The writer works as a nurse in a British hospital. Names have been changed to protect privacy.
The Acute Medical Unit is a high-octane environment, a tangle of clinicians engaged in the frantic battle to save lives. End-of-life care has never been its forte. On a cold, dark October evening, an eighty-four-year-old man named Mark lay in the electric profiling bed adjusted so far forward that his chin dropped onto his chest every time he nodded off. The relentless struggle to breathe had exhausted him, and the increasing roar of the CPAP machine forcing air into his lungs confirmed that his efforts were flagging. Arms and feet purple from continuous blood samples, Mark looked like he’d been through a war. Intravenous fluid cascaded down a line into his arm. The all-too-predictable progression of chronic obstructive pulmonary disorder had taken its course, and Mark was on the final lap.
Mark’s daughter Clara sat by his side, changing the damp towels on his forehead and adjusting the fan on the bedside table. They didn’t want me to call his wife. “She has dementia,” Clara explained, “and it would be too much of a shock.” I called the outreach nurse. Sally was on call for all wards of the hospital that night and I wanted Mark to be on her list as I didn’t think he’d last until tomorrow.
Later in the evening, Sally and I arrived at Mark’s bedside simultaneously. Both of us were surprised to find the chaplain there. Neither of us knew who had called him but guessed it had been Clara. The staff regarded him coolly, as if he’d just jumped out of a time machine from the Middle Ages to remind us that “the end is near” in a sonorous bass voice. Standing in the midst of a world where clinicians expend every option in a persistent attempt to save life – or at least prolong it – a man who comes to help someone prepare for death is an outsider. Sensing this, he was fidgeting and slightly uncomfortable. We all exchanged awkward formalities, our invisible worlds clashing. Then Mark tore off his oxygen mask.
It was difficult for him to be heard over the alarms beeping at him to replace his lifeline, but his voice was clear and crisp between gasps. “Could we sing ‘O come all ye faithful’?”
His words were a bomb in the unit, but everyone knew the unspoken code: a patient’s wish should be respected. It felt zany and out of place singing that particular song in that room. The two atmospheres collided like cumulonimbus, producing a near-audible thunderclap that sent vibes across the unit. The frantic pace dropped off for a moment. People looked. Some joined in. But our little corner was bright with Christmas cheer. It was as if the benevolent Spirit of Christmas Present had stepped out of Dickens’ novel and was sprinkling everything with magic from his torch. I’m sure there were a few Scrooges whose hearts were warmed.
“Sing choirs of angels, sing in exultation!” rang out louder and stronger – and we could practically hear them singing along! The whole room was filled with their glorias.
It was a moment I wished would never end. I have relived it in my thoughts many times since because it gives me hope that the spirit of Christmas can break in anywhere and everywhere. Let it in! Risk giving it a day-pass into your workplace. If it feels out of order then it is all the more urgently needed.