Most of my writings have centered around the challenges and difficulties of working in the ER. The job is difficult. Clinicians need support. But I have recently been reminded of the heart of Medicine as Ministry. We are here to care for people. We have a calling to care for people. That makes this difficult work more than a job. It is ministry.
I recently finished the memoir, When Breath Becomes Air. This is an amazing book by Paul Kalanithi. He was a gifted and passionate neurosurgeon who died in his thirties just at the end of an intensive neurosurgery residency. He had a passion for philosophy, understanding life and death, and caring for people. He describes the journey from medical school into the specialty of neurosurgery. Many of his peers began to understand the rigors of being a physician. They desired balance between their work, family, recreation, etc. They were grappling with how much of their lives to give away to medicine. The oath that they would take at graduation from Yale medical school included phrasing that they would put the patients' interests above their own. Some wanted to remove this statement. Dr. Kalanithi writes,
"The rest of us didn't allow this discussion to continue for long. The words stayed. This kind of egotism struck me as antithetical to medicine and, it should be noted, entirely reasonable. Indeed, this is how 99 percent of people select their jobs: pay, work environment, hours. But that's the point. Putting lifestyle first is how you find a job - not a calling" - When Breath Becomes Air, 68-69.
That served as a firm reminder that what we do in medicine feels hard because it is hard. And yet, we have a calling to enter into this work with a different expectation for ourselves. We should expect that this job will demand more of our time, more of our mental and physical energy than most other careers. We must remember that working to meet the needs of others is a calling, not a job.
I will add that balance is important. To sustain this work for long, we must figure out a way to care for ourselves and to find rest, reflection, and time with friends and family. But Dr. Kalanithi is right. We didn't sign up for a job so we could punch a clock, be home every night for dinner, or take a lunch break every day. We have a calling to something greater and that carries a high price for us.
As I read the inspiring and sad story of Dr. Kalanithi I kept wishing that I could have known him. I was saddened that this brilliant and seemingly very kind surgeon who had so much potential to contribute to our world, left us so soon. I suspect he was funny and intense but given all of my insecurities I would have been intimidated as hell to meet him. I am thankful for his bravery and honesty both in the struggle of medicine and in the struggle of death. I will add him to my list of heroes and learn from his example.
(In medicine) "What had not changed...was the heroic spirit of responsibility amid blood and failure. This struck me as the true image of a doctor."
- When Breath Becomes Air