Life at Grady: One is enough

A version of the following post, by Kimberly Manning, FACP, first appeared on her blog, Reflections of a Grady Doctor. Names and identifying information have been changed to protect individuals' privacy.

Sometimes I wish I were a superhero. Better yet, two superheroes. One with super powers to do things like write long prescriptions in a single bound, and another to wipe snot from my kids' noses and console crying patients. But I know I'm not a cloned superhero. I'm just one person with two feet, two arms and one brain. I work with what I've got.

Yesterday morning was crazy-busy. Our clinic session, which is supposed to end at noon but rarely does, kept chugging along despite our efforts to hustle. On Thursdays at Grady, our General Medicine division meets for a lecture or general business. Today, one of my friends was the presenter. I really wanted to make the meeting.

Fortunately, we have a system where a colleague comes to cover the noon hour while others make the meeting. We all take our lumps on this coverage schedule, but there's this unspoken rule that a few of us have where if it's crazy-busy, you stick around and help. At least to tie up loose ends.

There seemed to be a lot of loose ends yesterday.

(Click "more" below to continue reading this post.)

The more I tried to get out of the Residents' Clinic, the more things kept popping up. Like:

"Dr. Manning, somebody told this patient just to come down here and get a flu shot. She was in another clinic already. I know they have flu shots up there. That's ridiculous. I explained that you can't just walk in like that."

I looked at the patient, a doe-eyed woman on the brink of me deeming her a "Grady elder." I recognized her as one of our regular clinic patients. Hmmm. I took a quick glance at the clock: already past the 12:00 start time of our meeting. Uggghh.

"Okay. Well, tell me this… what would we need to do to give her a flu shot here?"

The nurse looked at me and, I'm pretty sure, gave me the hairy eyeball. Dang.

"She could just go back to the specialty clinic where she was," she countered. I nodded in acknowledgment.

"I mean… she's our patient," I said, "Yeah, she should have gotten a flu shot up there, but can we actually do it now that she's here?" I looked at the patient and added, "I'm glad you know how important it is to get your flu shot."

The busy (and seriously, awesome on most days) nurse just sighed and said, "Fine, Dr. Manning. We'll just check her in." She muttered something under her breath as she walked off, but that was okay. I have a good working relationship with this nurse, so knew that she was just frazzled from the morning, like me.

Okay. Now I could go.

A patient in a room called me by name. "Miss Manning!"

I looked. I didn’t know her. I walked over and raise my eyebrows. "Hey Miss Manning…I see you on Fox 5 and you give some good information."

A compliment. I'll take it. "Thank you very much, ma'am. I appreciate that."

"Can I ask you a question?"

Despite the protests from my growling stomach, I obliged. "Sure."

"Do it mean you might have breast cancer if you had to repeat your mammogram?"

Loaded question. Great. Not this. Not now. "Did you see a doctor this morning? I'm sure they can review that with you, because it really depends on what the mammogram showed."

She looked tearful. "I am waiting until my doctor come at one. I just got checked in. But I was. . . .worried. . . 'cause. . . I just been worried about the result and what it say. I ain't been sleeping 'cause I been so worried, waiting for this appointment." Tearful evolved to quiet crying with eye-patting.

Damn.

I got her name off of the chart and addressed her as such. "Ms. Campbell, give me a minute and I will pull up your mammogram result. Your doctor will go into it more with you, but I can check to make sure it's up."

"Thanks."

I went to the computer. Told myself that this was crazy. Could be stepping into a bomb. Why get involved? Her doctor would be here in 45 minutes. I told her to wait. But I didn't. I looked. And thank goodness, it was just a simple need for "compression views" in a woman with large breasts. Repeat mammogram free of signs of cancer. Radiologist recommended follow up in one year. Cool.

I told Ms. Campbell. I told her that her doctor would examine her and explain more. She was so happy she cried. And hugged me.

It was now 12:35 p.m.

Now I was really trying to go. Then, I saw one of our newest faculty members looking perplexed. She was stuck in the clinic trying to sort things out that aren't user-friendly to a new person. "You okay?" I asked. (Note: this is a rhetorical question. The answer should be "I'm fine!")

"Ummm. I'm trying to admit someone to the hospital. . . but I'm not sure what to do next."

Damn.

We worked together; we got the patient admitted. It was now 12:43.

That superhero clone of me would really have come in handy right about then. One could have been at my friend and former Grady doctor, Christina P.'s, presentation at 12:05 at the latest. The other could have stayed behind to help. But I'm not a superhero with a clone. So this would have to do.

I approached the double doors leading to the exit of the clinic, and I saw Nurse C. talking and smiling with the patient from earlier in one of the clinic rooms. She had just administered the flu shot to the patient, despite the hassle of another late check-in. She caught my eye and winked at me. It was her way of saying, "We're cool." I appreciated that gesture.

Once out of the clinic, I scurried down the hall and toward the stairwell. My stomach was hitting high notes, wondering what was up with the lack of food. I was walking 60 mph and simultaneously looking at my iPhone to make sure I didn't miss any emails. As I am sure you can imagine, I nearly mowed down a patient making his way to the elevator.

I dropped my coat and phone in the collision, but fortunately, he seemed okay. I apologized for not paying attention, and we both bent down to collect my belongings. Just then, I realized that I knew this patient.

"Mr. McCoy?"

"Heeeey, Kimberly!!!!" He let out a hearty laugh and gave me a big hug.

Mr. McCoy was a patient on my team a while back. He was, hands down, one of my F.P.'s of all time. (F.P. = favorite patient.) When he was on our hospital service, he'd passed out from what we discovered to be severe problems with his aortic valve. He needed that valve replaced.

Problem was he actively used crack. And was homeless. And didn't take his medications. There was some fear that he wouldn't follow up or take the required lifelong blood-thinner after valve replacement surgery. Despite all this, he had the best attitude of any patient I'd ever seen. He said, "I can do this, Miss Kimberly. I know I can." Seeing him on this day made me realize that I never found out exactly what happened with him. I left the service before a verdict was rendered on his valve operation.

"You doing alright, Miss Kimberly?" He handed my coat back to me, and smiled.

Mr. McCoy asked me on the first day we met if he could call me Kimberly. Funny. I'd never been asked by a patient permission to be called by my first name. At that point, he was already my F.P. for that day, so I obliged. Kimberly or "Miss Kimberly" it was.

"I'm doing great, sir! But how are you? Whatever happened with you?"

He gave me the biggest, warmest smile ever and then pulled his shirt apart like Superman. A well-healed vertical incision went straight down his sternum. That's when I knew he'd had the valve replaced. He looked good, too. Healthy. Well-groomed. Robust.

"Baby girl, I'm like a new man!" We both laughed. "I got my surgery. . .now Kimberly, I told 'em, 'Give me a pretty scar, 'cause I got to have a pretty chest!'" Awesome.

I stood there looking at him. Later and later for the last few minutes of the meeting. Would probably even miss out on the lunch. But this was worth it. I was really happy to see Mr. McCoy. I felt myself beginning to fret, hoping he was off the crack. He was insightful.

"I'm off that mess, Kimberly. I put it down. I even got a place to stay, too. No job yet, but my brother got me doing little jobs here and there with him. I go to Coumadin Clinic and the heart doctors. They said I'm a good patient. But I told 'em that Miss Kimberly already said that 'cause I was her favorite patient." Ha. True indeed.

"Wow. That has made my day, Mr. McCoy. I'm so happy I saw you."

"And I'm so happy I saw you, too, Kimberly. But you look like you lost a few pounds. I hope you eating."

(Is it bad that I wanted to hug him again for accusing me of weight loss?) I decided to let it be a compliment considering ninety percent of all comments I get in Grady Hospital regarding my weight are the converse of Mr. McCoy's.

"Naaah, just watching what I eat. It's so good to have seen you, and I am so proud of you, sir."

"I'm proud of me, too." Love that response.

"And you know what, Mr. McCoy? You are still one of my F.P. all-stars. That means you will always be a favorite patient of mine."

"Babygirl, I knew that already!" His hearty laughter rang down the hallway. "But for real, Miss Kimberly, I want you to know. . . .you my favorite, too."

Aaaaahh.

I gave him a big hug and waved goodbye to him.

12:53 p.m.

When I reached the faculty office building, I had already missed all of the meeting, including Christina's presentation. But I was able to give her that hug.

And as I scarfed down what remained of lunch, I knew one thing for sure: I had been exactly where I was supposed to be at the time I was supposed to be there. I also knew that if I'd had a clone, she would have missed out on seeing Nurse C. wink, on allaying the concerns of an anxious stranger, and of course, being there to witness Mr. McCoy open his shirt like Superman.

Nope, I am not a bird, and I am not a plane. But I do feel kind of like Superman sometimes. One of me is enough.

Labels: Life at Grady

posted by Jessica Berthold at 7:00 AM