Discover and read the best of Twitter Threads about #AmazingGrady
Most recents (21)
1/
#AmazingGrady
The Visitor
Her: "Girl, she snuck up on me."
Me: "Who?"
Her: "Honey, Miss Delta! Girl, I will be the first one telling folks that she ain't to be played with."
*laughter*
Me: "That's hilarious."
Her: "Shiiiit. It's hilarious NOW."
Me: *nodding*
#AmazingGrady
The Visitor
Her: "Girl, she snuck up on me."
Me: "Who?"
Her: "Honey, Miss Delta! Girl, I will be the first one telling folks that she ain't to be played with."
*laughter*
Me: "That's hilarious."
Her: "Shiiiit. It's hilarious NOW."
Me: *nodding*
2/
Her: "You know I had #COVID back in April of '20 when everybody was getting it."
Me: "Oh wow. Did you get pretty sick?"
Her: "Sick enough to be in my bed for a few days. But mostly it was just inconvenient for everybody that live with me, you know?"
Me: *listening*
Her: "You know I had #COVID back in April of '20 when everybody was getting it."
Me: "Oh wow. Did you get pretty sick?"
Her: "Sick enough to be in my bed for a few days. But mostly it was just inconvenient for everybody that live with me, you know?"
Me: *listening*
3/
Her: "Folk don't talk enough about that part. The way she bust a groove in all your plans even if you don't get real sick."
Me: "Yeah."
*silence*
Me: "So. . . . I'm surprised after all that you weren't first in line to get vaccinated."
Her: *shrugs*
Her: "Folk don't talk enough about that part. The way she bust a groove in all your plans even if you don't get real sick."
Me: "Yeah."
*silence*
Me: "So. . . . I'm surprised after all that you weren't first in line to get vaccinated."
Her: *shrugs*
1/
#AmazingGrady
Afternoon rounds with a Grady elder:
Me: "So. . .Ms. Hodge. . .uh. . . what exactly were you doing when this happened?"
Her: *smirks and does a body wave in her bed* "Getting it ON, baby."
Me: *chuckles and shakes head*
Her: "Oh, I'm serious."
*name changed
#AmazingGrady
Afternoon rounds with a Grady elder:
Me: "So. . .Ms. Hodge. . .uh. . . what exactly were you doing when this happened?"
Her: *smirks and does a body wave in her bed* "Getting it ON, baby."
Me: *chuckles and shakes head*
Her: "Oh, I'm serious."
*name changed
2/
Her: "People thing jest 'cause you up in age you ain't got no desires. But that ain't true, see."
Me: *nodding* "I hear you, Ms. Hodge."
Her: "You better hear me! 'Cause I be GETTING mine--even in my 80's."
She snapped her fingers and did another body wave.
*laughter*
Her: "People thing jest 'cause you up in age you ain't got no desires. But that ain't true, see."
Me: *nodding* "I hear you, Ms. Hodge."
Her: "You better hear me! 'Cause I be GETTING mine--even in my 80's."
She snapped her fingers and did another body wave.
*laughter*
3/
Her: "How old are you, Miss Manning?"
Me: "I turned 50 last September."
Her: "You got a lover?" *squints eyes*
Me: "Uhh. . .I guess my husband. . is uh. . my lover."
Her: *curls lips* "Well. I hope y'all be taking care of each other." *does body wave again*
*laughter*
Her: "How old are you, Miss Manning?"
Me: "I turned 50 last September."
Her: "You got a lover?" *squints eyes*
Me: "Uhh. . .I guess my husband. . is uh. . my lover."
Her: *curls lips* "Well. I hope y'all be taking care of each other." *does body wave again*
*laughter*
1/
#AmazingGrady
I placed my stethoscope upon a quiet chest recently. Flashed a penlight into eyes where pupils did not respond.
My fingertips rolled over the curve in the neck where a carotid pulse would normally offer up a reassuring thump--but felt nothing.
Nothing.
#AmazingGrady
I placed my stethoscope upon a quiet chest recently. Flashed a penlight into eyes where pupils did not respond.
My fingertips rolled over the curve in the neck where a carotid pulse would normally offer up a reassuring thump--but felt nothing.
Nothing.
2/
Just cool, quiet skin.
This patient was severely ill. The family and patient had chosen a "Do Not Resuscitate" order to allow a natural transition. So, once it became imminent, no one fought it.
No code sirens.
No cacophony of ACLS.
Just a peaceful acknowledgment.
Just cool, quiet skin.
This patient was severely ill. The family and patient had chosen a "Do Not Resuscitate" order to allow a natural transition. So, once it became imminent, no one fought it.
No code sirens.
No cacophony of ACLS.
Just a peaceful acknowledgment.
3/
The illness was far too mighty and swift to allow a transfer to hospice after leaving the ICU.
The family stood vigil for those first few hours. Then exhaustion set in. When it happened, no family was in the room.
But it was peaceful still. And with dignity.
It was.
The illness was far too mighty and swift to allow a transfer to hospice after leaving the ICU.
The family stood vigil for those first few hours. Then exhaustion set in. When it happened, no family was in the room.
But it was peaceful still. And with dignity.
It was.
1/
“Now that it’s raining more than ever, know that we still have each other. You can stand under my umbrella.”
– Rihanna
I entered the elevator alone one evening after a long day. Leaning my head back on the wall, I prepared for a peaceful ride to the ground floor.
Yep.
“Now that it’s raining more than ever, know that we still have each other. You can stand under my umbrella.”
– Rihanna
I entered the elevator alone one evening after a long day. Leaning my head back on the wall, I prepared for a peaceful ride to the ground floor.
Yep.
2/
After passing 6 floors, the lift stopped on the 5th floor. When the door separated, I opened my eyes and saw one of the Grady environmental services employees standing there with two giant rolling trash bins and a bunch of other stuff for cleaning.
He stepped back.
After passing 6 floors, the lift stopped on the 5th floor. When the door separated, I opened my eyes and saw one of the Grady environmental services employees standing there with two giant rolling trash bins and a bunch of other stuff for cleaning.
He stepped back.
3/
Him: *waving his hand* “I’m cool, doc. I got a lot of stuff. I'll just get the next one.”
Me: *stepping aside* “Nah. It’s cool. Come on.”
And so he did.
Me: *glancing at him* “You good today?”
Him: “Yes ma’am. ‘Bout to drop this stuff off & go to the hizzouse!”
*laughter*
Him: *waving his hand* “I’m cool, doc. I got a lot of stuff. I'll just get the next one.”
Me: *stepping aside* “Nah. It’s cool. Come on.”
And so he did.
Me: *glancing at him* “You good today?”
Him: “Yes ma’am. ‘Bout to drop this stuff off & go to the hizzouse!”
*laughter*
1/
1st day on a new service:
Me: "Hey there. . . Mr. Jones? I’m Dr. Manning. I’m the new senior doctor on your team."
Him: *arms folded in chair and staring at floor* "Mmm hmm."
Me: “Good to meet you.”
*silence*
I noticed his long, long legs extending across the linoleum.
1st day on a new service:
Me: "Hey there. . . Mr. Jones? I’m Dr. Manning. I’m the new senior doctor on your team."
Him: *arms folded in chair and staring at floor* "Mmm hmm."
Me: “Good to meet you.”
*silence*
I noticed his long, long legs extending across the linoleum.
2/
Me: “Hmm. Let me guess...are you... 6’4? 6’5?"
Him: *eyeroll*
*silence*
Him: "That's a dumb-ass question.”
Me: “My bad, sir. Guess I was just curious and thought I'd ask."
Him: "Go on and get curious 'bout these lungs, hear?"
Yikes.
Me: “Hmm. Let me guess...are you... 6’4? 6’5?"
Him: *eyeroll*
*silence*
Him: "That's a dumb-ass question.”
Me: “My bad, sir. Guess I was just curious and thought I'd ask."
Him: "Go on and get curious 'bout these lungs, hear?"
Yikes.
3/
Mr. Jones took exaggerated breaths as I auscultated his back. Lungs had good air exchange. He wasn't requiring oxygen. And, according to the respiratory therapist, he was tolerating less frequent breathing treatments.
This meant he'd be safe for discharge home.
Mr. Jones took exaggerated breaths as I auscultated his back. Lungs had good air exchange. He wasn't requiring oxygen. And, according to the respiratory therapist, he was tolerating less frequent breathing treatments.
This meant he'd be safe for discharge home.
1/
Virgo Season
Grady Hospital, September 2018
This diagnosis is messed up. Totally, completely messed up. It makes you have to endure excruciating pain--physically and emotionally.
Day after day after day.
Yup.
Disfiguring. Relapsing. And almost nothing in your control.
Virgo Season
Grady Hospital, September 2018
This diagnosis is messed up. Totally, completely messed up. It makes you have to endure excruciating pain--physically and emotionally.
Day after day after day.
Yup.
Disfiguring. Relapsing. And almost nothing in your control.
2/
"I'm a person who used to stuff not working out. 'Cause for me it never do."
That's how you described your every day life, filled with curious eyes craning in your direction but then darting away like they didn't see. But they see.
Of course, they see. How could they not?
"I'm a person who used to stuff not working out. 'Cause for me it never do."
That's how you described your every day life, filled with curious eyes craning in your direction but then darting away like they didn't see. But they see.
Of course, they see. How could they not?
3/
You hadn't smiled once the entire hospitalization. Not once. And to make matters worse, on this day you'd spent the entire day waiting for a procedure that called for you to have nothing by mouth.
NPO.
Then it got delayed.
You went OFF on me the moment I walked in.
You hadn't smiled once the entire hospitalization. Not once. And to make matters worse, on this day you'd spent the entire day waiting for a procedure that called for you to have nothing by mouth.
NPO.
Then it got delayed.
You went OFF on me the moment I walked in.
1/
Grady Hospital, 2019
Walked in on my Grady elder patient who is staring at her smartphone
Me: "Hey there. Came back to check on you before you go."
Her: *shows me her phone* "Which one of these dresses you like better? The red or the silver one?"
I leaned over and stared.
Grady Hospital, 2019
Walked in on my Grady elder patient who is staring at her smartphone
Me: "Hey there. Came back to check on you before you go."
Her: *shows me her phone* "Which one of these dresses you like better? The red or the silver one?"
I leaned over and stared.
2/
Me: "Red. Always the red. Red never fails."
Her: "Red do make you look sassy, don't it?"
Me: *chuckling* "Is sassy what you're going for?"
Her: *winks*
She enlarged the red dress picture on the screen and smirked.
Her: “Yeah, I thank this the one.”
Me: *thumbs up*
Me: "Red. Always the red. Red never fails."
Her: "Red do make you look sassy, don't it?"
Me: *chuckling* "Is sassy what you're going for?"
Her: *winks*
She enlarged the red dress picture on the screen and smirked.
Her: “Yeah, I thank this the one.”
Me: *thumbs up*
3/
Me: "What's the occasion?"
Her: "I'm having a big birthday party! My kids is giving it for me."
Me: "How cool!"
Her: “I'm 'bout to make 80 next month!"
Me: "80? What a blessing!"
Her: “Bible say you get 3 score and 10. Look like I got me 10 extra, don’t it?”
*smiling*
Me: "What's the occasion?"
Her: "I'm having a big birthday party! My kids is giving it for me."
Me: "How cool!"
Her: “I'm 'bout to make 80 next month!"
Me: "80? What a blessing!"
Her: “Bible say you get 3 score and 10. Look like I got me 10 extra, don’t it?”
*smiling*
1/
I saw this Grady elder in the clinic one morning. He was walking through the hallway and appeared a bit lost.
Not lost in that way like where you don't completely know where you are, but more in that way where you know you're right near where you're supposed to be.
I saw this Grady elder in the clinic one morning. He was walking through the hallway and appeared a bit lost.
Not lost in that way like where you don't completely know where you are, but more in that way where you know you're right near where you're supposed to be.
2/
Me: "Hey there. Can I help you out with something?"
He was staring at this blue index card that obviously served as his treasure map.
Him: "Look here. . . is this where the nutritionist is?"
Me: "Our dietitian is right here." *smiling* "X marks the spot."
Me: "Hey there. Can I help you out with something?"
He was staring at this blue index card that obviously served as his treasure map.
Him: "Look here. . . is this where the nutritionist is?"
Me: "Our dietitian is right here." *smiling* "X marks the spot."
3/
I pointed to the open door that was right behind him. He swung around, then threw back his head and laughed.
Him: "Ha! If it had'a been a snake, would-a bit me!"
He erupted into that same joyous chuckle once again.
Man. I was so glad to be there to hear it.
I pointed to the open door that was right behind him. He swung around, then threw back his head and laughed.
Him: "Ha! If it had'a been a snake, would-a bit me!"
He erupted into that same joyous chuckle once again.
Man. I was so glad to be there to hear it.
1/
#GoldenGirls
Grady Primary Care, Summer 2018
Her: "Look like I lost a lot of weight over the last 3 years. I guess it's good for my health but I just thought I'd mention it since I ain't been doing nothin' to try."
I clicked into the weight flowsheets in her chart.
#GoldenGirls
Grady Primary Care, Summer 2018
Her: "Look like I lost a lot of weight over the last 3 years. I guess it's good for my health but I just thought I'd mention it since I ain't been doing nothin' to try."
I clicked into the weight flowsheets in her chart.
2/
Her: “It's been gradual. It's only when I run into somebody who ain't seen me and they say, 'Dang! You lost a lot of weight!' or 'Girl, you look good! What you do?' I don't even have the heart to tell them that I ain't done nothing."
Hmmm.
Her: “It's been gradual. It's only when I run into somebody who ain't seen me and they say, 'Dang! You lost a lot of weight!' or 'Girl, you look good! What you do?' I don't even have the heart to tell them that I ain't done nothing."
Hmmm.
3/
I nodded at my patient—a Grady elder—and, following that prompt, moved back a few years to see what she'd previously weighed.
3 years ago: 228 pounds.
Now: 180 soaking wet.
Hmmm.
Me: "Wow. You have lost weight."
Her: "Told you."
I nodded at my patient—a Grady elder—and, following that prompt, moved back a few years to see what she'd previously weighed.
3 years ago: 228 pounds.
Now: 180 soaking wet.
Hmmm.
Me: "Wow. You have lost weight."
Her: "Told you."
1/
#AmazingGrady, Day 2
While typing a note at the nurses’ station, I overheard 2 surgery residents discussing a consult.
Chief: “I think we can do the procedure. I’m just not understanding the indication.”
Intern: “The primary team seems pretty adamant.”
*sigh*
#AmazingGrady, Day 2
While typing a note at the nurses’ station, I overheard 2 surgery residents discussing a consult.
Chief: “I think we can do the procedure. I’m just not understanding the indication.”
Intern: “The primary team seems pretty adamant.”
*sigh*
2/
Oh. Did I mention? The primary team was me. I decided to earhustle a little longer.
Chief: “I get that they want it. And that we can do it. But . . . just seems like more could be done first.”
Intern: “More like what?”
Chief: “I don’t know. Medical management.”
I coughed.
Oh. Did I mention? The primary team was me. I decided to earhustle a little longer.
Chief: “I get that they want it. And that we can do it. But . . . just seems like more could be done first.”
Intern: “More like what?”
Chief: “I don’t know. Medical management.”
I coughed.
3/
I was about to say something but before I could, that Chief was on the phone with the attending surgeon.
Chief: “This patient is a . . . “
And they explained the story and reviewed the findings. After a few moments of silence, a decision seemed to be made.
OR in 2 days.
I was about to say something but before I could, that Chief was on the phone with the attending surgeon.
Chief: “This patient is a . . . “
And they explained the story and reviewed the findings. After a few moments of silence, a decision seemed to be made.
OR in 2 days.
1/
#AmazingGrady, Day 1
Him: "You a coffee person?"
Me: "Am I? Look up 'coffee person' on Google and you'll see me."
*laughter*
Him: "When I woke up that morning and couldn't smell or taste my coffee? I started crying."
Me: "Wow."
Him: *shakes head* "I ain't lying, doc."
#AmazingGrady, Day 1
Him: "You a coffee person?"
Me: "Am I? Look up 'coffee person' on Google and you'll see me."
*laughter*
Him: "When I woke up that morning and couldn't smell or taste my coffee? I started crying."
Me: "Wow."
Him: *shakes head* "I ain't lying, doc."
2/
Him: "Like, I felt bad, you know? Like, my breathing, my muscles and all that. I was run down, had fevers, too. But my coffee? Damn. That broke a brother down!"
Me: "Rona messed with your coffee?"
Him: "My coffee!"
*silence*
Me: "Dang. That woulda broke me down, too."
Him: "Like, I felt bad, you know? Like, my breathing, my muscles and all that. I was run down, had fevers, too. But my coffee? Damn. That broke a brother down!"
Me: "Rona messed with your coffee?"
Him: "My coffee!"
*silence*
Me: "Dang. That woulda broke me down, too."
3/
Him: "But guess what? This morning I could smell my coffee!"
Me: "You could!?"
Him: "Never in my life thought I'd be happy 'bout some hospital coffee."
*silence*
Him: "I know I coulda died. But It's the little things, you know?"
Me: *whisper* "Yeah. I do."
I so do. 🏥🙏🏾
Him: "But guess what? This morning I could smell my coffee!"
Me: "You could!?"
Him: "Never in my life thought I'd be happy 'bout some hospital coffee."
*silence*
Him: "I know I coulda died. But It's the little things, you know?"
Me: *whisper* "Yeah. I do."
I so do. 🏥🙏🏾
1/
Him: "I need to leave."
Me: "Can we talk about it more? I'm concerned that you aren't well enough to go yet."
*silence*
Me: "Sir?"
Him: "I hear you. But I need to leave."
Him: "I need to leave."
Me: "Can we talk about it more? I'm concerned that you aren't well enough to go yet."
*silence*
Me: "Sir?"
Him: "I hear you. But I need to leave."
2/
Me: "There's
some things happening with your body that could be life threatening and--"
Him: *interrupting me* "Listen. I know I need some more tests. And I know y'all think it would be best for me to stay."
*wipes face with his hand and sighs*
Him: "I get that."
Me: "There's
some things happening with your body that could be life threatening and--"
Him: *interrupting me* "Listen. I know I need some more tests. And I know y'all think it would be best for me to stay."
*wipes face with his hand and sighs*
Him: "I get that."
3/
Him: "But away from this hospital? I got a WHOLE LOT going on. And you know what? That shit is life threatening, too."
Me: *listening*
Him: "'Scuse my language."
Me: "It's ok."
He sighed again. Hard. Then he started looking around his bed.
Him: "I got to go, man."
Him: "But away from this hospital? I got a WHOLE LOT going on. And you know what? That shit is life threatening, too."
Me: *listening*
Him: "'Scuse my language."
Me: "It's ok."
He sighed again. Hard. Then he started looking around his bed.
Him: "I got to go, man."
1/
A late afternoon at Grady
Her: "Do you know the words to the national anthem?"
That's what my last patient, a Grady elder, asked just before I got ready to leave her room on rounds one day. I’d just asked her if she had any questions for me.
This was not what I meant.
A late afternoon at Grady
Her: "Do you know the words to the national anthem?"
That's what my last patient, a Grady elder, asked just before I got ready to leave her room on rounds one day. I’d just asked her if she had any questions for me.
This was not what I meant.
2/
Uggh.
Were we about to unpack the NFL controversy? I was already tired. I had a lot on my plate and had had some pretty fitful sleep the night before.
A discussion about the anthem? Now?
*internal face wipe*
I took a drag of air and sat back down.
Uggh.
Were we about to unpack the NFL controversy? I was already tired. I had a lot on my plate and had had some pretty fitful sleep the night before.
A discussion about the anthem? Now?
*internal face wipe*
I took a drag of air and sat back down.
3/
She must’ve read my face.
Her: “I ain’t talking ‘bout no spangled one, neither. I'm talking 'bout the negro national anthem.”
I smiled at how she annunciated the word “negro.” Then came a breath of relief when it registered.
Oh. That.
I sat a little taller and nodded.
She must’ve read my face.
Her: “I ain’t talking ‘bout no spangled one, neither. I'm talking 'bout the negro national anthem.”
I smiled at how she annunciated the word “negro.” Then came a breath of relief when it registered.
Oh. That.
I sat a little taller and nodded.
1/
There was a code blue on the ground floor. Weird considering no code blue is ever called there.
Wait.
Codes DO happen there. But it never reaches the overhead sirens since almost always it's happening in the emergency dept where everyone is already there and ready.
Weird.
There was a code blue on the ground floor. Weird considering no code blue is ever called there.
Wait.
Codes DO happen there. But it never reaches the overhead sirens since almost always it's happening in the emergency dept where everyone is already there and ready.
Weird.
2/
I was on the tenth floor when I heard it. Typically those nearby run to get to the code. I wasn't near. But I did wonder what it was all about. Grady is busy, though. There's lots that I wonder about.
And then I go on to wondering about something else.
Yeah.
I was on the tenth floor when I heard it. Typically those nearby run to get to the code. I wasn't near. But I did wonder what it was all about. Grady is busy, though. There's lots that I wonder about.
And then I go on to wondering about something else.
Yeah.
3/
A few hours had passed. I was checking on one of my patients. The patient in the bed next to his was talking about what he thought had happened.
Neighbor Patient: "Somebody got shot right in front of Grady!"
Me: "Really? Oh my goodness. I hadn't heard that."
A few hours had passed. I was checking on one of my patients. The patient in the bed next to his was talking about what he thought had happened.
Neighbor Patient: "Somebody got shot right in front of Grady!"
Me: "Really? Oh my goodness. I hadn't heard that."
#AmazingGrady, Day 11
"Some type of way"
You'd been so upbeat before. So animated and full of light. Out of breath, yes. But joyful still. I pulled up a chair to sit down and just soak it up.
Today? It was none of that. Just quiet cooperation and a cloak of melancholy.
Hmmm.
"Some type of way"
You'd been so upbeat before. So animated and full of light. Out of breath, yes. But joyful still. I pulled up a chair to sit down and just soak it up.
Today? It was none of that. Just quiet cooperation and a cloak of melancholy.
Hmmm.
2/
Me: "What's wrong?"
You: *shrug* "I'm okay."
Me: "Really? You seem different. Like you're not okay."
You: *silence*
Me: *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.
Hmmm.
Me: "What's wrong?"
You: *shrug* "I'm okay."
Me: "Really? You seem different. Like you're not okay."
You: *silence*
Me: *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.
Hmmm.
3/
I didn't like the idea of you holding on to something all by yourself while laying in a hospital bed.
And so. I told you just that.
A tear slipped out of your eye and rolled under your chin. You shook your head hard. More tears followed. Hot, mad ones.
Me: "You ok?"
I didn't like the idea of you holding on to something all by yourself while laying in a hospital bed.
And so. I told you just that.
A tear slipped out of your eye and rolled under your chin. You shook your head hard. More tears followed. Hot, mad ones.
Me: "You ok?"
1/
#AmazingGrady, Day 9
“How do you want to do Saturday?”
That’s the question I often get from the senior resident on those days when the students and interns are off--when it’s just the 2 of us.
A little less formal.
A little more chill.
Easy-peasy, man.
What to do?
#AmazingGrady, Day 9
“How do you want to do Saturday?”
That’s the question I often get from the senior resident on those days when the students and interns are off--when it’s just the 2 of us.
A little less formal.
A little more chill.
Easy-peasy, man.
What to do?
2/
Off days for interns are usually non-admitting days. Barring any curveballs, things are usually pretty laid back.
Options:
1. Run the list +
2. Divide and conquer and/or
3. Quick management rounds #together.
And, for the most part, this usually works out fine.
Off days for interns are usually non-admitting days. Barring any curveballs, things are usually pretty laid back.
Options:
1. Run the list +
2. Divide and conquer and/or
3. Quick management rounds #together.
And, for the most part, this usually works out fine.
3/
I often ponder what more I with this one-on-one time. Of course, it’s great for #directobservation so there's that.
But in what else?
Well. Whenever I ask residents about THEIR goals, they often mention wanting to REALLY grow as teachers and leaders.
Hmmmm. . . .
I often ponder what more I with this one-on-one time. Of course, it’s great for #directobservation so there's that.
But in what else?
Well. Whenever I ask residents about THEIR goals, they often mention wanting to REALLY grow as teachers and leaders.
Hmmmm. . . .
1/
#AmazingGrady, Day 5
I was presented a patient with structural heart disease. Nonischemic HFpEF, to be exact.
PND. Orthopnea. S3 on exam. Reported some intermittent palpitations but EKG NSR, some LVH w/strain.
Admitting diagnosis: Acute decompensated HF
So far, so good.
#AmazingGrady, Day 5
I was presented a patient with structural heart disease. Nonischemic HFpEF, to be exact.
PND. Orthopnea. S3 on exam. Reported some intermittent palpitations but EKG NSR, some LVH w/strain.
Admitting diagnosis: Acute decompensated HF
So far, so good.
2/
Work rounds the next day:
Diuresis is going well. Responding to loop diuretics. And shout out to hydralazine for the double whammy of BP control + afterload reduction.
“Oh. But she had palpitations again. And on tele she was in atrial fibrillation.”
Hmm. Ok.
Work rounds the next day:
Diuresis is going well. Responding to loop diuretics. And shout out to hydralazine for the double whammy of BP control + afterload reduction.
“Oh. But she had palpitations again. And on tele she was in atrial fibrillation.”
Hmm. Ok.
3/
By the time I examined the patient, the heart rate was regular again.
Intern: “She’d been taking her meds and watching her salt intake. Maybe Afib is why she decompensated.”
Me: “We know the patient to have structural heart disease. So it all makes sense.”
And that was it.
By the time I examined the patient, the heart rate was regular again.
Intern: “She’d been taking her meds and watching her salt intake. Maybe Afib is why she decompensated.”
Me: “We know the patient to have structural heart disease. So it all makes sense.”
And that was it.
1/
#AmazingGrady, Day 1
From the ICU to the step-down unit. From the step-down unit to the floor. Things were getting better. You were getting better.
Yup.
But then the confusion came.
"My mama wasn't like this!" Your daughter was emphatic.
Your daughter was right.
#AmazingGrady, Day 1
From the ICU to the step-down unit. From the step-down unit to the floor. Things were getting better. You were getting better.
Yup.
But then the confusion came.
"My mama wasn't like this!" Your daughter was emphatic.
Your daughter was right.
2/
We reconciled the meds. The astute med student even cross checked your list with the Beers Criteria list since you're an elder.
Vitals were fine.
No sneaky hypothermia.
Or a sucker punch UTI even.
Nope.
"Now they got her tied down!" Your daughter shook her head.
We reconciled the meds. The astute med student even cross checked your list with the Beers Criteria list since you're an elder.
Vitals were fine.
No sneaky hypothermia.
Or a sucker punch UTI even.
Nope.
"Now they got her tied down!" Your daughter shook her head.
3/
The team had a good schema for delirium. I agreed with everything they'd already started to explore. And since your daughter was vehement about you never having cognitive issues, it wasn't fair to even think for five seconds that this was your "new baseline."
Nah.
The team had a good schema for delirium. I agreed with everything they'd already started to explore. And since your daughter was vehement about you never having cognitive issues, it wasn't fair to even think for five seconds that this was your "new baseline."
Nah.
1/ In the spirit of my mentor @gradydoctor’s #AmazingGrady series, a story:
Last week, I was giving a tour of Grady to group of suit-clad @EmoryMedicine applicants. As we were passing the back exit, one of the security officers stopped me.
Him: “Can I make an announcement?”
Last week, I was giving a tour of Grady to group of suit-clad @EmoryMedicine applicants. As we were passing the back exit, one of the security officers stopped me.
Him: “Can I make an announcement?”
Me, surprised by the request: “Um...Sure”
Him: “Thank you... Welcome to Grady! We feel lucky to have ya’ll here and seeing our hospital. Grady certainly ain’t perfect, but Atlanta is lucky to have her. She takes care of our city in more ways than you can imagine...”
Him: “Thank you... Welcome to Grady! We feel lucky to have ya’ll here and seeing our hospital. Grady certainly ain’t perfect, but Atlanta is lucky to have her. She takes care of our city in more ways than you can imagine...”
3/
As the security guard paused for air, right behind me came: “excuse me ya’ll. Just want to say.. Grady saved my life ya’ll. Grady saved MY life!”
I turned, and a middle-aged women in a wheelchair rolled by, not stopping as I imagine she was heading home after a long stay.
As the security guard paused for air, right behind me came: “excuse me ya’ll. Just want to say.. Grady saved my life ya’ll. Grady saved MY life!”
I turned, and a middle-aged women in a wheelchair rolled by, not stopping as I imagine she was heading home after a long stay.
1/
#AmazingGrady, Day 15
Stepped onto the E elevators on a Saturday morning, joining a young man who looked like me. We gave each other a nod.
Him: “Morning, doc. What floor?”
Me: “Good morning, friend. 10, thanks.”
Him: *pushes 10*
Me: “Preciate you.”
*ride in silence*
#AmazingGrady, Day 15
Stepped onto the E elevators on a Saturday morning, joining a young man who looked like me. We gave each other a nod.
Him: “Morning, doc. What floor?”
Me: “Good morning, friend. 10, thanks.”
Him: *pushes 10*
Me: “Preciate you.”
*ride in silence*
2/
Him: “Hey doc? Where you from?”
Me: “Me? I’m from California.”
Him: “No, I meant like, where you FROM FROM.”
*silence*
Usually this kind of thing feels like a microaggression. But this young brother could easily blend into my own family. I decided not to overthink it.
Him: “Hey doc? Where you from?”
Me: “Me? I’m from California.”
Him: “No, I meant like, where you FROM FROM.”
*silence*
Usually this kind of thing feels like a microaggression. But this young brother could easily blend into my own family. I decided not to overthink it.
3/
Me: “Umm. Born in Compton. Raised in Inglewood.” *holds up hand gesture* “West syeeeeeed.”
*laughter*
Him: *squints eyes* “But where your peoples from?”
Me: “Alabama.”
Him: “Alabama? I was thinking you was something else.”
Me: “I say we’re all ’something else.’ ”
*nods*
Me: “Umm. Born in Compton. Raised in Inglewood.” *holds up hand gesture* “West syeeeeeed.”
*laughter*
Him: *squints eyes* “But where your peoples from?”
Me: “Alabama.”
Him: “Alabama? I was thinking you was something else.”
Me: “I say we’re all ’something else.’ ”
*nods*
1/
#AmazingGrady, Day 10
Me: "Hey there. Just came back to check on you."
Him: "Lawd. Did you come back to bug me about that pill some more?"
Me: "You mean the PrEP? Nah. Well. I mean, I do want you to take it. But I legit came to check on you."
Him: "Mmmm hmmmm."
*laughter*
#AmazingGrady, Day 10
Me: "Hey there. Just came back to check on you."
Him: "Lawd. Did you come back to bug me about that pill some more?"
Me: "You mean the PrEP? Nah. Well. I mean, I do want you to take it. But I legit came to check on you."
Him: "Mmmm hmmmm."
*laughter*
2/
Him: "You a dog on a bone, you know that?"
Me: "Me?"
Him: "Yeah, YOU. But for real. . .I'm pretty low key. I don't need that pill. I ain't out like that, feel me?"
*silence*
Him: "What?"
Me: *shrugs*
Him: "Why you so pressed for me to take this pill?"
Him: "You a dog on a bone, you know that?"
Me: "Me?"
Him: "Yeah, YOU. But for real. . .I'm pretty low key. I don't need that pill. I ain't out like that, feel me?"
*silence*
Him: "What?"
Me: *shrugs*
Him: "Why you so pressed for me to take this pill?"
3/
Me: "Because. I care about you."
*silence*
Me: "So--tell me again why you aren't feeling it?"
Him: "I don't want nobody experimenting on me. Or using me to get paid."
Me: " Tell me what you mean by that."
Him: "Look. I ain't even out like that. So I'm good." *turns up TV*
Me: "Because. I care about you."
*silence*
Me: "So--tell me again why you aren't feeling it?"
Him: "I don't want nobody experimenting on me. Or using me to get paid."
Me: " Tell me what you mean by that."
Him: "Look. I ain't even out like that. So I'm good." *turns up TV*
