By Keren Avnery BSN, RN
When you work in a hospital, the holidays can be a strange time. Two years ago, when I worked on a step-down unit at a prominent inner city hospital in Philadelphia, I was at the final junction of many a-holiday-gone-wrong. One Christmas Eve, one of my patients (to whom I will now refer as Edward) arrived on my unit in a distraught heap. Edward was 49 years old and had multiple comorbidities including heart disease and diabetes. He had been on his way home to his family when he suddenly collapsed on the airport floor, chest pain and dizziness overcoming him.
He had been transferred to my unit for close monitoring, though testing did not indicate a cardiac event. The doctors diagnosed him with a panic attack, and he was going to be discharged the next day. However, when the doctors gave him what I thought was the relieving news, he only put his head in his hands and softly cried. He didn’t look the type to do so often. The doctor became uncomfortable and looked to me, so I put my listening and comforting skills into action.
“What’s wrong, Edward? We thought you’d be happy to hear you’ll make it out of here tomorrow. I know you missed Christmas Eve but you should make it out of here for the second half of Christmas Day with your family.”
He slowly calmed down but wouldn’t look at me. He was looking out the window, though it was dark outside and there was nothing to see but his own reflection.
“I promised them,” he said, full of regret. “All year long I’ve been either away on business or working long hours in the office. My kids are beautiful and at best I’ve been watching them grow in snapshots. And I kept telling them, ‘I’ll be home for Christmas, you can count on it,’ like an old cliché. And now what? One more major letdown to add to a year of chronic disappointment.”
He paused a moment. Then let out a long sigh. “My wife is going to kill me! She may even divorce me,” he said softly.
As a nurse, I am responsible for my patient’s holistic wellbeing, which stretches way beyond his physiological health. Nurses are in the trade of easing and eliminating suffering, and there was no question that the man in front of me was suffering, despite the fact that he was physically “healthy” enough to be discharged. The doctor made a comment about how he should be glad it was nothing serious with regard to his heart and left the room, but the comment didn’t seem to register with Edward.
“Hey,” I began to gently stir him out of his sorrow, “it’s not too late.” He sniffled despondently and left his head in his hands.
“I’m no stranger to over-working,” I continued. “Ultimately, you just have to ask yourself, ‘what am I doing and why? What do I really want, what is it that I need, and am I going about things the right way?’” His face looked anguished. He moaned,
“I started this job when my wife got pregnant with our first. It was a great opportunity, and I took it to support the family. A stable life, a financially sound future—things I never had. But now…” he trailed off and looked out the window again, “what’s money worth if I lose them? What’s it worth if I hardly even know my own family?”
“Well,” I began slowly, “It’s wonderful that you are so committed to supporting your family. But it sounds like this job is really wearing you thin. Though a panic attack is not a heart attack, it is still a significant indicator of your health. You are putting your mind and body under a lot of stress.” His crying stopped and he stared off thoughtfully ahead. I watched him, seeing the machinery in his brain slowly clicking things into place. “What if you start to think about alternative ways to support your family that would also allow you to see them more?” I asked gently. After what feels like a long time he said,
“Maybe… maybe not.”
I knew I needed to remind him that he had control over his own life in order for him to start making healthier choices for himself. I continued, the point almost driven home,
“It’s easy to feel trapped, to get locked into whatever we’re doing, but you’ve got to remember: it’s your choice. You can put together the life that works for you. Trust me, as a nurse I can tell you: life is precious, and there aren’t any do-overs.”
For a long time, we sat in silence together. Then he heaved a long shuddering sigh and looked at me for the first time. His eyes were shining, but a faint smile played on his lips.
“Thank you,” he said, “maybe it’s a good thing I ended up here tonight.”
“Everything happens for a reason,” I responded, smiling, and he smiled fully at that.
“Now you get some rest, and if there is anything else I can do for you, just ring your call bell.”
I left him as he reclined back, still staring thoughtfully ahead. He was sleeping for the remainder of my shift with him, and he was discharged the following day. I never got to speak with him again. Though I have no way of knowing whether or not Edward changed his life around, somehow I have a feeling that that Christmas Eve was the start of something new for Edward; the start of him living and building his life around what he felt was important.