CMDA's The Point

What Am I to Do? On Our Time and Talents as Practitioners of Healthcare

September 8, 2022
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by Danielle Ellis, MD, MTS

Two confessions before I get too far in—the first is that this post is a reflection of my own struggles that remain very much unresolved and in process; the second is that this post is a summation of that which I have heard in sermons, read in seminary and absorbed from my elders over the years, and any wisdom gleaned from it ought to be attributed to these people of God. Now, to begin.

 

To join me in this journey that it seems so many of us take, perhaps on multiple occasions throughout this life, you must agree we are all called to cultivate something. John Mark Comer writes masterfully about how were all created to, like Adam and Eve, tend a garden. Which part of the now metaphorical garden we spend our six, non-Sabbath days cultivating might be conceived of as our vocation. The word vocation comes from the Latin vocare, which means to call. I think we are all called to tend a part of the garden, and we are uniquely created for just that purpose. For those of us in healthcare, the sick are a part of our gardens.

 

If you agree with me so far (and are tired of Latin), we can move on to opine about more practical matters. The one at hand has come about as a result of my indecision about a subspecialty choice, and more broadly about what kind of surgeon I feel called to be—one with a niche maximizing the gifts and interests God has given me, or one who by virtue of doing more general work is interchangeable; one whose chosen population requires constant availability to patients, or whose chosen population begets availability to family and friends. The indecision and, in particular, the inability to know the cost of each choice a priori has become increasingly weighty. You may not be choosing a subspecialty or be a surgeon, but I imagine deciding between options that make the most of one’s passions clinically, technically and academically versus those that allow more flexibility and time outside of healthcare is in some sense universal. I have conceived of the problem most simply this way: time is precious and finite, and the vocation of medicine can be time consuming. In light of having chosen this profession, what ought I do with my time here on earth?

 

Philosopher Alasdair MacIntyre suggests that one can only answer the question “what am I to do?” once she can answer the question “of what story am I apart?” As practitioners of healthcare who are also believers, we find ourselves situated between two stories—the story of Christ as preacher, teacher and healer (Matthew 4:23), which to some extent informs our imagination of what kind of clinicians we can and ought to be, and the stories of the industry of healthcare and the tower of academia, which propel us toward faster, higher, newer, bigger and better (at least as “better” is conceived within this framework). And then, there are the other stories we inhabit—stories we live as members of families, reciprocators of friendship, participants in communities. All of these stories inform what we ought to do, and in so doing inform how we spend our time.

 

But in healthcare and, some might argue, in any “greedy profession” wherein long hours and the expectation of more are normative and even praised, these stories can seemingly come into conflict. What does it mean to serve one’s patients like Jesus did, and also honor the call to “Impress [the Lord’s commandments] on your children. Talk about them when you sit at home and when you walk along the road, when you lie down and when you get up” (Deuteronomy 6:7-8, NIV) when caring for one’s patients with Christlike sacrifice might mean not sitting at home, walking along the road or lying down all that often?

 

The tension created by seemingly conflicting stories in both our present and future lives is often the pressure which nudges us to re-evaluate the question of what we ought to do with our time here. It can force us to consider our choices past, and it can tempt us to perseverate over the choices that lie ahead.

 

What specialty should I choose? Which job should I take? Should I pursue the opportunity that was just offered to me? Ought I have gone into healthcare at all?

 

For myriad reasons, those questions and the choices that belie them impact women in healthcare in a categorically distinct way, but the challenge of stewarding time is common to all of us.

 

We could say that, as believers, we should make these choices by prayerfully asking and listening for God’s will: Lord, which choices ought I make such that my time is being used in service of cultivating the part of the garden to which you have called me? That answer is true, but somewhat reductionist. Because even though God speaks to us, we cannot know His will for every choice in every moment of our lives (the theology underlying this assertion is a bit too long for an aside in this piece, but this sermon I heard recently nicely encapsulates the idea). While God sometimes makes it abundantly clear what we ought to do, other times He gives us choices. Consider, for example, how God opened the prison gates for both Peter and Paul—while Peter was led out with clear intention, Paul was given something of a choice, and elected to stay, ultimately saving a guard’s life and participating in his coming to know Jesus (Acts 12, 16).

 

As the story of healthcare meets the stories of marriage, motherhood, membership in our communities and the like, we may not always know God’s will in making the choices that weave the chapters of these stories together to produce our ultimate vocations. Nevertheless, in these moments wherein we are given the chance (and challenge) to choose, God’s character always speaks volumes, even when His specific will is less audible. A few of the following elements of God’s character have spoken loudly to me over the last few months:

 

God is a God of restoration and resurrection, reflective of and sustained by His glory.

All of our earthly lives must be seen in light of God’s ultimate plan to bring about a new heaven and a new earth. This new heaven and new earth are imbued with God’s glory, and it is God’s glory which illuminates it (Revelation 21). What we do with our time matters only insofar as it allows us to participate in bringing that kingdom near (which we have the chance to do in general, but specifically when healing the sick – cf. Luke 10:9). Accomplishing the work God gives us to do—the vocations to which we are called and the various stories of which we are apart—in bringing the kingdom near brings Him glory in the here and now (John 17:4-5).

 

God is a God of calling.

God has been calling His sons and daughters ever since He put Adam in the garden of Eden “to work it and take care of it” (Genesis 2:15b, NIV). Sometimes He calls people to things that are hard or undesirable; sometimes He calls people long before the promise is brought to fruition; sometimes He calls people who run away, but who He ultimately never stops pursuing. Jonah to Nineveh, Paul at Damascus to the gentiles, David to the throne, Moses to lead God’s people out of Egypt. Most emblematically, He called Christ first to the cross and then to the highest place (Philippians 2:5-11). We can be sure God has called us to something. And though we cannot be sure our callings will be easy, we can be confident He has equipped us in ways we may not have even perceived and has prepared a way such that He will be glorified.

 

God is a God of generations.

If the number of genealogies in Scripture weren’t enough evidence, there is ample discussion of the importance of discipling the next generation in good and godly ways. Families—not to be exclusively understood as the nuclear entity which is glorified in the modern West, but the inter-generational units of community made up of biological and non-biological relationships which have spanned cultures and time—are one of the primary ways by which His truths have been heard throughout human history. Families definitely matter to God.

 

God is a God for the least of these.

Referring to that spoken by the prophet Isaiah, Jesus tells us He is the fulfillment of a promise; He is the one sent to proclaim good news to the poor, freedom for the prisoners and the oppressed, and recovery of sight to the blind (Luke 4:18-21, Isaiah 61:1-2). These—the oppressed, the imprisoned, the poor, the widowed, the orphaned, the sick—are so precious to God, and Jesus reminds us that whatever we have done for the least of these, we have done unto God Himself.

 

God is a God of multiplication.

Lastly, God is and has always been invested in multiplication. This element of His character is first mentioned as it relates to children (Genesis 1, 9), but it is seen arguably more prominently in ministry. For example, God does the work of multiplication as we participate in the commission to make disciples as we go (Matthew 28:19) or in the act of Jesus feeding 5,000 people from what began as so little food (cf. Matthew 14). The parable of the talents is one of Scripture’s most striking pictures of this, because Jesus says this is what it will be like at the coming of the kingdom of heaven—a looking back on how we too multiplied that which we were given in hopes of hearing, “Well done, good and faithful servant” (Matthew 25:14-30, NIV).

 

Talents, though a monetary unit in the case of the parable, has something of a useful double meaning. As practitioners of healthcare, we too might be thought of as having been given talents, each according to our ability (Matthew 25:15), one of which (but importantly, not the only of which) is the healing presence that allows us to participate in coming alongside the sick and suffering. The art of discerning how to multiply the handful of talents we have been given for the glory of God and good of the world is, I think, the task of a lifetime. These truths about God’s character—revealing as they are—may not always give us the agenda we wish they did in detailing the exact choices we ought to make about what to do with our time here and about how to invest our talents, both in and outside of the hospital. In the absence of the instruction manual, the choices can feel weighty, big and binding enough to start or end our lives and the paths they take. On the days the weight of those choices is heavy, even in the absence of knowing what I ought to do, I have come to know this—we do not walk alone in this garden. The God who walks alongside us wrote our stories in His book before any of them came to be (Psalm 139:16), and whether because of or in spite of our choices, the story ends eternally in God’s glory.

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About Danielle Ellis, MD, MTS

Danielle Ellis, MD, MTS, is a general surgery resident at the Massachusetts General Hospital and an alumna of the Theology, Medicine and Culture fellowship at Duke Divinity School. She is deeply committed to cultivating kingdom principles for both patients and healthcare professionals, a commitment which was nurtured by her CMDA chapter in medical school and formation in seminary. She plans to pursue pediatric surgery and palliative care, with interests in health parity and practical theology.

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