Required Reading

Friday, December 12, 2014

Three Ordinary Miracles this week at Grady.



"And expect miracles, sugar. Everyday, okay?"

~ a Grady elder


I love working at Grady Hospital. Moments like these underscore why.


#1

Expect miracles

"Will y'all be able to give me some medication before I go?" my patient asked.

"I think so, "I replied. She was talking about a program offered by our pharmacy that assists patients with either a seven or thirty day supply of their medications upon discharge from the hospital. "Do you have a plan for getting them after that, though?"

She dropped her head and gave this lopsided shrug. "Nope."

Nope? Ugggh.

The problems that landed her here were all because she hadn't been taking her medication. This was the wrong answer.

"We've got to figure out a way to get you to be able to get and take these meds."

"I'm on a fixed income There's nothing I can do about that."

And you know what? It was true. She had no family that could step in or other forms of income. She was a little too young for medicare but not really equipped to do the kind of hard work that she used to do. It was terrible.

And so. My intern and I sat in chairs in her room brainstorming ways to help her make a dollar out of fifteen cents. Or rather savvy ways to afford prescriptions that she'd need each month to stay alive. And what sucks is that no matter how many permutations of a game plan we made, it still involved her needing $17. Which regrettably she just didn't have.

And yeah. In these moments, I am tempted to just go into my pocket and pull out the money to place into her hand. Tell her "I've got it. Don't even worry about it" --and then keep it moving. But really, I can't do that for reasons more than just how endless that cycle would be.

Sigh.

But then something happened. I heard this muffled sound from the other side of the curtain in that hospital room. As it got louder, I realized that the person in the next bed was crying. I leaned around toward the other bed to put my eyes on the patient. I mouthed to her, "You okay?"

The patient, a sixty-something year-old woman with salt and pepper hair, just nodded her head while wiping her cheeks with the heel of her hand. She sucked in a big breath of air and exhaled with a shivering weep. "Lord Jesus." That's all she said and then erupted into even more tears.

I wasn't sure what to do since I was with another patient. My resident was still talking to our patient in the other bed about her medications. I looked around for a nurse and tried to decide how involved I wanted to get. But before I could do anything more, she spoke, "I know you ain't s'posed to be in another patient's business and that y'all got rules on all of that. But you know? I'm just sitting here thinking about what I do with 17 dollars each week and how much it's hurting my heart to know that somebody is in a life or death situation over less than twenty dollars." She shook her head and started crying again. "God been so good to me. I got to be obedient. I just. . ." It was too much. Her hands came to her face and she slowly shook her head again.

The whole room fell silent. Our patient could hear this and immediately her own tears started flowing. "God bless you, ma'am. Jest for caring." My patient spoke those words out into the air since the curtain separated them from seeing one another.

By this point the neighbor had gone into her purse and pulled out a card. On the back she wrote a name and then handed it to me. "Give this to her. It's from my church. I know they can help her with the seventeen dollars she needs to stay alive. And I put my name on the back to let her know who to say referred her. She ain't got to say nothing to me. I just want her to be okay."

I thought for a moment about whether or not this was okay. But you know? I was running out of answers. I put the card in my pocket and thought on it for a bit. While writing my notes, I picked up a phone, looked at that card and dialed the number on it. Sure enough, it was that church indeed and a kind voice answered. Instead of going into anything, I just said "good morning" and then got off of the phone.

A couple of hours later, I came back, walked straight into that room, and handed the card to my patient. "This is a community resource," I said. "I hope you'll look into it."

"I will," my patient said. "I will." Her bottom lip started trembling and she couldn't hold back the tears that came streaming down her face. The late morning light from the window was bathing her glistening cheeks and the sight of it made my eyes sting, too.

"God hasn't forgot you, sugar."  That's what the neighbor in bed one said toward that curtain. "Be encouraged, okay? And let people help."

"O.  . . ka-ka-haaaay," my patient said through now heaving sobs.

"And expect miracles, sugar. Everyday, okay?"

And that part was such a good word that I almost unraveled right then and there. I had to stick it on a post it note in my heart to unpack later. Yeah. But the first thing I did was leave that room, slip myself into the nearest bathroom and allow myself a good hard cry.

I sure did.

Before she left the hospital, my patient called that church and gave the name as requested. And they arranged to assist her with her medications. They did.

You know what? It was a miracle.


#2

Head back, shoulders up


I met with a student on a late afternoon earlier this week. A young woman with a brain made for learning and a heart made for caring--perfect ingredients for a the makings of a great physician. Problem is, she has a bad case of the "Imposter Syndrome" and her light was dimmed because of it. Eyes shifting sideways instead of straight ahead. Shoulders slumped instead of back. And a smile that almost seemed apologetic.

Yeah.

And me telling her that she is smart wasn't enough. The inventory of her high scores and hard work, I wish, should have been the panacea but it wasn't. And it never is.

Instead, I just looked at her. My eyes were soft but the focus on her beautiful brown eyes was searing. I reached across my desk and touched her hand. "You are enough, you know. Already, you're enough." And I could see her eyes starting to glisten with tears. So I spoke again before she started crying. "Your words are worth hearing. Your face is worth seeing and noticing. Your ideas are worth sharing. The minute you believe it, others will believe it, too." She nodded and kept her eyes on mine.

Next, I told her about the night on call during internship that my fellow in the NICU taught me how to be a lion. To stand tall and not keep apologizing for things that didn't warrant apologies. And I promise you, that day changed my life. It did. And so, I reflected on that and realized the power in the actions instead of just the words. Yes, I did.

"Come with me." I suddenly stood up from my desk and slipped on my white coat. "Let's go for a walk together."

The student was intrigued. Her face broke out into a big smile and mine did, too. I had no idea what was about to happen but I was hoping ti would be pivotal for us both.

Yep.

And so. Out we walked. Out of my office, out of the faculty office building, out across the street, and into the entrance of Grady. We stopped in the lobby and I turned and put both of my hands on her shoulders while staring into her eyes. "Owning your space takes practice. I've had more practice than you. But here's what's going to happen--we are just going to walk around the wards. And I want you to  watch and model what I'm doing, okay?" She nodded.

Inside it felt a bit hokey and maybe even a wee bit self important. But that wasn't my intention. I wanted her to pay attention to the interactions she witnessed and how powerful our self images can be in not only doing well in medical school but just being able to do anything. Our energy and strength permits the same of others.

At least that's what I think.

We rode the elevator up to 5A first. When we stepped out into the hallway, I turned to her and said, "Head up, shoulders back. Eyes straight ahead. Make eye contact with those you see. Acknowledge them and let them know you see them."

We walked up that hall and did just that. I put my eyes on people. Said hello. Approached some cardiologists and talked to the about our patients. Tried my best to show her that there is room for everyone, including her.

And she got it. She did. "You've got to own your space," I told her. "Or someone else will take it from you."

"I see it. I see what you are saying," she replied.

I thought for a moment and then added, "You know what? I think people want us to walk in our full authority, you know? Like it feels better. Does that even make sense?"

"It does."

"I want the challenge of being me in the face of you. Not trying to overpower you or make you invisible, you know? I sort of think that's what everyone wants. It feels better."

"I think you're right."

"Head up, shoulders back, okay?"

"Head up, shoulders back," she replied.

"I have to coach myself, too. It's all a work in progress, you know?"

"For you, too?"

"Definitely."

Definitely.

She felt better, I think. And, to me, it felt like a small miracle.

Yeah.

#3

Gradypocolypse

This last one is simple. Yesterday, the hospital was busting at the seams. Sick-sick people with few-few resources needing care. Too little being divided by too much. Which makes for some real bad math.

But you know what? Our chief residents came in dressed in scrubs. They rolled up their sleeves and went hard. Senior residents who were on light rotations came in and took admissions. Our chief of medicine and Grady residency program directors went into damage control. And you know what? It all worked out. That sure leadership made a difference, man. And it allayed everyone's fears, too.

You'd think everyone would be freaking out and hating life yesterday. But nothing could be further from the truth. Instead, hearts were light. We took excellent care of our patients and I know we did. And you know what else? We had fun.



That, too, was a miracle.

Look, man. It's Christmas time and people are struggling. But you know what I know for sure? Miracles aren't just happening on 34th street. They're happening everywhere. On Jesse Hill Jr. Drive and even nestled in the everyday hustle bustle of the things you have to do before going to sleep. if nothing else, Grady Hospital teaches me that.

Which sort makes me want to cry this morning.

Damn. I'm just glad to be here. Right here, right now, witnessing these everyday miracles.

Yeah.

***
Happy Friday.  I hope you expect some miracles today and appreciate the when they happen. I've missed y'all.

Now playing on my mental iPod.

First this one which I can't stop hearing in my head . . . . The Clark Sisters kill it on this one. Dang. It's making me cry all over again. This? All day long.



Next this one. . . .Whitney and Mariah did this true justice.  Le sigh.






5 comments:

  1. And now I am crying, I witnessed two miracles in the past two weeks, one of my very own happened yesterday. Truly expect miracles, they do happen every day. Love you Doc.

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  2. I just wanted to say that I really really really appreciate you. I met you years ago at the ACP conference (I was a part of the Meharry crew.) and have been following your blog ever since. Now I am a geriatric fellow. As a young physician, I still sometimes feel like I am trying to learn how to ride a bike so to speak. But with this post today, you reminded me to get back out there and find my inner lion and fight the Imposter Syndrome. So thank you very much for your kind words and stories. You inspire me. Have a blessed Christmas and New Year!

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  3. Thank you for this. It is perfectly timed. My son is struggling with a physical therapy clinical in which his CI took every opportunity to tear him down. He has lost all his confidence in himself, though he is smart and good at what he does. I will share this with him. Sassy

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  4. Miracle #1 - made me cry!
    Miracle #2 - everyone should have someone chanting that in their ear daily, preferably from a very young age. . .
    Miracle #3 - teamwork at its finest!
    Well worth the wait!

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  5. Beautiful, beautiful post. Thanks for sharing.

    ReplyDelete

"Tell me something good. . . tell me that you like it, yeah." ~ Chaka Khan