It was a bleak and relentless Siberian winter in Minnesota. Few who lived through it would ever forget it. My moustache froze every time I walked outside, and my car battery was perpetually in a coma. The hospital was filled with respiratory infections, snow-shoveling back injuries, and little old ladies who “just wanted to see if it was slippery outside.” (It was.)
I was the attending on a resident service. Christmas week was supposed to be a quiet time, but the census was not in concordance with this concept. At least there were no meetings scheduled.
I always enjoyed the holiday week. I grew up in a Jewish home where we gave Christmas presents. But we would have been just as likely to celebrate Kwanzaa or Boxing Day, Saturnalia or Omisoka, even Festivus! We just liked to eat big meals that would make us swear we'd never eat again and give valuable gifts like ugly ties and easily broken toys.
As an adult, I continued this family tradition. I had already made my last-minute run to the dollar store for some low-quality, hideously ugly wrapping paper, my favorite kind. While I was there, I spotted a Santa, lying forlornly on his side. I bought him, shoved him in my sports coat pocket, and forgot about him.
On Christmas Eve morning, the service had a load of patients to see. Only the sickest and the most unplaceable patients filled the hospital and we were trying to discharge at a holiday pace. But nobody was going to a skilled nursing unit for the next few days. As we rounded, we saved Miss Querkie for last. It often took a prolonged, emotionally exhausting effort to extricate ourselves from her room.
Miss Querkie had been in the hospital for over two months. It was her third hospitalization of the year. She lived in a hotel attached to the clinic with visits from health aides. She had several chronic and serious illnesses, with acute flares of each, exacerbated by nonadherence. Complicating matters were her borderline personality disorder and a truly unbridled streak of plain old meanness. She would curse at the nurses and alternately berate and coo at the interns, but she was sweet as pie to the phlebotomists, if they got her on the first stick. Ethics, patient services, and the chaplain were brought in for consults, to no avail.
She reserved her most vitriolic and acerbic outbursts for me. I had been blasphemed, maligned, cursed, and threatened. She had fired me three times, but I was persistent. The team was amazed that I took it with such equanimity. I wanted to show them how to manage a difficult case like this. I explained that I had grown up in Brooklyn, so I was used to bad behavior and I didn't care if anyone liked me. But that was just a humorous façade. The reality was that it was painful and unpleasant to even walk by her room.
That Christmas Eve, we girded our loins and prepared to enter her room. I was wondering what strategy to use (maybe Good Doc/Bad Doc?), when I suddenly noted the bulge in my jacket pocket. A proverbial light bulb went off. I strode into her room and smiled. She grimaced.
“Miss Querkie,” I said. “I know you don't like me, and the reality is I don't like you much either. But you're stuck in the hospital on Christmas, so here's a present for you.” I put the dollar Santa on her bedside table. She looked at it for a moment and began to silently cry.
“Oh, Dr. Newman, nobody has given me a Christmas present in years,” she said. “Thank you. Bless you.”
From that point on she was pure compliance, until discharge. It was a Christmas miracle. Was it humanity calling out to connect, or a Machiavellian manipulation? Perhaps it was a combination of the two. Sometimes all it takes is to remember that the patient's life is made up of more than a hospital stay, and that behavior reflects the summation of a lifetime's experiences.
Every year since then at Christmastime, I go online and buy increasingly larger volumes of smaller holiday finger puppets, mostly red-nosed reindeer, perky penguins, and Dickensian duckies. Plus, of course, some Santas. I fill my pockets to the brim as I wander the hallways, sharing the cute little toys with everyone: staff, patients, families, and students alike. Nobody objects to a finger puppet, and I see many of them adorning desks year-round. It's a very small gesture but has become my personal holiday tradition, along with overeating and buying clothing for my children that they'll never wear (but I just might).
And nothing says Merry Christmas like a little plastic Santa, made in China, given to you by a Jewish doctor.