The Hope That Is In Me

I just found out that I passed boards.  To celebrate that, I thought I'd give an update on how my very first rotation is going.

My first rotation is an elective in the ER.  It's a fairly small hospital, and thus a small emergency department, but the medicine is still fascinating.

First of all, I will say it's astounding how little I know about day-to-day medicine.  Brand names of drugs.  Basic, common infections and diseases.  How to gracefully cut off an old lady so she will stop talking about her lunch and get back on the subject of her heart attack in progress.  All of these are things that I've been trying to pick up each shift, and they have been coming slowly but steadily.  I cannot tell you how encouraging that is.  During classes, I felt like I could never get anything right enough to be satisfactory.  I was constantly struggling against the knowledge that God was teaching me what He needed me to learn, not just about medical science, but about divorcing my sense of self-worth from my accomplishments.  I have gotten better with that, but even as I continue to walk down that journey, it is a relief to be in an environment where I'm allowed to learn things and make mistakes - where I have the room to improve.  I can put in IVs now!  And I've done a whole bunch of things that to me are crazy but to the people around me are totally normal:

• draining huge, gross abscesses.  Also draining tiny lame abscesses that were almost just pimples and the patients really just should have taken a pin and a deep breath and done it themselves.
• putting in a nasogastric tube, which is horrible for all concerned.  The tube goes in the patient's nose and down the esophagus into the stomach, which means the patient gags miserably the whole time and you feel like you're committing assault and praying you don't accidentally go down the wrong pipe and end up in the lungs instead.  And then you suction out the stomach!
• digital fecal de-impaction.  A medical term for using your medical finger to medically clean out someone's rectum chunk by medical chunk and wiping that on a medical towel.  This is maybe even less glam than it sounds.
• about 5 jillion pelvic exams.  Which, for the record, are gross.  I'm already dreading having to actually watch birth.  A future OB/GYN I am not.
• about 3 jillion digital rectal exams.  Which are not as gross as pelvics.
• suturing!  I sewed up this hand that was moderately chewed up.  I was terrified.  It was awesome.  And my suturing job was approved by the doc, so I didn't have to cut my sutures out and redo them!
• seeing things like incredible ascites, or a classic example of strep, or someone on meth asking for "ice for my pent-up rage."
• watching a dislocated finger get put back in place and almost passing out.  Everyone is a wimp about something.

So, medically this rotation has been amazing so far.  But... well, here's an excerpt from an email I sent my husband last night:

"...spiritually each day has been more of a struggle than the last.  I wrote in my journal that it’s difficult to pinpoint what’s bothering me, but I trust the sense of my soul that there isn’t a single person who works in that ER who has Christ in him/her.  Of course there are symptoms of this – endless gossip, for example.  But more than that, I’ve come to realise that I’m watching people who are cut off from the Source of all love and strength.  They are weary and, under the surface, so bitter.  And there are times during a conversation where a corner of the veneer of jokes and sarcasm peels back, tattered and thin, and there is meanness and hate under there.  And I think the Lord, in His mercy, has been allowing things to slowly ramp up to the point where it would crystallise my discomfort into outright rejection of the way these people do things. 

Two of the nurses and two physician’s assistants (PAs) made fun of a suicide note today..."

Let me stop here and say clearly that the nurses, PAs, and doctors working at this hospital do care for the patients.  They work to be nice and show compassion even when patients are being rude or demanding.  I feel certain that this is one of the "nicer" groups of staff you'll find in emergency rooms.  But because I'm on the inside, I get to hear all the backbiting, all the spite against patients, all the vitriol.  These people all work incredibly hard.  The difference between them and many of the medical Christians I have met is that the work is wearing these people out.  It's upsetting to watch.  And as for my own part:

"...my own timidity is killing me.  Each day I get a bit better at openly disagreeing with the people I’ve been working with, but I should have clearly objected to what they were saying today instead of just saying, “Are you really making fun of a suicidal patient right now?  Really?”  and suggesting – suggesting! Like there’s room for debate! – that these people really need compassion more than judgment.  And twice now I have ignored the call to pray with patients because I was afraid of messing up the flow of things in the ER.  I feel like I have been the living embodiment of Much Afraid.  And I’ve been repenting of that the last few days; still the Lord hasn’t, as far as I know, given me any more nudges to pray with patients since the last time I disobeyed Him.  I feel so bad.  These patients need true love; they don’t just need medical help, a lot of them need healing.  But I’ve been so focused on learning, on taking in, that I haven’t been giving out."

I think what I've been doing is probably pretty typical for a medical student out in the hospital: I shut up and watch.  Do what I'm told.  Work hard but generally don't interfere.  I take it all in, process it, and store the important parts for future use.  Afterwards I ask questions about parts that need clarification, and then I process a bit more.  But that only works in the areas where the person teaching me is the authority.  And because I'm currently in an environment without any other Christians, there are no spiritual authorities present besides the One who lives in me.  Which means I can't rely on someone around me to help me with spiritual direction; I have to get it all from the Lord.  I have been doing a terrible job of that recently.  And now that I've realised that, my heart feels broken.  

“No one lights a lamp and then covers it with a bowl or hides it under a bed. A lamp is placed on a stand, where its light can be seen by all who enter the house. For all that is secret will eventually be brought into the open, and everything that is concealed will be brought to light and made known to all.  So pay attention to how you hear. To those who listen to my teaching, more understanding will be given. But for those who are not listening, even what they think they understand will be taken away from them.” - Luke 8:16-18

This is a dense passage, but part of it is that the light is the light of God, and it illuminates truth and defeats lies and deception.  Christians bear that light with them wherever they go.  The second section of this passage is discussing how being willing to listen to the leading of the Holy Spirit allows Christians to increase in wisdom through their connection to the Source of all wisdom and knowledge.  People who lack this connection are cut off from the wellspring of true wisdom.

I have resolved to listen better, and obey.  I am a child of God, and I have the risen Lord directing my steps.  I need to shake off my student stupor and start living that more openly.