Cowboy Santa is the first ornament out of the box this year, the first gift ever given me by a patient, many Christmases ago. There was a different one for each of us in the clinic, Santas in various occupations. Given to me by a young patient who holds the unlucky honor of having the worst veins I ever had to contend with, and the patience of a Saint as we stuck him over and over, making him miserable as we tried in vain to make him well.

Cowboy Santa is always a reminder of him and all the patients, and the things they have given me.

A baby outfit smocked with trains for my first child.

A Christmas Cactus that in an act of yearly rebellion, blooms at Thanksgiving.

An enamel box in the shape of a Christmas Stocking. It came with a note of thanks and appreciation, one for each by name, from a man who could measure his time left on earth in days.

A recipe for Salsa from Big Dave, in his own handwriting, and another for Miss Edna’s tea cakes, in shaky cursive like they used to teach.

And food, oh the food. They press cakes and cookies and homemade candy into our hands as though love and gratitude could only be properly conveyed through butter and sugar.

A tray at Christmas from the Mother of a patient who thankfully was healed years ago, and has gone on to live a wonderful life. She turned up with one faithfully every year until she died. I eventually became a Mother that understood that impulse.

The look over the head of a woman from her husband as we admitted her for what would be the last time. His lips saying “Thank you” with his eyes saying all the things those two words could not.

The knowledge that there may be less time than you think and not to squander it.

The understanding that in the end, no matter who you are, it all goes back in the box.

That peace can come and be overwhelming when there is no reason for it. That the veil is very thin around the dying, and they are not alone when they leave us.

That in the end, all you leave and all you take away is who you loved and how you loved them, and who loved you.

That is the best gift they have given me.