MEDICINE AS A VOCATION (CALLING)

The following account is a collection of personal reminisces of mine since starting medical college and then going on to work as a junior doctor. Six years ago God had called me to this great life of servant-hood. The challenges, frustrations and commitments that we face as young doctors day in and out make us believe that we are not here by accident, but His grace and providence. He works through our hands and minds to bring about heavenly healing. We are called to serve others, sometimes expecting nothing in return. We are called to take up the cross of Jesus Christ and strive to be more like Him, in our day to day patient interactions.
Author: Dr. Divya Susanna Ninan
Address: CSI Hospital, Bangalore 560051
 
MEDICINE AS A VOCATION
It was the year 2010. I had completed eighteen years of age and 13 years of school life. A life I had known like the back of my hand, the movements of which I had lived day after day, predictably like the monotonous motions of clockwork. I was childish, naïve, not very ambitious, missing my school friends and the well structured and cohesive environment of school life.  One chapter of life had ended. The page now turned to reveal a new, blank sheet.
When I was young, medicine had hardly kindled much interest in me. Coming from a family of doctors, you reader, may find that queer. But I assure you, it is not at all abnormal to wish to break away from the norm and yearn for a different path of vocation to tread. Not because one has anything against the healing profession, but simply because one wants to take the path less travelled, as Frost would have penned it. I used to casually laugh off the wry comments that my peers would make, about me not being able to escape the “medicine gene”, which would eventually express itself. But I considered it highly improbable.  I had taken science as my major subjects in the last 2 years of school, and I was reasonably good at it.  However, I was never one to make elaborate plans for the future. I was as confused and as lost as any wayward eighteen year old would have been.  I dabbled in a few areas of my interest, but never firmly decided for or against anything.
However, in the summer of 2010, I was mildly surprised when I received a call from Christian Medical College Vellore, for their medical undergraduate admission interview.  I went with great trepidation and caution, thinking that I surely would never make it into such a prestigious institution, for such a prestigious calling. But lo, and behold I was selected to be a part of the medical students batch of 2010. Suddenly my future had been set; the next 7 years of my life were paved out for me. All I had to do was buckle up and sit back for the ride of a lifetime! I squirmed in my seat, restless, full of doubt in myself and fear for the future. I questioned God several times, and several times he answered “Be still, and know…” I truly felt in my heart, as I had never felt before, that this had been His plan all along.
A new chapter began, one that I had never imagined myself experiencing in my wildest dreams. I was going to become a doctor, a third generation in my family, since my grandfather left his native-place of Kerala to pursue his dreams of medicine.  And not by the works of my hands, but by God’s grace, He had called me out of the stagnation of my ordinary, boring life and into a new and adventurous one. College began and, later I would know that those years in CMC, studying the art and science of medicine, receiving patients day and night, pacing through the wards late at night, and into the operation theatres before the sun rose, staying at the bedside of sick patients, sacrificing food and sleep and many other creature comforts, forging friendships with each other that would last a lifetime, those were some of the best years of my life.  We were young and intelligent, full of the vigor of youth, eager to learn and to experience all the heady highs and lows that life had to offer.  Through it all, we were constantly reminded, that we were brought together by God’s marvelous plan. There was a reason he had brought us together, to learn what we had to, so that we could go out into the world and help his flock in need.
Besides the hectic work-hours we had to make time for leisure and a quiet time for inward meditation. Without these, the work we did would take a toll on our physical and mental health and we would eventually burn out from exhaustion. Occasionally a break down would occur, after a hard day, but within each of us was a small voice, urging us to carry on. That tomorrow would come, and it would be a better day. And we’d learn from the mistakes of yesterday and life would go on. In this way, we were trained to be the best, even on our worst days. As Gandalf would tell Frodo Baggins in JRR Tolkien’s fantasy novel The Fellowship of the Ring, when the young hobbit was wishing that he wasn’t the one entrusted with the big responsibility of destroying the ring of power, “…So do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given us.” Through sweat, blood, toil and tears the years of training passed, and soon we were handed the power to prescribe and a license to heal.
 As doctors, day after day we face innumerable challenges. It is a slow uphill climb to attaining our ultimate goal. The years are long and tedious, and we never stop learning or studying. Advances in medicine progress in leaps and bounds, and everyday either a new drug/disease is discovered, or a “clinical criteria” for diagnosis of a disease or staging of malignancy or a treatment protocol is updated.   We have to keep abreast of all these changes and stay in the game. We spend a good portion of our lives poring over reading material; be it for self learning, research, publishing papers, conducting surveys etc. We learn the evasive art of truly listen to people. Trying as it is, as some patients would ramble on and we keep half an eye on the clock remembering the list of unending tasks we have left to complete. We still patiently listen with a smile on our face and a ready ear to pick up a small chink in their story which would clinch the diagnosis. We are expected to be alert and attentive, and able to discern problems in patients who will not readily give us a history, such as children or old people, or comatose patients in the ICU. Our medical knowledge and skill is only a backup, to the real lessons which occur day after day with multiple patient interactions and difficult case scenarios. At the end of the day, learning is acquired by trial and error. 
We are not only called upon to treat, but also to teach, educate and cultivate in our patients a way of healthy living. We are called upon to explain a difficult prognosis to a worried relative, whose imploring eyes and ears hang on to every word we say. We learn how to say the right thing, at the right time, and how to give good news and break the bad. When conversing with patients, it is crucial that we avoid the medical jargon, that we are all too familiar with and speak their language to make them understand, as if explaining to a little child. My heart melts, when at times like these, patients look up to us in desperation and believe that we are truly gods who can perform healing miracles. Yet we are not gods, we are merely human vessels in the hands of God, bringing forth His healing. Try as we might, when we put the best of our heads and hands together to save a life, sometimes they slip within our grasp. And when the time comes, exhausted and emotionally drained, we are called to gently yet professionally comfort those who have lost a loved one, despite our best attempts.
An old friend of mine used to say “The patient is always supreme. His wants, needs, desires, always consider them your priority. And do your best to deliver.”  Whatever decision we make, it must always be in the best interests of the patient, going by the ancient Hippocratic Oath that we abide by.  Corruption and malpractice are regular affairs at the medical workplace, and we are not immune to it. Be it from fellow colleagues, or senior consultants whom we respect and look up to. The lure of big money must never be an incentive for a doctor to succumb to base methods of cheating and deception of innocent lives. We are called to stay strong and keep our head above the water, and not be drawn into this evil current, which surrounds us every day.  Standing up against corruption is difficult, especially when one is standing alone. But good doctors are equally responsible, if they turn a blind eye and let important matters get shelved under the carpet. We need to keep our eyes wide open and our ears attentive, quick to listen and even quicker to respond, and always remember to keep patient’s health top priority. 
At CMC, the motto we imbibed was “Not to be ministered unto, but to minister.” Ergo, we are called to be ready, at any time of night or day, to provide the best service we can muster. Critical patients, sick children, women in labor, road traffic accidents, mass casualties, fractures, head injuries, attempted suicides, psychiatric cases, emergency surgical cases, the list is never ending. And here we are, sacrificing everything we can to serve the common crowd of humanity that is wheeled in through our casualty doors. This responsibility is never easy, and certainly not everyone has the strength to carry it out. When I am writing these qualities, I believe that the role of a doctor is the closest that a human being can assume, to the person of Jesus Christ, the Great Physician. He was a patient listener, comforter, healer and teacher, a humble servant, righteous in everything He did. He was the perfect example of the kind of doctor we need to become. Through patient prayer and guidance from Him every day we will soon be transformed to His likeness. None of us are perfect doctors; we are still trying and may spend the rest of our lives learning how to be a good doctor. The hardest thing we learn to do is to forgive ourselves, and to let go of regret of the past. Forgive ourselves for the mistakes we made, for the wrong decisions, for the slip-ups. At times we wish we could go back in time and do things differently. Maybe to have tried a different treatment regimen, or to have been more careful while closing up after a surgery, to have concentrated while listening to a patient, or have kept a closer watch on him before he worsened. Maybe we wish we could have done more and procrastinated less.  Maybe we wish we could have spent more time in college studying then on the badminton court or talking late into the night in hostel. So much that we hold on to from the past, hinders us from moving forward into a better future. But all our past experiences add a little bit to our repertoire and we build on these to become better doctors. 
Many times I wondered, “This is too great a calling. Why me, God? Am I good enough? Can I truly help people this way?” But the amazing thing about our heavenly Creator is that he sees potential in us we can’t even see in ourselves.  We are who we are today by His infinite grace, and His strength is made perfect in our weaknesses. Many doubts plagued my mind then, and they continue to do so, even today. But when I look back, I realize that there is no better way, than this to truly help people. I know now, there is nothing else I can do better, and there is nothing else I’d rather be doing. The journey has just begun, and there are many more miles to be travelled. And when I look back at how far I’ve come, His foot prints have always been beside mine.
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References:  Robert Frost (1920), The Road not taken.
JRR Tolkien (1954), The Fellowship of the Ring, Chapter 2, The Shadow of the Past.