Affirmative actions.

Best moment of my week at Grady:

Yesterday I encountered a young man at Grady who spoke to me by name.

"Hi Dr. Manning!" he said. Even though I wasn't sure where I'd known him from, I smiled big and responded in kind. He went on. "I know you don't remember me. But I just want you to know that I just matched in Emergency Medicine and am about to graduate from medical school at Morehouse School of Medicine!"

"That's fantastic!" I replied. "Where are you going?" He told me and I congratulated him. Genuinely, too. Because matching into a residency program is a big effing deal and a huge accomplishment. And since he stood there still smiling, I repeated myself. "That's really, really awesome."

And I said that because it was. But then he jogged my memory about how we'd met:

About 5 years ago, I was making rounds at Grady one afternoon. This young man was working as a one-to-one patient safety sitter (not for the faint at heart at ALL) and, since his patient was fast asleep, he'd brought along books to study to make the most of his time. I was seeing the patient in the next bed over and couldn't help but notice how fervently he was scanning the text in front of him. This kid meant business.

"What are you studying?" I asked him.

"Ma'am? Oh, studying for the MCAT," he replied.

And honestly? I mostly remember was that I liked his hustle and the tenacity in his eyes. So I told him just that. Then I extended my hand and introduced myself because I knew what it meant for him to be a black man sitting in that chair studying for a med school entry exam with a black doctor standing in front of him.

I really did.

This was 2013--within the year that Deanna had passed. My intention with people changed when she died. Even the tiniest moments I think about, wonder about . . like, "Hmmm. . .. what am I supposed to be doing with this one moment in time with this person?" Heavy, I know. But this was my paradigm shift. And so. I know exactly what happened next: I gave him a word of encouragement and told him that I was sure he would become a doctor. And that big smile on his face showed me that he believed me.

Then I took his picture so that I would remember that moment in time. And I am so glad that I did.
Yep.

You know what? When I ran into him, I didn't remember him. But you know what? He remembered me. He also remembered that I encouraged him, too. Then he reminded me that I had taken his picture that day. Sure did. And I knew then and there exactly who he was and could see the moment crystal clear.

Here is what I know for sure:

Life is but a twinkling of an eye. Every little sliver of time that we get is an opportunity. And sure--from this 2013 photo, it's clear that this young man was already well on his way to succeeding. But I love knowing that God placed me in his path that day and that I noticed him. I really am. I could have walked right by and not seen him at all.

My goal is to see people. Like, for real see them. I loved this moment and the affirmation it brought to us both about the power of letting our lights shine.

Yeah.
***
#idontmakethisstuffup #bestjobever #thisisgrady #choosekindness #hegraduatesinmay #howdopeisthat #whoareyoumissing #speakaword #wordshavepower #morehouseMD #meharryMD #lookatGod #iseeyou

The Gospel.

I was told one thing. That your aortic heart valve was narrow and tight and that, just maybe, one day very soon you would need that valve replaced.

Aortic stenosis. That's what I was told. With clear certainty and not so much as an eye twitch or a blink. From his lips to my ears like it was the gospel. Aortic stenosis.

I entered the room alone. Armed with the gospel that I had been told about you. Aortic stenosis. I spoke to you for a few moments and talked about what was going on. "What is your understanding of what is happening with your heart valve?"

"The blood rush over it in a way that's not normal. They heart valves don't open and close like they s'posed to."

I nodded because, for the most part, that was true. It was. And I went into a description of what it all meant. Your tight and narrow heart valve. I said the words over and over again. "Aortic stenosis" this. "Aortic stenosis" that. You looked a little bit confused but when I asked if you understood you said, "I think so."

I think so.

Next I pulled my stethoscope from my pocket. Slipping the rubber tips into my ears, I looked at you and smiled. You smiled back. Then I gave the diaphragm a vigorous rub with my palm remembering that a Grady elder had told me once: "Even though it don't do much to warm it up, something 'bout seeing you try make me feel good."

So I did that. And I do that. Most times, I do.

I close my eyes and place the instrument on your chest. I follow the map of listening areas taught to me as a medical student and quietly listen for the tell tale sounds of aortic stenosis:

First a soft sssssssshhhh. Then it grows louder to a SSSSSHHHHH. Falling down quickly to the that soft hush again.

I know it when I hear it now. And so, instead of fighting to discern what it is, I am armed with experience. You patiently allow me to confirm what we both already know. My breathing slows. My hand glides with the stethoscope over your skin.

You are so cooperative and kind, I wish I wasn't alone and that a student could be beside me. To hear and learn right next to me. Aortic stenosis.

My eyes open.

Wait huh?

I am hearing sounds, yes. But they are NOT the ones I expect. I squint my eyes and listen harder (as if this changes what the ears hear.) "Can you hold your breath?" I ask. And you do.

Same thing.

A soft whoosh followed by what sounded like a deep sigh between heart sounds. Again and again I listen. And again and again, I hear the same thing.

Shit.

"They told you your heart valve was small? Like tight and stiff?"

"They told me something. I don't know if it sounded like that."

"What about a leaky valve? Did somebody say that?"

"I don't know, Miss Manning. Y'all be saying so much sometimes."

And you're right. We do.

You don't have aortic stenosis. And while you do have an issue with your aortic valve, it isn't that. And though I am not a cardiologist, I can say that right now it doesn't look like you need surgery either.

You were gracious when I told you I was wrong. You shrugged and laughed a little. Like none of it was a big deal.

While my face burned hot like coals.

This happened a while ago. But what it taught me was that, like all gospels, I need to listen for myself, examine for myself and interpret for myself. Because even though a lot of times there is no discrepancy. . .sometimes there is. When telling someone life impacting information, it's good to have at least checked for yourself before talking.

Whew. Preach, pastor.

I also learned that there is a lot we say that gets missed. Yeah, so I work at doing a better job in that area, too. Explaining until you know so. Not just think so.

Yeah.

Last I checked, you hadn't had your aortic valve replaced. You were still doing well and seeing the cardiologists regularly. Today I am hoping and praying that you know exactly why. This is what I am hoping. And that the gospel you hear is the gospel indeed.

Yeah.
***

Get (TF) out.

I used my softest voice. Tender and earnest. Made sure my body movements were slow, gentle and nonthreatening. You'd been through so much already. And even though your distrust and refusal to cooperate with nearly every doctor who'd stepped into your room was so unwavering, I knew that NOT seeing you wasn't an option.

"You'll probably get kicked out," someone said.
"We'll see," I replied.

And so I went.

"Hi there."
Your eyes flung open, suspicious and glaring. "Who are you?"
"My name is Dr. Manning. I'm the senior doctor that's going to be taking care of you."

You stared. Didn't say anything.

"How do you feel?"

Still nothing.

I asked two more questions and you shut me down. "I don't know you," you said. "You could be anybody."
"I could," I responded. "But I'm not. I'm your doctor."

The next things you said made no sense. They flew out of your mouth and splashed against the walls and floors. I tried to grab them up and make sense of them. But I could not.

I could not.

"May I examine you?"
"No."
"No?"
"Hell no."

I didn't know what to say so stayed silent.

"Can I--"
"Get out." That's what you said. Then you said it again. "Get the fuck OUT."

Which is what I did. As you turned up the television, rolled on your side and refused to look at me.

Two hours and some change later I came back. This time you were nice. Like, super nice. Like none of that had ever happened. You complimented my hair and my shoes. Then said it was really nice meeting me. Then you asked me for some strawberry Boost and a ginger ale. And the name of where I got my boots.

The interface between medical illness and psychiatric illness is one of the hardest parts of my job. They wrestle each other to the ground and when they aren't on the ground they play a hellacious game of tug-o-war. It sucks. A lot of days it really does.

But I signed up for this. And you? You signed up for nothing. So I'll keep coming back. Again and again I will.

Before I left, I placed three things on the bedside tray table in your room:

A ginger ale.
A strawberry Boost.
And a piece of paper that said, "Frye. But they sell them on Amazon or eBay for cheaper."

Yeah.

***

Happy Monday.