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Wednesday, June 9, 2010

Life at Grady: Innocence Lost

The following post, by Kimberly Manning, FACP, first appeared on the blog Reflections of a Grady Doctor.

Last week, Gary Coleman, who played Arnold on the T.V. show "Diff'rent Strokes," passed away. I used to love that show. Apparently he fell and bumped his head, and died of an intracranial bleed of some sort. Similar to when Michael Jackson passed away, sandwiched in between the quasi-flattering comments about his life were coldcuts--literally cuts--about all the unfortunate twists his life's journey had taken. I felt sad about them both.

There are others who make me sad, too. Okay, so I admittedly do more than just thumb through People magazine and Us magazine. Yep, I read them more than I probably should, but mostly when I want to just do something that requires zero thought. When I'm thumbing through the pages and seeing which Housewife did what, and what the Jolie-Pitt kids are up to, there is inevitably some sad, drunken picture of Lindsay Lohan. Every time I see her in those pages I feel a little sad about her, too. I imagine her freckled face in "The Parent Trap" and "Mean Girls," and shake my head. Damn.

It all comes down to the same thing: innocence lost before it was time. There are some things that kids just shouldn't have to see. . . .or do. . . or know until they can handle knowing it.. . .or seeing it. . .or doing it. For many kids, they don't even have a choice. It seems like everything that messes people up somehow traces back to someone or something that robbed them of their innocence prematurely. They spend the rest of their lives trying to make sense of it or reconcile it. . . some kids slug it out and make it. A lot don't.

I see them every day at Grady. The products of innocence lost. Confused, addicted, troubled. Then I see that tiny percent of overcomers. . . triumphant, driven, surviving. The overcomers always share some story of some person who stepped in and fought off the demons that lurked in the shadows. . . . . protecting them, believing them, needing them, cherishing them. Isn't that what we all need from the start?

Today I am reflecting on all that my loved ones did to preserve my childhood during my childhood--and I am reflecting on every single one of my patients who were dealt a different hand than my own. Those tied up in a vicious cycle of confusion, lack of resources and ill preparation. Those whose lives are manifestos of generational curses that eventually lead them to lay in hospital beds before me as my patients in this public hospital. I am pondering how blessed I am to have been placed in my family as the middle daughter of two committed young parents. I am thinking of each curfew, each "Go back in the house and change clothes". . . .every "I don't care what their mama does because your mama says no." . . .and all of the "Because I said so's." Thanks to my parents, for the most part, I haven't had to "slug it out."

But now times are different. Kids see more, do more, have more. It's a different beast. Sigh.

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Blog log

Members of the American College of Physicians contribute posts from their own sites to ACP Internist and ACP Hospitalist. Contributors include:

Albert Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.

David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.

DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.

Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.

Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.

FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.

Glass Hospital
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.

Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.

I'm dok
ACP Member Mike Aref, MD, PhD, ACP Member, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.

Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.

KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.

MD Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Medical Lessons
Elaine Schattner, MD, ACP Member, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.

Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.

Reflections of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.

Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.

White Coat Underground
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.

ACP Internist and ACP Hospitalist also contribute to and draw upon content from Get Better Health, a network created by Val Jones, MD, to support and promote health care professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the clinician's point of view on health care reform, science, research and patient care.

Other blogs of note:

American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.

Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.

db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.

Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.

PLoS Blog
The Public Library of Science's open access materials include a blog.

White Coat Rants
One of the most popular anonymous blogs written by an emergency room physician.

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