Some soles to keep.

*details, names, etc. changed to protect anonymity

min·is·try n. pl. min·is·tries 1. a. One that serves as a means; an instrumentality.

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"Excuse me, I'm looking for the social worker on call?"

The clerk in the emergency department looked up from her multitasking and raised her eyebrows ever so slightly. Holding up one finger in my direction, she placed the call she was handling on hold and pushed a button to take another.

"Blue Zone!" she announced not exactly cheerfully, but not rudely either. "The attending is Dr. Heron but she's with a patient. Uh huh. Okay. Sure, please hold!" Methodically, she mashed the hold button and repeated this same process with two more calls.  I patiently waited for her and watched her hands on those buttons. Each of her fingernails was adorned with a long, curving acrylic coating and intricate decorations. The index finger responsible for that hold button was painted a different color altogether and was glistening with some kind of rhinestone design. Not to be overshadowed by those nails, she wore a fancy ring on every one of her fingers, including her thumbs. She caught me studying her hands and smiled.

"I'm sorry, baby. Now what was you saying?"

"Yes, I was just wondering--whoops, I mean, hey there, I'm Dr. Manning from the Medicine service. You doin' alright today?"

"Girrrrl, it's on like Donkey Kong down here, but you know how it is in the ER!" She let out a quick chuckle and as soon as she did, I noticed that one of her front teeth was completely overlaid with gold with the exception of an 'L' initial cut-out. I immediately liked her. "What you need, baby?"

"I was wondering if you could tell me where the social worker on call is? I need to find a patient some shoes."

That may have sounded like an odd thing to request, but she didn't even flinch. At Grady, this isn't unusual at all. "She down here somewhere. I can page her, but the box is in the social work office. I heard they was kind of low, though."

"Low on shoes?"

"Yeah. It's a man or a woman? They ain't hardly got no man's shoes. At least not in no size that nobody wear. Girl, you know Grady like a ministry, though, so like any ministry we do what we can!" She sighed and splayed her hands out; she looked a little like an ornate version of Edward Scissorhands. I stuck that statement on a post-it note in my mind for later. Grady is like a ministry. Hmmm. With any kind of ministry, you give and serve yes, but everyone knows you always get something intangible yet valuable in return. Grady is like a ministry. I liked that concept. "Yeah, but go on to the social work office and see what they got. I'm sure you can find something up in that box!"  She smiled quickly and raised her eyebrows to punctuate that this was the end of her being able to help me. Diligently she went right back to answering those blinking call buttons just like before.

"Thank you, ma'am," I said while moving away from the counter. She raised her arm and pointed in the direction of the social work office with that same rhinestone pointer. In that moment I thought to myself that perhaps there was a method to her madness in those nail designs--this especially fancy one had extra jobs so needed extra attention.

I stepped into the social work office and found another woman behind a desk. "Good morning. I'm Dr. Manning from the Medicine service and I was coming to try to find some shoes for one of my patients?"

She had a phone balanced on her shoulder and nodded to me silently. Next she pointed toward a weathered cardboard box sitting in the corner. It was only halfway full, but toward the top I could see that it had a collection of shoes inside.

These shoes were for a patient on my ward team, Mr. Shane. He was homeless due to a combination of severe mental illness, a stronghold of substance abuse, and poor resources. On this admission, he'd come to us for a persistent cough and an abnormal X-ray. Mr. Shane also happened to have advanced AIDS, so his subtle lung and radiograph findings made it necessary for us to exclude tuberculosis in the hospital, which fortunately for him, we did.

That morning was a Saturday and it was just my resident and me. I had agreed to manage the discharge for Mr. Shane and was nearly finished when I saw him lacing up a pair of sneakers so worn that I thought they'd disintegrate in his hands.

"Are these your only shoes, sir?" I'd asked that morning.

"They all I got. But it's better than nothing," he replied.

On this particular morning, I wasn't so sad to be at work because the weather was awful. A cold rain pelted the side of the hospital all morning long and I knew for certain that Mr. Shane's shoes would be no match for it. He had no interest in going to a shelter no matter how hard we'd tried to convince him. Though mentally ill, he was decisional. I knew he would choose to be discharged to the street.

"Maybe I can try to find you some shoes," I offered. "What size do you wear?"

Mr. Shane looked at me and shrugged. He truly had no idea. I stared at his sneakers and tried to guess-timate for him. "A ten maybe?"

"I 'on't even know. But 'preciate you for looking. I'll take whatever you got."

So I stared at him for a beat and then looked past him at that window behind his head. A dreary frame of a  bitter and wintry day was what I saw; I resolved to try to find him some shoes.

That's how I ended up hunting around for that box of shoes in the social work office on a rainy Saturday.

I paused for a moment and thought about his feet again. Then I dug my hand straight into that half-full box of donated shoes. That clerk in the ER was right. Nearly seventy-five percent of them were ladies shoes--loafers, moccasins, and even a pointy toed pair of heels. I sifted through all of the shoes, putting the men's ones aside and finally had four pairs to select from. One appeared to be no larger than a seven. Another had a hole on the sole so immediately was tossed back into the box. The remaining two included a pair of hightop sneakers that had to be a size thirteen at the least. The last was an overworn pair of wingtips. I turned them over and looked at the bottoms of the soles which appeared to have been redone at some point. I also noted the size: ten.

"I'll take these with me," I announced to the lady behind the social work desk who nodded once more from her receiver-on-shoulder position and held a thumbs up in my direction.

Off I went with wingtips in hand. As I reached the elevator I held the shoes up and inspected them. Fancy white and black shoes that would likely pair nicely with a zoot suit. But in this instance, they would have to work with one half of a warm-up suit and multicolored crew neck sweater reminiscent of Dr. Huxtable himself.

When I reached Mr. Shane's room, his bed was empty. I checked the bathroom and craned my head out of the door into the hall. A nurse standing nearby saw me looking for him and offered some information.

"He was ready to go so he was discharged already."

"Dang!" I said with probably a little too much emotion. "I had just gotten him some shoes!" I held up the wingtips for her to see.

"You got him some shoes alright!" the nurse teased. I flushed a bit because just then I remembered that those shoes just happened to be a dapper pair of Stacy Adams specials.

"Oh yeah. Swanky, right?"

"They're something," she replied with a shake of her head and the can of Boost she was about to give her next patient.

I stood there for a moment in his doorway. Wondering what to do with the shoes. I decided to take them back to the box they came from.

The emergency department is on the ground level by the hospital entrances. Instead of going straight to the ED, I took a chance and made a detour--walking outside near McDonald's--just in case Mr. Shane might be out there. By the time I stepped through the automatic doors, I immediately wished I'd had more than just my thin white coat. Even though the rain had subsided, it was still cold. Surprisingly, though, there were still a significant number of people walking around in front of the hospital.

I scanned the area. Then from the corner of my eye, I saw him. Mr Shane standing under the covered walkway just  before the entrance to the McDonald's next to the hospital. And yes. There is a McDonald's next to Grady hospital, but I have also worked in hospitals with Pizza Huts and Mickey Dees and Starbucks on the inside -- not even next door like this. So anyways--there he was, chatting with a man who also had a Grady armband. Talking all animated with a Happy Meal hamburger in one hand and an unlit cigarette in the other.

"Mr. Shane?" For some reason I hid the shoes behind my back. That nurse's teasing had left me a bit self conscious of those wingtips so I didn't want to embarrass him.

Mr. Shane smiled at me big and wide. He wasn't the least bit embarrassed by his decaying, fractured teeth. That's when I knew that he'd be the last one fazed by someone's opinion of some zoot suit shoes.

"Hey doc! What you doing out here?" He said that as if I hadn't just left him ten minutes before to go get some shoes.

I extended my arm toward him, wingtips in hand. "I was going to get you some shoes, remember?" I glanced down at his feet and those unbelievably ripped up Converse All-Stars. They were filleted open from the big toe all the way to the pinky toe exposing the royal blue hospital-issued socks he'd left in.

He froze and didn't say anything. Mr. Shane narrowed his eyes and leaned his head forward to get a better look at what I had to offer him. I couldn't read his expression so I just sort of stood there with my hand out not knowing what to do.

What was I thinking? Why didn't I just get the size thirteen high tops? Or better yet--why didn't' I just go back to the box in the social work office instead of hunting him down outside of McDonald's?

"Damn, doc."  That's all he said. He didn't even reach for the shoes when he said it either. So at this point I felt my face getting hot and heard a little voice in my head saying, Just go, will you?

Then, Mr. Shane abruptly plopped his bottom straight down onto the wet concrete and began pulling off his Converse. There was light in his eyes and a child-like animation in his movements. Within two seconds, he had thrown those sneakers to the side and was reaching for the wingtips. "Damn, doc!" he repeated, this time with great enthusiasm. "People always be saying they gon' come back and they don't get around to it or they just don't. Especially when iss Saturday. So I just went on and left 'cause I ain't think you was gon' make it back up there."

He got both shoes onto his feet and stood up. Next he stomped his feet and paced back and forth. "Awww yeah, doc! These is cold!" And from the big smile on his face, I knew for certain that "cold" was a good thing.

"Do they fit?" I asked in that rhetorical way that people ask about gifts that someone has just opened and appears to be loving.

"They fit perfect!" He kept pacing around and this time added a little point of his finger and "cool-brother" swag to it. That made me laugh out loud.

My daddy calls that the "Sunday stroll." The walk to do when you've got on your Sunday best or, as my dad says, when you're "clean as a Safeway chitlin." It warmed my heart to see Mr. Shane doing his Sunday stroll right there in front of Mickey Dees.

I reached down to pick up his Converse and gestured to a nearby wastebasket. "Can I pitch these?"

"Aww, naw. I need to save those. Just in case, you know, like somebody try to steal these from me."

And just like that I was jolted straight out of the warm and fuzzy of that moment into the harsh reality of Mr. Shane's real, true existence. He was still smiling as he took them from me and stuffed them into the white plastic bag on the ground next to him that he'd been issued for his belongings at discharge.

"I sho 'preciate you, doc. For real."  I looked in his eyes and smiled. He meant every word of that.

"Alright then, Mr. Shane. Take care of yourself, okay? And see about staying in a shelter tonight so you can get yourself all the way better."

"Okay, doc," he replied while still looking at his feet. He looked up at me with a twinkle in his eye, "For real, I'm gon' try."

"Okay." I reached out and shook his hand hard. I closed my fingers tightly around his and pressed them into his leathery skin. I wanted him to know that I wasn't afraid to touch him. I also wanted him to know that the doctors at Grady will come back to you. And they'll even find you and bring you some shoes in front of McDonald's if they can.

I turned around and walked away and, for some reason, no longer felt as cold as I had before.

As I reached the door, I glanced back over my shoulder at Mr. Shane standing under that breezeway. He was laughing out loud and holding that unlit cigarette and the hamburger in one hand. And despite the fact that all he owned was in a plastic bag at his feet and the fact that he might very well be standing in the very shelter of his choice for that night, in his face and laugh I saw some peace. It gave me some, too.

Imagine that.

Though not an unusual day for Grady, I'll always hold that memory close for years to come. That day, I made someone smile by giving them  a old pair of resoled wingtips. And in return? I got some soul to keep.

"Girl, you know Grady is like a ministry. . . ."

Yes, girl. It sure is.

***
Happy Wednesday.

Have you ever read this book? If not, you should.