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Finally, Those Bittersweet Holidays are Over

Another holiday season has ended. And thank goodness!

Don’t get me wrong. It is not that I don’t like the holidays. I do enjoy parties, spending time with family, drinking eggnog laced with brandy and freshly-ground nutmeg, nesting before the fire with a stack of DVDs. It is enjoyable to see my clinic get decorated by the medical assistants. And the holidays always bring back fond memories from my childhood growing up on the Kansas plains.

This holiday season was particularly special because my wife Myrna and I just learned that grandchild #1 is on the way. After years of hearing about how great grandparenthood is, we will get to enjoy it first-hand. Due date is July 9.

So why as I glad the holidays are over? The end-of-year holidays arer always a bittersweet time. And this past season was more poignant than usual. While I relish the good and sentimental aspects, the holidays also bring to the surface much sadness and despair for many patients.

Being a doctor over the holidays is a difficult job. It usually starts a week or two after Thanksgiving. There is a notable increase in patients coming in carrying heavy burdens. Family conflicts and shortcomings rise to the surface. Adult children won’t come home for the holidays or won’t even return phone calls. Parents demand too much. Patients recount stories of family get-togethers ending in argument and despair. For so many people, the holidays cannot possibly live up to the expectations of warmth, comfort, and good cheer. And this leads to stress, headaches, tiredness, elevated blood pressure, and a need to talk.

The holiday problems are not just psychological. Cancer refuses to take time off even though the holidays are supposed to be a time of joy. Maybe cancer decides to act up because the weather is getting cold and the days are growing dark. Every year, three or four of my patients are either diagnoses with or succumb to cancer between Thanksgiving and New Years, guaranteeing their loved ones not only have a sorrowful holiday, but also insuring the holidays will be marked with mixed emotions for years to come. Trust me, I know this. I still remember the evening of December 18, 1985, when my dad’s doctor called me at 6:15 p.m. and said, “I’m sorry, Richard, I have nothing but bad news for you about your father.”

Sorrow was more widespread this past holiday season because of economic problems. Several of my patients were in the midst of losing their homes in December. And was it just me, or did you too notice that there were an inordinate number of layoffs this holiday season? Quite a few patients asked if I would still refill their chronic meds even though they had lost their insurance. They would take their prescriptions to an outside pharmacy.

Sitting in the exam room with people I have known for years, some for decades, it is impossible not to resonate with their despair. Yet what can I do to help? I certainly can increase their anti-hypertensives to counter their rising blood pressure. But I cannot cure their problems. I am a good listener, and I sometimes feel my ears are the most therapeutic tool in my medical arsenal. Not infrequently, I resort to hugging patients, or utilizing the power of touch, laying my hand on their shoulder, or cupping their hand in mine. In the interests of full disclosure, these efforts yield mixed results since my hands are often ice cold.

Yes, I know there are patients on my panel who are having pleasant holidays. There must be, even though during the month of December I tend to forget this. I keep reminding myself that my patients who are experiencing an archetypal holiday filled with joy and cheer are not coming in to see me. Their doctor’s office is probably the last place they want to hang out during this happy season.

For me, the sweetness of the holidays resides in the fact that I’m blessed with a wonderful family who provide warmth and respite from the professional stresses.

The net result is that my December days are bittersweet, and that is why I am glad they have ended once again. December’s professional stresses and strains are powerful, at times overwhelming. I feel more helpless and inadequate as a physician during that month than any other. Give me a cold, gray, rainy day in February, anytime.

Now that December is over, miraculously July 9 is on the horizon. Even though my new grandchild has not even seen the light of day, I’m already anticipating creating a raft of great holiday memories for this new child of the 21st Century. I hope my grandchild will grow up experiencing the holiday season as a time of year much more sweet than bitter. And, if you’ve stuck with me to the end of this reflection, I wish the same for you and your family.

(January 2010)