Christmas Eve

Tuesday, December 24, 2013

There is a strong pull to be home for the holidays. 95 million Americans will travel more than 50 miles to connect with family over Christmas and many will gather round the television to watch a college football or pro basketball game. What they may forget is that those who are playing and those who are announcing are just the face of the millions who work when others are celebrating the holidays. For every game, there is a cast of ticket takers, ushers, concession workers, cleaners and parking attendants. Each broadcast has directors and engineers, camera and sound people, working behind the camera to make television happen.

There was some mild public outrage when large box retail stores decided to stay open on Thanksgiving and asked workers to give up their holiday. How could business be so insensitive to the family needs of their employees and yet, shoppers shopped. There has always been a world filled with those who work when others play or sleep. Christmas becomes just another work shift, no different than a Saturday or Tuesday.

This year, my holiday is shared with hundreds of people from nurses and EMTs to housekeepers and central supply technicians, all working their regular day, keeping the hospital open. The ER is like the casinos in Las Vegas, there are no locks on the doors. People don’t get sick only Monday through Friday from 9 to 5. Often illness and injury can’t wait. With millions of people travelling, car wrecks happen and trauma teams need to be activated. Babies will be born and new families are created.

Time in medicine is critical, just like in sports. When the clock runs out, the game is over and the same is true when dealing with many medical conditions. For those with chest pain, an EKG needs to be done within minutes of the patient arriving at the ER door. Should it show a myocardial infarction or heart attack, the goal is to get the patient to the heart cath lab to open a blocked blood vessel within 60 minutes of the patient hitting the door.. In stroke patients, there is only a 3 hour window to give clot busting drugs to restore blood supply to the brain and return body function. The clock starts ticking at the onset of symptoms and includes the time it took for the patient to show up at the hospital door. When the clock hits zero, that opportunity is lost. In trauma, the golden hour of resuscitation suggests that the sooner a victim can be stabilized, the better the outcome. That hour isn’t written in stone, but close enough.

For the hospital to funct8ion, there needs to be more than the cast of the doctors and nurses at the bedside. It’s the people who draw the blood, the lab techs who run the machines and the x-ray tech who takes pictures. There are housekeeper and laundry workers and those who prepare equipment and keep carts stocked. Operating room nurses and anesthesiologists stay ready for the next surgery. There are people on call who leave their family because a patient needs emergent dialysis or a heart catheterization. Social workers and chaplains provide support to families in need. There are many people with critical roles that allow the hospital to meet its mission and I’ve missed naming too many.

The world does not stop for Christmas. When I come home, there will be newspaper at my door, meaning that reporters and editors were up past midnight meeting deadline to write the stories. There are people who print the paper and those who deliver it. The corner gas station will be open and there will be fresh milk and juice that did not magically happen. These are a just few of the invisible workers who touch my life and I am just one of the many whose job it is to be invisible for others.

To those who aren’t seen, Merry Christmas, Feliz Navidad, Joyeaux Noel.

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