The privilege of service available to us all

Much of my work as a physician is in the ditch beside humanity’s road, into which so many are dumped, ejected, abandoned or simply driven by the need for respite from the road. There I find the drugged and the dangerous, the retching and the wretched, the gracious and the grating, the thankful and the fully tanked, the children and the childlike, the odorous and the onerous. There I find my humanity and my grace, and the great privilege of my work.

That privilege is the privilege of service in the care of other human beings. It does not simply belong to physicians, but to teachers and parents, to children who care for parents, to priests and to nurses. It belongs to those who shelter and serve the poor, to those who stand guard for us at night and in foreign lands, to media reporters, and to so many others. At any given time it can belong to any one of us, to any who recognize and appreciate that being asked to work in the service of others is an honor to be honored in return.

Sometimes the work is saving someone’s life. Somewhere out there is a boy I remember as a newborn who lay in front of me in cardiac arrest after an emergency Caesarean section for fetal distress. To this day I remember his eyes most of all – sightless, unblinking, black coals staring up at me. I intubated the baby, resuscitated him, and he is now a healthy 13-year-old I have never seen again.

On a bad day I can blow on that coal of a memory and have it glow just enough to warm my soul with the realization that, no matter what I have done poorly, I have done something wonderful. It is a privilege to have been given the opportunity to have such a memory.

Sometimes the work is saving someone’s moment, and the difference we make is smaller. The privilege of service is, in part, the endless opportunity to make important differences with little effort. It is the kind word despite fatigue and frustration, an understanding tone in response to someone’s need, or the forgone opportunity to express righteous disgust. It is sitting down to interview the patient, so you look like you have all the time in the world to listen when you really don’t have a moment to spare. It is telling the young woman who has just had a miscarriage that it was not her fault, and that one pregnancy ending in a miscarriage does not mean all of her pregnancies will end in a miscarriage, then making sure her husband knows and believes this. It is the parent who overcomes the instinct to judge the pregnant teenager daughter, and the daughter bathing a bedridden parent with the compassion necessary to preserve dignity.

The privilege of service carries with it the obligation of compassion against all odds, for those who come to us for service bring their vulnerability and must offer us an intimacy with their personal lives we would never be offered otherwise. That obligates us to respect their vulnerability, and to protect it from our baser instincts, because we cannot share intimacy that allows us to see the undressed human soul, then abuse what we see, and say we truly serve. We cannot take the clothes off the human psyche and then chastise if there is a bit of behavioral cellulite we don’t like, and then say we truly care.

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Without our compassion the trust placed in us by others in our care is at best misplaced, and at worst, cruelly betrayed. Without constant and extraordinary compassion as our commitment, we who care for the weak and the vulnerable are simply voyeurs looking through the window at their unguarded moments, as though watching their reality TV for our entertainment and gain. Without compassion, the buzz we feel when we have done something great is really just intellectually “operating under the influence.” Without compassion we really work in the care of our own egos and not in the care of others.

The privilege of service gives the gift of understanding and accepting human frailty, including our own. Constant exposure to the failings of others teaches that each one of us, sooner or later, will fail. We will all make mistakes and fumble lives we literally or figuratively hold in our hands – perhaps even our own lives – because we are not perfect. Almost every physician sooner or later lies down one night and stares into the darkness of understanding that he or she made a mistake and harmed a patient. Parents will stare at the reality of having failed their children in some way, and lovers at the reality of having scarred another’s heart forever. True service forgoes the many opportunities to judge others and ourselves.

The privilege of service is the best of what I am paid for my work as a physician, and is compensation available to us all. The world, the community, the family and the moment are filled with opportunities to serve in the care of others and to find the privilege of service. It is our own loss when we miss them.

Erik Steele, D.O. is a physician in Bangor, an administrator at Eastern Maine Medical Center, and is on the staff of several hospital emergency rooms in the region.