A Merry, and Resilient, Christmas – A Personal View.

Some posts are liable to divide opinion – this post may well be one of them. Not because I’m going to discuss the merits of Marmite, not because I’m about to express a political opinion, not even because I’m on the verge of venturing a view as to whether GPs should give up doing home visits. No, far more contentious than any of these things, this post is about Christmas.

Well the wait is almost over, and soon the last doors will be opened on a million ‘Sleeps ‘till Santa’ calendars. The choice this year has been huge. Believe it or not, today you could be opening drawers or pulling back cardboard squares to reveal nail varnish, Play-doh, or the components to build an FM radio. My favourite though has to be the ‘Drinks by the Dram’ Calendar, sold on Amazon for six shillings short of £10,500. Who wouldn’t want to start the day with a 60 year old Glenfarclas to accompany their Coco Pops? But don’t worry if you’re a traditionalist, there have still been plenty of calendars out there that retain the true meaning of the holiday season and counting down the days with chocolate impressions of characters from Star Wars has remained an option. There’s no doubt about it, it’s beginning to look a lot like Winterval.

As the year draws to an end it’s inevitable perhaps that one looks back at what that year has brought. Without doubt it’s not just been me, my friends and colleagues, and my patients who have known sadness and difficulty these past twelve months – it’s been your patients too, those you know and work alongside and, quite possibly, you yourself as well. For many the suffering continues still. But, regardless of whether or not it’s a bad time for you right now, I’d like, if I may, to take a moment and wish you all, as I do my patients, a very Merry Christmas.

When life is characterised by sorrow and despair, the forced jollity of Christmas is frequently unwelcome, few of us are up for a party in such circumstances, regardless of how many amusing Christmas jumpers are on display. It has been suggested by some that we should no longer wish others a ‘Merry Christmas’ since to do so risks being insensitive to those who are experiencing difficult times. But to suggest as much is to misunderstand Christmas, to consider it nothing more than an excuse for overindulgence as we try to deny the vicissitudes of life. One of my favourite carols is ‘God rest ye merry, gentleman’ – note the position of the comma. For many years I misunderstood this carol, imagining that the words were expressing the hope that God would give a bunch of already merry gentlemen a well earned rest! This is not the point at all, as the position of the comma makes clear. Whilst rest would undoubtedly be welcome, what is being hoped for here is not that God would organise a couple of days off work for these men of gentle disposition but as yet undisclosed happiness, but rather that he would render them merry.

Whether you are a person of faith or not, and regardless of what that faith might look like, my wish for you is that you will rest merry this Christmas, that you will know some happiness this coming week, even if it has to be experienced alongside enduring sadness.

For many though, Christmas is just too busy to be enjoyable. Even without the current prevalence of winter illnesses making on call days busier than I can recall them ever having been before, at Christmas there is simply too much that has to be done. Some of us, perhaps, long for the Christmases of our childhood, fondly remembered as magical times when we believed in a red suited figure who insisted on bestowing upon us one kindness after another without us doing anything whatsoever to deserve it. Now though, as adults, we have lost sight of any transcendence that Christmas once held and, rather than resting in the generosity of one greater than ourselves, find ourselves burdened with a list of a thousand things we must do if we are to be deemed acceptable celebrants of what a consumerist society has made of Christmas. Wouldn’t it be lovely if we could experience Christmas, indeed experience life as a whole, as we did when we were little, with that childlike faith that someone other than ourselves would be kind to us and see to it that everything worked out just fine in the end.

Perhaps that sounds like heaven, something that appears too good to be true, especially at a time when workload seems to be increasing year on year and many have little faith in those in authority who seem to see the NHS as a political football rather than something that needs to be protected and supported. In addition the world has seen its share of difficulty this year, natural disasters and terrorist outrages to name but two, and closer to home we have all looked on as many of our patients have suffered and some have died. Add to all of this our own difficulties and one can understand why some see little cause for merriment this Christmas.

Of course it can be tempting to try to distance ourselves from all the pain, and hold on to the lie that it couldn’t happen to us – until of course it does. For many it already has. In the week before Christmas, do we simply pay lip service to how dreadful it all is before pushing it all to the back of our mind, and continuing on our merry way – unchanged, unmoved, unaffected. After all – what’s suffering got to do with Christmas?

And therein lies the problem with Christmas, or rather the problem with the Christmas that we have created. As with life, we struggle to conceive that the realities of hate, pain and suffering sit alongside those of love, joy and peace, that these things, to a greater or lesser extent, are present in all our lives, present indeed, even in ourselves. We have marginalised the horror of the Christmas story, preferring the sanitised version that fits better with our over optimistic outlook on life and the over optimistic view we have of who we really are. ‘It’s all good’ we try to tell ourselves but the truth is rather different – we exist in a world of good and evil.

Life can be filled with overwhelming joy.
And yet, life can be hard, very hard. For some, impossibly hard.
And for many the sadness is just too much.

Regardless of whether or not you are somebody who believes the Christmas story, it none the less reflects the reality that this life is a mix of the good and the bad. The joy of the birth of Jesus, and the hope that his arrival brought, is mixed with the abject poverty into which he was born, the rejection experienced by his parents and the murder of the innocents at the hands of Herod. And, of course, what began in ‘O little town of Bethlehem’ continued to ‘a green hill far away’ where the baby whose birth we celebrate at Christmas, having grown up, suffered the horror of crucifixion. The Roman orator Cicero described crucifixion as ‘a most cruel and disgusting punishment’ and suggested that ‘the very mention of the cross should be far removed not only from a Roman citizen’s body, but from his mind, his eyes, his ears.’ That is the world we live in, joy and sadness, pleasure and pain – we cannot have one without the other. Indeed for me the two are inextricably linked to each other. The existence of suffering is, I believe, why we need a redeemer, one who, through the suffering he endured, ensures the suffering that we all still share in will one day come to an end.

‘Sorrowful yet always rejoicing’. These are words, written by the apostle Paul, that I find helpful to reflect upon. We cannot expect to live trouble free lives. Hardships and calamities will befall us all and when they do they will bring with them great sorrow. Yet despite those hardships, despite the awful suffering, there is, I believe, still hope in Christ and, therefore, a cause for rejoicing. Leonard Cohen said it well:

‘There’s a lover in the story but the story’s still the same
There’s a lullaby for suffering and a paradox to blame
But it’s written in the scriptures, and it’s not some idle claim’

We live in the tension of ‘the already and the not yet’. For those who believe these things, Jesus’ life, death and resurrection, and the redemption that he thereby achieved, has secured the future – a future so certain that we can count on it as if it were ‘already’ here. We can live rejoicing in the confidence of its inevitability whilst, at the same time, honestly acknowledging that it is still ‘not yet’. We, and our patients, live in the very real pain of today, the heart breaking awfulness of now. Even as we rejoice in the joy of Christmas, and the hope that still remains, we dare not tell ourselves differently. To do so is to delude ourselves, and ensure disillusionment and despair when eventually the truth can no longer be denied. Joy then is not the absence of sadness just as sadness is not the absence of joy. Though a paradox, we can be happy and sad at the same time.

Some years ago, at our daily get together over coffee, I announced to my partners how I was rather enjoying Justin Bieber’s Christmas album. There followed an embarrassed silence, one that I did not fully understand until that evening, when I realised my mistake. I had confused my Justin Bieber’s with my Michael Bublé’s! That was an embarrassing Christmas mistake, one I was quick to put right, but not as big as the one some might think I’m making here. Some may be asking what place do matters of faith have on an online forum encouraging GPs to be strong. For me, the answer to that is simple and lies in the the fact that, in and of myself, ‘strong’ is exactly what I’m not. Not infrequently the job is beyond me. The demand is too great, the need too vast, the expectation too much. Furthermore, rather than always being hard done by as a consequence of the actions of others, too often I am the problem, it is my actions that burden others with the additional work I create.

Of course I endeavour to carry on, to do my very best, but faith brings with it the realisation that, when I’m overwhelmed it’s not all down to me. It gives me the encouragement I need to keep on going in the face of ongoing difficulty, and reminds me that hardships really are to be expected. And when life itself is just too sad, it gives me the assurance that even as we suffer and are sorrowful we can still hope and rejoice in the better future that I believe is surely coming. It is what keeps me resilient. Furthermore it gives me something to sometimes offer my patients when it is all too clear that it’s not just me who’s reached the limit of what I can offer, when it’s all too clear that medicine has reached its limit too.

So I’m going to embarrass myself some more by saying that I really do believe the message that those angels brought to the shepherds that first Christmas night. So often at this time of the year I hear that ‘Christmas is for the children’ and yet, as the angels said, the birth of a Saviour is good news ‘for all the people’, even for those of us who are worn out and exhausted from having worked all year in general practice. Indeed it is, perhaps, when life is at its hardest, when sadness and suffering are all around, that our need for Christmas and the hope it brings is most evident. Because Christmas really can cheer the broken-hearted, and rest merry even the most downcast.

I said this post may divide opinion and so it might. But if it has, and you find yourself feeling uncomfortable with what is written here, please know that it is sincerely written, with goodwill intended, in the hope that it might offer encouragement and hope to some who have known what it is have struggled this year. It is, after all, Christmas. But regardless of whether you have found it helpful or simply consider me to be a naive fool, whether you share my faith or follow another, my hope for you remains the same, that this year, no matter what your current circumstances may be, yours will still be a Merry Christmas.

Now, where’s today’s shot of Pappy Van Winkle’s 23 Year Old Family Reserve.


Other medically related Christmas themed blogs:

For ‘A Primary Care Christmas Carol – Stave One’, click here.

For ‘Twas the week before Christmas’, click here.

For ‘How the Grinch stole General Practice’s Christmas’, click here.

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