At every hospital around the nation, there is a dedicated crew of physicians, advanced practice providers, nurses, techs and other hospital staff, who take call, administer medications, cook food, operate and care for those who enter our clinics, hospitals and pharmacies over the holiday season.   These are staff willing to leave their families to help those who can’t be with theirs.

I am one of them.

As I walked the halls this week, it made me reflect – Why do I volunteer to work over the holiday season? 

Just like every year, I harken back to one specific moment and a personal connection that helped make my career possible.

The cancer ward can be a tough place to work over the holidays, and my first as a fellow was December 2006.  I was lucky enough to take care of couple who had traveled over 2000 miles to our center for the wife to get a transplant.  Our team had been consulted to help treat an infection.  When I stopped by a week later to say that she didn’t need to see us anymore (usually a good thing), I was a bit surprised that her husband seemed disappointed.   In fact he made it his mission to keep me, as he said “on the case.”  During morning rounds, he would stop me and in his low rumbling Southern drawl and ask, “Dr. Steeeeve – are coming to see us today?”

So I did.  It became my evening routine to just check in and chat.  Sometimes, depending on the day it was late in the evening, but regardless, they were always gracious hosts. I learned how they met taking a class as “older students”, their passion for their local college basketball team, and how hard it been to move away from friends and family over the holidays.  I also knew the wife was gravely ill.

But what I remember most was a conversation one evening with the husband before Christmas when we talked about crackers. Not crackers the food, but crackers the English holiday tradition, whereby wrapped cardboard tubes are snapped open over the dinner table.  Two people are supposed to pull on the edges till the cracker goes “ bang” or “pop” (like a firecracker) to get a prize hidden inside – usually some small trinket or limerick along with a paper hat or crown.  I had been fortunate enough a few years back to be introduced to this tradition at a friend’s house.  The image of my friend’s grey-haired father snickering in his red paper crown was indelible, and one that brought to mind the true spirit of the holiday season – joy.   I also loved how the dramatic “pop”  brought a touch of vaudeville to the evening.

We talked about sneaking some in to the hospital to enjoy together, but then thought better of it.  Bringing even a small amount of gunpowder (often the cause of the pop) while she was on oxygen was probably not the best idea.  That alone made us all laugh.

When I rotated off, we said our goodbyes – and I never saw them again.  I know she died with her beloved husband by her side.  I never sent a note to the husband, because nothing I could say felt sufficient.  To this day I regret that I didn’t, regardless of how hollow the words might have felt.

In the years since, I have had time to reflect on that moment. As we had bonded over gunpowder, pastel paper crowns, and a mutual appreciation for the unexpected, I discovered a career path both intellectually challenging and incredibly fulfilling.  I learned these wards and these patients were where I wanted to spend my career.

So in effect this is my long overdue condolence letter.   In this version, I would tell him how much I enjoyed their company, how sorry I was for his loss, and how to this day, I am forever grateful for being asked to “stay on the case.”

And although I don’t get to work every Christmas, I always feel lucky when I do.