medicine, a pathway to love

*ALL OF THE DETAILS SURROUNDING THE NARRATIVE HAVE BEEN CHANGED

There is a celebrated question that each person is asked at some point in his or her life – “Who do you want to be?” The answer to this question very commonly precedes as follows: “I want to be a firefighter!”, “I want to walk on the moon!”, or “I want to help people as a doctor.” All of these aspirations are wonderful, and they are in and of themselves inherently good things! However, herein lies the problem: they are answering the wrong question.

A female patient by the name of Ms. Rhonda was brought into the Emergency Department by ambulance complaining of a severe burning chestpain and nausea. Ms. Rhonda had a relatively extensive medical history and was on many different medications; most patients in Ms. Rhonda’s condition require home health assistance to do normal daily tasks such as going to the bathroom, changing clothes, and bathing. After a thorough workup, it was determined that all of her symptoms were caused by nothing more than acid reflux, and because of that she was treated with some medications that brought immediate relief. I went to see her to let her know that she was going to be discharged, and as I opened the curtain, she looked at me with incredible appreciation, for she was so thankful for everything that we had done. After delivering the good news that she would be going home, she broke her eye contact with me and adopted a rather somber demeanor. I quickly reiterated the good news again that she would no longer have to stay in a room next to an inebriated man who wouldn’t stop vomiting and the psych patient who wouldn’t stop shouting profanities; I told her that she would be able to go home to her family and be with her two daughters. She looked back at me and said that she didn’t want to go home and that she wanted to stay. I was taken aback by her response and asked her why she wanted to do such a thing. I will never forget her response. She turned her head back towards me, looked me in the eyes, and said “My daughters don’t take care of me. Nobody in my family takes care of me. This is the only place where people take care of me. This is the only place where I feel like people love me.”

This is a moment that I will never forget; the yearning behind her words; the ineffable burning in her heart for love and affection;the look in her eyes – these are all things that I will carry to my grave, and yet amidst all of her suffering, she answered the celebrated question that many people never get right.

Let us now return to the celebrated question, “Who do you want to be?” The question itself is not inherently misdirecting; however, most people derive from it a false understanding of identity. I myself have fallen into this trap a multitude of times. Whenever I was young, the image of a labcoat, stethoscope, and gloves was extraordinarily attractive to me, perhaps even more than the work that I would be doing. Expanding that to the present day, I believe very strongly that medical school students, student nurses, physician assistant students, etc. get infatuated with the idea of letters behind their names and the “prestigious” inauguration of becoming a doctor, nurse, physician assistant, etc. After all, who can blame them? All of the programs mentioned are extraordinarily rigorous, competitive, and carry a substantial paycheck. Truthfully, if not for any other reason, the sheer competition is enough to fuel even the most ill-directed person to endure years of education and training in a field they are not truly passionate about. Believe me, I have talked with residents who, after completing 4 years of medical school and 3 years of residency training, wholeheartedly regret their decision to become a doctor. Then again, what are they supposed to do? They now have more than $250,000 of student loans to pay back.

Having said all of this, I am proposing that a considerable amount of people who are working in healthcare, not only nurses and doctors, but also almost every facet of the healthcare industry, have perverted reasons for why they are currently working in their chosen profession. Many have lost the fire they had whenever they first entered medical school, nursing school, physician assistant school, etc. In the beginning, the majority of people who enter into these very specialized educations have a desire to make a difference, to help a person who is suffering, and to literally save people’s lives. There are some many things that can distort and snuff the fire within those who, in the beginning, seek out the healthcare profession with desires ordered towards the good: the threat of being sued for malpractice, the difficulty of the education, or the constant pressure that one mistake could mean the difference between life and death. The culmination of all of these trials and pressures could be enough to break even the most compelled person.

Why does this infatuation with one’s profession lead to a diminution of patient care? What is the correlation? I propose that the infatuation with one’s profession and diminution of patient care are directly correlated by an erroneous understanding of one’s identity. I am not proposing that this is the foundation of every problem; however, I am very confident in saying that one’s identity is crucial in evaluating a healthcare providers mindset and attitudes towards the patient he or she serves. The identity that I speak of comes not from one’s title, career, or license, but from one’s relationship with the God who created them.

Notice the progression that I have just laid out: one’s identity comes from one’s relationship with the God who created them. It is through knowing one’s creator that we better come to know ourselves, and by which, we come to most fully understand that which we were created to do – love. One may be quick to ask, “why does knowing our creator help us to understand ourselves?”  To answer this contention, I ask: does knowing the painter that made a painting increase one’s understanding of the painting; does knowing the composer of a piece of music heighten the themes that are brought out in the work; does knowing the author of a document help to better guide the reader to discern the meanings interlaced within the writing? I believe that everybody can indubitably respond yes to all of these questions. Whenever we know He who created us, we can understand more clearly who we are and what we were made to do.

Our perspective of who we are as people comes from first knowing who God is. In order to avoid a seemingly interminable discussion of who God is from a philosophical point of view, I seek to adopt a more palatable writing by St. Francis that attempts to recognize the truth, beauty, and goodness of who God is in relationship to His people. I choose to use this writing because it contributes greatly to the discussion at hand. Did St.Francis write this himself – no, the vast majority comes directly from scripture; however, he beautifully and poetically aligns these lines of scripture so as to reach to the divine and come to know the Father in such an intimate way.

Praises of God

You are the holy Lord God who does wonderful things.

You are strong. You are great. You are the most high.

You are the almighty king. You holy Father , King of heaven and earth.

You are three and one, the Lord God of gods;

You are the good, all good, the highest good,

Lord God living and true.

You are love, charity; You are wisdom, You are humility,

You are patience, You are beauty, You are meekness,

You are security, You are rest, You are gladness and joy,

You are our hope, You are justice, You are moderation,

You are all our riches to sufficiency

You are beauty, You are meekness,

You are the protector, You are our custodian and defender,

You are strength, You are refreshment.

You are our hope, You are our faith, You are our charity,

You are all our sweetness, You are our eternal life;

Great and wonderful Lord, Almighty God, Merciful Savior.

I invite you to spend some time sitting with this writing. By coming to know who we are meant to be in relationship with the Father, we can more easily see the dependency we are meant to have to Him. G.K. Chesterton in his book St. Francis of Assisi speaks at great lengths about how St. Francis came to understand this principle. St. Francis at one point in his life retreated to a cave, whether metaphorically or literally is a point of contention among scholars, and in this time of extreme self-reflection and spiritual darkness, he came to know the Father in such an intimate way, and in turn, he came to know who he was in relationship with the Father. He came to understand the freedom of dependency; he came to understand that the more dependent you are on the Father who holds all things in being, who is perfect, who knows you more than you know yourself, the more you are free since you have absolutely no control whatsoever. Mumford and Sons captures this idea in their song The Cave when they say “You can understand dependence when you know the maker’s heart.” It is this type of dependency that leads to the most freeing and wild relationship with Jesus Christ.

After saying all of this, one could be quick to respond with this question, “Why should I love the man who comes in every week because he is intoxicated? Why should I love the psych patient who just punched me in the face? Why should I love the patient who calls the nurses station every 5 minutes to complain that he is hungry after he has already gotten 3 food bags? Why should I love the guy who continually takes advantage of the system?” To these questions, I propose one simple answer…you should love these people because Jesus loves them. This may seem like a pithy aphorism, but I mean it with all certainty. Because Jesus loves them, Jesus is also with them and in them. Jesus Christ is present within every person you meet, regardless if he is apart of the Mystical Body of Christ, because of no reason other than the fact that He loves them. Plain and simple.

Now that we have a much better understanding of identity, let us go back to the celebrated question, “who do you want to be?” The answer now seems so simple and is unanimous to every human being. The answer is one who loves. Now, the way in which each person was made to love is different. All of the answers that were given in the beginning of this writing were answering the question, “what do you want to do?” All of the previous answers would answer this new question perfectly. So many people in medicine have forgotten this simple truth. Every human being is called to be one who loves. First and foremost, no questions asked. Whatever you are called to do, this must be the primordial understanding of your career.

In the end, medicine is not about the test results, the exams, the licenses, the degrees, the instruments, or the jargon…medicine is first and foremost a pathway to love, and in my opinion, one of the most tangible ways that you are able to seek the person within, that is, to recognize Jesus Christ in every patient that comes through the door.

Medicine at it’s core is nothing more than a pathway to love. Plain and simple.

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