< Back to front page Text size – +
Posted by Ishani Ganguli December 27, 2012 07:00 AM
The hospital can be a strange place over the holidays. This year, it was work as usual, save the nurses' station festooned with tree lights, the occasional jolt of festivity from teen-aged Christmas carolers fulfilling their volunteer requirements, the frenzy of activity that came on the Friday before the holiday - arranging for patients to get procedures, speaking with consulting specialists, making follow-up appointments - and the unsettling quiet that dropped during it.
I spent the past two weeks as the supervising resident for a team of five interns on a general medicine unit at Massachusetts General Hospital. One of my jobs was to oversee the admission, care, and discharge of the 20 patients on our team’s service, so I grew sensitive to trends.
We had fewer new patients over the holiday. The ones who came to us were either sicker (with alcohol abuse, depression) because it was Christmas or so sick they didn't care. (Interestingly, the widely held belief that more suicides occur over the holidays isn't borne out by evidence, though there may be higher rates of death from heart attack.) As for patients whose stays extended into Christmas, their reactions gave us new insights into their lives outside the hospital as well as their medical conditions. More than one octogenarian told us it was best that she stay till after the holiday so that she wouldn't trouble her family to come get her in the midst of their celebrations. Others had family piled onto their beds or miniature Christmas trees flashing on their bedside tables. Some, of course, never observe the holiday. For the rest, we worried more about those who were content to be there than those who itched to go home.
In several ways that were predictable but still frustrating, short-staffing during the holiday made patient care more difficult. Procedures and specialists were hard to come by. A few patients waited for rehab beds that couldn't be arranged till after Christmas. When I explained this to one patient's husband, he nodded resignedly: “It's a lost day.” He was a physician himself and he expected this from health care. (Such delays, too, are more anecdotal than evidence-based, and one year-long Swiss study of 500 patients found the same to fewer unneeded hospital days over the Christmas-New Year holiday.)
I left work on Christmas overstuffed on homemade cupcakes, saddened for patients who would spend the evening alone, and eager to start another day of work - truly - as usual.
The author is solely responsible for the content.