the72: Jason Kippenbrock - Great Patience and Great Love

Hope does not disappoint,
because the love of God has been poured out into our hearts
through the Holy Spirit that has been given to us.
For Christ, while we were still helpless,
died at the appointed time for the ungodly.
Indeed, only with difficulty does one die for a just person,
though perhaps for a good person
one might even find courage to die.
But God proves his love for us
in that while we were still sinners Christ died for us.
--Romans 5:5-8

My life is pretty boring right now. As a first year medical student, I mostly study, put off studying, sit through lectures, eat, sleep, and try to motivate myself to study more. I’m currently up to my neck in fatty acid biosynthesis and amino acid degradation (and to all you non-medical-type folks out there, it’s just as fun as it sounds).

In my experience thus far, one of the greatest challenges of medical school is to venture outside of my own world. It’s kind of easy to fall into the trap of self-importance, given the emphasis on grades and competition amongst my peers. Honestly, if I’m not looking at the big picture, life can be very miserable.

Through the drudgery of studying day in and day out, I have to constantly remind myself that whatever I can learn now will help to make me a better physician in the future. Really, it’s for the well-being of my future patients. So even though I haven’t been going to daily mass as much as I’d like, I think that I can be a good, practical Catholic right now by being diligent in my studies.

There are significant tensions between my Catholic faith and medicine today which will continue to challenge my profession in the future. Examples include abortion, physician-assisted suicide, embryonic stem-cell therapies, and in vitro fertilization, to name a few. However, I think that there is a more subtle and common challenge facing me and others in the field of medicine: actually caring about the sick people we care for.

Let me shed some light on this issue. In the year after graduating from Notre Dame and while applying to medical school, I worked as an emergency department scribe at St. Joseph Regional Medical Center in Mishawaka, Indiana.

In a nutshell, my job was to follow the doctor around the ER as he/she saw patients, and using my computer on wheels (aka “COW”), I would type out the patients’ charts, including patient histories, physical exam findings, medical decision making, lab results, and diagnoses. It was a great learning experience for me, and it helped to solidify my desire to become a doctor.

However, at every shift, I was also exposed to the not-so-pretty side of medicine. By that, I mostly mean the patients. Bear with me through these non-fictional scenarios:

Example A: 24 yr old male presents to the emergency department (ED) with complaint of dental pain for the past week, worsening last night. On oral examination, his teeth are literally rotting away due to widespread cavities. He states that he doesn’t have enough money to go to the dentist… but he DOES have enough money to smoke a pack of cigarettes every day, which does not contribute to oral health. (For the record, smoking makes everything worse.) 

Example B: 35 yr old male presents to the ED with complaint of back pain for the past couple months, worsening this week. He has difficulty getting up from his bed and couch because of the intense pain. He does not remember any specific injury or accident that caused the pain… but he is 480 lbs. He is very much offended when the doctor suggests that losing weight would help solve the problem. 

Example C: 26 yr old female presents to the ED with complaint of pain in bilateral cheeks… after voluntarily having both of sides of her face pierced one month ago. She has not taken out her “cheek studs” since that time, and the piercings have become infected, since they extend into the oral cavity. Skin and pus have begun to engulf the studs, so the doctor will have to use a scalpel to dig them out.

Really, God? I know You said, “Love one another as I have loved you,” but did You really mean these people, too?  Personally, I think that it sounds pretty reasonable to feed the hungry, give to the poor, and care for the sick. What I have difficulty with is finding the motivation to care about people who make really stupid decisions.

That’s bad, and unfortunately I’m not alone in this either. Although the ER physicians and nurses who I worked with were great overall, nearly everyone seemed jaded in one way or another. Patient incompetence was just a part of the daily conversation.

I sometimes feel like the Pharisee in Luke’s Gospel who thanks God that he’s not “like the rest of humanity,” even like the tax collector (Luke 18:9-14).  This in turn makes me feel awful about myself. How am I supposed to love others perfectly when, because of my sinful nature, I judge people based on how I see them, and not how God sees them?

A helpful and necessary realization is that I make really stupid decisions. Maybe I’ve been fortunate enough to be born to and raised by parents with common sense (who passed it on), but I’m no less human than any other person I encounter. I am definitely a sinner, and I’ve hurt myself and other people in really stupid ways. Also, the older I get, the more I realize that I’m really not that smart in the first place. (And my med school classmates remind me of this daily.)

Also important: God doesn’t ask me to understand why people make the decisions they do. His command is simpler: He asks me to love others as Christ loved us. I am reminded of a fantastic quote by Thomas Merton: "Our job is to love others without stopping to inquire whether or not they are worthy. That is not our business and, in fact, it is nobody’s business. What we are asked to do is to love, and this love itself will render both ourselves and our neighbors worthy.”

As an antidote to my own sinfulness, I have personally tried to be more like the tax collector in Luke’s Gospel and incorporate the Jesus Prayer throughout my day: “Lord Jesus Christ, Son of God, have mercy on me, a sinner!” It’s a vital reminder of just how much I need God’s saving grace. Additionally, I like to think of that prayer as a dual acting remedy; it’s a gift which helps to cure both pride and despair.

So how can I realistically care for challenging patients like those mentioned above? I think it requires great patience and great love. Maybe the smoker will actually be motivated to quit if he knows that I really do care about his health, so I can spend a few minutes talking with him about a patient-specific smoking cessation strategy.

But, at the same time, if he’s up to 1.5 packs/day by the next time I see him, I can’t throw in the towel. I may need a quick prayer when the time comes, but I hope that I’ll have the patience and love needed to give him another talk about quitting smoking. Regardless of my success in getting through to him, a loving act in itself is still worth something, both to the patient and to me.

Beyond passing all of my med school classes and surviving residency training, my primary goal is to become a truly caring physician, and to make sure that every single one of my patients benefits from my caring. I cling to Hope, and trust that, despite my sinfulness, the Holy Spirit can work in me and through me to be Christ’s healing presence in this world. In my case, that means being a physician who imitates The Physician.

Jason Kippenbrock graduated from the University of Notre Dame with a BS in Biology. There, he joined the Knights of Columbus, to which he still belongs, worked as a Mentor-in-Faith with Notre Dame Vision, and served as a Resident Assistant in Carroll Hall. After graduating, Jason worked as an ER scribe for a year while applying to medical school. A native of Brownsburg, IN, Jason now lives in South Bend, IN, where he is a first-year medical student at the Indiana University School of Medicine. Jason can be reached at jkippenb@alumni.nd.edu.