Family History

By Leslie Walker, MD

Recently, my 11-year-old daughter was screened for a research project at Case W. It will compare functional MRI scans of bipolar children with healthy children at two-year intervals to look for differences in development and function. I thought that the biggest hurdle to her acceptance in the study would be getting her retainers removed. But when the screening questions moved to family history of psychiatric disorders, I realized that she might be in trouble.

Have you ever taken your own family history? What illnesses run in your family? One of the really interesting findings I learned about 10 years ago was from a study that looked at medical, dental and law students. They were asked whether they had a first-degree family member with a history of depression or other mood disorders. The medical students were far more likely to answer yes. The authors hypothesized that having a family member who was ill might cause individuals with caregiving traits to enter medicine. But the consequence might also be an increased risk of depression in the doctor. This might be especially true in women physicians, since we have a 40 to 70 percent lifetime prevalence of major depression, and triple the risk of suicide of our non-physician friends. Professionally, one of the best parts of my job is treating women physicians, because they usually get better, and because I know that when they get better, it not only benefits my patient and her family but also her patients. It's really rewarding. But it's still a frustrating risk factor.

And for my daughter, having a family history could mean exclusion from the study, which would be too bad because she already had a plan for the compensation checks. And I was in the unexpected position of trying to explain to her why even if she didn't have an illness, the investigators might be concerned that her brain was vulnerable because of her family history. She has a second-degree family member who had a serious suicide attempt several years ago. That alone might be enough for them to be concerned that she might not be a true healthy control for their study. "That's not fair!" she said.

What about our family history as Christians? I've been having faith discussions with one of my friends. A sticking point for her is the concept of original sin. She had a Christian family member point at her newborn baby and say, "For all have sinned, and fall short of the glory of God" (Romans 3:23, NIV 2011). She was so angry and upset, she left the room. Unfortunately, her relative didn't add the corollary from 1 Corinthians, "For as in Adam all die, so in Christ all will be made alive" (1 Corinthians 15:22, NIV 2011). But my friend was struck by how unfair it seemed to see an innocent baby as sinful from birth. But the family history we carry from our ancestors Adam and Eve is that sinful nature.

So when we struggle with sin, we're in good company. The apostles Peter and Paul are part of our spiritual heritage as brothers in Christ, and their sinful acts are recorded for us to read about. How would you like it if your sins were forever recorded in the Bible? And yet, the rest of the chapter in 1 Corinthians 15 reminds us that, "The sting of death is sin, and the power of sin is the law. But thanks be to God! He gives us the victory through our Lord Jesus Christ. Therefore, my dear brothers and sisters, stand firm. Let nothing move you. Always give yourselves fully to the work of the Lord, because you know that your labor in the Lord is not in vain" (1 Corinthians 15:56-58, NIV 2011). Wow. So, yes, our family history leaves us vulnerable, yet we can move forward in what God calls us to do and know that it counts. When you do what God has called you to do, it really matters, at work or at home.

That's what I had to teach my daughter. Yes, we have mental illness on both sides of the family, probably like a lot of you. Unfortunately, mood disorders are very prevalent. But that vulnerability should never keep her from doing whatever God calls her to do, even if the PI decides that it will keep her out of this fMRI study. We'll see. Right now, she's pretty confident that she will be an engineer, a graphic designer or a children's minister. And she wants to be a wife and mom. I'm letting you all know, secretly, that she would be a GREAT psychiatrist. But her family history doesn't define her, and it doesn't have to keep her from doing great things.

For all of us, our shared sinful nature is a vulnerability, but don't let the struggle with sin ever keep you from following Jesus where He calls you to go. Get the support you need from friends you can trust. Confess your sins and be honest about your struggles, so that we can support each other as we are forgiven and cleansed (1 John 1:9), and seek to live upright and godly lives (Titus 2:12). At the CMDA National Convention in early May, we had a great opportunity to share openly with other women in medicine who can keep our struggles in confidence, even while we pray for each other and encourage each other. None of us are perfect. My talk last September about my ongoing struggle with the sin of gluttony has given me new sources of accountability with friends, which is sometimes painful and always humbling. But that reminds me of how much they care, and how much they, like Jesus, want to see me become "holy and blameless" (Ephesians 5:27, NIV 2011).

If you are looking for an opportunity to pursue more depth and growth in your life with Jesus, and to look honestly at your sinful nature, WIMD has two options that you might want to consider this year. Our small group GPS weekend retreats, Grasping Power through Surrender, are for six to eight graduate physicians or dentists. These are facilitated by Rev. Marti Ensign, a mature woman with seminary training and a long history with women in medicine. We have two this year: Oklahoma City from July 18-21, and Seattle from October 24-27. The second option is to come for a whole weekend of WIMD at our national conference in Dallas, September 19-22. Our theme this year is "Shine Like Stars, Hold to the Word" from Philippians 2. Our goal is to support each other as we live our faith, pursue holiness and hold fast to the Word of Life. I really hope to see you there.