I wanted the Christmas eve night shift to be like one of the Christmas episodes of the long running series ER. That famous series of course is based on County’s ER. I wanted my  ER, the real ER, to be beautifully lit with strings of blinking blue lights and a tree with presents  under it and lot’s of  decorations scattered around. I wanted to see glass block walls that create wavy shadows and light that the show prominently features; there are no glass block walls at the real County. I wanted to hear in my head all the great music the series wove into each episode. I wanted something really important and profound to happen:  Clooney and Hathaway share a passionate kiss and have sex standing up in a closet,  Mark Green doesn’t die in Hawaii, or I get invited to a holiday party at the Drake Hotel by Dr. Carter and his rich family.    

Instead the drab and harshly lit ER was full of homeless men and women. I know a couple of them now and greet them like old friends. Christmas eve doesn’t feel like Christmas eve in the ER because homeless patients aren’t trying to get home to spend the holiday with family or friends. It’s a terrible holiday because it excludes them. Their families have rejected them or vice versa. So there are no presents, no great meal and cocktails, no parties, no “great to see you, how ya been?”   

I decide to give away all the food in the refrigerator that I can. I give some patients two sandwiches a juice and a milk. There are a couple of Styrofoam trays with hot food and I hand them out, too. I brought a box of chocolates and offer patients one.

At one point a bunch of young people come into the ER waiting room with a box of presents. The security guard/police officer announces to everyone waiting that there are presents for their children if they have children. They’ll need to prove it somehow. Several patients get up to claim a present.  

Patients are asking me for clothes, boots, shoes, underwear, hats, scarves, and gloves. It’s freezing out, below zero with the wind chill. We have a few boxes of clothes  up on the 7th floor. I go up to the floor and there isn’t much, a few women’s sweaters and one coat. I grab the coat, it’s from the Gap and in great condition. It’s last year’s must-have Gap blue P-coat. I give it to my patient who basically has no teeth, splotches on his cheeks and a squashed flat nose. He looks great in the coat! I can see how if he was cleaned up a bit, got some teeth, psych meds, and some stability in his life he would be oddly attractive.

I get a call about a patient that has sobered up and needs a shelter. I meet with the man and he still looks and acts intoxicated. He’s been in trauma obs for almost 2 days. He has a bulbous, red nose like Rudolph the Red Nosed Reindeer.  He has great difficulty answering questions, remembering what I say to him. I suspect Wernicke-Korsakoff’s Syndrome. This chronic brain syndrome is a result of thiamin deficiency. It’s most striking feature is a dementia characterized by permanent, short-term memory loss coupled with the telling of “fanciful” tales in an effort to fill in blanks in the memory, confabulation, really. The patient tells me he is going to the firehouse to pick up his medication. I couldn’t suppress a laugh at that one.

I want to help this guy get into treatment so I bring him to the social work office. I call a couple of places but no one will take him because he doesn’t have his seizure medication. He can’t get his prescription until tomorrow but he never takes the medicine because he’s drinking most of the time. The patient doesn’t like to mix prescription drugs and alcohol, that’s both good and bad. So no treatment program. He asks me to call his father to see if he can stay with him tonight. He gives me the number, it’s been disconnected. He says it can’t be disconnected and I try again. It’s disconnected and the patient just sits there in sad, disbelieving silence.

I ride my bike home in the freezing cold. I love the holiday lights that shine and blink along Taylor Street. I get in and make myself a pomegranate martini with fresh mint. The red juice with flecks of green looks festive in the clear martini glass and the vodka tastes clean and smooth.

Call me the grinch, but I hate Christmas.

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