Can you be a Christian in the ER? Grace abounds…


Many young physicians in training have asked me, quietly or by e-mail, ‘is it possible to be a Christian and practice emergency medicine?’  I think that they ask a good question, and likely for good reasons.

In their rotations they have witnessed, first hand, life in the ER.  They are uncertain, perhaps, because they see the frustration that boils over in the words and actions of otherwise compassionate and caring doctors and nurses. They hear the bitterness and sarcasm, the profanity, the unkind words spoken behind the glass window that separates professional from patient.

They also see, hear, touch…and often smell…the humanity that pours through the doors of trauma centers, academic emergency departments, community ER’s and all the rest.  There is suffering and loss, and the long, piercing wail of the bereaved down the hall, receiving the worst news of all.  They experience the addicted, the drug seeker who will tell any lie, contrive any store to get the pill or injection he or she so needs and desires.  They witness the poverty and need, the hungry, empty eyes of neglected children.   The may witness, or experience, the explosive violence and cruelty of the drunk, the criminal, the wounded.  In such a place, between suffering patients and suffering staff, what young, wide-eyed Christian wouldn’t ask, ‘Dr. Leap, is it possible to keep your faith and work in the emergency department?’

So here is my short epistle on the topic:

‘To the believers in the hospitals and emergency rooms, the church medical, across the land, around the world.  From your brother Edwin, who these years has fallen and gotten up over and over and who loves you and wishes to encourage you.

It is my prayer that you have strength to face the sickness and pain into which you plunge yourself every day.  All around you come victims; victims of disease and accident, victims of violence and neglect, cruelty and hatred.  The drunk and addicted, the angry and the sad, the suicidal and lost, the rejected and abused, the healthy and also the dying; and all are among the dying in the end.  Remember that all of them, and all of us, are also victims of sin, for it was in our separation from God in ancient times that all of this pain began, and in which death took hold of those originally destined for life.

Remember that the guilty and the innocent alike suffer from this, and that our Lord came to be an intercessor, high priest and atoning sacrifice for all.   Your struggle is against the infirmities of the flesh, but also against the wounds of the spirit that underly all suffering in this veil, until we reach the kingdom where death has no power…and you will be out of work for all eternity.  Amen.

Look around you each day, and consider that the emergency room, the hospital ward, the clinic, the operating room, these are places where the gospel is shown forth to you in power, a great gift from the Father so that you may understand by the example of others’ troubles what spiritual truths lie beneath it all and undergird it all.

Although we are all poor reflections, destined to one day (as the word says) ‘be like Him, for we shall see Him as He is,’ we are still his dim but ever growing likeness.   And we are His hands, feet, mouth, eyes, mind.  Like Him, we who go day in and day out among the lost, the suffering and those who (despite their willfulness) are hostages to evil.

And although we may have sin in our hearts, although we judge and are angry and frustrated, we do His work.  That is, brothers and sisters, we bring love and touch and healing and comfort to those who frequently have done nothing to deserve it, who exhibit no gratitude or intent to change, but who need our love, need the love and redemption of Jesus.  And like Him, we will show it seventy times seven, through temper tantrums thrown our way, complaints, cruel words, irresponsibility, patient satisfaction, EMR (the devil’s work) and every other difficulty.

Dear ones, in the ER, grace is at work, and a model of grace is there for you to enact and understand.  You give undeserved love and care for everyone all day, every day.  The Spirit gives you strength in hardship so that you may be bold, whether rested or tired, prepared or unprepared.  Also, remember that the spirit works in your sinful heart, to your salvation and holiness.  Those your treat are no worse than you and you no greater than them.  There is a great gift of holy humility in that truth.

One day, on that Great Day, you will see that each act, every stitch, every comforting hand, every EKG, every airway, every psychiatric commitment, each and every weary step into the same room with the same patient and same complaint, every unkind word for another physician restrained, every patient act, these were all acts of grace that molded you.   And the Father, Son and Spirit will welcome you, veteran of ten thousand daily trials.

And it is in this way that one can be a Christian in the ER, in the trauma center, clinic, operating room, delivery suite and all the rest despite the trials, temptations and bitterness that the enemy of our souls inflicts up on us in our work.

May the God of all peace guide you and strengthen you in your difficult work, and fill you with radiant, overwhelming love.

And may you have a quiet shift.


13 thoughts on “Can you be a Christian in the ER? Grace abounds…

  1. Well put. There is no better place to be image of Christ. I love the fact that my coworkers won’t deal with a poser. You have to be all of the way or none.

  2. Thank you for this beautiful, compassionate, healing and very Christian perspective on illness.

    As a nurse with a little extra training in faith community nursing, I am so glad to see you address the spiritual problems that contribute to (and result from) medical problems: thank you!

    Sometimes spiritual problems can be addressed via the “lovingkindness” (Psalm 119) that you layer onto your interaction with a patient, and in a way that does not necessarily require additional time or EMR documentation. This can make all involved feel better and more able to carry on.


  3. Great post.
    But how do you find your way back? I feel so drained and depleted! My cynicism is as high as my other colleagues. I am not a good role model for my faith-I am cussing at EMR, at administration and whatever else with the rest of them. I work most Sunday’s. Few people my age are Christain, so can’t even discuss with peers. I spent residency in the inner city of the most dangerous city of the nation. I should have strengthened my faith through those trials but that is where my faith stumbled and quickly lost ground. Just when I was recovering from that I am in the midst of huge challenges at new place. This place was great first year then administration went crazy. Now we can’t admit many days as hospital closes service! We can’t get people transferred (and no EMS even if we do-seen people die b/c I can’t get them there fast enough), psych holds (often kids!) are here for at least a week, no security most days and all the while the administration and patients blame us for the LOS and hospital problems. The patients I have stayed for 3 hours after shift trying to find a place to admit to complain about how we had to transfer them and how we “kept” them in the ER on purpose……well at least they are alive to complain! I went into this job because of my faith, my life’s calling and a way to express God’s love and as a way to give back as my life was saved as a child. In the midst of my dying I heard God. I should of been too young to understand but I knew it all in an instant. My faith should be so strong, where did it go!? How do I find it when my own negativity and burn out is so high!? I am so new in this career and so sad to feel this way all ready. I still want to be a dr but I hate this system, I feel my hands are tied at every turn and yet we are held responsible for anything that happens to a patient despite lack of resources to work with. Not sure how I can keep on if I don’t find my way back to faith (only massive student loans motivate me these days)! Right now I am trying to,hang in there for this community, without this hospital people WILL die who could been at least stabilized. This is the time to find my faith again but all I feel is great great fatigue and anxiety. Not sure there is any answer to this at all.

    • @Michelle. Greetings, on my own walk with God I noticed that when I get cynical I need to have that childlike Faith once again I need something to laugh about maybe a baby picture of me so I don’t take myself too seriously or a walk (I’m a psar volunteer at Grand Canyon)

      God wants us to come to him when tired and when we feel like our faith at its Lowest it’s actually at its highest.

      Remember to practice compassion because what you do to people you do to God even if what you do is not quote on quote good enough God sees it he sees everything you do. I’ll pray for you, and for the rest of the healthcare system.

  4. To Michelle-my heart goes out to you. Even Jesus went to the mountain to be alone and find times of quietude. I’ve often suspected that He needed a break from all the hands grasping at Him wherever He would go (the disciples, the needy, the Pharisees, etc.).

    You are at a difficult part of your career-the transition from the overwhelming challenge of residency to the overwhelming challenge of a new job. And it sounds like your job is a bad one. I hear that you feel that if you would leave people would die. You cannot save the world.

    It doesn’t have to be this bad. There are many jobs out there where the patients need you, administration supports you and you are compensated appropriately for your work. If you are drowning and don’t see a life preserver, it’s okay to swim out of the pool. There are plenty of swimming pools to enjoy where people aren’t trying to hold your head underwater.

  5. Thanks Ed for writing this.
    Was a blessing and an encouragement to read. Every day I pray going into work that I would love those I come in contact with as I have been loved by Christ. I pray that I would not only do unto others as I would have them do to me but also that I would love even those who seem my enemies (admin, the hyper-blocking Hospitalist, drug seekers, etc). I don’t always perfectly succeed in these quests, but daily prayer for assistance in the higher calling to love God and my neighbor is imperative for me to maintain any semblance of grace in the warlike ER environment. Another important thing for me to do before attempting to disseminate grace is to learn what it looks like. For that reason, I try to read the Bible daily and learn what it says about the One who gives grace and truly controls all things. I also watch those around me who know how to do this….. my wife primarily comes to mind. The Word helps me make sense of a lot of the craziness we encounter in the ER. I especially take heart in knowing that as you said, I will be out of work eternally one day and that is a true comfort. For now though, fighting the good fight and hoping for the end of sin’s consequences to soon appear.

  6. Thank you David. My job used to be great, it all changed recently. If not improving by contract time I will have to work someplace else, at least for a time!

  7. Bless you!! As a nurse practitioner who tends to the adult and juvenile prisoners of a county jail, I have often struggled with my faith and the barrage of negativity I receive from ungrateful patients and non- Christian staff. These are just the words of encouragement I need!!

  8. Thank you for this beautiful post! I am a Christian who became a nurse when I was 60 years old. I worked for several years in an HIV/AIDS clinic for low-income people. It was a labor of love, and your post contains many things that I had to continually remind myself of as I was working with the patients. Jesus healed lepers and often touched them in the process, and he associated with the outcasts of society while strongly rebuking the religious elite for their self righteousness. May Christians in the medical field who struggle with the darker aspects of their profession read your excellent article and receive perspective and encouragement, as did I.

  9. Dr. Leap –

    THANK YOU for this wonderful, insightful essay. I am not an ER doc but a pediatrician/lawyer who has seen so much pain in the faces of parents and children (in both fields) that my faith has often been seriously tried. You remind us that for some of our most desperate patients we are the imperfect human face of God and we must be the best representatives of His love that we can be.

    I would like to print and pass your article on to my first-year medical students – and the fourth-years I see too here at Loma Linda. They will need it very soon.

  10. Dr. Leap,
    Thank you. As a former chaplain for pediatrics, NICU, and the ER, I noticed that there was a high staff burn-out rate in all three areas… however, I also noticed that it was the people of faith who tended to be able to hang in there and provide care over the long term. I am not sure how a person could function long term in any of these areas without faith — because sooner or later, they would run out of hope. But since there is more to life than we now see, there is hope, and we can be renewed in our strength to carry on and make a positive difference. Thank you for all you do.

  11. Dear Dr Leap and all the other people who have responded to his post, thanks for all your encouraging words! Im a young ER nurse from Singapore and its been pretty overwhelming. Asking myself if its worth it staying a nurse when my body aches terribly after every shift and facing really rude angry pts. Seeing so much sickness around. But yes, may all this spur us to crave eternity in heaven, where there is no more suffering! And to be even more grateful that God took us in and loved us when we were as unlovable as our patients. God bless you all!

  12. Dear Dr. Leap and all the Doc’s who have responded. We are healers just as Jesus was. Most importantly that healing was with unconditional love, compassion and forgiveness. There is no sin only choice to do the loving thing. First to ourselves and then to those we treat and love. We are all connected. As healers we must be a part of the TEAM because the system is one that has created separation leading to frustration, anger, rage , anxiety and exhaustion. The Dr Barkus Welby’s, the Nurse Ratched ‘s , the Patient’s from the Dark, are all crying out for help, to be heard and be loved as Jesus did – unconditionally and without judgement. Kindness and understanding goes a long way when outcomes are not as we had hoped. This is the wisdom that must be shared NOW. We are blessed to be able to serve as Physicians, Nurse Practitioners, Nurse Mid-Wives, Physician Assistants, Nurses, Aides , EMT’s, and all people who work in the Health care fields. We are all blessed by God and it’s as simple as a decision to choose every moment. In those moments just Breathe – it is life confirming. Surround yourself with those who really love and celebrate YOU. In Love and Light, Mindy

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