Hair Raising Tales Part 3: The F.P.

*names and details changed although written with patient's permission.

The long (hair) good-bye.

The history behind the F.P. thing.

I have this little thing that I do on rounds each day. I've done it ever since I was an intern and how or why I started this ritual, I do not know. But I do it and I've done it going on fifteen years now. Every day I knight one of my patients as my "F.P." --shorthand for favorite patient.

When I first started doing this, I kept it to myself. On rounds, I'd simply place an asterisk in the upper right hand corner of the patient's tracking card--which meant that the patient was in the F.P. running. When rounds ended, I'd place the card of my F.P. on top. Again, why I did this? Eh. Beats me. I guess it just made the whole process of meeting and caring for folks a little more fun.

The other funny part about the F.P. thing is that there has never really been any kind of rhyme or reason to what deems someone F.P.-worthy. Sometimes it's something obvious like being wonderfully pleasant for no reason. Other times my F.P. might be delightfully wrapped in a cocoon of mild senile dementia interrupted by wisdom so crisp that if defies belief. And then there are the days where my F.P. is mindblowingly contrary and cantankerous, doing anything from kicking the whole team out of the room to tossing f-bombs around like confetti to refusing any and every therapeutic thing offered.Yep. Those folks challenge me so much that they're paradoxically endearing to me.

When I became an attending, I got a little more open about my F.P. ritual. So much so that by the midpoint of every ward month, members of my team often preface their patient presentations with this preamble: "This patient is totally going to be your F.P. today, Dr. M." By the end of the month, they are knighting their own F.P.s. And I just love it.

Which reminds me--I'll never forget the day that I hugged my student, Joelle, in the hallway as she cried over her patient who'd taken an unexpected turn for the worse. With a red nose and leaky eyes she sniffled quietly and said, "He was my F.P., Dr. Manning." Hearing that made me cry, too.

Every now and then, I meet a patient who is just so special that their F.P. status transcends a one day designation. These patients achieve a title that I developed somewhere during my senior year of residency--"F.P. All-Stars." I guess being an F.P. All-Star is like being in one of those airline platinum clubs where you immediately trump all others upon arrival. Work in a hospital long enough and you can form quite the collection of F.P.s. Not to mention F.P. All-Stars.

Anywho.

On Friday I was at the end of my solo rounds. I'd allowed the team to disperse after seeing our new admissions, especially since I knew the senior resident had already work rounded with the team on all of our pre-existing patients. At this point, I had been going around seeing the rest of our service of patients, reiterating the points that had already been made earlier that morning by the team. I love moments like this--they give me time to really connect with my patients in that way that I used to during internship. And enjoy my F.P.s even more. Especially ones like Mrs. Zebedee.

Mrs. Zebedee.

I'd intentionally saved Mrs. Zebedee for last. She was not only my F.P. on this day, but an F.P. All-Star. Even though she was pretty sick, seeing her was such a treat. Her attitude is always so calming and sure that it immediately washes me with a peace that is hard to explain. On this day, it wasn't terribly busy, so I'd carved out a little extra time at the end of my rounds just for enjoying her presence. I couldn't wait.

A fairly aggressive cancer was what had her hospitalized this time--the same one that caused our paths to meet in the past. The team had already told me that Mrs. Z. was doing okay today and that she was still tolerating her chemotherapy like a champ. My plan was to confirm this through a quick examination and a few questions then, depending upon how she was feeling, let her dictate what would happen next. A chat perhaps? A hand squeeze followed by a request to close her window shade? The ball was in her court. No daycare clock ticking or meetings looming over my head. This time was hers.

I approached her room, pausing to press down the sign hanging on the outside that had come partially untaped. It read "Neutropenic Precautions"--indicating that the chemo had wiped her white blood cells down to nearly nothing. This meant anyone with so much as a sniffle should steer clear of her and avoid bringing anything that could put her at risk of infection. After a soft rap on her door, I entered and just as predicted, was greeted with a big, warm smile.

"Hey, pretty lady," I greeted her.

"Hey, baby," she replied while sitting up in preparation for my examination.

I asked her my obligatory questions and searched her chest and back with my cold stethoscope. After a careful inspection of her skin for rashes or pressure ulcers and that ever intrusive abdominal examination, I recounted what she'd already heard from my resident and interns. She nodded in acknowledgment.

"You look good." I studied her smooth brown skin that didn't even have a hint of a wrinkle. Deep dimples sunk like valleys into her cheeks as she smiled in response to the compliment. Then she patted her covered head and then furrowed her brow.

"My hair," she said, pausing to clear her throat. "My hair is coming out."

I pulled a chair and sat down as close to her bed as I could. From the corner of my eye, I could see a picture of her beaming with those signature dimples and the thing she was most known for--her thick mane of jet black hair. As a hairstylist for many years, she was the master of doing the thing that every black woman has wanted at least once in their life--growing long hair. Hearing that she was officially losing hers immediately put a lump in my throat.

"How is it--I mean--are you. . .okay?" Great. That came out stupid sounding.

She slid her hand from her forehead, wiping off the satin bonnet that had been hiding her scalp. Instead of a clean ball of fuzz, I saw patchy areas of complete hair loss interspersed with islands of intact hair now clipped close to her scalp.

"I expected it to be different," she answered me while staring somewhere distant. "It's not. . . like I thought."

"What did you think?"

"I thought I'd feel more devastated. But surprisingly, I don't. It feels a little like a rebirth, you know? It's funny. Seems to bother everybody else more than it bothers me."

I narrowed my eyes and leaned forward. Propping my foot up on the edge of the bed, I rested my elbow on my knee and my chin in my palm. I wanted her to know that I wasn't in a hurry and that I was there to listen.

She went on. "I went ahead and clipped it on down. Once it started coming out, I figured I'd help it on along."

"Hmmm," I murmured not knowing what else to say. "How do you like it?" Right after saying that I immediately pressed my lips together out of fear that I'd said something stupid again, but she didn't seem bothered.

"Well," she said while cocking her head sideways to find her words, "I hadn't really ever had my head shaved before so I never knew what my head looked like. And you know what I'm thinking?"

"What's that?"

"I'm thinking my head is kinda cute." We both laughed as she struck a playful pose in her bed.

"You go, girl!"

"Girl, I woulda cut this mess off sooner if I'd known underneath all this I was Halle Berry!" She chuckled again, but this time more gentle. Her face became serious. "The hard part was yesterday. . ."

"What happened yesterday?"

"My daughter. She was trying to put my hair into a pony tail for me and every time she brushed it, a whole handful came out. I think it really upset her."

I thought about what she was saying and tried to imagine that exact scenario between my own mother and me. A quick wave of angst came over me as I found myself reminded of my own parents' mortality. "Did y'all. . .talk about it?" I asked. I didn't know what else to say.

She sighed hard and rubbed her head again. "Naaah. She wasn't ready."

"Has she seen you since you cut it down?"

"No. And I'm not going to even tell her unless she asks me to remove my bonnet. It's funny. Now this child's hair has been all the way to her tailbone one year and then fried, dyed and laid to the side another year and then she came home once with it buzzed down with clippers just like a boy--but me, her mama, has had the same hair for her whole life. I just think it was a lot."

"Wow," I whispered. When looked at from that perspective that sounded like a lot.

"When people love you, it becomes your reason for living. Like, before when I was younger? You know, I was worried about me. But now, I'm concerned about me because they love me and I love them. It wasn't like that when I was younger. 'Cause I didn't know love like I know it now, you know?"

I just sat there staring at her with these images swirling in my head:

Finally, I nodded my head and closed my eyes. "Yes, I do know." Because I did. I understood exactly what she meant.

"Don't get me wrong," she went on, "I care about myself and I want to get well for me, too. But, see, as you get older, if you're lucky everything you do is in the context of love. Everything."

I felt myself getting choked up so decided to stay silent. I took in her words carefully, scribbling notes in my head and across my heart for later.

She touched her head again slowly. "So, this hair? It didn't hurt me to lose it until I saw the look on my daughter's face. Now that? That hurt." She stared out of the window for a moment and I followed her eyes to the giant Coca Cola billboard with Atlanta traffic underneath. Eventually she sighed and looked back in my direction, shaking her head quickly and putting back on her signature dimpled smile.

"Everything you do is in the context of love," I repeated her wise words back to her. Staring skyward, I nodded slowly and let those words marinate. Then I added, "I like that. I will remember that."

Because I did like that. And I will remember that.

She reached out and squeezed my hand. "You are sweet," she said.

"And you are wise."

I hugged her and told her to get some rest. She hugged me back and said, "God bless you, baby. And all the doctors here at Grady." She hugged me like she meant it and she said that like she meant it, too. Because she did. I could tell.


"God bless you, too, Mrs. Z." I headed across the room toward the door.

She watched me walk past her bed and then said, "Love you."

I paused for a second, peered my head back inside and said, "You, too, Mrs. Z."

Because in that moment, that's exactly what I was feeling, too. And I felt lucky that I did.

"If you're lucky, everything you do is in the context of love."

~ Mrs. Zebedee

May we all be so lucky. And may your life be filled with your own collection of All-Stars, too.

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Happy Tuesday.