His name was Gary...

... and he believed in Santa.He was SO excited for the big red guy to come that night, it was all we heard the entire shift - "Santa? Santa Claus?!" - and thrilled murmurs about presents to come.  Between the palpable joy in his voice and his garbled speech, it was tricky to even understand this much sometimes --- but once you figured it out (or if you knew Gary*), there was no question.

He was pumped.  It was Christmas Eve, and as soon as he went to sleep that night, you-know-who would be slipping in to drop off something special.  It didn't matter to Gary that he was stuck in a hospital bed, miles away from his home, or that there was no Christmas tree, chimney, or fireplace near which his stocking could be hung with care; there was snow out the window and he knew. 

Gary could've been any other six-year old that Christmas, except for the IV taped to his arm and the feeding tube inserted into his stomach. 

Also, Gary was in his late forties. 

Every so often I remember that Christmas Eve shift that I spent caring for Gary; I had taken care of him a few times previously on the Medical/Surgical unit of the hospital during short stays, and was familiar with his cognitive impairments.  Confined to bed or a motorized wheelchair, Gary had severe contractures of his extremities, and cognitively functioned at the level of a toddler.  He was always pleasant, but often confused; I rarely saw visitors, though on occasion he would have an older gentleman or few women stop in, who I assumed to be older relatives. I never met a mother or father, sisters or brothers; whether there simply were no closer family members or they lived too far away to visit frequently is impossible to say. As a nursing assistant at the time, I had little background information; I assumed (and still assume) that Gary lived at one of the nearby long-term care facilities. 

Like most holidays, that particular shift was bittersweet; though it's always miserable to be away from home and family during such intimate hours, there is a certain honor to be able to sweeten those same hours for someone who might otherwise have a much less warm celebration (the trend tended to be lower census on our unit, but there was always a few patients with pneumonia, unexpected broken hips from falling on the ice, etc...).  Once I was able to get past the initial crankiness of pulling away from my family --- this was prior to the Mini's, so in retrospect it shouldn't have been so hard at all! --- I made it to the hospital to find a pretty festive mood on the Med/Surg unit. A potluck was in full swing, carols were playing quietly at the nurse's station, and staff were bedecked with twinkling pins and bright scrubs.

I worked my way through my rounds, passing ice water, dinner trays, helping patients up to the potty and down to bed. Families visited, stories were told, and smiles brightened the halls. In Gary's room, especially, the spirit of the holiday was huge. Every visitor - from housekeeping to dietary to nursing - heard about the REAL visitor Gary was anticipating, and his excitement for "pres'nts?" in the morning.

And, so, we played along. Of course Santa was coming!  "Any sign of him yet? Nope?" "Gotta go to bed early, though, Gary!" "Hope you were good this year!" Each question and every statement met with a beaming, toothy grin from Gary's stubbly face.

It was only at about 9 p.m. that we realized... Would Santa come?  Gary had had few visitors, none that seemed to be a caretaker or close relative... Gradually we recognized what this meant - Gary could awake not only to an empty, stark hospital room (bare of Christmas decorations or cards) but also devoid of any sign that Santa had dropped by. Our hearts broke thinking of the spoils of gifts awaiting us in our own homes. We set out on a search of the hospital, able to procure a few small stuffed animals, a child's book, and a bit of candy (useless to Gary and his feeding tube, but something anyway...) to leave from Santa.

Our meager pile seemed so small, but there was nothing else. I drove around for an hour after clocking out at 11:30 p.m., but in small-town USA just before midnight on Christmas Eve, even gas stations and Wal-Mart close. I considered driving home (an hour away) and driving back, but was uncertain what I could scrounge up. In the end, we left Gary his gifts, decorated with a few balloons and a note from "Santa". By my next shift, Gary had been discharged, and I never really learned how his Christmas morning ended.

~ * ~ * ~ * ~ * ~

I'm not sure why Gary's story is here; it's clearly about as far from a midwifery story as you can get, but it has been on my mind as of late. I think, on some levels, caring for Gary on Christmas Eve was the first true experience I had in falling short of what I felt I needed to do... and yet, considering the obstacles, I feel that we (my partners that night and I) pulled together to make Gary's Christmas morning so much brighter than it may otherwise have been.  

And that, I think, is the true spirit of any caregiver. We may not know it all, we may not have all the tools or resources that we need, we may encounter obstacles beyond our control -- but the heart of our profession is by pulling together as a team, then putting forth the best effort possible so that each person we serve is able to have the most positive outcome possible. (I need to remind myself of this often --- I can't "fix" everyone, prevent everything, or do it all myself  but I'm there, anyway.)

* not his true name...