“Engage or Run”: Reflections on my Intern Year By Brian Lindman, M.D.

Perhaps the most significant personal transformation of this intern year has been the shift of the fallenness and brokenness of this world from an intellectual apprehension and more theoretical consideration to a monkey on my back that weighs me down, beats me down, taunts me, and dares me to give up and give in. Did I know the world was fallen, cursed, and broken before this year? Yes. Had I experienced it? Yes, but… my experience was far more limited. My life was insulated, with walls around it, protecting me from having to “touch” the brokenness in all its messiness and ugliness. The brokenness I had experienced previously in my own life and the lives of my close friends and family always seemed finite and fixable; it did not seem out of control. Was I wrong to see it this way? Sure, in some sense. Was I blind to the infiniteness of sin even if more “minor”? Probably. But that is not my point here. My point is an existential, internal, emotional one. In some ways, I felt like sin, the fall, and its ramifications were contained. But, over the course of this year, that feeling has been destroyed.

My clinic and inpatient experience is an uninterrupted procession of people with poor insurance, an inability to afford medications, unaware of the seriousness of their medical problems, obese, poorly groomed, smelling, with grandchildren who steal their food, husbands who abuse them, addicted to cocaine, alcohol, or cigarettes, asking for the newest Viagra equivalent to keep up with his 2 girlfriends who don’t know about each other, paging me once a month for a refill on Percocet for chronic pain of dubious etiology, complaining of joint pain while not recognizing that their body mass index of 35 may have something to do with it, letting their blood sugars go unchecked for two years and letting a foot ulcer develop out of control to the point where an amputation is the only option, arrested for drug possession, admitted for an abscess in the groin because there was nowhere else to shoot the drugs than under the skin, not being able to be placed out of the hospital (including to the prison from which he came) because he is such a difficult/manipulative person to deal with, someone admitted from a psych hospital for chest pain where she was involuntarily committed after trying to stab her husband with a knife, a lady admitted with chest pain on the anniversary of her son being shot in the head.

In the face of this, what is one to do? Everything in me wants to run, retreat, disengage, turn off my pager, get these people out of my office or off my inpatient census. I get depressed, impatient, and distant. I get angry at these people because they have so many problems and so many non-descript complaints that I don’t know where to start and I don’t feel like I have the time, energy, or resources to get started. My tendency towards condescension and pride reaches new heights as my

compassion reaches new lows. When I leave the hospital, I am far more often drained than energized. My battery is on empty and usually it’s not because I have spent myself in kindness and acts of mercy, but rather because I feel burdened by the weight of the Fall and the many pathological ways in which it manifests itself; and I feel burdened by the inadequacy, ineffectiveness, and disengagement that so often characterizes my response to it.

When God somehow grabs this hard heart and softens it enough for mercy and compassion to flow the effect can be beautiful. A widowed woman needed to hear what would undoubtedly be a complete surprise: she had an unknown type of metastatic cancer. “May I pray for you,” I asked. “Yes, I would like that.” I sat beside her at her bedside and put my arm around her. The Spirit provided words that I could not have manufactured for such a time. Five minutes later through her tears, she mumbled, “thank you so much.” The next morning when I came to see her, she was standing by the window as I entered. Immediately, she walked over to hug me. “Thank you, doctor, thank you.” Another young woman came in with chest pain; it sounded somewhat atypical, but she had risk factors for heart disease. It was midnight and I needed sleep, but something (or Someone) prompted me to check on her. She wasn’t asleep yet and for the next 30 minutes we talked about her husband leaving her after he was unfaithful, her son being shot in the head and the police not pursuing the investigation, and her co-worker recently being shot in the head in circumstances similar to those of her son’s death. We talked about the emotional pain, sin, hope, and Jesus. I prayed for her. She told me I was “an angel, brought at just the right time.”

Engage or run. I usually want to run and often times do. When I engage, it can be messy, but sometimes beautiful. This year the Lord has shown me that I don’t have what it takes to engage the brokenness of the world. I am weak, stubborn, resistant, empty, prideful, impatient. I feel inadequate. This is a new place for me: rarely, if ever, have I really felt inadequate or unable. I once asked my wife before we were dating what she thought of me (I know it seems strange, but the question had a context). She said, “Brian, you seem like a person who does not have any needs; you have it all together.” I seemed like a person without needs probably because I felt (for the most part) like I didn’t have any needs. The tasks I was faced with were largely ones that I could apply my strengths to: getting good grades, absorbing information, training for an athletic competition, getting into graduate programs, etc. With enough effort, I could succeed. But these tasks to which I applied myself, these barometers of my degree of neediness never placed me face-to-face with a task that I was incapable of handling. This year has exposed my weakness. I now recognize that I am a man in need. I cannot love, I cannot embrace, I cannot engage the brokenness and ugliness of this world, a messy world that now has a face to it, on my own. I am not up to it; I lack the strength.

The ironic or dangerous thing is that this newfound deficiency is not one from the world’s perspective. To the world, there is no call or requirement to love the world, to engage the brokenness. Each to his own. Get what you can. Take care of

yourself. Look out for number one. But the upside-down, inside-out perspective of the kingdom tells me that in the area of greatest importance—love the Lord your God with all your heart, soul, mind, and strength and love your neighbor as yourself—I am deficient, needy, bankrupt, weak, insufficient, and incapable. When the brokenness presses in on me, I am crushed. I can’t love as I am called to love.

Two roads diverge… which will I take? One is more convenient and safe. The other is draining and messy. One avoids suffering. The other walks into it and through it. One is more peaceful. The other involves going into battle. One sees people as hopeless. The other sees them as bearing a holy image and longs to see that image recovered. One finds relief and refuge in the distractions of this world. The other lays up hope for a redemption that has yet to be consummated. One produces a hardened, calloused heart. The other produces a dependent, broken heart. One avoids Jesus because there is a false sense that all is well. The other cries out for Jesus because there is a palpable awareness that without Him all is not well. One leads to death. The other leads to life.

I have never really longed for redemption to be consummated, at least not until my four score and ten were completed. I thought life here was pretty good. Certainly there was nothing in my experience to cause me to yearn or “groan” as Romans 8 says for redemption to be made complete. But perhaps only now I am gaining the eyes to see (and feel) some degree of the depth of the brokenness of this world. The walls have come down this year and I don’t like what I see. How will I respond? Which road will I take? There is a strong current that pulls me towards despair, cynicism, self-protection, and disengagement. Lord, give me the faith to believe that the road less traveled is the road that leads to life, and hope, and beauty, and deep, unshakeable joy.

I am just starting to understand at a more existential level what I have known intellectually: “having faith” is more of a dynamic than static concept. “If anyone would come after me, he must deny himself and take up his cross daily and follow me.” It is a relentless battle to maintain faith. Paul tells Timothy to “fight the good fight of faith.” When he had reached the end of his life, Paul said, “I have fought the good fight, I have finished the race, I have kept the faith.” This is active, dynamic, persevering language. Having faith, remaining faithful, believing is not some autopilot state of being. It is a deliberate and ongoing battle to swim against the stream of forces that carry us towards complacency, apathy, faithlessness and unbelief. This perspective ought to produce a reinvigorated sense of urgency in my often stale, lifeless pursuit of the Lord. As one more and more sees life as war and faith as a fight, it ought to generate a more pressing desire and need to communicate with the Commander in Chief. To some degree it has, but not in proportion to the despair I have felt at various times of this year. For a number of reasons—some of which I am aware of and others that I am not—the quicksand of despair can sometimes be paralyzing and not lead to a crying out to the Lord but rather silence.

This year has been hard, but it has also been good. It has been hard for all the reasons above. It has been good because I think I have had some things exposed in my heart that needed exposing and because my perspective on life in the kingdom is undoubtedly more in line with reality. I see the brokenness of the world more clearly, my sin more glaringly, and my need for Jesus more convincingly. I see that faith is indeed a fight and that I am ill-equipped to fight the fight relying on my own resources. I need the Spirit of God to fill me if I am to fight faithfully, love as I am called to love, engage the brokenness of the world with hope, and walk the narrow road that leads to the life “that is truly life.”

Praise be to the God and Father of our Lord Jesus Christ! In his great mercy he has given us new birth into a living hope through the resurrection of Jesus Christ from the dead, and into an inheritance that can never perish, spoil or fade—kept in heaven for you, who through faith are shielded by God’s power until the coming of the salvation that is ready to be revealed in the last time. In this you greatly rejoice, though now for a little while you may have had to suffer grief in all kinds of trials. These have come so that your faith—of greater worth than gold, which perishes even though refined by fire—may be proved genuine and may result in praise, glory and honor when Jesus Christ is revealed. Though you have not seen him, you love him; and even though you do not see him now, you believe in him and are filled with an inexpressible and glorious joy, for you are receiving the goal of your faith, the salvation of your souls.
1 Peter 1:3-9

To him who is able to keep you from falling and to present you before his glorious presence without fault and with great joy—to the only God our Savior be glory, majesty, power and authority, through Jesus Christ our Lord, before all ages, now and forevermore! Amen.
Jude 24-25