When I was a boy, I often heard that old saying that parents told their kids to ease their fears of the night. “Now remember, there’s nothing in the night that isn’t there in the day.” Of course, the counterpoint was my mom double and triple checking the locks after the sun went down. But that’s beside the point.

Later, after studying zoology and spending some time living in the sticks, I would like to go back in time and say to my elders, “What? Have you never heard the word nocturnal? There are lots of things that are out there in the night that aren’t there in the day. Sure, most of them are harmless, but some of them aren’t.”

But there’s more in the night than noises and creatures.

What we see in the night, in the ambulances, police cars and emergency rooms of the land, is suffering, fear and loneliness.

What we see are seniors, living alone, who suddenly wake up terrified. Sometimes they are fearful because they have depression, anxiety and grief. Sometimes they develop chest pain, or trouble breathing or numbness or weakness. They are reasonably fearful of stroke or heart attack. Sometimes their fears produce the symptoms and they became frantic.

We see the same group of people falling at night, with terrible injuries. In the past year I have seen senior citizens with: a hangman’s fracture of neck from a simple fall against a wall, a massive head injury from falling off of a ladder at 4 am and two patients with ruptured spleens from simple falls against boxes or counters, both of which required emergency surgery. This doesn’t include the standard hip fracture on the way to the restroom.

The night brings children with fever, whose parents are terrified (and who often lack involved grandparents to help ease the fears). The night brings the barking cough of croup, or the terror of asthma, the parental nightmare of childhood seizure, injury or accidental ingestion. The night amplifies the love of parents who want nothing more than their child sleeping soundly in next room.

In the night, while the gentle world sleeps, the night brings overdoses. The methamphetamine users, picked up by police frantically raving and twitching on the street come to us uncontrolled and in danger of stroke, heart attack and seizure. The fentanyl users come to us blue and pulseless unless someone had some naloxone to give them.

When the sun goes down, we see the violence that sleeps during the day. The machete attack, the shooting, the beating. (And beatings are so much more than what television shows; with crushed faces and airways, with brain injuries and longterm pain and debility.)

Those driving in the dark, on alcohol, opiates, marijuana or G-d knows what else wreck their cars and have to be extricated, and brought to the hospital or flown to the trauma center. In the night, these events result in phone calls to sleeping loved ones of the drivers or their victims, bringing terrible news of death or severe injury.

(In the night, the screams of grief seem louder when we give bad news.)

But worse, in the night there may be less we can do for those who are suffering. There may be no beds to admit them, no ambulances to transport them out of town (“we’ll have a transport crew at 8 am, but not until then”).

When the critical trauma or heart attack need higher levels of care, the night may bring fog or storms so that no helicopter can fly.

The night can bring a kind of medical hopelessness to those working and doing their best. The local ambulances keep coming and the patients in the front door keep coming and all of it piles higher and higher.

Sadly, the truth is that for all of our skills we’re tired at night. The aging populations, the drugs, the mental illness, the complexity of medical problems, the declining resources, these require all of our faculties, but even the best physician, and nurse and medic grows weary as midnight rolls around, and then 2, and 4 and 6 am, and we pray silently for day shift to arrive with their energy and their fresh coffee.

The night has dangers. The night, in some ways, has monsters of disease and injury, of social dysfunction and brokenness. It has zombies of addiction. It has predators of cruelty and violence. And it has the angel of death, swooping near on a regular basis.

There are things in the night, things that the rest of the world only reads about in the morning or (as so often happens) on social media. The rest of the world, the daytime world, says ‘tsk tsk!’

And those who shepherd the night stumble to their cars, to their beds, and sleep, knowing that for a few hours, the day holds fewer threats.

As the sun goes down, they rise up and do it all again.

Pray for them.

Watch, O Lord, with those who wake, or watch, or weep tonight, and give Your angels and saints charge over those who sleep.
Tend Your sick ones, O Lord Christ.
Rest Your weary ones.
Bless Your dying ones.
Soothe Your suffering ones.
Pity Your afflicted ones.
Shield Your joyous ones, and all for Your love’s sake. Amen.

St. Augustine


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