Is Medicine Not Enough?

by Lewis Carter

Today, I am concerned for missionaries in service-type ministries who must satisfy supporting churches and justify their financial support by adding on a church planting activity to an already busy schedule.

When my wife and I first went to the mission field in 1974, our goal was to practice the best medicine possible at Egbe Hospital in southern Nigeria. We worked long hours and gave our best to the patients. Our patients were our mission field as they came to us ill and in great need both medically and spiritually. We felt that the Lord sent those to us who were ready to hear the gospel. Many trusted the Lord including a large number of Muslims. Though I personally witnessed to many, I relied on our hospital chaplains/pastors to speak to the patients in their own language and to confirm any decision to follow Christ. The chaplains understood the culture from which the patients came and could determine the sincerity of their conversion experience or whether it was just a desire to please the white doctor. Many seriously ill patients came to us and a high percentage of those in shock from trauma or infection or those with cancer trusted in Christ. I went out with our local Nigerian church’s gospel team on Sunday afternoons if the hospital was quiet, but I did not feel compelled to do so to be a complete missionary.

We never thought of our patients as just diseases or injuries, but as needy individuals whom God sent not only for our specialized care but also prepared to hear the gospel. It often takes a life-threatening illness or injury to cause us to look seriously at eternal matters. I tried to give extra effort and time to care for the most seriously ill because I knew a large majority of these would trust in the Lord, especially if they recovered. I would visit and review their condition many times each day even if overwhelmed with other routine cases. We also had wonderful hospital chaplains who would spend time with each patient every day. I would usually discuss critically ill patients with the chaplain assigned to their ward so they would understand the patient’s condition and probable length of time in the hospital. God brought opportunities for evangelism to us and we had a wonderful platform—medicine—to share the gospel with our patients and especially with our Muslim patients. Since we offered the best possible care in our area of southern Nigeria, the hospital was always crowded.

Our hospital chaplains knew the home villages of our patients, and they understood not only their culture but also any difficulties the patients might have if they returned home as Christians. Our chaplains would visit these villages and follow-up on the patients who came to Christ. They would ensure each new believer was introduced to a pastor and a church in his or her community. At no time did I feel the need to leave the hospital for some outside ministry that would justify my role as a missionary physician. Any free time was spent in staff teaching or in improving the hospital and the care given. I felt that a patient’s response to the gospel was related in some degree to the quality of care he or she received.

When I first went into missionary medicine, the excuse other doctors often gave for not going—even though called—was the great demand on a doctor’s time at mission hospitals, leaving little time for family. In reality, even then a missionary doctor spent more time at home than a doctor in practice in a home country. Today, some give the excuse that there will not be time for outside evangelism which they feel must be done in order to be a complete missionary. Many doctors want to be doing some real missionary work, i.e. church planting. Unfortunately, home churches have emphasized this and some churches have dropped missionaries who are not involved in church planting. Several mission boards are also gradually eliminating missionary positions in service roles. Do we forget that in the last century missionary medicine has been used by God as a primary evangelistic tool and many churches have been planted as a result?

At one hospital, the doctors spend an afternoon each week, but not on their day off, in the local city or with a nearby tribal group for evangelism or handing out food or clothing. It is certainly praiseworthy to look at the needs of those in areas around where you work, but at this hospital the patients were lying in beds staring at the ceiling all day long with hardly anyone to talk to them about the Lord. The hospital chaplains are often not aggressive in their evangelistic efforts, and do not talk to each patient every day. Many of the patients are seriously ill and open to considering eternal matters.

Furthermore, they may be from the same tribal area where the missionary doctors visit each week. The mission field has come to the hospital, but the missionaries have left the hospital. At the hospital the patients have already entrusted their lives to the doctors, but the doctors leave the hospital and those whose hearts have been prepared to hear the gospel.

When a doctor leaves the hospital he or she is going to a place where there has been little groundwork and possibly no heart preparation. So instead of witnessing to their own patients who are seen each day on rounds and who respect and trust their doctor, and where the seed has already been sown—often with extensive life-saving surgery—they are out searching for someone to evangelize cold turkey. There is nothing wrong with cold turkey evangelism, but only a few have the gift for such outreach. This is not to say that the Spirit of God cannot and does not prepare the hearts of those who are approached for the first time with the gospel. He certainly can, but doctors and nurses often leave an obvious God-given mission field to develop their own and on only a once-a-week basis.

In Nigeria I never had time to take a day off and never even considered taking an afternoon off just for evangelism. Evangelism was a part of every day, whenever I perceived a need. Also our hospital chaplains saw each patient before discharge and were required to write a note at the bottom of the discharge sheet where there was a place for “Pastor’s Comment.” This note stated that the gospel had been presented to the patient and his or her response recorded. I have seen this practice in only a few of the eighteen mission hospitals my wife and I have visited over the past eight years. Since many different tribal languages were spoken at the two hospitals in Nigeria where we served, there was no way I could speak to each patient in his or her own tongue. Usually our chaplains spoke more than one language, so they could discuss the claims of Christ with almost every patient.

I think it is imperative that the missionary doctor sit down with the national church leaders and explain that they came to their country as a missionary first and then a physician. Sometimes the church leaders look upon missionary doctors only as care givers and do not realize the doctors have a heart for evangelism. When we were missionaries in Nigeria in the 1980s, I requested that the church leaders assign some of their best pastors to our hospital as chaplains. I reminded them of my real motivation for coming to Nigeria, and how I realized the pressure of work and demand for medical excellence would not allow me to witness to each patient as I would like. National church leaders usually have great respect for missionary doctors. Often the missionary is their personal doctor. I have found these leaders willing to grant the missionary’s request if asked. Unfortunately, a mission hospital may often be a dumping ground for retired or sick pastors who are slowing down or have not worked out as church pastors. These may be ineffective as hospital chaplains.

In small rural mission hospitals, where there are only one or two doctors, leaving the hospital for evangelism is not really possible since one is so busy and often on call. One reason young missionary candidate doctors do not want to go to small mission hospitals is just that—there is little chance for outside ministry because they must work at the hospital day in and day out. There seems to be a strong feeling in our home countries that each missionary must be involved in real church planting, and missionary doctors must do more than just care for patients. Unfortunately, time is spent on outside ministries instead of building relationships with patients or improving the hospital. It is not unusual for emergencies to arrive just when the physician has left the hospital to justify his missionary status.

This attitude seems also to be prevalent among other service-type missionaries such as MK teachers. The work they have been called to do is just not enough to be a real missionary. Recently we received a prayer letter from MK teachers. They listed several evangelistic activities they hoped to be involved in off-campus in their free time even though they also had their own young children to care for. I ask, “Is MK teaching not enough?” or “Is MK teaching only a part-time job?”

Few of us can do more than one thing well. Doctors should put their energy into giving patients the best care possible, showing them Christ-like compassion, and allowing the Spirit of God to do what only he can do—prepare hearts.

There are exceptions. First, occasionally God gives a unique outside evangelistic ministry to a missionary doctor. In such cases it is usually obvious the doctor has a special calling and special God-given ministry skills. In addition, in these rare exceptions, God has also provided sufficient doctors to carry the patient load at the hospital. Second, I am not referring to a ministry such as teaching an evening or weekend Bible class.

Today, I am concerned for missionaries in service-type ministries who must satisfy supporting churches and justify their financial support by adding on a church planting activity to an already busy schedule.

“Is medicine not enough?” I think for the majority of missionary doctors it should be. After all, God has brought our mission field to us. There are more than enough opportunities at our God-given mission field.

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Dr. Louis Carter is a general, plastic and hand surgeon with SIM. He and his wife, Anne, an OR nurse, teach missionary and national doctors at various mission hospitals each year.

EMQ, Vol. 40, No. 1, pp. 38-41. Copyright © 2004 Evangelism and Missions Information Service (EMIS). All rights reserved. Not to be reproduced or copied in any form without written permission from EMIS.

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