The Irreducible Trust

(by Eric McLaughlin)

I try to picture it from their perspective.  Something has gone wrong.  It might have been fast with a panicked call to 911.  Or it might have been a slowly creeping problem, coupled with a significant desire to avoid going to the hospital.  But at last it becomes apparent that everyone's plans have to be disrupted, because the problem is big enough that we need help.  So we head to the Emergency Room, where our blood is taken, we wait for a long time, we get a bunch of tests done.  Maybe it's a good experience there, maybe it's not.  But eventually they tell us that we need to plan on staying in the hospital for a few days.

In other words, this is pretty serious.  You need professional medical people to be watching you.  You need help that can't be provided at home with pills.  Something could go quite wrong if you were to try and manage this at home.

This is the point where I come into the story.  The ER doctor calls me and tells me that there is someone needing admission, and I'm the one to do it.  I get the story, review the chart, and walk into the room.

"Hi, I'm Eric McLaughlin, one of the general medical doctors, and I'll be taking care of you here in the hospital."

We talk about the problem.  I examine the person who has the problem.  We talk about what is going on, and what we need to do about it.  The reactions are mixed.  Oftentimes, they are just thankful that their concerns are addressed, and that I'm optimistic about everything getting better.  Sometimes they are just resigned.  But several times over the past month in my US medical experiences, I've encountered a completely natural, understandable, and extremely challenging reaction.

They don't trust me.  Or they haven't figured out yet whether they will or not.  And why should they?  They just met me.  I smile and do my best to convey that I really care.  I went to medical school and have appropriate credentials.  Shouldn't that be enough?

Well, maybe.  But this is serious, remember.  This is a big problem.  Big enough to come into the hospital.  What if this young doctor makes the wrong decision?  How can I know that I should trust you?  Maybe I had a bad experience several years ago.  Maybe I felt mistreated by another doctor once.  Maybe I never trust anyone, and that is how I've lived my whole life.  Maybe I'm so scared right now that I'm paralyzed into not trusting anyone.

What if I decide not to trust you?  What then?  Ah, a good question; one in which I unfortunately have enough experience to know the answer.  You run the risk of hampering the very care that I'm trying to bring you.  Things may be delayed.  Compromises may be struck at your request that really shouldn't be.  I know I'm not perfect and won't always get it right, but please, for your own sake, trust me.

You can't get around it.  For all of it's fancy machines, computers, and multi-center, prospective, randomized controlled trials, medicine retains an irreducibly human element.  And personally, I am thankful that it does.  But that means that there is a leap of faith, a leap of trust.  We all try our best to discern if our trust is well-placed, and we all pray that it is.  This is not unlike the same leap of faith that is required for any real relationship or love in our lives.  But it's a quick one, an uncomfortably quick decision that has to be made now to meet the urgent problem that has arisen.

And as much as this is a reflection on my time here in the US, this theme is very much preserved in Africa, sometimes even more so since I am not of their culture, and may not even speak their language.  Compared to Americans, I think Africans are generally more used to the feeling of things not being totally under their control, but a lot of trust is still required.

***

I try not to make a habit of quoting early 1990's CCM songs to make a point, but I love this old song of Christian music's quintessential poet Rich Mullins.  The first verse and chorus chime in on just how hard trust can be.

Though we're strangers, still I love you.

I love you more than your mask

And you know you have to trust this to be true

And I know that's much to ask

So lay down your fears, come and join this feast

He has called us here, you and me.

And may Peace rain down from heaven 

like little pieces of the sky

Little keepers of the promise 

falling on these souls the drought has dried

In his blood and in his body, in this bread and in this wine

Peace to you - Peace of Christ to you.