Christmas Eve, ED, 2009

Ever since I entered the medical profession, Christmas Eve has always been a workday for me. While it’s true that as an MOT (Member of the Tribe) I have no spiritual affiliation with the day, I enjoy a day of cheer, fellowship and good tidings as much as anyone. But the simple fact is that the nature of what my colleagues and I do for a living means someone has to be in the ED at all times. That’s why I like to think of Christmas Eve as The Official Shift of the American Jew (if only I could get a beer sponsor for that). It’s why I’m at work, or sleeping off night shifts, while most of my fellow co-religionists are performing the holiday rite of eating Chinese food and going to a movie.

This concept of the Official Shift does not just exist in my mind. I actually tested this theory last year. It was two AM, and I called two other ED’s in town and two out of state to see which doctor was on. It was always the Chosen People, chosen especially for duty that night. I was so inspired by this phenomena that I wrote a poem about it:

‘Twas the night before Christmas
And Elvis was bluish.
All the doctors on duty
That night had been Jewish.

I recited this poem last night to my friends Hung Doan (Buddist) and Ahmed Amawi (Muslim), who had also drawn the holiday duty. So the poem has now been modified to be more inclusive:

It’s the night before Christmas
And in case you have missed ‘em
Here’s all of your friends
Who say they’re not Christian.

Every year I keep expecting Christmas Eve to somehow be radically different from any other shift of the year. I expect it to be slower than usual, and I always anticipate a certain gentleness of spirit among patients and staff, and for all of us to have a better perspective on what’s really important in life…friends, family, the blessings in life we have from living in this country.

In reality, it’s not all that different from any other day. People come in for the same things, you see the same range of problems and personalities, they get on your same nerves and you get onto theirs (the latter phrase translated as “You’re here at 3 AM all the way from Orlando, bypassing three other hospitals on the way, for THAT?). In the wee small hours of the morning, you get just a bit philosophical and start to wonder if there really is a Christmas, or if Christmas was just a day in the calendar picked out by someone to celebrate an event, the same way that New Year’s Day is not really the start of anything but just a day we picked to commemorate the next revolution around the sun. Maybe we could have made Christmas April 14th and New Year’s August 22nd and had the same effect.

But then you notice the subtle things that make Christmas Eve in the ED just a bit different than usual. Food is one. Piles of it. Industrial strength sheet cakes. Cookies. Hot dishes. Tins of popcorn. Platters of sandwiches and veggies from the grocery store, sausage and cheese from Hickory Farms. It comes from lots of places. Hot foods we bring for ourselves, potluck style. Some is provided by local churches as an appreciation. Much of it comes from doctor’s offices to say “thank you for your patronage…and for covering our butts.” There is so much food that we violate our normal Rule of Hoarding and invite patient’s families to raid our stash because we simply can’t get through it all.

It’s kids in fleecy holiday pajamas with colds and earaches who want nothing more than to go home and wait for Santa. It’s watching the NORAD Santa Tracker (www.noradsanta.org) and telling them that Santa will be at their house very soon, as he’s flying up the coast of South America right now. It’s letting them know that the best thing they can do is go home, lay out cookies for Santa and carrots for the reindeer (they LOVE carrots), and get to sleep because everybody knows Santa doesn’t come when kids are awake. It’s watching them nod gravely with understanding.

It’s the family of the bedridden elderly woman who didn’t give her insulin for four days so her blood sugar would be critically elevated and she would need to be admitted to the hospital. It’s knowing that they did this so they could get her taken care of while they went on vacation.

It’s the guy who brought in his cetacean mother with low back pain, who dressed for the holidays in a red knit hat, red Dale Junior #8 Budweiser shirt, green sweat pants, and red hospital socks that have little white treads on the bottom to prevent slips and falls.

It’s the lady who decided to de-louse herself before she went to church because she thought she had flies in her head that nobody had ever been able to see. She got the shampoo in her eye and now has pain which her Methdone just isn’t helping.

It’s two women who come in by ambulance within an hour of each other, both short of breath, both in heart failure because they’ve been stuffing themselves with turkey and ham and handfuls of salt, and you just smile at them and wish them a Merry Christmas, because this is the one day the dietary rules don’t apply.

It’s not being able to stop at Dunkin Donuts on your way to or from work for a Vanilla Chai tea because it’s closed. (You see a lot of forlorn police officers on Christmas as well).

It getting doubly upset at the person who comes to the hospital at 4 AM because they don’t need to be there, they’re abusing the system, they’re trying to take advantage of the holiday spirit by requesting I give them the gift of pain pills, and they’re interrupting my viewing of the White Christmas marathon on AMC. (Okay, I know I was born forty years too late, but I must have Vera-Ellen.)

It’s the patient EMS brings in a 6:45 AM, fifteen minutes before it’s time to go home, who is pulling an extremely loud Reverse Santa (“OH! OH! OH!”)

It’s the nurse telling the doctor who’s been watching the Santa Tracker all night that Santa might not be real, and watching his face fall. It’s watching the Charge Nurse tell her to never say that again.

It’s going home and jumping into bed.

It’s moving on to the next day which, in the end, is the best holiday gift of all.

Merry Christmas, everyone. Best wishes to you and yours for the New Year.