From winter 2005 - Me - a Witness to Patients?
Many students feel frustrated that there are limitations set on the clinical procedures they can do on the wards before they qualify. When it comes to being a Christian witness, no such boundaries exist: students have at least as much opportunity as anybody else, and usually more time. So take heart! Let’s look at a few basic principles.
God is interested in the whole of our lives. In Colossians we read that everything we do should be done wholeheartedly as though we are actually doing it for him. This includes our work and leisure activities, and all the practical responsibilities we have in our relationships with family and friends. We need wisdom to make the most of every opportunity we have with outsiders, both in our behaviour and speech. Surely patients we meet in the clinical context are among these ‘outsiders’ that Paul is talking about?
Jesus commissioned his disciples to take the good news to the whole world, starting from where they were. From Paul’s letters we learn that we are ‘Christ’s ambassadors, as though God were making his appeal through us’ and that Paul himself is ‘not ashamed of the gospel, because it is the power of God for the salvation of everyone who believes’.
It is interesting that the Bible doesn’t use the verb ‘to witness’, but rather speaks of you and me ‘being witnesses’. The distinction is that being a witness is something we do all the time whatever we are doing and wherever we happen to be, while we may be inclined to think of ‘witnessing’ as something we do on particular occasions, by following a planned pattern of conversation.
We might believe that there is a difference between the work context and the rest of life. Some feel that work is just that, and should be done well to high ethical standards, but being a Christian witness is something that strictly happens at home or with friends or through church activities.
At CMF, we think differently. The second of our aims reads, ‘To encourage Christian doctors and medical students to be witnesses for Christ among all those they meet.’ This is most certainly a biblical principle; but do the profession and the public at large consider it ethical to share faith with patients? What about our privileged position? The General Medical Council (GMC) looked at this issue some years ago and whilst warning against the ‘abuse of privilege’, their advice still leaves the way open for the appropriate and sensitive sharing of faith if and when God creates a door of opportunity. The report reads:
The Committee’s attention was drawn to the activities of a very small number of doctors who use their professional position to proselytise patients, or who offer diagnoses based on spiritual, rather than medical grounds. The Council has hitherto taken the view that the profession of personal opinions or faith is not of itself improper and that the Council could intervene only where there was evidence that a doctor had failed to provide an adequate standard of care. The Committee supported that policy and concluded that it would not be right to try to prevent doctors from expressing their personal religious, political or other views to patients. It was agreed, however, that doctors who caused patients distress by the inappropriate or insensitive expression of their religious, political or other personal views would not be providing the considerate care which patients are entitled to expect. This view was supported by the Council and a report of the debate was published in the GMC News Review.
Even if we are keen to witness to patients we may find ourselves feeling like a square peg in a round hole and traditional models of evangelism (eg for door to door visiting) may not sit comfortably in the clinical context. Discouragement sets in and we decide to try sharing the gospel elsewhere. It would be helpful to identify what we perceive as being difficult, so we can overcome these problems.
Some healthcare professionals feel that all they can do is fulfil their clinical responsibilities on any allotted day: time pressures are inescapable, and we all have to be wise in our priorities. However, we may well find that in our patients, many physical problems have spiritual or emotional roots which need to be addressed, and if we don’t do something about them, no real progress is made. In addition, there is now mounting evidence from research that faith and spirituality generally improve physical and psychological health and recent articles in the BMJ and elsewhere have highlighted this.
We could be afraid of pushing our beliefs on our patients, or frightened of what our colleagues will think. In his first letter, Peter encourages those to whom he writes to be prepared to give a reason for the hope that they have, but to do it with gentleness and respect. Approaching our patients with sensitivity and respect, and checking that we have their permission to discuss any matter, are basic principles of all clinical care. Developing and maintaining good open working relationships with all our colleagues will always be essential anyway, if the clinical teams we work in are to achieve their goals. We also need to remember that as Christians we are engaged in spiritual warfare and the devil will do whatever he can to discourage and make us doubt that God can use each one of us. We would do well to take Paul’s advice to ‘pray in the Spirit on all occasions with all kinds of prayers and requests’. Our job is not to force doors open, but rather to recognise where the Holy Spirit is already opening a door, and to have the courage to walk through it.
We may be unsure of what we believe, how to identify patients who desire discussion and how to use appropriate language; all these can make us hesitant. Are we confident with the basics of a gospel outline, when we have the opportunity to explain the tenets of Christianity? We shall look at how we can engage in conversation and identify interested patients later.
Evangelism is a process, not an event. The process involves guiding an unbeliever, in the power of the Spirit, in making a series of step-wise decisions that result in placing his/her faith in Christ.
There are usually plenty of hurdles to be overcome along the way. Many people whom we meet in clinical practice will have emotional barriers to faith in Christ, based on bad experiences with Christians, religious groups or hearsay from someone else. The way forward is to take time to ‘cultivate’ relationships of trust with people so that their interest in you, ‘the messenger’, may be provoked even before they hear the message. This may well be the hardest and most prolonged stage of evangelism and needs the guidance of the Holy Spirit as much as any other; yet many do not even realise that it is evangelism, because the name of Jesus may not be mentioned at this stage.
The time taken for cultivation varies greatly with different relationships. I can recall a lady whom I saw with depression: she had a history of her father abusing her, was divorced from an abusive husband, separated from her two sons and harassed by neighbours in her block of flats. She presented as a very private person. For several years I treated her for depression, which involved prescribing medication, regular follow-up consultations, helping her with the police in dealing with her neighbours, negotiating with housing authorities for new accommodation and liaising with the then Department of Social Security for financial help. One day, after ten years, she said to me that she was desperate to see her two sons again, and she had managed to find out where they lived. There was no obvious medical intervention available, but when I expressed my concern for her plight and that I believed God was also concerned for her, a door opened for further conversation and an opportunity to pray with her. In contrast, sometimes conversations go much quicker. One man, who presented to me for the
first time in a personal crisis, told me his story and then exclaimed, ‘Doctor, I don’t know why God would allow this to happen to me!’ In a situation like this, it is important to be gentle and ask further questions first, but God may be already providing an opportunity for subsequent conversation.
As emotional hurdles are overcome, we may encounter genuine intellectual barriers and ignorance of the truth. This is a time to sow the seed of the gospel and painstakingly weed out misconceptions and erroneous beliefs. Within clinical practice this will usually occur after some time, but if we are sensitive to the Spirit’s prompting, we may sometimes find that we are presented with someone in whom emotional barriers are already breaking down and we are being given a ‘sowing’ opportunity. Two things are worth noting here: first, it is important that we ourselves are being fed by God’s Word and growing in our knowledge of Christ, so that we have something to share; second, be prepared to stop and allow people to comment or ask questions or terminate the conversation before you’ve finished. If we study how Jesus spoke with people, we will see that he never told anyone everything, but he did say something that would help his enquiring listener take the next step of the journey.
As intellectual barriers break down, we encounter the stubborn desire of self-will, where a person has to choose to leave his/her old life behind and place his/her faith in Christ. This phase of ‘harvesting’ is the work of the Holy Spirit but involves us in praying and ongoing conversation. Personal testimonies can help to clarify what Jesus has done and how to respond to him.
We can see that our role in day to day activity is to help an unbeliever move one step closer to a relationship with God whatever that may involve (or to help a Christian take the next step in his/her relationship with God). Much of our time will be spent in ‘cultivating’ and ‘sowing’ so that a person may be prepared for the moment of ‘harvesting’, perhaps years later in a different context.
First and foremost we need to be competent clinicians. It is likely that for most of the patients we will meet throughout our lives, this is the main thing that God will require of us and from the start of our student career; it is worth gaining this perspective and recognising that we are here to learn. As students we are not expected to know everything, but we should show that we want to learn and do our work as well as we can. Ultimately as doctors, our patients will not respect us unless they trust our clinical judgment and skills, and working capably is an essential part of a Christian’s witness.
Second, we should demonstrate Christlike character and compassion. Compassion will involve how we behave, listen and speak. We will frequently fail in this area, but that need not deter us, as from the outset we choose with God’s help to grow in Christ. Compassion really comes from knowing how much grace we have received from Christ ourselves. It will help us to get off our high horse (never a useful place from which to speak to a patient!) when we acknowledge how much we ourselves have received from God. The combination of competence, character and compassion gives our witness authority and at some stage will give us opportunities for careful communication.
While a great deal of emphasis is placed on our behaviour, I cannot agree with those who say that we are witnesses purely by our actions. None of us will be perfect enough to evangelise by this method, and furthermore Jesus needs to be named for people to turn to him.
It’s good in the course of ordinary conversation to say things that identify yourself as a member of God’s family. This may be anything from a casual response to the question, ‘How was your weekend?’ with the words, ‘After church we went for a barbeque’ to dropping in a phrase like, ‘We’ve got a lot to thank God for, haven’t we?’ These comments give the listener a chance to respond, but it doesn’t matter if they are not picked up at the time; they may open the way for further conversation later. At this stage we are not specifically telling the gospel story, but rather identifying ourselves as people for whom God/prayer/the Bible are important. As people see how we behave, they may enquire more: subsequently we might tell a bit more of our personal story, showing what difference God has made in our lives. Stories that show ourselves in an appropriately vulnerable light are likely to be helpful. For example, I have sometimes found a door opening to share how God helped in difficulty in my own family life or how he helped us prepare for my father’s death.
Jesus is our example and one of the things he constantly did was ask questions. In palliative medicine, it is normal to take a spiritual history, but this is something we may have opportunity to do in many situations, particularly if someone is facing serious illness or dying, preparing for an operation, having a routine maintenance check or going through a social crisis or time of loss. We can ask questions such as, ‘Do you have a faith that helps you (in a time like this)?’, ‘Have you ever prayed about your situation?’, ‘Who gives you support?’ or ‘What keeps you going?’ If the response to these questions appears negative or the patient seems not to want to continue this line of conversation, then it is fine to leave it and move on. Our task is to allow the Holy Spirit to work and not to force the issue in our strength. Recently I came across a colleague who on asking one of her regular patients the question, ‘Do you have a faith that helps you?’ received a rather gruff answer, ‘Well, I used to be a Catholic.’ Wisely the doctor felt nothing more should be said at that stage, but two weeks later the patient came back and opened the conversation by saying, ‘Do you think God can help me, doctor?’ There followed a wonderful opportunity for this clinician to talk about Christ and guide the patient towards a lively local church. A question posed two weeks previously led to a gospel discussion.
‘Would you like me to pray for you?’ is a question I have used many times and it produces a vast range of responses. If the reply is ‘no’, we have learnt something useful about our patient and can leave it there, but sometimes our patients may talk wistfully about their parents’ faith, or explain why they don’t go to church but do pray at home, or respond in some way allowing the doctor to pray with them. As we pray on our own or with patients, we become better at recognising when God provides opportunities, and discern whether they are ready to hear more about Jesus.
Moments such as these are relatively rare in clinical practice, but once someone is ready to know more about Jesus it is important to be able to explain the gospel clearly. It may also be appropriate to give a patient a gospel in a modern translation or a gospel booklet. Whatever you do, avoid using spiritual or biblical language that the patient can’t understand - practice makes a difference here, so that you can spot the signs when you are mouthing away but have left the patient behind!
Happily this is absolutely true for all of us. Most important, for all of us, is to pray about our work and those we meet. It is easier to talk to somebody about God, if we have already talked to God about somebody. Similarly it makes a big difference if we are always on the lookout for our fellow Christians and take time to pray with them. Our role may simply be as a catalyst to introduce a patient to someone or something else, be it a hospital chaplain, a local pastor, a specialist drug and alcohol counsellor or an Alpha course. The tiny connection that we make for a patient may actually make the difference between eternal life and death.
Confident Christianity (CC) is a one-day training course designed to help you to understand and articulate the gospel more clearly, while providing biblical answers to common objections. The course material is available online at www.cmf.org.uk and training manuals can be ordered from firstname.lastname@example.org. Contact the office or your regional staff worker to arrange a CC day in your area.
The Saline Solution course is a new venture pioneered by our sister organisation in the US, the Christian Medical and Dental Associations (CMDA). Saline Solution helps believers to live and speak for Christ effectively in the clinical situation with patients and colleagues. The material used highlights ways in which patients and clinicians can speak about the gospel in a natural way. There are day conferences planned around the country and one in London on 19th February 2005, to which students are especially invited. See www.cmf.org.uk for further details and dates.
I suggest two things:
(1) Whenever you meet anyone, recognise that God has gone before you and rather than impose your own agenda, ask the question, ‘What is God doing?’ with this patient, in this family, with my colleague, in this situation etc. As you listen to the prompting of the Holy Spirit, you will discern whether this is a moment to do a job well, to listen carefully, to show compassion, to ask a question or to say something.
(2) Look for ways of showing God’s love practically around you every day. You can’t convert anyone - that is the Holy Spirit’s work, but you can introduce Jesus to someone and leave the outcome to him.
Remember, you don’t have to ‘witness’ to someone every day in a particular routine way, but you are to be a witness all the time and the Holy Spirit will open doors for you: have the courage to step through them.