Becoming a Physician in Trying Times

Dr. John Bruchalski after a delivery

Dr. John Bruchalski

“It is always a challenge to be the point of the spear,” Dr. John Bruchalski began in a slow, quiet tone. Five medical students and he were seated around a collapsible particle-board table, topped with a vase half-full of drooping sunflowers, in his slightly-shabby women’s clinic. There, in “the board room,” he gave us courage.

As much as I want to become a doctor, I am pretty depressed by the state of medicine today. I’ve known three PAs in my life, and two of them have (independently) told me that “the golden age [of doctoring] is over,” and becoming a PA is “the fastest way to get to do what [you] want to do.” Doctors are doing more paperwork, dealing with more lawsuits, and being subjected to more government regulations than ever before. They are seeing patients for shorter and shorter times; they are seen in a poorer and poorer light by the public; and their profession is yielding to self-destroying ethical choices.

As I applied to medical school and continued through my first year, I kept wondering: “is this the right profession? Should I be a nurse/practictioner, or a midwife, or a PA, or fertility care specialist, or a counselor, or a psychologist, or…? Am I sure? Should I pull out and cut my losses?”

I persevered. And for the first time, I felt really excited about that perseverance when Dr. Bruchalski admitted, “Everything’s imploding. [But] be encouraged–it’s actually an awesome time to be a doctor. There is hope, not because it’s getting better, but because there is love.” By this, he meant that there are great and widening opportunities to show love to patients and colleagues. Because of this love, he said, “when healthcare [implodes], we’ll still be standing…pro-life and filled with social justice.”

“It’s a perfect time to be a doctor,” he restated, “because you can make a huge difference.”

Tepeyac Family Center LogoDr. Bruchalski told us briefly about his conversion; as a resident, he performed, but he’s now the founder and director of the Tepeyac Family Center, a pro-life, OB/GYN, integrated healthcare practice with top notch medical expertise that cares for the whole person (according to their website). Next, he counseled us in ways to become a good physician.

Dr. Bruchalski’s Story

“My patients weren’t getting any better after I terminated them [aborted their fetuses],” Dr. Bruchalski remembered. At the same time as he experienced this during his residency, he began to see data in the 1950s and ’60s about the abortion-breast cancer link. Convicted by experience and data, he stopped doing abortions. In the earnest calm of a supernatural confidence, he spoke about abortion candidly. “It is not a loving act,” he said. It’s combat, and it’s difficult combat: it’s killing at close proximity, ten inches away.

Dr. Bruchalski’s Recommendations

Abortion, Dr. Bruchalski said, is “based on being used, loneliness, no relationships.” (Reminds me of my research.) Most post-abortive women don’t follow up with the abortionist because abortion is a technique, not part of a patient-doctor relationship. To repair this defect, we need to be good physicians, and Dr. Bruchalski listed three goals, and three principles of medicine.

Goals for a physician:

  1. Be the best doctor you can be: know the literature and keep up with your CME. A movement like repairing the profession, or repairing the culture is embarrassed by a doctor who doesn’t support his practices (e.g. NFP) with evidence.
  2. Build relationships: acquire a good bedside manner (know and work your defects) to build relationships with individual patients. In addition, network with other like-minded organizations and professionals.
  3. Serve the underserved in your practice. Dr. Bruchalski used to volunteer a few hours for a free clinic, but he steered us away from that and toward what he has done with Tepeyac: he has made it a not-for-profit organization that sees patients with insurance as well as patients without.

Faced with millions of underserved or uninsured patients, many feel politics creeping into the conversation. ‘The problem is this party or that party which has made the healthcare disparities so pronounced’ (we might say), or ‘it is the overwhelming inertia of a bad education system and poverty,’ or ‘it’s the corruption of the insurance industry….’

“The problem,” Dr. Bruchalski said simply, “is us.”

By this, he meant that we don’t help things when we aren’t completely pro-life. “How much are [you] willing to integrate pro-life principles in your life?” he asked. If we put our money where our mouth is, we no longer see political parties, industry, and blame. We see people to love, and we are bothered that they are suffering. “You have been given much, and much will be expected of you,” Dr. Bruchalski told us soberly. If others are suffering, we will be expected to love.
The three principles of medicine repeat some of this content. Good medicine…
  1. Is as consistent as possible, applying the ethic of life to all situations (e.g. does not permit “social death,” the isolation of elderly patients from all friends and family once they are placed in a nursing home)
  2. Is based on relationships
    1. Among people in the community. Lowest morbidity statistics correspond to intact families.
    2. Among organizations in the community (e.g. PRCs), and
    3. Between doctors and patients (and patients’ families). Doctors who don’t see beyond physiology offend patients or (at best) don’t help. However, doctors who forge relationship do, since they aim to fight the patient’s illness with them (and Anatole Broyard says eloquently that that is what patients want).
  3. Is an act of mercy, taking the Good Samaritan as a model. It is not a political football, a job, a technique, or a science. So, the good doctor hates the disease, but loves the patient,
    1. Not permitting distance between himself and the patient (i.e. the patient is more than a click on a screen),
    2. Not treating desires, but diseases, and
    3. Welcoming back any patient who has not followed his advice (“Even if you have the termination, you are more than welcome to come back; we will always be here.”).

Physicians and all healthcare workers who follow these principles “can love enough together to make abortion unwantable.” Dr. Bruchalski has certainly made this his aim: the purpose of Divine Mercy Care, the organization overseeing (and funding) Tepeyac Family Center, is “transforming hearts through healthcare.”

Finally, Dr. Bruchalski told us that “everything you’ve learned will be required of you in a very short amount of time.”

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