Summary

A doctor reflects on the somber reality of working in a hospital on Christmas Day, contrasting the festive joy with the sobering experience of dealing with life-and-death situations.

Abstract

The article narrates a doctor's experience working on Christmas Day, a time when most people celebrate. Despite the festive season, the doctor faces the harsh reality of patients battling for their lives, which starkly contrasts with the usual merriment. The doctor recounts the silent and deserted streets on the way to work, the philosophical musings prompted by a patient's decline, and the emotional toll of a patient's death amidst global Christmas celebrations. The narrative touches on the resilience and coping mechanisms of healthcare professionals, including the use of humor and the importance of laughter, and the impact of such experiences on their personal lives. The doctor also shares insights into the challenging conversations with patients and families about end-of-life care, the signing of a DNR (Do Not Resuscitate) order, and the unpredictable nature of medicine. The article concludes with a stoic perspective on embracing life's fragility and the importance of cherishing every moment.

Opinions

The author acknowledges the stark contrast between the celebratory nature of Christmas and the sobering reality of life in a hospital.
Healthcare workers, despite personal sacrifice, maintain a sense of duty and continue to provide care even on holidays.
The experience of dealing with life-and-death situations on a day of global celebration intensifies the emotional impact on medical staff.
The author suggests that laughter and maintaining a sense of humor are essential coping mechanisms for healthcare professionals.
The signing of a DNR is presented as a complex and emotionally charged decision that involves careful consideration and sensitive communication.
The author reflects on the philosophical aspects of medicine, drawing parallels with ancient stoic philosophers who found wisdom in hardship.
There is an underlying hope that families affected by loss can find a way to celebrate the life of their loved ones rather than dwelling on their death.
The article emphasizes the fragility of life and encourages readers to live fully, echoing the stoic philosophy of making the most of life's challenges.
The author promotes their weekly newsletter, emphasizing the value of time and the importance of seeking extreme value in life.

While The World Celebrated The Birth of Christ, Others Held Their Tears In Sadness

Life and death moments during Christmas Day

I have never snoozed my alarm as much as I did on that day.

Plus, a slight drizzle that morning turned me into a philosopher. Sweet morning-snoozed sleep has that effect. For a few minutes, it turns you into a philosopher.

Is it really a must?

Should I really go?

One more snooze won’t hurt?

Uhh! What’s the point of it all?

The drizzle didn’t make it any easier.

Despite these questions, most of us wake up and prepare for work.

I did the same on the 25th of December, Christmas day because hospitals don’t recognize holidays. They also don’t care about your morning philosophical questions.

This was the second year since I started working as a doctor that I’d have spent my Christmas day in the hospital. I know some of the senior doctors reading this would be like:

Does he even know? It will get worse.

Yes, I know.

The first festive holiday where I barely celebrated was in 2021, as an intern. It was the maternity unit, and many mothers wanted to have children born on the same day as Jesus. For obvious and other-worldly reasons.

So no Christmas for me.

I didn’t know what I signed up for when I enrolled for that course. Bachelor of Medicine and Bachelor of Surgery AKA the no-holidays-for-you degree course.

On such days, we laugh because it’s the only way to survive. Laughter. Our daily dose of medicine. We then brave the cold mornings and lower our laughter thresholds, because life can dissect you, like a surgeon, and wounds can fester without a repeated, recycled, and re-used daily dose of laughter.

Most men end up taking the first part of the degree seriously. That is, they remain bachelors for most of their lives. I hear it could be worse for ladies.

While we’re on this topic, I hope you sent that doctor friend a gift to appreciate how often they give you free consultation advice. It goes a long way.

Anyway, on this particular Christmas, I never got any such gift, but I had a different experience.

We’re so used to Christmas being a celebratory moment

Christmas outfits.

Christmas trees.

Christmas carols.

Those were the highlights of the December holidays when we were young. I don’t know if the same fever strikes kids nowadays.

For some of us in healthcare, outfits are the last of our concerns when headed to work. Fashion is unfashionable when your patients are gasping for life.

This morning was unfashionably silent.

Too silent.

The usual route I used was abandoned. The wet road further dampened the mood. Only one motorbike was waiting by the stage.

The guy I’d buy sweets from, to boost my energy levels during the day had not set up his shop.

The newest guy on the block, who sells groundnuts wasn’t standing at his usual spot.

I was practically the only one on these streets, while everybody was in the sheets. I was expecting a calm day.

Relatively, it was a calm day. And calm moments can make you think. On this day, I had a lot to think about.

In the event of a patient's demise, the moods can change. At such moments, you wear your amateur philosopher hat. Even better is if you have someone to bump your ideas to.

Tried so hard to get this far

When you have a patient who is making slow progress despite attempts at controlling her systematic infection, outcomes tend to narrow.

The commonest is death.

The other is complete recovery.

The most tiresome one is an oscillation between positive progress and downward spirals, or cycles of progress and stagnation.

We had such a patient in the unit — talking to the nurses and myself. Through the same patient, I learnt of a new heart condition, and how to detect it from a consultant who has always been like a mentor to me.

He must have been the only other person driving — not walking, like me — these streets, making sure the patient got the best care.

But a DNR form was already signed. A DNR is a do-not-resuscitate document. Before anyone signs such a paper, much has to be discussed.

These are the toughest conversations I’ve had to give in the past year. I like laying the facts gently. But life and death moments are still rough, despite these well-meaning, gentle-intended conversations. It helps to clarify the management goals for the patient before any emergency eventualities.

This time around, on the 25th, we had such a case.

We had tried to attain stability but teetered at its edge.

We had come so far. We were hopeful. Then the nurse alerted me about the instantaneous deep in the blood pressure.

Performing CPR would have worsened the condition. Already with low clotting factors, any form of trauma would have increased the bleeding internally. Having already received supplementation for the same products, but with little improvement, extra chest trauma would have eventually led to the single outcome you were already thinking about.

Death.

No amount of preparation gets you ready for it. Conditions worsen. Conversations happen. Still, death sticks its bloodthirsty claws.

Then there’s the hope of nurturing a positive outcome only to have it ripped from you. That’s painful.

Add to that the fact that it’s all happening when the world is celebrating Christmas Day.

One of the nurses pointed out to me the ripple effect of such a demise. The immediate relations have to remember every Christmas day as the day they lost someone dear to them.

Christmas will no longer be festive.

I felt that.

Our world tends to think philosophers burn the midnight oil scouring page after page of durst-ridden tomes.

Ancient philosophers, however, developed their ideas from everyday experiences. In particular, stoic philosophers learnt to make the most of their hardships.

Marcus Aurelius was a wrestler turned Emperor. Epictetus was a slave. Socrates…well Socrates was just Socrates in the most liberal way to the point of facing death in the way that he did.

My hope for that family was that they flip the situation, stoically. Rather than remembering the death of their loved one, they can celebrate a life, every year, on the 25th.

Celebration of life

The 25th of December is a day of celebration.

Christians celebrate the birth of Jesus. Others celebrate Saint Nicholas. The rest celebrate a day away from work.

For some doctors and nurses, and the staff who have to help this small carder of workers, Christmas is business as usual.

It was also a moment to appreciate life, and how fragile it can be. Jesus escaped the claws of death after King Herod gave a decree to kill all males in Jerusalem below 2 years of age.

Other people died on the same day, within and outside hospitals.

It’s a moment in life when deep thought is often sidelined. But it’s shouldn’t.

For me, it was a reminder of how moments can change in a snap.

Make the most of life, because everybody dies.

But not everybody lives.

PS: I also want you to have the best life. I don’t waste your time with fluff and ads but get straight to the point in my weekly newsletter. It helps edge you towards extreme value with every moment of life you have left. Check it out.