Can we really keep faith and work separate?
It’s a question any person of faith has to deal with.
I had to face just this question with a recent patient. Like a lot of patients who show up in the emergency room for psychiatric assessment, what she was experiencing was more emotional distress than definite mental disorder. That meant she would need support and care, but not directly from our psychiatric team. Instead, we would be referring this patient on to social and other relevant services. So far, so normal.
What stood out, however, was a recurring theme throughout the assessment. It showed up in statements that popped up every now and then:
“I was in the prayer meeting when…”
“My friends from church have been very supportive…”
“I’ve been trying to pray but it’s been so hard…”
Evidently, she was Christian.
And not just in the sense of something to tick on a form, but of a lived faith. It was part of who she was, part of how she would find healing.
At the end of the assessment, after we’d discussed available options for support and drafted a basic plan, I said to her, “I’ll keep you in my prayers.” Through new tears, she said, “Thank you—that means so very much.”
In a time of distress, I’d acknowledged something that meant a lot to her, instead of ignoring it. That, in turn, had evoked a response.
The pro-personal divide
We’re well past when being professional was equated with being impersonal; when work and home were meant to be kept separate, never the twain to meet. The coronavirus pandemic has accelerated that even more, and it’s not out of the ordinary to see children and pets appear in the background during video calls.
But for doctors, the old rules still seem to largely apply. And understandably so. Ours is a profession wherein life and death may hang in the balance, and even when they don’t, we are often dealing with people in times of vulnerability. And so we were taught to keep our personal lives and biases and beliefs at home, to keep elements like faith separate from work. Our job was to be objective observers, not subjective intruders. The last thing anyone needs in such times is any suggestion of impropriety on the part of the professional they’re opening up to. People don’t come to hospital to be preached at.
And yet, they do come hoping to meet a real person. We are human, after all, and expect our professionals to be no less. People generally like their doctors warm, not cool. They want them to show feeling, to respond with empathy, to be sensitive and kind. The “technical” name for this is bedside manner, and any doctor learns very quickly that it’s just as critical to what most people understand by a “good doctor” as professional competence.
The doctors I myself have most admired, from medical school right up until now, were those who were truly human with their patients—and they both connected better with and were more respected by patients and other professionals alike.
So we have ourselves a conflict: as doctors we’re expected to be objective and not let personal elements intrude on practice, and yet, the very nature of the work requires us to be personal with those who come to us. And nowhere more so than in mental healthcare, where we get into that most intimate of zones, the mind.
How, then, to resolve this conflict?
I think a way through is to accept what we are, that to be human is to be inherently subjective. We are probably better off working to gain awareness of our inclinations and biases and defaults, and then to correct for them. If true objectivity was even within our reach, it would only render us devoid of personality, essentially unrelatable. Who, after all, really wants Spock for their doctor?
Humans want to be cared for by other humans—who know what they’re doing, to be sure, but not at the expense of their humanness. As an ancient Jewish philosopher-physician put it:
“The physician should not treat the disease but the patient who is suffering from it.”Moses Maimonedes, 12th century
That advice, which we are still reminded of, means my job as a doctor is to care for the actual patient right in front of me—not impersonally, but in a way that bests fits who that patient is. If that is the case, then what I should be aiming for is not to split my self, but to modulate my self to the person under my care.
How does this work in practice?
What do YOU want?
Well, the operative phrase is “the person.” It means letting them lead: trying to understand what they want, and to determine what they might need, and then offering what I can while leaving them the choice of whether they wish to accept it or not. It’s rather like the frequent response of Jesus to people asking his help: “What do you want?” That’s what patient-centred medicine is all about, after all.
And as it turns out that’s ultimately not very different from how I am with my many friends who aren’t Christian, or even religious at all. They know I’m Christian, and they know we can go there if they want, and talk about religion and faith and the big questions. But they also know that our friendship is defined, not by our agreement on those areas, but by the mutual respect we have for each other. Rather than pretend I can separate parts of ourselves, I’m willing to be open about it and let those who know me decide.
In the case of the lady I saw, faith came up as part of our conversation because she brought it up, and it clearly meant something to her. But in the emergency care setting, offering to pray for her right there might not be most appropriate. Plus I questioned in my own mind if at all I needed to tell her I’d pray for her, given that a key teachings about prayer in Christianity is that it isn’t something to publicise (yes, the irony is not lost on me). But I thought it’d be helpful for her to know she was being prayed for by the doctor she saw that night.
So, yeah, if what a patient wants is to discuss their problems and their care in the context of their faith, sure, I’m happy to go there with them, whatever faith that is. And if faith isn’t their jam, we don’t go there at all.
And that’s how I resolve the faith-work dichotomy. Rather than attempt to split myself, I bring all of my self—from jokey me, reading me or geek me to philosophical me, Christian me or writer me. None of it is all of me, but all of it is me. And I offer them whatever aspect of me might be helpful in the moment. And, even then, we only go as far as they’re willing to go. Because I’m professional, after all.
But humanly so.
My thanks to Adam Tank, Joseph Kuo, Cam Houser, Charlie Bleecker, Cullin McGrath, Ryan Mullholland and Hamda Abdi for their feedback, and to Madison Lavern (via Unsplash) for use of the image. (It really does take a village!)