1/
#HumpDayHumanism

I'd just gone hard on some #motivationalinterviewing about smoking cessation with a Grady elder one day. We talked about his grandbabies and his life. We even talked about his "nature."

He was looking deep into my eyes--like it was really resonating.

Yup.
2/
Me: "Well?"
Him: "Well what?"
Me: "What're your thoughts?"
Him: "My thoughts 'bout what?"

I groaned. He was tickled.

Me: "Sir! About quitting smoking?"

He raised one eyebrow at me and laughed again. This raspy, gravelly chuckle.

Him: "Miss Manning?"
3/
Me: *listening*
Him: "Tell me. Have you ever had somebody piss you off on a hourly job real, real bad--then step outside, flick your lighter, and then take a good, hard drag on a menthol cigarette?"

I shook my head no. Because I had not.
4/
Him: "What about when you come home and your lights is off 'cause you ain't paid the bill--and you know you ain't gon' have the money for it for like 3-4 more days--so you sit on your porch and you light you one just to ease your nerves?"

I twisted my mouth and said nothing.
5/
Him: "Or this--you ever played a late night hand of spades with a good, shit-talking partner and some Jack Daniels?" *snaps finger* "Oooh! Or pressure-washed your driveway all day on a Saturday?"

*silence*

Him: "No?"
Me: "No."
Him: *chuckling* "I ain't thank so."
6/
Him: "You ever got stuck in traffic behind a jackknifed semi on 285 after a long-ass day? Looking all through your glove box and pockets and then felt glad as HELL to find 3 looseys and a pack of matches?"

He was amusing himself. I heard him mumble something under his breath.
7/
Me: "What's that, sir?"
Him: "I just said that y'all doctors is funny sometimes."

*silence*

Him: "See, if you knew what you was REALLY asking somebody to do when you try and get 'em to quit smoking, you'd know it ain't easy as some peptalk 'bout how folk love you."

Ooph.
8/
I sat there thinking about the principles of #motivationalinterviewing--and one of the main strategies being to highlight the discrepancy between goals and current behavior.

But also a big piece is #empathy.

Yeah. That.

Him: "You ain't never been a smoker have you?"
9/
Me: "Uh. No, sir." *squinting an eye* "Wait. Unless you count the semester me and my college roommate used to play dominoes and smoke Virginia Slims after really big exams."
Him: "Dominoes with. . . Virginia Slims? Why?"
Me: *shrugs*

*laughter*

Me: *now serious* "Sir?"
10/
Me: "I'm thinking about what you said. And I'm wondering how you think I should talk to people about smoking instead."

He narrowed his eyes.

Him: "Well. I say part of it is just understanding. Shit. Sometimes easing your nerves feel more urgent than anything else."
11/
Me: *listening*
Him: "You could start out finding out what the smoking do for the person. And who they smoke with. Not just at home but period."
Me: *listening*
Him: "Ooo--and which one is they favorite."
Me: "Wait. What?"

I cocked my head in confusion.
12/
Him: "Like. . . . is it when you first get up? The one with coffee? After a meal? In your car? And so on and so forth. 'Cause see that's the one that's hardest to let go of."
Me: "Hmmm."
Him: "And you got to ask about situations. Which ones always make you want to smoke."
13/
*silence*

Me: "Okay then."
Him: "Okay what?"
Me: "Which one is your favorite?"

He stared skyward, then glanced back at me with a mischievous smirk.

Me: "Oh Lord."
Him: *laughing* "Naww. It ain't that. I promise."
Me: "Okay. . . ."

He paused. Then shrugged.
14/
Him: "It's when I'm on the can. I take me a ashtray, some piping hot coffee, and a newspaper and settle right on into it." *shaking his head* "Whew. My best time to think!"

I stared with out blinking. He threw his head back and laughed.

Me: "Eww sir."

*laughter*
15/
Him: "Shiid. Just ask your patients who smoke. They'll tell you. Half the world's problems could get solved on a commode with a good smoke. Plus you already got the matches in there."
Me: "Huh?"
Him: "You don't know 'bout matches? That's the old school air freshener!"
16/
Me: "So once you know, what should you do next?"
Him: "Well. I say make that the last one they give up. Like I could see me not smoking before bed or after dinner. But I'd need to ease into the other ones."
Me: "Hmmm."
Him: "And think up some stuff to ease your nerves."
17/
Me: "Gotcha."
Him: "I ain't a doctor but I DO know about smoking."
Me: "I like this advice."

*silence*

Me: "Okay. So can we start by cutting out your 2 least favorite cigarettes?"
Him: "I can do that."
Me: "Bedtime and after dinner?"
Him: "Okay."

Okay.
18/
Me: "And your nerves? What about that part?"
Him: "I'mma have to think on that."
Me: "Okay."

*pause*

Him: "My grandson got this fidget spinner thing. What you think?

He was serious. I did an internal pirouette.

Me: "I think that's great."
19/
And that was pretty much it.

I saw him checking out a few moments later.

Him: "Virginia Slims?" *shaking head* "Why?"
Me: *shrug* "We liked the slogan."
Him: "You come a long way baby!"
Me: "Exactly."

Exactly.

Damn, I love this job.

Yeah.

#humanismalways

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More from @gradydoctor

29 Apr
1/
Grady Hospital, 2019

Her: "Um. . . the family invited us to the funeral. Dr. Manning, how do you handle something like that?"
Me: "Like what?"
Her: "Like being invited to a patient's funeral."
Me: "When I am, I'm honored. So if I can go, I go."
Her: "You do?"
Me: "I do."
2/
Her: "Should I go?"
Me: "Do you want to go?"
Her: "I do."
Me: "Then let's go.”
Her: *smiles*
Me: *smiles back*

And so. On a wintry Saturday, we met up at our patient's church. And from the countless cars surrounding every inch of the building, the love was evident.

Yup.
3/
"Loooord...help me to hold out...until my change has coooome. . ."

Those are the words that the mass choir lifted over the sanctuary as loved ones walked down the center aisle into our patient's homegoing service that next day.

And those loved ones included us.

Yup.
Read 22 tweets
11 Apr
1/
I remember saying in a talk once:

“Bad intentions aren’t a prerequisite for something to be considered a #microaggression.”

Funny how our own words and lessons can come back to tap us on the shoulder.

Let me explain.
2/
All of our luggage was clustered near the front porch. It was about five minutes to the hour that we had to be fully vacated from the house that we’d rented for spring break.

Everyone was scrambling about and making sure we had everything after a lazy week of relaxing.

Yup.
3/
The hatch was up on the back of my car and my teen son was loading in bags with me.

That’s when I noticed a gentleman walking toward me from what appeared to be a truck filled with cleaning items. I could see that he was accompanied by some others gathering what they’d need.
Read 18 tweets
27 Mar
1/
Discharge day

Me: “Couple more updates—so I spoke our social worker. We’ve got some ways to help.”
You: *staring at me*
Me: “Also the pharmacist worked the stuff out with your insulin pen. They’ll be right over to help with that. Oh! And I found the pill box.”

*silence* Image
2/

Me: "You okay?"
You: "Yeah. I’m good.”
Me: "Okay. I thought maybe something was wrong.”

You fixed your eyes on me and shook your head. Hard.

Me: “What?”
You: *sigh* "I'm just tripping, that’s all."
Me: *squinting* "Tripping off of what?"
3/
You: "I was just thinking. . like every time I see y'all . . .everybody be hustling to help me. Almost like y’all really, truly give a shit about whether I live or die."

*silence*

I placed the pill container on the tray table and sat down.
Read 13 tweets
17 Mar
1/
My patient died the other day. One often described as “cantankerous" and known for his legendary cuss-outs and kick-outs from his room.

And one who was sick.

"Cantankerous" by definition is:

bad-tempered
argumentative
uncooperative

A bad rap if you're a patient.

Yup.
2/
On my first day meeting him he told me to go away. Let me know he didn’t give a damn about me “needing to take a look” or “just give a quick listen.”

I explained that I was the senior doctor and he sucked his teeth hard. Then sighed and quickly had a comeback.

Mmm hmm.
3/
Him: “Well, how ‘bout you carry your 'senior doctor' self down to the cafeteria and talk to them 'bout my food!”
Me: “What’s wrong with your food?”
Him: *glaring* “What’s not?” He lifted the top on the plate and slammed it back down.

Then he told me to beat it. Verbatim.
Read 20 tweets
10 Mar
1/
I was talking to this person who said something that made me uncomfortable. The kind of thing that is best to think in your head instead of saying out loud.

Wait. I take that back.

I'm glad they said it out loud. Because sometimes it's good to know how people feel.

Yup.
2/
Them: "If I see one more article or hear 1 more presentation or podcast on anything related to racism or diversity, I'm going to pluck out my eyeballs."

They laughed when they said that. And me, who felt sort of ambushed by hearing this statement spoken out loud, just froze.
3/
Them: "Every journal. Every conference. Like, give me a break."
Me: *squinting* "Uuuuhhh. . . "
Them: "But come on. . .you have to admit that it's seriously out of control."

I still didn't know what to say.

I awkwardly stared and shrugged. As they continued to talk.
Read 16 tweets
27 Feb
1/
#WhatsYourWhy

RN1: “I’ve known her since she was carrying them babies!”
RN2: “I’ve known her since she had all black hair and was fresh out of residency!”

*laughter*

Me: *patting my hair* “Well, if she knew me pre-grey, we have a winner for sure.”

We all laughed again.
2/
For me, they’d both become woven into the fabric of the Grady I know and love. Experienced nurses who’d already been around the block a few times before I even arrived back in 2001.

I was always happy to see them.

Always.
3/
RN1: “You have a patient here?”
Me: “Yes, ma’am.”
RN2: “Yeah, that’s my patient today.”
Me: *pretending to leave* “Oh, YOU have my patient? I’m good then.”

*laughter*

Even with her caramel complexion, her eyes told me that she was blushing from the compliment. I smiled.
Read 18 tweets

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