In honor of Grand Rounds (best of health blogosphere) theme over at GlassHospital, I felt motivated to write about celebration especially as we mark the first holiday of the new academic year. However, when I sat down to think about celebration, I realized it is important to recognize how healthcare workers, including residents, celebrate holidays. While many of us spent this past week at fireworks, festivals (Taste of Chicago anyone?), barbecues or even bar mitzvahs (where I happened to be), many healthcare workers spent their holiday caring for patients.
For those residents and students (especially on those July subinternships) who are taking call for the first time on the holiday, it’s a great reminder that a life in medicine at times requires sacrificing personal pleasure. With this in mind, I flashed up a picture of fireworks at this years orientation for our subinterns, knowing that many of them may not see them this year. This sacrifice continues even for attendings. For example, a colleague recently confided that they were slated to work on three different holiday weekends, but chose not to complain since everyone has their turn. I remember my turn – as a resident, I worked every July 4th weekend either as a new intern or training the new interns. As a first year hospitalist attending, I worked on the most undesired months: July (enough said), December (holidays), and March (Spring Break).
Although healthcare workers sometimes miss celebrating with their family or friends, it does not mean that they don’t celebrate on the wards. Celebrating on call comes with its own set of amusing traditions that keep healthcare workers and their patients in the holiday spirit.
- Festive feasts – This is by far the best part of being on call over the holidays. When I was a resident, Thanksgiving meant holiday dinner sponsored by the program from eveyone’s favorite Indian restaurant. If that wasn’t enough, one can always go from nursing station to nursing station looking for the most exciting confections leftover from the potluck lunch. In my experience, the ICU nurses seem to have or know where the best treats are.
- Holiday trinkets – Over the past few years, I have started to realize the value of providing small holiday gifts to my teams that are on-call over the holiday. This past year, when my team started on-call on New Year’s Day, I brought them candy cane pens (always can get these at a discount after Christmas). By far, the biggest hit in this category was the Christmas socks I gave my team when I was a first year attending. The team became the envy of the hospital and the bright spot for our patients due to their excitement over their matching socks.
- Holiday decorations – There is nothing more festive than sprucing up the dry sterile hospital hallways with some holiday cheer. However, its important that these decorations don’t interfere with patient care. This past Halloween, I was on rounds and started backing into the hallway when a patient transporter came through with a stretcher only to find myself screaming as I thought the ceiling was somehow caving in. Fortunately, it was just a ghoul head hanging from the ceiling that got me. I was okay and the event provided endless amusement for our team. On a side note, while most holiday decorations use positive cheerful images, having skeletons and ghosts hanging on Halloween in a hospital ward may backfire.
- Pray for an easy night– This by far is the most important tradition, especially so holiday staffers can go home and celebrate the next day. Unfortunately, holidays can either bring two different outcomes – the best night on call or the worst night ever. Everyone knows holidays can be slow because patients and their families may choose to delay seeking care until the holiday is over. However, by this same argument, anyone who forgoes their holiday festivities to come to the hospital is usually very sick. Some have even studied this showing worse outcomes for patients admitted during holidays (which could be due to patient factors or hospital staffing). For example, Americans are most likely to die on or after Christmas Day and on New Year’s Day than on any other day of the year. And as USA Today recently reported, the number of hospital emergency department visits associated with underage drinking on July 4th nearly double. In addition, certain conditions are especially prone to present over the holidays:
“Merry Christmas Coronary” and the “Happy New Year Heart Attack” – many reasons are postulated for the higher rates of heart attacks during these holidays including binge eating, drinking, stress, and suboptimal staffing at hospitals
“Holiday Heart” – fast irregular heart rate due to alcohol binge in a person with an otherwise normal heart; also a favorite pimp question on cardiology
“Gout: the Scourge of the Holiday Season” – overindulgence of certain foods especially over the holidays can trigger a gouty attack
“Holiday Blues” – some may feel down during the holidays due to a variety of reasons such as financial stressors or remembering those that have past away
So, as we pass the first holiday of the new academic year, let’s remember to celebrate the healthcare workers who missed seeing fireworks because they were seeing patients.
–Vineet Arora MD