An ongoing dialogue on HIV/AIDS, infectious diseases,
January 2nd, 2024
Reflections on Working in the Hospital During the Holidays
For the zillionth year in a row, I spent the Christmas holiday working in the hospital. For me, it’s not much of a sacrifice — we don’t celebrate Christmas, and my kids are long out of school so the strict limits on when we can take vacation are a thing of the past. But it puts me in a notable minority, as around 90% of U.S. workers have the day off.
So what do we 10%-ers get in exchange for working? Here’s a secret — we get plenty. A brief rundown:
Camaraderie. This is one of the best things — the immediate recognition among those in the hospital that we’re in this together. Take a look at that picture of the faculty and fellows on call. Do those look like unhappy doctors? Importantly, a couple of the members of this quintet do celebrate Christmas, yet made the sacrifice to come in. To them, an especially big thank you!
Continuity. Sadly, illness doesn’t take a holiday and neither do hospitals — they’re a 24/7 business. The patients who must be in the hospital over Christmas are mostly quite sick, or socially disadvantaged, or both. They’re usually pretty upset about having to be there, quite understandably. So they very much appreciate that some of the doctors who were following them before the holidays know them during the holidays too.
Barter. Working Christmas allows us to trade this important holiday for others. For example, I haven’t worked Thanksgiving in years and almost always find a way to get coverage for Passover. Already I’ve blocked off Christmas 2024 as a time both my wife and I will be working — you’re welcome, happy to do it.
Bonus. Several years ago, our division adopted the policy of providing a small bonus to the on-service faculty for working certain important holidays. (Apologies to our residents and fellows who don’t get this. Maybe that will change now that they have adopted a union?) Note that for most salaried workers, it’s typically 1.5 or even 2 times the hourly rate. Believe me, it’s appreciated.
Citizenship. Some of the crew on call over Christmas volunteer to do so nearly every year. As the person in charge of clinical scheduling, I hereby give them the Golden Citizenship Award. Mike, Eric, Amy, Anna — you know who you are — thank you! Place this award in a prominent place, it’s quite valuable.
Sustenance. The hospital president every year sends around an email wishing us happy holidays and announcing that lunch and dinner in the hospital cafeteria are free. This year’s entrees were pretty good, both the chicken and vegetarian options, though I wasn’t a big fan of the dessert. But if it’s sweets you’re after, no worries — hospitals are replete with goodies, homemade and otherwise, practically everywhere you go. This year, I arrived on one hospital unit to find gorgeous homemade chocolate chip cookies invitingly set out on a tray with a sign saying, “Take One”; another unit had a huge basket of assorted Lindt truffles. Noticing my rapt attention to the chocolates, a kind nurse insisted I not leave the floor until taking a few. Yum.
Appreciation. If you work over the holidays, you can pretty much guarantee that plenty of people will thank you. Patients, doctors, nurses. Hey, note that even I am thanking people (see “Camaraderie” and “Citizenship”, above).
Learning. Medicine is a lifetime of education! No reason this needs to stop over the holidays, right? Cryptosporidiosis, vascular graft infections, bacteremia as a complication of appendicitis, drug-induced vasculitis — summarized these topics and others in an on-line thread. Plus, one of the fellows shared an interesting paper on antibiotic-associated neutropenia. Much appreciated, Carlos!
Pace. Hospital census used to drop dramatically in the week before and after Christmas, leading to a delightfully slower pace in what is usually a very busy environment. While that effect is much less dramatic with the post-pandemic bed crunch, there are still fewer elective surgeries and admissions. So it’s still not quite as busy as during the rest of the year, a welcome break. And if you’re worried that I’m going to jinx this effect by even mentioning it, I refer you to a classic paper.
Diversity. Here’s a wonderful thing that made me smile on December 25, courtesy of Dr. Vamsi Aribindi:
Happy New Year, everyone!