Some type of way.

When I saw you on rounds today you were quiet. Your eyes looked in my direction but were otherwise vacant. This was a change.

Me: "You okay?"
You: "I'm okay."

I asked you to sit up in bed and carefully untied the back of your gown. Gently, I searched your back with my stethoscope, listening to see if you were improving.

Me: "Can you take a deep breath?"
You: *deep breath*
Me: "And let it out."
You: *let it out*

We repeating that exchange for a few more beats. The sounds emitted from your lungs confirmed what I'd been told. Things were improving.

I'd attempt to lift the mood.

Me: "You sound so much better!"
You: *head nod and shrug*

No such luck.

You'd been so upbeat the day before. So animated and full of light. Out of breath, yes. But still with eyes that twinkled. And so loquacious that I pulled up a chair to sit down and just let you talk. Today? None of that. Just quiet cooperation and a cloak of melancholy that didn't make sense.

Me: "What's wrong?"
You: "I'm okay."
Me: "Really? You seem sad today. Like you're not okay."
You: *silence*

Another shrug.

I slowed my movements and looked for a chair. Perhaps if you didn't feel like I was too busy to listen, you'd share. Something was wrong. And I didn't like the idea of you holding on to that something all by yourself while laying in a hospital bed. And so. I told you just that.

Me: "I don't like you in here by yourself with something heavy on your soul. If you feel like sharing, I want to hear. If you don't feel up to it, I can respect that."

A tear squeezed out of your eye and rolled under your chin. You sighed.

You: "Somebody came to talk to me about all this. Told me that if I don't do better I'm not gon' be here this time next year."
Me: *listening*
You: "Saying 'You need to lose weight and take your medicines! And stop missing appointments! And why you don't exercise and why you keep eating the wrong stuff and smoking cigarettes? You keep this up and you gon' die!' That's what they said to me."
Me: "Hmm."
You: "They kept on saying it was 'tough love.' Like every few words it was 'tough love' this and 'tough love' that. But to me? It wasn't no love in it."

Another tear slipped over your nose and disappeared into your nostril.

You: "I wanted to say, 'Do you know my life? Do you live where I live? Like, do you even know? I want to be healthy, too!' But all I did was just wait for it to be over. I just said, 'Okay' and acted like it was cool." *shaking your head*
Me: "Man. I'm sorry."
You: "That hurt my feelings, Miss Manning. For real. I know that doctor meant well but I felt some type of way about that."
Me: *silence*
You: "Like, I think when a doctor speak to you they should look you in your eye and see where you at. And if your face say this ain't okay? They need to do something else. Or just stop talking."
Me: "That's good advice for anyone."
You: "Know what? You right."

After that, we talked more about what makes it hard for you to get your medicines and make appointments and eat healthier and move your body and move toward being a non-smoker. You told me about where you live and who you live with and what it's like and how you get the things you need and what makes your nerves bad. Then we talked about a few strategies to help you make steps in the right direction. And the whole time I watched your face to see where you were.

Or if I needed to just stop talking.

The doctor who gave you what was believed to be "tough love" is a good one who, I have to believe, was looking to motivate you not be unkind to you. And I told you that, too. That we are all works in progress with blind spots and ball drops. All of us.

This seemed to resonate with you.

We didn't fix all your problems. But you were smiling when I left. Which, to me, was a start.

Yeah.

***
Happy Sunday.

Ms. Doctor.

I was walking near the hospital entrance today and saw three young brothers standing out front talking and laughing in the sunshine. One was slender with long locs rolled into an afrocentric hipster man-bun. He was animated and talking with his hands. Another was short and stout with flawless espresso skin and a close cut fade haircut. His mouth was gleaming with gold teeth. The third fellow was leaning on the wall chuckling in response to his comrades. His dancing eyes were a beautiful shade of amber and his nose was dusted with freckles.

They were beautiful. Seriously, they were. They greeted me in deference as I passed by.

Manbun: "Hey Ms. Doctor."
Me: "Hey gentlemen. You guys doing alright?"
All: "Yes, ma'am."
Me: "That's great. Have a good day, gents."
They smiled and all said it again: "Yes, ma'am."

I liked the way they all called me ma'am. Even though hearing it always jolts me out of this frozen-in-time idea in my head that I'm forever thirty years old, something about hearing it said in my direction feels maternal and special. I always return the favor, greeting the young men I see around Grady as "gentlemen"-- no matter who they are. Just like I do my own sons.

Yep.

I could immediately tell they weren't being fresh. Just pleasant and respectful toward a woman that they saw as--dare I say it? An elder.

Gasp. An elder.

Ha.

As I walked by, I admired the vast variations in blackness that each of them represented. All so different yet clearly unified in this cultural thread that weaved them all together.

And me with them.

Manbun reached for the door when I got to it and held it open. Just then I noticed that all three of them had their pants hanging nearly to their mid thighs. At first I was going to ignore it but then I decided to use my elder license instead.

Sure did.

Me: "Now you know I don't like seeing my three handsome little brothers standing out here with their pants falling down. Pull up those britches, gentlemen."

And yes. I said "britches."

You know what happened next? All three of them immediately pulled up their low slung jeans up over their hips. And all of them mumbled apologies and words like "my bad" and such.

Me: "Who y'all here to see?"
Manbun: "Our homeboy."
Me: "Is his mama there, too? Did she have to see what I just saw?"

*laughter*

Me: "If she is there, I know she don't want to see your whole behind hanging out of your jeans."

And yes. I said "whole behind."

Manbun: "Ha ha ha we hear you, Auntie."
Me: "Okay, but for real--what's the deal with your entire butt and drawers hanging out of your pants?"
Them: *looking at each other with amusement*
Me: "I'm serious, y'all!"
Freckle face: "It's just the style, I guess."
Me: *old lady scowl* "A style that makes  it where you walking like a penguin?" *shaking my head playfully*

*laughter*

Me: "Okay, gentlemen. Let me go in here and do my job."

*laughter as I walked through the door*

Manbun: "Hey Ms. Doctor!"

I turned around from the door and looked back. All three of them were standing in a row with their pants pulled all the way up and holding them at the waist. They all had these goofy, exaggerated smiles that reminded me of my own sons. Then we all burst out laughing.

I waved my hand at them and walked away shaking my head and smiling.

I told my team on rounds today: "If you stay with someone long enough, you'll always find a place where you intersect. Always."

No-- I don't like the sight of sagging jeans. At. All. And honestly? I'm not a huge fan of gold fronts either.

But I also don't like that video game Fortnite.
Or the random YouTube gamers I have to hear about nonstop from the backseat of my minivan.
Or dinner table discussions about Fortnite skins and virtual outfits for video games.

Nope.

But what I DO have is a soft spot in my heart for goofy sons with silly smiles. And beautiful brown manchildren with knotty hair and easy slang who hold doors and also poke fun at me and each other. Just like the ones that stood outside of that hospital entrance today.

And just like the ones that came from my own body.

Yeah.

***

Pollyanna.

Her: "Do you think we should do any more testing?"
Me: "I think we should check another round of cardiac enzymes, don't you?"
Her: "I don't know, Dr. M. The timing aligns with the crack use."
Me: "That's true."

*silence*

Me: "Cocaine accelerates coronary heart disease. So, like, even if you use, it adds risk both short term and long term."
Her: "I get it. I guess I'm just trying to think through what we would do next, you know? If the cardiac enzymes are positive. Would we suggest cardiology come do a cardiac catheterization?"
Me: "If they are suggestive of an acute coronary syndrome? Yes."
Her: "Hmmmm. But let's think this through. So then we do the cath and it calls for an intervention. And then the intervention calls for the patient to take anti-platelet medicines that must be taken."
Me: "And that if they don't take them they'd be worse off."
Her: "Exactly. So I am torn. This isn't because I don't want to advocate for the patient. It's actually because I do."

*silence*

Her: "So what do you think?"
Me: "The same thing. Check them."
Her: "Really?"
Me: "Yeah."
Her: "And if the cardiac enzymes are positive?"
Me: "Consult Cardiology."
Her: "For a cath? And intervention?"
Me: "Yeah."
Her: "You wouldn't be scared of doing harm?"
Me: "I'm always scared of doing harm."

*silence*

Me: "Listen. I should tell you. I'm a total Pollyanna. . an eternal optimist--often to fault. So I want you to know that I truly get what you are saying. But I always have this little idea in my head that I can encourage the patient to quit. Like, if your heart depends upon it? And I believe right along with you that this isn't your lot in life and that you can recover? Yeah. I tell myself that this might be the day. The discussion that turned the ship around."

*silence*

Me: "But I get it."
Her: "I get what you're saying, too."
Me: "You make great points."
Her: "Let's check one more set. And if they are abnormal, we will cross that bridge when we get to it."
Me: "I like that plan."

*silence*

Her: "Hey Dr. M? What's a Pollyanna?"
Me: "You don't know what a Pollyanna is?"
Her: "I'm a millenial."
Me: "Then Google it."
Her: *smile*
Me: *smiles back*

Let's be clear: My resident is sensitive and empathic. And this discussion is as old as crack cocaine itself when it comes to ethical dilemmas at Grady. But regardless of that and all that I see, I can't shake my optimism. Some piece of me always believes that this might be the day.

Yeah.

I love this job.
****

#amazinggrady #eternaloptimist #igetburntalot #butsometimespeoplewin #blindspot #rooterfortheunderdog #alwaysalwaysalways #thismightbetheday