“You are the perfect employee!”

A manager once exclaimed that at a gig I had through high school. I offered to work Thanksgiving, Christmas and even New Year’s because my family stayed in anyway. At the time, we didn’t observe any of those holidays, except watching the ball drop on TV on the 31st. If one of my co-workers had to get home for Christmas, I was happy to stand in. So began my path to not only honoring my religious tradition of honoring religious tradition, but also pleasing employers. Besides, I quickly learned the added perks of working these days. They include:

1. Holiday potlucks: Don’t worry about packing a lunch. Or dinner. Take leftovers after and save that grocery money for gas or rent.

2. Mood: Staff is just nicer during the holiday shifts (well, in certain industries). The ones who observe Christmas but “got stuck” working aren’t usually wallowing in their sorrow. Typically ornery coworkers even smile during these skeleton-staffed shifts because hey, if you can’t beat ‘em … and we learn something about why the person is so crusty and gain new insights into the human condition - and if we’re lucky, ourselves.

3. Presents: Secret Santa, baby! Sadly, white elephants became a thing when I missed a few years of working Christmases, and now people exchange gag gifts, which I loathe. I’ve gotten a foam Jesus frisbee and a homemade colon in these new work rituals. This is yet another reason why Muslims should work the holiday: save Secret Santa!

It was common during medical school and residency to observe Jewish and Muslim doctors offering to cover Christmas, and sometimes Thanksgiving, for their colleagues. Hospitals don’t close for the holidays but neither do family traditions. As Muslim doctors, we signed up for those nights in anticipation of Eid coverage twice a year, so it (usually) balanced out.

Which leads me to a particular Christmas when I was doing a shift at the hospital and became part of that elite group of doctors who are privy to a “Christmas coverage miracle.” Settle in for the story!

Christmas 2008 was a milestone for me as a family medicine resident physician, as I recovered (or thought I had) from postpartum depression while working 80 hours a week and breastfeeding (pumping, rather, most of that time). I had many overnight shifts that November and on one of those, I was assigned to the delivery room of a screaming woman who’d had no prenatal care. The staff knew her well because she’d been there nine times before and none of the kids were in her custody. She was addicted to crack, unhoused and unhelped. But she wasn’t my patient. Her baby was.

He shot out like a bullet as premature babies can, especially when they’re as tiny as he was. I still remember the smell of him. Either mom had been laboring for a while or her water had broken the day before, but he’d been swimming in infected fluid for a while. Yet, he looked good and sounded mad enough to come to the intermediate newborn nursery for close watch while his blood was checked and for neonatal abstinence scoring. Mom tested positive for cocaine and opiates, as did his umbilical blood, so he had to be monitored for withdrawal symptoms.

That baby STANK, and I was glad the nurses immediately bathed him. But, he didn’t take a bottle or dropper well. His wail was a piercing shriek followed by a silent gape for several seconds, because he just wasn’t strong enough to sustain a full cry. Baby X entered the world in a mess, and he wasn’t happy about it.

Every delivery caused my milk to let down and between babies I’d run back to my call room, pump, clean, refrigerate and run back to either a screen to look up labs, or perform a bedside check on a newborn. We had babies being delivered every 20-30 minutes all day and night long. It was during these relays that Baby X’s labs came back positive for infection. Of course it was the middle of the night and as a resident, I had to wake up an attending doctor and ask him to come supervise me perform a spinal tap on someone who fit easily in my palm.

I was petrified because I feared for Baby X, who now had an infection in addition to impending cocaine withdrawal, and because I hated doing spinal taps on babies. They’re so tiny and helpless and the only way to do it right is to put them back in a fetal position (after they worked so hard NOT to be in) and go for it. There’s no anesthesia or glucose pacifying. The babies scream if they can, and they curse your name to the angels if they can’t.

Given the size of my patient, I fully expected my attending to do the procedure, but be handed me the tray. “This is YOUR baby. You’re doing this.” I’d never done a tap on a preemie. With another letdown pressing in my underarms, a full bladder, sleepless exhaustion and imposter syndrome, I pleaded not to do it. He insisted, “This is your baby.”

With every du’a and tasbeeh I knew, I got it on the first pass. Of course I made my attending talk me through each step again as I practiced in the air with my eyes open and closed first. While he punched the air and shout-whispered, “You did it! I told you you could!” in the quiet nursery, I wanted to vomit. Baby X had no mother advocating for him. She barely asked any questions when I explained why this needed to be done and hurriedly signed the consent forms before she went back to sleep.

By the morning, Baby X had an IV in his tiny head pumping antibiotics in him, oxygen forced onto his doll sized face, and a feeding tube going through his nose, all while he lay inside an NICU incubator to retain body heat. My job was to calculate his caloric needs every morning before I left to make sure he gained weight appropriately, as well as to check for signs of withdrawal every three hours on my shift.

Mom denied drug use when I asked the next morning. I had to take a call and by the time I returned, she’d left the building. Nursing shook their head saying, “Every time,” or “She’ll be back next year” with resignation. Admittedly, I wasn’t very kind to her either and in hindsight, she needed mothering as much as her son did. I needed to find her, or Baby X was all alone.

The child protective services case worker wanted Baby X checked for syphilis, because his mom was documented to have it. It’s an infection that has to be reported in the county, and the caseworker knew EVERYTHING. So in addition to antibiotics for his infection in labor, now we had to check him for syphilis, but we hadn’t ordered it on his spinal fluid the night before. The county had levels recorded for mom from the calendar year, but we doubted treatment had taken place, given her circumstances.

Baby X had levels of exposure detected in his blood, but it was not proof of infection. Ideally, we’d compare his levels to mom’s current ones, but she wasn’t anywhere to be found. He needed another spinal tap and got it during the day I was off, Alhamdulillah, and didn’t have to do it. His test indicated congenital syphilis and required 14 days of a different antibiotic to make sure this infection didn’t debilitate him in the future.

During his stay, I found a contact number for his biological grandmother, who lamented that she could only care for two of the now 10 grandchildren her daughter had out in the world. Seven of them were in foster care and she didn’t see them often. She had no idea where her daughter was and couldn’t guess. Her other children had their own kids to tend to. Baby X had no family that could take him, and until he was medically cleared, he couldn’t be placed in foster care either.

There were a couple of other complicated babies I was following in those days, but it was Baby X I prayed for on every night shift and the drive home, a frosted breath of a du’a written in the frigid morning air. At first I prayed for his mother to get help and come take him. But when he started withdrawing on Day Four of life, that du’a evolved into bringing him comfort. Withdrawal is painful, and now his sharp wail pierced us all; pain control became necessary.

His syphilis work up was a nightmare and I either prayed, but most likely cussed on more than one occasion while on hold with county public health while they searched his mother’s records, or the lab said his results weren’t back yet. Every time he lost weight, I second guessed myself, but my calculations weren’t wrong. Just breathing used up so much of his energy, and he still couldn’t maintain his body temperature. He lost weight just being. In the minutes I was free or passing by from another newborn’s side, I’d slip my hand in to stroke his chicken legs or hold his doll hands. Only the incubator held him.

Things started to improve. Alhamdullilah, even though his abstinence syndrome seemed to last longer than expected, he gained weight and held his body temperature after a couple of weeks. He transferred back to intermediate care, and the nurses there held him while they cared for other babies. Their babies weren’t as sick as the NICU ones. He cried less, but loudly when he did, didn’t sleep well, and continued jerking at times.

He had already been checked for seizures, and was clear of those. The antibiotics were still being given. Did they cause this, or was it withdrawal? We couldn’t be sure, but CPS wouldn’t place him until we were. In my spare minutes I’d go to the nursery just to hold him against my chest, which promptly soaked my shirt with a letdown. He slept right through it most times. As soon as one of us put him down, he’d start screaming and we could only guess pain and treat him for it.

After three weeks of living in a hospital, Baby X’s aunt stepped forward to take him when he was cleared. I was excited to hear it and desperately tried to score him lower on his abstinence scales, and he was actually doing better on most days. After several days of hopeful planning with his care team, the caseworker let us know that someone in the aunt’s household didn’t pass muster. Baby X was still our baby.

In fact, after another week he was fine. A normal newborn with a shaky start in life, but he was ready to go out into the world. He just needed a home to go to. The caseworker changed and I made call after call in the mornings, staying until noon to make sure I left messages that Baby X was medically stable. Where was his home? The social worker at the hospital would be there if they called back to answer, but when I checked in at night, no calls had come.

The desert is bone chilling cold in the winter. I know parts of the country lay claim to bitter chills, but the desert at 30 degrees hurts more than a zero elsewhere. I’ve experienced both. I think that’s why Prophet Muhammad (saw) and the pious predecessors’ du’a were accepted so much. They prayed in these bitterly cold hours and made wudu’ in them without warm water! Blessed to live in similar conditions, I prayed qiyam and fajr at work, willing Baby X to go somewhere safe and warm. Okay, I had warm water and a space heater, but I think it still counted.

Listen to this Episode of Mommying While Muslim about fostering unaccompanied refugee children.

About a week later, after a busy night during which I hadn’t even had a chance to check on Baby X, I learned from the morning nurse that a foster family was found, and they were picking him up the next day. My last hours with him would be on my shift that night. I wasn’t ready. Who are they? Will they come get him? What did the caseworker say? The nurse didn’t know, but there were some papers I had to sign.

I sobbed, and she hugged me because she was “so happy, too.” But I wasn’t happy, even though I got what I’d asked for. I felt selfish and possessive with just a hint of relief for our baby.

At the beginning of the month, our attendings asked us who could work the holidays. I was game from force of habit and well, I was the only Muslim on the team. I felt it was only right and offered to cover both Christmas Eve and Christmas Day night shifts so my colleagues could spend at least the evenings with family.

I was so glad I did because on Christmas Eve, the nurses and I took turns holding Baby X, even though he comfortably slept in his swaddle. We’d been through the ringer with him, although he’d done all the heavy lifting. They called it a “Christmas miracle,” which sounded kitschy to me my whole life. Even though I knew how commercialized and historically inaccurate Christmas was, now I wanted to say it too: “Christmas miracle,” knowing fully that indeed, Allahu Akbar.

Wait to heal for weeks, then wait again for two weeks only to go to a family on Christmas Day? That’s a Hallmark movie!

I’ve never believed in accidents, and as a Muslim, I never will. Surely Allah (S) is the best of Planners. Working the holidays for colleagues has never been as fruitful, no matter how much food or what presents I received, than it was that night. I loitered in the nursery the next morning until I could choke out a “goodbye” to our Baby X, then rounded on my patients and heated the Christmas morning air with “Alhamdulillah,” warm tears and snot freezing on my face on the way home.

Dr. Uzma Jafri is originally from Texas, mom to four self-directed learners, a volunteer in multiple organizations from dawah resources to refugee social support services, and runs her own private practice. She is an aspiring writer and co host of Mommying While Muslim podcast, tipping the scales towards that ever elusive balance as the podcast tackles issues second generation Americans have the voice and stomach to tackle.