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From Luke’s Journal June 2024  |  Vol.29 No.2  |  Christian Hospitality

A Working Background

My grandfather, Arthur Millington White, was a humble, hard-working farmer and family man. He was a tail-gunner in a Lancaster Bomber who got shot down bombing Dresden on his 21st mission. On the 13th of February 1945, he parachuted into the burning city and was captured by the Germans and made a prisoner of war.

Amazingly he survived. After the war, he was fortunate enough to be given a small soldier settler farm between Orange and Cowra. Like fourteen other soldiers, he was given an area of land to make a living. There was no infrastructure and he had to get rid of the rabbits and weeds, build the fences, and the sheep and cattle yards. The crowning glory was a beautiful shearing shed that was built to a higher standard than his own house. With the other settlers, they built a community and constructed a small school to teach their children.

My Background

Growing up on this farm, my background was one of hard work and a love of people who live in rural Australia. This took me to study Rural Science at the University of New England in Armidale to become an agronomist working through much of regional NSW. My aim was to work very hard, get a good job and eventually buy my own farm. However, the drought meant that there were very few jobs in agronomy, so I went back to Uni for a year to sit it out.  When I logged on, I discovered that there was a new medical school opening up in Armidale. I applied and did a few tests and interviews. To my surprise they let me in… and after five years of study, I came out more an ‘accidental doctor’ than by careful preparation.

Throughout this time, I had been a Christian. Very early on in primary school, I had the gospel shared to me by the Scripture teacher. He drew a diagram (Fig. 1) to teach me that there was God who made the world, people whom He had made, and then this cloud of sin that separated them from God. Even at a young age, I knew that this was true. I just knew God existed and that somehow, He had made me. I was also very aware that something deep inside me kept me from knowing Him. Learning about sin was very confronting, but the Scripture teacher made it clear that God had sent Jesus to bypass sin so that we could know God again. I believed this with my whole heart.

At University there were many challenges, but in becoming part of the Christian group, I saw massive changes. The Bible became alive. There were Bible studies, church and beach missions. Jesus felt really close and I wanted to serve him with every part of my being.

However, when I went home to the farm, my father, although impressed at the situation, said, “You say you’ve become a keen Christian….but you still don’t do the washing up.”  I had been working hard but not in such a way that my faith in Christ could be seen in what I did. My father’s challenge stayed with me – “Show me your faith by what you do!”

Medical Work

When we enter medicine, we enter difficult work. We usually enter as hard-working students that have achieved at school and university and are immediately thrown into the world of patients, sickness and hospitals. We soon find that it is confronting mortal work: cancer, trauma, heart attacks, stroke, dementia… the list goes on. Suddenly the bright, young, capable person finds that they often can’t do much about the illnesses that they discover…and they learn the medical paradox: you spend your working life helping those who are polar opposites to yourself. For example, the physiotherapist who was the high school sports star becomes the medical support person and now spends their life being the slowest person in the hospital; or the elegant and eloquent speech therapist now helps stroke patients swallow their yoghurt. We, the capable, are given the role of helping and enabling the often incapable.

Coming from a farming background with a love for rural life, I’m often asked whether I like being a doctor.  “Like” is such a hard word, isn’t it? My usual response is, “It is a good job, but not an easy one.” 

There is a lot to like: 

• It is interesting – I’m never bored at work.
• It appeals to a scientific and inquiring mind.
• Medicine is an art as much as a science, which adds further interest.
• It is social – there are always people around to talk to. Patients, random social situations, and doctors themselves are often quite interesting people.

There is a lot that is difficult: 

• We become aware of others’ difficult life circumstances.
• Diagnosis can often be harder than first thought.
• Relationships can be strained, even with the best of intentions.
• There is often suffering that can only temporarily be alleviated.
• We often know too much….

Then there are the external and internal factors of our work. Externally, we are affected by relationships (partner, children, extended family), finances, and our physical and mental health. Internally, there is the work itself, life disruptions from rotations, difficult colleagues and business relationships, the high and changeable standards of the system (including training programs, AHPRA*, Medicare, the local health service, etc.), and the politics which dictate what happens in general practice, urgent care clinics, telehealth, etc..

This difficult work takes its toll:

“The stress on doctors is such that their health deteriorates. Our stress-related disease rates are two or three times that of the general community. The suicide, drug and alcohol abuse rates and marital breakdown rates are all incredibly high in the medical profession. So one of the least appealing things is to know that you’re not going to have a life like any normal person, whatever this means…” Lilienthal (1996) Medicine: A Guide for Prospective Students

Against this background, it’s important to consider how we did get into and through our medical training. I’ve concluded that it’s because of just three things: ability, stability and opportunity.

1. Ability: God has gifted us with certain academic gifts and abilities.
2. Stability: Even with some significant challenges, life hasn’t thrown too many curve balls, whether it be health, financial or emotional.
3. Opportunity: We in Australia were given entrance into medical school in a country where it is possible for anyone to attend university.

All these things (ability, stability and opportunity) are the gift of God. There is something miraculous about both getting into and through a medical degree. All the glory of us graduating in medicine must go to Him alone. It’s no wonder that we marvel at Jesus, who only had to speak, and it was so, “Little girl, I say to you, get up!” and “Lazarus, come out!” Here is the Master Physician. Here is God, who came to live on earth, yet is in charge of His world. He sees death as sleep. He brings life with a word. He touches the leper. If only we could work like Jesus.

The Bible and Work

The Bible has a lot to say about work. The book of Proverbs confronts us with two characters. There is the hardworking or diligent, and there is the lazy or sluggard.

1. The diligent person sees opportunities within work. They work hard over a long period of time and avoid futile schemes. It is the wise farmer who plants and harvests his crops at the right time (Proverb 10:5).
2. It is the foolish one who is lazy and leaves things until the last minute. The sluggard is habitually lazy, idle and inactive.

When we read the wisdom in Proverbs, it does little to show us how wise we are. Instead, the very fact that the sayings ring true reveals how often we are unwise. We should feel convicted of our foolishness and the need for God and His wisdom in our life: we are naturally much more like the sluggard than the hardworking and diligent wife of noble character.

My weakness is coming home from work to find there are chores to do – especially washing up! Coming home and seeing further responsibilities. Ah, life is so tiring. If only this work could end and I could finally get some rest and comfort! Here, we need to heed the warning of 2 Thessalonians 3:6-11, which urges us to follow the disciples’ model: working day and night, labouring and toiling so that they would not be a burden to others. Our diligence is to cover the whole of life, not merely while at work.

At the same time, as medical people we often pride ourselves on being hard-working. We are always busy. If we are not busy, we can feel guilty and find other ways to keep our hands working. Rarely is a medical graduate lazy.  And because of our background, training and expertise we are often in danger of forgetting that it is Christ’s work that is sufficient.  We are saved by grace, “not by works, so that no one can boast. For we are God’s workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do.”  (Ephesians 2:4-10 NIV)

So often I go back to what my Scripture teacher in primary school taught me. It makes increasing sense as  I continue to learn more about God, about myself, about sin, and am more strongly pointed to Jesus’ saving work.

As the church, and medical people within the church, we are given gifts to complete Jesus’ work in the world, “To prepare God’s people for works of service, so that the body of Christ may be built up until we all reach unity in the faith and in the knowledge of the Son of God and become mature, attaining to the whole measure of the fullness of Christ… He…must work, doing something useful with his own hands, that he may have something to share with those in need.”  (Ephesians 4:11-13, 28 NIV)

Within our confronting mortal and difficult work, there are wise ways of working. Although we work for Him, we are not Jesus. We must set limits, adjusting our work environments so they are sustainable and making changes that show our trust in His work through us and not dependent on our own efforts. Medicine is a great career, but a terrible master. It is interesting, rewarding and noble work, but it can be easy to slide into workaholism. 

• We need to take appropriate rests – on weekends, Sabbaths and holidays.
• We should consider the pros and cons of full-time, part-time or casual (or locum) work at different life stages. 
• It is beneficial to all if we enjoy our work relationships, be it with staff, patients or the general public. 
• We need to be careful not to take on our doctor role in spheres where it is not appropriate.
• We need to prioritise so that we are working smarter, perhaps by sharing the work wisely with administration and nursing staff. 

Personally, I have found the Pareto principle of prioritising work helpful: “For many events, 80% of the effects come from 20% of the causes.”

For example,

Therefore, we should organise tasks into:

• High importance/high urgency: do now.
• High importance/low urgency: do later.
• Low importance/high urgency: delegate to others now.
• Low importance/low urgency: delegate or leave for another time.

And yet, Scripture also teaches that we must rest, and rest in God. Self-care matters – we must use our own oxygen masks first in order to be able to care for others. God has designed us to be in friendships as the ‘stuff of life’, and resting in relationship with God’s people will keep us accountable and encourage us in the faith. These are the people that know and love us and can see how we change under stress. If we are struggling more significantly, we should seek medical help. We also need assistance with tasks that we are not good at, which may include financial advice, relationship counselling, or a mentor or life coach.  Sleep is not a luxury, and doctors who take regular holidays (every day/ week/ month and year) are able to sustain their work much longer. Hobbies that take our mind off our work are also good for us. My wife and I have taken an interest in Scripture Union camps and this has been wonderful for us and our young family.

Rural Medical Ministry – Second World Ministry

CMDFA** is a wonderful organisation. Through it, we are encouraged to take the gospel to all nations and use our medical skills to both alleviate suffering and to testify to our love of the Lord Jesus and what He has done for and in us. The motivation for this is Jesus himself. He is our Master Physician, He is our personal Saviour from sin and death, and He is our closest friend, who reveals the God He knows as our Father. Christians who take this seriously are very encouraging, and there are many in this fellowship.

How might CMDFA help rural Australia? The need is dire (Fig. 2). In the Hunter/ New England region, we are 49 doctors short of the 93 needed (or 47% staffed) and it is rapidly getting worse as doctors age and retire. We live in Glen Innes with a severe shortage of doctors. Our town needs 12 doctors; we are down to 7. We used to have 8 doctors at the hospital. We now have 2 and one locum with Telehealth support. Nevertheless, I am fully convinced that rural Australian people are just as valuable as anyone anywhere in the world.

Rural work is both rewarding and challenging. Surprisingly, it doesn’t necessarily need the gungho firebrand individual doctor. There is a place for everyone and we are much more supported now than before. The virtual rural generalist support (VRGS) has transformed higher level care and there is substantial paramedic and aeromedical support.

My family has benefited a lot by living rurally. It is a great lifestyle for families and young kids.  We live in a house we couldn’t afford in the suburbs. My children walk to school. I walk to the practice and hospital and come home for lunch each day. I’m much better paid than I expected, and this is increasingly so as the doctor shortage becomes more apparent. Medicare rebates tiered according to the Modified Monash Model (MMM) support higher billing fees without disadvantaging patients.  Workforce incentive payments are paid annually, and local subsidies for housing, car and fixed wages can be negotiated. For those with specialty training (eg. emergency medicine, anaesthetics, obstetrics and gynaecology, and mental health) there are further workforce incentive payments. Some of these only require a day or a month to obtain.

We have been able to help the local minister and have taken on various roles: everything from helping with youth group and Sunday school, to lay preaching. As a youngish medical family, we have also been able to help the church with finances that are often tight in a rural community.

The rural Australian church:

• Needs you.
• Is waiting for you.
• Is praying for you.
• Will appreciate you.

Over time, I have started to see that we are doing “Second World Ministry”. We are not missionaries with postcards on the board or the fridge. We are not funded by any organisation. We are just slightly over the hill from our friends who are living a much more comfortable life than us.

So really, how might CMDFA help rural Australia?

• As an advocacy and support body. Bishop Tony Nichols, of Northwest Western Australia (WA) said “Go as far as you can…you can always come back.” That changed Indigenous mission in WA!!
  
• “Go West Young Man, Go West!” Effectively, go more rural. 
  • Go further. Go smaller. Go less comfortable. Go strategically.
  • Go with others, eg. Bush Church Aid.

If every doctor would consider going even fifty kilometres further west, it would make an enormous difference.  Have courage to forgo comfort, especially when starting out or finishing up. 

• Partner with a rural general practice to provide locums, collegial support and assistance.
• Do one-off locums whilst on extended leave or when winding down towards retirement.

Go as rural as you can… you can always go urban if you don’t like it!

I’d challenge you to think about how you and the CMDFA might support or encourage rural medical ministry.

Conclusion: Work That Lasts

We are told clearly that the Lord Jesus is using us for His eternal work. Just as in the Garden of Eden Adam and Eve were to continue on the creative gardening that God had started, so we are to continue His saving work in restoring a broken world. We are saved to do good works. The great thing about being made wise through a knowledge of the death and resurrection of Jesus is that we have a great purpose in the world. We can tell people about how they can know God, who is the source of all wisdom. His work transforms how we do everything. These are the only efforts that are rewarded in eternity.

There is a warning here for us not to repeat the error of the rich fool. We can all make that mistake:

“I will pull down my barns and build larger ones, and there I will store all my grain and my goods. And I will say to my soul, “Soul, you have ample goods laid up for many years; relax, eat, drink, be merry.” But God said to him, “You fool! This very night your life is being demanded of you.” (Luke 12:18-20 NIV)

We must work hard. We must look after our patients and do what we are called to do in our workplaces. But we have a more important job to do: we must speak of Jesus, tell of Him crucified and teach others what His death means. Do this whenever and wherever you can, and find ways where you can be most effective in building the church while we do so:

• When you are teaching children.
• When you are visiting others.
• When you are welcoming others.
• When you are giving of your time and money.

Let us do things that are of eternal benefit. Don’t waste the opportunities God has given you.

Jesus said:
“Come, follow me,” Jesus said, “and I will send you out to fish for people.”
(Matthew 4:19 NIV)

“Therefore, go and make disciples of all nations, baptising them in the name of the Father and of the Son and of the Holy Spirit, and teaching them to obey everything I have commanded you. And surely I am with you always, to the very end of the age.” (Matthew 28:19-20 NIV)

How can you make the most of the opportunities God has given you to make an eternal difference?

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