing great, ma'am? You doin' alright?"
"Blessed and highly favored! But I'm looking for the Dermatology clinic! You know where that is?"
I pointed to the elevator beside us. "Up one flight, and make a left. You can't miss it."
"'Preciate you!" she announced while stepping inside. I waited for the doors to close before heading on.
Can't miss it, I told myself in an effort to be okay with not joining her to make certain.
Conference was about to start, so I let it go and keep walking, my heels like drums on the linoleum.
::click, click, click, click::
Conductive hearing loss involves the external ear and the middle ear. Can you think of some causes of conductive hearing loss? What if you looked in someone's ear and saw what looked like a hunk of feta cheese on their tympanic membrane? Right! A cholesteatoma. Who knows what that is?
"'Scuse me, doctor. Do you know how I can get to the cancer center?"
A frail appearing Grady elder stands in front of me while holding a piece of paper with an appointment on it. His face is gaunt with sunken in temples. His clothes appear two sizes too big. "May I see your appointment, sir?"
He handed me the paper and I quickly scanned it for where he was supposed to be going. Radiation Oncology for a radiation treatment.
"Sir, let's get you over to the information desk. This appointment is for you to get radiation. Did they talk to you about that?"
"Yeah, ma'am. They talked about so much. Mostly my wife keep up with 'em and she know her way 'round Gradys. She under the weather, so I got dropped off."
I thought about the fact that Radiation Oncology was actually outside of the building altogether. I also registered the fact that he was holding a paper in his hand that said just that but, for whatever reason, didn't realize it. I imagined the hassle that this was about to be for him and felt myself badly wanting to take him there myself.
But it was five minutes before my lecture was to start. The best I could do was point him to information. As we reached the info booth, I immediately speak on his behalf to the woman behind the glass.
"I need you to help me with something. This gentleman has an appointment with Rad Onc, and was dropped off here. This is kind of a disaster because he's not anywhere near the Rad Onc building. Please tell me there's something that can be done to help get him there."
And just like that, the woman smiled at me wide and warm and genuine and said, "No problem. We got this." She picked up a phone preparing to dial someone somewhere, but first stopped and spoke to the patient, "Hey there, sir! You doin' alright, sir?"
I like the way real true Southerners tack "sir" onto things when speaking, and especially when speaking to sho' nuff elders. It's a habit that I've admittedly adopted. "Alright then, sir," I said while shaking his skeletal hand. "Looks like you're in good hands!"
I wave and nod as I ease toward the hall near the conference room where I'm scheduled to give my talk. The nice lady at the information desk winks and nods while balancing the phone on her shoulder. We got this.
I went back to reviewing my "chalk talk" on (yawn) hearing loss in my head and drumming the floor for the last few yards before I reached the room.
::click,click,click,click::
Who remembers how to use a tuning fork? Don't worry. I always forget, too. I have an easy way for you to remember how to tell whether you are dealing with conductive hearing loss or sensorineural hearing loss without you being intimidated by this tuning fork!
"What the f&% are you doing? Let's f&%-ing go!"
When I look up, I immediately make eye contact with this stunningly beautiful young woman with piercing green eyes contrasting her cocoa complexion.The nineteenish - twenty-one year old tops guy who was speaking to her in that venomous tone had already passed me and was easily fifteen feet ahead of her now. All I could see was his backside--low slung designer jeans, a hooded sweatshirt, and plaid underwear popping out in between. I paused with my hand on the door of the conference room.
I did my best to hug my little sister with my eyes.
She gazed back at me, almost like a regal gazelle who just noticed a tiger moving in the brush. Her slim fingers clutched her cellphone as she shuffled her feet reluctantly. I offered her a half hearted smile as she passed, which she tried her best to ignore.
"What the f%&$! Come on, dumb-ass!!" bellowed her "friend" from the lobby.
Dumb-ass? Wow.
There were people everywhere. And you know what? He not only yelled these things without any consideration for how this might make her feel, but it also didn't seem to even cross his mind that there were children under the sound of his voice, too. And Grady elders--including my friend who had gotten lost on the way to get radiation.
I try my hardest to think of a reason why young man would think this was okay, and then I try harder to find one to explain why such a lovely girl would be with him. But I knew why--and it was an unfortunate truth that I preferred not to think about.
They were lost, too.
"Here I come!" she finally replied, with an emphasis on 'come' that she somehow seemed to think would sound to all of us like she was defending herself. Her anemic and defeated body language spoke otherwise.
I followed her silhouette down the hall and then noticed it disappear into the sea of other Grady people. My hand was frozen on the door handle as I fell into a trance wondering who among them were lost, too.
In that moment I hope that what I can offer is enough sometimes because on this day, it doesn't seem like it. I start feeling lost myself.
Suddenly, I felt someone pushing against the door. "Dr. Manning? We thought you got lost out there!"
I look at the resident on the opposite side of the entrance and beyond him to the several other learners seated in the conference room facing the clean dry erase board.
On Monday evening I headed to New York City for a quick turnaround trip for work. When I left Atlanta it was 65 unseasonably warm and luscious degrees. Well, let me just tell you that it was not anywhere close to 65 degrees in New York. My coat was not warm enough for the weather which automatically took two notches off of my cool factor, which had already dropped four notches by the mere fact that I was a non-New Yorker in New York.
But that's cool. On Tuesday morning, I completed my commitment by 11 a.m. and had time to enjoy a nice lunch in the Rockefeller Center before my flight out. I was all alone in this incredibly crowded, hustly bustly city, which was really kind of fun considering I got to do one of my fave, fave things: People watch!
Rockefeller, y'all!
And so. . . .
All that people and hustle-bustle watching led me to this week's edition of the Thursday Top Ten--the top ten things I observed during my New York minute spent in Manha'an!
Top Ten!
Observation #10
Everybody is in a sho' nuff hurry, and they ain't even lookin' for your down south "hey y'alls" or your warm and fuzzy eye contact. In fact you can look someone straight into the face, smile all cheery and say, "Good morning, sir!" and be met with painfully obvious indifference. Wait--worse than indifference--they don't even realize you're there.
Observation #9
The dudes in manha'an believe in wearing these super-fitted slim-look suits. I'm sayin'. . .these suits look painted on, man. Very Rachel Zoe project. Chic, yes, but I have a fundamental issue with any dude who has a waist smaller than mine. I'm just sayin'.
Observation #8
The Burberry scarf is alive and well. Somebody suggested to me in the hair salon one day that the Burberry scarf is "played out." Turns out that the people in the only place that rivals Paris in chic-ness think otherwise. (I am so busting out my Burberry on the next cold day.)
I am so pulling it back out!
Observation #7
Felt like paparazzi while taking these. . .
. . .and especially this one!
A dude WILL get him a shoe shine in Manha'an. I have never seen more folks getting their shoes shined in my life! My husband, who is quite shoe-shiney, would do well with this aspect of NYC.
Observation #6
Snow don't stop no show. At all.
Observation #5
A Banana Republic-ier Banana.
A Cole Haan-ier Cole Haan.
Everything feels fancier in New York. Banana Republic feels Banana Republic-ier and even PayLess seems inviting. Put on 50th street and fuggeddaboudit. It's automatically shmoov.
Observation #4
"Schmoov."
And speaking of shmoov. . . . .why is it that flats look flier on New York City girls than on Atlanta-based girls like me? Like, for me, a flat shoe adds at least five pounds. I have decided that if that flat shoe is paired with a messenger bag, a faux fur hat and this season's Burberry scarf, and it is all worn while scurrying down into the nearest subway station, you automatically score at least twenty cool points.
Observation #3
Ordering coffee in New York City requires knowledge of a language that quite possibly deserves its own Rosetta Stone Language software. (See my last New York City observations.)
Observation #2
People in New York City really dig fresh flowers. This part, I really like about New York City. I like this whole process of hollering at a barista to give you a red eye with an extra shot, screaming at him for getting it wrong--"Hey, what are you some kind of moron?"--but then, while waiting for barista to get it right, smelling the lovely bouquet of fresh cut flowers that you just picked up next to the newspaper stand. I liked this dichotomy--kind of like the way sweet and salty go well together.
and Observation #1
wait for it. . .wait for it. . .
As long as you don't talk at all to a person in Manha'an, you can share their personal space at the tiniest of tables. I bought my lunch and entered this ginormous sea of people in the Rockefeller Center, all filling every single table in sight. I walk around scanning the spot, and finally notice a young woman at a teenie-tiny bistro table eating a croissant and playing with her iPhone 4. I remember the rules of seating arrangements in NYC (remember the booth-sharing incident of NYC in 2010?) I smile big and wide 'cause I know the drill.
I barely even talk--I just pull the back of the chair and gesture as if to ask "Anyone sitting here?" She looks up from under her faux fur hat, Burberry scarf and cashmere coat. A quick hand gesture and two simple words give me the green light:
"Ga' haad." (Which, since I have been to this place before, I recognize as "Go ahead.")
I sit down, right, right across from this lady at a miniscule bistro table. I am smart enough to not utter one word. I decide in that moment that so long as you don't talk or make pleasantries, in New York City you can damn near sit on someone's lap without them even noticing.
(Just keep your piehole shut.)
Happy Thursday!
Bonus observation:
What's the deal with them selling Pepsi all over the place? Blasphemy, I tell you!
In Atlanta, it takes an act of God to find a Pepsi product within a fifty mile radius of the city. I mean this is the Coca Cola mecca, after all. I was SO happy to get on that plane and finally enjoy a nice, cold Diet Coke in a frosty silver can!
Aaaaaahhhhhhh!
****
(Shout out to my favorite Grady doctor New Yorkers: Neil W., Lesley M., David M. and Stacy H.! Oh yeah, and my medical student advisee, Flatbush-bred Tony C-Q.)
Okay. So I'm pulling out of my garage this morning . . . . late for clinic and in a sho' nuff hurry. I look at my windshield and see something black stuck near the wipers.
"What the. . . .?"
I get out for a better look. Car is running, so is the clock. . . .
"Awww damn! Not again!"
DUN-DUN-DUN-DUUUUUUNNNN!
You guessed it. The Puppy Mafia had struck again.
It was almost curtains for this one. . . .
So what was it that I saw? I'll tell you what it was. It was freakin' "Baby Chancey" of the Manning Boys Puppy Mafia. . . . thrown on my windshield wipers before work! A-freakin'-gain!
Seriously??
You got a problem wit' me?
Seriously.
Okay. This puppy throwing thing is totally out of hand. Totally.
Which reminds me:
In my last Puppy Mafia report, I need to clarify that I REALLY did find Pup Pup posted up with his legs crossed next to a stop sign on Lullwater, for real. Some obviously nice-slash-retired neighborhood good Samaritan saw the poor thing laying face down in the street and took it upon him or herself to prop the little fella up next to a pole.
Ain't that sweet?
Not only is it sweet--it's true. My mom accused me of using "poetic license" in that story which, although I have been known to slightly embellish a good story, was not the case in that particular one. The evidence above now lets you all know that I was preaching the truth, the whole truth and nothing else but the truth.
Take that, Mom.
But real talk?
The Puppy Mafia must be stopped. I'm just saying. This situation is completely out of hand.
If you know anything about this group, you are officially old school.
"Nobody told me there'd be days like these. . .
Strange days indeed. . .
Most peculiar, mama!"
~ John Lennon
___________________________________________
Walking to outside the toward the hospital entrance:
Dude: "Hey there, lady."
Me: "Hello, sir. You doin' alright?"
Dude: "Oh yeah. . . 'specially now that my eyes is layin' on you."
Eeeww. Eyes? Layin' on me?
Dude: "You wearin' that haircut, lady."
Me: (smile)
Dude: "You lookin' real good, too."
Me: (in my head) Ewww again.
Okay. Let me make this story as funny as it really was for you. "Dude" was about sixty-something years old, and if I guessed it, at least two hundred seventy-five pounds of southern gentleman. (If you count his comments as southern gentleman-ly.) Anyways. Dude had a hospital gown on, was pushing an IV pole with two different medications, and smiling wide with lots of interruptions in his dentition. (That's my medical way of saying that Dude had a very complicated grill--whoops grill = teeth.)
So check it out. All of this was going down right outside in front of the entrance. He was sporting a rather spectacular salt and pepper, fully picked out afro, which I have to say boasted a rather impressively intact hairline for a dude his age. And how perfectly picked it was! I mean it had to be freshly picked out because not even one side of it was smushed in-- and folks who know afros know that afros can sometimes get, well, smushed.
That reminds me. His afro kind of reminded me of when my brother used to ask me or my sister to plait his hair all over so that when he unraveled the braids his afro could be that loose, blow-in-the-wind type afro that only has been attained by the following people: Chaka Khan, young Michael Jackson at the post-ABC but pre-Thriller age, and a group called The Sylvers that, unless you are over 40, black, and real, real ol' school, you'd never know so I won't even mention in great detail. But my brother? His afro was pretty awesome--particularly when freshly picked out after some mean plaits courtesy of his sisters' nimble fingers. I'm just sayin'.
Chaka Khan. . Chaka Khan
Wait-- where was I?
Oh. The unsmushed afro of this dude who could be my father was, quite possibly, one of the best I'd seen in a long, long time. Definitely as good as my brothers, and perhaps one step under that of Chaka. But despite his lovely afro, I wasn't looking to have his eyes layin' on me much longer so I keep it moving. The good news is that after ten years of working at Grady, on a scale of one to ten on how fazed I was by it, I'd say it was a solid two.
Anyways.
So as I walk along past him, Dude posts up in the little outside smoking area, designated for folks who wish to smoke. He reaches into the afro and pulls out a cigarette.
Yes!
This is the point where I know FOR CERTAIN that I will be blogging about this (and NO, Mom, I am not using poetic license here--Dude really pulled a square from up out of his afro.) Then, as if on cue, a lady gives him a light. I stop and watch for a few seconds because I'm convinced that she doesn't know him and that it's all a part of some complicated smoker's etiquette. I was right. Before I know it, they're yucking it up. I rather dig the camaraderie.
Lady catches me looking and smiles. "Baby, you wearin' that haircut!" she says in a surprisingly loud yet unsurprisingly raspy voice. She follow it with a sassy laugh.
Dude chimes in. "Tha's what I jest told her!"
Lady nods fast as she lights another cigarette, takes a deep drag and then says to Dude in that same loud voice, "You know she be on TV. On Fox 5."
Dude turns his head sideways at me and squints his eyes. "Sho' is, ain't it?"
Lady cackles and says, "Yep. Sho' is. You betta do it, girl! You be doin' yo' thang!"
They both look in my direction and give me an approving nod. I decide I like the kindness in their eyes and return the favor.
I stood there for a moment watching them. . . .as crazy as it sounds, I admired how content they were. Suddenly, a bigger smile creeped across my face. This is Grady, I say to myself, and man, I'm just glad to be here. I took in a few more sights and sounds around me as I walked into the building: A rather odd homeless lady unashamedly singing a gospel song on the bus stop--"I--HIII-HIIII I KNOW I BEEN CHANGED!! THE ANGELS IN THE HEAVENS DONE SIGNED MY NAME!!!"-- a man riding by in an electric wheelchair that seemed turbo-charged, and a woman with extremely swollen ankles eating french-fries from a McDonald's bag.
I think of how peculiar all of this seemed when I first started working there, and how at home I feel standing in the middle of it now some ten years later. I turn around and look back out the glass doors, and shake my head. In a way that moment feels divine.
I think to myself, You are exactly where you are supposed to be.
Sho' is ain't it? Sho' is.
I head off, wearin' my haircut, to do my thang.
*****
The Sylvers on Soul Train. . . .consider yourself now officially "old school."
It's a world of laughter
A world of tears
It's a world of hopes
And a world of fears
There's so much that we share
That it's time we're aware
It's a small world after all. . .
There's this funny thing about blogging. You sort of make "friends" with people that really kind of feel like sho' nuff friends, but instead of it being because you're both on the P.T.A. or in the same class at the gym, it's because you've been privy to some of their innermost thoughts and them to yours. And even if it isn't your innermost thoughts they're privy to, it might be, at least, your random musings which, if you ask me, is the stuff that some of the very best sho' nuff friendships are made of.
That said.
When I started this blog, I sort of imagined it being read by a smattering of local medical students and residents, my doting family, and perhaps a teeny weeny number of others. But something rather interesting happened. More people than that ran across it and actually read it. And then they read it again. Guess what happened next? We all (sort of) became "friends."
Now because I am not Facebookey nor am I a Facebook-er, it somewhat pains me to acknowledge that I've. . .errr. . ."friended" a few wonderful people in lands near and far thanks to this blog. Oh, and for the record. . . . the reason I don't Facebook is because something about Facebook slightly scares me. Kind of like it has the capability of becoming its own form of crack kind of like that Angry Birds game or Sudoku puzzles. For that reason, the only people I'll "friend" will be nerds who read blogs or folks who are on the P.T.A. and in the same class with me at the gym. (Although I did watch and was deeply intrigued by "The Social Network" movie on pay-per-view last week!)
Wait, what was the point?
Don't worry, I do have one. Tonight I am reflecting on one of my blogworld "friends." Specifically one who happens to live in New Zealand. Yes. You read it right. New Zealand. New Zealand Lucy---who not only faithfully reads these crazy and oft times non-medically related ramblings, she also happens to be one of the most consistent comment-ers next to my parents (which, if you blog, you realize is mighty kind.)
Anyways. This morning I was watching the news and all of a sudden this breaking story comes on about this awful earthquake in New Zealand. Buildings collapsing. People getting hurt. Others losing their lives. . . .
Oh no!
That's what I said when I saw the news story. Before I started this blog, I am certain that I would have seen that headline and still said, "Oh no!" But this, "Oh no!" today was different. It was like the "Oh no!" I said when I watched the levees breaking in New Orleans. I actually knew people who lived in the Big Easy and I also knew people whose people lived there, too. With that it was personal.
When that tsunami swallowed an entire coast, I also said "Oh no!" But again. It was different. Yes, my heart ached for every single person affected. . . but I didn't have a real person to call up and ask, "Hey, Is your mom okay?" or "How is your sister?" With every natural and unnatural disaster, I pray. . . often cry. . . look for ways to give. . . .but many times, especially when it happens far away from home. . . I am mostly praying for nameless strangers.
But not today.
Today, I saw that news and immediately worried about my "friend" in the South Pacific. I know so little about New Zealand and other than it being very far, very beautiful, and obviously very gnarly considering it was good enough for the "Lord of the Rings" movie trilogy and to be the location for the last cycle of America's Next Top Model, I am pretty much clueless. So I hear of these terrible earthquakes and their aftershocks, and I hope that New Zealand Lucy is no where near the fault line and that her "people" aren't either. I see a building crumble and clutch my chest because in a way that I can only describe as indescribable it is a little bit personal. Imagine that. I am a black woman in Atlanta, Georgia and there is somebody in New Zealand--yes, New Zealand--that I am hoping is okay.
Crazy.
So right now my prayers are with my "friend" in New Zealand, and perhaps some other New Zealand "friends" who also read but don't comment. I am reflecting on the blemishes to your stunning countryside that I've only seen in pictures and I'm hoping you're okay. And even if you're okay, I'm asking, "Hey, how is your mother?" and "Is your sister okay?" I am crossing my fingers and looking for your faithful comments at the end of my posts. . . .and hoping they can somehow be translated to mean "Yeah, girl, I'm okay." And what's really crazy is, now that you all are reading this post. . . . you're hoping it, too. Will you say a little or even a big prayer, too?
Thanks.
Yeah, man. Writing this blog has taught me a lot. And one of the very best things it has taught me was something Walt Disney tried to get into my thick skull over thirty years ago -- it's a small world after all, man. . . . . .Crazy small.
I am drinking a cup of piping hot coffee out of a mug with Isaiah's soccer picture glazed onto its side . . and I'm thinking that it's really, really good. I am looking at this mug and looking at my son and feeling like my heart could not love him more or his brother more. I am asking myself how something as simple as a cheap mug from the cheapest photo package could make a person so happy.
Right now. . . .
I am thinking about the fact that this exact time last week, I was sitting in the same chair drinking from the same mug. . . except instead of blogging I was somewhere in between reflecting and praying. You see, this time last week, my father was on a stretcher in an ER on the other side of the country. His chest "felt funny" so he went in. The tests suggested something could be going on with his heart. . .on Valentine's day, no less. He has a "heart history." His daughter is a doctor who happens to know that "heart histories" are the number one things that take beloved patriarchs and matriarchs out in this country. So last week, with all of my medical knowledge and such, all I could do was sit in this chair, pray to my God, and wait to see what would happen next.
Right now. . . .
I am feeling thankful and full at the mere thought of my father being okay. Cardiac catheterization confirmed---the pipes were clean. I am also smiling because I realized that it didn't take this to make me realize how much I love-need-respect-adore-cherish-everything-else my father. In fact, it is for that very reason that I could focus just on him and his heart instead of me and mine.
Right now. . . . .
I am thinking about my good friend Michele T., who is the same age as me and a mother of two like me except instead of sitting at her kitchen table with a cup of joe, she is lying on an operating room table getting ready to have breast reconstruction. She is a survivor in every sense of the word. Resilient in a way that you couldn't get your mind around unless you knew her. And peaceful? I've never known a more peaceful human being. Right now, my heart is touching and agreeing with her heart and I am holding her hand even if she can't feel it. And I'm claiming the best.
Right now. . . . .
I am surprised at how much Isaiah has grown up since that very first time I put him on the school bus in August. He sprinted toward the bus this morning, and literally said to me, "I'm good." He's good? Really? Wow.
Right now. . . . .
I am reflecting on a world that is so terrible that it includes people who shoot their children out of frustration, people who languish in jails for things they didn't do, and that oppresses people just because they have two X chromosomes instead of one. . . . .but marveling at how the same world is so beautiful that it includes Zachary looking at me last night and learning how to wink his eye from across the room, and also wild dandelions on the side of my driveway for Isaiah to pick and hand to me in imperfectly perfect bunches. A world with hugs so tight from my husband that they feel like they'll suffocate me for sure.
Right now. . . . .
I'm thinking that I'm okay with right now. And you know what? I think I'm good, too.
Just when I start to think that I am somewhere even remotely close to a big deal, I am grounded by my daily family life. Isn't it funny how different the word "problem" can be defined depending on whether you're at home or at work? Ummm. . . yeah.
Kind of a big deal. . . . .?
"Don't forget--you're dropping Zachary off tomorrow. I have an early meeting."
Those were the last words Harry said to me before we turned off the light to go to sleep last Wednesday night. I think I replied with a mumbled "Gotcha, gotcha" or something like that. All I know is that I was unusually tired that night.
"Mommy, may I have some soy milk, please?"
These were the next words I heard which, much to my terror, were spoken at 7:10 a.m. the following morning by Zachary. This meant a few things. One, that we had missed Isaiah's bus. Two, that I would be tortured by the carpool lane at Isaiah's school. And three, that in addition to all of that, I had to factor in getting Zachary to his school that morning, too. In other words, I was pretty much hosed.
And so. We scramble all over the house. The bathroom is like a factory assembly line with Harry and me as the only ones who crossed the picket line during a union strike. Teeth brushed, hair brushed, face wiped, boogers removed -- "Okay, go to Daddy." Undershirt on, Old Navy or Target special over your head, jeans zipped-- "Hey, Mommy! Does Zachary have a single pair of pants without a hole in the knee?" "No." "Really?" "Really."--socks on, sneakers tied -- "Okay, go to Mommy." Coats on, zippers zipped, hats secured, lunchboxes in backpacks, homework in backpacks, backpacks on shoulders--"Go to the door."
"7:35 Mommy! You need to hustle!"
Reheat coffee for the third time, put mascara in my purse along with lipstick with plans for dolling up in the (slow) carpool lane, open the door and head down the steps into the garage like thunder. "Let's move and groove, gentleman!"
"Boys, listen to Mommy. Let's rock and roll."
Obligatory horsing around, predictable fighting, annoying whining, and finally -- click, click--buckled in and everyone is ready to get going. Well. . . .almost everyone.
I throw it hard into reverse and whip out of the garage. I hear Kai Ryssdal on NPR reminding me of my limited time before the bell rings at Isaiah's school which was just enough to make me really burn rubber. I am halfway up the street when I hear this:
"Mom-meeee! Pup-Pup!"
I see Zachary through the rear-view mirror with a look of terror in his eyes. What now? "What about Pup-Pup?" I query.
"Zachary threw him and he landed on the roof of your car when we were coming down the stairs," Isaiah clarified.
"Mom-meeee! Can you get him? Can you stop and get him, p-leeeeeeeeaaassse?" Zachary pleaded.
But this would surely be a lesson that Zachy would have to learn the hard way: The law of late mommy and toy on roof of Volvo. "Pooda, I think Pup-Pup isn't on Mommy's roof. And Mommy can't stop because Isaiah will be late for school. I'm sorry."
"Ohhhhh noooooo," Zachary whimpered, "He's going to be lost and all lonely. And. . . and. . .a stranger might get him!" He let out a cry that was 100% genuinely real.
"Poor, poor, Pup-Pup," Isaiah said with the most melodramatic yet also serious tone humanly possible. He eyeballed me from the back seat like I was the worst parent ever and repeated,"Poor, poor Pup-Pup." This just made Zachary cry harder.
I feel terrible, but not terrible enough to be forced to sign Isaiah into school late---so I keep it moving. After Zachary and I pull out of the carpool lane, he sniffles and asks, "Do you think Pup-Pup will be cold at night?"
"Uuuuhh, no. He has that blue fur, so he should be okay," I quickly replied. I made every effort to sound chipper.
"But if it rains, he will get all wet!" Zachary began crying again.
Oh Lawd.
So, yes, even though I am late, I try my best to make a pass down the streets which (are out of my way and) yield no Pup-Pup. Ugggghhh.
Okay. Let me tell you about the stuffed dog situation in my house. It all started when my mother gave Isaiah this stuffed dog that quickly became his lovey when he wasn't even a year old. Isaiah promptly named him "Puppy" which started the whole family tree. Next came "Teddo," who was originally supposed to be named "Perro" (as in 'dog' in Spanish) but "Teddo" became the default of then eighteen month old Isaiah. Then the growth of the Puppy Mafia went something like this:
"Puppy" -----> "Teddo" ----> "Puppy Dog"----> "Pup-Pup" ------> "Little Guy" ----> "Biscuit" ----> "Jack" -----> "Cody" -----> "Baby Chancey" (named after our next-door neighbors' black lab, Chance) ---> "Pups" ----> and so on, and so on, and so on.
Other than my children, I seem to be the only one who knows the difference between all of the ginormous puppy-brother family. Whenever I round on weekends and Harry is home with the kids alone, it isn't unusual to hear, "Okay, who in the hell is 'Puppy Dog?' I thought he was the blue one."
And I say, "Yeah, he is blue with a little bell inside of him when you shake him. His ears are white."
"White or stripes?"
"That's 'Pup-Pup.'"
"Well, have you seen 'Puppy Dog?' Zachary is crying specifically for this 'Puppy Dog'"
"Not for a few weeks."
"Uggghh."
With the exception of Puppy and Pup-Pup, all of the dogs get loved in waves. One week it's Baby Chancey this, Baby Chancey that. The next, it's Biscuit and Cody. But Puppy and Pup-Pup? These two are somehow the alpha males of the bunch. Isaiah still sleeps with Puppy every night, and Zachary continues to love his Pup-Pup.
So now you know. This was kind of a big deal. In fact, it was bordering on a catastrophe. I mean. . .I was breaking up the Puppy Mafia, just because I wouldn't stop my car. Surely, someone would put a hit on me if I didn't do something about it. I called Harry.
"Dad?" (Sidebar: We have accepted that we are officially lame because we refer to each other as 'Mommy' and 'Daddy' even when the kids aren't a part of the conversation--but I digress.) "I need you to do me a favor. . . " And so I commenced to explain the dire situation and that he needed to comb all of in town Atlanta to locate Pup-Pup.
"Which one is Pup-Pup?"
"The one you thought was Puppy Dog that day."
"With the bell in his chest?"
"No. That's Puppy Dog."
"The little black lab?"
"That's Baby Chancey."
"The one with the red, white and blue collar that looks like Obama's dog? He's been the main dog all week for Zachary. You mean him?"
"No. The blue one with the striped ears that you thought was Puppy Dog."
"Uhhhh, okay. I'll look."
"Really look, Dad. He's losing his mind back here."
"Okay."
Unfortunately, Harry had no such luck. When I picked Zachary up from school that afternoon, his teacher told me that he had a good day with the exception of him being sad about "Pup-Pup" getting lost.
"You have a dog?" she asked.
"Uhhh, no. Long story," I replied as we headed out.
And so. . . .the whole way home, I have to hear about how cold, lonely, and scared Pup-Pup will surely be. We get Isaiah from after care, and now it's double. "Mom, you should have stopped immediately and looked for him. You should have, Mom. Then he wouldn't be lost forever," Isaiah chastised me.
Zachary whimpered even louder. "Lost for-ever!"
Uggghhh.
I decide to say nothing. Instead I just drive. . . Isaiah hazing me with his unhelpful commentary and Zachary wailing in response to each insult. And did I mention that my day had been super busy and ridiculously crazy?
I stop at a red light and shake my head. I rub my eyeballs with my thumb and index finger and long for the moment that I would be able to take a breath. The light changes and I let out a big sigh. Two seconds after stepping on the gas, my eyes wander over to a traffic sign on the side of the road. I have no idea why, but I follow the sign down to the pole positioned firmly in the ground surrounded by tufts of grass. And right there, on the side of the road amidst those green blades of overgrown Fescue was the last thing I expected to see: Freakin' Pup-Pup. Posted up against the pole chillin' like a dude waiting for the bus.
I couldn't contain my surprise (and excitement). "Pup-Pup! It's Pup-Pup!"
Chile. You'd have thought we'd spotted Mr. Obama himself strolling down Ponce de Leon Avenue. Those kids went BER.ZERK. Do you hear me?
"Pup-Pup! Pup-Pup!" Zachary squealed from his seat as I whipped the car into the nearest driveway to make a U turn. I throw on the hazards, jump out of the car, and retrieve our long lost friend, Pup-Pup.
Hallelujah.
Later that evening, Harry comes home with a slightly long face. "I drove around to see if I saw P-U-P-P-U-P but no luck. I'm sorry, babe."
Isaiah, who Harry continues to neglect to accept can READ, says, "Oh, Pup-Pup got found. He had an adventure but he got found."
Harry looked over at me. "Don't even ask," I said.
That night, an hour after we'd tucked in the kids, I hear something moving in the kids' playroom. I walk into the room and turn on the light--and there in the playroom is Zachary digging through the toy box.
"What are you doing? You need to go to bed."
"Mom-meeee, have you seen Little Guy?" He looked up at me with glistening, doe-like eyes. "Pup-Pup is asking for his baby brother." I look and see Pup-Pup tossed on the floor behind him. Zachary's eyes begin welling up again. Seriously?
Top ten medical jargon-ish terms to use about patients on rounds that (if overheard) will guarantee that they:
a.) have no idea what you are talking about b.) kick your ass or get someone else from the waiting room to kick your ass c.) never come to see you again d.) all of the above
#10
acute: (adj.) a relatively new problem
Doctor: "This really isn't an acute thing at all."
Patient: "Oh yeah? Well, I think you're a-ugly, too."
#9
unremarkable: (adj.) in medical terms, this means completely normal, which is a good thing.
Resident to attending on rounds: "Nothing about her jumped out at me. Everything about her screams unremarkable."
Patient in hospital bed: "Well, you ain't exactly Brad Pitt yo' damn self!"
#8
impressive: (adj.) something that's so abnormal on physical exam that it warrants bringing the medical students in to see.
Attending: "I'm pretty sure this meets criteria for micro-penis."
Medical student: "Wow. That's pretty impressive, Dr. Johnson."
Patient (with big smile and raised eyebrows): "Ya think so? I'm so flattered."
#7
S.O.B.: (n) shortness of breath
Resident in the ER speaking to his colleagues while putting his initials next to the complaint listed on the board:
"I think I'll take this S.O.B. right here!"
The patient sitting in a hall spot in the ER speaking into his cell phone as that same resident approaches him:
"I guess I'm stuck with this S.O.B. as my doctor today!"
#6
appreciate: (v.) what you see on physical examination when looking at a patient.
Patient: "But look at my ankle! Can't you see it's swollen?"
Doctor: "I don't appreciate that."
Patient: "Appreciate what?"
Doctor: "Swelling in your ankle."
Patient: "Well it ain't like I twisted it on purpose, you self-centered jerk!"
#5
presentation: (n.) what a person looks like when they arrive at the hospital, or the act of discussing a patient with another physician.
Attending: "What was her presentation like?"
Intern: "It was so impressive. You wouldn't even know she was the same person!"
Patient, in bed: "What presentation? I didn't give no presentation."
Attending: "Just one moment, sir, I'm listening to your doctor's presentation."
Intern: "Yeah, my presentation about your presentation."
Patient: "Say what?"
#4
tachy: (adj.) an abbreviation used to describe someone who is tachycardic, or in other words, that has a fast heart rate. Pronounced "tacky." tachy = fast, cardic = heartrate
Attending (feeling pulse of patient): "You didn't tell me she was so tachy!"
Intern: "I thought I'd mentioned it during my presentation. Yeah, she was super tachy from the moment she arrived."
Patient: "Well it ain't like that comb-over and those pleated poly-blend slacks you have on scream Project Runway, either, you rude bastard!"
#3 express: (v.) to get pus out of something.
Attending: "Were you able to express anything from her?"
Intern: "No. We tried but couldn't express anything."
Patient: "Tha's 'cause y'all don't listen to nobody! I can express myself very well!"
Resident: "I think this marked weight gain represents heart failure and fluid retention."
Intern: "Hmm. You may be right. Twenty pounds in two weeks is some pretty marked weight gain."
Patient: "Wow! You think I gained twenty pounds just from trying all those samples when I was in the supermarket?"
#1
chronic: (adj.) something that's been going on for a long time
Intern: "The chronic cough is the main thing I'm concerned about."
Patient: "Aww, damn doc! My ol' lady keep telling me to stop smoking The Chronic so much!"
Intern: "Uuuhh, okay."
***
Before you jump off of the exam table and tear your doctor a new one. . . . take a moment to ask them exactly what they meant by that. . . . .and if they meant to call you an S.O.B., then you have my permission to proceed with the butt-whooping. :)
"What it all comes down to. . .
Is that everything's gonna be fine fine fine
'cause I've got one hand in my pocket
And the other one is giving a high five . . "
~Alanis Morrisette's
"One Hand in my Pocket"* circa 1995
*(constantly played on my mental walkman and real walkman during my med school days!)
When I was a medical student, we were on a standard grading scale--A, B, C, (no 'D', sorry) and F. You studied hard. You pulled all-nighters. You drank four cups of disgusting coffee in a row, and then you arrived to your lecture hall bright and early to take your lumps, err, I mean exams. And a few days later, there was no mistaking where you stood. A-B-C-(no 'D', remember?)-F. Period.
A lot of medical schools have gone to a pass/fail system of grading. The drill, for the most part, is similar. You study hard and pull the all-nighters, but now it's a little more fuzzy. Either you pass or you don't. It's kind of like being pregnant. You go into the bathroom with the stick, and when you come out, there's either there's two lines or one. No room for "Mr. In-between."
So.
Somewhere toward the end of the pre-clinical training with all of its pass-fail nebulosity, the anxiety begins. A deafening sound begins pounding in the chests of medical students which they mistake as palpitations when really it's that ginormous drum roll revving up toward the US Medical Licensure Examination (boards). . . .
Thump-thump-thump-thump. . . . .been pass/fail up 'til now. . . .thump-thump-thump-thump. . . . studyin' for boards, 'bout to have a cow. . . .thump-thump-thump-thump. . . . straight P's 'til now, I've had it made. . . .thump-thump-thump-thump. . . .this board exam will feel like my very first grade. . . .thump-thump-thump-thump. . .
Something like that.
And therein lies the problem. After all this pass/fail business, a whole ton of weight ends up getting placed on this score--this three digit number that suddenly becomes the first publicly objective measure of where you stand as a medical student. Uggghh.
So like clockwork, it happens. Smart students start freaking out. Pulling out their hair, crying into the crooks of their arms, and having panic attacks over their MacBook pros. Terrified that, after two years of exceptional test scores that only they and a few powers that be could fully appreciate, everything will come down to one painfully long day in a testing center. The days of "P = MD" are officially over and by the time it's test day, the drum roll is thundering so loud that the student can barely hear their own thoughts.
Thump-thump-thump-thump. . . .
If the student is lucky, it's a good day when they take the exam. The birds are chirping, the boyfriend is calling, the hair is behaving, and the knowledge is resurfacing.
If the student isn't so lucky, the day leaves a bit to be desired. A cat is in heat next to the bedroom window all night, the girlfriend accidentally pocket dials while giggling a little to flirtatiously with some dude that you know for sure ain't you--only because you're you, and you're not there. A bad haircut throws your looks into serious question and the knowledge that day? Oh man. You can't even remember your social security number to gain access into the testing center. And if you're lucky, it comes together at some point.
But either way, whether you had a good day or not, a few weeks later, you get a lovely little token via email that includes three digits: Your board score.
And like I said . . . .for many students, this three digit score has suddenly become the very first outward measurement of their awesomeness as a medical student. And that? For uber-achieving academic types (aka the type of folks attracted to medical school in the first place) is a hell of a pill to swallow.
And so.
To those whose three digit score is so high that it makes program directors like me stop and scratch their heads and saying, "Damn! I didn't even know you could get a score that high!" and also to the others whose three digit score so narrowly ekes by that they spend six straight weeks wailing over a box of Puffs Plus tissues wondering if they will ever, ever become somebody's doctor. . . . .I have a message for you all:
It's only a test. Seriously.
When I was a medical student, we all took that heinous little USMLE Step 1 on the same day all over the country. This was before the computer centers and before the staggered test dates. And back then, every person in the U.S. and beyond got their scores on the same day. A treacherous little situation, I tell you.
So picture it: June 8 and 9, 1994. Two painful days of sweating bullets over scantron sheets after two months of denying ourselves anything remotely close to fun. We took the exam, and on July 1, we hit our clinical clerkships in our short white coats--before the scores came back.
Mid-July we were all working on the wards, doing what spanking new clinical medical students do. And then, that's when the message arrived. Some kind of inter-office telegram (don't I sound old now?) came to all of the hospital rotations and attendings interrupting everything:
"Release all M3 medical students ASAP to the Dean's office to pick up USMLE Step 1 Scores." Stat.
Yeah.
Back then, the scores hit the Dean's office before they hit your mail box. This was before the whole email thing was available to allow you that privacy of logging on at home. And sure, a lot of people just waited until they came via snail mail. But at my school? This was the culture: to report to the Dean's office.
But in 1994 there was a problem. Something really terrible had happened. . .so terrible that the Deans summoned us all out of our classes immediately to get our scores. For the first time ever, for some inexplicable reason, some unconscionable number of people in my class had failed, yes failed, the Step 1 boards. This meant, they didn't get a three digit number that was even high enough to pass go or stay on their clerkships.
Yeah, girl. A scary percentage of your class, the rumor mill gushed. Even the smart ones. Did you hear about so and so? Even HE didn't pass. And what's-her-face, the student leader? Yup. She didn't make it either.
Lawd have mercy.
I'm telling you. . . .the walk from the parking lot to the Dean's office was like the freakin' green mile, man. And even worse? All of the pre-clinical students were sitting outside of the building like vultures--staring at peoples' facial expressions in an effort to discern whether or not they were in the number who'd made it or in that dismal group who had pseudo-disgraced the institution.
Lawd have mercy.
A close friend/class mate and I met in the parking lot. We locked arms and charged our way into the building. We pushed past the vultures, refusing to make eye contact with them. Once inside the building, it was eerie. I'll never forget it. . . two really smart people were sitting cross legged on the floor near the lecture hall. One was crying, the other was consoling. "We will get 'em next time," the consoler murmured as the cryer heaved over and over again.
Lawd have mercy.
I tightened my grip on my friend's arm. We finally make it into the Dean's office where we're each handed an envelope with our score in it. As a side bar, there was this executive secretary who was known for her vacillating emotions while giving out the results. Allegedly, she'd show you all kinds of love if you'd done well, and give you the hairy eyeball if you hadn't. My experience was somewhere in the middle--a big smile while being given the hairy eyeball. Perplexing. But I digress. . . .
So me and my friend decide we will take a deep breath and open them together. We studied hard, we told ourselves. We did fine. I opened mine first:
PASS.
Okay, I admit---I was so happy to not be one of those who hadn't passed, that I barely realized the relative crappiness of my score. A little under the national average, which is a nice way to say that it was sho' nuff below average. Damn.
Next we opened my friend's score:
FAIL.
Tears. Hugs. Consolation.
"I will never be a doctor!"
"Yes, you will. You will."
"This is the end of the world."
"No, it's not. It's not."
But you know what? At that moment, it really did seem like it.
Well, a lovely little thing happened after that. Time. It marched on and gave me something that must marinate before you can really use it: perspective. And now, I know for sure--it wasn't the end of the world. It so wasn't.
I've met some medical students with amazing board scores who had amazing work ethics and clinical acumen. But I've also met some test czars who were pompous and unprofessional jerks. And high scores or not, I wouldn't want them anywhere near me or my loved one. One of the best students I'd ever had the pleasure of working with had received a whole lot less than stellar score on the first and second board exam. He just wasn't a good test taker. But a good doctor? I tell you without flinching--he remains one of the best I've ever seen.
So with my perspective, I know that folks with three digit scores that don't break records can and do become exceptional physicians. And the other thing is this-- at the end of the day, the patient wants someone who cares enough to listen, to learn, to try, and to know when they need to go find out more. The patient wants someone who comes through not just in a computer testing center, but when it really, really counts. A doctor that holds their hand and calls them back. One that remembers what they said. And that? That never comes up on those exams.
Let's not get it twisted--I'm not saying that objective measures for medical students and residents should fly out of the window. But I do think that more emphasis should be placed on professionalism, humanistic qualities and how well students care for patients. I just wish there was some universally objective measure that trumped those pesky three digits --especially considering how easily they can be thrown into an upheaval by anything from a feral cat outside your window to an idiotic boyfriend who breaks up with you on Facebook two days before the exam.
The friend who failed the board back in 1994? A wonderfully successful physician and community leader with legions of loyal patients. One of those "smart people" who was sitting cross-legged on those cold tiles weeping that fateful day? Nationally known and recently promoted to one of the most coveted leadership positions at their institution. And me, the one who made it through just by the hair on my chinny-chin-chin? I think I turned out alright, too.
And so. . .to every three digit scorer young and old, I say this: Give it your all, study hard--but then relax. Because at the end of the day, the truth is this: It is only a test. But the patients? Those real, breathing, living patients? That part ain't a test. And as long as we can keep that part straight, the rest of it comes together.
And what it all comes down to. . .
is that no one's got it all figured out just yet
'cause I've got one hand in my pocket
and the other is playing a piano. . .
And what it all comes down to my friends
Is that everything's just fine fine fine
'cause I've got one hand in my pocket
And the other one is hailing a taxi cab. . .
~ Alanis Morrisette
Somebody needs to hear this song today, too. Aren't we all brave but chicken-sh@%?
This morning I am reflecting on these words by the great Maya Angelou:
"When you learn, teach. When you get, give."
"What I think it really means is: I'm a teacher. I am a teacher. I teach all the time, as you do and as all of you do—whether we know it or not, whether we take responsibility for it or not."
"One isn't necessarily born with courage, but one is born with potential. Without courage, we cannot practice any other virtue with consistency. We can't be kind, true, merciful, generous, or honest."
"A bird doesn't sing because it has an answer. It sings because it has a song."
Lady: (without even flinching)"You 'spectin, ain't you?"
Grady doctor: (Looking mortified) "Uuuuhhhh, no, ma'am. I'm not."
Lady: "Oh. . . .okay, then. . . . . you just need to make sure you hold yo' stomach in a little more." (Demonstrates belly suck in case she didn't know how.)
Grady doctor: (Blank stare)
Lady: "Yeah, girl. . . .Don't worry. That be happening to me sometimes, too."
Mommy + Daddy + Isaiah + Zachary + together = One perfectly hot date for Valentine's Day.
However.
New Year's Eve 2011
Mommy + Daddy - (Isaiah + Zachary) + together = Very necessary component to keeping Valentine flame perfectly hot.
New Year's Eve 2010
Believe that.
***
Enjoy this song if you have a moment. . . . now playing on my mental iPod today and reminding me that even though I'm a mommy-slash-doctor-slash-teacher-slash-wife, I'm also just a girl. . . which reminds me of this wonderfully cheesy movie scene:
Sigh.
Happy Valentine's Day to all of you girls and boys.
Honestly? I write this blog to share the human aspects of medicine + teaching + work/life balance with others and myself -- and to honor the public hospital and her patients--but never at the expense of patient privacy or dignity.
Thanks for stopping by! :)
"One writes out of one thing only--one's own experience. Everything depends of how relentlessly one forces from this experience the last drop, sweet or bitter, it can possibly give."
~ James Baldwin (1924 - 1987)
"Do it for the story." ~ Antoinette Nguyen, MD, MPH
Details, names, time frames, etc. are always changed to protect anonymity. This may or may not be an amalgamation of true,quasi-true, or completely fictional events. But the lessons? They are always real and never, ever fictional. Got that?
