The Holiday Shift

December 24, 2017
by Mark David Siegel

Hi everyone,

For the first time in years, I’ve pulled the holiday shift.  Saturday started slowly as I chiseled ice off the Nissan before driving through the gloom to the hospital.  I’m rounding this weekend without a fellow, so it’s back to my roots, just me and the patients on the consult service.

I spent yesterday percussing and listening to patients who also pulled the holiday shift.  A woman with asthma was lucky; she was going home.*  A man on the same floor had to stay until his house is cleaned.  He can’t leave until the dust is gone. 

I saw a man about my age, a mechanic who’s smoked for decades.  His twang reveals he’s not from Connecticut.  He moved from Wisconsin about the same year I arrived for fellowship.  He’s been coughing for a month and an x-ray shows a mass.  He rubs his eyes.  He needs to stay strong for his family.  He’ll have a bronchoscopy after the holiday. 

I evaluated a woman with pleuritis who can’t take a deep breath.  She works with children, and we love the same restaurant in Stratford.  She lists her favorite dishes while her back is prepped for thoracentesis.

I visited an old friend, Mr. R, who hasn’t been home for months.  He’s been my clinic patient since I was in a fellow. He’s in his 80s now.  He has severe emphysema and recently developed heart failure.  He looks better than expected, with a crisp crewcut, sitting beside his bed, finishing lunch. 

I worry when my patients are hospitalized.  They get excellent care, but I fear their stories will be erased.  I’m asked repeatedly if we’ve ever discussed code status.  I answer, “Yes, many times.”  I call Mr. R by his first name and he calls me “doc.”  I join his resident and intern in the charting room.  His nurse enters, worried that Mr. R is lonely.  How often does his family see him?  “Often,” I say.  The nurse asks if Mr. R can have rice pudding.  The residents like this idea.  The nurse will go shopping after her shift so she can bring Mr. R a treat the next day.

We consultants spend our days moving up and down the stairs, in and out of patients’ rooms, in and out of charting rooms.  We’ll share this weekend with everyone who’s pulled the holiday shift.  Nurses and nurses’ aides, therapists, pharmacists, cafeteria workers, business associates, car parkers, the men who wax the floor, chaplains, PAs, APRNs, residents, fellows, and attendings.  We’ll do our best to care for patients who’ve pulled the holiday shift as well. 

If today is quiet, I’ll make it home for dinner with Heide, the girls, and my in-laws.  I hope to raise a glass to honor my dedicated friends and colleagues who will join me this weekend to comfort and heal, all together, on the holiday shift. 

Happy Holidays, everyone,

Mark

*These stories are fictionalized to protect patient privacy. 

Submitted by Mark David Siegel on December 24, 2017