Wednesday, April 23, 2014
Life at Grady: Tears of a clown
My patient was one of those people with humor shut up in his bones that just had to get out. His intonation, his mischievous expression, and the timing of how he said things always induced laughter from any and every person around. Real laughter, too. Not just those obligatory giggles you give pseudo-funny people.
Yes, my patient was hilarious, but his issues weren’t. After some joking around, I gently waded into the purpose of my visit. “Mr. Floyd? Did they already take you down for the test?”
“Yeah, they did. And some lady with a soft voice but some man hands was the one who helped me get on the table. You ever seen a lady with the man hands? All pretty in the face but then hands big and muscular like she been chopping wood?” He shuddered like he was terrified.
“Oh wow. I sure hope I don’t have the man hands, Mr. Floyd.” I couldn’t help but pause to laugh at that term “man hands.” He seemed glad that I did. “Did it go okay, though? Your procedure?”
“I think so. They said they got what they needed. And ol’ Man Hands seemed satisfied.”
I pressed my lips together and then sat down next to his bed on the nearby chair. His room was unusually barren. Not a single flower, card or balloon was there, even though he’d been with us for at least four days. When I asked him earlier about family, he brushed the question off saying that he mostly does for himself.
“Everybody needs somebody,” I recall saying.
“But not everybody want to be needed,” he quickly countered.
And what could you say to that?
The test he had confirmed the worst. Disease far more advanced than our medicine could handle. And even though we explained that part and told him of the things that could be done to improve his symptoms, he continued to crack jokes and keep things light instead of wrestling with the unpleasant facts before him.
“What do they do with somebody that pass but don’t have money for a funeral?”
“Pardon?” That question surprised me. Even though he was going home with hospice care, I still didn’t expect him to say that.
“I’m gon’ call Willie Watkins’ Funeral Home and see what kind of hookup I can get. Y’all don’t have no coupons at Grady?”
This time my chuckle was less genuine. His words were funny, but mostly I felt sad. Sad that he was dying. Sad that he was talking about it like this. And even sadder that after four more days, there still wasn’t any evidence that a loved one would be coming to his side.
“Mr. Floyd? I will be thinking about you a lot, okay? And I promise to never forget you, sir.” That’s what I said instead. I needed him to know that part because it was true.
“I ‘preciate that, Miss Manning.”
“I wish you didn’t have to go through this. I really do.”
“I know. But man plans and God laughs, right? At least that’s what my grandmama used to say.”
The corner of my mouth turned upward in a half-hearted smile. That was all I had at the moment.
“But you know, Miss Manning? Laughing is how I get through. I hope I die with a big smile on my face, too. And that I die mid-breath telling a joke to somebody or playing the dozens.”
And something about that image brought out inexplicable emotion in me. Tears rushed to my eyes and fell too fast for me to blink them away. I wiped my cheeks with the heels of my hand and shook my head feeling embarrassed. “Uggggh. I’m sorry, Mr. Floyd.”
He reached for my hand and squeezed it. “Thanks, hear?”
I felt awful for making my patient feel like he had to console me. Wrapping my hand around his, I nodded and tried to smile. Mr. Floyd placed his other hand over mine and patted it gently. “You know what, Miss Manning?” He cast his eyes down at our hands and then looked up into mine. His eyes were glistening with tears, too.
“What’s that, sir?”
“You don’t have the man hands.” The tears evaporated from his eyes just enough to leave his signature twinkle of mischief.
And that time? I did laugh out loud. And so did he.
Kimberly Manning, MD, FACP, FAAP is an associate professor of medicine at Emory University School of Medicine in Atlanta, Georgia where she teaches medical students and residents at Grady Hospital. This post is adapted from Reflections of a Grady Doctor, Dr. Manning’s blog about teaching, learning, caring and growing in medicine and life. It has been adapted and reprinted with permission. Identifying information has been changed to protect individuals’ privacy.
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