On the way to your office or hospital, what are you
thinking? What concerns occupy your attention?

Will I find a parking place?

Did I remember to lock the door at home?

Does our son's cough mean that he will become ill and I will have to pick him up in the middle of the day?

The bill for my malpractice insurance is due. Where will I get the money for it?

Recently, my nurse hasn't been keeping up. Will I have to replace her?

Mrs. Smith will call again and I can't bear the thought of talking to her! It is impossible to bring her monologues to an end.

The list could go on and on. Major and minor issues crowd our consciousness, clamoring for attention.

These are legitimate concerns, real issues. So what grabs your attention?

Let me ask a simple question. "Why do you go to the office or hospital?"

"My job is the way I get paid." Or "I'm a responsible person. I do what I agreed to do. I agreed to be present, so I am!" Or "I like my work. I look forward to it. It fulfills me. I enjoy the challenge." Or "I like the people with whom I work."

Are your reasons adequate? When weighed against the demands and harassment of providing clinical care, your personal sacrifice,the price that your family pays, the loss of sleep, and the ever-present threat of a malpractice suit,are your reasons adequate?

Regardless of how much satisfaction you get from your work with and for patients,at some point it will become "just a job." Of course,not you! I understand! That is what I use to think!

Then something happened that changed the way I practiced medicine and rescued me from weariness.

When I realized that each patient is precious and is God's child entrusted to me for medical care, I viewed my practice very differently.Now I enjoy medicine even more. I am personally more gratified than ever. I find it more challenging and satisfying. I acquired a new "Boss." Although still responsible to insurance companies (to those who pay the bills such as the HMOs), I was freed from slavery to them. I signed on as God 's slave. I am responsible to my heavenly Father. I have a divine assignment. God wants me to participate with Him in physical healing and to be His agent as He cares for my patients' "whole being."

My assignment expanded from the physical ("Tell me about your fever.") to every aspect of my patients' well being. "How are you doing?" became serious inquiry regarding my patient 's physical,emotional, social, religious, and spiritual well being. When patients immediately reply, "I'm doing all right," now I look incredulous and ask again, "No,seriously, I really want to know how you're doing."

I face this simple problem: I am a super-specialist because I don 't have the emotive courage and wisdom to deal with the panoramic problems with which patients struggle.

So what has God done? He said,"Harvey,I want you to minister to every part of my child!"

"God, you must be kidding!I haven't been trained to do that. I have neither the arrogance nor ego strength to step out and try something I haven't been trained for and know for certain that I am qualified to do."

God is persistent. He brought me through a long series of training exercises without the comfort of a fellowship. He simply said, "Just do it. I will show you and guide you."

Now on the way to the clinic or hospital,I meditate: "Lord,what are you going to teach me today? Who are you sending me? What are their needs? Why are you sending them to me today? What is Your treatment plan?"

Frankly, I am scared. The responsibility is too great. I can't do it; only God can do it. I need Him to do for me what He wants done. The only way that can happen is by acknowledging my great needs, submitting to His guidance,and asking Him to direct me. I must listen to God and to the patient as I take my history; I must observe God's workings as well as the patient's responses as I perform the physical examination. My impressions must include not only the physical illness, but also the emotional,social,religious,and spiritual brokenness.

Next time I will discuss in practical terms how I think about patients.

I am happy to hear comments and respond to your questions.

Professor of Medicine
School of Medicine
Loma Linda University

Contact Dr. Elder at:  helder@GoMETS.org.