I wrote a post around Thanksgiving about the strange chasm between holiday bliss and hospital grief. After that post, our unit entered into a stormy December when we saw one tiny human go from just so new to the world, to an everything-altering diagnosis, to sick but cute and alert, to crashing onto ECMO and dying within about a week. We saw another three teenage patients with cancer wither at an agonizingly slow pace before our eyes, only just alert enough at times to show us they understood they were to be the most pitied among all, with their unnaturally jaundiced skin and bloody mouths and occasional weak smiles for the ones they loved most, that split us all open as we tried to hold ourselves together for their sake. They spent enough time in our units for us to get to know them and their families. Enough time for us to begin wrapping our hearts around how devastating this holiday season, and every subsequent one, would feel for these families, because we saw clearly how this was going to end for all of them.

All three of these patients died within a two-week time span, just a couple of weeks before Christmas. We are the ones who stand inches away from the people who love them the very most, as we all watch them take their very last breath. We are the ones who silence the hospital alarms because these patients have crossed over all the alarm limits, and there remains nothing else to measure but the days cherished and the days lost. We are out of heroics and miracles, and we stand next to the ones who love them the most, with nothing left to offer but our presence and our “I am so, so sorry.” We are the ones who do this work, week after week, month after month, new year after new year, and it feels like both a blessing and a curse. Maybe because we inhabit those spaces where some of the greatest blessings and greatest curses collide.

It is and will always be the strangest thing to go from these spaces in the hospital to just outside, where we see the very tall Christmas tree and sparkly lights erected by this same hospital. I suppose I understand and can appreciate why a pediatric hospital would still put up gorgeous decorations for the holiday. And yet the dissonance between just inside and just outside the hospital becomes all the more marked.

I don’t know how to move easily or effortlessly between these patient care experiences and gatherings with my people in the outside world, where we are swept along in the one-directional cultural push to set goals for health and success and happiness in the new year. I know these are not bad pursuits, per se. I try not to give in too deeply to pessimism that as much as we can’t imagine what good might lie ahead, we also don’t know what indescribable trials might come as well. But the very loud shouts of “HAPPY NEW YEAR!!” just aren’t in sync with the undertones that still rumble in me. I think it’s the hard insistence behind those shouts to just get past the painful realities already, of vulnerability and grief and mortality that we as a world had to come up against during COVID. The hard insistence that these things are only behind us now and that surely everyone must have only good days ahead. God, I want all kinds of good for all of us and I believe in it, but why is the messaging still just one of strong dichotomy? Good for everyone outside the hospital, and well…. pity and shush don’t talk about the other parts for those still inside.

I go into this new year so acutely aware of both sides of that dichotomy, and I remain convinced there’s still a simultaneous holding of both spaces that we need to move towards in our day to day experiences and interactions with each other. I want to hold your hopes and your grief, and I want you to hold mine too. I don’t think being people of hope, joy and fortitude was ever meant to be equated with being people of denial, ignorance or stoicism. To me, that’s not real hope or real joy or real fortitude.

I want what’s real for this new year, all of it.