Top Ten: S.J.G.R. moments.

*Warning: The post contains the word "shit" kind of a lot.

Some people are made of plastic

You know some people are made of wood

Some people have hearts of stone

Some people are up to no good

Aaaaah, but baby, I'm for real

I'm as real as real can get

If what you're looking for

Is real loving

Then what you see

Is what you get

~ The Dramatics

______________________________________________________

No matter who you are or what you do, there will be these points in your life where you stop, look around, and say these words:

"Whoa. Shit just got real."

Or S.J.G.R. for short.

S.J.G.R. moments are those ones where reality sets in. Those times where all of those hypothetical things come crashing to the ground and are replaced by reality. And when those moments happen--and they always do--all you can do is freeze where you are and recognize it for what it is.

The S.J.G.R. point differs for all of us--but not by much. The realness wake up call has some pretty universal features. And the realness doesn't care if you're black or white or male or female or rich or broke. If you live long enough, it will find you. And when it does? You'll know it. Because you'll be saying those words to yourself:

"Okay. Shit just got real up in here. For real."

And okay, maybe if you never, ever use four-letter expletives you don't actually say these actual words, but I assure you that there comes a time in every grown or even almost-grown person's life where they think something very similar.

And it happens in waves. These thunderous waves that sometimes you are completely ready to surf on top of but other times ones that totally, completely smack you down to the sand with no warning at all. Then there's the times that you're somewhere in the middle of those two. Where you thought you were kind of prepared and actually you kind of were, but the enormity, the realness, the magnitude of it all just leaves you in awe. Sitting there shaking your head and saying those words:

"Damn. Shit just got real up in here."

And I added that additional expletive because I admit that this is often the way I think it in my head instead of the "whoa" way. For you, insert your own words in those strategic spots. Feel free to say "Darn. Things just got serious" or to even blend in an f-bomb adjective if you like. Either way, it's all the same. Life just gets real sometimes.

One of my former student advisees called me the other day and he was fretful. Fretful about residency and work/life balance and the pressure of it all. He described things like the physical and mental exhaustion, the fear and the high expectations. And he wanted my advice on it all which I sort of gave him. But mostly, I shrugged and told him the real deal.

"Look, dude. You've just hit one of those points where shit just got real."

And since he is now an upper level resident in another state and more like family now, I felt okay saying it just like that. And I had to say it just like that because he needed to know that there wasn't any real answer. This was his new reality. Shit just got real for him.

So yeah. We all have these moments. Here's a few of mine.

Today I bring you:

THE TOP TEN MOMENTS IN MY LIFE (THAT I CAN READILY RECALL) WHERE I STOPPED, LOOKED AROUND, 

AND SAID, "DAMN. SHIT JUST GOT REAL UP IN HERE."

Ready? Leggo!


#10  The first night in my dorm room at Tuskegee University in August 1988.

 

I am from Southern California. Specifically, I am from Inglewood--a Los Angeles suburb--which is very much metropolitan and urban. Concrete covers everything. The air is dry and the summer nights have a teeny bite on them that require light jackets. No one says "y'all" and the "ma'am's" and "sirs" are heard only rarely from the mouths of babes.

And.

There are no flying, gigantic cockroaches. There are not.

Now. I was fully aware of what I was in store for with going to college in Alabama. I was prepared for the red clay and humidity. I was. I had braced myself for the slow drawls and hand painted mom and pop store fronts of my college town. I even had my mind wrapped around doing my work and stepping my academic game up now that I was a collegiate. But the flying cucarachas? Fuggeddaboudit.

Maaaan. That first night, I had to go to the bathroom. And that bathroom was up the hall, as dorm bathrooms in Fredrick Douglass Hall were. So me, I slide on my flip flops purchased special for college and head down toward the latrine. A dim exit light was in the hall way and the fluorescent glow shone out of the doorway of bathroom.

Not such a big deal. Novel, even.

So I trudge down and am thinking that it kind of bites to have to walk down a hall like this at night to potty, but that Hey! I'm in college now! so really it's mostly cool. Until I saw it. This big, brown thing in the middle of the corridor.

Hmmm.

It was the size of a child's hand and it was sitting still. It looked bug-ish but it was so big. . .so. . .mammoth in proportions that I wasn't so sure. And so. I tried to scoot past it as fast as I could. But that's when it happened. The damn thing started to move. And it moved fast. . .kind of in my direction.

O.M.-EFF-G.

Now. I ain't no punk, so I took off my flip flop and prepared to nail the sucker. But then. But THEN?  The mo-fo took flight. I mean, flapped its wings and went skyward.

*thump* (that was me fainting)

I had never seen anything like it in my entire life. Not only was this the biggest insect I'd ever seen, it was a cockroach-esque thing with super powers like flying. I ran for my life. I swear to you I did. Because I wasn't waiting around to see if it shot fire or sucked blood.

And the good news is that I was so terrified that I didn't need to pee anymore.

Maaaaan. I jumped back into my room, locked that door and just stood up against it panting hard. And my roommate--who was from Tennessee--asked me what was wrong and when I told her she just laughed and laughed.

And as I climbed back under my twin sized comforter and tried to close my paranoid eyes, it hit me.

"I live in the deep south now. Damn. Shit just got real up in here."

We ain't in L.A. no more, Toto.


#9  When I took the MCAT.

I studied for that sucker. I did. Hard. But let me tell you, once I sat down and started working on the Physics section? Dude. I skipped one question. Then another. Then another. And then after skipping the fifth question, it dawned on me:

"You have to be kind of smart to go to medical school. This test is hard as Gibraltar and I'm wondering if med school is like this. And! This test cost me a lot of money. Damn. Shit just got real up in here."

As for the med school being hard thing? Um yeah. I was right about that part.

(Insert "USMLE Steps 1, 2, and 3", "American Board of Internal Medicine Boards and Recertifying Boards",  and "American Board of Pediatrics Boards and Recertifying Boards" into this last section because the exact same thing applies with those.)

#8  Sub-internship with Jada, Rainbow Babies and Children's Hospital at CWRU, M4 year.

When I was a senior medical student, I heard about these awesome opportunities for underrepresented minority students to do "away" rotations at certain institutions that were looking to increase diversity. The awesome part was that not only did you get exposed to new places outside of your own school, but often times they housed and paid you to come and do it. Um yeah.

So me and my friend Jada heard about this one clerkship in Cleveland, Ohio at Case Western Reserve University called the David Satcher Clerkship that offered this great clinical exposure but ALSO room and board and a STIPEND to boot. And can I just say that the stipend they provided (which I'm not sure they still do) would even be a lot now? It was win-win, especially for broke medical students like us.

And so. We both applied and listed that we wanted to do an outpatient pediatrics rotation. Jada was going into Family Medicine and I was applying for Medicine/Pediatrics so we imagined a laid back clinic month in a different city with free weekends and free food. Win-win, I tell you.

Well. How happy were we when we got accepted? Answer: VERY. So. We quickly completed the paperwork and it was all a go. At the start of October '95, we jumped into Jada's Toyota Corolla and rolled up to Cleveland for this lovely month of fun and surprises.

Surprises is exactly what they had for us. Starting with a call schedule that had our names on it. Turns out that the "chill clinic month" was already filled so we were put on a WARD TEAM as a pair instead. Which included call every fourth night, crazy hours, and a bunch of really sick kids. Oh, and did I mention? As an added bonus, we had a lazy resident. So lazy that the only thing I remember about him is that he carried a portable radio around to listen to the Cleveland Indians games and his mantra before retreating to the call room:

"Call me if you need me. But need me if you call me."

Just awesome.

And so. Here is what I recall. One night Jada and I were on overnight call and our lazy resident was somewhere fast asleep. And this kid was breathing like a thousand times per minute and looking really, really, really sick. I looked at Jada and Jada looked at me and it was obvious that the kid was about to code on us. In the middle of the night. With just two medical students.

We quickly learned that we actually had more of a clue than we realized. We took great care of that child and even were the ones to help with key parts of the code sequence. And when that child was intubated and getting whisked off to the ICU, we looked at each other and didn't even have to say it. But the look said it all:

"Damn. We're about to be doctors. Shit just got real up in this hospital."

Note to the students: At some point, you actually have to make decisions that are life or death for patients.

#7  Student Loans.

It turns out that in addition to being hard, medical school is also rather expensive. Mad expensive, actually. I will never forget the day I did my exit interviews from medical school which included a stop by financial aid to "sign off" on everything. On that day, they gave me this pink sheet from a set of triplicates that listed at the very bottom the six figures of debt that this wonderful education had set me back. And they also gave me a shpiel on the importance of "keeping my word" and paying the good people of Sallie Mae back for having such faith in a young, gifted and black girl from inner-city L.A.

I looked at that sheet and remembered the day I had freaked out because my Discover card bill had reached $250 dollars for the total amount owed. And then I asked the financial aid dude at my school to tell me "about how much" would I need to pay back every month once I finished up. He let me know that this all depended upon whether or not I deferred or forebeared or whatever and that, if I did either of those things, that the interest would keep on keeping on so that by the time I finished training and got a real job, it would be more. Like several thousand dollars more. And seeing as I would be making twenty-something thousand dollars per year as an intern, it was guaranteed that I would be deferring or forebearing or whatever so that six figure number was sure to be substantially higher.

And the payment? Let's just say that monthly payment is a helluva lot more than the $22 minimum I had to pay for the $250 dollar total of my Discover card purchases back in 1994. And let me just say that the day I got that first bill from Sallie Mae with the "amount due" at the bottom of it? I looked at it and said out loud:

"Damn. Shit just got real with these loans."

For reals.


#6  Internship.

I spent the entire first year of my residency saying this every single day.

But never was it made more clear than the first big snow storm of my intern year. I was scheduled to be on call overnight and wasn't sure what this meant. I mean, it had to mean something seeing as the entire city was blanketed in white and all you heard on the news and radios were school closings.

Wooo hooooo!!!!

The schools were closed so I assumed there was some kind of contingency plan for us, too. But since this was all new to me, I needed some confirmation. So I picked up my phone and paged my chief resident so that I could, you know, confirm how the whole snow day sitch worked. While staring out of my window at that winter wonderland, the California girl in me squealed with delight. I'd never really lived in a place that got real snow on a regular basis. This was exciting. I began looking around my apartment for something that I could make into some sort of sled. I mean, since I wouldn't have to work or anything.

Dude. When my chief called me back and heard my (dead serious) question, I thought he'd hung up because of the silence. "Hello?" I said. "You still there?"

And that's when I heard it . . .first softly. . . but then quickly rising in decibels. A low, throaty laugh that eventually became this howling cackle. No question about it. My chief was laughing. At me. Not with me.

"Yeah, uhh, so you're a doctor now," he said between snickers. "So the plan on snow days is that you come in and work. Yeah. Pretty much, that's the plan." And he hung up as quickly as he could and since I've been a chief resident, I know that this was because he was in a hurry to LOL about it with his co-chiefs.

So on that day? That snow day that initially looked like a fun-fest from my bedroom window? That's the day it truly gelled for me:

"Damn. I'm a doctor and hospitals don't close. Shit just got real up in here."

Note: There are no "snow days" for doctors. Capisce?

#5  Becoming a senior resident.

It's pretty simple. As an intern (or first year trainee) when you do something great, you're a rockstar. But if you do something wrong? It's okay. Because you're only an intern.

But just you wait until the day you become an upper level resident. On that day, two things happen:

1.  People start asking you what to do instead of you being told what to do.

2.  That whole blissful ne'er do wrong nirvana comes to a screeching halt.

As a supervising resident, the expectation is as follows: Do something great and it's what was expected of you since you're no longer a neophyte. And screw something up? Then you are a total loser. At least, that's how it was back in the 90's. And my guess is that it sort of still goes down like that because this is very likely the reality that my former student was feeling pressing down on him.

Mmm hmmm.

Man. The day that I saw the man with atrial fibrillation in the ER as a second year resident was when I knew. I palpated his abdomen and felt this pulsatile mass. I ordered an ultrasound and detected a gigantic aortic aneurysm that appeared to be near rupture. Vascular surgery was called and, from what they told me, I saved that mans life. The abnormal heart rhythm was because he was so anemic from the leak. And the sucker even started bleeding while they had him on the operating table.

I was SO proud of myself. So, so proud. But my attending in the ER simply gave me a pat on the shoulder and handed me another chart for a new patient. And that was that. No champagne. No roses. No hooplah. And that's when I realized something:

"I'm an upper level resident. Damn. Shit just got real up in here."

#4  My first mortgage.

I was so excited when I got my first "real" job as a faculty member. New to Atlanta, I wanted to be a responsible adult and wanted to step out of the realm of the renter. Yes! I wanted to buy. It was time for me to be a homeowner.

And so. I declared to the agent that I "definitely wanted to live in town." And I scouted out the cutest areas and wrote them down in case they weren't sure of what I was looking for.

My price point? Uhhh . . . .whatever price point gets me where I want to live. And, I mean, I'm a doctor. Like a full fledged, dual board-certified one. So I can get me a nice crib in a nice area for sure.

Well. Turns out that when you owe more in student loans than you make annually, that's a little issue. And turns out that what I thought was so much money wasn't enough to put me anywhere close to those swanky neighborhoods I coveted.

Uuuuhh, that would be a NEGATORY.

And so. I sat down with my dad and later a mortgage broker and that's when all of it hit me.

"This debt to income ratio situation is no joke. Damn. Shit just got real up in here."

And yes. Eventually I was able to get a nice place in town that I could afford. And even at the price that worked for me, on that very first month when the home owners' fee and the mortgage were due and I wrote those checks, it happened again. And later when I got a leak in my garage and couldn't call up a landlord? It happened then, too.

"You ain't renting anymore. Shit just got real up in here."

Uhhh yeah.

#3  When I was a newlywed.

Ha. I will never forget the first few weeks Harry and I lived together as husband and wife. I came home from work and was sitting on the couch watching television. Harry got home around seven and had brought some take out from a restaurant we love.

"Oh, I already ate," I said.

"Really? I tried to call you but couldn't get you. I can just save this for later. What did you make?"

"Make?"

"Yeah. You said you ate already."

"Oh. I ate some leftovers from my work lunch."

"Umm. . .did you think about whether or not your husband was hungry, too?"

And the truth is that I hadn't. I'd never had a husband before. So I hadn't really gotten used to considering another person in my meal game plan. Before marriage, we'd plan meals together but the whole everyday part of meals and life and living and all of that? None of it came natural.

Until then.

That's when I knew:

"Hold up. I's married. And I need to think about another grown person besides my damn self. Whoa. Shit just got real up in here."

Note: Marriage is a selfless walk. And after the flowers wilt and the gifts stop landing on your front porch there's a relationship waiting for you to work on. And the wedding part is fun, but the post honeymoon phase is where it gets real.


#2  When I had my first child. 

We'd just gotten home with Isaiah. I was asleep. Harry was asleep. And finally, Isaiah was, too. He was born at nine pounds and two ounces. And the thing about babies that are that size is that they get real, real hungry.

Mmm hmmm.

But instead of crying, Isaiah just used to make this funny little panting sound that somehow, some way, The BHE could never, ever hear. And me, I was still sore from pushing out nearly ten pounds of human being so getting out of bed was a bit of a production.

Yeah.

So I hobble over and get him. Put him on my breast which he promptly chomps down onto like it is some kind of enemy in the wild. But eventually he drinks and I try my best to look at this as my life's greatest gift. But see, having a large-for-gestational-age baby who is HONGRY not hungry is hard on a mama's nipple. For reals. That was the first time it got real.Wait. I take that back. The ridiculously high deposit for daycare after getting off of the 100 year long waiting list was the first time. The hongry-muncher-baby realization was the second time.

Where was I? Oh. So then, after a few days of Pacman-boy chomping me to red, ragged bits I was sure that I would absolutely die. Because those things have nerve endings, do you hear me? Lots of them. And YES, I DID talk to all of the boobie experts and lactation ladies and leche lords. I DID. And I spoke to my homegirls and aunties who told me to put cabbage leaves on my breasts and to just stick with until the engorgement-pain-terror-trauma ended.

FINALLY at the height of my mauled mammary-ness, he seemed to be sort of figuring out the latch-on thing. And so. I'm in bed one night and I hear that panting sound at 3:22 AM, which I feel certain it was because this sounds like the time that is the EXACT middle of the night. And I get up and get that baby to put him on my breast. And that boy, he tilts his head, opens his mouth, clamps down like an angry shark and goes straight up Jabber Jaws on me. Yes. In his full nine pound glory.

And that? That was more than I could bear. I shrieked out in pain. Loud. Super, duper, duper loud. And do you think The BHE woke up? Uuhhh, yeah, that's a NO.

Awww hells naw!

Maaan, I kicked over that rocking chair-glider thing, limped over to him and handed him his son. His son. I poked him hard in his shoulder until he woke up and placed a bottle of milk into his hand. "Take your son." And you know? I said nothing else. I just put on my satin eye mask and got back in bed. Surely did.

And let me assure you of what The BHE was thinking as he rubbed his tired eyes and burped that big ol' hungry baby at 3:24 A.M.:

"Damn. Shit just got real up in here."

The realness knows no gender lines. Believe that.

#1  The Economy and The Rhythm of Life.

When the economy crashed I saw all kinds of stuff. I saw my own household income fluctuate dramatically. I saw new patients coming to our safety net hospital who had never even set foot in a place like Grady before but had no choice. Because they were sick and needed doctors but they'd lost jobs and subsequently insurance. I even saw close friends foreclose on homes and lose businesses and go through all sorts of unfortunate things that this plummeting financial crash left them to deal with.

The economic downturn affected us greatly. We have rental properties that bring us income. And those tenants, our tenants, they lost jobs so couldn't pay. Harry's business owners in his commercial properties couldn't cover their leases. And even beyond that, some of our favorite places to patronize that seemed like institutions that were untouchable closed. For good. You saw it in your neighborhoods, too. Places that seemed like they'd never, ever close. Those places shut their doors. Because they had no choice.

So one day, we were sitting at the kitchen table discussing our budget. And at first we were fretting, but then we started realizing that we have each other and that, along with our jobs, still put us ahead of the vast majority of Americans.

But still.

Our paradigm had shifted. Things that we didn't think about before we now had to think about. And monies that seemed superfluous no longer were. And perhaps they never should have been. But either way, it woke us up and rattled our cages. And we slugged it out and learned to value different things. And once we did, it seems like things started looking up. But still. Now we were changed people. We recognized that nothing is promised for anyone. Not financially.

Hell, not any kind of way.

Then, last fall, when Deanna left us, reality came knocking again. This jolted us and forced us to accept that these bodies we are given are only on loan. Souls pass through -- and pass on -- sometimes when we least expect it. And that? Man. That was a hard pill to swallow. Even for a doctor and a former bad-ass Army Ranger infantry guy, both of who had seen mortality up close and personal. See this? This was different. Shit got real.

But.

In all of that, something else happened. We focused more on the things that mattered. The material things we did own we appreciated but not nearly as much as the people that we love. Little spats and misunderstandings were short-lived. Relationships were redefined into new, more meaningful definitions. Or at least more authentic ones. In other words, shit just got real.

And that? That is the beauty of the realness. It requires less memory. You just go forward in truth and with your eyes focused only on the things that last. Like love. Like family. Like faith.

And can I just digress quickly and say this? The very night that Deanna left us, I turned to this blog and typed. I posted her picture and shared our love and people came and read and listened and grieved right along with my family. And every time I opened my stats and saw how many people were coming to love on us and reflect on my sister, I saw how powerful this forum can be. It became more than just this place where people stop by to read when they are bored or whatever. I was no longer just this hypothetical woman in Georgia with kids and a husband that she calls The BHE with her tongue in her cheek. I became human.

And because of that, even more, the patients here and their stories, became more than just novelties and Grady more than just some fictional place.

Yeah. We are all human beings, interconnected by our stories and our triumphs and our tragedies. When we let that happen, something amazing happens. We see ourselves in one another. In other words, shit just gets real.


***
Happy Thursday.

Now playing on my mental iPod. Y'all don't know nothing about The Dramatics. Yeah, dawg. S.J.G.R. with the music on this blog, people.




Hey. . .what's one of your most memorable S.J.G.R. moments? Do tell.