Wherever there is jealousy and selfish ambition, there you will find disorder and evil of every kind.

I wrote this a week or two ago, but followed the advice of a wise friend who suggested I wait and make sure I could handle this much transparency.  I'd be lying if I said this issue is closed, but I've already sat on this post in one form or another for months and I'm starting to feel like I'm hiding it.  That's not okay.  I don't want to give the false impression that this walk with Christ has no stumbles or sharp turns in it, and I don't like keeping secrets.  So here it is.

I often get the sense that real struggles with sin are not okay to talk about in a lot of church circles, but I don't currently have any thoughts on eschatology or the latest Joyce Meyer book, so this will have to do for discussion.  Let me start by saying that I'm still really ashamed of the content of this post, which is proof that this internal journey is nowhere near finished yet.  But it would be dishonest of me to pretend this isn't going on, and it's something that many, many doctors (Christian and not) have a hard time with, so it should be brought out into the light and examined with the eyes of truth. 

The real story of my winter and spring is not auditions, or rotations, or matching, or medicine.  Those things just form the backdrop for the action.  The real story of my past six months is how, for the first time since coming to know Christ several years ago, I fell unresisting into sin - the sin which some have said lies at the root of most other sins, pride.  I have almost no idea how to even talk about it.  It's so hard.  It came about so gradually at first, over years, that I didn't even notice it, and it started with something very simple and not wrong at all: I liked emergency medicine more than family medicine as a potential career.

You all know that for me, the FM/EM fight has been raging for years, and I always put it like this: I feel like FM has big strengths and undeniably lends itself to missions, but I just honestly like the ER so much.  And that sounds good.  But I didn't realise that other things were building up around that, things like: ER doctors get to tell cooler stories.  All family physicians get to do is drudgery, and they don't get any respect.  I would really like the flexibility that comes with shift work.  I don't have fun managing diabetes and such.  My feet hurt when I walk the floors on internal medicine.  I would hate to have to run a business so I'll never be a clinic doctor.

I have listened to so many incredible doctors warn about how obstacles to serving Christ creep in and take the form of our desires for comfort, stability, respect, and choice.  And you know what?  I still have let all of those things creep into my heart.  And I was so sure that everything was fine that I let it get worse.  By fourth year, my thoughts went more like this: yeah, I'm going to be an emergency doctor.  I'll do all the interesting stuff.  I will be the Christian who survives in a demanding secular environment.  I will be the spiritually sound one who still has the trendy job. 

Pastor Mark Driscoll did an interesting sermon series this year about identity, and he mentioned something that resonated like a bell for me: when you commit identity idolatry, that is, when you define yourself by something other than your relationship with Christ and put great worth in that identity, you eventually get extremely nervous.  This is because you can sense that whatever or whoever you have pinned your identity on is not reliable enough to keep you stable.  I recognise this in myself during audition season.  I had let my career become everything to me, the deepest part of my desires for my future and the center of my self-image; and the strain was starting to show.  My anxiety about matching into family medicine vs. emergency medicine was profound.  I probably cried about it 2-3 times a week for months.  It became very important to me that I match into an EM residency, although I still didn't realise why.  I just knew that I had to match into emergency medicine.  I had to.  That was all there was.

Except I didn't, did I?  I matched as a family medicine resident with a Christian residency program.  (How I was brought there when I was essentially running full tilt in the other direction is a whole other post.)

I wish I could tell you that I'm thrilled to start at this program.  I should be.  It is an incredible place, filled with deeply admirable people, and they deserve better than I am giving them.  And it is really sick that I can look at their graduating class and think, I really want to be like each of those people both as doctors and as Christians, and yet I feel shame when I tell people that I am going into family medicine. During my spring rotations I had to constantly interact with ER attendings and residents and a hot little knife of embarrassment jabbed me every time.

I haven't been able to pray with a whole heart since October or November.  I feel like I'm fleeing from the Word even as I seek it.  I have no peace about my immediate future even though it's settled now.  I am terrified that I am denying myself joy in the beginning of my residency.  I've admitted to myself that I crave recognition and am full of self-righteousness, that it's possible I never wanted EM for the right reasons, and that part of me wants to simply switch those terrible reasons over to my new field without working on my heart so that I can keep my pride.  There have been many layers to this repentance and each is more painful than the last, and I'm still not finished; at this point part of me doesn't even want to continue, which is why I persist in this spiritual listlessness.  I feel like a fraud and I feel an inch tall.  I wonder how the Lord could possibly use me for His purposes when I am such a sinner.  I wonder why on earth He would inflict me on such a good Christian ministry when I am anything but an asset to them right now.  And part of me can't help but repeat that maybe if I'd loved Him more, if I'd been a better Christian, I would be headed to work in an ER right now - which is totally theologically unsound.  The Lord doesn't work that way.  I know there is victory and freedom in Christ, and I have reveled in that in the past, but I am so far from that now.  And I worry that I don't know how to truly seek the ways of the Lord instead of the world.

So there you go.  I am lost and I feel like time is running out. I trust God's promise that He is with me always, even to the end of the age, but I also remember Jesus' clear warning that following him requires taking up your own cross - a metaphor for death to self and a call to sacrificial living.  My faith is small right now.  I'm glad all He asks is a mustard seed's worth.