By Dr. Thomas Duffy

My quest or query on the subject of grace in a secular profession has its origins in the circumstances surrounding the care I offered to a patient near the end of his life. The patient was an elderly gentleman with far-advanced leukemia of five years’ duration, during which he had undergone multiple remissions and relapses of his disease. His final hospitalization proved the most harrowing and tortured experience for him as well as for his caregivers. After treatment with an aggressive chemotherapeutic regimen for his recurrent disease, he experienced worsening of his already debilitating physical condition. He developed a bacterial super-infection with Fusarium which had several devastating effects, including blindness and numerous painful ulcerations over his entire body. The recommendation to move from a curing to a caring stance was accepted by the  patient and his family. The decision – his decision – to withdraw therapy was considered appropriate in light of the advanced stage of his disease and the degree of his suffering.

What was unknown to me during this challenging period was a meta-text that was  occurring in parallel to my care of the patient. A hospital chaplain had befriended and counselled him beginning from the onset of his illness and subsequently provided me with an essay describing her experience ministering to him. Her essay describes her painful accompaniment of our patient in word and silent presence as he moved from “roaring against the dying of the light to an acceptance of his journey through the valley of the shadow of death.” She appeared to be empowered and energized from her encounter with the dying patient. In striking contrast, I had come through his illness with feelings of disappointment and defeat, of being bruised and saddened. I was forced to ask why I had come away exhausted and limp whereas the same experience was a source of apparent transcendence for the chaplain. Upon reflection, I entertained the thought that she had access to a resource that I lacked in the encounter.  Her accompaniment had graced the dying of a human being and she had in some way shared in this grace through her actions. Her role as a chaplain afforded her a strength which eluded me. I was left to ponder whether I could share in this resource.  Grace was a fuzzy concept for me. It was an entity that involved the presence of God and a belief in God. And if God is essential for grace where does that leave grace for a non-believer in a secular profession? Had I, in entering that profession, cut myself off from grace and the power it imparted? Is grace an option for non-believers? I couldn’t answer any of these questions until I corrected my woefully inadequate knowledge of grace. This was the initial query which the encounter stirred up and initiated a journey in search of possible sources of grace in the secular procession of medicine.

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