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with Rod Moser, PA, PhD

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Monday, December 22, 2008

Twas the Night Before Christmas – The Medical Perspective

As a child, I was fascinated by this old poem by Clement Clark Moore. As a seasoned medical provider, I tend to look at most things from a “medical perspective” – analyzing the passages a bit more methodically.

“Twas the night before Christmas, and all through the house, not a creature was stirring, not even a mouse.”

This really concerns me. Was the family somehow comatose, perhaps from carbon monoxide? When people and even mice are out cold, this is not a good sign. Hopefully, they weren’t burning charcoal in those fireplaces.

“The stockings were hung by the chimney with care, in hopes that Saint Nicholas soon would be there.”

Let’s hope those stockings were hung with care. A stray spark from that fireplace could ignite those hanging stockings, especially the ones with COAL! As a child, my stocking alway had coal.

“The children were nestled all snug in their beds, while visions of sugar-plums danced in their heads.”

I have had a lot of weird dreams in my life, but I can’t say I have ever seen dancing sugar-plums. Sugar can sure zip-up kids before bed, but I am thinking “substance abuse“. Could there be hallucinogenic drugs, mushrooms, and other mind-expanding substances involved here? Could those sugar-plums have turned to alcohol?

“Mama in her ‘kerchief, and I in my cap, had just settled our brains for a long winter’s nap.”

So…I am imagining two people in bed. Mama is wearing only a handkerchief; Papa is in a baseball (?) cap. I think something is stirring…and it ain’t a mouse! Looks like someone’s getting his Christmas gift a little early.

“Then out on the lawn there arose such a clatter, I sprang from my bed to see what was the matter.”

Isn’t that always the case? You are getting down to some serious lovemaking, and something or someone interrupts you. It is usually the kids: “Mom, I keep dreaming about plums…” “Don’t come in; go back to bed.”

“Away to the window, I flew like a flash, tore open the shutters and threw up the sash.”

And what did Saint Nicholas see? A naked man, wearing a baseball cap, standing in an open window – The Full Monty. If I were Santa, I would definitely hesitate about going into that house.

“The moon on the breast of the new-fallen snow, gave the luster of mid-day on objects below.”

Note the clever use of the words “moon” and “breast” in this passage, as well as “objects below”. I will leave that to your imagination. Imagination – isn’t that what Christmas is all about?

“When, what to my wondering eyes should appear, but a miniature sleigh, and eight tiny reindeer.”

Now, this would freak you out; perhaps make you question the expiration date on the egg nog you drank before bed.

“With a little old driver, so lively and quick, I knew in a moment, it must be St. Nick.”

Or, perhaps you didn’t pay your mortgage and some old man from Fanny Mae is coming to throw you out? Did you take undue advantage of those teaser interest rates? Did you make your car payment this month?

“More rapid than eagles, his coursers they came, and he whistled and shouted, and called them by name.”

Now that’s nice. First, St. Nick interrupts some good, ‘ol, yule-time lovemakin’. Now, he whistles and shouts. Or, maybe St. Nick finally looked up and saw the flasher standing in the window.

“Now Dasher! Now Dancer! Now, Prancer and Vixen. On, Comet! On, Cupid! On Donner and Blitzen!”

What kind of names are those for reindeer? They sound more like exotic dancers. Oh, well…what goes on at the North Pole, stays at the North Pole.

“To the top of the porch! To the top of the wall! Now dash away! Dash away! Dash away all!”

If I were trying to fly a bunch of reindeer up on a roof, I think I would do the wall first; then the porch. You don’t see many walls up on a roof.

“As dry leaves that before the wild hurricane fly, when they meet with an obstacle, mount to the sky.”

??? What the hell does that mean? What obstacles are we talking about here, Mr. Moore? This passage has always been the big obstacle for me.

“So up to the house-top the coursers they flew, with a sleigh full of toys and St. Nicholas, too.”

St. Nick apparently gives up on that wall/porch route. Now, he is getting somewhere.

“And then, in a twinkling, I heard on the roof, the prancing of pawing of each little hoof.”

You are going to be doing some roof repair in the morning. Think about getting dressed.

“As I drew in my head, and was turning around, down the chimney St. Nicholas came with a bound.”

Old homes usually had more than one fireplace and chimney. Apparently, St. Nicholas, in his rush to quickly get things accomplished, came down the one in the master bedroom. Or, maybe, just maybe, mama and papa were getting in on in the living room after the kids went to bed.

“He was dressed all in fur, from his head to his foot, and his clothes were all tarnished with ashes and soot”

I did not know that Santa only had one foot. It doesn’t really surprise me, though. Looking at the way he takes care of himself, I am thinking “diabetes with a foot amputation“. And, we certainly have a hygiene issue here.

“A bundle of toys he had flung on his back, and he looked like a peddler, just opening his pack.”

Or, someone has broken into your house and is about to rob you…or worse. You definitely should have gotten dressed…

“His eyes how they twinkled, his dimples how merry! His cheeks were like roses, his nose like a cherry.”

I am now thinking “pink eye“; maybe Fifths Disease, although this would be highly-unlikely in the elderly. That red nose? Alcoholism? Rosacea? Congenital deformity? I can’t really get a good look.

“His droll little mouth was drawn up like a bow, and the beard on his chin was white as the snow.”

The mouth: Bells palsy? Stroke? The beard is normal, of course. Many of us have white beards.

“The stump of his pipe he held tight in his teeth, and the smoke it encircled his head like a wreath.”

St. Nicholas was a smoker. It isn’t bad enough just to be obese, have one foot, diabetes, Bells Palsy, pink eye, Rosacea, etc., you gotta smoke too? That’s probably what all of those ashes and soot are about – riding around in that open sleigh tokin’ on your pipe. You might as well add lip cancer to that medical problem list.

“He had a broad round face and a round little belly, that shook when he laughed like a bowl full of jelly.”

The face? He has got to be either hypothyroid or have Cushing syndrome. The belly? It could be a tumor, edema, ascites from advanced liver disease, or just a serious lack of sit-ups.

“He was chub
by and plump, a right jolly old elf, and I laughed when I saw him, in spite of myself.”

Yes, he laughed…in spite of the fact that he was still naked and wearing a baseball cap; his scantily-clad wife crouching behind the sofa. Clearly, Santa has an elevated body mass index (BMI) and apparently, doesn’t really care about his overall health. I bet those reindeer would have something to say about his weight.

“A wink of his eye, and a twist of his head, soon gave me to know, I had nothing to dread.”

There you are…standing buck-naked when a big, dirty, fat, one-footed, grinning, red-nosed, diabetic, stranger who just jumped out of your chimney, winks at you, and you think you have “nothing to dread”? Think again.

“He spoke not a word, but went straight to his work, and filled all the stockings, when turned with a jerk.”

This is just too weird. He’s not talking, but he is abruptly turning and jerking. Stroke with aphasia, maybe? Parkinsonism? Seizure disorder?

“And laying a finger aside of his nose, and giving a nod, up the chimney he rose.”

If you are going to pick a booger, Nick…just pick it. Don’t try and fake it by nodding and putting your finger “aside” your nose, like we all do when someone catches us. And, don’t try and wipe in on the couch! I am standing right here!

“He sprang to his sleigh, to his team gave a whistle, and away they all flew like the down of a thistle.”

Thistle down kind of floats in no particular pattern, a virtual slave to the the wind. This is really no way to get places quickly; especially when you seem to be in a hurry.

“But I heard him exclaim, ‘ere he drove out of sight, Happy Christmas to all, and to all a good-night.”

Not “Happy Holiday”? He apparently didn’t hear me tell him that he needs a complete physical, some baseline blood work including a complete metabolic panel, nutritional consultation, smoking cessation classes, and neurological consult.

Now, where was I before I was so rudely interrupted? Where’d ‘ya go, Mama?

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Posted by: Rod Moser, PA, PhD at 7:00 am


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