From the drafty hospital home to my drafty castle and face first into my coffin…Oy the crick in my neck. Holidays are tough in the hospital. If there is a time that anyone wants to be there less, I can’t think of it.

Last night, I was called to evaluate a depressed/suicidal person. All the bad things were there. Lethality, plan, mindset, and previous injurious behavior. My walk to the ER is a bit of an adventure so as I walked over, I struggled with it. What do you say to someone like that? Can you say the right thing? Finally, my instinct and intuition won when a small but correct voice said, “be yourself and ask the tough questions.” I have always called my intuition the “little voices” since working with a paramedic who always described her assessment and then saying, “the little voices say we need to do this now.” I can’t tell you how many times in my many years that those voices have made all the difference in patient care, and tonight without exception, they worked again.

All ER’s have a psych room. It’s a spartan little affair with a bed that is part of the floor and the seating in there is dense, weighted plastic (think Igor’s head). When I walk in, he has three friends with him. They were having conversations, but you could tell that the patient was depressed. So, after asking if it was ok if they stayed in the room during the physical, he said to me, “these guys are more family than my family.” I froze and thought, wow, and then oh crap, there is a lot to chart on this statement. I won’t go into all the gore because you don’t need to know why someone is depressed, just that they are there to get them help. His “chosen” family saw the changes and, in their words, “hauled his ass up there here to get help.” Let that sink in for a bit and ask yourself, would you do that for a friend? And then really ask yourself, “would you put down the bullshit in your own life to make that sacrifice?” Those guys did and after the exam was done and it was time for him to go over to the psych unit, his friends, who by the way, were super chatty and super fun if you can call that macabre situation “fun” asked if they could go with us. Since I was walking back, I offered to help the ER since they are often busy and walking a patient to psych is a bit for them. His friends asked if they could go at least as far as the locked unit. What the actual? Its nearly a half mile to the unit and they shouldered his gear, walked, and talked the whole way, not just with him, but with me. Amazing. They weren’t prying, they weren’t feeling sorry for him, they just said, “look he needs some help”.

This is that time of the year. We think about those that aren’t with us anymore. We think about friendships and people who go to be with their biological families and that loneliness. We think about the crap we take from our families because we don’t pray the same, like the same politics, television, and maybe even each other or they don’t approve of “lifestyle choices”. We want out of the stress. For some, this completely overwhelms them, and they want it to stop, permanently. They don’t cope with the holidays well. One of the biggest things people do is not manage their stressors. Why do you go to a family dinner with your racist cousins? Family unity? You have to ask yourself if you would subject yourself to that in a public place and then decide what to do. Why put yourself under that stress? If you were there and so depressed, would your biological family really notice?

This guy’s chosen family did, and it saved him. One of the things in my veteran experience is, always watch your buddy’s six (their back). Reach out, hold your friends and your family, take time to pay attention, and make those difficult calls. Nursie’s castle is a tad warmer today thanks to this example.