Radiant source by Alan Johnston for article by Dr Anne Malatt on 'When Medicine is a Calling'

When Medicine is a ‘Calling’

- Photography by Alan Johnston
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What do we mean when we say that medicine is a ‘calling’? And what implications does that have for the way we practice medicine and the way we live our lives?

Nearly 3 in 4 US physicians who responded to a recent poll (1) say they see the practice of medicine as a calling rather than as a good profession or a job. The main reason most doctors give for this sense of calling to practice medicine is a deep love and care for people.

What is a calling?

A sense of calling, has been defined as “committing one’s life to personally meaningful work that serves a prosocial purpose”.(2) There is a sense of work meaning something to you, and being meaningful for others.

Others have defined a calling as “feeling a deep sense of purpose about one’s profession, being personally invested in one’s work and an alignment of values”. Whereas a job is primarily about earning money and serves as a means to an end that can allow for personal investment in other areas of life.(3)

Traditionally, most doctors have viewed medicine as a calling and doctors who don’t hold that view have experienced backlash or criticism and may also be more likely to get burned out or retire earlier.(3)

What are the pros and cons of seeing medicine as a calling?

Feeling that our work has meaning and purpose, and holds value that is more than just a means to a financial end, can imbue us with a strong sense of vitality and joy. It can give us a reason to get out of bed in the morning and sustain us through our working day. It can support us to deal with the challenges of being a doctor, which can be physically, mentally and emotionally arduous at times.

Without this sense of purpose, the everyday drudgery of our work (especially the administrative side!) can wear us down and lead to tiredness, exhaustion, burnout and depression with all the (largely unhealthy) coping mechanisms that we have developed to try and deal with (or not feel) those feelings.

The main reason most doctors give for having this sense of calling to medicine is a deep love and care for people. If we make medicine about the people we care for and the people we work with first and foremost, that love and care can sustain our sense of purpose and our daily practice and enjoyment of our work.

But this sense of calling can be and has been used and abused by our patients, our colleagues and our employers and we have allowed, even encouraged this abuse.

“Being personally invested in one’s work” (3) means that we can be used to work for longer, harder and less money than we perhaps otherwise would if we were not so personally invested. Our innate sense of care for people can be used to make demands on us that ask us to override our own need for a healthy and sustainable working day and life. We can be asked to go without food, water, regular breaks, sleep, work crazy long hours, forgo holidays, and generally work without the rest and play parts of the day. Our own health suffers, our relationships suffer, our families suffer and at the end of the day our patients also suffer if we are stretched beyond what we are physically, mentally and emotionally capable of doing.

And if we are personally invested in our work, we can tend to keep going to the point where we cannot keep going any more, as we do not know what else to do. Doctors are notoriously reluctant to seek help, for various reasons, including being too busy to take time off to see another doctor, thinking they can treat themselves (I am a doctor, I should be able to diagnose and fix myself), and fearing that they will be reported to regulatory authorities if they admit to or show any signs of vulnerability, with potential loss of reputation and licence to practice. As a result, they can carry on working way beyond their ability to do so, self-medicating with alcohol and other drugs, and suffering mental ill health in silence, which is why doctors have a ridiculously and tragically high rate of suicide.

Many of the problems we face in Medicine stem from the fact that we were taught to override our bodies and our own needs and health while we were training. The systematic abuse of medical students and young doctors and our ongoing abuse of ourselves has helped to create a medical system that is sick, if not terminally ill.

The system is inherently broken and we cannot change or fix it. We can only change ourselves in the system. Learning to live in a way that is healthy, loving and deeply caring of ourselves as well as everyone else allows us to serve as a point of inspiration in the system for all those around us, inspiring our patients, colleagues, employers and employees to live in a more healthy, loving and caring way themselves.

One step at a time, one person at a time, is how we change the system of Medicine…starting with ourselves…from within… the place inside us that knows what is true, for us and for everyone around us.

How can seeing Medicine as a calling truly serve us all?

Making medicine about people, starts with us. The fact is that we can only care for other people as deeply as we care for ourselves. Seeing ourselves as an integral and vital part of our calling to practice medicine means that we attend to our own bodies, first and foremost. We care for our physical health with what we put into our bodies by way of food and drink, as well as how, when and why we eat and drink; exercising in a gentle loving way to build a strong, supple and vital body; and living in a way that honours the rhythms and cycles of the body in life by resting when we are tired, going to bed early to get good quality sleep, and taking time to play as well as work.

A body that is deeply cared for cannot but care for other bodies and we are able to sustain ourselves through our working day while honouring our body as well as everybody else’s.

A body that is deeply cared for will not accept abuse from anyone and will lovingly say no to any such energy, whether it comes through patients, colleagues or employers.

A body that is deeply cared for will continue to deepen that quality of care for itself and for all those around it, so that we develop healthy loving relationships at home with our family and friends as well as at work with our patients and colleagues.

“First, do no harm” applies to ourselves, first and foremost and when we treat ourselves with harmlessness, we are no longer capable of harming another, and true healing can begin. That is the calling to the practice of Medicine.

What is calling us to practice Medicine?

So what is calling us to practice Medicine? Some are called by the energy of desire – desire to make a good living, to have prestige in the community, amongst peers, with family or friends. Medicine is seen to be a ‘good’ career and can increase your marriage prospects in some cultures and your standing in the community generally. When we are called to Medicine for such reasons, it can be a fragile foundation to stand on. If we have expectations about what a career in Medicine will ‘give’ us – be that money, prestige, a partner, lasting happiness – we may end up disappointed, sometimes bitterly so. For the practice of Medicine can be demanding and can consume more of our time and energy than we perhaps planned on giving to it, for less reward than we were expecting.

If we respond to the calling from a deeper place, that can truly sustain us during our practice of Medicine. A calling for greater meaning and purpose than our own personal desires. A calling from the place that serves all of us, and that calls us to serve all equally. We may call that place different names – a higher power, the universe, Our Soul, God – but this place lives inside us all. When we are called from within to practice Medicine, and indeed to do anything in life, we are given the energy to do it, so it is done without effort, struggle, or a sense of entitlement and need for reward. There is a great joy in doing it and a vitality in the body when we work in this way so that we can work long hours and end the day feeling tired, but complete, rather than burnt out and exhausted. We can then wind down at the end of the day in a loving way, ready to rest and prepare ourselves for the day to come. We live and work in a rhythm and a flow that sustains us, day after day after day.

Living and working in this way, with and from an inner sense of calling, can sustain us through our days and lives to live and work richly imbued with vitality and joy.

References:

  1. https://www.medscape.com/viewarticle/978003
  2. https://www.mayoclinicproceedings.org/article/S0025-6196(16)30770-4/fulltext
  3. https://www.medscape.com/viewarticle/979790?src=wnl_tp10_daily_220827_MSCPEDIT&uac=170126PV&impID=4576042

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