1/
This car pulled up to a 4 way stop just after me the other morning. On my left. As I pulled out, they did, too.

We nearly collided.

After a brief pause, I continued. Moments later, the driver swooped alongside me, extended an arm over the passenger seat, & flipped me off.
2/
Then, they sped off. But got stuck at the red light just ahead.

2 lanes. An empty street. On an early morning.

And this person in a car now beside me who, after not having the right of way, decided to greet me with a middle finger.

Mmm hmmm.
3/
Did I mention that this was on December 26? And that I'd worked not only on Christmas Eve and Christmas Day--but 12 consecutive days before?

And where I come from? Flipping folks off is not compatible with life.

Or at least compatible with not having it threatened.
4/
Anywho.

I stop at the light and allow my eyes to drift to my bird-shooting comrade. And then, after a few moments, they looked over toward me.

Mmm hmmm.

I felt my lips curling. My eyes narrowing. My hand reaching for the window button.

And then I stopped.
5/
I thought about this instance where someone made me very mad when I was an intern. A really intimidating person who was tasked with performing a complicated straight cath on my unstably housed patient who had urinary retention.

Yup.

Here's how it went down:
6/
My patient, who wasn't circumcised, had a bad case of phimosis and couldn't retract his foreskin. He also had trouble urinating. He was miserable.

Me: "Hi. I was hoping you could come assist me with catheterizing this patient."
Them: "Did you try?"
Me: "I almost did ..."
7/
Them: "And?"
Me: "I was concerned I'd hurt him. There's a lot of inflammation. So I was hoping you could look."

*silence*

Them: "Well. You need to try."
Me: *blinking*

I went to my attending. Who went to the bedside, saw the patient, and agreed that it was too complex.
8/
Me: "Hey. I spoke to my attending and we think it's best if you give it shot since you have more experience."
Them: *hangs up*

On me.

I shrugged and went about my business on that ED shift.

Moments later, I see the person huff by with cath supplies. They were NOT happy.
9/
After like 20 minutes, I am standing in front of a computer checking labs. Suddenly, out of the corner of my eye, I see something coming toward me.

It was them.

Them: "I got your magical, impossible catheter in. You happy?"

Which, yeah, was rude. But whatever, right?
10/
But then they did something else. With an outstretched hand, they held out a hazard bag with two murky urine samples inside. And then put it so close to my face that it nearly bounced off of my nose

And, just like that driver, they sped away.

Yup.
11/
Also, like that driver, there was a speed breaker. They needed to take the sample to send it to the lab in the vacuum chute.

The urine sample. You know, the one that they'd held close to my face and nearly smacked me with in the middle of the emergency department.

Mmm hmm
12/
And you know? I recall this split second where I felt my blood boil but still had impulse control.

Kind of like when that person flipped me off after I'd been working my ass off serving patients in a full-to-capacity safety net hospital in the middle of a pandemic.
13/
I was tired. And in need of some diastole. And just not in the mood for anyone to be mean to me, man.

And this? This was a tipping point.

I was what the Grady elders call "38 HOT." As in, so mad that whoever is in your path better watch out.

38 HOT does not end well.
14/
And so. After that split second, I let 38 HOT, tired, and mad kick me into gear.

I am not proud of it.

I marched over to that lab chute, stepped into the face of that urine-wielding person, and commenced to offer a full dress down complete with copious F-bombs.
15/
It was so bad that someone had to pull me back. Like, I felt my fist curling into a ball and this recklessness coming over me.

Me: "I will kick your ass right here in this emergency department."

Yes. That is what I said.

And that person looked afraid. Very afraid.
16/
My attending somehow calmed it all down. And then pulled me aside.

What I remember was that my attending was supportive. I didn't get admonished or punished or anything.

I mean--because URINE. In my FACE.

But they did make it a teachable moment that I never forgot.
17/
Att: "Listen. That wasn't cool. Like at all."
Me: *still 38 HOT*
Att: "But you know? All you can control is you. So before you act, just ask yourself a simple question."

They paused for effect and I looked up.

Me: "What?"
18/
Attdg: "What good can come from this?"
Me: *staring* "You mean from me fighting? Or cussing someone out?"

*laughing*

Attdg: "I mean any of it."
Me: *squinting*
Attdg: "It's kind of like. . .you drinking the poison and expecting them to die, you know?"

Hmmm.
19/
That person was written up. I finished my shift. And all of it faded into the lore of residency.

But.

I held that advice close to my chest and use it regularly.

"What good can come from this?"

and

"It's kind of like you drinking the poison and expecting them to die."
20/
And so.

When the middle finger-marauder met my glance, I ran that through my head. And you know what happened next?

I waved. And mouthed and exaggerated, "Merry Christmas."

Which disarmed the hell out them. And even brought out an embarrassed chuckle.

Yup.
21/
And so.

I'm not sure who needs this today. But I thought I'd share.

We are all tired right now. And on edge. Some people are not being nice.

But.

Today, I'm going to do my best to control the one thing I am lucky enough to be able to control: ME.

#thatsall #choosekind

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More from @gradydoctor

18 Dec 20
1/
You: “They crazy as hell if they think I’m doing that shit.”

We stared at the wall-mounted TV showing the news. Health care workers gleefully rolled up sleeves and smiled for cameras as they received the first batches of the #COVIDVaccine.

You shook your head hard.
2/
I’d swung by to check on you after missing you on rounds earlier that morning. Even though the television was muted, what was happening was clear.

Me: “What makes you say that?”

You cocked your head and raised your eyebrows at me.

Then threw back your head and laughed.
3/
Me: “I’m serious!”
You: “Shiiit, I am, too!”

*laughter*

Me: “But real talk, though. What makes you say that?”
You: “Say what? Say I ain’t taking that half-cooked shot they peddling?”

Your reply was telling.

I sat on the bedside chair and waited to see what you’d say next.
Read 18 tweets
15 Dec 20
1/
Tonight

Me: “Sis! I got your text. Damn.”
Her: *coughs* “Yeah. I feel like I got run over by a truck.”
Me: “How's your breathing?”
Her: “Bad cough. But OK, I guess.”

*coughing paroxysm*

Me: “Do you feel short-winded?”
Her: “No. Just worn down.”
Me: "Okay."

*silence*
2/
Her: “Dang. I would be the one to test positive for #COVID on the same damn day they start giving the vaccine.” *chuckles then coughs*

I wasn’t sure what to say to that. So, I let out a weak laugh, too.

Her: "Damn. This is kinda scary."
Me: *thinking* "Yeah."

It is.
3/
Her: “What should I do?”
Me: “Well, you’re already isolated. So that’s good.”

After that, I told her about supportive care, red flags and reasons to go to the hospital. As I was talking, she started coughing again. Super hard.

Me: “You okay, sis?”
Her: *coughing* “Yeah.”
Read 12 tweets
11 Dec 20
1/
PM rounds at Grady

Him: "You alright, doc?"
Me: "Me?"
Him: "Yeah you. You seem outta sorts."

*silence*

Me: *smiles* "I'm in sorts I promise. Now tell me--you alright?"
Him: "Me? Feeling a little better."
Me: "How's your wind?"
Him: "Waaay better."
Me: "Yay."
2/
I sit him up and carefully untie the back of his gown. On cue, he takes breaths in and out as I listen intently.

Me: "Lungs sound good." *moves around to front of chest* "I'm listening to your heart now. You can just breathe regular now."
Him: "Okay."
3/
After pressing my palm to his chest to feel his heart, I search his chest with stethoscope. Although it's not normal, it hasn't changed. Still he keeps making big gasps, forcing breaths in and out the whole time exaggeratedly.

Me: "Just breath regular, okay?"
Read 9 tweets
8 Dec 20
1/
Like many of you, I’m an unapologetic book nerd. I love a good recommendation and love sharing after I enjoy a book.

So check it:

Just finished this book by our very own #medtwitter @AaronLBerkowitz. Here’s my unsolicited review.

(Spoiler alert: I loved it.)
2/
In full transparency, @AaronLBerkowitz told me (via Twitter) about his recently published book. And because:

1. I like books.
2. I believe #supportisaverb
3. It was on Audible.

I immediately used my November @audible_com credit and gave it a try.

Yup.
3/
I’ll admit—I’m a fan of @AaronLBerkowitz’ Neuro textbook. But I had no idea what to expect out of THIS particular book.

I mean, even with reviews from everyone from Dr. Paul Farmer himself to @drsanjaygupta, the book nerd in me was skeptical.

IJS
Read 10 tweets
6 Dec 20
1/
PICU rotation, 1998

I leaned over the sink with its rust-stained drain and ran cool water over my hands. Patting my fingertips over my face, I stared in the mirror. I’d been awake for >24 hours. It showed.

I tried to give myself a post-call pep talk.

Me: “C'mon, sis.”
2/
I was tired. But not just tired from the lack of sleep. It had been a cognitively hard night with sick-sick patients. While it had gone mostly fine, my brain was still steaming. Not to mention the sustained tachycardia I had every time I took call in the PICU.

It was rough.
3/
This was before duty hours reform. And it’s relevant here is because it explains why I had clinic that afternoon--even though I was post call.

I had just one wish:

To get through rounds in time to finish all my work and avoid having to return to the PICU after clinic.
Read 20 tweets
4 Dec 20
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.
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.
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*
Read 8 tweets

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