Friday, March 28, 2014

Helplessness, Prayer, Serenity

The days that hurt the most at my job are the days I feel helpless. Yesterday I saw a family with a couple small kids, and although I can't tell you what was going on I can say that it wasn't good. Best case scenario is that there are a couple of sad, scared, confused little kids out there today, and worst case scenario is that there are a couple of neglected, sad, scared, confused little kids out there who can't get in touch with someone who will help them. Sometimes people just stink. No one I called about the situation seemed to believe there was much that could or should be done, which left me feeling angry, scared, and sad. And helpless.

After a lot of self-reflection and observation of my colleagues, I'm pretty sure that everyone who goes into medicine has two characteristics in common. The first is a desire to help, rescue, fix and save other people. The second is a desire to be always in control, capable, competent, and powerful. Medical training reinforces those characteristics, but as far as I have seen they are present in every medical student, right from the start. I'm sure you can imagine how troublesome this is. Saving others and being in control are pretty much doomed projects from the start. My training has taught me to work with these traits. I do my best to recognize when I'm operating out of these paired desires and to soften myself, my stance, my actions. To accept my limitations, to recognize that rescuing isn't even always wise or right, to know that presence can be enough at times. To be honest, it's an up and down kind of struggle. Those twin pulls can be terribly powerful at times. Particularly when there are children involved. 

There's a prayer that speaks to a lot of people, that I've seen quoted in more books and websites then I can conveniently remember, that addresses this struggle. It's called the serenity prayer and I'm sure you've heard it. "Lord, grant me the serenity to accept the things I can not change, the courage to change the things I can, and the wisdom to know the difference." It's credited to Reinhold Neibuhr and it's used in addictions treatment, in mindfulness books, in memoirs, and by pretty much anyone who has ever struggled with a tough situation. Which is pretty much everyone.

I believe this prayer is wise but I'm not very good at it. I find myself more inclined to inwardly scream and rage than serenely accept what I can't change. So, while I pray quite a lot at work, my prayers tend to sound more like this: Please, Lord, please. Intervene. Protect these kids. Do what people won't or can't. Please help. Please be with this person. Please soften that person's heart. Please bring healing, bring comfort, bring grace to this person or this situation or this family. Please give me the wisdom, strength and courage to help. 

I don't know if my praying helps. On my good days, my days filled with trust, I believe it does. I believe that it makes a difference to others. On my not so good days, the days filled with doubt and anger, I at least know that praying makes a difference to me, that it keeps me showing up and trying to help. Even when I can't change things. Even when I'm helpless. I guess the balancing point of serenity for me is to trust (or at least hope) that's enough.