It’s no secret that health care in our era of “a thousand clicks” is hard. The days and nights are long and often seem filled to the brim with mundane and painful tasks. In medicine, we are asked to give — our expertise, our time, our compassion, our skills. Giving to others is why we entered this field. And yet, to keep giving, we must be replenished. We are precious health care resources and we must work to preserve ourselves. We need the moments when we get to say, “You’re welcome” — the moments of connection, of feeling like we are making a difference, of beauty. These are the moments of grace that make all of it “worth it” and that will sustain us. And yet, it’s also no secret that these moments can sometimes be pretty hard to find.
Many years ago, at the end of a long obstetrics clinic day, I was told that the triage clinic midwife still had patients and I needed to help her finish her session. The last patient was a recent Somali immigrant who came to Boston by way of Houston. She carried with her many needs and questions, and also a stack of transferred records from her first clinic visits in Texas. She had been spotting, had headaches, and needed prenatal vitamins and other prescriptions. In the cartoon that illustrates equity, she needed a really big box to see over the fence and certainly a larger one than we were equipped to provide after 6 p.m.
I would like to believe that my frustration and impatience did not show at the end of that clinic day so many years ago, but they probably did. Despite this, patient “M” booked her follow-up with me and became someone I would follow through many complicated pregnancies over the next 10 years. I watched her not only grow her family, but learn English, find a job, and manage being a working mother with school-age children. To this day, when her husband accompanies her to visits, he never fails to tell me, “Dr. Boyle, we always talk about you and we pray for you. How is your family?” He often seems to appear and remind me of this at times when I most need to hear it.
Sometimes, the hidden grace is revealed sooner rather than later. I once had a patient who booked the last appointment of the day for every one of her prenatal visits. Our clinic is high volume, and we often have embarrassingly long wait times. A last appointment at 4:50 p.m. usually means starting the visit at 5:45 p.m. at the earliest. I don’t think she had many friends in the U.S. because, in addition to standard prenatal care stuff, this patient would ask me questions like, “Is labor really painful?” Spoiler alert: Yes, it is. It felt like a lot. Every week, the questions would extend the visit well past 6 p.m. Her mother joined her from Nepal for the last few weeks and I hoped that then her needs and questions would lessen, but they did not.
I was on call the day she went into labor. “She’s so glad you’re here,” her nurse told me before I entered the room.
“Oh good,” I said weakly, feeling my heart shamefully cold. She ended up having a truly beautiful and memorable birth. There was no TV in the background, no rah-rah cheering, no pump up music. She, her partner, and her mother had a level of focus and centeredness that brought us into a birth that literally felt sacred.
When my role was finished, my patient’s mother pressed her hands together, looked in my eyes, and said, “Namaste.” I had never heard this outside of a yoga class, and in the moment, it brought tears to my eyes.
To paraphrase Bishop Tim Norton,“The God (grace) that dwells in everyone is often unavailable to us because sometimes God (grace) does not appear to us in ways that make us feel good.” At the end of that long day in 2012, I never would have guessed that an extra visit would lead to a moment of grace and to one of the most rewarding relationships I have had as a doctor. Similarly, I had no way of knowing that all those 4:50 p.m. appointments would culminate in one of the most moving births I have ever attended.
When I am struggling, and I often am, I try to recall the hidden moments of grace that have revealed themselves to me over the years, and to remind myself that you can’t always know when and where they will appear. These moments don’t necessarily come cloaked in warm, glowing light and don’t always make us feel good at first. But we have to stay open to finding them, even, or especially, when we feel overwhelmed by mundane and painful stuff. We have to continue to search for the divine and the grace that exists in our patients and also exists in all of us. Like the new grandmother said, “Namaste.”
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Dr. Jennifer Boyle is an ob/gyn who lives with in Boston, MA with her husband and her three teenage children. In her free time, she runs, reads, and bonds with her labradoodle, Teddie. Dr. Boyle was a 2022–2023 Doximity Op-Med Fellow, and continues as a 2023–2024 Doximity Op-Med Fellow.
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