Disclaimer: Pardon the hiatus. I find I am out of practise with writing down stories of life and work.
June 16, 2015
Yesterday marked the six-month anniversary
of starting a new job in a very big, primary care clinic. More than sixty
doctors, nurses, and physician assistants care for thousands of outpatient in
the rapidly expanding urban medical complex where I work.
Did I mention it’s big? It’s a vast labyrinth
of medical services. I often find myself feeling like the mouse-doc scuttling
around in a medical maze and discovering a delightful piece of cheese tucked
away in a hidden corner of the system.
I am constantly greeting new faces and finding new pieces of “cheese”
within the clinic.
Although my work environment is a dramatic
change since relocating to the Northwest there are many additional cultural differences
to decipher: Church. Local community. Politics. Socials. It’s another foreign country,
in a way. Portland is a ‘hipster’ city where food that is cooked without meat
is no longer termed “empty”. Instead eating establishments proudly proclaim
“gluten-free”, “vegan”, and “organic”. Being a vegetarian is not on the extreme end of the spectrum.
It’s more on the moderate end of a very broad spectrum of dietary preferences.
The vast dietary spectrum of preferences if
relatively an easy cultural adjustment – instead of green leaves floating in
palm oil there is organic kale salad with alfalfa seeds and thistle milk or
something along those lines. The bigger struggle for me has been to find a
sense of belonging and assurance that I’m still ministering to others and leading
a worthwhile life. I find it challenging to feel like I’m a part of a bigger
picture. I have an inner, subconscious sense of losing an exclusive membership
in a noble club. I find pieces of my heart sometimes shifting around
uncomfortably like a loosened shingle, pulsating against the battering of
life’s storms. One end is still fastened firmly to the practical, logical area
of my brain and affirms that I’m still doctoring. I’m still performing a
necessary service to those suffering and sick and in need. But a portion of my
emotional, irrational subconscious wobbles with uncertainty and doubt when
adversity and discouragement pour down in a deluge of negativity. I waffle at
the fringes, constantly questioning myself:
Am I still serving God in a secular clinic?
Are my skills as a physician needed in a
country with so many doctors?
Am I utilising my time appropriately seeing
so few patients in comparison to Cameroon standards?
Without the external affirmations one
receives as a missionary, can I believe in my calling here?
Do I believe in my heart that I’m currently
where God wants me?
Do I believe He’s called me to such a
large, institutionalised office to serve as His ambassador of love?
Lately I have found my creative writing
energy sapped. I don’t find it easy to outline interesting and noteworthy
aspects of my work. I am not involved in the same severity of life and death struggles
that clawed at my work while in Cameroon. I am surrounded by ailing people but of a different type. Sick
but a different kind of sickness.
I discovered when I first met Mr AT that he
had been having ankle pain for years. It had been worse lately with all the activity
necessary in his new job as a construction worker. He’s already been
appropriately treated with the anti-inflammatory medications (Aleve, Advil). He
had an ankle brace. Work notes that dictate modified work activity had been
written. Physical therapy had been offered although he couldn’t find the time
to attend such therapy sessions due his demanding daytime job schedule.
“What are you hoping to get out of your
visit today?” I searched his face for a truthful explanation. I dreaded his
answer though as I was pretty sure I knew what it was going to be.
“Well, doctor, I guess I was hoping maybe
you could just fix things, make all the pain go away.” Mr AT laughed nervously
and gave an apologetic shrug.
I return his laugh with an echoing helpless
shrug. “I wish I had my magic wand and could fix all your problems. It sounds
like you already know what you need to do to fix your ankle though. You’ve just
told me that your ankle is fine on the weekend after you rest it.”
He nods.
I continue. “Either you need a new job, one
that doesn’t involve all the heavy labour that you’re doing; or, you need a younger
body, a new ankle. I’m not sure how to give you either of those though.”
Mr AT gave a rueful smile. He understood I
couldn’t satisfy his wish to make all his problems disappear. I could listen. I
could empathise. I could affirm him in what he already knew. But, I couldn’t
cure him of chronic ankle pain. In the end, we agreed upon the imperfect solution
of partially masking the pain with pain killers while he promised to try eating
healthier and losing weight – two modifiers that were controllable unlike his
job duties and taxing work schedule. It was a temporary patch and not
completely satisfactory for either of us. I would have loved to have taken away
his diseased ankle and vanquished his pain forever. However, such was not going
to happen. It wasn’t even possible under the circumstances to enact physical therapy
and a different job. Those were the long-term solutions he really needed for
ankle healing. Such situations leave me feeling helpless and frustration. I
wonder if this is really what God is asking from me: to temporarily placate
people’s pain brought on by poor lifestyles and bad luck?
Work days in Cameroon could be long and
emotionally challenging. A frenetic pace from 8 o’clock in the morning with
staff worship until the last patient of the day was served. Some days were
certainly busier than others. It was hard to quantify the hours spent in the
hospital and clinic. Now my days are more regimented. No early morning doorbell
signalling a hospital emergency or midnight obstetric summons. Four days a week
I walk to work, closing the door behind me at 6:30 in the morning and generally
wrapping up the last of my charting and phone messages by 6:30 at night. Long
days but defined “off time” away from sick patients and clinic duties. No call
except the occasional urgent care shifts. So why is it that I feel less
productive overall? Why do I feel like I accomplish less outside work than when
I lived and breathed hospital air in the same mission compound? I am still
sorting out that answer. Twelve hour days, four times a week, should give me
plenty of free time, right?
Perhaps part of the reason for my lassitude
outside clinic is due to the emotional tragedies that siphon off energies
previously used in other pursuits.
Madam T came in for anxiety and depression.
It’s a very common problem in Portland. People are “weird” here but also rather
prone to worry-laden depression. As
I sat down to listen to Madam T, the floodgates opened and she spilled out a
story of woe rivalling Lemony Snicket’s [series of unfortunate events]. Reflective empathetic statements of
compassion are appropriate in such times and yet incapable of dispelling the
sad consequences. Life is unfair. I wished for a loving community safety net
that I could toss her into for that moral support she needed. Does they exist
in Portland? Are there communities that have the resources to help such sad
souls in need of a friend? Traditional medicine is not designed to manage the
intricacies of psychiatric depression and anxiety. It’s frustrating.
“I know I need to call the mental help line,
I just don’t have the energy,” Madam T laments.
I nod. “I wish circumstances were different
for you. If I could change them for you, I would.” I pass her the box of
tissues so she can wipe her tears and blow her nose.
By the time we part with appointments
scheduled to touch base again on the telephone, I find myself relieved to
escape. The atmosphere is full of suffocating despair. I feel for her but I don’t want to
absorb all the misery and bitterness she carries. I rather doubt that I’ve done
anything clinically to improve her health. I’m not sure if we’ve connected at a
therapeutic emotional level either. She’s still shedding tears when I exit. Is
this what God has planned for me? Are these the type of encounters He wants me
to keep muddling through year after year? My emotional fatigue level leaves a huge margin of doubt on
the reasonable longevity of such a plan.
And so as six days have turned into six
weeks and now six months since beginning my new job in Portland, I find that
the saying is true: ‘the days are long but the years are short’. It’s hard to
imagine that it’s been six months. It feels like forever and yet it feels like
I’ve only just begun. I have so much still to learn.
I’m still a novice with most things at work.
I am still part of the “newbie” group of
primary care providers.
I still haven’t found my place in the
community.
I am still a stranger at church.
I am still finding those friends that you
can just “pop on by for a drop of tea and encouraging hug”.
I am still searching for a small group to
nourish my spiritual fellowship needs.
I am still learning how medical services
like chiropractors, massage therapists, and acupuncture work.
I am still adjusting to all the naturopaths
and alternative healers available.
I still have “I miss Cameroon” days
I still refrain from mentioning my time in
Cameroon for fear of being forever labelled “the doctor from Africa”
I still worry about losing my identity as a
physician with a mission heart.
I still fight against the temptation of
self-pity when I work long hours without the same affirmations that come from
working internationally
I still have grey days of depression and
self-doubt about the future
I still am figuring out what my calling in
Portland is these days.
There are a lot of unknowns. In the midst
of the unknowns I have hope. God has been a guide for me in the past; I have
faith he will continue to mentor me here in Portland.
Jesus spent 30 years in Nazareth, first
growing up as a boy and then working as a carpenter. He spent three years in
active, public ministry. Thirty years sawing wood, carving wood, pounding wood,
smoothing wood, and sweeping wood dust off the floor of his tiny shop. He could
have been doing spectacular, crowd-pleasing miracles like curing world hunger,
walking across oceans, raising whole cemeteries, and eradicating leprosy and
blindness. He could have reached more people, ministered to more sick, done
more impressive feats of glory, fed millions instead of thousands, if he’d left
Nazareth at 20 years instead of 30 years of age. Was it really that important
to craft another kitchen table, another oxen yoke, or carve that one-hundredth
window frame? Jesus spent the majority of His ministry plodding along, a
faithful carpenter with the lathe and the hammer in the mundane duties of life.
Perhaps I’ve re-entered the proverbial carpenter shop? Crafting another wooden
stool might be compared to reassuring another sniffling American that it’s a
viral respiratory infection. Hanging out in the carpenter shop chatting to a
few clients over the latest design in wooden ox yokes might be like sitting
next to a tearful, depressed Portland hipster and offering encouragement and a
box of tissues. Our small, insignificant mundane acts can still be sacred acts to
God. Perhaps?
“That we ought not to be weary of doing
little things for the love of God, who regards not the greatness of the work,
but the love with which it is performed.”
― Brother Lawrence, The Practice of the
Presence of God
