CMDA's The Point

Pushing, Pulling and the Tension in Between

March 16, 2023
Protecting our Healthcare Conscience Freedoms

by Autumn Dawn Galbreath, MD, MBA

Just today in a text exchange about job hunting, a CMDA friend reminded several of us that God can lead us in a variety of ways. Many times, God calls us, or pulls us, into the roles He has for us. We feel clearly instructed, and we feel certain we are following His leading as we step into a new chapter, be it a job or school or church or a new family decision. As American Christians, we are used to thinking about decision-making this way, I think. We feel that we must not know the right thing to do if we don’t feel pulled to one of the options. We pray for clarity, and we seek advice because we want that sense of calling, of being pulled in the direction God would have us to go.

However, my friend reminded us that God also pushes us into decisions sometimes. Essentially, other doors close and we are forced into a specific option. It doesn’t sound as spiritual as being called, and it doesn’t feel as good as being led to one of many options, but it is certainly a way God leads us at times. It might even be more common than a sense of prospective calling.

And then, there is living in the tension. My friend didn’t mention this particular part of God’s guidance in her pep talk to the group, but as I reflected on her words, I was struck by how few clear pulls and pushes I have had in my life, as compared to the thousands of days spent living in the tension between the pulls and the pushes. Living in the tension is what I am calling the simple day-to-day life that most of us lead most of the time—the parts of life when we are not experiencing a dramatic spiritual clarity, but we are doing our best to live lives that honor God. As we live in the tension, we prayerfully make the best decisions we can, even if we don’t have a “word from the Lord” about them. We lovingly serve those around us even if we don’t have a supernatural insight into their needs. We humbly rear our children even if we don’t have all the answers to every parenting question. In short, all that we do, we do to the glory of God (1 Corinthians 10:31), for it is these moments in the tension that make up our lives.

God once irresistibly pulled our family to a place. The pull was clear, and it was immediate, and we responded. God has now pushed us from that place with a long and painful pressure that we resisted until it was finally clear there was no other option. The pull and the push were both clearly from God, and both marked the beginning and ending of chapters in our family’s life. They were dramatic and important, as were our responses to both. In between the pull and the push, there were 18 years of living in the tension. Eighteen years unmarked by any dramatic word from God. Eighteen years of raising our family and living in community. And, while the pull, the push, and the chapters they punctuated were critical, they could never supersede those 18 years. This is life in the tension, and this is the reason it’s critical. Long stretches of our lives pass by, and if we are too busy waiting for a dramatic calling, we might miss the years of steady time living in community with the opportunity to glorify God and love others.

Jesus commanded us to love God with our heart, soul, mind and strength and to love our neighbors as we love ourselves. These are high commands, and they require much of us, but for most of us the results will not be dramatic or newsworthy. They will be “a long obedience in the same direction,” as Eugene Peterson described it. That’s the reality of life in the tension between pushings and pullings—the day-to-day life of faithfulness. Join me in striving to remain more faithful in the long in-between times, that the Lord might be more glorified and the people around us more loved.

Autumn Dawn Galbreath, MD, MBA

About Autumn Dawn Galbreath, MD, MBA

Autumn Dawn Eudaly Galbreath, MD, MBA is an internist in San Antonio, Texas, where she lives with her husband, David, and their three children. Though they met in medical school, David now owns a restaurant in the San Antonio area. Between the two of them, they have experienced multiple career transitions, and weathered the resultant stresses on their marriage and family. Autumn Dawn speaks to the issues of Christian marriage, being a working mother in the church, and being a woman in medicine with an engaging humor that brings perspective to these difficult issues. Autumn Dawn earned her MD from the University of Texas Medical School at San Antonio, where she also completed her internal medicine residency. She earned her MBA from Auburn University in Auburn, Alabama.


  1. Avatar Joyce Eden on April 3, 2023 at 6:08 pm

    My seasons of significant change have escalated with the pandemic. I describe it as letting go of one trapeze and hanging in air to catch the next . Your description of the “push-pull tension” is a good word picture too. No matter what, we can still show up each day, share the good news, love on people, and know God is at work for us even when we can’t see it or feel it. We just have to stay in motion, He is for us.

  2. Nicole Hayes Nicole Hayes on April 4, 2023 at 9:58 am

    Love your article’s message, Dr. Galbreath! Thank you!

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