A Believer in Bolivia (*Sensitive)

Patrick is a young medical resident who is “passionate” about his work. After his sister died of leukemia during his senior year in college, Patrick became a Christian in order “to find meaning in life,” and he now feels deep ties to Christianity. Patrick has long been concerned with issues of social injustice, and he sees becoming a doctor as his way of helping the poor. After completing his formal medical training, he wants to establish his own orphanage in Bolivia, where he has worked with children before. Patrick’s very strict moral and ethical standards for himself and his work are visible. He makes decisions according to his understandings of right and wrong, and understandings based on his Christian beliefs. Because of these beliefs, Patrick refers patients to his colleagues if there is an issue that is in conflict with his values. He does not care if he gets a “bad rap” or a “bad mark” as a resident.

Patrick is a young medical resident. He is currently focusing on both internal medicine and pediatrics, because he has a special interest in treating the family as a whole. After completing his formal medical training, Patrick wants to live abroad in a developing country. He will most likely return to Bolivia to work, as he has before, with street children and prostitutes. Patrick has been concerned with issues of social injustice since childhood. Becoming a doctor is his way of helping the poor. 

Patrick explains that he is “passionate” about his work and that he “feels things more than other men.” He believes these feelings are the result of his deep ties to Christianity. He explains that he believes in Christ as the absolute truth; he will follow Christ “no matter what,” because otherwise, “everything is pale in comparison.” Patrick also calls himself an “extremist” because he wants to rectify issues; in other words, he wants to move from meeting immediate needs to actually solving problems. Patrick feels it would be selfish for him to marry, because a serious relationship would take time away from his work. He openly and honestly acknowledges that he does not have balance in his life; he has no family, no social life, and barely makes time to go to church. 

Creativity plays a large role in Patrick’s work with the children in Bolivia because he is always willing to “take risks,” “solve problems,” “step out of the box,” and “fail.” In Bolivia, he is “doing something that nobody else does,” especially by trying to get children off the streets and into orphanages. He stays with children from 10 p.m. to 3 a.m. and “goes everywhere” with them. He teaches them about Christ and through his work, “brings the church to them.” Eventually, he wants to establish his own orphanage, ideally with a four-to-one ratio (four children to one clinician). The orphanage that exists now “is doing the best it can,” but Patrick sees room for improvement. Patrick is also working on a book about children living on the streets. When asked if he has had any “success stories,” he responds that in his work over the past year, he has gotten ten kids off of the street. Although he admits this is a relatively small number, in his mind, “at least it’s ten less kids on the street.” 

Patrick’s parents originally came to the United States from Taiwan in search of educational opportunity and political freedom. They were very poor and had no money for health care or even, sometimes, for food. His family grew up in housing projects in Texas and, as Patrick explains, he “knows what it’s like to grow up when forces are against you.” His sister had leukemia and passed away when Patrick was a senior in college. Although his parents were atheists, Patrick became a Christian shortly after his sister’s death because he “wanted to find meaning in life.” 

From a very young age, Patrick wanted to excel. When he was in sixth grade, he audited classes at a neighboring university in order to expand his “knowledge base.” When he reached high school, he spent half of each academic day at the university, taking classes. Patrick’s father, who was a mathematician, taught him at home so that he would be ahead of students at school. As a young child, he knew that he wanted to have a career in medicine. He decided against politics because as a politician, “you have to do things that you don’t think are morally and ethically right.” Medicine appealed to him because “you get to know the inner being … People consider your goals altruistic.” In addition, he says, “you have instant respect and power to make changes in people’s lives.” 

Patrick’s very strict moral and ethical standards for himself and his work are visible. He describes a desire to “at the end, feel good about what I have done for others,” and he is less concerned about what looks good on his academic record. Patrick makes decisions according to his understanding of right and wrong, understandings based on his Christian beliefs. He refuses to perform or even to consult with patients about abortions. He will not give medication that might have a harmful effect on a patient’s body. Patrick firmly believes in “comfort care,” not assisted suicide. He believes there is “too much money” being spent on prolonging people’s lives, and that “people should be let to die peacefully.” 

With patients, Patrick hardly ever runs into issues around his beliefs. He refers patients to his colleagues if there is an issue that is in conflict with his values. He does not care if he gets a “bad rap” or a “bad mark” as a resident. In his mind, it is more important to follow his beliefs and standards about what is right and wrong— “people should be able to develop [and act upon] their own moral and ethical boundaries”—without being persuaded by insurance companies, hospitals, or other doctors.

How would you describe the relationship between Patrick’s beliefs and his work? Are there important personal values and beliefs that you bring to your work? Have you ever experienced a moment where your personal beliefs are in conflict with your work responsibilities?