Most health professionals know all about tiredness. Long hours and the demands of the job leave all of us exhausted. Here I want to address the issue of spiritual tiredness. Spiritual tiredness is a form of exhaustion in our soul, in our innermost being. Spiritual tiredness is not helped by working long hours but its source is not the long hours. Spiritual tiredness comes when we give up believing that Christ was speaking the truth when he said, 'What good will it be for a man if he gains the whole world, yet forfeits his soul?'[2]

It's my observation that in medicine it is particularly difficult to avoid this form of tiredness. Part of the reason is due to the place that medicine has in our national psyche. As Britain has become more and more post-Christian, people naturally tend to cast around for a new source of hope. One of the resources that people often look to is the doctor. The hope for a medical cure in many people's minds is the nearest they get to salvation. Hospitals become temples and doctors the priests of this new religion. In his book How to be Good, Nick Hornby portrays a GP called Katie Carr who has been caught up in this idolatry of medicine. She believes her mere status as a doctor makes her good. 'Listen.' She says,

'I'm not a bad person. I'm a doctor. One of the reasons I wanted to become a doctor was that I thought it would be a good - as in Good, rather than exciting or well paid or glamorous - thing to do. I liked how it sounded. “I want to be a doctor.” “I'm training to be a doctor.” “I'm a GP in a small North London practice.” I thought it made me seem just right, professional, kind of brainy, not too flashy, respectable, mature, caring…anyway. I'm a good person, a doctor.'

It's easy to fall in love with the status that we automatically acquire in the medical profession - to be intoxicated with the idea that the skills that we have are the answer to people's problems, because people treat us in that way every day of our lives. But there is a cynicism that follows hard on the heels of such idolatry.

When we place an unreasonable expectation on anything we are never far from experiencing crushing disappointment and cynicism. In his book The End of Christendom, Malcolm Muggeridge described this as engaging in 'idiot hopes and idiot despair':

'On the one hand' [he said] 'some new policy or discovery is confidently expected to put everything to rights: a new fuel, a new drug… world government. On the other some new disaster is confidently expected to prove our undoing. Capitalism will break down. Fuel will run out. Plutonium will lay us low. Atomic waste will kill us off.....'

This wild fluctuation is exactly what we see in the book of Ecclesiastes, a meditation on life, as the author puts it 'under the sun'. That is life without God – or at least life without God as an active loving dynamic agent in our world. In the first couple of chapters the author, who calls himself 'The Teacher', recalls that he actively explored potential sources of satisfaction 'under the sun'. He indulged in laughter, alcohol, sex, retail therapy – it didn't satisfy. So he pursued wisdom but that actually only helped him see the futility of life more acutely. Like the man who said to Dr Johnson:

'You are a philosopher Dr Johnson. I have tried too in my time to be a philosopher, but I don't know how, cheerfulness is always breaking in.'

Most especially he realised that death strikes a fatal blow to all our idolatrous hopes. We know in medicine that is shoved under our noses. Every person's medical history is terminated by what the American's sometimes rather coyly call 'a negative patient outcome' – death. Living in that world; a world where everyone is only looking at life 'under the sun', draws us inexorably towards cynicism and a profound weariness of the spirit. Then as Ecclesiastes unfolds, however, it starts to become clear that The Teacher cannot sustain his radical scepticism. Faith cannot help breaking through.

The Teacher's faith

For me that is epitomised in Ecclesiastes 11:1. Here The Teacher still affirms that the world is a chaotic confusing place. Trying to do anything of value in the real world is like scattering breadcrumbs in a river. You just set them loose and off they float we know not where. Was it worth showing real love to that patient who simply took the prescription and was gone? Would it have been less costly if we had just been distantly professional? Have I ever seen fruit from praying for my patients? Or is it all chaff in the wind?

True. It is chaff in the wind, bread on the water – all floating away we know not where. But there are results. We just need a longer perspective. The Teacher says we will see fruits 'after many days'. We may even have the privilege of seeing results in our lifetime, but there is no guarantee. Jesus was absolutely clear that the main reward is on judgment day:

'Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in.'[3]

Just occasionally we get encouragements to help us keep going. I know a couple who worked in the 1970s in a hospital in a Muslim country. Recently the wife by accident met a young man who had recently become a Christian. He told her that he had been seriously ill as a baby and his mother had taken him to the very hospital where that couple had been working. Always afterwards this boy's mother had taught him to respect Christians because she said 'it was Christians who saved your life'.

As a young adult he began to search spiritually and eventually was converted. 'Cast your bread upon the waters for after many days you will find it again.'[4]

Cultivating marks of faith

We need to cultivate the marks of faith mentioned in verses 2-6. The first is generosity or liberality. Knowing that life is unpredictable shouldn't paralyse us. None of us know which of our patients will respond to our Christian love and concern, or which prayers God will answer with a yes. So we need to be confident to give and let God sort out what he will do with the gift.

This is one reason why I'm not a great fan of a totally focused life. It's common for Christian doctors to feel that the medical profession is so demanding with so many opportunities that their whole ministry must be focused on that world. It seems to me that an undue focus on one area of ministry can in fact lead to a thoughtlessness and even heartlessness about other areas of opportunity.

The Teacher says you don't know what ministry will bear fruit so spread it around. It may be teaching Sunday school which is the real centrepiece of your crown, or involvement in that small group Bible study, or your befriending of that marginalised person. Jesus got the balance right. He had focus, 'set his face towards Jerusalem' and yet on the way he would turn aside to help people, sometimes to the complete exasperation of his more calculating disciples.

Give portions to seven yes to eight [5]

The second characteristic of Ecclesiastes-like faith is boldness. The Teacher is telling us here that once things have happened they have happened. You see a rain cloud which is ready to shed its load – it will rain. You see a tree fall in a certain direction that is where it will lie. Life doesn't offer reruns.

It may be that you know that there are aspects of your life which require attention. Perhaps it is church involvement, a call to a different ministry, to get your prayer life in order, or to be more public about your faith at work.

You have found Christ – don't waste your life as if it made no difference. A few years ago Os Guinness wrote a book which I would thoroughly recommend. It is entitled The Call. The subtitle sums up Christ's call on our lives:

• Everything we are
• Everything we have
• Everything we do

Don't grow weary. Don't grow cynical. Follow Christ – it is worth it.