Physicians Anonymous

Christmas in hospital as a physician

Christmas in hospital as a physician

In this article we discuss the joys and tribulations of working over Christmas in hospital as a physician. Can you relate?

T’was the night before Christmas, and all through the ER, everyone was stirring, shouting, vomiting, and hemorrhaging. Except for the mice, who very sensibly stayed away, because it was chaos.

OK, so technically it was after midnight, and therefore Christmas Day. But our patients’ optimal blood alcohol levels which triggered the need for hospital were only reached in the small hours. 

Those semi-occluded coronary arteries just needed a good meal to clog up. 

Those esophageal varices just needed one final event to rupture. 

That simmering resentment towards the ex’s new partner just required a level of inhibition for you to say your mind – and his level was perfect for reacting with violence.

All was not merry and bright. A silent night it was not. 

Illness and death do not take time off for the holidays. Thankfully, neither to healthcare workers.

All was not merry and bright. A silent night it was not.  Illness and death do not take time off for the holidays. Thankfully, neither to healthcare workers.

Christmas Carol

I had just finished treating a patient with a severe asthma attack when I was called to the emergency room to consult on a case. When I arrived, I found a young woman who had been hit by a car while crossing the street to get to a party. She was unconscious and had multiple fractures. Her parents told us her name was Carol.

While we waited for the scan results, I talked to her family, who were understandably anxious. They told me that the young woman was a nurse, and she had been looking forward to starting in our hospital in the new year.

As the night wore on, I worked closely with the rest of the ER team to provide the best possible care for the patient. Her injuries were severe, and we knew that the road to recovery would be long and difficult.

A shift like any other

As a physician, I had become accustomed to working holidays and weekends, but there was something special about being on duty on Christmas Eve. The hospital was bustling with activity, as people rushed in with injuries and illnesses related to the celebrations. 

The season is often a busy time for hospitals, especially in colder climates where icy roads, cold weather, and a plethora of parties can trigger illness or injury during this time of year. 

Healthcare workers are not immune. Being human beings, they are vulnerable to infection and trauma like everyone else (more so according to some studies). Other human clinicians would like time off to be with their families. All of this can lead to increased workloads and longer shifts for healthcare workers.

For most of us it was a shift like any other - just with more twinkly lights, tinsel, and free chocolates. Yet at every moment, and like every other day of the year, patients could be going through the worst day of their lives. And it was my privilege to be there with them as their doctor.

For most of us it was a shift like any other – just with more twinkly lights, tinsel, and free chocolates.

Yet at every moment, and like every other day of the year, patients could be going through the worst day of their lives. And it was my privilege to be there with them as their doctor.

The downsides of working in hospital in the holidays

Having started my first hospital shift on New Year’s day some 20 years ago, and worked every holiday season since, it never occurred to me that for most people, the holidays are a time for family and friends, relaxation, and rest. 

Only once I stopped working in clinical medicine did I realise what ‘normal people’ did at Christmas. They spent time with their families, eating too much, and arguing. But also creating memories, bonding, and recharging from work.

For decades, I resented that I did not have more time off, but I resigned myself to the demands of the medical system (not realising until later that it was designed to maximise profits – which meant minimising staff). We all did what we thought was necessary. Too few of us looked at the profits of healthcare systems and insurers were in the billions. Imagine how many extra medical and nursing shifts just a small percentage of those profits could have bought.

Resentment aside, the downsides of working in hospital over the holidays are:

  • Time away from loved ones
  • Associated guilt for not spending time with loved ones
  • Higher workloads
  • Lower staffing levels
  • Readmissions
  • Lack of step-down/rehab beds
  • Norovirus
  • Patients don’t want to be there even more than usual
  • Alcohol
  • Heart-related deaths increase by five percent during the holiday season, peaking on Christmas Day, according to the University of California San Francisco.
  • Deaths tend to peak in the last week of December
  • In many countries, pay is the same, Christmas/New Years Eve or not

The rewards of working as a physician in the holidays

Despite these challenges, there are also many rewards to being a doctor working on Christmas Eve. Being able to provide care and support to patients and their families during the worst day of their lives can be a deeply fulfilling and rewarding experience. Additionally, working with a team of dedicated healthcare professionals can create a strong sense of camaraderie and support during this busy and oftentimes stressful time.

As physicians working in the holidays we get to:

  • Be there with a patient during the worst day of their life
  • Be part of a team where you’re all in it together 
  • Tinsel, chocolates, cocoa, and Christmas lights
  • Your showing up matters — even more than usual
  • Stories to tell the grandkids: Christmas disasters, dark humour stories — and Christmas miracles
  • Have an excuse not to spend time with family that are not healthy for us (and darn the guilt!)
  • Drink alcohol (within public health guidelines)
  • Have the power to make it a Merry Christmas for all!

Personally, I used to enjoy the sense of doing something special and different. While ‘normal people’ were doing normal things, I was in a position to make a difference to someone in great difficulty.

As a nursing colleague quoted on Reddit:

“If I work a 12 hour shift on Christmas, I still have four or five hours at home that day to open presents, and eat a good holiday meal. I have all the time in the world for holidays. But those people at a long term care facility have limited years and need to feel cared for and loved”

Overall, being a clinician (or first responder, in the armed forces, and all the other key professionals who keep the wheels of society moving) working in a hospital on Christmas can be a challenging but rewarding experience. It requires dedication, hard work, and a commitment to providing high-quality care to patients and their families, even during the holiday season.  The health service is an immensely rewarding place to work: our colleagues are amazing and caring for people at their neediest is a privileged occupation.

Epilogue: a Christmas Carol

As the dawn broke on a crisp Christmas morning, instead of opening presents and sipping cocoa, we finished our shift and went home to get some rest.

Carol was stable but her Christmas Day would not be at home with family or friends. She would spend it on painkillers and stuck in bed. But she was alive and on day one of her recovery.

Leaving the hospital, I couldn’t help but feel a sense of privilege and gratitude for everything that being a doctor means. 

While I was working and away from my own family and loved ones, I was able to be a part of something much bigger – the care and support of this young woman and her family during a difficult time. It was a reminder of the importance of our work as healthcare professionals and the impact we can have on the lives of others.


In this article we have discussed the joys and tribulations of working over Christmas in hospital as a physician.

I was reminded of the privilege we have to be with patients, often making a difference, and able to bring in some Christmas cheer on the worst day of their lives.

PS – if you are a physician in hospital over the holidays and feeling isolated or alone, (1) you are not alone – thousands of others are on duty around the globe, just like you, and (2) why not connect with others at one of our free peer-support meetings?

PPS – if you are feeling low or suicidal , please read this:

If you think that a friend or loved one might be suicidal, you need to take action. Call 911 or your local emergency services.

US physicians in crisis can seek help by calling:

  • Physician Support Line 1 (888) 409-0141

    Psychiatrists helping US physician colleagues and medical students. Free & Confidential | No appointment necessary
    Open 7 days a week | 8:00AM – 1:00AM ET

  • or the National Suicide Prevention Lifeline at 800-273-8255.

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