Hospitalized on ChristmasThis morning as I rounded on my patients in the hospital, I wished each of them a Merry Christmas. It felt good to say but at the same time slightly odd, not because I worried that somebody wasn’t Christian, but because spending your Christmas sick in the hospital probably isn’t anybody’s idea of a merry Christmas. It’s kind of like when you go to the doctor and he asks you, “how are you?” and you say “fine, thanks,” to be polite, but you both know that if you really were fine you wouldn’t be there in the first place. The exchange somehow only serves to highlight that something is wrong. And so wishing Merry Christmas to my patients, as cheerfully as I tried to do so, in part only seemed to emphasize their misfortune. For no matter how caring your nurses, how thoughtful your physicians, how friendly your roommate, how beautifully decorated the hospital, how frequent your visitors, the ugly truth remains that the hospital ward is a horrible place to spend Christmas.
It’s only the last couple of years when residency has prevented me from returning home to Alaska over Christmas that I’ve realized the importance of spending Christmas at home. My parents have been coming here to celebrate with my brothers and me, but as nice as it’s been to see them, Christmas in Washington just isn’t the same. What’s missing? The boxful after boxful of Christmas decorations that my mom starts putting up after Thanksgiving; the making and decorating of gingerbread cookies with Dad; the mustard-encrusted Swedish Christmas ham that provides daily lunchtime ham and cheese sandwiches; the luxury of being on vacation; the Christmas tree with its entourage of multi-shaped and multi-colored Christmas presents; the straw Swedish Christmas goat with its red necktie; the cozy darkness that sets in shortly after noon and the Christmas lights that softly brighten it; the dozen or so different kinds of Christmas cookies that Mom bakes; the nightly living room concerts with us brothers alternately singing and playing the piano; the glowing white snow coating the entire outdoor landscape; Swedish Christmas dinner on Christmas Eve with broccoli soup, spare ribs, meatballs, potatoes, glogg, whipped rice pudding dessert; American Christmas dinner on Christmas Day with the entire extended family. In short, what’s missing in Christmas in Washington for me is everything that makes Christmas special.
Patients realize this as well. They do their darnedest to stay out of the hospital over the holidays, minimizing symptoms, ignoring pains, waiting out dizzy spells, in vain attempting anything possible to convince their fragile bodies that staying home will be ok. One of the questions we normally ask when admitting patients is what changed in their condition that day that made them seek out medical attention. (Admittedly, sometimes we are curious why, if the pain has been going on for six months, the patient decided to come in just on our particular shift.) During the holidays, though, we instead find ourselves asking, “Why on earth did you wait so long to come in?” The invariable answer: I was hoping I could make it through the holidays. It’s hard to be mad at a patient like that. I mean, you’d think people would realize when they can’t move one side of their body that the problem bears some urgency, but just wanting to spend Christmas at home is a wish that's much too understandable. Those patients, despite their best efforts, will hear Merry Christmas from someone like me. Others, though no more determined, are more lucky. The medicine service at my primary hospital averages roughly sixteen or so admits over every twenty-four hour period during the winter. Over the past three days, we had seventeen admissions total. Pity the resident who gets assigned call on the day after Christmas.
As the hospitalized patients and I have discovered, though, there are worse things still than spending Christmas in the hospital. On the bright side, and despite its reputation for being a cold and foreboding place, the hospital actually turns out to be quite conducive for meaningful human encounters, conversations, and interactions. Telling someone that you love them is easier in the hospital. People are always around, so nobody has to be completely alone. Additionally, there is a deeper sense of camaraderie in the hospital during the holidays, as healthcare workers from the top of the command chain to the bottom feel increased solidarity and commitment to our profession.
For these reasons, my mood was bright this morning as I showed up for work, and I was genuine in wishing each of my patients a Merry Christmas, and in hoping that I wasn’t just rubbing in that they were more or less missing Christmas this year. They smiled and wished me a Merry Christmas in return, the more clever ones maybe feeling reciprocal misgivings in figuring that rounding on sick patients in the hospital wasn’t exactly my preferred way of spending Christmas either. But despite our perhaps mutual concerns, and despite our less than ideal circumstances, on both sides I think we took satisfaction in the greeting. Because when it comes down to it, no matter what your religion, and no matter what your disposition, it’s hard to take a well-wishing negatively, especially when that wish is for a Merry Christmas on Christmas Day.