Kimberly D. Manning, MD Profile picture
Sep 13, 2020 17 tweets 4 min read Read on X
1/
I can’t say I always had an illness script for your concern. But back in 2013? I acquired one—for sure.

Yup.

See, that was the year when I became a runner. And if you’d known me before 2013, you’d find it laughable. But it’s true. I became a runner that year.

Yup.
2/
See, my sister had a sudden cardiac death in November 2012. And since I was grieving and I wanted to stick it to heart disease, I became a runner.

Crazy, I know.

But I did. I saw an ad for the Army 10 Miler and impulsively registered.

Did I mention? I wasn’t a runner.
3/
I’d been active. But not run ten miles without stopping active. So this? This was going to be a change. A big change.

I got some running shoes. And one day, I did a Forrest Gump. Just went outside and decided to go for little run.

Well. A run-walk. Which became a run.
4/
Whenever I felt sad, I would run. Which meant I ran every single day. With almost no rest.

When I first felt that twinge on the side of my leg? I ignored it. Because this was my personal way of shaking my fist at this ruthless disease that robbed me of my sister.
5/
Each time my foot struck the ground, I felt I sharp pain in the same place. I told one of my seasoned runner friends.

Me: “I’m having this pain in my leg on the side whenever I run.”
Them: “How many miles you running?”
Me: “Like 5 or 6.”
6/
Them: “How often?”
Me: “Every day.”
Them: “Like, 7 days?”
Me: “It’s saving me.”

*silence*

Them: “Okay. Whatever it is involves overuse. Probably an IT Band.”
Me: “A who-who-what?”

And see? This IT Band thing was something that I, a non-runner, knew nothing about.
7/
And so. Being a true nerd, I built a solid illness script on this who-who-what syndrome—also known as IT Band Syndrome.

Sharp pain on lateral side near knee
Pain when bent at 30 degrees
Pain on foot strike
Overuse

I got one of those leg roller things.
8/
But it kept hurting. So eventually I saw sports medicine. Turns out I didn’t have who-who-what syndrome at all. It was a stress fracture. From overuse.

Yup.

Though I officially got sidelined from running and had been wrong about the diagnosis, there was an upshot.
9/
I’d learned a bunch about IT Band Syndrome. And stress fractures, too.

Yup.

Turns out that my pain wasn’t in the right place for IT Band Syndrome. It was too low. It radiated toward my ankle instead of my hip. So it didn’t fit the illness script.

But your pain did.
10/
The only part missing was the story of overuse.

Me: “Do you . . .run?”
You: “Other than for cover? I ain’t ran since I was in middle school.“

*laughter*

Me: “Your pain makes me think of this thing called IT Band Syndrome.”
You: “Who-who-what syndrome?”

*laughter*
11/
Me: “It’s this thing people get who run or who overdo it.”

*silence*

You: “Does walking a whole bunch more count?”
Me: “Define ‘a whole bunch more’.”
You: “Like 5 or 6 miles every day?”

Hmmmm.
12/
You: “You know with Corona they don’t run all the buses no more.”
Me: *listening*
You: “Yeah. So now it add like 3-4 miles walking on each side easy. A lot of time more.”
Me: “Wow.”
You: “And don’t have a bunch of grocery bags!”

Wow.
13/
Your exam combined with that history was suggestive of IT band syndrome. So we gave you some stretching exercises, talked about ways to make a makeshift roller, and made a PT referral.

Yup.

After that, we talked about other things.
14/
But my mind was still stuck on the bus schedule. When I left the room, I went to the MARTA site to learn more.

Bus ridership - down 44%.
Rail ridership - down 68%.

You'd said, "One thing always seem like it lead to another, don't it?"

Ain't that the truth.
15/
Less riders mean less buses and trains running.
Less buses and trains running means less riders.

And less both of these means less hours for drivers.
And less hours means less money.

Sigh.
16/
And less money and ability to get around leads to less access to healthcare.
And less access to healthcare leads to a suboptimal health milieu.

Which is set up for poor outcomes with COVID-19.

Damn.
17/
"One thing always seem like it lead to another, don't it?"

Today I’m thinking of your wise words. And of how interconnected everything is. What we learn. What we live.

Everything.

I hope your leg can feel better soon. I really do.

#thisjobishardsometimes

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More from @gradydoctor

Mar 24
1/
On rounds at Grady

Me: "How're you feeling today?"
Him: "Well. I been better. That medicine y'all gave me made me run off!"

My team looked puzzled.
I did not.

Me: "Oh no! You talking 'bout the medicine we gave you for your gout flare up?"
Him: "Yeah! That one!" Image
2/
Him: "Shit, you coulda warned a brother."
Me: "Dang. I really should have. I'm sorry."
Him: "Yeah, if it wasn't for that bedside commode it woulda been a clean up on aisle 1!"

He laughed.
I was glad he was making light of it.

Me: "I apologize, sir. Colchicine can do that."
3/
Him: "It's cool. My knee is feeling a little bit better so that's good."
Me: "I'm glad. And again, I'm sorry for not giving the heads up."
Him: "I'm okay, doc."

I turned to my team.

Me: "'Running off' is diarrhea."
Them: "Ohhh."
Him: "Oh my bad, y'all."

*laughter*
Read 15 tweets
Jun 23, 2023
1/
Her: "Why haven't you left for L.A. yet?"
Me: "Huh? Oh. Yeah. I'm pretty much almost done. It's okay."

*silence*

Her: "But, like is it?"
Me: *sighs* "Me rushing there won't change anything."
Her: "Depends on who you ask."

And after that, we both went back to charting.
2/
I was on the hospital service last April when I got the news. Dad had this sudden onset of disabling vertigo. We'd learn it was a cerebellar stroke. My sister was there in LA. At the bedside and wringing her hands as next-of-kin.

So she kept me posted.

And I kept rounding.
3/
On that first day, I walked right in and told my team.

Me: "My dad has been admitted to the hospital. It seems that he's had a cerebellar stroke."

And I said it in that "but I'm fine" voice. Because at that time that's what I was telling myself.

My team listened intently.
Read 16 tweets
May 10, 2023
1/
Me: “I’m glad to see you.”
You: “You know what? I’m glad to see you, too.”

*silence*

Me: “You know how you’re loved, don’t you?”
You: *smiling gently* “I do. I think that’s what makes this so hard, you know? Can’t feel a loss like that without feeling a love like that.” Image
2/
We both let out big exhalations. After a few beats, you swung your head in my direction.

You: “How are you?”
Me: “Me?”
You: “Yeah. You.”
Me: “I’m fine. I just wish... um… you didn’t have to feel what you’re feeling.”

You reached out for my forearm. And then sighed again.
3/
You: “Yeah. But I’ll be okay. We were soul-connected. That will comfort me.”

I nodded. Then we sat in silence.

You: “But for real—how are you? Like with all this cool stuff you’ve been doing.”
Me: *puzzled look*
You: “It has to make you miss your dad and your sister.”

Ooph.
Read 9 tweets
Apr 13, 2023
1/
I just finished this beautiful, courageous, and searing memoir “I Can’t Save You” by @CQ__MD. It was . . . in a word. . . sublime.

Whew.

And full disclosure—as his former med school advisor & friend—I love Dr. CQ.

But.

I also love books and honesty.

And he knows that. Image
2/
@CQ__MD will be the first to tell you that I won’t endorse anything—even a book my my beloved little bro CQ—unless I’d read it myself and believed others should, too.

And now I have.
And wholeheartedly I do.

But before you jump in—and you should—let me say this. . .
3/
There are some parts that explore depression, thoughts of suicide, and self-harm. No, not recklessly. But yes, with raw honesty. So you need to know that up front.

He does NOT play it safe around his lived experiences as a Black man in the ivory tower.

So hold on tight. Image
Read 6 tweets
Mar 18, 2023
1/
Thought I’d show some Black joy from this year’s #MatchDay. Because sometimes we don’t see that enough.

And there IS joy.

Especially on this day.

The ancestors are surely rejoicing. I know I am.

I think the words of Jill Scott will say it best. . .
2/
“I'm taking my freedom
Pulling it off the shelf
Putting it on my chain
Wear it around my neck

I'm taking my freedom
Putting it in my car
Wherever I choose to go
It will take me far . . .”
3/

“I'm livin' my life like it's golden

Livin' my life like it's golden

Livin' my life like it's golden

Livin' my life like it's golden

Livin' my life like it's golden, golden . . .”
Read 11 tweets
Mar 14, 2023
1/
I had imagined what this day would be like. Played it out in my head and saw various iterations of me exploding in celebration.

In some versions, I was doing the running man or, quite literally, running in triumphant circles, #MatchDay envelope in hand.

"Wooo hooo!" Image
2/
I also saw these visions of me quietly weeping, one hand extended to the heavens in gratitude. My lips quietly murmuring prayers of thanksgiving.

See, I was my ancestors' wildest dreams. And not even just my enslaved ancestors but the Jim Crow survivors who raised me, too.
3/
So, yeah. This was about to be big.

I was even on the #MatchDay party committee. And since we were broke, that meant soliciting donations from faculty & parents & anybody who felt proud enough of us to shell out a few coins.

Which, fortunately for us, was a lot of folks. Image
Read 20 tweets

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