Christmas: Sitting in the ICU, Hoping for Peace on Earth

Sitting in the ICU, one week before Christmas, a word came to me: POIGNANT. The word is defined as “evoking strong emotions,” with some sources more specifically defining it as “evoking strong emotions of sadness.”

It was the former, broader definition that came to mind as I surveyed the twelve rooms in the unit. The patient I was seeing had had an airway reconstruction for sleep apnea. She was struggling to eat because of the changes in her throat, but she was improving and would be home well before Christmas.

In the next bed, a young woman sat, crying inconsolably, slumped over the railing of a bed in which her grandmother lay, intubated and ventilated, with little hope for recovery in sight.

Two rooms over, a man in his seventies was being emergently intubated as his pneumonia had weakened him to the point at which he could no longer breathe on his own. His condition was precarious, and whether he would stabilize and improve, or continue to deteriorate, was not clear.

In the next two beds, two patients at the brink of death, one from an abdominal infection resolved with surgery, the other from a cardiac arrest that she survived thanks to expedition care by EMTs and, subsequently, by the cardiac catheterization lab.

So many emotions.

Poignant.

In some way, these feelings heightened by the fact that this is the holiday season.

The Intensity of the Christmas Season

I find myself contemplating the intensity of the season. The fervor to get the right gift, to dare to face the gauntlet of the shopping malls. The planning of the perfect holiday dinner. The review of the Christmas card list – should I send this person a card, did they send us one, which card should I send, which family picture should we choose.

And here I am, realizing these considerations pale in comparison to the emotions faced by the people and their families in this ICU.

I love Christmas and the holidays. I anticipate Christmas now, at age 52, the way I did when I was a child. I always have this incredible sense of hope. There is a feeling of closeness with others, a desire to give, and a need to lift others up. I don’t mind the hustle and bustle of the shopping centers – they give me a sense of engagement. Personally, I celebrate the religious aspects of the holiday with great enthusiasm, and it may be that my spiritual excitement at this time of year tempers the commercial stress we often feel put upon us.

But, I have learned in my medical career that illness knows no holiday, and life does not necessarily follow a calendar of emotions that we would deem appropriate for the seasons.

Holidays May Not Be Merry for Everyone

At church this past weekend, the bishop relayed a message to be cognizant that Christmas and the holidays may not be merry for everyone. We must recognize that the holidays are difficult for many people, and we need to be supportive of others, particularly those for whom this time of year is a struggle.

That advice reminded me of my own thoughts as I sat in the ICU thinking that, for some people, this Christmas would be a miracle Christmas. Their loved one would survive a life-threatening illness. Each subsequent year, Christmas would serve as an anniversary of that medical miracle.

For others, Christmas would mark the time of year that a loved one died. Each subsequent year, Christmas would serve as an anniversary of the death of a loved one. I thought about losses people suffered this year, and how this would be the first Christmas without a loved one, a friend, or a family member. I also thought about people I know who have returned from military duty in another country, and are now home for the holidays for the first time in years.

So many emotions.

Poignant.

I’m struck by my own losses around the holidays. I had a favorite uncle who passed away two days before Christmas. We used to fish together, tell jokes, and spend holidays together. Christmas reminds me of summers fishing at Plum Island in Newbury, MA. My dog, who passed away on Christmas Eve my first year in college. As an only child, he was my brother since I was eight, and the loss was devastating. A close high school friend who died that same year, our first year in college, when his car drove into a river during the holiday week between Christmas and New Year’s. These emotions led me to immediately relate to the following post I have seen many times of Facebook in the last few days:

“Just some thoughts as we enter the Christmas season. It is important to remember that not everyone is looking forward to Christmas. Some people are not surrounded by large wonderful families. Some of us are having problems during Christmas and may be overcome with great sadness when we remember the loved ones who are not with us. For many it is their first Christmas without a particular loved one and many others lost loved ones at this time. And, many people have no one to spend these times with and are overcome with loneliness. We all need caring, loving thoughts right now.”

My Family’s Christmas, Now and Then

So many emotions.

Poignant.

In my own family, there are people who we no longer see, not only at Christmas, but year round. Family arguments, estrangement, hurt feelings, and insurmountable and irrevocable differences have gotten in the way. This year is a bit difficult for my immediate family because of some mental health issues. The Christmas cards have not been sent, gift-giving has been left for the last minute and simplified, and hope is being threatened by hopelessness.

I have the awareness to look beyond those emotions to a larger scope. Our recent election has shown vast rifts in cultures in our country. I have heard people anticipating with terrible anxiety the political battles that may ensue at Christmas dinner, casting a pall on their Christmas celebration. I see the homeless on the street corners, braving the cold, struggling to survive. For them, the positivity of the holiday season is lost in the instinct to make it through each day. I listen to the BBC World Report and get my daily share of reports from Aleppo and the atrocities that have been alleged on both sides of the conflicts. I hear about acts of terrorism throughout the world and the failure of mankind to treat each other with respect and dignity. World peace, the peace on earth we associate with Christmas, seems so distant in these reports.

So many emotions.

Poignant.

In spite of all the sadness that I consider, I still feel this amazing sense of hope at this time of year. I await Christmas Day with the same excitement I had when I was a child. In fact, when I was a kid, I would look up at the night sky on Christmas Eve, trying to spot Santa. As an adult, I still find myself glancing upwards on that night, perhaps looking for a sign of peace, a sign of hope.

There is a sense of nostalgia we get at this time of year, and my belief has been that nostalgia may be in some way our own recognition of a certain amount of depression we have that things are always changing. Nostalgia – a sentimental yearning for the happiness of a former place or time. How often do we feel that the Christmas of past days cannot be recreated? That we have lost the happiness that we had in past years?

Yet I still feel hope. We make new memories. We establish new traditions. We can look upon past Christmases and instead of feeling sadness, we can recall those times with fondness.

I’ll admit, I truly enjoy Christmas Day, but the day that gets to me is the day after Christmas. I feel a sense of deflation. As a kid, Christmas went on for days. The day after Christmas was a day to see relatives we had not seen on Christmas Day. There were additional gifts to give and receive, more dinners and desserts, and more Christmas lights to see. Now, many of those relatives are gone or live far away, and my large Italian family has dwindled to my immediate family.

I have worked out new traditions, sometimes simply spending time alone recalling fond memories, and at other times, occupying my thoughts with a day of watching English soccer Boxing Day games. I also focus on making those donations and gifts that I may have not done earlier in the year, a means for me to keep my focus on the wonderful spirit of giving I love at this time of year. Hope and happiness allow me to put the nostalgia in its rightful place and allow me to enjoy what I have here in the present.

The Christmas Truce of 1914

So many emotions.

Poignant.

I am reminded of the WWI Christmas Truce of 1914, when enemies on the Western Front laid down their arms and celebrated Christmas with each other. Thereafter, they resumed the fighting in the war that would hopefully end all wars. Of course, it didn’t. I marvel at the spirit of giving we have at this time of year, yet also despair at the fact that we too often pick our arms again, returning to our own lives without necessarily continuing the spirit of giving and compassion year-round.

This year, two members of one of my favorite bands – Emerson, Lake, and Palmer – passed away. Greg Lake recorded a song, I Believe in Father Christmas, a staple of my Christmas listening, that pairs a tremendous musical orchestration with lyrics that are, well, poignant:

“They said there’ll be snow at Christmas / They said there’ll be peace on earth / But instead it just kept on raining / A veil of tears for the virgin birth.” 

The song, released in 1975, was described by its lyricist Peter Sinfield as “a picture-postcard Christmas, with morbid edges.” And here we are, in 2016, still searching for peace on earth, still cautiously hopeful.

So many emotions.

Poignant.

There are moments of great happiness at this time of year for some, moments of sadness for others. We must be supportive of each other. Christmas and the holidays bring us an awareness of each other’s passions and plights, successes and failures, triumphs and tribulations. This support and awareness are heightened at this time of year, but should not be reserved for this time of year only.

Lake’s song includes the line, “And I believed in Father Christmas / And I looked to the sky with excited eyes.”

Perhaps I am just being nostalgic, but I remain hopeful and happy about Christmas. You might see me on Christmas Eve. I‘ll be the one glancing at the sky, maybe not to see Santa, but to see a chance for peace on earth.

 

Merry Christmas and Happy Holidays!

Arthur M. Lauretano, MD, MS, FACS

12/17/16

 

My book, Do the Right Thing: A Surgeon’s Approach To Life is now available on Amazon! Read an excerpt here. 

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photo courtesy of Unsplash