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ss nucleus - winter 2006,  Medicine - high ideal or great idol?

Medicine - high ideal or great idol?

Tim Hinks warns us about serious but common pitfalls

It is an immense privilege to pursue a career in medicine: few careers are more sought after or respected. The history of our profession is marked by countless men and women who have strived selflessly to serve the needs of their fellow men, through long years of study and tiring work, often at real personal cost. At its best, through our committed labour and continuing care, we are expressing Christ’s love in action.

Many bonuses await us: few people find their daily work so intrinsically stimulating. Medical science reveals the intricacies of God’s craftsmanship in creation. Kepler, one of the founders of the enlightenment, said we are literally ‘thinking the thoughts of God after him’.[1] I often reflect how strange it is that I am paid to do this. I am paid to talk to people, paid to care, paid to think, and sometimes even paid just to sleep!

We should value our work in medicine. We have fought off sharp competition for medical school. Our families and the wider society have invested vast sums in our education. With this comes great responsibility.[2]

A hidden danger

But being entrusted with such a gift can also bring a real danger. We don’t have to read far through the Bible to realise the potential of our sin to corrupt even the very best of God’s gifts. Thus man turns God’s gift of freedom into opportunity for rebellion,[3] marriage becomes struggle for domination;[4] brotherhood ends in murder.[5]

What is the nature of the danger? It is rare for us to squander our opportunities through laziness. Rather, I have found the greatest danger has been from idolatry. Throughout Israel’s history, this was the people’s first and foremost sin.[6] The first two commandments given to Moses were, ‘You shall have no other gods before me,’ and, ‘You shall not make for yourself an idol’.[7] And yet before Moses had even come down from the mountain, God’s people had fallen into deep idolatry.[8] They had been showered with gifts of gold from Egypt, and yet took this good gift and turned it into an idol.

Fundamentally, an idol is anything that claims loyalty which belongs to God alone:[9] it is spiritual adultery.[10] The Bible uses graphic and uncompromising language to show its utter detestability to the Lord. In the book of Ezekiel, God shows how he rescued Israel, his bride, and gave her the choicest of all things, such that the splendour he had given her made her ‘beauty perfect’. Despite this, she used her fame ‘to become a prostitute’, ‘made for [herself] male idols and engaged in prostitution with them’ and ‘offered [her] body with increasing promiscuity to anyone who passed by’.[11] You can read the judgment in Ezekiel 16:35-42.

We may not make idols of molten metal now, but we can commit idolatry in many other ways. The New Testament clearly tells us that attitudes such as greed are forms of idolatry.[12] If we let medicine become our idol we are in danger of forfeiting the grace that could be ours.[13] At stake is our very salvation.[14]

Making the diagnosis

What is the typical presentation of idolatry? An early sign is when we we’re beginning to love medicine just a bit too much. It is not wrong to enjoy God’s good gifts, but we should always be asking ourselves, who comes first in our heart -God or merely the gifts he gives us? What have we set our hearts on? Who or what is our first thought on waking, or our last thought at night?

Another sign is finding that our identity is defined by medicine. Our work is our life. Medicine gives us a new language. On graduation we even change our names. Soon we don’t just work as a doctor; we say I ‘am’ a doctor. How much does that all mean to us? If we lost our jobs, how much of our identity would we lose at the same time? How much has medicine taken over our lives?

We can not only find our identity in medicine, but also our security. We are needed; we are valued. We are well paid and always in demand. But in the end it is always foolish to trust in idols. Maybe the UK SHO job crisis this year has been a timely reminder to us that our ultimate security is not in our job or our pay, but in God alone who provides.[15]

A subtle sign, visible only to the experienced observer, is that of distorted motives. What is our motivation through months of revision for finals? Do we idolise success? It is right that whatever we do, we work at it with all our heart, but we must be careful that we are working for the Lord and not for man’s praise.[16] To be honest I know I’ve achieved a lot more in medicine for the sake of impressing others, or even impressing myself, than out of a desire to glorify God. How much do we remember the one who gave us the minds and the opportunities? Will we instead live for the day when we will hear our Lord say, ‘Well done, good and faithful servant’?[17]

Even working hard for God’s glory can come with dangers. The doctor’s life offers exceptionally rich rewards to those who put everything into it; the gratitude of patients, fame, power and occasionally wealth.[18] Jesus’ warning is made apparent for those who have started well in the Christian life. Like plants growing amongst weeds they can be ‘choked by life’s worries, riches and pleasures, and they do not mature.’[19] Have we learnt to take lightly the riches and pleasures in medicine?

Previously as a first year clinical student I was overwhelmed at the amount of medical knowledge to learn. Beyond graduation there are always more patients to see. One response is to work harder and harder. But we can never give medicine enough. If we don’t learn to be driven by call, rather than need, we end up becoming busier and busier as we take on too much – hospital committees, research projects, etc.

I have been astounded by the things I can make an idol out of. For most Christian doctors a major factor in career choice was the desire to serve others. But even service itself can become idolatrous, toiling out of love for service, rather than love for the one we serve.

As an example, Luke the physician recorded an intriguing incident at the house of Mary and Martha. Martha was busy preparing a meal for Jesus, but became irritated with him for distracting her sister. Jesus’ reply showed his priority for Martha was her relationship with him, even above her service of him.[20] In contrast, Mary was listening to Jesus and his words. Are we nurturing this relationship, or is medicine driving a wedge between us and God? Above all else, is it service itself we love, or is it our neighbour and the Lord our God?[21]

A management plan

Putting medicine before God is a great risk. How can we tackle this threat and keep Jesus number one in our lives?

1. Put medicine in the service of your faith

An Albanian medical student once told me that he aimed ‘to put medicine in the service of his faith, to put the profession in the service of his love’. I have been very struck by this clarity of thinking. His was not a life in service of medicine, but in service of his Lord, and that made his priorities very clear.

For him, the crunch came a few months later when an examiner demanded a bribe. Though his friends paid, because of his faith he refused, and failed the exam. In spite of five years of hard study and his parents’ financial sacrifices, he was prepared to retake a year. A year later he faced the same examiner and the same demand. This time his whole medical career was at stake, but he stood firm and was failed again. By God’s grace he was allowed to continue in medicine, an example to others who have sadly been forced to follow in his footsteps.

2. Be wary of status and money

How we avoid being choked by ‘worries, pleasures and riches’ will differ for each of us. If status and image ensnare us, aim to seek lower status. I know of one doctor who deliberately owned a Skoda car all his life. When they became more upmarket he switched to driving a Lada. For others it means that they’re careful when they use the title ‘Dr’. One professor I know, though not a believer, is as comfortable pushing trolleys and chatting to the porters as when mingling at international conferences.

Jesus and the apostle Paul warn us of the love of money.[22] We should be known as those who are content with what we have, rather than forever comparing our salaries with those of lawyers, or campaigning to have our pay re-banded. If we want more money we will never have enough. Some of our colleagues will take on extra commitments and spend extra weekends doing locum work, just to pay for another skiing holiday or a second house in Dordogne that they’re too tired to enjoy. Do we really need these things?

My wife and I have benefited from advice to borrow much less than we were able. A smaller mortgage has allowed Naomi to reduce her hours as a GP to be at home with our children and enabled me to work part time for CMF. A family we know, despite impressive educational achievements, has learnt to live on the wage of a single manual labourer enabling them to work in cross-cultural mission in the UK and bring up their child themselves. A friend told them she wished she too could be at home for her child. On two good salaries her family earned four times as much, yet she felt enslaved by the lifestyle choices they had made.

Any career in medicine in this country will come with the challenge of being wise stewards of significant material wealth and we must prayerfully consider how we will divide this between ourselves and family, gospel ministry and other charitable projects. I have found it very useful to see how older Christian doctors have used their wealth, and I have often benefited from it personally. For example, many churches in this country, particularly in low income areas, depend heavily for their finances on the giving of doctors. Likewise, support of Christian mission agencies provided the majority of medical care in Africa for most of the 19th century.

3. Prioritise family

David Short, former CMF member and medical professor in Aberdeen, wrote:

I have no doubt that doctors tend to neglect their wives and families. Medical work is much more exciting than discussing the details of family life. It is more flattering to our ego to be engaged in the battle against major illness than having to show our ignorance about how to treat our own crying child who has had an attack of earache. We can so easily persuade ourselves that the time we spend away from home is unselfishly devoted to the benefit of humanity. [23]

One Christian consultant I knew was head of a very large clinical department. He took unpaid leave for several months to devote to his family, to show them where his priorities lay. Though the move was unusual, he had arranged people to cover his work and has set a clear example to over a hundred doctors who work under him, of what he believes should be a doctor’s priorities. Many other junior doctors have taken part time work for the same purpose.

In a society that prizes career and earning power, this is a powerful counter-cultural statement to their peers. Even as far back as the reformation in the 16th century, Luther encouraged men to be at home changing children’s nappies and to look ‘upon these insignificant, distasteful, and despised duties in the Spirit, and [be] aware that they are all adorned with the costliest of gold and jewels…[to confess] that I am not worthy to rock the little babe, or wash its diapers, or to be entrusted with the care of the child and its mother.’[24]

4. Discern your calling

We have seen that there is no end to medical needs. We can be encouraged that Jesus too faced this unlimited demand[25] and we can learn from his response. Clear that his primary work was to proclaim the gospel, he refused to let medical needs distract from his most important task, but continued to meet those needs as his ministry allowed and required.

Medicine has a tendency to push out our priorities of fellowship, prayer and the Word. Involvement in church, home groups, and quiet times fall by the wayside, becoming subservient to our work. We need to be ruthlessly clear that first and foremost our calling is to be followers of Christ, and only secondly to be medics, and our lives should reflect this.[26] One common area of conflict is our need for rest, against the pressures to use our free time for medical research, audit or exam revision. Alan Johnson, CMF president, said that throughout his life he resolved never to do academic work on his day of rest, and I’m encouraged that it hasn’t prevented him becoming a professor of surgery. Maybe we could achieve more success in medicine if we worked on our days off, but at what cost to our spiritual lives? We should ask ourselves whether it is merely another sacrifice to the idol of medicine.

5. Worship God with your career choices

We are to worship God with our whole lives. So we should consider prayerfully how each career move will better help us do this. These decisions can be tricky, and no one answer will be right for each person.

I have found a useful question to ask is, ‘What is it that I can do, as the person I am, with the gifts that God has given me, to bring greatest glory to his name?’ For some, like Prof Johnson, this will mean working as a high-flying academic medic, but doing it for God’s glory. For others it will mean considering overseas work where our gifts can have much greater impact on the health of communities. For others it could mean choosing less glamorous or demanding specialities to enable us to devote more time to families or to church. Many Christian doctors I know have chosen to work part time, so they are free to be more involved in church administration, evangelism, or preaching. We can do this by choosing specialities that allow sessional work (eg general practice, anaesthetics, A&E) or through flexible training. In my case I chose to work for CMF and God very soon provided a paid research post tailored to my needs.

I know several doctors whose working patterns allow extended leave to teach trauma care, general practice or the gospel in developing nations or those closed to the gospel. Some of my friends have felt that their particular gifts would be best used by leaving medicine for full time paid gospel ministry. For me, this did not seem the best use of my gifts, but considering the possibility was a challenging experience.

A final thought

Medicine is full of opportunities to worship God, as we show his love in action, steward his wealth and speak his gospel. But we will also face the danger of the idolatry of worshiping medicine. As we run the race of a medical career and make career choices we need to keep a future perspective. The famous 17th century physician Thomas Sydenham wrote:

Whoever applies himself to medicine ought seriously to weigh the following considerations: first that he will one day have to render an account to the Supreme Judge of the lives of sick persons committed to his care; next, that whatever skill or knowledge he may, with God’s favour, become possessed of, he should be devoted above all things to the glory of God and the welfare of the human race.[27]

Further Reading

  • Anon. Why ever did you take up medicine? London: CMF, 1980
  • Downing C. Why ever did I take up medicine? Nucleus 2003; October:30-35
  • Graves D. Doctors who followed Christ. Grand Rapids: Kregel Publications, 1999
  • Greene M. Thank God it’s Monday. Milton Keynes: Scripture Union, 2001
  • Short D. Medicine as a vocation. London: CMF, 1987

References
  1. Anon. Why ever did you take up medicine? London: CMF 1980:7
  2. Lk 12:48
  3. Gn 3:1-7
  4. Gn 3:16
  5. Gn 4:1-8
  6. Dt 31:16, Jdg 2:10-17, Je 2:1-13
  7. Ex 20:3,4
  8. Ex 32:1-8
  9. Is 42:8, Marshall I et al. New Bible dictionary (3rd edition). Leicester: IVP, 1996:496
  10. Ho 2
  11. Ezk 16:15,17,25
  12. Eph 5:5, Col 3:5
  13. Jon 2:8
  14. Rev 22:14,15
  15. 1 Tim 6:17
  16. Col 3:23
  17. Mt 25:21
  18. Short D. Medicine as a vocation. London: CMF 1987:33
  19. Lk 8:14
  20. Lk 10:38-42
  21. Mt 22:37-40
  22. Mt 6:24, 1 Tim 6:9,10
  23. Short D. Op cit:35
  24. Luther M. The estate of marriage (1522). www.warwick.ac.uk/fac/arts/History/teaching/protref/women/WR0913.htm
  25. Mk 1:32-39
  26. Mt 6:33, Mk 12:28-31
  27. Short D. Op cit:4
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