Every boy, girl and grown-up knows very well the sparks of gratitude upon receiving a gift on the Christmas festival. When we make a wrong choice of "gift", the resulting ripple can be far-reaching, though.

On the Christmas Eve, I made a phone call to my patient, a young lady who recovered from a stormy hospital course with a disease called systemic lupus erythematosus, after receiving her magnetic resonance images (MRI). "Good afternoon, Ms L, this is Dr. KM Chow who saw you last Tuesday and requested a MRI of your painful left hip. Should I go on?" With that, I then said, frankly, "The films did show a lot of destruction at your hip joint. Yes, quite badly damaged. Simply put, the previous steroid drug treatment led to permanent loss of blood supply to the bones. Without blood, the bone tissue dies and the bone at your hip collapses. Do you follow me?"

Before I had any chance to go on telling her the joint replacement for the injured bone, Ms L broke into tears.

I have since come to realize that breaking bad news on the Christmas eve is one of the stupidest things a doctor wants to do. The Herculean task of giving her words of comfort was never easy after the stupid conversation on the Christmas eve.

"Silent Night..." the music goes on around me and seems to remind me the holy grail of keeping silent.

Lesson learned.