H & D

Maybe Paul can say these things, but there are many ways I am not like Jesus, with behaviors that people will learn or see in me that they should not put into practice:  anxiety and impatience when I am stressed, a tendency to defend myself rather than immediately take responsibility and repent for a mistake, hesitancy to help and serve another when it is not convenient for me, and a hard-driving desire to succeed which sometimes neglects others and leads to “task over relationship.” On top of that, as I heard in a sermon recently, “We are really so much worse than we think we are.”  I’m a sinner in need of daily grace.  One of my most entrenched weaknesses is the tendency to think “everything is up to me” and to forget how desperately I need God (ironically, that weakness is the flipside of my strength in achieving things like finishing med school).  I am so prone to forget that “apart from Christ I can do nothing.” (John 15: 5)

But God, in his grace, led me to work and worship among people who come from poverty and broken families.  I have been working in community clinics in the inner city of Los Angeles for 13 years, and work now as medical director of Los Angeles Christian Health Centers in Boyle Heights and skid row, ministering largely to people living in housing projects or on the streets.  I have worshipped in a multi-cultural, socioeconomically diverse church in a working-class neighborhood in the Los Angeles area for 15 years, mostly befriending people who don’t look like me and don’t come from the same white, privileged background that I do.  God brought me to people who are not like me: they are so much more desperate for hope and aware of their brokenness.  He brought me to people whom I can’t “fix,.”but here he has opened doors for me to disciple and mentor others.  Through church I have met Rhonda*, a woman who has faced pain and wounds I could never imagine, but who has taught me so much as I have discipled her.  At work I have mentored Karla*, a younger physician assistant in our clinic next to the projects.

I did not jump freely or eagerly into discipleship.  About five years ago, an acquaintance at church emailed me, asking asked me to consider jogging with Rhonda, because apparently she needed some encouragement and had asked for a jogging partner.  My immediate response came out of my self-centeredness coupled with self-preservation. My jogging schedule—like my life in general-was highly scheduled and fairly rigid.  I was trying to balance demanding work as a physician with parenting two young children and being married to a pastor. I already ran 3 mornings a week, and Rhonda wouldn’t run at my pace, so that meant adding another 5 am morning.  I was not interested.  I hoped someone else would volunteer…but they didn’t. So I met Rhonda, who was quiet and somewhat shy, with a Latin accent reflecting her Mexican roots. I asked her if she wanted to jog with me for a few months, once a week at 5:30 am. She had to come to my house since my morning schedule was so tight (and frankly, because I was selfish and didn’t want to wake up any earlier than I had to).  So she came, week after week, and we spent 40 uninterrupted minutes jogging, chatting, and praying.  She shared about her brutal childhood, her husband’s affair, and her ongoing struggles after she reconciled with a man who is was completely broken yet pretended to be together. I tried to listen, asked questions, shared Scripture occasionally, and we prayed for each other each week at the end of the jog.

Rhonda has since joined me in Christian community over the years.  We invited her and her husband into a marriage group with us and some other couples, which they did join for a while, but then dropped out when he did not want to continue coming. Then Rhonda joined me for 2 or 3 years in a women’s small group, in which she grew in her intimacy with Jesus, and found strength to continue on despite a difficult life. 

Now, 5 years later, Rhonda still has much suffering.  Her family has been through homelessness, lack of transportation, conflicts and struggles with their children, joblessness, addictions, and codependency. Today, her circumstances are really no better,and perhaps even worse.  But Rhonda has been resilient and committed to our relationship. She keeps coming, week after week, to jog with me, even though she has to drive further since we moved recently.  Despite having little money and few resources to support her, Rhonda has been an incredible friend to me. She has taken me to the airport at 4:00 AM any number of times. She arranged a special 40 year birthday party for me and some friends. She has cooked meals for my family, given me thoughtful gifts, including my favorite scripture to post at work, brought roses to me at work for my birthday, and written me countless thoughtful notes. 

 Rhonda has also been committed to her own personal and spiritual growth.  Rhonda has been willing to “go there” in, being honest about her brokenness and sin.  She has invited me into the recesses of her life, sharing her pain with me, but also the small and big steps of success. She used to explode in anger more often but; now she is much more patient.  She has moved from helplessness and depression to strength and determination.  She went from never jogging more than 3 miles to running 2 marathons and I had the immense privilege of jogging the last few miles with her of both marathons, looking silly as I recited Scriptures for her about how “He gives strength to the weary and increases the power of the weak.”.

Rhonda has not only been committed to our relationship and to her own spiritual growth, but she has moved beyond the safety of our relationship toward deep, authentic community with other believers.  For a few years, I was probably the only person Rhonda confided in.  I had encouraged her to share with others, but she wasn’t ready.   In the early years, she would kind of “disappear” for a couple weeks when things were especially bad.  Now, even though I have moved onto a new church plant over the last several months, she has found a new small group in our old church and is committed to growth, and increasing transparency with others, sharing more and more of the real struggles in her life with other people.

Rhonda has been Jesus to me, even though she says I have been Jesus to her.  In our friendship and time together, I continued to wish that I (or God) could fix her circumstances, but Jesus promises that his followers will suffer, and he has allowed me to walk with her in her suffering.  I have learned to listen and to offer little suggestions or scriptures at times, but mostly to keep praying like the persistent widow, and to wait.  Through this long journey with Rhonda, I know more now than ever that apart from Jesus I can’t do anything, and she has learned that the grace of God is sufficient for her, and that His power is made perfect in her weakness. She has learned that she can do all things through Christ who strengthens her.

Karla came right out of Physician Assistant school to work at our clinic.  She had done some volunteer work through her church at one of our sites, was drawn to our Christian foundation and principles, and wanted to work under someone who could teach her how to be a great provider.  I guess that person was supposed to be me!  She didn’t come from poverty like Rhonda did,and was involved in a solid church, but she was overwhelmed by the complexity of our patients’ lives.  It seemed like every day she was seeing a new homeless patient referred from the nearby shelter, who had a tragic story and with needs way beyond what we could provide in our clinic.  As it sometimes happens when we minister among people who have been deeply traumatized, Karla was vicariously traumatized by the brokenness in her patients’ lives.  She had homeless patients in their 70s and 80s,;and it was just heartbreaking to see people that old with no place to sleep and no one to help them.

One morning before I arrived, she had performed CPR unsuccessfully on a young man in his 30s who arrived in our parking lot in full cardiac arrest.  (We later found out he had died of a heart attack, with virtually no risk factors.)  This traumatized her and several of our staff for months afterward.  She has had moments of crises of faith, coupled with  some personal challenges and struggles that were also coming out into the open.  I didn’t have the luxury of having 40 minutes every week to listen and pray for her like I did with Rhonda, since we were struggling to remain productive and efficient, and we always had patients to see.  I just encouraged her in little ways each day, to just try to focus on one problem at a time. 

I have sought to mentor Karla spiritually and clinically, but mostly I have simply invited her into my journey as I limp along behind Jesus.  I reminded her and myself that we might feel like we care more for our patients than they care for themselves, but unfortunately we can’t work harder on their health than they do.  It just doesn’t work that way.  We need to let go, to give it to God.  We found a “Monday verse” after many exhausting days, asking Jesus to speak to us not only to start off a draining week, but also on other tiring days: “In this world you will have trouble, but take heart: I have overcome the world.” (John 16:33)   We reminded ourselves out loud “God is God and we are not.”  We said daily prayers with the other staff before we began seeing patients, and I always tried to encourage her to step out of the room for our prayers even if she was already in with a patient. Some days I just said little prayers for her, out loud with her or on my own. I have also tried to be transparent with her about my own struggles in being overwhelmed with patient needs, sharing with her when I have felt angry with patients or their families, or when I am angry with myself or with God, or when I am just really sad. But I also have tried to listen to her share her sadness, her anger, her frustration, the burdens she feels. I am not a very good listener when I am stressed or rushed, but sometimes I have listened better than at other times.

Clinically, I have mentored Karla with thorough teaching and modeling. Sometimes spontaneously, and sometimes when she asked, I shared clinical pearls about chronic conditions or urgent care issues.  I brought her in with me to do knee injections and wound care, and she has since become better than I am at most procedures. And I tried to always be available to answer her questions, although I’m sure there were many moments when I wasn’t.  I tend to be compulsive and thorough with patient care and charting, and I have pushed Karla to be the same.  Sometimes I have pushed hard on Karla in specific ways, gently but firmly reminding her of the need to catch up on charting when she is behind, or sending her messages about ways to improve her charting.

When I reviewed Karla’s charts a week ago, I suddenly realized,with great delight and gratitude,that she is becoming a great clinician. She handles difficult, complex patients with increasing confidence, she charts well and efficiently, she gives excellent preventive care and treatment, and she is a great preceptor for the many Physician Assistant students that she trains.  There are other clinicians I supervise, but since I have worked the most closely with Karla, she seems the most “like me” in her approach to patient care and charting.  As I have mentored her as a health care provider, she is now mentoring others.  I am so encouraged by her growth over the last 3 years. She has also stepped up as a clinical leader, helping us research and create systems and individual care plans as we move toward becoming a “patient-centered medical home”, a place where patients can get coordinated, comprehensive, excellent, systematic health care.  But I am even more encouraged to see her growing spiritually.  She is handling the heavy weight of patients’ needs with increasing resilience and patience.  She is praying for patients.  She does things that our other physician colleagues modeled for her, like giving generous and thoughtful gifts to staff and patients alike, and as well as providing emotional care for the staff who work for her.  She has been honest about her own needs and brokenness, traumatizations and burnouts, and I see her transparency and authenticity allowing God to begin and continue a deep healing process in her. 

I really haven’t mentored someone as closely as Karla in my 13 years of medical practice. It is humbling to see some of my weaknesses also coming out in her—like being prone to get upset, frustrated or angry when a patient doesn’t improve more rapidly, or being fatalistic or cynical about the possibility of patients to get specialty care in our broken system in Los Angeles.  She learned those responses from me, just like she learned healthy habits and approaches from me.  May God have mercy on me, a sinner, as I mentor others to become like me as a doctor or leader or follower of Christ, and as I disciple others by walking with them along the journey toward knowing Christ deeply and following him wholeheartedly.

*Actual names have been changed

Katy White is the medical director for L.A. Christian Health Center in Losa Angeles and Former Board Chair for CCHF. She has a passion to help Christian providers who are serving Christ in secular settings find the encouragement and strength they need to continue their difficult work.