If there’s one thing academic physicians tend to avoid - or, at least, try to minimize - it’s service time.  The fewer months per year you‘re “on service” seeing patients and supervising trainees, the more time you have for scholarly pursuits.  And, to be honest, the more time you have for personal life.  There’s a reason the term “being on service” echoes the old British working-class job option of “going into service” (think Downton Abbey).

Service time is notoriously draining.  For a few days I might think I’ve “gotten it” — made some connections, figured some things out, even helped someone else learn something.  Then there will be a stretch when, at best, I’ll have scraped by: seen all the patients, signed all the progress notes, done all the billing.  On the worst days I’ll be dragging myself out of the hospital after dark, feeling like I’ve been hit by a truck along with the rest of my team —  and feeling entirely, if somewhat irrationally, responsible for the damage.  And never mind what happens when I then finally reach home and berate myself for neglecting my family and household!

I’ve come to realize that service time drains me because it humbles me: it uncovers the depths of my self-deceptions and expectations of self-sufficiency.  I went into medicine thinking I wanted to help people.  But service time often doesn’t feel like “helping!” And the reason is that my operational definition of “helping” has been faulty.  I expect to know the answers, fix the problems,  have control of my time as well as of the patients’ issues (yes, sometimes even control of their little baby lives). I also expect to teach students and trainees useful information: how to use their knowledge to make a diagnosis, formulate a management plan, tell families what to expect.  It seems, though, that what I often end up showing them is dealing with uncertainty. Making  decisions knowing that you won’t ever have all the answers.  Sitting with families in agonizingly difficult circumstances. Giving unwelcome news.  Being distrusted at times — even reviled.  

Do we who want to  “help people” really understand that this means service: humility, emptying ourselves, taking on the mind of Christ in the form of a servant (Philippians 2:5—8) — His willingness to die? There’s no way I can do any of this in my own strength. But His power shows itself most effectively in our weakness (II Cor 12:8) and service isn’t just about trying to imitate Jesus - it comes from receiving the gift, through the Holy Spirit, of becoming like Him.  (Romans 12:6-8, II Corinthians 2:18). Accepting the gift means relying on His grace to sustain me: trading my self-centered expectations of control for His abundant love and power.  It takes constant, careful, prayerful reliance on Him for the long haul, recognizing “these limitations that cut me down to size” again and again, throwing myself on His mercy repeatedly. And trusting that since I am, in fact, His — it is His plan to make this happen!  He promises eternal life: abiding connection with  Him.

I  have learned, over and over, that I really don’t have knowledge or power or control!  But I don’t really need them.  What I most need is to stay rooted in the Presence of Christ through His Spirit the Comforter, the only source of power to truly serve. I want to be able to maintain a calm, comforting, welcoming presence: overflowing with His peace and love.