Devotion

Definitions

1. Devotion in medicine: A habitual act of the will that makes the physician ready to serve the patient.
2. Love: Willing the good of another person; the outline presents love and devotion as mutually strengthening.
3. Whole-person service: Attending to the patient's health, dignity, and material, emotional, and spiritual good.

What Is Devotion?

Drawing on Aquinas's account of devotion as readiness to serve God, the outline considers its application to medical practice. The devoted physician serves a real, particular patient, including someone who is difficult to like. Devotion joins concern for that person's good with a willingness to give oneself in service.

Why Should We Practice Devotion?

• Relationships: Patients need a physician who remains attentive to them as persons.
• Healing: Care for dignity and personal well-being can continue even when cure is unavailable.
• The profession: Devotion gives personal expression to medicine's commitment to beneficence.
• Meaning: Seeing the good served by daily work can deepen the joy and purpose found in it.

How Do We Practice Devotion?

1. Know the patient: Learn what matters to this person and what illness has changed in their life.
2. Practice presence: Give your attention to the patient before you rather than remaining mentally scattered.
3. Serve faithfully: Let repeated acts of duty strengthen affection and willingness to care.
4. Balance responsibilities: Attend to justice toward family, friends, and other patients as well as devotion to one person.
5. Accept human limits: Accompany patients well within medicine's limits, and be fully present with family when you return home.

Clinical Case 1: Devotion Under Pressure

You are a medical student shadowing a senior family medicine resident in clinic. The resident is seeing at least twenty patients a day, sometimes up to 12 per half day, and you do your best to keep up and see patients alongside of her. You’ve observed several instances in which the patient seems to have more going on than the resident can adequately address in the time-allotted in her clinic schedule. Just yesterday a patient asked a question while the resident had her hand on the doorknob, ready to leave the room. The resident interrupted her tactfully and asked her to make another appointment, apologizing that she doesn’t have the time she wishes she had.

You decide to ask the senior resident about this. She is typing in the electronic health record, pauses, and says: “You just have to do what you can in the slots you’re given. You could invite the patient back for a longer appointment like I did, but probably not every time—and honestly I’ve tried that a lot and they don’t always come back. And at some point I have to get home. I can’t give every patient the extra 15 minutes they might need. Maybe once I’m out of residency and have more control over my schedule... There’s just no time right now.”

Clinical Case 2: Devotion to the Patient

You are a primary care clinician in an outpatient clinical setting. Ms. Davidson is a 78 year old widow who you established care with 6 months ago. Since that visit, she has visited you every two weeks, each time with a long list of complaints that usually have no actionable endpoint or even clinical importance. You’ve been praised before on your patience and listening, but today you’re behind, and Ms. Davidson senses your frustration. She says “I know I’m a handful. I just don’t have anyone, and I get anxious. Other doctors have told me they need to set boundaries with me, but I’m not stupid. That usually means I just end up talking to random clinical staff because they don’t want to talk to me. I’m just looking for a doctor who will stick with me even with all my questions. Are you that kind of doctor?”

Sources: LearnWorlds outline; Canva one-pager, page 12.