Hear this recurring theme?

I'm afraid I might begin to sound like a broken record when it comes to talking about work and the sheer busy-ness of being a junior doctor. Unfortunately, this week just past has not done anything to change my experience, and in fact might have gone an extra way to solidifying the well-known fact that junior doctors are run off their feet.

I have started working at Peter Mac, a specialist hospital for care of patients with cancer, covering some of the surgical and radiation oncology units. It's only been one week so far, but whew! It was quite a week. Getting used to a new environment is always taxing - there is much time spent having to introduce oneself to everyone else around, finding papers, patients and files. I'm also showing myself short in the fitness stakes - running the stairs to the ninth floor is quite exhausting! On the bright side, I should be fighting fit by the end of my thirteen weeks here. I have some hope that things will improve somewhat over the coming weeks, however. Tomorrow, many of the registrars return from conference or study leave, and I will have more people to share the workload with! Watch this space - my crazy hours might become more reasonable. I have to say, the work itself is quite enjoyable and rewarding. It's never easy dealing with such serious illness as cancer, but it means that each little difference one makes can make an incredible difference to the person's life and experience.

I guess I want to talk a bit about a seminar Sal & I attended last night, run by CMDFA (Christian Medical and Dental Fellowship of Australia). There were three speakers, each Christian doctors, specialists in their own fields, talking from their experience about witnessing in the context of medical practice. One had been pulled up by the medical board and found guilty of unprofessional conduct when he had prayed for a patient. The account of the story was such that permission to pray had been obtained, but as there was a bystander (the patient's friend) present, it was the friend who had been offended and brought up the complaint.

The issue of boundaries was addressed. I think that this is important, since we live in a society where we are closely identified to our occupational roles, which are bound with implicit expectations. We need to work within the framework defined by our roles. This includes boundaries, and it's important to not step outside these boundaries set by our roles, except by careful exploration. Take, for example, a doctor who offers his patient chiropractic services. Or a dentist who offers to fix up a patient's crook knee. Analagous is the practitioner who offers to pray, in the eyes of many. This is like offering a pastoral service - it lies outside the bounds of what is expected of a doctor, and hence represents dangerous ground on which to tread. The most important danger to recognise in breaching, or even blurring, boundaries is that any step out of the predefined roles represents an avenue towards role confusion. It is easy to see how role confusion already causes trouble - for example in the country town, a patient might be a friend of the doctor, or the partner of a relative, or something like that.

On the other hand, as Christians, we are first and foremost children of God, and only secondarily are we defined by our occupations. We are called to promote the Gospel of Christ through our lives, and this includes our work! This, then, has been a difficult sticking point for many Christians in the health profession - when is it appropriate to pray for patients? Is it appropriate for us to openly display our faith through our attire - e.g. wearing a cross? Back in the first century, Paul said that he had "become all things to all people, in order that I may win some". Also, he called early Christians not to be too caught up with their newfound freedom in Christ, but to think carefully about the impact of their actions on others. His experience reveals that we have to be culturally sensitive. Although here, twenty centuries later, our world holds as its highest value the elusive concept of "freedom", as doctors we should still voluntarily behave within its expected boundaries, so as not to upset the primary reasons for which our patients come to us in the first place.

Being a Christian doctor does require us to excel in our work. Being a good doctor is already a powerful witness for Christ. Being a caring doctor, coming across as a person whose primary aim in the doctoring role is to serve his or her patients, is already a wonderful testament to our loving God. Our behaviour, not just our words, can serve to point patients and bystanders in the direction of Christ, by showing forth His character. There is no rule against caring. So, firstly, we ought to do well in our occupation.

Secondly, there are times and places to talk about our own faiths, and those of our patients. On occasion, patients want to talk about their faith. If so, then this is one of the best times to think and talk about Christianity - but we need to listen, and find out where our patient is coming from. Some patients may already be Christians, and may wish to pray. Other patients might be agnostic, but might realise the increasing urgency to meet God, to find out if He exists or not. Yet others might come from a radically different background, and who knows, they may even try to preach to the doctor! Either way, it is safe to discuss faith issues if the patient brings up the issue in the first place - because their raising the issue is a sure sign that they are comfortable with talking about it, in some form at least.

I think it's worthwhile mentioning that there are chaplains and priests in many hospitals, whose services can be enlisted. Additionally, we can refer patients to a church, should they enquire or seem interested. It is too much for a doctor to pick up the task of pastorally shepherding a patient in the long term - ultimately, linking them with a welcoming church community is the best way to ensure their spiritual needs are met.

Anyway, I think it's time for me to sleep, and prepare myself to embark on what promises to be yet another busy week! God bless!