Born in 1969, I land squarely in the middle of the so-called Generation X. Thirty three years later I am a priest and a general surgeon who is also passionate about choral music, ultimate frisbee, squash, and good food of any variety. I have also been known to chase some of God’s innocent wingèd creatures around the woods with a shotgun.
Called to a bivocational ministry at the interface between church and hospital, I am currently working at Duke University as a post-doctoral fellow in religion and medicine where I endeavor to formalize the rules for conversation between church and hospital. In 2004 I will return to Pittsburgh to complete my residency in general surgery with the goal of developing a clinical practice with cancer patients. One of my interests is the very privileged (and priestly) position of physicians when they convey life-changing diagnoses for the first time.
My path to this odd interface started with an early and long standing fascination with the world around me, focused in a love of basic science. In addition, I cannot underestimate the importance of growing up in a church family that formed my heart, mind and imagination according to the language, music and practice of Eucharistic community. In college I discovered that in addition to studying the molecules in the cells of the lichen on the bark of the tree in the forest, it was also fun to study the forest. My growing interest in philosophy coincided with the process of claiming the faith of my childhood as an adult. For reasons that still baffle me, the notion of ordained ministry snuck up from left field and forced a reckoning, and I tested this call to priesthood for two years as a missionary teacher of biology and chemistry in Zimbabwe.
While in Africa, it seemed to me that it would not be wise stewardship of my gifts to turn away completely from my passion and ability to understand the world in the language of basic science. Consequently, my perceived call to priesthood could not take the shape of conventional parochial ministry. Yet the call to ordination persisted, and integrating the advice of several mentors, my vision started to focus on a bivocational ministry that would utilize my passions for both science and faith.
Ten years of training later, my ministry is still a work in progress. The integration of these two identities of priest and surgeon will be the task of a lifetime, but the project keeps me interested and busy. It is a holy thing to approach the altar table and encounter the Triune God in the presence of the entire communion of saints. It is a similarly holy thing to approach the operating table and encounter (and sometimes expose) the mystery of life, illness, suffering and healing. The challenge is not so much the perceived “conflict” between science and religion. (That “conflict” evaporates with a proper understanding of the differing truth claims of science and religion). Rather, the challenge of such bivocational ministry seems to be learning how to live faithfully within a faithless system. That is to say that although many physicians are people of faith, the modern medical system has no category or space for the God active in history and revealed in the person of Jesus Christ. Yet, like all Christians called to step outside the walls of their churches, I am called to live faithfully as a witness to a reality denied by the system around me. Such a calling is likely to be more cruciform than any of us would choose.
What is Bivocational Ministry?
Like any form of ministry, bivocational ordained ministry is not definable as one particular “thing.” Just as ice cream comes in many different flavors, it is possible to conceive of nearly any combination of vocations. My experience as a physician and priest is offered as one particular example, but through this example I hope to provide a more detailed interpretation.
Before diving in, there are two common models of bivocational ministry that I will not address. The first is the priest as professor. Many seminaries and universities are staffed by clergy who have chosen to live out their vocation in the academy as scholars and teachers. This model is so common and intuitive that it does not require much creative thought to understand. The second common model is priest as “tent-maker.” Drawing from the example of St. Paul who supported his preaching ministry through his trade as a maker of tents (Acts 18:3), there are a growing number of clergy in many denominations who support their ministry through some secular job. This model is increasingly important in churches and regions unable to support “traditional” churches with full time staff. However, the model is more practical than theological: the tent-maker tends not to express a “call” to tent-making. Rather, their vocation is exclusively priestly, but they support that ultimate end through the means of their “trade.”
My approach to bivocational ministry is more global and systematic. I am a priest called to live out my priesthood as a surgeon. I am called to both vocations, and my ministry is aimed at the interface of these two vocations rather than one “trade” serving the ends of the other “vocation.” Neither identity would be complete without the influence of the other. What this means in practice requires some unpacking.
As a priest, I am ordained to pastor, teach and preach. As a pastor I have ears to recognize and the vocabulary to address the spiritual concerns of my patients. The physician-patient relationship is incomplete if the physician does not claim his rightful role as pastor and guide the patient through the process of interpreting the meaning of illness. More often than not, after the “physical” complaints are addressed, patients raise concerns that are better addressed through the language of faith than the language of science. I suspect that much of the current dissatisfaction with “modern” medicine rests in our (physicians) abdication of this pastoral role—what used to be called a physician’s “bedside manner.” But my pastoral calling is not even primarily focused on my patients. I am also called to pastor my colleagues who struggle day after day to work in the midst of crushing illness and despair, yet by and large, they struggle alone. There are few resources to address the spiritual trauma that physicians endure, and to the extent that I am able, I offer myself as a resource.
As a teacher, I am an ambassador between the two worlds of church and hospital that deal with many of the same people in the same life crises, but speak totally different languages. Because I am in this sense “bilingual,” I can facilitate the conversation between these two worlds so that each might better address the needs of the people in their care. To this end, through my own exploration and example, I hope to help my colleagues become more sophisticated at recognizing and addressing the spiritual needs of their patients.
As a preacher and a priest, I am called to be a sacramental witness of Christ in a foreign land. My vocation is nothing less than the conversion of a faithless system. This is not to suggest that I do not respect or honor the goodness of modern medicine. I do. But it must serve God, and to this end I do rebuke medicine as faithless inasmuch as the system (not the individuals) raises up “health” and “long life” as its ultimate aim. God is supplanted by the false god of some proximate end, and in this, the system is faithless and idolatrous. What is required from the perspective of Christian discipleship is to restore faithfulness as the ultimate aim of medicine. God does desire for us a full life, and we are called to be stewards of our knowledge and resources in ways that participate in this holy desire. But the modern obsession with the individual divorced from the community and divorced from relationship to God denies our true identity and blasphemously rejects the love of God who calls us into relationship and thereby gives us life. Medicine can serve the end of restoring us to communion with our neighbors and with God, and in this its passions are properly ordered. But medicine can also serve the end of preserving “life” or “health” independent of communion, and in this, its noble aims are distorted.
I am convinced that the church needs more examples of this type of bivocational ministry because it is an incarnation of God’s claim on all human endeavor and knowledge. Faith is the foundation for all of our life, not just the life lived from nine to noon on Sundays. Bivocational ministry breaks down the false dichotomy between the sacred and the secular, and in the particular examples of ordained bivocational clergy, it becomes more than just a symbol, but an actual sacrament of the call of every Christian to live toward the eschatological horizon in a faithless world.
If the church is to become a Eucharistic community--the bearer of God’s history, the Body of Christ, vibrant and alive—then it needs to stop trying to be “relevant” in cultural terms and start transforming the very terms of that culture. This task is not compartmentalized, but comprehensive. It is as valid in our churches and families as it is in our boardrooms, courtrooms, factory floors and office buildings. The church is called to transform all that is around it, adding leaven to the loaf, and the leadership of the church (both lay and ordained) must lead by example. We are commissioned to go forth and make disciples of all nations. This does not mean organizing prayer vigils in all nations. It means transforming the way all nations perceive the world such that it corresponds with the eschatological horizon revealed in the person of Christ Jesus.
A final note of balance. In bringing God to a faithless world, we invoke the Holy Name, and as such we run the risk of blasphemy. In our attempts to “translate” the good news into terms perceptible by the world around us, we run the risk of fatally distorting its true meaning. The stakes are high. But like Peter, we are each called out of the boat to walk on the tempestuous waters of the faithless world in which we live. We cannot retreat into the relative safety and comfort of exclusive, sectarian communities. But as we venture forth into the tempest, we stay above water only as long as our focus remains sharply fixed on the eyes of the one who calls us.