The alarm’s deafening, staccato siren cuts into the thick cloud of sleep and jolts me out of the soft warmth of my sheets. It is 4 am and time to get up for work. The ache in my lower back from wrapping presents and transferring them from their hiding place to under the tree is a reminder that today is Christmas Day. I fumble in the pitch black to find my bearings and ready myself. 

Once I am dressed, packed to go, with my coffee mug security blanket in hand, I feel the sleep that once clung on my eyelids slink away.

I sit in the dark, blanketed by silence. The glow of the Christmas tree reminding me that on the other side of this work day is magic with my family. 

Working holidays is a non-negotiable in my profession, as in many professions. We take our turns, and we are exponentially grateful for the holidays we are off when our colleagues share the load to allow us time with our families. On holidays I am on, I remind myself that it is not the time of day or date that will make the Christmas magic come alive for my family, but the togetherness and traditions we foster, whether in the earliest parts of Christmas morning, or when my work day has ended. 

Once I am in my car, coffee thermos still close by, music turned up, I have fully transitioned to the mental calm I need for the day ahead. With the unpredictability of each day in the Emergency Department, all I know to do is to set a consistent, steady mindset and be prepared for anything.

Christmas Day is no exception. Just like work days do not stop for holidays, neither do illnesses, traumas, and all things unexpected. 

My day starts with a toxic Tylenol overdose closely followed by a patient with COVID-19 struggling to breath. As we work quickly to reverse the damage she has done to her liver with the massive amount of Tylenol she took and simultaneously try to stabilize his breathing three rooms down, I am summoned to the ICU where another COVID-19 patient, who has been on life support for 4 weeks, has suddenly collapsed a lung and is downward spiraling. The family has been called to say their goodbyes. 

The ICU team has been working to expand her lungs with a chest tube. They have called down to the ER looking for backup. I focus on the task at hand, quiet the busy around me, and methodically place a chest tube. Her lung re-expands. Her oxygen levels rise. She lives through Christmas Day.

How much difference I made in her long-term prognosis is yet to be determined, but I am forever grateful that my training and experience let my hands move reflexively and quickly in that moment. She was sedated on life support and may never know I was there that day, and her family may never know I was there either, but I am hopeful this has allowed the magic to stay alive on Christmas day for those that love her. She is a mother, a wife, a daughter. They may never know me, but I will remember her, this day, and have thought about her often since Christmas. 

Death around the holidays has always been a heaviness that we carry with us in the ER. A time of togetherness shattered by loss. The heartbreak magnified by feeling isolated in your feelings of devastating grief when the world around you appears to be swept away in festivities and joy. It is not lost on us in the Emergency Department. We are fighting alongside you to keep the holiday magic alive.

I open the door when I arrive home and I hear my kids’ footsteps pounding down the hall to me, their loud excited voices echoing in a capella. My son yells, “STOP! Don’t touch Mom!” They know the drill. Before they can hug me, I will rid myself of the day’s worth of germs. My seven-year-old halts in her tracks, and trails closely behind me, brimming with anticipation and giddiness, trying to practice patience in her every electric, bounce.

“How was work?” my son asks, as he always does. 

“I saved a mom’s life, so it was really good.” I respond. 

“Is that why you HAD to go to work today?” my seven-year-old asks.

“Yes. That is exactly why.” I tell her. 

I can see now that the magic did not begin at the end of my work day, but started the moment I woke up on Christmas Day. I can walk through my day and be thankful for every minute I was gifted. As our family Christmas morning traditions officially started that day at 4 pm, the day’s events filled me with gratitude for family, for love, and for the lives that would make it through the magic of Christmas day.