Fear not.

The Avengers are here and, for a full-sized Snickers bar and some Skittles, will save your life.

If all you have is pretzels and oranges, though, you're on your own.

***
Happy Trick or Treat Day.

Inchworm.

This one time in front of Grady. (photo shared with permission)

Inchworm, inchworm 

Measuring the marigolds

You and your arithmetic 

you'll probably go far

Inchworm, inchworm

Measuring the marigolds

seems to me you'd stop and see 

how beautiful they are

This morning I was in the Primary Care Center seeing a patient with one of my favorite residents. The patient was there for a follow up and despite being on medication already, her blood pressure was high. She was already on one medication for it but it appeared that this wasn't enough. And the plan my very able resident had put together was evidence based and perfect reasonable. He wanted to add on a diuretic--or a water pill--to her regimen.

And that was mostly cool.

Except. She was wearing a ring with six different colored gem stones. And next to her chair was a red metallic cane with a black rubber stopper on the end. Though mild enough to not warrant joint replacement, the osteoarthritis in her hip was significant enough to cause her to use that walking stick for assistance in her ambulation.

"You want to give her a diuretic?"

"That or a calcium channel blocker. I mean, had she not been a diabetic, my first line monotherapy would have been a water pill, you know?"

I nodded and jutted out my lip.

"That's reasonable, right?" This resident--who is now a senior--was asking this as a rhetorical question. He'd been at this long enough in this clinic to know that it was perfectly reasonable to start an African-Anerican lady with normal kidney function on a water pill for her blood pressure."Dr. M, what do you have against hydrochlorothiazide?"

I chuckled and shrugged. "Nothing, man. I was just thinking about her Mother's ring with the six birth stones and her fancy red cane, that's all."

He squinted his eyes at me for a beat and then pressed his lips together. "I get what you're saying, Dr. M. But she gets around really well with that cane--seriously, she trucks it. Honestly, I think she can make it to the restroom--even with a water pill making her have to go a little more."

"Okay. But did she have six vaginal deliveries? Because that's a game changer." I raised my eyebrows after that question.

"You know? I don't know. But my guess is yeah, she did. Hmmm. . . .okay. Gotcha."

So that resident went back and chatted with that lady. And he learned that, like many women who pushed out six babies, even without arthritis making it harder to get to the commode, urge incontinence was a bit of an issue. Or better yet--it was a major issue. Given that fact, a water pill wasn't something that she felt too excited about  and since there were other options, we went with one of those instead.

Yep.

You know? I noticed that ring but never had a big conversation about it. I just saw that it had those six stones and that it said "MOM" on it. And I did point it out and call it pretty at which point she said that her children had given it to her more than twenty years before. And that she'd always loved it.

And I could see why. I really could.

Yeah.

Two and two are four

Four and four are eight

Eight and eight are sixteen

Sixteen and sixteen are thirty-two

You know? I am not the smartest person in my hospital by a long shot. I forget all the details of certain medical facts and have to look up stuff that many other people have long since committed to memory. I blank on the names of research trials and read probably just as much as a resident to jog my memory or teach me new things when I'm on the hospital service.

But.

I do love people and, for that reason, I notice them and the stuff around them. I do.

Today when I parked in the garage at Grady for that clinic session I was a little late. This older gentleman who appeared to be also heading into work at some office part of the hospital system held the elevator for me which I appreciated. And when I got on, he looked right at me and said in the warmest, brightest way, "Good morning!" And the way his eyes twinkled under his salt and pepper eyebrows, I immediately knew it would be just that.

His shoes were shined. I knew it because my husband shines his shoes and irons everything he wears each day, so I sort of appreciate it when a man is attentive to such things. For a minute I felt slightly embarrassed when he caught me looking at his feet. But then I decided that it wasn't a big deal that he did.

"You shine your shoes,." I said it with a confident smirk.

He threw his head back and laughed deep and hearty. "That I do."

"My husband gets his shoes shined every chance he gets."

"Sounds like my kind of gentleman. Military?"

My eyes enlarged. "Wow. Yes. Previously in the army."

Just then the elevator opened. "Same here," he replied while gesturing for me to exit first.

"Alright then, sir. You have a great day."

"It's already done," he responded and waved good bye.

And that was that.

Right after that, from the corner of my eye, I saw one of our residents helping this lady figure out the payment system on the new electronic parking meters. They were both leaned over and peering into that contraption studying the LED lights and trying to make sense of it all. It looked like it was taking a lot of time but he was patient,  I could tell just from his body language. I could tell she appreciated it. I did, too.

It had been raining for the last couple of days. The concrete was still brown and damp and the grass was glistening. The air felt more autumnal and crisp which I liked. The heels of my boots were clicking on the asphalt. I'd decided that I'd move into my fall-season attire regardless of the weather. So I was glad that, on this day, the climate seemed to be on the same page with that decision.

As I hustled by, I saw that a broken umbrella was lying on the grass, probably the aftermath of a gust of wind or from some frustrated person who'd reached their wits end with a dollar store special. It looked salvageable if you asked me.

"I like your boots!" That's what this man sitting on one of the smoking area benches called out to me between puffs on his cigarette. And it was kind of sweet, too, because the way he was smiling at me felt sincere and not fresh.

"'Preciate that!" I called back.

"Go 'head, then, Bootsy Collins!" He laughed loud and so did I. Because I know who Bootsy Collins is. And him saying that was pretty funny.

And that was that.

So yeah. I do this every day. Like, I walk through and around Grady and I just look and notice and take stuff in. The sights, the sounds, the scents, the all of it. I see flowers on window sills and allow myself to appreciate the tiny miracles happening in that place every day. And now it has become a habit. Which I love.

See, medicine is so serious, you know? I mean, you're trusted with caring for human beings and for making decisions that could hurt them if you aren't careful. You want to make the right diagnosis, prescribe the right treatment and stay up on all of the latest medical literature. And that--all of that--requires a level of precision, focus, and diligence that makes it hard to notice much else.

Yeah.

But medicine also opens you up to humankind in the very best ways. Especially at a place like Grady.  There are some days where I get so bogged down with the medicine and the details that I forget that part. I neglect to notice the birthstone ring or to have a little small talk about whether or not the Falcons are better than the Saints. When I'm in that place, I miss things. No, not life or death things, but still things that just might change the trajectory of everything. Like the freckles sprinkled across a patient's nose that could create a space for us to start calling each other "cousins" since I have them, too. Which would be bad since sometimes I might be the only "cousin" or family that patient has. So yeah, whenever I get like that, I know it's not ideal. Like, even if the medicine is accurate and evidence-based, without the humanistic component it never reaches the gold standard.

Does this even make sense? Lord, have mercy. I know I'm rambling.

But yeah. It's kind of like that inchworm, you know? Measuring these gorgeous marigolds and never once marveling at their beauty whilst making meticulous measurements. I have always loved that song and sing it to my children to this day. I sing it as a reminder because these same lessons apply to every aspect of our lives--particularly family. So busy focusing on the to do lists that we don't take in the experience. So consumed with making sure our kids are clean and have homework ready and are safe that we don't enjoy them. Yeah. Kind of like that inchworm.

Two and two are indeed four. And four and four indeed make eight. But what about the marigolds?

At the very end of that clinic visit that patient told me about her grandchildren. Three of the eleven that she had were now in college. And that was a big deal because neither she nor any of her six children had attended college. And I told her that she should be proud and she replied that she was indeed very proud. I also loved when she said, "I'm especially proud that I raised the kids who are raising my grandkids."

Yeah.

After clinic when I crossed the street, it was drizzling again. I popped open my umbrella and began hustling toward our faculty office building. Then, I caught a glimpse of a man in tattered clothing walking down Jesse Hill Jr. Drive in the opposite direction. He was holding what I am sure was the same umbrella that I'd seen earlier on the lawn that morning. . . .and it was keeping him dry. And when he saw me looking in his direction, he waved at me and then called out in my direction, "I like your boots, doctor!"

And in an equally booming voice,  I replied, "Bootsy Collins!"

He stomped his foot three times and laughed at that. He even slapped his thigh for emphasis. Which I think might have been the best thing I saw all day. In fact, I know it was. Because this probably homeless gentleman had something to protect him from the rain and he also had enough joy in his soul to still smile on a wet and wintry day.

I loved it all.

Inchworm, inchworm 

Measuring the marigolds

You and your arithmetic 

you'll probably go far

Inchworm, inchworm

Measuring the marigolds

seems to me you'd stop and see 

how beautiful they are

I hope I never get too caught up in the arithmetic of life. Because these marigolds around me? Man. They're too beautiful to overlook.

Yeah.

***
Happy Saturday.

Now playing on my mental iPod. . . . my two favorite versions of this song. My kids and I sing both parts just like this. First, Danny Kay and the Muppets.



And the classic Sesame Street version which I love for it's literal interpretation. 

The Miracle Workers.

Oh, if you were like me

You didn't have a lot of gold

Possessions or money

You didn't own wealth untold

But I'm glad

You didn't look on the things that I had

But you looked on the things you were able to give me.

~ from CeCe Winans "In Return"

I saw this woman once in clinic. It was December and she'd caught two buses to reach us just to get her blood pressure checked and to get her medication refills. And at the end of that visit we were talking about the holidays and such and she let me know that Christmas used to be her favorite but now wasn't. And I won't belabor this with some elaborate tale but instead will go ahead and cut right to the predictable chase and let you know that it had to do with her financial situation. She had an eleven year old daughter and a nine year-old son who wouldn't get a single gift because she couldn't afford it.

Yeah.

But they had food and a warm home, you know? And she seemed cool with all of that. Like, she wasn't all super melancholy or mad dramatic about it. It just was what it was. And even that--the fact that this was her normal and clearly she'd figured out how to navigate it--isn't the point. I really tell you this to tell you about something else that happened after this encounter.

Oh.

And let me just preface this by saying that what happened after that encounter wasn't exotic or unusual at all. Instead it was something that happens on a daily basis in hospitals like Grady all over the country.

Yup.

I called our social worker. And all I did was tell her about this woman and her situation. Then, like our social workers do, she came over to the patient and sat down and spent time finding out her situation. Next thing I knew, some community resources were identified that happened to service the area right where my patient lived. And they were willing and also able to help this woman give her kids just a little bit of magic on Christmas morning.

Yep.

It was short notice. We were like three days shy of Christmas, so that social worker went to wherever she got those resources, retrieved some gift cards and personally went out and bought things for those children herself. Then she delivered it to my patient's home along with some stuff for her to present it to her kids as gifts.

She sure did.

A man I cared for on the hospital service had been ill and was estranged from his family due to a multi-year drug stronghold. He'd been unstably housed and mostly on his own or in the streets. But this illness was serious and sidelined him in that way that no one ever wants to be sidelined. "Where are your people?" I asked. And I asked that because in a place like Georgia everyone has "people." Or even "peoples" as some folks say. Anyway. This man said he did have people but that he didn't know where they were or how to reach them. The names were patched all together in a ragged little tapestry that fractured into pieces the minute any of us tried to pull it all together.

But.

Then I told the social worker. And that social worker stepped in and got to work. And if you work at a place like Grady or have had any contact with a great and dedicated social worker, you know that there is no need to even say "spoiler alert" before anything else. She found that man's people. And his peoples, too. And those folks were worried and glad and thankful to be able to come to the side of their family member during that time.

Now.

Finding somebody's people or peoples may not seem like a big deal to you but it is. And when things like drug addiction and untreated mental health issues and time stand as looming barriers, many times it's a downright miracle when those pieces get put together. And even more of a miracle when something right and good happens as a result.

But this--these sorts of ordinary miracles--happen every single day at Grady. And in this moment I am reflecting on our social workers--the miracle workers--who open the doors and windows that have been painted shut for so many for so long. I cannot do what I do without them. The obstacles are too great; my caring alone is not enough.

Earlier this month, one of my favorite Grady social workers of all time died. She fell ill swiftly and was gone in the twinkling of an eye. And when I heard the news it truly broke a piece of my heart. Truly, it did. Because she was my friend. Or rather, we were very friendly. And I realized that I loved her. And no, not in the eros sense but something different. More like some hybrid between the brother-sisterly philos love and the nebulous agape-type love that one experiences spiritually. Somewhere in my deep appreciation for the selfless contributions of every single social worker I've known through the years, my heart felt a particular sadness at this loss because of that love.

Yes. That.

She--Mrs. Veronica Smallwood--was a wonderful human being--let me not trivialize that piece. But no, she was not the social worker involved in those two aforementioned encounters. That said, in countless other ways she was.

Does that even make sense? I know. I'm probably rambling.

Either way, I'm feeling this weird mixture of sorrow and deep, deep gratitude. It's hard to explain, but I'm trying.

And so. To honor her life, today I honor her peoples--the social workers like her. The selfless legion of women and men who stand ready to help people find soft places to land. The ones who navigate the red tape of socioeconomic speed breakers and mysterious Medicare rules and nefarious nursing home situations. The fearless servant leaders who run into the burning houses armed with nothing more than clipboards and willing hearts and who, on my watch,  are often the ones who pull the screaming baby or decrepit elder from the asphyxiating plumes of black smoke before anyone else. Just in the nick of time. Yet so interestingly they quietly hand them over to someone else just in time for them to get the glory.

That last sentence just brought tears to my eyes. Because it is so, so true.

Sigh. 

Mrs. Veronica Smallwood and her peoples have helped me help others more times than I can count. Surely I could fill an entire blog up with daily tales of these very moments like the two above. I could fill one book alone with just stories of things Mrs. Smallwood specifically did to assist my care of patients for the last fifteen years. I surely could. And I am deeply grateful for it all. I am.

You know? I told Veronica how much I appreciated her every single time I called her or saw her. Not because I foresaw this, but just because it was how I felt and she always gave me space to be honest. I take some solace in that. I do. But I guess today, I felt the need to go and tell it on the mountain. Not just how thankful I am for Mrs. Smallwood, but instead putting a bullhorn to my lips to shout to the world who the real miracle workers are in a place like Grady. In a place dedicated to serving the undeserved? It's them. The ones stealthily making dollars out of fifteen cents day after day after day and leaping from often dilapidated buildings in a single bound--the social workers.

The bible says, "The greatest among you will be your servant." (Matt 23:11.)

Yes. That.

That. That. That.

Yeah.

***
Happy Wednesday. And thank you for being the greatest among us at Grady, Mrs. Smallwood. You will be missed. And today you are remembered.

*And shout out to Mrs. Valerie Beaseley and Mrs. Dorothy Zimmer, respectively--the two miracle workers who made things happen in the two 100% true stories above.

Now playing on my mental iPod. . . for you and all of your peoples, Mrs. Smallwood. "In Return" as sung by the matchless CeCe Winans. Perfect lyrics for the ones who bless our patients every day at Grady--and ask for nothing in return.

Mother.

*names, details changed to protect anonymity. . . . duh.

 "It was a gift I ain't never seen coming. But as special and precious to me as being raised by her."

~ Ms. Ables

I saw this Grady elder one day in clinic on an ordinary weekday. It was a simple follow up for diabetes and hight blood pressure and high cholesterol and not much more. She was adherent to her medication regimen, kept appointments, and was up to date on all of her age-appropriate cancer screening. It seemed that she was in good shape.

Even though Ms. Ables was in her seventies, from looking at her smooth brown skin you couldn't tell. Her crop of silver curls was the only tell-tale sign that she probably earned a senior discount in Publix and Kroger. She had a beautiful smile, too. It was big and vibrant; so wide that you could see the gold edges of the partials she wore. But somehow it all just made her more pleasant to the eye. I liked her immediately.

"Is there anything you're particularly concerned about today?" I asked. Of course, the resident physician seeing her with me had already asked her this same question but I thought I would ask again for good measure.

"Well. . . hmmm." She twisted her mouth for a moment and chose her words carefully. "I feel like I lost a lot of weight over the last three years. And I guess it's good for my medical conditions but I just thought I'd mention it since I ain't been doing nothin' to lose that much weight."

As soon as she said that, I clicked into the weight flowsheets in her chart. The last three visits appeared to be pretty much two to three pounds in the same range. She saw me doing that and added, "It's been gradual. Nothin' real, real obvious. It's only when I run into somebody who ain't seen me and they say, 'Dang! You lost a lot of weight!' or 'Girl, you look good! What you do?' I don't even have the heart to tell them that I ain't done nothing."

I nodded at her and, following that prompt, moved back a few years to see what she'd previously weighed. Sure enough, I saw what she meant. Three years ago, she was 228 pounds. And now? She was a solid 180 soaking wet. "Wow. You have lost weight."

"Told you."

I looked up at her and pressed my mouth into a straight line. I mean, her screenings were all without evidence of cancer. Her blood work was pristine, too. Her address hadn't changed nor had her medication list. This was weird. "Have you been on any diets? Or given anything up since then?"

"No, ma'am."

I leaned my chin into my hand and squinted an eye. "Well, you're definitely right that it's been gradual. And it obviously started somewhere around 2012. Can you think of anything that has happened since then that could explain this?"

"In '12? Hmmm. No. Not as I know of."

"Okay," I responded. And honestly, I wasn't sure what else to say. I mean, anything life threatening that would cause weight loss of this amount would have fully been declared by now. But more than 40 pounds was a lot of weight to be losing without trying.

A whole lot.

Her mood and affect were light and normal. She definitely didn't strike my resident or me as depressed, but I've paid enough attention to some very strong people affected by depression and anxiety to know that this means nothing. Out of necessity people find their best "game face" and strap it on for moments such as this. And so. I went ahead and did a simple screen for depression which, for the most part, came up negative.

For the most part.

When asked her the question about changes in her appetite, she said, "It's there, but I just don't eat as much these days."

I didn't beat around the bush and came right out and asked. "Why is that?"

I needed to know. I mean, was it a money thing? Or an access thing like living in a food desert or not having transportation? Was it a dental issue--which is super common in indigent populations--requiring her to get a tooth pulled or to be fit for dentures? I wanted to know.

Turns out, it was none of those things.

"I eat to live now and that's it. But I used to live to eat." The side of her mouth turned up and some inexplicable emotion washed over her face. She cleared her throat and went on. "My mother and I used to have dinner together every night. She was a great cook and taught me all she knew."

I just stayed silent, nudging her to go on. She did.

"When Daddy passed on about fifteen years back, Mother came to live with me. Not 'cause she couldn't do for herself or nothing. Just because she liked being with people and such. Mother was like that. She liked people and company."

"That's great."

"Yeah, it was good for both of us. My kids' dad and I split a long time back and my kids were all grown and on they own. I was glad to have her move on in."

"Sounds special."

"You know? It was. It sho' was. And Mother? Whew-weee, she loved food." Ms. Ables shook her head then swallowed hard. "Jest loved it. Everythang about it. And nawww, she ain't never got real heavy or anything. But food was her thing. And a good meal with everybody together enjoying it? Now that was her favorite." Her eyes had already begun welling up with tears that she blinked back as hard as she could.

I decided not not to overthink it and bit with the obvious question. "Did your mother pass?"

"Yes, ma'am. She went home jest before Christmas in leb'm." I liked the way she and many of my Grady elders pronounced the word eleven as leb'm. And I also liked the way death was described as "going home."

"I'm sorry."

Ms. Ables sighed hard. "Yeah, baby. Me, too. Once Mother moved in, it was just us for some time. We was both up in age so look like we was jest two peas in a pod, me and her. And since she loved food and cooking so much, we made dinner side by side in the kitchen and ate together every night."

"Wow," I said. At this point Ms. Ables was sweeping tears off of her cheeks. I pushed a box a hospital-grade Kleenex in her direction. Watching her cry made me feel this dichotomous mixture of sorry I'd asked about her mom and yearning to hear more about her. Now that I know how good it feels to talk about someone you love--especially when they're no longer alive--I stuck with embracing the latter. "What kinds of things did your mom like to eat?"

Ms. Ables placed her hand on her bosom and laughed hard and deep at that question. Immediately I felt glad I'd asked. "Chile," she sucked in a big drag of air and chuckled again. "Mother liked it all. And see, since she was one of them old school cooks, she knew how to make everything from scratch. But the reason I'm laughing is 'cause later on she got into them cooking channels. And I tell you she'd have me in the store and down by that curb market with her looking for all sorts of stuff. I mean anythang you name, Mother and me tried it out. Right there in my kitchen."

Shit. This is the kind of thing that always makes me want to cry. I mean, I can't even type it well without crying so you can only imagine what I was like when I was there. But surprisingly, I held it together. That is, until she said this:

"And no matter what, Mother had me set that table jest like I did as a girl. And you know? I would. I set it just like she taught me every single ev'nin. And Mother believed in eating on your good plates. We ain't never had no china or nothing. But we had some nice stuff and we used it every day, me and Mother. We sure did."

And that? That did me in. Man. I tried my best to smile at her as the fat tears rolling down my cheeks mirrored the ones that had been sliding down hers. Because now? Now, I got it. I got why this woman, who used to live to eat now only eats to live.

"I'm sorry," I finally whispered while patting my eyes with tissues from the same box I'd just handed to her a few moments before. And I said that because I was sorry. "It's just . . . that. . .it's just a beautiful image, Ms. Ables. You and your mother dining together like that. I can see it."

She froze and closed her eyes for a moment. Her breath hitched briefly, then she gave her throat a clearing. Ms. Ables' eyes were somber when she opened them to look at me again. "So guess it do make sense why my weight fell off, don't it? 'Cause now I just eats to live and that's it. I mean. . . " Her voice faded off and crackled a bit. I could tell these words hurt but she pressed on. "Now I just like to get meals on over with, you know? I picks something real simple to make, too. 'Cause a real complicated recipe make me miss my mother too much." She looked frustrated when the tears started to return.

All I could do is sit there. Sit there with my eyes on her and not flinching as she honored her mother and told her story.

Ms. Ables looked skyward and then dropped her head. "Lord Jesus. Mother, I miss you so much. I mean every single day, Lord knows I do."

Now she was weeping. And let me tell you, it broke my heart into a thousand tiny pieces. I reached for her hand and she let me hold it. "Take your time, Ms. Ables."

And you know what? She did.

"You know? I still eat on the good plates, you know? Jest 'cause I know Mother would want that. And my life a good life. I go places and do stuff and enjoy my life, too. But it's just that meal time. Something about sitting down to a meal that I believe is probably gon' hurt my heart until I take my last breath. 'Cause that? That I associate with Mother. And I doubt I'll ever reach a point where I don't feel that way. And that's okay with me."

I decided it was okay with me, too.

So there you had it. This is why my patient had lost more than forty pounds in three years without trying. And you know? I'm realizing more and more how much you can learn about people by asking the right question and then--the real key part--by actually listening to what they say in response.

More discussion revealed that Ms. Ables was indeed enjoying a very good quality of life outside of meal time. We completed a PHQ-9 depression assessment, too, and she didn't meet criteria for depression with that one either. Ms. Ables just missed her mother. Plain and simple.

We wrapped up the end of the visit and tied up the loose ends. I reached over and gave Ms. Ables a big hug and she hugged me right back. And all of it was authentic and good. Truly it was.

I thanked her for introducing me to her mom and that made her smile. Then, one of the last things she said before I left was this:

"This probably sound silly to a lot of folk. I mean, look at me--seventy-four years old and crying over losing my mama like she ain't never get a chance to grow old. Mother made ninety-four. Ninety-four! And she was in her right mind that whole time, even up until her last days when she just fell on asleep one day in her chair and didn't wake up." I stepped away from the door and sat back on the edge of the chair when she said that part. Then Ms. Ables rested her eyes on mine and finished. "But here's the thing: Mother wasn't just my mama. She was my friend. And I loved growing old with her. It was a gift I ain't never seen coming. But as special and precious to me as being raised by her."

And that? That I knew I'd have to place on a post-it note in my heart to come back to later. Because until then the idea of living long enough to become an elder with your parent was something I'd never even thought of. I guess because it calls for planets and birthdays to be aligned just so, but still. I now know that hearing that will surely change the way I view loss in those who get the chance to experience that uniquely special phase together.

Sigh.

See this? This is Grady. A world of people and lives and lessons and love. Of Ms. Ables and Mothers and so much more. And me? I'm just glad to be here, man. So, so glad.

Yeah.

***
Happy Wednesday. And thank you, Ms. Ables, for showing me yet another dimension of love between mother and child.

This reminded me of this poignant word that Billy Bob Thornton shared on the show "Master Class." Some piece of me relates to this, too.

Big B, Big F.

Whenever I'm down, I call on you my friend 

A helping hand you lend, in my time of need so I 

I'm calling you now, just to make it through 

What else can I do? Won't you hear my plea?

Friends may come and friends may go--

But you should know that 

I've got your back, it's automatic 

So never hesitate to call 

'cause I'm your sister and always for ya 

and I don't know. . . 

I don't know what I'd ever do without you 

From the beginning to the end 

You've always been here right beside me 

So I'll call you my best friend 

Through the good times and the bad ones 

Whether I lose or If I win 

I know one thing that never changes and 

That's you as my best friend

~ Brandy, "My Best Friend"

____________________________________________

I remember my third day of medical school well. Well, not the full day of it but one part in particular. I'd just parked in the lot next to our academic building and had slung my backpack over one shoulder. Since it was the start of the year, I wanted to hustle inside and get a comfortable seat in the lecture hall before it got too crowded.

Yep.

Like always, I was walking fast. But this time, since it was that point at a new place where I was just making my mark, I wanted to be early. With blinders on, I picked up my pace. It surprised me when, despite how quickly I was trucking, someone would decide to sidle up next to me, match my pace and make small talk.

"Hey there! I'm Lisa," the person panted.

Mid-stride, I swung my head to the side and noticed this woman walking lock step with me. I hadn't seen her on the first day of orientation but something about the way she introduced herself made me immediately know that she was just as new to our medical school as me.

"Oh, hey. I'm Kimberly," I replied. I pulled my strap over onto my shoulder and then reached for her hand, legs still moving the entire time. "I'm sorry. I'm just trying to make sure I get a decent seat."

"Oh, no problem. I'm a fast walker, too." Her voice was hi-pitched and her tone was familiar. I noticed that immediately. That and the fact that, like me, she had a smattering of freckles over her nose and cheeks. She was smiling at me in this warm and easy way. Like an auntie or a neighbor welcoming you into her home for a slice of homemade pie.

"Nice to meet you, Lisa," I finally replied.

Swiftly, she spoke again. "I went to Hampton. Where'd you go to school?"

"Tuskegee." I took a few more steps and then looked back at her. "Hey, Tuskegee and Hampton! We've got the Booker T. Washington connection, right?" I chuckled and offered her a high five. Lisa obliged me, quickly affirming that she knew the association between her fellow Hampton alumnus, Booker T. Washington , who would go on to later found my alma mater in 1881.

She was wearing her sorority jacket. This isn't such an unusual thing for folks who graduated from historically black colleges. The most striking thing perhaps was that it was the first obvious thing we didn't have in common. Lisa was an AKA unlike myself, a recent initiate of Delta Sigma Theta. "AKA, huh?" I feigned a look of disapproval as we continued up the path.

"And proud of it!" she giggled. "Delta?"

"You know it!"

"Mmm. Some of my closest friends have that problem." We both shared a collective laugh as we took the last few steps into the Basic Sciences Building. We diligently found our seats in the freshman lecture hall and started what would be the first of many days just like this.

And the rest, they say, is history. That was the day that Lisa Walker became my best friend. And I guess I say that because every memory after that gets blurry and runs all together for me. That walk from the parking lot has always stood out because it really is impossible for me to get my mind around the time at Meharry or beyond where she wasn't just that--my best friend. It's a title she holds to this very day.

Yep.

Now. As far as close woman-friends go, I am deeply blessed in that area. Without question, my collection of "Ruths" (as I call them) sustains me. And you've heard me speak of that very idea of women being there for women and how important that is. Regardless of marital status, age, sexual orientation or socioeconomic position, women need women. And me? I've been fortunate to have them surrounding me.

Yes, I have.

But a best friend is different. You grow up together and grow through things together. You become uniquely vulnerable to one another. The spinning merry-go-round of joy, pain, sunshine and rain is one that you try your best to cling onto together without getting thrown off. And with best friends you do cling on. Or you get right back on the second you're flung into the sandbox. You mature and learn that love and acceptance are found there like nowhere else. That being you is just fine. Especially with her. Your best friend.

Do I have some other super-duper tight-girl besties? Of course I do. And so does Lisa. But it's weird. There's this unspoken thing between those who enter this kind of friendship that is its own kind of special. Separate from what I share with my blood sisters or my mom. Just. . .I don't know. . . .different. And I guess any woman who knows of this kind of friendship is nodding her head and understanding. Maybe. Maybe not. Either way, having this kind of best friend doesn't undercut or minimize other friendships. In fact, quite the contrary. That kind of friendship makes you a better friend. It keeps you in check and teaches you loyalty.

At least that's what I think.

And you know? Not every woman will know of this. That is, a real, true, bona fide best friend. A Big B, Big F best friend, as my sister Deanna used to call it. Some have "good girl friends" and that's it. Or they're best friends with their spouse--which is fine--but again, different. So no. Not every woman can say she has a ride-or-die, undeniable, go-to BFF. But what I'm saying is that I do. And I'm so, so glad.

Damn, I am.

Anyways. Stay with me. I'm going somewhere.

Okay. So last month, I heard some awful news. A college friend and sorority sister had a sudden death in her home. A massive pulmonary embolism which the doctor in me recognizes as a very ruthless thing to have. What's even worse is that her own mother found her and tried to do CPR. She had two daughters, countless friends and was simply an amazing human being. She truly was.

Sassy and quick-witted. Fiercely loyal and ready to have your back. Thoughtful and attentive.  Her name was Jackie and I'm so glad to have known her. I really am.

Man.

JoLai was the one who told me. She abruptly cut into what had been a lively phone chat and blurted out that she'd just heard it via text message. With emotion in her voice, she quickly hung up and left me to wrestle with that bombshell.

Shit.

Of course, I felt all the things any person feels when hearing of the untimely passing of a peer. But now, my feelings always have this new complexity since Deanna's death. I cried immediately upon hearing the news. Jackie and I didn't talk much so I admit that I wept for her mother first. Then for her daughters. I knew that for her mother, a resilient and strong woman, this unnatural order of events would introduce her to a level of pain unlike any other. I'd seen it up close and personal in my own parents. And that? That broke my heart. And breaks my heart. Because no mother should have to attend her child's funeral.

Nope.

And so. I looked on social media at the beautiful words and photos posted in her memory. Friend after friend reminisced on special moments and priceless memories shared with her in school and beyond. I loved it all, particularly because Jackie was not only my friend but Deanna's close friend. The pictures of Jackie that started popping up often included her friend, my sweet sissy, too. All of it warmed my heart.

It sure did.

But then, as I clicked through post after post, something grabbed me by the neck and squeezed the air out of me. A simple, yet sorrowful post that read:

"I have to say this is the worst day of my life. I feel like someone just ripped my heart out." 

And that was it. No photos. No hashtags. No nothing. But those words, coupled with the knowledge of who wrote them, invoked a sympathy so deep that I had to close my computer and drop my head into my hands.

Those were the words of her best friend.

Shit.

No. Not her close friend. And no, not her very, very, dear friend. This was her Lisa. Her 3am phone call. Her bridesmaid that didn't even need to be asked or assigned since it was a given. The peanut butter to her jelly. The hip to her hop. Any who knew Jackie, knew that she and Joye, her best friend, went back like car seats. Not only had they attended Tuskegee together--they both came there after transferring from Syracuse where they'd met as freshmen. Years, miles, husbands, children, health issues and anything else that could potentially tease them apart never had a chance. These two were like peas in a pod, sisters from another mister. And you know? It was just one of those things that everyone knew. Jackie and Joye were best friends. Big B, Big F friends. And like Lisa and me, I doubt that either of them could ever remember a time that they weren't.

Nope.

And so. After reading Joye's words, it dawned on me what she, too, had lost. I imagined the terrible, raw and gaping hole that had to be throbbing in Joye's chest--or the chest of any person who has just lost THAT kind of friend. Their Big B, Big F Best Friend. Especially one with a personality as big and alive as Jackie's.

Damn.

Of course, my thoughts constantly went to her mother and her two girls. But closely tethered to that would be this relentless, gnawing sympathy for her Big B, Big F best friend.

Yeah.

On and off, I also had these fleeting thoughts of what it would feel like to hear such news about Lisa. The thought made me so immediately nauseous and tearful that I'd do my best to think of something else. Once I even told Lisa all about Jackie and Joye and my morbid thoughts. I could tell that she, too, had never even thought of what that must be like.

Sigh.

When Deanna passed away, I was so consumed with the grief of my family that this thought never crossed my mind either. That is, this specific idea of what Deborah, Deanna's very best friend must have been feeling back then. Or what she feels to this very day.

Hmmm.

So I guess that's what I'm reflecting on this evening. The blessing of living into your adulthood with a Big B, Big F best friend--one with whom you become so close that the whole world knows it, especially the two of you. You know? I wish a Lisa or a Jackie or a Deanna or a Deborah for every woman. Because even when you are surrounded by throngs of amazing friends, having that Big B, Big F one is like climbing into bed with freshly laundered Egyptian cotton sheets.

Comfort on a whole 'nother level.

So yeah, despite how painful the thought is, I have let myself think about what it means for someone to lose that person to death. I try to get my head around it but honestly can't. Instead I've just decided to let it remind me of how blessed I am to have my Lisa. I appreciate how much better we make each other and how much we've grown together through the years. I love that we give one another space for other close friendships. Sometimes they overlap, sometimes they don't. And with your Big B, Big F friend? It's all good.

Yup.

The older I get, the more I see. And I'm okay with expanding my view to include the suffering of others. Today, it includes that of a best friend who is trying to navigate a world that suddenly doesn't include hers.

So to Joye and Deborah and any other Big B, Big F friends who know this unusual grief, I'm so, so sorry. No, I don't know what it feels like to lose a best friend. But I do know what if feels like to have one. That I know for sure.

Yeah.

***

Now playing on my mental Vine.



And my mental iPod. . .

One helluva guy.

My dad turned 72 today. The older I get, the more I realize how fortunate I am to have been raised in the safety of this man's arms. I grew up with him looking at me lovingly and having high expectations of me. The smirk on my face tells me that I was pretending to be asleep but what I know for sure was that I was indeed content.

Being raised by this man continues to be an awesome journey. I love him more and more each day.

You know? He's just one helluva guy.

That's all I've got.

***
Happy Thursday.