This is my column in December’s Emergency Medicine News:
I like to think back on favorite Christmas gifts I have received down the years. I don’t think I can do any better than the children of mine who were born around Christmas. Three of the four came within one month of Christmas day. One came on December 23rd. What wonderful presents!
Going farther back, I recall sitting by the Christmas tree at my childhood home, or the homes of my grandparents. I found toy soldiers, toy horses, Matchbox cars, pocket knives and many other little-boy wonders. I remember the beautiful wooden stock and golden trigger of my first shotgun, and how it pulled me irresistably into a sense of impending manhood to know that my father and mother trusted me enough to give such a gift.
I have been thrilled to give gifts to my wife and children down the years. I smile when I consider stuffed animals, American Girl dolls, Polly Pockets, toy knights, castles, iPods, bicycles, books, a small harp, and a shiny sword. I admit that I love putting their packages under the tree.
I enjoy hearing about the things my loved ones love. It is my delight to know their hearts and to go and find the perfect thing that, when opened, will make their eyes light up and give them delight.
But there are people other than my family, and there are many kinds of gifts. I can’t help but think that if I were giving the perfect gift to my patients, some would love to open a gold-embossed Oxycontin prescription with the “infinity” emblem under “number of refills.” And others would be speechless to dump out their stocking and find their disability paperwork completed. The tears of joy would flow!
Others need things of greater depth. Some would love nothing so much as finding that their chronically-ill children were suddenly well, that their diabetes was magically gone, their recurrent infections healed, their cancer dissolved like snow in the Carolina morning sun.
But what about you? What could I give you, my friends and colleagues? What could I give you, my faithful friends and readers? Well, you know how collections are in this economy, so I can’t afford to send you much. But what if I could? If reminds me of the game Jan and I play: The “Lottery Game.” In our game, we imagine how we would spend our money if we won some ghastly amount of money, like $50 million. We divide it up among family and friends and causes (with a beach-house thrown in for hedonistic self-interest).
So I can, at least, imagine what I would give you for Christmas. First, I would give you permission. I would give you permission to do what you think is right, even if other people in your group, hospital or family disagree. Even if your actions are neither popular nor politically correct.
I would also give you permission to speak the truth. If you cannot do it at work, at least to your spouse, friend or dog. Or into a hole in the earth. It has to come out somewhere. Truth is a rare commodity, and if it trapped in our minds with no outlet, it can become toxic, or can drive us mad as it tries to claw its way out. Modern medicine, private, corporate or academic, has a way of discouraging truth for political and economic ends. But you don’t have to be party to falsehood. You can be your own person. I don’t know what truth you need to tell, but please, go and do it.
I would give you permission to be human. And most importantly, that would mean that whatever mistakes you have made as physicians are not the result of cruelty or incompetence, but of frailty and mortality. I give you permission to shrug off your sense of deity and embrace your incapacity. If you have ever made a mistake, minor or grave, remember that “mistake” does not mean “sin,” no matter what attorneys or administrators say. We all fall down, just as the children in “Ring Around the Rosie.” We all are flawed. Accepting that is like collapsing in a soft bed and sleeping off exhaustion.
I would also give you the capacity for forgiveness. Learn to forgive those who have wronged you: Patients, colleagues, friends and loves. The anger and bitterness we so often carry is too great, and is a distraction from whatever joy we can wring out of life. Likewise, I would give you the desire for confession. Confession, done properly, is like opening an abscess so that disease can flow out. The old country folks call the contents of an abscess “corruption.” How appropriate in terms of confession!
I would give you so many things, if I could! I would give you at least one miraculous medical event per year, so that the person you knew would die came back a week later to say: ‘Thanks, I feel much better!” And one miraculous non-medical one: A wayward child brought home, a shattered marriage made whole, a broken relationship welded together in tears.
I would give you the ability to select 10 shifts per year when your department was like a ghost town, so that on those rare occasions when you did not sleep, or could not sleep, or were overwrought with life, you could sit in a well-lit department and sip coffee with your eyes staring off in reverie, without wondering what horror was coming through the door next.
And finally, I would give you — once each day — a patient or co-worker in whom you could see your purpose, your necessity, your importance as clear as the winter dawn, as clear as the star above the manger. Someone who needed you, someone you saved, someone you eased out of this life, someone you comforted or touched. I would send you a person who showed you that success is not measured only in terms of procedures or diagnoses, billing or volume, but in compassion. I would give you — every day — someone you reassured who said (if only with their eyes): “Thank you for being there.”
Merry Christmas! I pray that all these gifts come to you this year and every year. Thank you for being my family. May you find beautiful gifts beneath the tree and beautiful loved ones at your side.
*This blog post was originally published at edwinleap.com*