What drives us to embark on the marathon ahead?

10 MINUTE READ

From Luke’s Journal Jan 2023  |  Vol.28 No.1  |  Evolving Professionals

“Why did you choose medicine/dentistry?”

Either you’ve heard this question from someone else or asked this question of yourself, and each time it seems like a test.

If you’re like me, you want to give an answer that is both true and humble, without seeming too proud. In your pursuit of a medical or dental degree, you may have heard the term ‘calling’ to encapsulate this motivation to make decisions and sacrifices towards performing well in academics, extra-curricular activities, and completing a degree, or whatever you put your head and hands to. For me, this is the question being asked of me when I’m asked, “Why did you come to Australia (from Canada)?”

In this article, I want to turn the lens into our own hearts: What is the fuel that drives us to start our engines and embark on the marathon road trip ahead that is medical and dental training? I will use this question to jumpstart a brief survey of the Biblical understanding of ‘calling’ that finds its roots stemming back through history to Creation in Genesis 1 and 2.

The term ‘calling’, though not found directly in the Bible, is nonetheless a Biblical concept. The essential idea is that of purpose: the entirety of Scripture’s redemptive history purposes towards the coming of Jesus Christ (from creation to fall to redemption); and after his ascension, all of creation’s purpose looks ahead to Christ’s second return. To discover something’s purpose we can look to its design: it’s God’s design of man that furthers our understanding of man’s purpose.

“To discover something’s purpose, we can look to its design; it’s God’s design of man that furthers our understanding of man’s purpose.”

In Genesis 1:27, we read that God created man in His image. This term alone deserves its own article or conference to expound the depths of its implications. For our purposes here, however, suffice to say that we are His representatives as His likeness on earth, which includes certain tasks. In Genesis 1:28-30, we find these tasks in the ‘creation mandate’ that God sets for man: an announcement of all human activity in God’s creation. William Edgar argues for and teaches that this is also a “cultural mandate” (a term attributed to Klaas Schilder, Dutch pastor and theologian who lived from 1890-1952): to spread and inhabit the earth (“be fruitful and multiply and fill the earth”), to exercise what Edgar calls “benevolent lordship” over the earth (“subdue [the earth]”) and all this is in relationship to God, to bring glory to Him who brings blessing to man’s endeavours¹. We see in Genesis 1 that this includes work, Sabbath rest, marriage, and family. After the Fall, we see disorder completely disrupt the intended good order with which God had originally designed these aspects of culture. As we move into Genesis 2 and 3, we see culture expanding to include the creation of tools, musical instruments, cities, and different languages when God intervenes at Babel. We see this cultural mandate unfolding in God’s establishment of a covenantal relationship with Abraham, promising blessing that would come to all nations. 

We interrupt Scripture’s story of redemption to highlight why culture is important to consider when thinking about calling in medicine or dentistry. This is where I’d like to share some of my journey into medicine and Australia. To answer the question of “Why medicine?” required me to pause and notice the atmosphere in which I grew up, which included the values of immigrant parents, academia and careerism, and even Christian ‘missions’ all converging in my desire to study medicine. A stable career was prized by my immigrant parents who sought belonging to a new community as foreigners. Academic achievements were fueled by a love of learning about the intricacies of the genetic code and the atoms that comprised the building blocks of our cells. The ‘Great Commission’ (Matthew 28:18-20; Mark 16:14-18; Luke 24:46-49; arguably also John 20:30-31) was the fuel that fired the ‘missions’ emphasis in the Christian context I was brought up in. This included mission conferences and short-term mission trips, which fed my ideal of becoming a missionary doctor – a position in which to help others in a very tangible, Christ-like, laying-on-of-hands way. My understanding of ‘calling’ to pursue medicine was shaped by this cultural context.

“My passion and interest in clinical rotations had always been mental health; how could I make disciples of all nations through counselling others?”

While completing six months of obstetrics and gynaecology, the foundations of this understanding of ‘calling’ showed its cracks when I became disillusioned at my own lack of zeal and competence. My preconceived notion of serving in a rural cross-cultural hospital with surgical, hands-on skills was crumbling. My passion and interest in clinical rotations had always been mental health; how could I make disciples of all nations through counselling others? Evangelism in this field of medicine seemed inconceivable. My mind couldn’t resolve the seemingly separate goals of evangelism, discipleship, and being a medical doctor. In summary, I didn’t know how to relate the cultural mandate with the Great Commission.

William Edgar’s book “Created and Creating” has shown me that I had created a false dichotomy between ‘missions’ and medicine. Our ‘calling’ in the Great Commission is a reiteration of the cultural mandate, as fulfilled in Jesus Christ, as the central calling for all humans. God is not just calling us to make disciples in conversions but also to promote human flourishing in God’s world, unto the glory of God, as revealed in Jesus Christ’s life, teaching, death on the cross, resurrection, and ascension.

I had been too narrow in my thinking.

I began to see through eyes of Biblical freedom that the fulfillment of both the mandate and the Great Commission were taking place whenever excellent healthcare is being provided, whether locally or globally. I witnessed both Kenyan and American physicians and surgeons seeking the flourishing of local African communities during my first-year medical elective in a rural Kenyan missions hospital run in partnership with the Africa Inland Church. This was through the use of clinical medicine, surgery, good governance, mercy and teamwork to alleviate physical and emotional suffering, facilitate many deliveries of newborns, and share the Gospel.

I witnessed the same while shadowing primary care physicians in a public hospital and on home visits to isolated families in rural China, with both doctor’s bag and Chinese Bible in hand. Though more disparate and dilute, I have witnessed the same in medical wards during night shifts and general practice consultation rooms here in Queensland, and through stories shared while attending training in the Saline Process² on how to assess the spiritual condition of a patient.

So how does having a broader Biblical understanding of ‘calling’ play into our motives in pursuing specific achievements and goals in medicine or dentistry? Al Wolters’ framework of distinguishing the “creation order” as having a “structure” and “direction” is helpful here. The structure that God sets in his creation order remains good after the Fall, creating man as male and female in His image to fill and inhabit, subdue, and worship God. After the Fall, this creation order is deeply and thoroughly ruined, leading to an evil orientation. Both the image of God and the tainting effects of the Fall continue to work actively in the heart of each person. For example, working to help others thoroughly and accurately is good but working to the point of burnout is disorderly; competency in studies is good, but to the point of neglecting fellowship with God and others is disorderly.

So, let’s take some time now to reflect on:

• What led you into medicine?
• Was it a desire to help others?
• Was it a fascination and drive to understand the intricate workings of the human body?
• Was it a desire for a financially stable career?
• Was it parental expectation? Social expectation? A need to prove yourself to … yourself?

Now where do you see evidence of both Creation and Fall in your desires?

I want to affirm that we have good and godly desires. The importance of human improvement, or a more commonly used term today, human flourishing, is a common thread in decades of cultural studies. God gives us the eyes to appreciate his Great Biological Engineering design of the human body in all its complexity and harmony. Nevertheless, the truth is we still have the sinful tendency to suppress our sinful tendencies as Romans 1 so confronts us. We are deceived if we think our desires and motivations aren’t plagued by the effects of the Fall and so readily become disordered, wandering off into what is portrayed Biblically as idolatry, including greed, self-indulgence, or seeking to please others. Our desires to study well and perform well on assessments can just as easily become tainted by the desire to please ourselves and others. Our desires can become more in line with Paul’s warning to Timothy in 2 Timothy 3:1-4:

“But know this: Hard times will come in the last days. For people will be lovers of self, lovers of money, boastful, proud, demeaning, disobedient to parents, ungrateful, unholy, unloving, irreconcilable, slanderers, without self-control, brutal, without love for what is good, traitors, reckless, conceited, lovers of pleasure rather than lovers of God…”

How does reading this list sit with you? My immediate reaction to reading this is to feel repulsed and disbelieve that these idolatrous desires do exist in my own heart. Can there truly be redemption for our devious desires and mixed motives?

Only in Jesus Christ can there be any redemption! As the image of the invisible God (Col 1:15-20), He is God incarnate and by His finished work on the cross, offers us reconciliation, first to God and then is working to reconcile all things. In Him, our desires can be redeemed for the good of others to the glory of God. For example:

• A desire to help others will be guided by what is good for the person being cared for in the same ‘upside down’ dynamic at work when Jesus laid down His divine privilege and power in order to “give His life as a ransom for many” (Philippians 2:1-11; Matthew 20:28; Mark 10:45; John 13:1-17) and “to the glory of God the Father”.
• Competency and excellence in studies will be tempered by our creaturely limitations (Proverbs16:9; Psalms 139:5-6,15-18)
• Your body also belongs to the Lord and requires stewardship with adequate rest, nutrition, and movement (1 Corinthians 6:12-20)
• Finances become a talent to steward, alongside your knowledge (Matthew 25:14-30).
• Your audience, while populated by peers and supervisors to impress, will also include the One who created your mind with its intellect and your mouth with its ability to speak and deserves the ultimate glory (Genesis 4:11; Psalms 139:13-14).

And when we notice the self-ward focus, the drive for omniscience, the greed and envy, or even self-neglect for the sake of a myriad of idols, we turn to the Lord in repentance, who is faithful to forgive and steadfast in love, and continues to reconcile all things to himself (Colossians 1:20). Edgar encourages us this way: “Christ’s redeeming grace moves culture in the right direction, ennobles it, and allows it to extend the realm of God’s shalom, His goodness, His justice, His love.”

So how does one discern one’s calling in this medical or dental path? In the tapestry of my journey to Australia, there were intersecting threads of pride in persevering with an undergraduate degree that led to a less-than-stellar GPA, an inferiority complex of being rejected from all medical schools in my Canadian applications, the greed of higher education as an export, and the sacrificial love of my parents for financially supporting me through four years of international student tuition fees and sending me halfway across the world to complete a medical degree. In the process of the tapestry being woven, the underside always appears messy and tangled. However, never forget that each thread was held in the hands of a sovereign God who works through common and special grace into relationship with Him, for my good, the good of others, and for His glory. So for me, also for you. It is helpful to remember that this tapestry is woven while in relationship with others: my parents, my peers, academic and spiritual mentors, and a faith community, for the way of wisdom in Scripture is walked in community.

When following Christ, both the mandate and the commission includes all of life, and thus we can engage with culture in each aspect. Edgar defines cultural engagement as “the human response to the divine call to enjoy and develop the world that God has generously given to his image bearers” with the purpose of “improv[ing] the human condition”. It is a false dichotomy to live out the cultural mandate at home and the Great Commission at work. Jesus is working to reconcile every aspect of your life and this world from the ruinous effects of sin.

Our calling includes our studies, where we learn the created order of the human body, mind, and dentition. We see how the Fall wreaks havoc in pathophysiology and socioeconomic barriers to health. We teach our patients how to enact “benevolent lordship” over their bodies, minds, and teeth. But our calling also includes our relationships with our patients and our classmates, our supervisors and our friends, our spouse, our parents, our children; the way we think about and use money and holidays to care for our families and ourselves; how our generosity can look including our skills and knowledge; the forms of rest and entertainment we engage in; the way we drive our car on the highway; and how we vote.

“Ultimately, all of our lives matter to God, and God matters to all our lives, from our work to our play to our relationships to our heart motivations.”

I am currently single but have a desire to also fulfill the mandate and commission in a ‘help-meet’ role as a wife and in a nurturing and discipling role as a parent, and even if this doesn’t happen, I can engage with culture by partnering, discipling, evangelising, and enjoying God’s world in a myriad different number of avenues. Ultimately, all of our lives matter to God, and God matters to all our lives, from our work to our play to our relationships to our heart motivations³. Our faith changes our motivation and our mindset about work, where pouring a cup of water for the patient in the emergency bay is also a part of our job description. Our faith provides a high standard of ethics in the workplace, and a Saviour who lived sacrificially: we may notice that some practices (both clinics and ways of practicing medicine) make money or get the work done more efficiently, but don’t contribute to patients’ well-being. What will our response be? We will meet countless people: doctors and wardsmen, dentists and receptionists, nurses and allied health workers, baristas and cleaners, all of whom we could become an unpaid, “unofficial, de facto chaplain”⁴ for and possibly lead to a conversation about faith and Jesus. In whatever path we choose to take down the road, whether in medicine or dentistry and outside these areas, may the cultural mandate, the Great Commission and the example of Christ be our guide, our mirror, and our fuel for the journey ahead.

You may also like to read: Making Sense of “Calling” by Dr Irene and Mixed Motives: Unpacking the “Why? of What We Do by Dr Jeremy Beckett

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Footnotes:

1. William Edgar, Created and Creating (InterVarsity Press: Downers Grove, 2017), 166-169, 176.
2. The Saline Process, https://www.ihsglobal.org/SalineProcess
3. Timothy Keller, Centre Church (Zondervan: Grand Rapids, 2012), 331-332.
4. Sam Chan, How to Talk About Jesus (Without Being That Guy) (Zondervan: Grand Rapids, 2020).