doctor's life support

5th February: Bottom of the Pile

Have this mind among yourselves, which is yours in Christ Jesus, who, though he was in the form of God, did not count equality with God a thing to be grasped, but emptied himself, taking the form of a servant, being born in the likeness of men. Philippian

The final common pathway is an idea beloved of physiologists and practical reality to the houseman, who finds he is the administrative cornerstone of his firm. If he fails to inform theatre or the bloodbank that their services will be needed, if he keeps Casualty waiting, or fails to persuade X-ray to part with vital films for the ward round -- or, worse, does not return them afterwards -- he can call down upon his head the wrath of almost every group of hospital staff. Often their irritation is justified, and then there is no cause to complain. But sometimes it feels as if they are taking the opportunity to hand out abuse simply because they know the houseman cannot answer back. Resentment can easily build up if after five or six years of training -- towards the end of which the student has achieved some seniority and respect, culminating in the excitement and satisfaction of passing Finals and at last becoming a doctor -- he begins work only to find himself a glorified technician -- not a clinician, but a `dog's body', an unappreciated organiser of trivia, and the target of everyone's bad temper. Disillusionment and depression are not far away, and it is not unusual during these early days for a houseman to be so frustrated as to wonder why he took up medicine at all.

It is a relief to realise that at times the complaints are not directed personally at the houseman, though he may be the recipient. In a hospital, the demands on people's expertise, emotions and energy sometimes become excessive, and they take it out on the person who is nearest and least able to hit back.

More importantly, though, there is a parallel with how Jesus must have felt. He deliberately chose a menial lifestyle, and endured regular and unjustified abuse. The houseman is the most junior and least experienced member of a medical team, but Jesus was God -- far above any humanly authoritative figure. And he endured it with and for love. And we have the mind of Christ.

Teach us, good Lord, to serve thee as though deservest;
to give and not to count the cost; to fight and not to
heed the wounds; to toil and not to seek for rest; to
labour and not to ask for any reward save that of
knowing that we do they will.
Ignatius Loyola.

Further reading: Col 3:12-14. 1 Pet 1:18-24. Ps 43.

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