Where is God in a bad week?

Posted on January 1, 2008

It was Tuesday morning and I was already behind at my clinic in Compton, a satellite site of a secular federally qualified health center in Los Angeles. I arrived early in the hopes that I would catch up on the mounting stack of lab reports and charts that needed to be reviewed. This task is crucial, since I’m the only medical doctor in the clinic. It is up to me to review all the labs and charts, and usually I find infections and abnormal results that should have been pulled to me many days earlier!

Unfortunately, upon entering our little provider room (which doubled as a break room), I encountered one of our medical assistants holding her sick child, asking me if l could see her. I spent the next 15 minutes (my only time all day when I wasn’t running to and from patient rooms) investigating books and the internet to discover what could be causing the little girl's strange rash. The stacks remained.

Wednesday morning, I had a much needed weekly prayer meeting with the other Christian provider in our clinic, a nurse practitioner. We desperately asked God to help us with the overwhelming needs we were seeing, and to help us be agents of peace when tensions rode high in our crowded, understaffed office. Despite not having a lunch break, the day went smoothly until I walked into the last patient’s room.

There I found an older woman who hadn’t been seen in almost 2 years. She was coughing and short of breath. She probably needed to go to the hospital to see if she was suffering from an exacerbation of her heart failure, but since she had no transportation she just walked (slowly) down the street to our clinic. After finishing with her, I had to call my husband, apologizing that I had left late and would not be able to sit down to dinner with our family.

Thursday, I started out excited. My plan was to arrive early and get through the stacks of charts and labs, a necessary task since it was my last day in the office for the week. Thankfully, it was a short day which I had packed full: I was supposed to leave on time at 1:30 pm to rush to the store and then meet my kids and my visiting mother, who graciously offered to pick them up from school.

When I walked in 30 minutes early (so I thought), the receptionist “We have patients in rooms ready for you to see!" He thought I would be thrilled since we were working on not getting patients in rooms too late. He was wrong! Firmly and impatiently I said, “No. I need to get through these charts and labs now. The patients need to wait.” Five minutes later, my medical assistant came in: “Doctor, I put a patient in a third room for you because she looks really bad!" Frustrated, l left the stacks and grouchily trudged into the room.

I found a pale woman well known to me named Maria*, who suffers from depression, asthma, chronic pain, and multiple risk factors for heart disease. She was leaning on her hands and kept saying she was about to pass out. This kind of situation is especially stressful for me because I do not like emergencies. I'm a primary care person through and through. I thrive on long-term relationships with patients, outpatient chronic care and preventive health. Fortunately the patient stabilized from what appeared to be a panic attack, not a heart attack. However, the stacks of charts remained as I began to see the waiting patients.

I continued through a succession of patients, mostly new to our clinic, who had come in desperation because they couldn’t afford the cost of care or medicines from other low-cost clinics. Many of the patients had blood pressures or blood sugars completely out of control. I do not even remember how many electrocardiograms I ordered, or how many times I explained the patient assistance programs which would help patients get their medicines. I had to explain to a complaining patient (and her complaining family member) why she had to buy the powerful pain medicine I had prescribed, since it wasn’t available in our limited dispensary.

Exhausted, 10 minutes before I was supposed to leave, with the stack of charts still barely touched, I walked into the room of an 80 year old patient, who somehow temporarily had no chart available... and who needed all her medications and was complaining of shoulder pain. It turns out she could barely lift either shoulder! Having had several falls in the past, she really needed x-rays to make sure there weren’t any fractures. But we just lost access to free x-rays, so she and her family would have had to pay $100 or more that they didn’t have. Then the daughter walked into the room and listed three or four more complaints. I could feel that I was at my emotional limit.

When I finally walked out of the room, I saw that another patient had been put in after her. I blurted out “I can’t see that patient”, right in front of the waiting patient, and begged another provider to see him. I was too angry and frustrated to even be embarrassed about complaining in front of the patient.

While I was finally finishing the charts and labs at 2 pm, I received a message that a former patient from my old clinic wanted to talk to me. Not being good at saying no, and knowing I wouldn’t be back for 4 days, I called the patient and spent 15 minutes listening to her share about how she lost her insurance, needed eye surgery, could I write a letter for her to help her get disability, and could she sec me at my new clinic? I wearily warned her that the new clinic was more chaotic than the other one, more frustrating for patients at times, but if she wanted to come, she was welcome to try.

I finally left at 2:15 and drove to the store in silence. I could feel the steam rising within me. I’m not an emotionally volatile person. I had no idea why I was so upset, but I was more angry and frustrated than I had been for many years. I was mad at myself for addressing too many complaints, for not setting better boundaries of what I could do, thus running late and cutting into precious family time. I was angry at the management of our clinic for not helping me set limits by restricting the number of new patient visits or complete physicals I was asked to do. I was angry at the patients for waiting to come in until they were desperate, and for having so many needs! l was mad at my assistant for putting that last patient in the room when she knew I needed to go. I was mad at God for giving me more than I could handle this week. I was mad at everything. And the irony was that 4 days ago, for the first time I specifically submitted a prayer request at church to pray for me and my nurse practitioner colleague as we were feeling overwhelmed. Some things had only gotten worse. I said some very angry prayers to God that afternoon.

As is usually the case when we cry out to God, especially when we are at the end of our ropes and ready to give up, God graciously met me. My mom was not bothered that I was late. She arrived late with the kids just as I arrived home. My husband and another friend prayed for me that evening. But I still felt heavy hearted and was not sure why.

The next morning, I came to terms with my own sin and brokenness. I listened to music as I wearily did my Friday morning run, and I was reminded that God is the God of the city. I am not. Lord, have mercy on me, a sinner; forgive me for trying to single-handedly save these brothers and sisters. I learned the hard way that apart from you I can do nothing. I was reminded that I was made to love God and be loved by him, not to complain about him and the people he has made. Lord, forgive me for not seeing my own brokenness and need for you, and blaming other people for their needs instead. Help me receive your love, especial on the hard days.

That same morning, I sat down to a cup of coffee with my devotions and turned to Colossians 1:15-29. The writer of the devotional asked me to read the passage several times over and make a list of who Christ is and everything he has accomplished for us. I just wept as I realized who Christ is (and who I am not). He is the image of God, the born of all creation, the reconciler of all things and all people to God the Father. He is supreme in all things. Through his death on the cross, he reconciled even me to the Father, presenting me holy in God’s sight...angry, proud, self-righteous, impatient me.

I thank God for that week, because had I not been so angry, so frustrated, so overwhelmed, so in touch with my own failure and weakness, I would not have cried out so desperately to him. I would not have been so moved by who Christ is and how much I need Jesus. I might not have instituted the prayer that I now try to say before walking into patients’ rooms: “Lord Jesus Christ, have mercy on me”.

That week was not an isolated incident: it is often difficult to work with patients who have such great need, in a health care system that is so overwhelmed and so insufficient. But Jesus truly meets us with his presence and his power as we confront our own weakness. May we look for him, may we cry out for him, may we listen for him.

Kathryn White, MD is a family practice physician working in Compton, California. She lives in Paramount, California with her husband and three children, and serves on the board of CCHF.

Tags: H&D, Doctors, Stress & Burnout

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