My tear ducts are no match for the Christmas card Sammy Wilson gave me when he was five years old. Every Christmas Eve, it’s the same routine. My family gathers in the living room. I make a big show of the card as I build up to my annual telling of the Christmas story you’re about to hear. Every year, I tear up before I can get through the story’s opening stanza. Sammy handmade Christmas cards for the entire oncology staff at All-Children’s Hospital that year. I had hair then, so that should give you an idea of how long ago it was. You’d never know how many Christmases have come and gone by looking at the card, though. The corners haven’t the slightest bend and it looks like the crayon marks were made yesterday. Storing my most cherished holiday keepsake in an air-tight plastic sleeve, in a fire-proof safe for 364 days of the year may have something to do with the card’s immaculate condition. It’s my wish that after I’m gone, my family will continue the tradition of telling Sammy’s story on Christmas Eve. I’d love for the card to be in presentable shape when they do. My Christmas card from Sammy has a wavy crayon drawing of me in my white coat, the one I wore nearly every day on my rounds that year. Sammy is next to me on the bed. Santa Claus is sitting on the bed with Sammy. We’re all smiling. There’s a slight halo around Sammy’s head, but he didn’t draw it. That came when I first held the card in my hands, so many years ago, and a single tear escaped my eye and landed on Sammy’s hand-drawn self-portrait. The scene is an innocent five-year-old’s rendering of hope. For me, it’s meant so much more. Every Christmas I adorn the mantle next to our Christmas tree with the card and tell this story about what really matters. May it speak to you as it has to so many through the years. Five-year-old Sammy Wilson was the first terminal case I treated in my medical career. You never forget your first, no matter how many children you may have saved since. This isn’t a sad story, though I always seem to start it off on a somber note. That’s because pediatric oncology is a tough specialty. Sometimes, you lose a child whose aura pushes past your professional wall and finds its way into your heart. Sammy Wilson was one of those kids, as thoughtful and generous as any child I’ve ever met. He was also one of the sickest I’d treated in my career at that point. He didn’t have much time left, and I couldn’t give him more. I was willing, however, to do anything in my power to make the time Sammy had left special. Sammy Wilson had an aggressive case of acute lymphoblastic leukemia—the kind that, in those days had no effective treatment. All you could hope to do was delay the inevitable by the blasting the cancer with as much chemotherapy as the child could take. Sammy had been in an out of hospitals for most of his life. The last six months, however, had been the toughest. The chemo had taken his hair and nearly every ounce of his strength. Draining as the treatment regimen was, it wasn’t enough to appease the boy’s affliction. The cancer in Sammy’s brittle bones just growled and kept coming, killing the child’s white blood cells in droves and leaving his withering body a vulnerable open target for infectious disease. Sammy dealt with his illness as though it were just a bump in the road on the way to the playground. Even though his sickness had kept him away from most playgrounds in his life, the boy’s heart never faded. Neither did his smile. It was December 24th and I had just gone over the latest cytogenetic analysis with Sammy’s mom, when Sammy turned to her and asked the hardest question a boy can ask his mother. Angela Wilson had done everything humanly possible for her only son. She’d taken him to every specialist on the East Coast, and spent every penny she had doing it. To look at Sammy’s mom, you would have thought she was the patient. The sleepless nights of worry had extracted a heavy toll on the woman who couldn’t have been more than thirty. Her hair was thin. Her frame gaunt. Her eyes looked like they hadn’t rested in years. She didn’t have any delusions about what part of the journey she and Sammy had reached. Angela Wilson was a realist. Still, Sammy’s question caught her off-guard. “Mom? Will I live to see Christmas?” Even today I can hear Sammy’s delicate voice ask his mom to predict a future she was too heartbroken to consider. Like the card he would later give me, the memory of Sammy’s innocent question still gets me the way a moment you were never meant to forget should. Sammy’s mom didn’t tell her son the truth, not in the clinical sense anyway. Like all great answers moms provide to the really hard questions, Angela Wilson’s explanation gave Sammy the comfort that there would be a tomorrow, and it would be even better than today if Sammy greeted it with love in his heart. For the first time in my professional life, I prayed to anyone who might be listening to let Sammy Wilson live long enough to see Christmas. God didn’t answer. I gave it about a 20% chance. The truth was, Sammy’s bone marrow was overrun with immature lymphocytes. Any night could be his last. Leukemia doesn’t care if it’s Christmas Eve. None of the patients at All Children’s Hospital are ever on the naughty list, which is why Santa Claus makes regular appearances here during the holiday season. He always makes the rounds on Christmas Eve, but Sammy was in a deep sleep when he did during this particular year. Christmas Eve is a busy time for Saint Nicholas, and the chances of getting Santa to hold his appointments to make a personal appearance for Sammy seemed a grim prognosis. There were other kids at other hospitals, Santa assured me, who, like Sammy, wanted nothing more than to make a Christmas wish to St. Nicholas, himself. The doctor in me understood that there were other kids in need of Santa’s love. There would always be others. But the thought of Sammy Wilson’s last Christmas coming and going without the boy seeing Santa was too much for me to bear. Theresa, the charge nurse on duty that night, told me about The North Pole, a talent agency that specialized in Santa Claus impersonators. Their actors, Theresa assured me, were the giants of their field, spitting reflections of the real thing, and the go-to Kris Kringles of All-Children’s Hospital—largely for their ability to make special calls for time-sensitive cases like Sammy’s. We both understood that Sammy, despite his frail state, had an uncanny knack for identifying anything that fell short of the genuine truth. This went for medical explanation and iconic holiday figures. Theresa was steadfast in her support of The North Pole. Like me, she was a straight shooter when it came to treatment recommendations for tough cases. She’d been at All Children’s ten years longer than I had, which was enough for me to realize she was the expert in this delicate matter. I was convinced her prescription was the proper one, and so I made the call. In those days, we had what were called phone books—tomes of newsprint and advertising that held the phone numbers of every resident and business in town. I walked my fingers through the book and found the number for The North Pole. A half-page advertisement next to the number touted the virtues of the agency, which all but assured the real Santa would be available no matter how dire the circumstances. My heart pounded like a first-year surgeon’s waiting for lab results as I dialed the number and the ring chime echoed in my ear. Four rings, then five. Obviously they were busy. It was Christmas Eve, after all. The line clicked on the seventh ring. There was a pause. I held my breath, then let my heart drop to my feet when I heard the hiss of the tape and the recorded voice of the answering machine (another relic from the pre-cell phone past). The North Pole was booked solid for Christmas. I spent the next half hour desperately scanning the phone book in search of anyone who might stand in as Santa Claus and brighten Sammy Wilson’s last Christmas. It was no use. My ears were continuously tortured by a cackling symphony of unrequited phone rings and campy holiday-themed answering machine messages. Santa had left the building. All of them. No doctor likes to admit defeat, but we all inevitably learn when it’s time to accept it. Just as I had resigned to the truth that nothing more could be done, a custodian across the room opened a window. A rush of night air swept in and found the pages of the phone book, flipping the bulk of them like a paper wave that fell on some random, useless page. Disgusted at the prospect of failure, I snatched the phone book and was just about to slam it shut, when I saw a block-type listing whose tiny presence barely stood out from the rest on the page. My eyes focused and I took in the words: Santa’s Workshop. With nothing to lose, I dialed the number and again hoped someone, anyone, would answer my prayer. Salvation came on the fourth ring. I can still hear the voice on the other end of the phone—so bouncy, so high-pitched and energetic, so…elf-like. Santa, the elf explained, was extremely busy this Christmas Eve. But after my pleading the details of Sammy’s case, he affirmed that the Father of Christmas could indeed make time for a personal visit to see such an obviously special boy. I waited with Sammy and his mom, still praying that Santa would arrive and bring joy to the boy who’d had the toughest of years. Sammy lay in his bed, asleep and at peace. The tubes that had penetrated his tiny body for as long as I could remember had lost all medical meaning to me. They’d become constant reminders of a childhood marred by undeserved hardship. I tried to imagine the visions of sugarplums dancing in Sammy’s head. Then I looked at his mom, and she at me. We held our silence with the understanding that there was nothing left for us to do, except wait. The door opened slightly and a plump, spectacled face poked through and smiled, first at Angela Wilson then at me. “I hear there’s a special boy named Sammy Wilson in here,” Santa spoke in a soft voice, careful not to wake the boy he’d come to see. Sammy’s body shifted on the bed and his eyes slowly opened. “Santa?” the boy said through a groggy voice. “Hello, Sammy,” Santa answered, sliding his round frame through the door. “And a jolly Christmas Eve to you, Mrs. Wilson,” he said as he crossed the room and shook Angela’s hand. I took in Santa as though I were a boy in awe, myself. He was wearing green overalls, which seemed to me the perfect primer to his trademark red suit and cap. He looked real. “And to you, Dr. Talbott.” Santa extended his hand to mine and I took it, and, for reasons I still can’t explain, felt rejuvenated with the power to heal. “Shouldn’t you be wearing your suit?” Sammy asked. The boy had put his finger on the ruse. I swallowed hard, while Santa stayed cool. “Mrs. Claus is putting the finishing touches on my coat for tonight. Good thing you live where it’s sunny and warm, Sammy.” “You really came all the way from the North Pole?” Sammy asked, sitting up in his bed. The boy who could spot a phony under any sedation was now convinced he was looking at the real thing. “Santa’s Workshop is working overtime tonight.” Santa gave Sammy’s mom and me the slightest of winks. “The elves are finishing the last of the toys, and Rudolph is a bit under the weather. But fear not, Sammy. Mrs. Claus will make sure Santa makes the rounds to all the boys and girls this Christmas Eve. She always does.” Sammy’s smile was bright enough to guide Santa’s sleigh. “Well, then young man, you and I have a great deal to talk about.” Santa pulled a chair next to Sammy’s bed. It was then when St. Nick noticed the cookies on the bedside table. A crayon drawing of Santa with his name written in bright red, and an arrow pointing to the plate let the world know who the treat was intended for. Sammy had insisted on leaving Santa sugar cookies with green and red icing. The boy only mildly protested when his mom procured a six-pack of Oreos and a single-serving of milk from the cafeteria. “How did you know Oreos were my favorite?” Santa asked. Sammy looked at his mom with wide eyes of love. “My mom said you probably would get tired of sugar cookies,” Sammy said. “Mothers do know best, Sammy,” Santa replied, taking hold of an Oreo. The three of us watched as Santa unscrewed the cookie sandwich, licked the filling clean, pushed both cookies back together, dunked it into the milk, then swallowed the thing whole. His face lit with joy. “Now then, Sammy, I have a big night ahead of me, but it can wait since you and I have a lot to discuss. I wonder if your mom and the good doctor would mind leaving us to ourselves for a few minutes.” Angela Wilson and I were all smiles as we stepped from the room. Moments after the door shut and we were in the hall, the woman who’d logged more hours that year at All Children’s Hospital than anyone on staff thanked me through tears. She gave me a hug and I told her that Santa was right. Sammy is a special boy. I stopped there, not wanting to speculate on what the future held. In that moment, the world was full of possibility. Sammy was happy. So was his mom, and so was I. Not more than a half hour had passed, when the door opened and Santa emerged and gently closed the door behind him. His eyes fell to the floor. When he pulled them up, Angela Wilson and I saw not an actor playing a role, but a man fighting back tears. “That’s quite a young man you have there, Mrs. Wilson,” Santa said, pulling his glasses from his rosy face and wiping his misty eyes. “No. Not yet,” Angela said, pushing past Santa and stepping into the room. I thought of what I’d say to the mother who’d just lost her only son on Christmas Eve. It was then when I realized I hadn’t heard Sammy’s monitor issue the slightest warning that something was wrong. Angela pushed to door open enough to see Sammy in bed asleep. A smile stretched across the boy’s glowing face. Santa said, “I told Sammy he could have anything in the world for Christmas; anything at all. He told me that this could be his last Christmas, and he’d given a lot of thought to what he wanted. What he wants more than anything is for all the children on this floor to get well, so they can spend Christmas with their families.” Mothers are supposed to cry on the oncology floor of a children’s hospital. It’s expected. The unwritten rule is that doctors are expected to remain composed. Neither Angela Wilson nor I could help ourselves. Sammy Wilson likely wouldn’t live through the night, but he was alive now and had just drifted to a peaceful sleep after seeing Santa Claus on Christmas Eve. “Quite a young man,” Santa said, shaking his head in amazement. “Oh, I nearly forgot. Sammy made Christmas presents.” St. Nick reached into his green overalls and produced a stack of papers. He carefully selected two from the lot and handed one to me and one to Sammy’s mom. “Apparently the boy’s been working on these for some time,” Santa said. “There’s one for every staff member on the floor.” I held the paper in my trembling hands and studied its crayoned markings. The greeting read: Dear Doktar Talbutt. There was a drawing of a stethoscope on the cover under a bright green Christmas tree. I opened the card and saw the scene that would forever bring me to tears each Christmas since. There was the now immortal, hand-drawn scene of Santa, and Sammy, and me. I couldn’t take my eyes from the card, even after the tear dropped from my eye and landed on Sammy’s crayon-sketched face, making him look like he’d been kissed by an angel. I don’t remember Santa saying goodbye that night. But I do remember later standing on the roof of the hospital, looking down over the lights of St. Petersburg and up at the sky above. A shooting star streaked across the horizon. I tried to ignore the scientific fact that it was nothing more than the visible path of a meteoroid entering the earth’s atmosphere, on a one-way course with destruction. Instead, I imagined the brilliant streak was Santa’s sleigh making its rounds across the world. I closed my eyes and made a wish that Sammy’s wish would come true. The next day’s sun rose like any other. I tried to pretend like it was any morning other than Christmas as I made my way through my routine. I smiled at well-wishing colleagues in Santa hats, who bid a cheery Merry Christmas as I made my way to Sammy’s room. My palpitating heart could surely be heard without a stethoscope as I reached for Sammy’s doorknob, slowly opened the portal to his room and peeked my head through the threshold. The first face I saw belonged to Father Carrol, a chaplain at our hospital, who stood bedside next to Sammy’s mom. Father Carrol’s face held a stoic look, typical for him on any day—including Christmas. Angela Wilson looked somber, but relieved, as though a burdening weight she’d endured for so long had at last been lifted from her shoulders. Sammy had enjoyed his last Christmas. We’d done everything to ensure he would. I composed myself as I opened the door and walked in, ready to offer my sincerest condolences. That’s when I saw Sammy. He was in his bed, sitting upright, as he played with a toy rocket ship. The smile on his face could have lit an operating room. Sammy Wilson was alive and enjoying Christmas with his family. In my profession, miracles aren’t the healthiest outcome to wish for, but once in a while, they make the world a happier place. My prayers had been answered. I was living a Christmas miracle. Theresa the charge nurse approached with a hurried stride, a perplexing look on her face, and a stack of files in her hands. “Doctor Talbott! Doctor Talbott!” she called, with an excited urgency. I stepped out of the room, leaving the door ajar as Theresa came to a short deceleration mere inches from me. “Sammy’s latest blood work,” she said. “It’s—well it’s amazing.” She handed me the report, so I could see with my own eyes that Sammy’s white blood cell count had returned to near normal levels. “This has to be a mistake,” I said with an even tone as I glanced back through the ajar door and saw Sammy laughing in his bed and bouncing on his bottom with the vigor and vitality of boy whose endurance knew no bounds. “It’s right, doctor,” Theresa confirmed with confidence. “I made the lab check three times. That’s Sammy Wilson’s blood analysis.” “Amazing,” was all I could muster as I stared at the numbers that simply defied modern medicine. A boy who was on the verge of losing his battle with leukemia just twelve hours ago was now cancer-free. “Doctor,” Theresa said with the knowing voice of a mother who has one last present for her child to open on an already plentiful Christmas morning, “there’s more.” She handed me the files of all the children on the floor. One by one I went through them, careful not to miss a single entry of data. Every child on oncology floor was not only alive and well, they had all entered remission. It’s then when I picked up my head and, for the first time that Christmas morning, saw the joy on every face around me. Every nurse, every tech, every parent, and every child was smiling with life and love. Christmas had come to the oncology floor of All Children’s Hospital. Sammy Wilson’s wish had come true. My family is grown now. My children have children old enough to dream on their own. Through the years, we’ve always enjoyed Christmas the way it should be celebrated. Together. Each year, when I tell the story I’ve just told you, someone always asks what became of Sammy. The boy who taught me to believe in miracles is himself a grown man today, with a loving family of his own. In fact, he too became a children’s physician. I had the privilege of mentoring Dr. Sammy, as the kids and parents called him, before retiring myself many years ago. And so we’ve come to the end of our story. I hope it’s inspired you to cherish the things that matter most on Christmas. And just in case you’re wondering if the Santa who visited Sammy all those years ago was real, know that a lot of kids—big and small—have asked me that question over the years. I always took pride in being a thorough physician, and, for the record, I did try to call Santa’s Workshop and tell Saint Nick what became of Sammy and the rest of the kids on the oncology floor at All Children’s Hospital. But when I went to the place in the phone book where the number should have been, I was surprised to discover the listing had vanished. I poured over every page of the book, with no luck. Santa’s Workshop had gone the way of Sammy’s cancer. It was as though it never existed. In trying to explain the seemingly inexplicable, doctors tend to side with scientific reason as opposed to outright miraculous explanations. Maybe what happened that special Christmas Eve long ago really was a miracle, after all. I like to think so. The truth is, I haven’t found the number for Santa’s Workshop on the Internet, either. Author's note:

A few years ago I spent some time in the oncology ward of a children’s hospital. It was a place of unrequited hope. I wanted to give the place, staff, and kids a Christmas miracle--because of all miracles, Santa's tend to have the most staying power.

Sammy Wilson's Last Christmas is a fictional story by Fred Smith. It is part of his soon-to-be released collection of short stories titled: Larissa's Friday Night Earthquake. The events and characters in this story are fictitious. Any resemblance to persons living or deceased is purely coincidental. (But wouldn't it be wonderful?)

Fred Smith is an author and filmmaker from Tampa, Florida. In the mid-2000s, he spent many a sunny day in the oncology ward of a local children's hospital working with a sick young boy who dreamed of curing cancer. Today that boy is a college student who's never given up on himself or his dream. You can see more of Fred's work on this site. Stick around. Have a few on the house. Then, you know, buy something.