Blog | Thursday, September 20, 2018

Some type of way


When I saw you on rounds today you were quiet. Your eyes looked in my direction but were otherwise vacant. This was a change.

Me: “You okay?”

You: “I'm okay.”

I asked you to sit up in bed and carefully untied the back of your gown. Gently, I searched your back with my stethoscope, listening to see if you were improving.

Me: “Can you take a deep breath?”

You: *deep breath*

Me: “And let it out.”

You: *let it out*

We repeating that exchange for a few more beats. The sounds emitted from your lungs confirmed what I'd been told. Things were improving.

I'd attempt to lift the mood.

Me: “You sound so much better!”

You: *head nod and shrug*

No such luck.

You'd been so upbeat the day before. So animated and full of light. Out of breath, yes. But still with eyes that twinkled. And so loquacious that I pulled up a chair to sit down and just let you talk. Today? None of that. Just quiet cooperation and a cloak of melancholy that didn't make sense.

Me: “What's wrong?”

You: “I'm okay.”

Me: “Really? You seem sad today. Like you're not okay.”

You: *silence*

Another shrug.

I slowed my movements and looked for a chair. Perhaps if you didn't feel like I was too busy to listen, you'd share. Something was wrong. And I didn't like the idea of you holding on to that something all by yourself while laying in a hospital bed. And so. I told you just that.

Me: “I don't like you in here by yourself with something heavy on your soul. If you feel like sharing, I want to hear. If you don't feel up to it, I can respect that.”

A tear squeezed out of your eye and rolled under your chin. You sighed.

You: “Somebody came to talk to me about all this. Told me that if I don't do better I'm not gon’ be here this time next year.”

Me: *listening*

You: “Saying ‘You need to lose weight and take your medicines! And stop missing appointments! And why you don't exercise and why you keep eating the wrong stuff and smoking cigarettes? You keep this up and you gon’ die!’ That's what they said to me.”

Me: “Hmm.”

You: “They kept on saying it was ‘tough love.’ Like every few words it was ‘tough love’ this and ‘tough love’ that. But to me? It wasn't no love in it.”

Another tear slipped over your nose and disappeared into your nostril.

You: “I wanted to say, ‘Do you know my life? Do you live where I live? Like, do you even know? I want to be healthy, too!’ But all I did was just wait for it to be over. I just said, ‘Okay’ and acted like it was cool.” *shaking your head*

Me: “Man. I'm sorry.”

You: “That hurt my feelings, Miss Manning. For real. I know that doctor meant well but I felt some type of way about that.”

Me: *silence*

You: “Like, I think when a doctor speak to you they should look you in your eye and see where you at. And if your face say this ain't okay? They need to do something else. Or just stop talking.”

Me: “That's good advice for anyone.”

You: “Know what? You right.”

After that, we talked more about what makes it hard for you to get your medicines and make appointments and eat healthier and move your body and move toward being a non-smoker. You told me about where you live and who you live with and what it's like and how you get the things you need and what makes your nerves bad. Then we talked about a few strategies to help you make steps in the right direction. And the whole time I watched your face to see where you were.

Or if I needed to just stop talking.

The doctor who gave you what was believed to be “tough love” is a good one who, I have to believe, was looking to motivate you not be unkind to you. And I told you that, too. That we are all works in progress with blind spots and ball drops. All of us.

This seemed to resonate with you.

We didn't fix all your problems. But you were smiling when I left. Which, to me, was a start.

Yeah.

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.