This Christmas, don’t forget to expect miracles

Sound Off is a public forum. Articles are selected from letters to the editor or may be written specifically for this feature. Today, Scott Ekin, an emergency room doctor at Harrison Medical Center in Bremerton points out that Christmas miracles come in all shapes and sizes.

Several Christmases ago, shortly after an anxious night shift departed, eager to get home to their families, an elderly woman arrived in our Emergency Department near death.

When the paramedics transferred her to the ER bed, she was pale, her blood pressure critically low, her breath coming in short gasps.

We were told that she was a “DNR” (Do Not Resuscitate) if her heart should stop beating.

An unuttered groan sort of coursed through our team, reluctantly facing the reality of beginning the holiday with an impending death.

Then her family arrived and told us her story.

Grandma, they said, had been in decline for some time, but had been significantly worse in recent months, and was living in a nursing home about 20 miles and a ferry ride away on the other side of Seattle.

As Christmas neared, she began to lobby to come to Kitsap where her family now lived, to spend the holiday.

Frankly, no one though this was a particularly good idea because of her frailty. But Grandma, as grandmas everywhere often do, eventually prevailed and one of her grandsons went to get her.

In the days before Christmas, she spent her time sitting on the couch, intermittently awake, often confused, more often asleep.

She rarely spoke. She barely ate.

Then, abruptly at 4 a.m. on Christmas morning, there was a change. Grandma awakened and made her way through the house insisting that everyone get up as it was “time for Christmas.”

For the next hour or so everyone, but especially Grandma, laughed and celebrated, opening presents, enjoying each other and generally carrying on.

When the last of the presents was opened, she went to the couch, sat down and closed her eyes.

Within an hour she was in the ER.

Death is a regular and real part of working in an Emergency Department. Her death, however, was clearly among the most remarkable and “best” deaths I’ve ever been privileged to be part of.

Her family was deeply thankful for her last hours and for the manner in which she was able to end this life. They felt as if they had been given an invaluable gift.

So did I.

My mother own has been a nurse for over forty years, spending most of her career caring for severely impaired, institutionalized, developmentally delayed children and adults.

She has spent her share of holidays at work, caring for those to whom, it seems, Christmas might be just another innumerable day among the many.

When I called home before this particular Christmas shift, she said, as she always does, “Look for the miracle, honey. You know there is always a miracle when you work on Christmas.”

I smiled to myself, as I always do, and with a measured and weathered — and slightly cynical — manner that most of us that do what I do for a living eventually develop, received her advice with the unspoken thought, “That’s quaint, Mom, but I wonder what the shift will really be like. I hope someone at least brings some cookies.”

The reality is that what my staff and I do in the ER is difficult. We live our lives with a persistent ground note of dissonance, knowing not only that bad things really do happen to good people, they do so with frequency.

We know that much of the energy we spend during our shifts is spent is in conflict – in fighting against unrelenting diseases. In shoring up a body beaten down by a lifetime of hard use and sometime misuse. In struggling with patients in whom the power of their addictions clouds their ability to see or behave rationally. In supporting and cajoling each other to work together and keep coming back to work when the battle often seems to be lost.

We spend so much of our time task- and data-saturated, frequently interrupted, constantly prioritizing, that the professional demands consume all of the available mental horsepower that we can bring to bear.

Much of our time is spent head-down in the details of trying to run an ER safely and care for an individual patient in front of us that it is almost too much to ask us to attend to the niceties of personal courtesy, or notice and account for the needs and strengths of the colleagues around us .., or notice much of the good stuff that is happening right around us.

By definition what we do makes us slaves to the tyranny of the urgent. Like the anchorman on the 10 o’clock news, the only things that typically rise to the level of our attention are the things that are remarkably bad, not good.

I don’t suspect that this job description is particularly unique to those who work in an ER.

But by working this way we are robbing ourselves of the very energy that makes it worth going to work in the first place.

Our world views begin to sound more like than of Eeyore than of an information-age Marcus Welby.

Should “Dr. House” really be today’s prototype healing hero?

This Christmas, take it from someone who was able to find the miraculous in the turn of a head, or a flicker of a crooked smile.

Look for the miracle. Once you’ve seen it, you might find it easier to see another.

Maybe once a month, or even once a week. They’re out there.

And don’t forget to call your mom.

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