Theology, Medicine, and Culture (TMC) Fellowship alumna Danielle Ellis, MD, MTS is a surgical resident known for praying with patients, singing in the halls, and wearing gold hoops with her uniform. She is also the fifth Black woman in general surgery training at her institution since it began in 1811. Below is an edited transcript of TMC’s conversation with her.
You participated in the TMC Fellowship between your third and fourth years of medical school. What questions did you bring to the program?
I came to medicine pretty much as a function of my faith and was asking, “How do these overlap? I’m not really sure.” By the time I was in my third year doing clinical rotations, my questions were much more tangible. I was doing advanced rotations where you’re more engaged in conversations with families at the end of the patient’s life. Especially when I was in the ICU, almost every night I was having dreams about patients. And I thought, “How do I stop this from happening?” I asked one of my attendings whom I trust a lot. He said, “You cannot keep getting involved with people. You have to just keep everybody at a distance.”
But, I worked that weekend on a Sunday, and TMC orientation started on Monday. I remember I had reverse whiplash; I felt like I was going like 90 miles an hour, and then I was in divinity school orientation the next day. During one of the sessions, Dr. Kinghorn [TMC Co-director] said something like “many of you in the TMC will wonder what it means to be present with people and how to do that in a way that is honoring to them.” I remember going to him afterward and saying, “So let me explain the situation to you (and by the way, nice to meet you). I was having all these dreams about my patients, and my attending told me to stop getting involved in their lives. What do you think about that?” He said, “I think you’ll come to find an answer to that over the course of your time here.” And I thought, “This is the least satisfying day of all time.”
Can you talk about how your experience of the TMC Fellowship has borne fruit in residency?
The biggest signpost of my faith is the MTS on my jacket, the modern equivalent of the white coat. Most people don’t know what MTS is. I probably get a question about what it stands for once a day. When I respond, “Master of Theological Studies” they usually ask me a follow up, such as, “how do you think that that’s related to surgery?” I will talk about how most of the world is religious and most of the world at some point will have a surgical need. So for every person I come across, there’s probably some extent to which they have a question–even if it’s something as straightforward as getting their gallbladder out–that might be related to their faith.
Some people are confused and think I’m a chaplain. So, what ordinarily happens is that people I’ve come across in a cursory way will circle back to me when something arises. There was a patient who had been in ICU for a long time and he was dying slowly. What the ICU wanted was for his family to [transition to less intensive treatment]. But the family was quite faithful and was waiting for a miracle. My colleagues said to me, “Oh, this is perfect for you.”
I had a really hard conversation with the family. I asked them, “Can you think of a time that God has ever said ‘no’ to a miracle?” It was almost Easter, and we ended up talking about when Christ says, “If it is your will, let this cup pass from me.” It’s a time that God said “no.” I almost always offer to pray with people, and I prayed for them. I was sobbing. The nurse said, “I’ve never seen a doctor pray with a patient.” I thought to myself, “What a surprising thing for someone who works in an ICU.”
Sometimes I feel like it would be better if people didn’t know [about my TMC training] so they wouldn’t call me in to say, “Hey, can you come talk to this family?” It can feel like a lot of pressure, but in the moment, I find it very freeing to be able to have conversations like that.
Last Spring, about a year after you graduated from the TMC Fellowship, you wrote about racism as a cancer in the church. Can you address your experience of racism in the medical realm?
One morning, I caught the elevator with my foot instead of my hands to keep it open for one of my attendings who was trying to get on. He then said to everyone in the elevator, “she’s smart—she caught the elevator with her foot, because she needs her hands. I know you wouldn’t think it by looking at her, but she’s a surgeon.” After that, I joked around with him a bit, and probably an hour later, I thought, “Wait a minute, what in the world did that mean?” What that means is he does not think that I look like a surgeon. I could come up with any number of things about me that don’t look like a surgeon, but it would be hard to pinpoint just one or which one I think he was talking about. This attending, whom I respect and admire, is susceptible (like all of us) to seeing people through a vision we’ve been taught to develop.
Those kinds of things happen all the time and make me wonder if everybody is as excited about me being here as I am. Those kinds of things are death by a thousand cuts. Do I really not behave or conduct myself like a surgeon? And what is it? And then if that’s true, then what does that mean? Do I need be more serious and straightforward so that my attendings or my patients think that I’m someone who should be doing the job to which I feel called?
What do you see as one of the most pressing needs for medical trainees today?
I think people are afraid to be authentic—young people because they worry that older generations will think that they’re not dedicated or competent, and older people because they worry about getting reported or being seen as “out of touch” by the younger generations. Particularly some of the moms talk about how some of the more senior males ask them, “How do you plan on really making this work?” They have this idea that the women are not really going to be developed as well as surgeons because they’re also moms.
I’m currently writing about borrowing [the church’s practice of] confession and bringing it into medicine. In surgery every week we have a conference called Morbidity and Mortality, where all we do is talk about our errors. It’s incredibly humbling. The whole point is to be honest, and to be able to say in front of this whole group, “I messed up.” How can we all learn from that and be better surgeons? The purpose is to not blame this person for their error, just as in confession you are honest before God via a mediator who is letting you know that you’re already forgiven.
There’s something edifying about this practice. In my ideal world, we would all show up to confession as a department. People would say things like, “I really don’t understand how it’s possible for our female surgical residents to have kids.” They would just say that, so that then the female surgical residents could say, “Well, what about your life and your demographic and your experience influences you to think that? What ways could we be redesigning our system to make it possible?”
Over the course of the TMC Fellowship, did you come to find an answer to that question you asked about getting involved in patients’ lives?
Yes. One answer that I got was a re-imagination of knowledge and wisdom and an appreciation for there being ways of behaving and thinking and seeing that are functions of habit, and not things that can be imparted in a moment. That was really valuable for coming to appreciate that we’re all evolving, constantly being reformed and becoming amateurs again. That has been very humbling, but also it has been really nice to project onto training itself and acknowledge, of course, I don’t know what’s going on in the same way the chief residents do. Why would I? So it has been comforting. But in terms of actually answering the question—“how does one remain present without becoming inundated with people’s lives, but also not totally withdrawing from them?”—I felt like TMC was the incarnation of that. We talked so much about really challenging and heavy subjects. Forming the habit of having to show up, to class, to spiritual formation, to conversations, and social gatherings with your co-fellows is what it looks like and feels like to be present in difficult spaces that are really charged. I’m really appreciating the moment to moment dependence on the Holy Spirit’s wisdom [I learned during my time with TMC]. The formation of the habit of attending to, being present with, and relying on, was ultimately the answer to that question I had when I started.
Also, listen to her reflections on inhabiting the Christian story during medical training:
Excerpt (2 min 30 sec):
Full presentation (8 min):