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“Orange is his favorite color. It’s all orange, all of the time in there.”

And indeed it was – with the deceptively soft glow from a garish neon storefront light passing through his room, it was impossible for one’s eyes not to be drawn inside. With a hunter blaze bedspread, pumpkin spice robe, marigold slippers, and even a persimmon beanie, wavelengths of orange permeated the otherwise drab, muted colors of the space. 

It became a bit of an endearing ritual for the nurses to start shift reports in this way, reminding all that beyond the chemo, beyond the complications, their patients were people with wishes and fears and love of things like hues found best in late summer sunsets and falling leaves. This patient in particular never failed to arrive to the unit – whether for a planned hospitalization or in acute crisis – with his orange gear in tow.  But this time around, like most of the other patients this time of the year, he was obviously more glum than she’d seen him before.

The holidays: With their arrival anticipated and relished by most, as a patient in the hospital, they were dreaded or merely tolerated. His sulking, ashen face and unnatural pallor seemed to contribute to the fight of the gray and beige room in overcoming the cheerful oranges that had been imported once again. She didn’t like it. It just wasn’t him. But she had a plan.

Absconding with a gown (they’d never miss it) at the end of her shift, she quickly drove home, changed out of her scrubs, and donned her other work clothes. She poured a glass of wine, found a semi-decent historical melodrama on cable – and where the hell were those shears? She worked late into the night, peppering the cool air of the house with obscenities from time to time, but otherwise with a grin of amusement on her face. It was well past midnight when it was done. With a giggle of satisfaction, she folded it up carefully and placed it into her tote bag. Then, valiantly, she attempted to get in a few hours of sleep while her mind filled with imagined scenes of the morning to come.

He was still grumpy, alright – grumpy and despondent, as was completely understandable. “Nothing like telling your patient he’s definitely spending Christmas in the hospital,” the doctor said dryly, walking up to the desk with an aura of dejection. She raised one finger, as if to say, “oh, just you wait,” arched an eyebrow, and beckoned him to follow her back into the room. 

She held the small tote bag tauntingly behind her back, but he was not buying it. “Have some more good news to share with me, doc?” he snorted. With an exaggerated sigh, his son in the lounge chair beside him shook his head sadly. Without a word, she placed the bag at the foot of the bed. With exaggerated motions and the flair of a magician, she reached into the tote and slowly, deliberately, lifted it up.

More than a few heads snapped to attention up and down the hall when he cried out in disbelief. Some started walking quickly toward the room and a few others called out, “should I bring the crash cart?” But, none even made it inside because there, standing in the doorway like a medieval knight, shining in all of his armored glory, was a vision in orange. Not just the pumpkin spice robe, marigold slippers, and persimmon beanie. Oh, no! Rounding out the entire ensemble was the pièce de résistance, the magnum opus of her handiwork and imagination – and affection. 

She beamed as he strutted out into the hall and toward the family kitchen. Gripping his IV pole with one hand and his wife’s shoulder with the other, his one-of-a-kind hospital gown swished around his calves. It was bright orange, “but not garish,” as she had insisted with a smirk on her face. It was technically a hospital gown, but unlike any other. Fashioned out of a pattern created by carefully dismantling the institution-grade original, she had spared no detail. The seams, folds, and even the snaps in the back were all the same. Just…much more suited for him, she explained. His rush to hug her was the only thing that kept him from immediately putting it on. 

My mother and I laughed over the phone as she painted the scene of her patient that Christmas. A bit depressed myself with pulling senior resident call that night at my own hospital instead of being at home with my little ones, I couldn’t help but feel a bit better seeing it in my mind. Surrounded by the jolly reds and festive greens of the season, he reveled in the perfect saturation of his contrasting orange-ness. Not a soul was able to pass without asking him, “where did you ever find that hospital gown?” And, it heartened me to hear Mom happily describe, with pride in her voice, his own little gift back to her in his answer. 

“Oh, you can’t find this anywhere. It’s one-of-a-kind. And, it was made just for me.”



Juliet B. Ugarte Hopkins, MD, CHCQM

Juliet B. Ugarte Hopkins, MD, CHCQM-PHYADV, is a physician advisor for case management, utilization, and clinical documentation at ProHealth Care, Inc. in Wisconsin. Dr. Ugarte Hopkins practiced as a pediatric hospitalist for a decade. She was also medical director of pediatric hospital medicine and vice chair of pediatrics in Northern Illinois before transitioning into her current role. She is the first physician board member for the Wisconsin chapter of the American Case Management Association (ACMA), a member of the RACmonitor editorial board, and a member of the board of directors for the American College of Physician Advisors (ACPA). Dr. Ugarte Hopkins also makes frequent appearances on Monitor Mondays and contributes to ICD10monitor.

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