Dr. Louis Girard (left) and Dr. Nuala Kenney have both let the Gospel help guide their career choices. Photos by Michael Swan

The good doctors: Fighting to keep morality in the age of the quick fix in medicine

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  • April 11, 2018

Hippocrates, the father of medicine, described a physician’s career this way: “Life is short, the art long, opportunity fleeting, experiment dangerous and judgment difficult.” So, who in their right mind would want to be a doctor?

Dr. Louis Girard — psychotherapist, family physician and palliative care doctor — knows the answer. It’s him.

“My choice of medicine was to go to the people most in need,” Girard told The Catholic Register. “Jesus said, ‘What you do for the least, for the poor, for the marginalized, it’s to me that you do it.’ That was certainly an influence on my choice of medicine as a profession where you can be in constant opportunity to help.”

Medicine might be just a job for some, but healing as a vocation goes much deeper. Today, however, it is a vocation often at odds with a society in love with quick fixes, from our reliance on drugs to normalizing such procedures as abortion and assisted suicide.

“The human person in his frailty stands at the centre of all medical and health care work,” Pope Francis told a conference of Catholic doctors in 2013. “On the one hand, we note — and thank God for it — the advances made in medicine. ... On the other hand, however, we also find the danger of a doctor losing his own identity as a servant of life. Cultural disorientation has beset what seemed to be an unassailable sphere — yours, medicine.”

Disoriented is how Dr. Nuala Kenny feels when she surveys the profession she entered almost 50 years ago.

“You don’t know how much of my time and energy has been devoted to the issue of what just happened to medicine in the medicalization of assisted death,” the Sister of Charity of Halifax said by phone from her community in Nova Scotia. “Doctors must do what medicine does. What is medicine about? Medicine is about health and healing. It isn’t about death…. Respect for autonomy is not translated into ‘Doctors do everything that patients ask of them.’ We’re not Walmart clerks. Medicine doesn’t do whatever you want it to do. But you can only have that understanding if there is some kind of internal morality of medicine.”

As the Catholic Health Alliance of Canada’s health policy and ethics advisor since 2009 and the founding chair of the bioethics program at Dalhousie University’s Faculty of Medicine, Kenny has struggled to claim her vocation in medicine. “I’ve been blessed with having three different vocational calls,” Kenny said. “The first and most important as a baptized Christian.”

But her second vocation almost eliminated her third. Kenny grew up the daughter of Irish immigrants in New York City. Her father was a welder and they lived in a working-class neighbourhood where she could attend good Catholic schools run by the Sisters of Charity of Halifax. When she looked to the front of the classroom, young Nuala Kenny knew who she wanted to be.

The trouble was that choice was in conflict with what she had wanted to be since girlhood — a doctor. The Halifax brand of Sisters of Charity didn’t have doctors. They were teachers.

“I was told explicitly when I entered that I would not be able to be a doctor,” she recalled. “I knew I wanted to be a doctor. But I knew that God was calling me to be a Sister of Charity. So I gave it up,” Kenny said.

With the Second Vatican Council, the Halifax sisters began to think of themselves in more vocational terms. Suddenly they were asking young women in formation like Sr. Agnes Sean (Kenny’s religious name) what they felt called to. Once her superiors finally convinced her to stop saying “Whatever you say,” they gave the whip-smart 22-year-old a year to plough through a raft of science courses and write her medical school admission test.

“For me it was a specification of my calling as a baptized and then as a religious woman and then the calling to the healing and reconciling mission of Jesus Christ, which is what health care is all about,” she said.

From the start of medical school, she looked up from her anatomy textbooks and saw the Gospel.

“There are three dimensions of Jesus’ healings that are universal,” she explains. “The first is that He paid attention to their physical distress. The second is that He in fact paid attention to their emotional and psychological distress. And third is that He restored them to the community.”

Restoring people was always Girard’s passion in medicine.

“The first employment I had was in palliative care — people who are dying, who are rejected by so many other people around them, including their treating physician,” said the transplanted Quebecker.

From palliative care in Montreal, Girard moved to family medicine in Toronto at a community health centre.

“I looked for a community health centre knowing that it’s not the best paid or things like that, but it’s the place where there were programs for the most marginalized,” he said. “I could do home visits there, having the support for that.”

Over the years, Girard came to see patterns of extra-medical problems that underlay the ailments of patients entrenched in poverty. A surprising number had experienced childhood abuse, frequently related to an intersection of substance abuse and mental illness.

As the profession was being revolutionized by new drugs, Girard’s own practice took a turn towards more conversation. 

“Unfortunately, in family practice I saw so many people who were coming to me asking for a pill for this, or a prescription for that — all of them coming from their psychological problem,” he said. “In the walk-in clinic way, you get the pill or the prescription in five minutes. The consumeristic way, in my mind, is lesser quality. It adds more risk and doesn’t bring more benefit.”

Beginning in 2011 Girard undertook the extra training to make the shift to psychotherapy and works today in the Clinic for Person Centred Psychotherapy. It’s the lowest paid and arguably the most urgently needed specialty in Canada’s medical system, but Girard was never thinking in terms of the better career move.

“Behind all my choices lays the Gospel,” he said.

As a former professor at some of Canada’s most prestigious medical schools, Kenny was always anxious to inform her students, “Actually you heal rarely, cure rarely, aid often and comfort always.” 

But as society gets more and more used to the idea that technology will fix every problem, the vocation of healing has to fight for air, lest it be smothered in an avalanche of new products and procedures.

“All of this relates to the context in which we’ve changed our understanding of what medicine is for,” Kenny said. “It has to do hugely with dependence on technology and technological fixes.”

Kenny knows that the core of her calling was never summed up in biochemistry. She signed up for what Pope Francis calls a culture of encounter.

“A health care encounter really is a place of all kinds of fundamental moral, ethical questions — spiritual questions,” she said.

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