When I get to heaven…

from Pilgrim's Progress

If you practice medicine, you’ll accumulate a lot of pain.  I’m speaking to those considering medicine, and to those who are starting.  I’m speaking to those who have been practicing and to those who are retiring.  Pain, loss, suffering, these are as surely the souvenirs of our practice as hope, help and happy outcomes.

So recently, I’ve been thinking of the pain we carry around.  See, I think that when we truly care for our patients, we take a little of their loss with us.  Not just the big things.  Of course, the traumas, the tragedies stick to us like cotton to Velcro.  But even the little ones.  The stories of broken families.  The stories of abused children. The empty eyes of women and men who have been broken by the ones they trusted and crushed by life.  The sad faces of children without hope.

It reminds me of Jacob Marley and his long chain in ‘A Christmas Carol.’    Except this one, the trail of misery we hold onto as we move through the practice of medicine, isn’t really of our own doing.  It’s the result of our love and compassion.  It’s the price we pay.  And the ability to drag it around is as much a qualification for medical practice as being able to memorize neural pathways or drug doses, anatomy or pharmacology.

And so recently, rather than wonder what I’ll remember as I grow older, I’ve been thinking of what I hope to forget.

In heaven, the Bible assures us we won’t know the pain we knew in this life.  I don’t really think it will be like a ‘spiritual lobotomy.’  Rather, I think we’ll be able to see everything from outside time, from outside our own perspectives; we’ll no longer ‘see through a glass darkly.’  We will ‘see face to face.’  Even our worst pain, or darkest memory, may either make sense, or seem so dim, so inconsequential by comparison to what we see, that we will actually forget.  I don’t know.  I’m guessing and hoping.

But I think this verse says it well:

‘He will wipe every tear from their eyes.  There will be no more death or mourning or crying or pain, for the old order of things has passed away.’  Revelations 21:4

So I have a little list of things I don’t want to remember anymore.  Tears I want wiped from my tired eyes someday, sometime, beyond time.  Here are a few for starters:

The miserable, unrealistic belief that I can ultimately control life or death.

The sound of someone screaming about their loved one’s death.

The silent sobs and red eyes of old couples as they hold hands while one of them dies.

The way people realize the moment of tragedy and that they cannot go back to change it, whether car accident or violent act.  The desperation they express at being locked in time, unable to undo anything, however horrible.

Paralysis, in old or young, but especially in those who were only just laughing and playing with friends, but now are consigned to the aid of machines and other people.

The guilt over patients lost; because I believe guilt has to do with sin, and even our worst mistakes are not sins, only the result of living in an imperfect world.

Violent death.

Violent life.

Abused children, and the bruises around their eyes, the swelling of their tiny heads.

The enslaved look of the addicted.

My crushing fatigue, felt at the end of a long night of uncertainty, when dawn brings relief but a vague discomfort, a wondering if I was right or wrong.

The weight of all of this.

What do you want to leave behind at Heaven’s gates?  What tears do you want wiped away?

I believe this will happen, because pain demands anesthesia.  We struggle to stop our patients’ pain, we don’t accept their pain as normal and reasonable.  As physicians, we never have!  Likewise, the pain we feel as practitioners, or even in daily life, cannot be normative.  It cannot be the way we were meant to be.  We gasp at suffering beasts; we cannot embrace the suffering of this life as something right, something acceptable, something to which there is no relief!

Christianity may be, to some, ‘unscientific.’  But it fits the evidence.  And it is is at least a hope that one day, all of the pain will be gone.

I, for one, look forward to that day with prayerful expectation.  I suspect you do, as well.  Because if you do what I do, in whatever specialty you do it, or even if your suffering comes from some other occupation or personal misery, if you are HUMAN, you have some pain to unload.

Edwin