American College of Physicians: Internal Medicine — Doctors for Adults ®

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Wednesday, November 20, 2013

Life at Grady: A reminder

The air was cool. Too cool to be outside with only a paper thin white coat and wintry enough for this Grady elder passing me by to give me a tiny head shake when I tried to pull that same inadequate coat closer to my body for warmth. But the walk wasn’t far. I was only heading out of the hospital door and half a block to our office building. Two minutes, tops. And sometimes the threat of chilly air isn’t enough to make you deal with the hassle of schlepping a winter coat onto the hospital floors.

For me, that is.

As I crossed the street, I saw a young woman walking briskly. She was holding what appeared to be a baby that couldn’t have been more than a few weeks old. Fortunately, she’d checked the weather and dressed her baby and herself appropriately. Unlike the doctor approaching them.

“Good morning,” I spoke.

“G’morning,” she replied, still hustling.

I craned my neck over to catch a glimpse of baby as we crossed paths. It warmed my heart when she paused for two seconds to pull down the fuzzy pink fleece covering her cherubic face. I stood on my tiptoes to get a better look. Reflexively, I smiled and placed my hand on my chest. “Congratulations. She’s beautiful,” I said. And then, since I knew she appeared to be in a hurry, I added, “Have a great day!”

“You, too, ma’am!” She was already four or five steps away by then and almost into the County Health Department--which is conveniently located across the street from Grady and is also a necessary destination for parents of new babies seeking birth certificates.

I kept walking and picked up my pace. On the steps of the Glenn building (also across from the hospital), I saw this rotund fellow sitting down and preparing to smoke a cigarette. He appeared to work in construction of some sort, as he was wearing a reflective vest and steel-toe boots. He looked up, made quick eye contact with me, and gave me the nod. I returned the favor.

In that glance, I also gave him some uninvited admonishment about the cigarettes. Since my expression was decidedly playful, his reply was, too. He held up his index finger and beat it in the air a few times--his nonverbal way of saying, “This is the last one!” I narrowed one eye, pursed my lips and pointed at him as passed. My way of saying, “I got my eye on you!” And then we both laughed. Which was cool because I didn’t know him yet we’d just had an entire exchange without saying a word.

At this point I was just a couple of strides away from the entrance to our faculty office building. I rummaged around for my access card to get in. It wasn’t clipped to my jacket and wasn’t in my pockets either. . . . hmmmm.

I thought for a few seconds and then. . . . Shoot! I remembered in that instant that I’d left it sitting on my office desk earlier that morning. Man. It was too cold for all this. Pulling my coat together once more, I decided to make a break for it around the corner to the public entrance.

I usually try not to run while wearing my white coat unless it’s an emergency. I know it always alarms people to see doctors rushing anywhere. This was no different; I could tell by the group of people standing catty-corner by the hospital who all stopped to watch me. When I noticed them, I stopped running and resorted to walking as quickly as I could instead.

Now, I was at the door. Finally. But just before I could escape the cool air, I paused. I was hearing something unusual.

“What is that?”

I turned around and stepped back out on the sidewalk to look around. I couldn’t see where it was coming from, but that sound was getting louder and louder. I looked over my shoulder to see if, perhaps, it was coming from our building. But it wasn’t.

Louder and louder. Closer and closer. And finally, I saw what it was

A man perfectly playing a flute. Not looking for money or applause or any such thing. But I was so entranced by its perfect pitch that I gave him all of those things.

“Beautiful!” I said while clapping my hands. It really was.

“Today, Grady, tomorrow, The Apollo!” And then he laughed out loud a bit before playing an up-tempo little piece right then and there for me on that sidewalk.

And I clapped and tapped my foot the whole time, forgetting about the cold and even why I was going back to my office in the first place. The song was short and sweet. And before I could say anything else, he’d tipped his hat and thanked me for listening. And I thanked him right back for blessing me with his gift.

I watched him long after he’d passed me by. On he went—walking and playing. The sound of his heels clicking the concrete were his makeshift metronome and I could see his shoulders hunching in concert with each note. I squinted my eyes to try to take in the expressions of those under the sound of his flute. And from what I saw, they all seemed to be blessed, too. And I swear to you, all of it was magical.

Eventually, he turned a corner and was out of my line of sight. Just then, I felt the chill of November on my chest again. I opened the door and went on up to my office.

So that was what happened in the two minutes that it took me to walk across the street from Grady Hospital to my office. But it was a reminder. A reminder of what can happen when I remember to open my eyes and notice the moments, the music, and the magic swirling around the most ordinary parts of my day.

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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Blog log

Members of the American College of Physicians contribute posts from their own sites to ACP Internistand 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.

And Thus, It Begins
Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich., from which she which chronicles her journey through medical training from day 1 of medical school.

Auscultation
Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.

Zackary Berger
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.

Controversies in Hospital Infection Prevention
Run by three ACP Fellows, this blog ponders vexing issues in infection prevention and control, inside and outside the hospital. Daniel J Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Richmond, Va., with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands).

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

Suneel Dhand, MD, ACP Member
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health 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
Mike Aref, MD, PhD, FACP, 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.

Informatics Professor
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.

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.

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, FACP, 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.

Mired in MedEd
Alexander M. Djuricich, MD, FACP, is the Associate Dean for Continuing Medical Education (CME), and a Program Director in Medicine-Pediatrics at the Indiana University School of Medicine in Indianapolis, where he blogs about medical education.

More Musings
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).

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.

The Blog of Paul Sufka
Paul Sufka, MD, ACP Member, is a board certified rheumatologist in St. Paul, Minn. He was a chief resident in internal medicine with the University of Minnesota and then completed his fellowship training in rheumatology in June 2011 at the University of Minnesota Department of Rheumatology. His interests include the use of technology in medicine.

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.

Peter A. Lipson, MD
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.

Why is American Health Care So Expensive?
Janice Boughton, MD, FACP, practiced internal medicine for 20 years before adopting a career in hospital and primary care medicine as a locum tenens physician. She lives in Idaho when not traveling.

World's Best Site
Daniel Ginsberg, MD, FACP, is an internal medicine physician who has avidly applied computers to medicine since 1986, when he first wrote medically oriented computer programs. He is in practice in Tacoma, Washington.

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.

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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