Working life: Celebrating Christmas – and life – in the hospice

Dr Ben Rusholme shares his special perspective of providing hospice care on Christmas Day with GP wife Dr Daisy Rusholme and their dog Storm

8am
A Christmas Day at the hospice usually has a relaxed start, so we have a gentle wake-up and open our stockings with coffee in bed. Storm, our cocker spaniel, gets his stocking, which includes treats to keep him occupied for the day and a fetching set of antlers to wear. Once the stocking chocolate has been exhausted, we venture to the kitchen for sustenance.

9am
Breakfast finished, Daisy calls Winchester Hospice to find out when she’ll be needed, while I call the Countess of Brecknock (COB) Hospice in Andover. I learn that the heating has broken.

Daisy sets off on her bike. I don an extra layer and put Storm in the car, with antlers, to charm the patients and staff at COB.

10am
Daisy parks her bike at Winchester Hospice and is briefed by the nurse in charge. Fortunately, nothing has changed since yesterday, so there’s time for a mince pie before the ward round. On this day, patients go home if they are well enough, so many of the rooms are empty. Those who remain are surrounded by family, and the atmosphere is a heady mix of powerful emotion.

One lady had a particularly rapid deterioration over the past week. She was admitted to hospital with sepsis, failed to improve despite IV antibiotics, and was found to have metastatic cancer on a CT scan. At this point, she was transferred to the hospice for end-of-life care.

The family are still confused and distraught. They can’t understand how their mother, wife and granny has gone from gardening and cooking to dying. Being surrounded by the jollity of Christmas rubs salt in the wound. Daisy spends a while talking through the details of the preceding few days, attempting to explain how a person can have hidden frailty and that the cancer has been a clandestine lodger in her body for some time. It never gets easier to realise how thinly we all tread the line between health and death.

Meanwhile, Storm and I arrive at COB. After his obligatory tummy tickles, I start the ward round. The heating is still out, but the nurses have found portable heaters and ensure that the patients are warm. The lack of heating means the hospice has closed to admissions, so I have three patients to review in a leisurely way.

A man with metastatic cancer is now settled, having been restless and uncomfortable on Christmas Eve. An elderly lady confined to bed and approaching her last few days beams with delight as her granddaughter helps her to unwrap presents and cuddles up to her.

In the third room, crackers are pulled and glasses of wine raised over Christmas dinner. The patient is delighted that at the hospice, a tipple with lunch is strongly encouraged. Storm plods round and gives several enthusiastic sniffs, becoming rewarded with rather too many offcuts of turkey.

4pm
Daisy and I meet back at home and take Storm for a walk around Winchester before driving to my mother’s with presents. Plenty of wine and food are waiting for us, and Storm has yet another stocking of treats.

We talk about our day, but in the vague way that you do with non-medical family, who don’t quite understand why we’ve chosen to spend Christmas Day with dying people. The view that it must have been awfully sad is the pervasive one, and yet this isn’t an emotion that either of us has really felt during our time at the hospice.

Dying can be cruel, and death is absolute and painful. Hospice care isn’t really about any of that, though. It is about enabling the dying to live. It’s about celebrating the snapshot of normality that a glass of Châteauneuf-du-Pape with Christmas lunch can bring you, and a dog trying to steal your turkey. Being able to provide locum cover to two such brilliant hospices is a privilege to us both – and particularly at Christmas.