Reflections on Holiday Melancholy and an Unexpected Guest

Reflections on Holiday Melancholy and an Unexpected Guest

Linda R. Duska, MD, MPH

Jan 08, 2020

The December holidays are always a hard time for my patients, and as a result, for me and my health care team. Ask any oncologist and they will tell you this: an unusually high proportion of our patients get sicker, and sometimes die, over the holidays. I’ve been doing this job for over 20 years and I know this is true (no, I don’t have actual numbers or p values—I just know).

I always work over the holidays; the hospital and the operating room are quiet, the parking lot is empty, and the staff are (generally) in a good mood. This year was no exception, as I worked the weeks of both Christmas and New Year. I saw a lot of patients, I operated two times more than usual, and I gave a lot of bad news to my patients. Someone’s cancer had progressed, someone else needed to transition to hospice. A patient who was planning a surgery had to hear that surgery was no longer an option due to identification of lymph node metastases. Another patient, gasping for air, received the news that she had bilateral pleural effusions and a pulmonary embolism, and was almost certainly not going to see her son be married in the spring.

So much pain over the holiday season: physical pain of course, but also psychic and spiritual pain. And in sharing this pain with my patients and their families (because that is, for me, the best and only way to give bad news compassionately) I gave away a little piece of myself, each time.

It’s hard to feel so depleted, especially over the holidays when there is so much pressure to be festive and merry. My husband and children love celebrating Christmas and they all had the week off from work and school. For a few days, when they were visiting my in-laws, I came home from work and went straight to bed in the quiet dark house. When they got home, I couldn’t share in their joy, and worse, I found them noisy and annoying. I was honestly emotionally exhausted and my family just made me more exhausted. They try hard to understand but I think sometimes it might be too hard.

And all of this somehow resulted in me bringing a new dog into the house.

I know. This is bad. It is actually worse than it sounds. The dog belongs to one of my patients, a woman I’ve taken care of for over 10 years. She had to be admitted to the hospital over the holidays and was so completely stressed about the dog and his care that I offered to take him. I was at work at the time, so I sent my husband and daughter over to her house to meet with her husband and bring the dog to our house, which they did. I hoped it would set my patient’s mind at ease, which it did.

Except now I have this dog.

He’s a nice dog. He likes me, he likes our house, he likes my other dogs. But I don’t want another dog. And I wonder, did I cross a line? Did I overstep a boundary with this patient that I shouldn’t have crossed? She doesn’t want the dog back, so what will I do with him? 

I voiced these questions to my husband, who reminded me of a quote we used to love from Susan B. Anthony: “Sooner or later we all discover that the important moments in life are not the advertised ones, not the birthdays, the graduations, the weddings, not the great goals achieved. The real milestones are less prepossessing. They come to the door of memory unannounced, stray dogs that amble in, sniff around a bit and simply never leave. Our lives are measured by these.”

The holidays are over now, the days are getting longer, and life and work will go back to their normal rhythms. I will somehow replete myself emotionally and spiritually, maybe with this dog (and maybe not). I will do this by trying to always remember that it is okay if we struggle to muster up the requisite cheer on special occasions, because the real milestones in life are unannounced, likely recognized long after they happen, and hopefully celebrated.

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