We took down all the Christmas decorations today. I hate doing that. Not only is it a lot of work, but I really love Christmas and taking down the décor seems to signify that it is really over. However, we always get it done before New Years because I don’t want to spend the first of the New Year packing up my favorite season. New Years has always felt to me like a second rate holiday coming right after Christmas. Maybe it’s also because I sometimes struggle with seeing the New Year as a new beginning.

Working in healthcare, my colleagues and I regularly hear stories of human suffering at its worse. We listen as people pour out histories so marked by pain I can’t imagine surviving them. In the week leading into Christmas break I spoke with one young couple whose baby would be in the NICU at Christmas. A rare genetic disorder means she will likely never see her first birthday. Another patient hasn’t seen her very young children in almost a year. Her husband brought her from Africa before the birth of her first child and then left her, taking the children. Her visa has expired and she dare not seek help as staying here is the only chance she has at ever being reunited with her children. I told a mother in her 40’s she has cancer. One of my prenatal patients told me she had fled her country in case the baby was a girl. She did not want her daughter to experience the trauma of female circumcision as she had. These stories don’t get a fresh start in the New Year. The trauma and pain is just as raw on January 1st as December 31st. As a provider, I am used to having ideas and solutions but far too often I find myself sitting next to a patient and simply saying, “this really sucks.”

The brokenness of the world doesn’t get erased with the New Year. People won’t suddenly be cured of illness, have secure housing, or enough money in their account. Celebrating a New Year seems cynical.

One of the reasons I love Christmas so much is that the message of hope is so central. The Christmas story is one of hope; hope born in the most unlikely of places, right in the middle of a broken world. The capacity for human hope never ceases to amaze me. What all of those patient stories have in common is that people are surviving in the midst of pain. Many go on to thrive in the aftermath of trauma and despair. Hope if often most clearly visible in the most dire of circumstances.

The week before Christmas I laughed with two of my favorite patients and showed them pictures of my kids who they ask about at every visit. Three years ago, they lost their son unexpectedly and we sat together in his ICU room the day before they authorized the removal of his ventilator. Somehow, they build a new normal. They work and are deeply involved in their temple and have improved their health. There is hope in the midst of suffering. I was able to tell a patient he qualifies for a housing program after years of living on the street. He tells me his frustrated with the waiting but this is good news. There is hope in the midst of waiting. Another patient, who is months behind on rent, unable to work, and raising his son as a single father, received financial approval from a hospital for a desperately needed pacemaker implantation. There is hope in the midst of illness. I will always remember meeting my daughter for the first time. She was in the NICU covered in tubes and you could barely see her face beneath the feeding tube and ventilator. I wasn’t there at the time of her birth so I hadn’t spoken to a medical provider and I didn’t know anything about her condition or prognosis. Yet, I was so in love with her already. I could picture a smiling toddler, a bouncing little girl with messy pigtails. There is hope in the midst of the unknown.

As I’ve been thinking about the New Year, I’ve thought a lot about hope. We don’t get a clean slate in 2019. Just like personal pain and suffering, poverty, homelessness, inequity, and illness will be just has present in the New Year. It’s OK to mourn that and it’s OK to feel hurt and disappointed. The brokenness of it all should hurt. But it is in that brokenness that we lean into hope.

I’ve been thinking about what it means to build hope. What can I do to build hope in my home, community, and clinic? My family can live a little more simply and give a little more to organizations building equity. I can find a volunteer outlet where my kids can participate with me. I can create spaces for conversation about health equity. I focus my clinical care around the question, “What do you need to be healthy?” and then listen, trusting the response no matter what it is.

As I pack up Christmas and prepare to start dating everything with 2019, I’m not going to imagine a perfect year without problems. I’m not going to turn a blind eye to all that is wrong with our world. However, I am going to hope because I have seen the power of hope over and over again through my patients. I’m going to be intentional about building hope because better is possible.

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