The meaning of seven Christmases

James Toh
Med J Aust 2014; 201 (11): 701. || doi: 10.5694/mja14.01428
Published online: 15 December 2014

Working on Christmas Day at hospital provides insight into the complex reasons why patients are there

For Christmas, my auntie has always made an amazing dinner, full of crustacean goodies on the barbecue, roast pork crackling with a tympanic crunch, turkey with my favourite stuffing, a nostalgic smell percolating the air, and pavlova with sweet berries. The home always felt like Christmas — a beautiful tree lights up the corner with thoughtful gifts, a Swarovski cabinet glistens with crystal figurines, the swimming pool and trampoline in the backyard bring back memories of backyard cricket and childhood games with my siblings and cousins. For me, Christmas has always been about love, family and happy memories.

Over the past 7 years, the meaning of Christmas to me has been shaped by my working on Christmas Day. Don't ask me how this consecutive rostering occurred — it's not possible, I've been told by administration. One year, a radio station bestowed on me an award comprising a cruise and a hotel voucher for being the “most shafted at Christmas”. I have a feeling my auntie may not recognise me the next time we meet, but I am hopeful I will see her again one day.

The sad thing is that while Christmas may be a celebration for most, to a small cohort of vulnerable people, it emphasises life's deficiencies. It is common during Christmas for older people to be “dumped” at a hospital so the rest of the family can enjoy the holiday season. Every Christmas, I see this happen.

Lonely people come to hospital to seek a human being to share the day with — even if it's a health professional. I remember an old man coming to the emergency department with vague chest pain. This was the first Christmas he had spent alone, as his wife of 70 years had passed away that year. He came to the hospital because he didn't want to be alone. He shared his life story with me and, sadly, later died in the ward from takotsubo cardiomyopathy. Yes, it is possible to die of a broken heart.

From the lonely to the reckless, many on Christmas Day end up in the resuscitation bay after alcohol-fuelled trauma, whether from fighting with the in-laws during Christmas lunch or from a motor vehicle accident. One year, I did two emergency thoracotomies and saw a young teen die.

Christmas may mean love and family to some, but to others it highlights a vast emptiness. I have learnt this from having had the privilege of looking after many vulnerable people over the past seven Christmases.

Perhaps on Christmas Day, we should not only care about family and friends but make an effort to be kind to everyone. Send Christmas cake to a neighbour you don't know, because at some stage you thought it was a good idea to build a fence that looked like the cement slabs of Silverwater gaol. Take your grandmother with dementia on a road trip — remember she once changed your nappies and fed you milk. Instead of road rage, let the other vehicle in and don't sweat the small stuff. This may also be good for your carotids and berry aneurysms.

This year, somehow I have again been rostered to work during Christmas. A colleague was also rostered with me, but his wife had just been diagnosed with breast cancer, so I told him to spend the day with her. I guess most people would be very upset that they have endured an unfair roster, and my own family have been disappointed that I haven't been able to spend time with them at Christmas. Don't get me wrong — I would prefer not to work on this important day. I would prefer to spend it with my mum and dad, my siblings and close family. One day, soon I hope, I would like to start my own family.

As I will be at the hospital, I will try my best to bring Christmas cheer where it is needed, to be the sunflower. Christmas should not only mean loving your family; it should also mean caring for all the human beings you have the privilege of meeting.

  • James Toh

  • Department of General Surgery, Liverpool Hospital, Sydney, NSW.



I dedicate this article to my father who courageously battled through major cardiac surgery this year; my family and friends who I love very much; my colleagues and mentors who have also dedicated their lives to saving the lives of others; and the patients I have had the privilege of caring for.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.