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

 
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Friday, February 19, 2016

The secret o' life

The secret of life is enjoying the passage of time.

Any fool can do it, there ain't nothing to it.

Nobody knows how we got to the top of the hill.

But since we're on our way down, we might as well enjoy the ride.

—James Taylor

“What's the key to making 89 and still looking as good as you?” I asked. The resident working with me smiled knowingly since this is 1 of the most predictable questions they hear me ask of the spryest of our Grady elders.

I never miss the chance to unlock whatever secrets my patients might have for longevity in life and marriage. So I always ask. And every time, I get an answer that makes me smile. Some short and sweet. Others long and elaborate. But somewhere nestled in every response is something for me to stick on a post-it note inside of my head for safekeeping.

And so. At the end of our visit, I asked that same question in that same way I generally do when addressing my Grady elders. I use their lingo, too. After hearing it enough times, I decided that I liked the idea of “making” some golden age. “Making” 89 sounds like climbing the rough side of a ragged mountain, and now reaching those elevations that few have achieved. And interestingly, years don't seem to be referenced as being “made” until you get over a certain hump in the birthday game.

Yep.

“You know I'm gon’ make 90 in one month!” she announced with a proud slap of her knee.

I clapped my hands and nodded. “I saw that on your chart, Mrs. Calhoun! That's so great!”

“Sho’ is.” And from the look on her face, I could tell she meant it.

“So no secrets? You know I'm trying to find out how to make 90 and have it look like it looks on you, Mrs. Calhoun.”

“Oh, baby it's simple. First, you gots to get on up in the mornings. Get on out the bed and move your body. I ain't saying you got to go crazy or nothin’. Jest get on out your door and walk some place. Work in your garden. Walk on over to see about a neighbor or to the store. But you can't jest stay holed up in the house watching the television.”

“I like that advice.”

“Mmmm hmmm. See, folk get up in age and stop moving they body. And now, I understand that ol’ Arthur set in on some folk bones and they can't move. But even with my arthritis, I makes myself get on up and move. Every day.”

“That's good stuff, Mrs. C. What else? You know we're taking notes.” I winked at her and pretended to position my pen to write down her next words.

“Well, now another one is minding your own business, you know?”

I laughed when she said that. “My husband tells me I need work in this area, but yes, ma’am. I hear you.”

“See, when you gets up in age, folk get to thinking they got the green light to weigh in on whatever they see fit. Like telling young folk what all they s'posed to be doing and how they s'posed to do it. Saying stuff about how folk run they house and who they decide to be with. And see, me, I figured out that staying worried ‘bout stuff that ain't your business ‘specially when it come to your kin as they start coming of age make you old. So, I jest mind my own business, you know? Even when folk used to try to get me to chime on in on something, if it ain't my business I jest shrug my shoulders and say, ‘Ain't my business.’” Mrs. Calhoun shrugged for emphasis.

My resident nodded slowly and looked over at me. “That's great advice, actually.”

“I never thought about the part about growing older and giving your opinion on something. That's a really good word.”

“It's true, Miss Manning. Look like people excuse they elders for saying crazy stuff that ain't none of they business. So I think that make people judge folk and get to talking about a whole bunch of stuff that jest make everybody uncomfortable, you know? And I still got my thoughts on stuff but if it don't affect me and mine, I don't really fret about it. Saying a whole bunch on people's lives lead to arguments and hurt feelings and all that. Plus it make people not want to be around you. All that make you old.”

“I really should have been writing this all down, ma’am.” I squinted an eye and went on. “I can tell you mean what you're saying, too.”

“I sho’ do.”

“Okay. So move my body and mind my business. Got it. Anything else we need to do?”

It's funny. Mrs. Calhoun was genuinely entertaining my questions about living to be an octogenarian. Though most of my patients answered me, few were so thoughtful in their replies. Her lip jutted out and she rolled her eyes skyward as if sifting carefully through her words. Finally, she lifted a long crooked index finger and looked straight into my eyes. “One more,” she said in her gravelly voice.

I scooted my chair forward and leaned in. She didn't speak immediately. Instead, she held my gaze with narrowed eyes for a few beats, curled in that finger and brought it to her lips. I stayed silent, waiting for what I knew would be worth the time.

Her finger extended again to point at me and then the resident physician beside me. “This probably the most important thang. You got to see about yourself. I mean look out for your own happiness and don't let nobody treat you bad, you know? Like, when you a kid or even a young person, it ain't always easy. But once you grown, you got to love yourself enough to not let nobody get away with being ugly to you. And that include you-yourself, too.”

“Okay …” I lulled her to go on, leaning even closer.

“Put on some clothes every day. Brush your hair and care ‘bout how you look. That's all a part of seeing about yourself.”

“Got it.”

She paused for a second and then patted her hand on the desk. “Oh! And I almost forgot. Make sure you got you a good stick a red lipstick in your bathroom drawer. And that you wear it sometime.”

Red lipstick?” My resident glanced over at me raised her eyebrows. We both returned our attention to Mrs. Calhoun, intrigued with this unexpected statement.

“Yes, sugar. A good one, too. One that make you feel like a woman. Not no gloss or tint neither. I'm talking ‘bout a R-E-D red that can't nobody mistake. You keep it there for when you need to feel strong and good. Or sometime jest for no reason at all. Paint it right on your mouth and look yourself in the face.”

Damn. I was taking this all in in giant gulps. I wanted her to go on and, lucky for us, she did.

“See, putting on some red lipstick; that's saying something to yourself. You telling yourself you worth noticing. But then you got to walk in that. Wit’ your head all the way up like you know something they don't.”

Whew. This woman was preaching, do you hear me?

My resident feigned a frown and groaned. “But Mrs. C, what if you look terrible in red lipstick? I can't even imagine myself with red lipstick.” She laughed when she said that but Mrs. Calhoun didn't.

“Every woman can look good in red lipstick once she find the one that suit her. But the key is jest that she just got to make up her mind that she deserve the attention it brang, see. It ain't never the color. It's that part that hold women back from it.”

And that? That I knew I wouldn't want to forget. Like, ever.

No, I would not.

A little later, I saw Mrs. Calhoun in the hallway, cane in one hand and discharge papers in the other. I stood there watching her and reflecting on her words as she took those short deliberate steps toward the exit. At the last minute, I decided to sprint up to her to hold the door, but mostly to tell her goodbye.

“It was so good talking to you, Mrs. Calhoun. Thanks, hear?”

‘Oh, Miss Manning, you know I love talking to you young people.” I beamed at her reference of forty-five year-old me as a “young person.” She nodded in acknowledgement of me propping open the door for her and headed into the lobby.

Just as she was right in front of me, I spoke. ”Mrs. Calhoun? I'm just wondering … do you still have a red lipstick?”

She turned to look me in the eye and smiled wide. “Sho’ do, baby.”

“I love it. Think you'll wear it next month when you make 90?”

“Maybe. But it ain't got to be no special occasion, do it?” Mrs. Calhoun reached out and patted my shoulder when she said that. Without saying a word, I dragged in a deep breath and nodded hard to let her know I received her good word.

Because I did.

Move your body.

Mind your business.

See about yourself.

Oh, and have a good red lipstick.

Words to live by. Like, literally.

Yeah.

Now playing on my mental iPod …

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 Iowa City, IA, 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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