I am sitting in my office after a long day. Everyone has left, rushing off to the hustle and bustle of their Christmas preparations. A quiet sets in, interrupted only by the sound of cars speeding by. As I sit here, I feel struck by the events of the last few days. Since Monday, I have done 8 early pregnancy ultrasounds and called 6 patients with pregnancy test results.

Most have received wonderful news and have left the office sharing a bond with the young pregnant woman who was making her way to Bethlehem this time of year so long ago. I think this will be one of the most special Christmases those couples will ever have. Others have received mixed news. There are aspects about the tests that are not reassuring, and we have to wait and see what happens. They leave the office with a desperate hope as they cling to the life that took so much to take hold inside of them.

Thankfully, I only had to give a few couples the worst news possible, that their hope for a pregnancy this time has ended. I feel like I have just given them a lump of coal that they didn’t deserve. It is never easy to give that news, but tonight, with the holiday season bursting around me, it seems particularly hard. I feel like I am caught up in some Charles Dickens infertility Christmas short story, and any moment a bright light is going to shine in under my closed door and the ghosts of pregnancies past, present, and future are going to take me on a journey to enlightenment.

Why does bad news have to come just before Christmas and cast a shadow of grief over the most joyful season of the year? As I struggle with this question and let my mind reflect on my patients at Christmas time over the past 18 years, I wonder what grand epiphany I might offer my patients on Christmas day if I woke up after spending the night with the three ghosts of Christmas. I think it would go something like this…

You must hold on to hope. Patients that sit across the table from me carry the best of what is in all of us. You are not searching for gold, frankincense, or myrrh. You are responding to a deep, profound, and holy call to nurture a child.

Your quest for a family is pursued at great physical, emotional, and financial cost. As I watch what unfolds in the lives of you, I can’t help but believe that your great sacrifice, placed on the altar of providence, does not go unnoticed. But rather, that something pure and bright is placed in your favor on the great balance of life that sooner, or later, will bless your lives. This is the hope to hold on to, that what you are striving for is good and noble and right. My wish is that all that strive for such things will receive their reward in the end.

And that in the end, God will bless you, everyone.