Our hospital president posted a poignant holiday message for the staff this week. He talked about the melancholy in Joni Mitchell’s song “River”. He wrote that “the song paints the picture of the season, but it juxtaposes against that backdrop a sense of melancholy that is not usually associated with the end of year festivities… One of the extraordinary blessings of delivering care is that, for a period of time, we are our patients' families. We are their loved ones. We are their company when no one comes to visit. We are their comfort when the outcome of their stay with us is uncertain.”
That post resonated with me. My first job here in the United States was in a long-term facility. The patients were long abandoned by their families; left under a stranger’s care. The nursing staff held their hands and listened to the nostalgic remembrances of their loved ones. I sometimes stayed past my shift just to listen. We became their family. The nurses dried their tears just as we dried our own tears of being away from home. We were their daughters and granddaughters.
The three years I spent in that hospital shaped me to be a better nurse. I emerged to be more compassionate and empathetic to the patients. The pangs of homesickness were better dealt with when amongst the patients who needed our care. I gave my patients an extra dose of care and attention during the holidays. The staff tried to cheer up the patients and to provide distraction when their families forgot to care. I remember holding the hand of one trache-dependent ALS patient as he waited for the visit that never came. He could not verbalize his disappointment but I saw his eyes react sadly whenever the other patients in the 4-bedded room received their own visitors.
In the merriment of the season, hospitals see a lot of patients overcome with depression. Those who are medically sick sometimes spend the holidays with the staff who had to leave their families to take care of their patients. In the emergency department, we continue to get patients who choose to binge drink to fight their loneliness and ended up with Holiday Heart syndrome.
One New Year’s eve several years ago, I stayed with one lonely 70 y/o patient as we watched on tv for the Times Square crystal ball to drop. She was waiting for her family to pick her up. She was teary-eyed, confused at the babble of voices in our crowded ED, unable to understand the language. But she smiled when I brought her food and counted down with her during the ball drop. As I hugged her, I was reminded of my mom, miles away in the Philippines. The patient eased my homesickness as I comforted her. Mrs. Chen bowed to me and said "Xie-xie" (Thank you in Mandarin).
During the holiday season when families spend time together, someone out there is looking for some love and attention. Like the woman from Oklahoma who posted on Craigslist, “Anybody needs a grandma for Christmas? I’ll even bring food and gifts for the kids! I have nobody and it really hurts.” This post went viral and illustrated the stark reality that many of our elderly population are isolated from their families. Actually, not just the elderly; there are many lonely people in the world.
Thank you to all of those who work during the holidays. At a time when all others celebrate the holidays in the comfort of their homes with their loved ones, it is a blessing to bring some kind of comfort and peace to those who need them the most. During the holidays, the ED is not always crowded so there is always a chance to spread some cheer around. A little touch, a little smile, and some time to just listen go a long way to ease a lonely heart.
"River" by Joni Mitchell
"River" by Sarah McLachlan
Holiday Heart Syndrome
In 1978, Philip Ettinger described "Holiday heart syndrome" (HHS) for the first time, as the occurrence, in healthy people without heart disease known to cause arrhythmia, of an acute cardiac rhythm disturbance, most frequently atrial fibrillation, after binge drinking. The name is derived from the fact that episodes were initially observed more frequently after weekends or public holidays.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998158/
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