Christmas at the
emergency room /2

Memories and musings on a Montreal Christmas

By Wanda Potrykus

December 29, 2021

It is Christmas Day in the workhouse,
And the cold, bare walls are bright
With garlands of green and holly…

George R. Sims, 1847-1922

In 1977, I was somewhat older than many undergraduate students at McGill, having decided not to attend university immediately after graduating high school, choosing instead to travel. Thus life for me at university began in my mid-twenties in Canada and not my late teens in the UK where my parents and siblings live. As I did not then qualify for Quebec government aid, I needed to work to support myself and to pay for my university tuition. It meant I didn’t have a great deal of time for socializing while at university as I organized my class and study time around the employment I found, which helped keep the proverbial wolf from the door during these hand-to-mouth years. I held a variety of jobs.

Initially, I was an evening and weekend receptionist-secretary in a real estate company on Greene Avenue in Westmount, then known as A.E. Lepage; subsequently an admitting clerk in the Royal Victoria Hospital (in those years it was still located at the top of University Street above the McGill University campus). That was followed by a stint as a drop-in centre assistant for an Introduction to Linguistics course offered at McGill. It was one of the first online personal study computer courses and the drop-in centre was where students came for in-person help and encouragement. It was the start of the ‘computer as learning tool’ era, years before the Internet became ubiquitous. In my final year, I toiled as a waitress in the former Tramway restaurant near the corner of Ste-Catherine and Peel. The peak lunchtime, evening and weekend hours enabled me to fit my class attendance around my shift work.

‘… the experience of working Christmas Day in an ER stands in a class all of its own.’

As these were all jobs that necessitated working with the public, it meant that, along with the academic education I was receiving, these jobs concurrently provided me with valuable instruction in the vagaries of human to human interaction, both verbal and non-verbal; of interest since my primary area of academic study was communication theory. Consequently, I have at times reflected that most young people would probably benefit from working as wait staff and also in the emergency room of a large teaching hospital (if such jobs were available to them) where they would be exposed to all manner of demonstrations of human nature in action, in all its high, middling and low forms. Theory in action so to speak.

A cold winter’s night in the city – Image: Josh Hild, Pexels

Nevertheless, the experience of working Christmas Day in an ER stands in a class all of its own.

For one thing, you may think it wouldn’t be very busy. Many might assume that most people would be safe in their homes, or in those of friends and relatives celebrating Christmas by opening presents and over-eating. The reality is stark and rather sad and dispiriting. For in cities and outside of them too, there are very numerous lonely, demoralized and sick people, many of whom come to seek help in hospital emergency departments over the Christmas period, in particular on Christmas Day. The truth is many may have nowhere else to go. The malls are closed, as are the High Street shopping streets along with most restaurants and institutions that admit the general public, paying or otherwise. Cinemas are the exception. They apparently do a brisk trade over Christmas for they are some of the few establishments that do remain open but not everyone can afford a trip to the movies then or now, and besides, in cinemas, you sit alone in the dark. Not everyone’s first choice.

‘… in cities and outside of them too, there are very numerous lonely, demoralized and sick people, many of whom come to seek help in hospital emergency departments over the Christmas period, in particular on Christmas Day.’

But why would this one day be different from other days, one might query? For starters, not everyone is Christian or even if claiming no religion at all, do not choose, or have no reason to celebrate this time of year.

Many faiths, many solstice celebrations

Those of Jewish faith do have Hanukkah, however, it follows the Hebrew calendar (which is lunisolar), thus it only sometimes falls on or near the same dates as Christmas, which in Canada, although titularly multi-cultural and diverse, is the federally mandated Christmas or seasonal holiday period harking back to the predominant religion the settlers of 375 years ago brought with them.

Some families, especially those of mixed religious heritage, or with no religious affiliation at all, still do choose to celebrate Christmas on December 24 or 25 by buying into the more commercial or perhaps the more ancient and long forgotten by some, pagan aspects of this time of year – such as those of the former winter solstice ceremonies and practices that previously marked these, the darkest days of the year.

In recent years, others of mixed Christian and Jewish faiths or heritage now refer to this holiday period as Chrismukkah (a made-up combined word using the first six letters of one and the last five of the other). Some choose to decorate a Hanukkah bush for the festivities rather than embrace the more traditional Christmas tree and its association with Christianity even though this too is a remnant of pre-Christian times.

Persian lady reciting poetry during Yalda – Image: PersianDutchNetwork, CC BY-SA 3.0, via Wikimedia Commons

Some Moslem families also introduce into their homes colourful candles, wreaths and other items that have a certain similarity to the uninitiated to some of the more modern-day Christmas decorations but which are in fact connected with variable Islamic feast days, such as the Persian festival of Yalda, or Shab-e Yalda. This is a celebration of the winter solstice and dates from ancient times but the date it falls on varies since the Islamic calendar is based on lunar cycles.

The Chinese have Dong Zhi, the “arrival of winter” – a time for families to get together and celebrate the past year they have had. Based on the traditional Chinese celestial calendar, this festivity generally falls between December 21 and 23.

North American Indigenous tribes also had traditions centring on the winter and summer solstice but many details have been lost or discontinued since colonial times. However, the Hopi of Arizona still celebrate Soyal, a winter solstice celebration, with feasting, dancing, ceremonies and rituals that sometimes include gift giving to welcome the kachinas, the protective spirits from the mountains. Yet another ancient and sacred place for solstice celebrations was at Cahokia, in what is now Illinois, across from St. Louis, which is the site of Woodhenge and other extensive ceremonial pyramids and long a place of pilgrimage. The Blackfoot Confederacy – the Niitsitapi of Montana, Alberta and Saskatchewan – historically kept a calendar of astronomical events that marked the time of the winter solstice and the “return” of the sun or Naatosi on its annual journey. They faced their tipis east toward the rising sun but because of the cold, they rarely held large religious gatherings in the winter, viewing the solstice as a time for games, family and community dances with unique dancing, drumming and singing.

Notwithstanding, the faith people do or do not practise today, the reality is that there are still a lot of people who either have no one to spend the holiday with or who have personal issues that for whatever reason get magnified over holiday periods when they erroneously presume everyone, except themselves, are in the company of loved ones and are happy and celebrating.

For whatever reason, it seemed to me while reflecting about my Christmas work shift all those years ago, that a substantial number of them do, at times, end up in hospital emergency departments for a wide variety of reasons. They are either brought in by others when they are hurt or perhaps come on their own because this is a place that is warmer than the streets and is crammed full of people, so they can sit there and potentially, or theoretically, maybe not feel so alone. There’s often at least one hospital cafeteria open, so they have access to a hot or cold drink and maybe, something to eat. Perhaps some rationalize that someone, if only for a few minutes, will pay a little attention to them, to their needs and ailments, whether real or imaginary.

‘… the reality is that there are still a lot of people who either have no one to spend the holiday with or who have personal issues that for whatever reason get magnified over holiday periods…’

That Christmas Day of 1977 was no exception. When I arrived at work at 10 am after early morning Mass and a quick (and then very expensive for my student era budget) telephone call home to the UK, I found the waiting room already packed. I hurriedly stored my coat in my locker and opened my station. As the day progressed, I quickly lost count of the number of patients I registered.

“Good day, sir/madam. What seems to be the problem? Can I have your Medicare card please? Have you ever visited us here before?” (Then code for “Do you have a hospital file here?”). Some of the people seated in front of me break your heart.

Mental health issues and physical beatings

One is an older lady arriving there with a middle-aged adult son who has mental health issues. For whatever reason, he’s lost his equilibrium and beaten her up, throwing the food she has painstakingly shopped, paid for and then prepared for them to eat onto the floor. She is battered and bruised and needs stitches. Even though she calmed him down somewhat, she still had to bring him with her as she has no one to leave him with at home. He sits there, slumped in his chair, mumbling and agitated. She has come to be patched up and potentially x-rayed for broken bones and to have someone care for her for a short while. Many hours later, they leave. She’s exhausted and sad. The doctors would have liked to admit her, but she had no one to look after her son and so, she takes him back home to that demolished and broken household. Happy Christmas indeed.

Gunshot and knife wounds

Another man comes in with a gunshot wound. He is bleeding profusely. I accompany the nurses and residents into a cubicle. They are furiously working on him to stem the blood loss. My assigned task is to ask as he struggles to breathe: “Do you have a Medicare card?” Even in life and death crises, hospital administration work, however unpalatable it is at times, has to continue. However, there’s no coherent response, not one that I can make out anyway, so my next designated task is to discretely hunt through the pockets of his discarded jacket to see if I can find his Medicare card, or indeed any identification, which would inform us if he is a Quebec resident or a visitor. Meaning does he get charged for hospital services or not. I don’t find anything and mark it in the file. Someone from billing will follow up. If he survives, that is, or perhaps even if he doesn’t – I don’t work in billing, so don’t really know.

Family violence and traumatized children

Some of the families that arrive are among the most poignant of ER visitors. Father has attacked mother or vice versa. Children are brought along since there is no one to leave them with. Sometimes the family members are subdued but others are still fighting. It’s evidently not a very merry Christmas in those households either. One looks at the pinched and worried faces of the children and wonders what they will remember and can only hope that there’ll be happier Christmases ahead. It’s not a given.

Heart attacks, strokes and drug overdoses

In addition, there are the countless heart and/or panic attacks, strokes, cuts, bruises, broken bones and a fair number of knife wounds as well seasonal influenza cases, some with extremely high temperatures and a few delirious ones, whether brought on by fevers or seizures, or an over-abundant intake of drugs or alcohol. One processes all of them the best one can, and they all wait for attention from others. For some, it’s a long wait.

These are a few of the scenes that forty-plus years later remain with you and spring to mind while facing another Christmas alone.

I doubt that even after 40 or so years since that first Christmas here in Canada, or indeed elsewhere, where major holidays are still being celebrated and emergency rooms are still needed, that these scenes have changed much in the intervening years.

‘Thus, the heroes of this piece, and they are many, are… all those who slog long and hard to care for us in good times and bad. And, yes, especially during Christmas and New Year and all year long during pandemic times.’

Although some of the check-in procedures for ER departments have doubtless had to evolve, especially in these years of the COVID-19 pandemic. Computers too are far more prevalent, of course. No more paper files to write up and consult as there were then. But there are still far too many sad, lonely people and damaged people in the world and I reflect Christmas in the ER is quite possibly not too much different today in 2021 as I write this than it was in 1977. Perhaps some of the faces in the seats are more diverse but many of the problems probably remain the same, except hospital workers now also have COVID-19 pandemic symptoms to watch out for and consequently, are even more exhausted and burnt out.

Nurses in COVID attire – Image: Governor Tom Wolf via StockPholio.net

A salute to our heroes

Thus, the heroes of this piece, and they are many, are the police and first responders, the ambulance personnel, the doctors, nurses, nursing aides, psychologists, therapists, and technicians of all sorts who work the complicated health care technology, the administration and maintenance staff, the porters and orderlies, the cleaning staff, the food service people along with the security guards, the parking lot attendants, the taxi drivers and the volunteers – all those who slog long and hard to care for us in good times and bad. And, yes, especially during Christmas and New Year and all year long during pandemic times.

Thank you all.

Please know you are deeply appreciated, particularly during the tough times… today, tomorrow, next year and every day. May you find warmth, peace, glad tidings and some pleasure and joy somehow, somewhere this challenging 2021 seasonal holiday season and in the years ahead.

Feature image: Pixabay

Read Christmas at the emergency room /1

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