Saturday night after Thanksgiving is usually quiet; the out-of-towners keep their hosts occupied and, after a busy day of shopping and football, no one really wants the aggravation of an ER mess if they can avoid it. But this was a busy night; the CHATS — County/Hospital Alert Tracking System — board was festively lit up in red-and-yellow. A year back, the state EMS council recognized the inexorable trend of hospitals going on “re-route,” diverting incoming ambulances. This needed some serious oversight and so they created a website to monitor the entire state, and allow each hospital to see what the others were doing; the 15 ERs in the Baltimore area could tell how many were open or closed at any given moment. If too many placed themselves on bypass, the regional director could override the whole system and open everyone back up — regardless of how busy each hospital was. So far, this kind of monumental cluster-fuck hadn’t happened, but I’ve gotten into the habit of looking at the CHATS board every day before my shift just to see how the county’s doing. There are 24 ERs in our wide swath from the DC suburbs to the eastern shore of Maryland, and on Saturday, nine were posting blocks for their ER (yellow alert) and ICU beds (red alert). Mine wasn’t on red or yellow, but that was a bad sign; we were due for everyone else’s rejected patients.

Pediatrics, as it had the night before, stayed oddly quiet, however. A couple of fever ‘n’ rash kids, sore throats, but not the onslaught of asthmatics or bronchiolitis, an infectious wheezing to which infants are susceptible, that typically starts abruptly after Thanksgiving. Three kinds of germs get traded between visiting cousins during the four day holiday get-together: the flu, a gastrointestinal virus known as Rotavirus, and a respiratory virus known as RSV. The New York strains plunder through the Maryland suburbs over the following weeks, and then regroup and light out for new populations at Christmastime. The result is constant ER overloads until St. Patrick’s day, but it looked like the start of the winter rush — for kids, anyway — was not going to happen for at least another day.

Something to be thankful for.

The worst case I had that night was a 13-year-old practicing skateboard moves in his basement who fell with a painful, genital-damaging split, but the adult side was rough going. A 39-year-old with an ultimately lethal stroke, some bad heart attacks and respiratory-failures, and some ½vicious psychotics. We skirted close to going on red-yellow status, but the next-closest hospital beat us out and we somehow managed to keep afloat.