I was stopped on the stairs outside our ward recently. It was one of my bosses and he looked a little awkward – as if he had something to tell me but didn't quite know how to express it. He explained that a patient's daughter had complained to PALS (Patient Advocacy and Liaison Services) about the fact that I'd discussed 'religious matters' with her father and given him a booklet about heaven (as well as a 'booklet' called the Good News Bible – a misunderstanding, I think ... thank you Gideons!). The situation she described referred to the evening I had talked with her father, a gentleman with end-stage prostate cancer, about the likely course of his condition and I'd then asked him whether he had a faith that helped him at difficult times. His answer was 'No, but why do you ask?' and I'd explained that I was a Christian and hoped that it would help me if I were ever in a similar situation. I mentioned that our vicar had recently died of cancer and written a small booklet about death called 'On My Way to Heaven'. (1) I offered to bring it in the next day. He said that he'd like to read it so I gave it to him on the ward round the following morning.
In the event, the daughter hasn't yet made a formal complaint. But the email that subsequently came through from PALS in response to the verbal complaint was revealing. The PALS co-ordinator advised first that only 'Trust literature' should be given to patients and that doctors should leave all 'religious' discussions to the chaplaincy staff! Many will spot that this is another example of a relative taking offence, rather than the patient. (2)It gave me the opportunity to reflect on our priorities as doctors. Was the PALS co-ordinator correct? As Christians, should we accede to decrees such as this? What should be our motivating force as doctors?
Someone once said to me that as Christians we have the tremendous privilege of being able to give a concrete answer to the question 'Why do we exist?'. According to Matthew 6:33 there are two reasons: two reasons why God hasn't come back yet and why we are still on this planet. First, to get ready for heaven. Second to get others ready for heaven. These are the two things that God wants us to focus on in this life. One is about personal holiness. The other is about evangelism and discipleship. 'But seek first his kingdom and his righteousness and all these things will be given to you as well' (Matthew 6:33). Jesus is addressing his disciples and they are worried about all that they will lose as a result of following him. How will they cope in this new life following Jesus without the everyday bits and pieces that they used to depend on? Jesus tackles this head on and sets their priorities straight. Seek first his kingdom and his righteousness. Of course, these are universal principles for all Christians. Let's have a brief look at each of these in turn and then think about what it means for life as a medic, thinking particularly of the clinical student or pre-consultant grade doctor, working up through the ranks.
seek first his righteousness – get ready for heaven (holiness)
Righteousness arises from a legal and moral relational view of innocence. Not guilty. To be declared innocent or 'justified' (Romans 3:24) by the judge is to have righteousness. We can only obtain this righteousness at the cross. 'For Christ also suffered once for sins, the righteous for the unrighteous, to bring you to God.' (1 Peter 3:18). This is where Jesus' righteousness is given to me and my unrighteousness is laid on him. But, while we are 'justified' at the cross, the work of 'sanctification' (of us becoming more holy in practice) is an ongoing work in us. 'May God himself, the God of peace, sanctify you through and through. May your whole spirit, soul and body be kept blameless at the coming of our Lord Jesus Christ' (1 Thessalonians 5:23).
Yes, when we trust in Jesus, we are seen as righteous, because God looks at us and sees Jesus. But we are also to go on seeking his righteousness because although the final judgement is secure, we want to get ready to meet him face-to-face, becoming more like him in reality as we wait. 'For those God foreknew he also predestined to be conformed to the image of his son' (Romans 8:29).
In part three below we'll think about what it might mean in practice to put personal holiness first in decision-making as a doctor.
seek first his kingdom – get others ready for heaven (evangelism and discipleship)
Jesus tells his hearers to seek first his kingdom. The obvious choice would have been to focus on their lives in first century Palestine where the crops needed sowing and harvesting, the barns needed to be built to house the produce, the nets needed mending to catch fish and the food needed to be prepared and the family fed. But Jesus tells them to lift their eyes from their transient earthly kingdoms and focus on God's heavenly kingdom which will last forever. God's kingdom is eternal, it will be more exciting than our wildest dreams, and it will be populated by people who have understood who Jesus is and accepted him as their Lord and Saviour.
In the booklet referenced above, Mark Ashton described the moment when he first received his diagnosis. Apparently he said to his consultant that, for a Christian believer, this 'wasn't bad news but good'; it was 'not the end of the story, but the beginning'. Mark was 'seeking first his kingdom'. Mark described the imaginary thought bubble appearing above the surgeon's head saying 'refer to psychiatry'!
Do we have the same excitement about God's kingdom? What drives us? What influences the decisions we make? Our attitude to God's kingdom is seen most clearly in our attitude to evangelism. If we really believe that God's kingdom is the ultimate goal, then we will be passionate about seeing our friends, colleagues and patients coming to know Jesus so that they can look forward to that kingdom themselves. If, however, we're more interested in this world then we'll be more worried about getting along with people, about not upsetting their feelings, about having a nice house, sending our kids to the right school, making the right pension investments....to be honest, not looking any different to those around us.
The corollary of this liberatingly simple answer to the question 'Why do we exist?' is that it allows the worries of this life, the anxieties that keep us awake at night, to settle into perspective. Jesus tells his disciples, who had given up everything to follow him, 'do not worry about tomorrow, for tomorrow will worry about itself' (Matthew 6:34). The beauty of having this Matthew 6:34-centred approach to life is that it invites us to ask ourselves two simple questions whenever we're anxious about a decision we need to make: 'How will this help me get ready for heaven?' and, 'How will this help others get ready for heaven?'
What are some of the things that we medics worry about? Here are some of the areas that spring to mind (particularly thinking of the trainee doctor, although many of these are not unique to medics).
1. fulfilling our potential
This is something that I've been particularly struck by recently. I think many of us Christians have bought the lie of the world around us that the biggest sin is the sin of not fulfilling my potential, even in my attitude to what I can achieve in Christian ministry. It sits nicely with my selfishness and my pride. It's clear from the Bible that the biggest sin is rejecting Jesus, and if we've accepted him then we're to get busy building the kingdom, not worrying about whether or not I've 'made the most' of my upbringing and schooling and gifts. Seek first his kingdom and his righteousness.
2. what our parents or boss think
Many of us live under a cloud of expectation, often built around making our family proud of us. This is linked to the previous point. Actually, it's what God thinks of us that counts. Now don't get me wrong, it's tremendously important to honour our parents. The Bible commands us to obey them before we have become mature adults. But what I mean here is that we shouldn't feel under pressure to live up to all their expectations. Or what about our consultant? We want to work hard and put Romans 13 into practice by obeying the authorities God puts in place over us, but ultimately, again, it's what God thinks that counts. We're to seek first his kingdom and his righteousness.
3. whether it's okay to talkto our patients about Jesus
Much has been written on this subject. (3) Suffice to say that if 'getting others ready for heaven' is one of our key goals in life, then we're going to find it hard not to want to talk to our patients (and colleagues) about Christian things. If we do this in a thoughtful and sensitive way; if we ask questions rather than talk at them; if we listen to our patients and their responses and give them the option of saying no, then I can't see any good reason why we shouldn't freely talk about Jesus with our patients. Seek first his kingdom and his righteousness.
4. getting married and having children
A whole article in itself. Suffice to say that God knows us and he loves us and we are valuable to him just as the 'birds of the air' (Matthew 6:26) and he knows what we need (Matthew 6:32). We can trust him in the big things in life as well as the small. And if, in the course of seeking first his kingdom and his righteousness, along comes a wife or husband or children, then excellent. Seek first his kingdom and his righteousness.
5. leaving on time to get to home group
I get this wrong all the time. Particularly when I started a PhD a few years ago and went back to being a 'new boy' again, I was worried about what people would think. I thought I should stay late to impress them. In clinical work, our pride often means we don't want to hand anything over to the on-call team. But, I think this is a key area in which Christians can show our difference in priorities. If I'm always asking, what is the priority for my holiness, then getting to home group midweek will be a priority. Prepare an efficient handover and then leave. Seek first his kingdom and his righteousness.
6. our image
Most of us are rightly concerned about what other people think of us. We want to be the one that people in our department turn to for advice. The one who makes people feel good about themselves. We want to leave a good impression when we leave a job. But are we doing this just so that people say 'he's a nice guy' or 'she's a nice girl'? Or is it so that we might win opportunities to tell others about Jesus - 'to shine among them like stars in the sky as you hold firmly to the word of life' (Philippians 2:15-16). Seek first his kingdom and his righteousness.
7. our CVs and five-year plan
Humanly speaking, these are important things to focus on. Proverbs 16:9 says, 'In their hearts humans plan their course, but the Lord establishes their steps.' It's good to be organised about our career development and to plan. But what are my priorities? Finishing my training, publishing well and landing that plum academic job may mean that I can stay in a university town and continue to teach the Bible to and disciple medical students (helping others to get ready for heaven). But it could also make me proud, arrogant and self-reliant, not helping my holiness at all. Seek first his kingdom and his righteousness.
In conclusion, this two-step answer to why we exist may seem like an oversimplified view of life. And maybe it is. Obviously, there are more nuanced descriptions of why we exist in the Bible. On the other hand, we could simplify things even further and say that 'Man's chief end is to glorify God' (Westminster Shorter Catechism, 1647) 4 and that would also be true. But I hope that by focusing here on these verses in Matthew, focusing on these two priorities of getting ourselves ready for heaven and getting others ready for heaven, that we can cut through the distractions of conflicting human priorities and live lives as doctors that will count in eternity.