I love Christmas parties in the same way that my Presbyterian raised son-in-law loves matzah and gefilte fish at Passover. They seem exotic and exciting. I love the lights and the smell of Christmas trees. I also really like that I am not obligated to do any heavy prep or be responsible for everyone’s good time. I just show up, buy a few presents, maybe a bottle of wine, and enjoy. I also enjoy working on Christmas. There is usually great food, as people bring potluck feasts. We have fun in that “comrades in adversity” esprit de corps way that a lot of health professionals secretly adore. We non-Christian docs get to have the undying gratitude of our colleagues as we put in a few hours of useful labour before going out to a Star Wars movie and eating Chinese food.
Forty years ago this Christmas Eve, I was a rotating intern at the old Queen Elizabeth Hospital, a small, excellent and friendly community hospital in Montreal. Christmas Eve, I visited with my friends Joanne and Ian at their newly restored Westmount home. When they bought the place, it was in terrible shape, which was why they could afford it. The house was completely covered in that disgusting 1950’s hospital-green paint. As a teacher, Ian was able to work weekends, evenings and summers to restore the ground floor’s elegant oak paneled interior. Now, after four years of hard work, the downstairs was restored to its Victorian splendor. The house shone. The golden oak paneling, with its elegant Ionic columns, was a fitting backdrop for the fragrant Christmas tree in front of the fireplace. Joanne and Ian were immensely proud to display the fruits of their hard work. Their guests were treated to a buffet dinner with punch in a silver bowl and a very traditional Christmas feast on the table. Best of all, for dessert there was homemade plum pudding and hard sauce, which I had never seen before. Joanne made these puddings in early November and anointed them with brandy weekly. Today they were steamed and then removed from their alcoholic swaddling clothes and served up with this concoction of butter and icing sugar known as hard sauce. It was amazing!
The next morning, I worked the day shift in the Queen E emergency room. When I got there at eight a.m. things were quiet, but by ten a.m. wave upon wave of sick, feverish, aching and miserable people poured through the door. My staff doctor, Steve, retired to the back of the ER, where he cared for the very sick patients: pneumonias, MI’s and other ambulance cases. That left me to deal with the hordes in the front.
The nurses, Joyce, Dodie, and Pat, brought in the patients in groups of seven. We then stuck seven thermometers in their mouths, did seven BP’s, respiratory rates and pulses (this was before pulse oximetry). I would ask a few questions, look into seven throats, and then bring them behind the curtain for a cursory physical. If they were breathing OK, I would say to all seven together: “You probably have the flu. There is nothing we can do for you here. Go home, drink plenty of fluids. Take acetaminophen and Ibuprofen, and have chicken soup. Come back if you are having trouble breathing.” If they looked or sounded terrible, we would send them for a chest x-ray, do some blood tests and send them back to Steve. Then we would wash, change masks and gloves, clean the equipment and repeat. At one point, Brian, the intern on call for internal medicine, came down, looking for Ibuprofen. He was shaking and pale, masked and wrapped in a blanket. Joyce took his temperature, which was 39.5. “Shouldn’t you go home?” I asked him. “I tried,” he replied. “It’s Christmas Day. No one can replace me. My staff is coming in soon, and he said I could go lie down for a bit.”
By noon I was fed up. Seven patients in, seven patients out, all of them with the same thing! More and more patients rolled through the door. By noon they had filled the waiting room and were leaning against the wall in the corridor. One or two were lying on the floor.
The team huddled in the back room eating pizza Steve had bought for us from B&M Restaurant, our usual ER takeout dive. As we inhaled some nourishment, a patient came to the folding door and opened it. “What are you doing back here?” he demanded, his voice raspy, his eyes glazed with fever. “We’re all sick, and all you are doing is eating pizza!” Steve got up and took care of him, finally repeating, “There’s nothing we can do for you here, go home, go to bed, drink plenty of fluids, take Aspirin. Come back if you can’t breathe.”
At four p.m. I was getting exhausted. I went to the bathroom and vomited. I had a secret that I was not ready to reveal to the team: I was about 9 weeks pregnant. Reinforcing myself with some milk and social tea biscuits, I went back out there. I peeked into the corridor at the miserable masses.
I walked into the waiting room, spoke as loudly as possible, and addressed all the people there. “Listen up!” I said, “I am Dr. Feldman. Everyone here with fever, chills, aches and pains, and feeling terrible, you have the flu. There is nothing we can do for you here! Go home, Take Acetaminophen and Ibuprofen. Drink lots of fluids and sleep. Come back, or stay if you are having trouble breathing. Thanks, hope you feel better.”
A few people did get up and leave. One man mumbled “thank you” as he passed me on his way out, but many stayed. I finished the shift. I had seen over a hundred patients in those twelve hours and picked up seven cases of pneumonia, one of whom needed to be admitted to the ICU. As I lay on the couch with my husband rubbing my feet that night, I had a second serving of Christmas pudding. It tasted like the reward I deserved.
The Influenza epidemic of 1980-81 was the worst flu outbreak in Canada since 1918. Thousands died. Yet I find it amazing, looking back, how little protection we had from the infection and how little back-up we actually had as interns. We were just expected to soldier on and do our best.
Now my youngest daughter has just finished her residency, and she is working in the Emergency Room. In an even worse pandemic, she is doing her best: telling people to rest, drink fluids and come back if they can’t breathe. This year for Christmas, I am, again, the designated hitter working the 21, 22, 24th and 25th. However, this time, there will be no Stars Wars movie and no Dim Sum feast, but we will carry on. Perhaps I can find some kind person to make me plum pudding.