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October 17, 2011

An Open Letter To Christian Medical Students

 
An Open Letter to All Christian Medical Students
Brothers and Sisters in Christ,
            Many of you find yourselves on a journey of uncertainty.  At no time in history has the landscape of health care been more capricious.  As with any time of significant change, fear and insecurity are plentiful as the path of the unknown is traveled.
            As we examine historical periods of change within health care, we see a distancing and devaluing of the sacred relationship that had existed between the physician and his or her patient.  Ever since the age of enlightenment, facets of health care that could not be proven empirically were relegated to magic, superstition, or sheer luck. 
            Where then does spirituality fit into today’s health care?  This question becomes ever more important when it is realized that every person, whether comprehended or acknowledged, is on their own spiritual journey.  This journey finds each individual either drawing closer to or further away from God, the first person of the Trinity.  God’s relationship, through the hypostatic union, with Jesus Christ and the Holy Spirit, assists us in bringing the time and space of our collective journeys together in one purpose and meaning.
            Within Catholic Health Care, we often hear the term Health Care Ministry to identify a local, regional, or national health care system.  I would like to attempt to re-evaluate our definition of what constitutes a Health Care Ministry when one speaks of extending the healing ministry of Jesus Christ.  Of the images of Jesus we know and continue to uncover, nowhere have I heard of Jesus being represented as a local, regional or national health care system.  Jesus is relational, one in Being with the Father, Love, and the model of this love for His people. 
            Jesus, fully human and fully divine, preached that the Kingdom of God is at hand.  He healed, He cured, He taught, and He prayed.  He challenged societal norms, as well as people’s preconceived ideas.  He led people to view others in ways that were uncomfortable.  By challenging and opening minds, Jesus was able to open hearts in ways that only God’s love is able to procure.
            Based on the knowledge of Jesus’ ministry, allow me to challenge you to re-think the common understanding of Catholic Health Care Ministry.  This challenge will allow the change from the macro-lens of what we now call a Catholic Health Care Ministry, to a micro-lens of what makes up a true Catholic Health Care Ministry.  This ministry is born of a vocation of service to others that allows physicians to be teachers, healers and people of prayer, in imitation of the life of Jesus, the Great Physician.   
            We’ll begin with the healing ministry of Jesus beginning with his baptism in the Jordan River to his arrest in the Garden of Gethsemane.  These stories of Jesus’ miraculous healings consist primarily of physical healings and the restoration to wholeness of persons as well as communities.
            Upon reading the healing stories of Jesus, the first observation is that His approach was holistic.  Jesus treated everyone he met with respect and compassion.  As we think through making compassion a foundational element to our approach to patients, physicians must accept that they will be made vulnerable in the process.
             To have compassion, to suffer along with another, is to acknowledge each person’s intrinsic dignity and to understand our interconnectedness with all other person’s by this shared dignity.  This vulnerability is derived from the acknowledgement of a universal humanity that rises above whatever categories we use to define ourselves from day to day.
            Let’s take for example, any class of people whose intrinsic dignity society has called into question, such as Hispanics, the disabled, the poor, homosexuals, etc.  When any member of these groups of people enters a health care system, they are already vulnerable.  Often times, by culture, training, or personal beliefs, health care professionals regard these and other groups as being unworthy of their service, thereby placing into question their intrinsic dignity.
            As we strive to add flesh to the healing ministry of Jesus Christ, it is important to closely study and learn from Jesus’ example.  Although Jesus fundamentally disapproved of many aspects of his society, Jesus was never judgmental.  He did not accuse, hold responsible, or criticize any individual person.  In the people Jesus encountered and healed, he saw only woundedness, brokenness, sickness, confusion, and fear.
            Next, I would like to address a profound vulnerability that affects physicians.  This vulnerability is manifest through the risk of failure.  This sense of failure, imbued within physicians during their training, is illustrative of yet another way spirituality has been removed from health care.  We have lost sight of the fact that life, by its nature, is finite.  Every patient will die one day and even the best physician is powerless to stop it.
            This reality takes us back to the equality of all people based on their intrinsic dignity.  However, within the relational dynamic between a physician and their patient, the physician maintains the upper hand of power.  Power granted by answering the call to a health care vocation is composed of knowledge and experience.  Like any power, the power granted to physicians can be used for good or for evil, to harm or to heal.  The key is to balance one’s vulnerability and power to see through the preconceived ideas of self and society.  By doing this, physicians will find themselves better able to walk beside their patients to lighten the load of their burden and not feel the urge to carry the patient with their burden.
            Next we move onto Jesus’ suffering and death.  Throughout His ministry, Jesus had times of suffering, but it was in the Garden of Gethsemane that Jesus experienced distress, sorrow, and loneliness.  Although Jesus entered the Garden suffering, through prayer, He left the garden strengthened in His resolve.  
            For Jesus, the Garden of Gethsemane was transformative.  Through His prayer and reliance on God, Jesus was able to confront His suffering and find the inner strength to complete His mission.  This inner strength didn’t take away His pain and suffering, if anything it consented to it.  If we as physicians are to model this example, it becomes essential that we spend time with our patients in their Garden of Gethsemane and assist in facilitating their transformation to enhanced inner strength and resolve.
            As He left the Garden of Gethsemane, Judas, with his love for money, betrayed Jesus leading to His arrest and crucifixion. The betrayal, abandonment, and physical suffering endured by Jesus, a necessary aspect of His slavific mission, also helps us to visualize the major themes of Jesus’ healing ministry.  The vulnerability of our patients is in large part, a feeling of betrayal, of “how can this be happening to me?”  This is often followed by a feeling of abandonment, loneliness, and physical suffering.
There are many modern day Judas’.  Much of the lack of faith and trust that people have in physicians today comes from the lack of discernment on the part of many of our colleagues.  For example, today we find insurers structuring health care in ways that prioritize outcomes over relationships.   While outcomes are important, when physicians buy into this structure and are primarily focused on outcomes, the relationship with the patient is jeopardized.  In this scenario, the patient becomes a mere pretext for a display of knowledge and skill.  This can add to the patient’s sense of abandonment and loneliness.
            As for the suffering encountered every day in the lives of our patients, be it physical, emotional, economic, or spiritual, we are given yet another lens through which to view our vocational ministerial paradigm.  As stated earlier, many health systems adopt mission statements that include the phrase “to extend the healing ministry of Jesus Christ”.  Although a noble and magnanimous goal, this approach to health care can be seen as very egocentric. 
            Certainly there is no harm in the claim that one aids in extending the healing ministry of Jesus, but one also has to recognize and accept the other half of the equation.  To see ourselves as the healing hands of Christ must not take away from also seeing Christ in the person suffering before us.  We must always keep in mind that where there is suffering, there is Christ.  Jesus himself said, “I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.” (Mt 25:40)
            Finally we come to Jesus’ death and resurrection, the fulfillment of the mission of the Word of God.  The death and physical resurrection of Jesus in a glorified body signified Jesus’ conquering of death and opening the Kingdom of Heaven to all believers.  This fact alone is of comfort to Christians throughout their lives.  For our purpose, the lesson can be made much more practical.  Within the Emmaus story in the bible, we find two disciples traveling on foot and encountering the glorified Lord.  They continued on their journey with Jesus, yet did not recognize Him.  It wasn’t until later in the day that the disciples became aware of whom their travel companion had been. 
            As you find yourself traveling on your journey, you will encounter many patients.  Your co-workers will see many of them as not worthy of your services.  They will be suffering from alcoholism, drug abuse, or preconceived economic or sociologic intolerance.  They will be foul smelling, have bad breath, and will likely not have bathed for several days.  They will present themselves to you on God’s schedule, not on the schedule of human beings.
            While you are in their presence, it will be important to ask yourself  “is your heart not burning within you?” “Did he (or she) not open up the scriptures for you?” Or “are your eyes (and heart) prevented from recognizing Him?”
            As we more closely examine the landscape presented to us as the “new horizon for health care,” without doubt much will seem outside of our control.  What is now and always has been within our control is the approach we choose to take towards our vocation in establishing a relationship with our patients. 
By viewing our vocational calling to health care as a ministry and structuring it on the model set by Jesus’ life, through suffering, death, and resurrection, enables us to address the barriers we will encounter.  These barriers, such as intolerance, injustice, apathy, and greed become less significant through a life of prayer and virtue. 
By fully understanding and utilizing the powerful tools available to you as part of your vocational ministry, such as humility, faith, and prayer, you will be better able to navigate the rough seas of societal and political change.  These tools will allow you to find the balance that will be essential to your ministry. 
This balance will assist you in also forming your own Garden of Gethsemane.  Within this garden, you can offer up your suffering and through prayer, increase your resolve to continue your ministry of healing and curing.  Without this prayer, you will find it difficult to fully understand that the needs of the sick are truly infinite.  Within this relationship with God through prayer, you will be better able to accept that it is God, not the doctor, who is indispensable.
            In conclusion, as you traverse this new terrain, keep in mind what remains within your control.  Don’t allow yourself to be distracted by the false gods that will present themselves on a daily basis.  Commit yourself to be the example of Christ in our culture, as well as to see Christ in all who you encounter.  Use the power and vulnerability given to you by your position to show people, in word and action, what is means to be human.  Continue to develop, foster, and share the truth about life, suffering, and salvation.
Mostly however, realize that God is love and that Jesus was sent as an example of that love for all people, to be emulated and modeled.  Our part in this relationship is that of prayer and recognizing prompts of the Holy Spirit. By doing this, we can share in and be conduits of the Love of Christ to bring about curing sometimes, and healing always. 
 
May the peace and love of Jesus be with you.
 
Don Bouchard, DO, MBA
 

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