Officially, Friday was a holiday for state employees. But for Loren Robinson, Pennsylvania's deputy secretary for health promotion and disease prevention, that just meant working a double shift.
Robinson, 34, moonlights as an overnight physician at Abington-Lansdale Hospital. And, as has been her tradition for a decade, it was a hospital Christmas: She worked from 7 a.m. to 7 a.m., with a six-hour break for a nap and a plate of cafeteria turkey and mashed potatoes.
The way the South Philadelphia resident sees it, it's the best and highest use of her holiday.
"It's so easy to see people burned out in the medical field. But on Christmas, it's different," she said. "It brings out the best in the staff, but also patients."
For Robinson, who was named in August to a post that encompasses everything from overseeing nutrition benefits to leading the fight against substance abuse, practicing medicine is more than a sideline. It's the key to putting her public-health work in context.
"It's really easy to forget who the people are that you're really serving. Doing this clinical work is the thing that keeps me grounded and humble. It really reminds you of your humanity."
On Christmas morning, only the sickest remained at Lansdale Hospital. Forty-nine of 135 beds were filled, and a steady infusion of agony was arriving via the emergency department.
Bundled in a green scarf and red Santa cap, Robinson attempted to put a dusting of cheer on what is often a grim time.
Maladies can be seasonal, it turns out.
"A lot of chest pain today. A lot of people get anxious," said Robinson, who is both an internist and a pediatrician. "Between Christmas and New Year's, we do see folks with emotional issues and substance abuse."
Sometimes, a person will be walking around normally at home, then have a sudden incident that sends him or her to the hospital, then to hospice.
"That's hard for the families," Robinson said. "We have to keep in mind, this holiday is forever changed for this person right now."
Still, there was room for jollity, especially on the calmer inpatient floors.
Steven Applebaum - a.k.a. Dr. Mystic - stopped by in a lab coat with multicolored pockets. A former Lansdale staffer, he was there to practice magic for patients and staff. He pulled out a fistful of $1 million bills and announced, "I've been authorized to give our nurses raises."
Even more popular was Snowy, an American yellow Labrador retriever wearing an illuminated halo and wings.
David Bond of Telford, Snowy's escort, apologized: His therapy dog does have a Santa outfit, he explained, but she broke the nutcracker on it coming out of the elevator.
The hospital can be slow on Christmas. Robinson welcomes that: It means more time to spend with patients.
"I'll try to stay and sit with them if they're from out of town or from a nursing home, so maybe they don't have anyone to visit them. Or if it's someone with mental illness or substance abuse," she said. "It doesn't always work, but I'm pretty pushy."
Other times, "they need you to sit there with them and not talk."
After morning rounds, she chatted awhile with Kenneth Schultz, 58, who was recovering from emergency surgery. She asked whether he needed anything.
"A wheelchair to get me out of here?" he suggested.
"That's how we know you're doing better," she replied, but advised staying put another day.
Other patients were less cheerful. A man arrived at the emergency department with chest pain related to heroin use. Robinson sees a heroin-related issue almost every shift at Lansdale; that's a big change from even a few years ago.
"The heroin epidemic is a huge problem for Philadelphia and our state," she said.
She hopes to take what she has learned from working with those patients back to Harrisburg, where the Health Department is grappling with a shortage of treatment programs. She's also working to launch a new prescription-drug-monitoring program to prevent addicts from shopping around for prescriptions - though, because of the budget impasse, she hasn't been able to hire a director.
Karen Murphy, Pennsylvania's health secretary, said recruiting Robinson, as well as Lauren Hughes, the new deputy secretary for health innovation, was a move by the department to stay current.
"They're both still clinically practicing physicians. That's allowed them to be really on the front line of health-care delivery," Murphy said. "So, as we try to shape health policy, they are really able to understand patients' needs and the needs of physicians, hospitals, and communities."
The daughter of a school nurse and a pediatrician in Buffalo, N.Y., Robinson went to medical school at Duke University and recently completed a master's in public-health policy research at the University of Pennsylvania.
She got used to working epic shifts during her residency - which helps, since she now has two long commutes: a 6:25 a.m. train to Harrisburg during the week, and the hour-long drive to Lansdale on weekends.
To her, both jobs are necessary to move the needle on the issues that most concern her: health access and disparities.
"Part of why I wanted to go to Harrisburg was to look at what we could do across the state to improve health, more than just you go to the doctor and get a prescription," she said. "It's the human side of medicine that I feel like you lose" sight of.
Closing disparities was also her motivation for becoming a mentor - now, to four aspiring physicians scattered from Philadelphia to Atlanta.
"It's important for me for young girls of color to have a mentor who looks like them," she said. "If you see someone who looks like you in the field, you might think you have a chance."
One of those mentees is Nelida Jean-Louis, a senior at Northeast High School. Jean-Louis dreams of being a pediatrician.
"When I have doubts, because it's like eight to 10 years to become a doctor, I'll talk to her, and she'll bring my hopes back up," she said of Robinson.
Back at the hospital, Robinson's pager was demanding attention. She headed back to the intensive-care unit, to give whatever type of care might be needed.
"I'm not going to be able to heal everyone," she said. "But if I can make someone smile or laugh, it's totally worth it to me."