Gotta Work


Trouble never takes a holiday … and neither do ER workers

By Pat Sherman

While friends and family belly up to the eggnog bowl, La Jolla’s emergency services personnel remain on the clock, responding to every Christmas feast casualty and Griswold-style decorating misstep.

Davis Cracroft, a La Jolla resident and medical director of Scripps Mercy Hospital in Hillcrest, has spent numerous holidays patching up people who never quite finished trimming their trees.

“People fall off ladders or their roof when they’re trying to put up lights and Christmas decorations,” Cracroft said. “That can lead to significant injuries and will definitely put a crimp in your holiday spirit.”

In addition, the flurry of culinary preparations — especially when libations are involved — can land ambitious hosts in the ER, with everything from cuts to burns.

“Julia Child could do it,” Cracroft said, “but not everyone can.”

At La Jolla’s Fire Station 9, captain and paramedic Kevin McWalters recalled once rescuing an ersatz Santa Claus from his rooftop.

“He spent an hour and a half trying to get down before a neighbor saw him and called us,” McWalters said.

Charles O’Connell, a resident physician at UCSD Medical Center, recalled what he considers a “New Year’s toast gone bad” — when someone broke a Champagne bottle over someone’s face, causing an orbital fracture and eye injury.

“New Year’s Eve is kind of a different animal,” he said. “We call it amateur hour because you have a lot of people who don’t tend to drink much who come in for intoxication.”

As the temperature dips, there is also a “higher risk of respiratory infections and flulike illnesses,” Cracroft said.

However, temperatures can also reach a boiling point when families get together and rehash old wounds, leading to an increase in domestic violence.

“It’s a wonderful time of year if you’ve got good family dynamics,” Cracroft said.

The bounty of fat, sugar and sodium laden dishes alone can be trouble for people with chronic medical conditions, including congestive heart failure, diabetes and gallbladder disease.

“I worked Thanksgiving and … we actually had a big post-holiday rush,” O’Connell said, noting that people often postpone treatment until after the festivities.

“A lot of people kind of fall apart over the holidays,” he said. “I’ve seen some people get into a real tight bind because they put things off and then they’re way behind the eight ball. If there’s truly an emergency or an emerging need to be seen by a physician, do not put that off because of a calendar day.”

Though the amount of patients seeking emergency care on Christmas and New Year’s Eve isn’t significantly higher than at other times, Cracroft said local ER staff is prepared to handle a potential surge.

“Overall, we have to staff up with both doctors and nurses in order to meet the demand at local emergency departments,” including Scripps Memorial and Scripps Green hospitals in La Jolla, he said. “There’s more traffic out there and, unfortunately, alcohol consumption can influence traffic accidents.”

Firefighters at La Jolla’s Station 9 — the bulk of whose holiday calls are related to drunk-driving accidents and fires started by heaters, fireplaces or faulty Christmas lights — work 24-hour shifts, receiving overtime pay for the first half of their shift.

“Those are unfortunate calls for us,” said McWalters, who will have his first Christmas off in three years this month. “A dry Christmas tree doesn’t take a whole lot to sustain ignition.”

At Station 9, firefighters offset such tragedy by inviting their families to the station for an early evening Christmas dinner.

ER staff may request holidays off, though if there are not enough charitable souls volunteering to work — or in need of holiday overtime pay — those with seniority typically receive priority.

“Within the residents we try to divvy it up fairly, between Thanksgiving, New Year’s and Christmas, so at least you have one of those days off,” O’Connell said.

“It does get a little lonely when you see everyone is at home with their families and friends celebrating,” he said, “but we have a nice kind of surrogate family here among the staff, including nurses, technicians, myself and fellow doctors. We bring a potluck dinner that we all eat out of the staff lounge.

Scripps’ ER staff muster the same feeling of camaraderie during the holidays, Cracroft said.

“We all recognize that we’d rather be at home with our friends or families, but in all the ERs I’ve worked in, everyone really pulls together. We try and make the most of it and, generally, food is the best way to ease the pain.”

Though the average wait time at Scripps emergency rooms is 30 minutes or less, Cracroft advises patients to take advantage of any extended holiday hours offered by their own physicians.

“A lot of doctors this time a year will add after-hours times to see patients,” he said. “If they’re not critically or seriously ill, that’s always encouraged, just to keep the loads down on ER departments.”

However, if walking into the ER with salmonella symptoms from a bad batch of eggnog or delivering a child with lacerations from toy packaging (a common occurrence), Cracroft advises patients to remember that there is a “prioritization of patients,” in which those in the most critical condition are seen first.

Cracroft’s pet peeve during the holidays — beyond people demanding costly antibiotics for viral respiratory infections (which he says don’t work) — is dealing with intoxicated or belligerent patients.

“I don’t necessarily enjoy those patients, but I also understand that sometimes there are other stresses behind that,” he said. “The good news is that most of them, once they’re sobered up, are very decent human beings.”