Thread by @gradydoctor

1/
“Can I run something by you?”

It was Saturday. I was already gone. She was still on the ward. I didn’t respond to that text. Instead, I called her directly.

Me: “Hey.”
Her: “I’m so sorry to bother you, Dr. Manning.”
Me: “Never be sorry.”

*silence*

Me: “I’m all ears."

2/
Her: “I’m worried about Mr. J. He has this new complaint of abdominal pain.”

She went on to describe what was happening.

Me: “Hmmm.” This wasn’t a feature on morning rounds and had come out of nowhere.

She'd gone straight to the bedside to see him.
Then she texted me.

3/
She unpacked what she’d seen on exam and some of the labs. Tachycardic. A lactate was elevated. WBCs on the creep up. And a near-fever.

But mostly? He just didn’t look right. And he looked afraid.

Her: “He’s guarding. I ordered a stat CT. They just finished it.”
Me: "Ok."

4/
I asked a few questions. She gave me answers. And honestly, she’d done every single thing I'd have done.

Maybe even better than me.

Her: *fretful* “Can you think of anything I’m missing?”
Me: *pause* “Honestly? No.”

*silence*

Me: “Would you like for me to come back?”

5/
Her: *thinking* “Come back? Uhh. . .no. I think I’m okay. I just wanted to make sure I wasn’t missing anything.”
Me: “It sounds like really thorough management. I mean it.”
Her: “That makes me feel better. I’m ok. Don’t come.”

I came anyway.

Yup.

6/
Yes. She was a highly competent PGY3. And yes. I trusted her and 100% agreed with her work up.

But still.

I got in my car. And I drove to Grady Hospital.

As soon as she saw me, her eyes widened.

Her: “You came anyway.”
Me: “Yep. To stand beside you. And worry, too.”

7/
She let out a big sigh. Then she smiled. And I was so glad she did, too.

Me: “Let’s go see him together, okay?”
Her: *nodding* “Okay.”

Side by side we saw him. And everything was exactly as she said. Yes, I examined him myself. But I had no recommendations to add.

Nope.

8/
We went down to radiology together. And I stood beside her as she spoke to our colleagues there. Hands stuffed in my white coat pockets. Saying very little.

Her: “Clinically it looks like a surgical abdomen. Like peritonitis.”
Me: *nodding* “I agree.”

Because I did.

9/
Hours later, the pt would end up in the OR. And not one thing I said or did changed the management ball that she’d already started rolling due to her diligent, meticulous clinical acumen.

No attending ah hah moment.
No rabbit from a hat.

Nope.

It was just as she said.

10/
I wasn't surprised either. Because on this day, I had simply come to stand beside her. And that was it.

Coming in is often a safety issue, I agree. And I'd submit that this WAS a safety issue, though. But of a different kind.

Yup.

This was about psychological safety.

11/
I'm learning that psychological safety is not just for errors or saying "I don't know" or having cultural comfort in clinical learning environments. It helps learners trust themselves and says:

See? You're not an imposter.
Yes, you can be wrong.

But you can also be right.

12/
And yes. We DO need to return sometimes. To step in and help make clinical decisions. Or to physically be there for the patient and family.

Yup.

But it’s also okay to be present just as a spotlight for someone else. Just to be their hype man. Or woman.

And nothing else.

13/
On a perfect Saturday afternoon, I chose to return to the hospital. To make not one decision or write one single order. But instead to stand beside my resident and intentionally affirm her.

It wasn’t lost on her.

But even better? It wasn’t lost on our patient.

Nope.

14/
“I appreciate y’all being so concerned about me." His eyes brimmed with tears. We nodded--in unison.

Sure did.

The crazy part? All of this transpired in less than 1 hour.

Her: “I’m really, really glad you came back, Dr. M.”
Me: “Me, too.”

And I was.👊🏾
#supportisaverb