Homemaker, MD

A few days ago, I listened to an interesting interview on the True Woman blog  in which the following question was discussed: Should a Christian young woman with a desire for marriage and a family set out to attend medical school and become a physician? Carolyn McCulley linked to it and invited comments and feedback regarding the issue on her site. Since a small comment box hardly sufficed to contain my opinions, experience and thoughts on the matter, I thought I’d respond with a post.

This is a question I’ve been asked before, and it is an important and valid concern.  I left my internal medicine residency when I was pregnant with my first child to be at home full-time, in lieu of continuing for further specialization beyond my general practitioner licensure, so I’ve thought about the issue a lot. I have a daughter, and I often consider how I’d advise her if she considered following her father’s and my footsteps. Here are some of my thoughts and opinions on the matter, given my current experiences and understanding of Scripture. This is not a “yes” or “no” question, so I will divide this into some of the topics that need to be thought about.

1.      Single women who are considering becoming a physician or other profession are often cautioned to wait because they desire marriage and children. But is it really advisable to avoid education and career because you might start something that you later stop? We live in a broken world, in which the healthy desire for marriage and family isn’t always completed this side of heaven. So why should a woman who is single sit around waiting rather that reaching beyond herself for more opportunities to impact lives with the love of Christ? Often we desire the path of our lives to be clear and strait, so that we can see the end of it and walk knowing what comes next. But God frequently shapes our path in a manner that is twisting and curved, and the weather is sometimes foggy. Often we cannot see ahead except to take the next step of obedience, and only then are we to see where to go from there. 

Such was my path into medicine. I initially considered a research field in virology, and loved philosophy, to the extent I obtained two degrees while in college (Grove City)—Philosophy and Molecular Biology. They were two different worlds, which I now find merged in my grappling with bioethics. Anyway, in college I took a trip to East Africa with a handful of other pre-meds, our anatomy professor , and an MD, who’d formerly worked there as a missionary. We went to a different village every day, each of us doing rudimentary exams in huts and under trees, then presenting and reviewing each patient with the physician before offering treatment and praying with patients. Sometimes there were hundreds of people waiting to see our little group, following us from village to village hoping to make it into the clinic. It was there in the bush of Tanzania that I knew first what the next step of obedience would be. Of course marriage was a desire for me, though at the time I had no prospects, and no reason to expect any.  I knew then that if I were ever to have the opportunity to have children and family, I would want to stay at home with them as much as possible. I really didn’t know how that would be possible, as it appeared to conflict with what seemed to be a calling into medicine, but after much prayer I moved forward into the only obedient step that was visible. After entering medical school, I was quickly gripped by the realization that I had already entered the mission field. I invited other female med students to study the bible with me and my roommates, a nurse and an occupational therapist. That first year of medical school I saw four of my female classmates come to faith in Christ.

2.        A Christian woman considering medical school should honestly evaluate what her motives are in seeking this kind of career. Prayerfully seek to differentiate between God’s calling and her own desires. This is, of course, very hard to do at times. Books and books have been written about it, which would likely be helpful to read, after the Bible of course.

Is there a desire for respect, identity and independence? A desire to be called “Doctor” and wear a long white coat? When I was in the act of leaving my residency, another female physician told me she could never do what I was doing because “My identity is being a doctor.”  But remember the temptation to base your identity on the roles you fill cannot be escaped simply by staying at home. The homemaker may be tempted to elevate her skill as a cook or a mother and disciplinarian over her identity in Christ. If a woman finds that she is seeking a career only as an avenue to building an identity she finds appealing, then her motives are amiss.

Perhaps, however, a woman has been through significant illness herself, and has vast resources of compassion to channel toward the ill through her life experiences. Or perhaps God has given her a distinct desire to serve people through comfort and healing. Maybe there is a strong pull towards the mission field in a developing country, and she realizes how practical the hands of a physician would be in that setting.  Muslim women will often only see a woman physician. There are many women medical missionaries who have been used greatly in these settings.  In fact, some of the first women physicians entered the field for those purposes. I have read numerous biographies of such women and perhaps I’ll post about them in the future.

3.      Student Loans. I can tell you that there are woman doctors who are working incredibly hard with kids at home, simply because they are trapped. Their hearts’ cry is to be at home with their kids, but loan payments are too high for them to get by on only their husband’s income. We aren’t talking about tens of thousands of dollars here, people. We are talking about hundreds of thousands of dollars.

Obviously debt should always be avoided if at all possible. But it is hard to ignore the fact that in our society the means most students use to seek higher education is via student loans, and such loans are often described as “good” debt. These concepts are discussed in great detail in many other places in print and online, and I won’t attempt to further delve into the issue here.

But think outside the box for a moment. Do we not believe it is possible for God to call a woman into medicine to serve Him, even while accruing debt, all the while praying and trusting for God to be her provider and the provider for her children? Any woman who enters a career should carry on with the thought in the back of her head that God could call her to leave it for a time, or even permanently, when and if she marries and has kids. She should pray and plan for that day, even if it appears far off. I can attest to the fact that God answered that prayer in my life, something I prayed about even as I applied and interviewed for medical school. He is my provider, and provided a way for me to be at home through my husband’s provision.  Some ask me: Doesn’t it feel awful, though, to have to be on the receiving end of that? Don’t you wish you could help economically? To that I would answer: Isn’t this another way for my husband to love me like Christ loved the church? To pay my debts? What an allegory of His grace which would not be possible otherwise.  

Also, can I look at the spread of the gospel in my medical school class as something that I can put a price tag on? Can I regret my loans when I look at how God used me (despite myself!) in the conversions of others? Also, when looking into future third world missions, an organization called MedSend is well known to help new physicians take positions on the mission field by paying their loan payments while they are abroad. So that obstacle is removed for many.

4.      Seasons. A lot of us Christian women physicians like to think about our lives and our careers as having seasons. And trusting that God works through those times.  I am now in a season of life where I have the pleasure of spending my days with a beautiful little girl. I read her books as long as I can hold her attention. I tell her stories. I teach her sign language and take her to the aquarium. I look forward to the day she can talk to me more.  Occasionally during this season I’ll do something medical. I may teach physical diagnosis at the medical school for two hours a week next semester while my daughter naps, for instance. But when I had a child, there was no doubt in my mind that after my husband, she was my first calling. I have heard other Christian docs tell me that they view their choice to work full-time as their “ministry” though they have kids at home. They are financially able to cut back on work hours, yet choose not to, pointing out that their kids are healthy and doing fine. From my perspective,  no ministry calling is as high a priority as my family, and there is no other mother for my child besides me, though there are many other physicians that can take my place at the patient’s bedside. I do not know how I could teach my daugther about God ”when I sit in my house and when I walk by the way, and when I lie down, and when I rise” (Deut 6:7) if the majority of every day was spent away from her.

5.      People often infer or ask me if I think my education was wasted. My first response is that I don’t believe in a God of waste. He had his purposes for my time as a full-time physician, and He has already used that time in big ways. I’ve had the joy of treating patients all over the world, and sharing Christ with them as I dispense physical remedies. I also have the unique situation of being better equipped as a help-mate for my husband than I would be had I never practiced medicine. He is almost done with his training as an adult Hematology/Oncology physician. Every day he takes care of cancer patients. This is a field where success is measured in weeks and months of life extended, rather than years and decades. The emotional and spiritual intensity of this field is immense. There isn’t a way to explain what being the bearer of bad news feels like, especially telling people they are dying, or that they have cancer, and then treating them as they deny it. I’m grateful I know better how to love him, that I have insight into his work. In many ways my reading in bioethics is another way to deepen my ability to support his work.

My education is also used in my discipleship of medical students. They tend to listen to those of us who have gone before them, for better or for worse. Also, I feel better equipped than any school to educate my daughter, and perhaps I will end up homeschooling, though I don’t know for sure yet. I read an Indian proverb once that said this: “Educate a man, and you educate an individual. Educate a woman, and you educate a family.”

Many recommend that women physicians who step out of full-time clinical work keep a hand in it by seeing patients even as infrequently as once as month, since the skills and knowledge can fade and be lost over time. To work this small amount is rarely possible. For about a year I spent a half day a week seeing patients in a Christian free clinic for the poor, while my daughter spent most of the afternoon napping at a friend’s house. Kind of like my own version of “mom’s morning out.” Currently, however, I’m not practicing at all. But I don’t believe in a God of waste. He has and continues to use my education in ways that are unexpected and exciting, and even if I never practice traditional clinical medicine again, I rejoice at the path He led me down, and rejoice in my current calling as a homemaker as well.

6.      In the interview I listened to, referenced above, one speaker mentioned the concern that women who enter medical training are investing their most physically and relationally fertile years in a time of intense training. Indeed , that time is quite intensive. But medical school doesn’t have to be a relationally barren time. I can say that the many years I spent in medical training were incredibly fruitful relationally. For one thing, I met my husband in medical school! He claims it was over a dead body in gross anatomy, but I think we first met in Sunday School. Either way, we were co-laborers in our class along with the other Christians we met there. The group of us found ourselves thrown into the kind of close relationships with non-believers that are forged only through shared adversity. At the end of each year, we took a medical missions trip together to a third world country, inviting our non-Christian friends to join us. Many came to be transformed and are now following Christ. I am grateful to be a part of small group Bible studies and discipleship with female medical students for eight years now. Currently I meet with a group of women students to teach Romans along with a pediatrician friend of mine on Tuesday nights.

The concern about fertility is valid. I spoke with an OB friend of mine recently who lamented that a lot of her friends in medicine didn’t realize that fertility rates actually start to drop after the age of 30. So women who wait until they are out of residency at 29 and then start to have kids could face more trouble.  But pregnancy during residency is not without risk. I stopped residency when I was still pregnant for that very reason—I was dealing with more risks than I was comfortable exposing my child to, and my residency program refused to switch me into outpatient rotations that would have resolved my concerns. This is one reason that I have trouble encouraging women who are married and planning on kids to start out in medical training.

7.      Some have raised the concern that women who enter traditionally male careers by becoming physicians, lawyers, or engineers might have a difficult time avoiding the qualities that success in these careers tend to foster. That these women would be more likely to lose femininity by becoming assertive, tenacious, driven, and that they would hold authority over men. To me this seems no different than the common struggles all Christians have who are called to be “in the world, but not of it.” I have seen Christian female medical students spend their afternoons hand feeding ill patients with the kindness and hospitality of Proverbs 31. I have watched women physicians who cultivated the mind of Christ quietly serve by washing the dirty feet of AIDS patients. I have worked next to a medical missionary as she gave her life away to lepers in northern Tanzania. By entering the profession of medicine, women can bring tenderness, compassion and gentleness that is not possible in a profession that is male-only.

Women everywhere and in every walk are tempted to grasp at autonomy, to reject submission. This issue is not unique to the professional women, and cannot be avoided by avoiding a professional life.

So those are my thoughts about the issue at hand. No role we fill, whether we kneel at the bedsides of the ill and treat their disease in the name of Christ, or spend our days caring for the tiny needs of our newborn, can fulfill the deep need for true identity that can be found only in Christ.

No one else can decide for an individual the path God is calling her to. She may wish that there was simply a sign post along the road or a Christian authority she can turn to for direction. But those would rob her of the opportunity to learn trust and deepen her relationship with the Lord by walking through the decision process and drawing closer to the heart of God.