Crozet Annals of Medicine: Dear Santa


I think I have been a pretty good ER doctor this year. I mostly kept a straight face during rambling, circuitous and preposterous stories of how various foreign bodies ended up where they did. I am sure the power could have failed in the middle of a shower, which would explain the flashlight, and maybe the slip and fall, but, weirdly, I have heard that story several times before.

I have willingly provided second or third opinions on many chronic non-emergency conditions. While midnight on Saturday may not be the best time for me to obtain and review records from three outside hospitals, I have done my best (thank you, scribes!).

Sometimes second opinions are quite easy. When three drugstore pregnancy tests in a row are positive, one doesn’t really need a board-certified ER doctor to confirm the blessed event. But I do. Congratulations! (Sometimes.)

I have updated to the ICD 10 billing codes but have seen no uptick in spacecraft injuries so far. But I remain vigilant.

So I think I have been pretty good this year. In consideration then, I present my list of gifts I would like this year.

1) Some Syrian refugees. We are one of the few International Rescue Committee resettlement sites in the U.S. and we should be proud of that. In fact, U.Va. has a dedicated refugee clinic that specializes in the particular challenges each culture brings with them. From Hmongs to Afganis, Iraqis to Nepalis, Burmese to Sudanese, I see them all in the ER. They present no threat; they just want their children or their parents to receive long-overdue healthcare. They still see America as the promised land, a great place. Many in the political sphere could learn a thing or two about America from them. It is a pleasure to care for them.

2) Healthcare insurance for everyone in the Commonwealth. I know that seems like a big ask with over 400,000 uninsured citizens, but remember how good I have been this year. Also it should be easy because the Affordable Care Act offers 100 percent federal funding for this for three years and then 90 percent funding in perpetuity. Seems like a good deal to me. Patient lives would be saved (estimated as 400 Virginia lives saved a year) and, equally important, I would get paid for doing it.

3) I would like all neurosurgeons to understand enough about science and archeology to realize that the pyramids were not built as grain storage warehouses and that the world is considerably older than 6,000 years and the scientific ramifications of that, including the evidence for climate change. We have enough charlatans out there denying climate change. Men and women of science ought to know better.

4) More residency slots for graduating doctors. Aside from the fact that I like residents and always want more, we are facing a physician shortage of 90,000 doctors by 2025 and the federal government, which pays for residency training, hasn’t increased the number of training positions since 1997. The medical schools are doing their part by increasing the number of graduates, but now the number of graduates outnumbers the availabilities for residencies for the first time in U.S. history. We need more doctors and that means more funded residency slots.

5) Vaccines for every child. We could wipe out polio and rabies worldwide and measles in the U.S. Santa, we already have the vaccines. I just need you with your magical sled to deliver them overnight to every child lacking them. Short of that, at least let U.S. parents know that vaccines do not cause autism and save many lives. They can get the vaccines themselves, no magic needed.

Thanks in advance, Santa, I know you will come through for me even though my legislators have not. Call it the triumph of hope over experience, I still believe!


  1. I love your stories of the ER room but can do without the politics or lecturing on things you know nothing about. Since Obamacare passed, my insurance has been cancelled 3 times after being steady for 15 years. Obamacare made me uninsured! Also, I know many very smart scientists who think climate change is a minor issue. Shouldn’t you leave climate to the weather column?


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