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Life in Emergistan

Pain and Suffering, Wonder and Meaning

Leap, Edwin, MD

doi: 10.1097/01.EEM.0000550375.05320.93
Life in Emergistan

Dr. Leap practices emergency medicine in rural South Carolina, is a member of the board of directors for the South Carolina College of Emergency Physicians and an op-ed columnist for the Greenville News. He is also the author of four books, Life in Emergistan, available at www.nursingcenter.com, and Working Knights, Cats Don't Hike, and The Practice Test, all available at www.booklocker.com, and of a blog, http://edwinleap.com/. Follow him on Twitter @edwinleap, and read his past columns at http://bit.ly/EMN-Emergistan.

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My love of Christmas as a child was a blend of nascent Christian faith mixed with the remnants of ancestral pagan magic topped with natural, kid-like avarice. It's a time I look forward to with a thrill even as an adult.

There were times in school and residency that Christmas had a little less of a hold on me, but I was back in its throes once our children were born. The music, the decorations, the gifts! One of my love languages is gift-giving, and I do it with fervor and a little obsessive neuroticism, as my parents did.

I'm still struggling with the fact that my children are all adults or nearly so, and probably don't want toys anymore. The feeling is so primal, so deep, that I am filled with grief when I drive past the shuttered Toys-R-Us.

Still, Christmas shopping is a delight. I enjoy it the way I enjoy all of my time in public. I realized a long time ago that I find solace walking through retail stores and malls, down city streets, and even among the cluttered chaos of antique shops. I find a kind of anonymity and calm there. It is unusual for anyone to run into those places, intentionally, with chest pain or bleeding wounds, suicidal thoughts, sepsis, or pneumonia. They are like peaceful nature preserves where humankind is the species to study.

It's even better at Christmas because humans are a species driven then. Like migratory animals crossing rivers, we go to shopping centers en masse, unable to resist the retail drive. There is an energy at Christmas that makes people-watching even more delightful. It is easier than ever to shed my medical personality in the crowds and simply be one of the thousands shopping, eating, walking, and watching. Christmas does not ask that I be a physician or in charge. It simply allows me to revel in being one in the crowd.

Christmas is also a time for family. Jan and I have always been purposeful in our celebrations. We have a routine, a pattern to our holiday behavior that is well worn. The pizza on Christmas Eve, reading assorted Christmas books when the kids were small, and reading the Christmas story to this day. The last presents wrapped, the cinnamon rolls and bacon on the big morning as we give one another gifts. It is almost instinctual by now; it may be difficult for my children to deviate from this with their kids, even as they add new traditions of their own.

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All Will Be Well

One of the most important things that Christmas does for the physician-me, now working for 28 years, is that it imbues me with hope. I really need Christmas. I need the story of the Christ-child. It reminds me to love the poor and broken (and the wealthy and misguided). It teaches me that wonder and meaning come in ways we never expect and that we often overlook to the detriment of our own spirits.

The story of the Christ-child, whether or not you take it literally, resonates deeply with many. And to make it culturally relevant, it is extremely important to many of our patients every day.

Even if it is a myth, it is an earth-shattering, civilization-shaking myth. And before we dismiss mythology, we must remember that we speak and think largely in story and metaphor. For all its modern, tawdry commercialism, the Christmas story truly understood shakes many of us to the core.

Christmas with its complex cast of players and breathtaking poetry stands in contrast to the chaos of the ED, to the pain and loss of teaching hospitals and missionary clinics, intensive care units and combat hospitals, rural EDs and urban trauma centers. The quiet of a starlit, desert night, the crying of a single child, the silent, awestruck shepherds, and singing angels may seem out of place against our beeping monitors and screaming ambulances, our raging psychotics and weeping parents, our angry consultants and our exhausted colleagues, against pain and death, loss and anger.

I believe, however, that it stands in contrast not because the world then was kinder (it wasn't), but because the message of Christmas is that God is love and suffers with us. There is hope. Someday all will be well.

Believe what you must, but believe something. Science alone, dear ones, is not sufficient to answer the questions that nag us in the trauma bay or in the dark of night when we look back on a day's troubles or when we face our own resuscitations.

I believe in a child in a manger and all his story meant. Maybe I'm mad. Maybe I'm a fool. I'm certainly weak and ignorant. But, boy, do I need Christmas after all these years immersed in this mess of medicine and humanity.

Merry Christmas!

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