it has taken me so long to get this blog going because of my perfectionist nature.  instead of getting something out there, i let myself be guarded by inhibitions.  it doesn’t have to be perfect - it just needs to be real.  straightforward, thoughtful, honest.

so here is my point of musing for the day - what draws people to engage in service? and, more importantly, what are the implications of a service relationship?

how much is one’s service selfless and altruistic, and how much of it is completely driven by one’s own selfish need to feel good about oneself?

kant always claimed that we are inherently selfish, that nothing we do is purely for the good of another person, without it at least to some degree having some positive impact on our own lives.  if we do it because it makes us feel good, it’s still selfish, even if it is unpaid, often thankless, hard work.

but still, who cares?  maybe it is selfish that we do it.  does it matter, if the end product is that someone is better off than he/she might have been without this service?

i think what can often prove to be more problematic is the way in which we view our relationships with the individuals and communities we serve.  is there a power differential?  i’d posit that there most definitely can be, and that’s where the issue lies.  is the volunteer viewing him/herself as somehow inherently better, because he/she possesses skills or resources that the individual or community being served lacks in some way?  or, in fewer words, is there a divide between the “have’s” versus the “have-not’s”?  or are we cognizant of the threat of a power differential and thus do our best to make it a mutually beneficial relationship?  for example, the person in need benefits from a particular service or resource, while the volunteer gains valuable insight on the struggles faced by the person or community in need.

the best example i have of this is when i served as a community mobilizer in mexico.  intellectually, i was able to understand the indigenous community as an intimate group of individuals, working hard to ensure that their basic needs were met, despite a lack of resources and education.  surely, my group of volunteers had skills and materials to make things happen that otherwise would have been lacking.  one instance of this was our initiative to work with local families to create stoves that were environmentally friendly and better for respiratory health.  we, as volunteers, had the resources and knowledge to create new realities for this community, but still, the community members laughed because i couldn’t wield a simple tool they used for building.  “stick to books”, they joked - but it was actually an incredibly refreshing moment because it highlighted that i, as a service provider, don’t have all the skills and knowledge.  while i might have been able to bring the community together for innovative projects, and teach english, and connect with the children, there were things they could teach me, like how to make tortillas, or use a huingaro (the tool that mystified me), or even keep my spirits up despite the long days of hard physical labor.  and that was the beauty of our service relationship - the give and take - no one was better than another.  it was simply a mutual exchange of talents, energies, and insights that led to community action.

i have known many community activists to carry what i like to call the guilt of privilege.  we are often unaware of the privilege we carry with us - whether it is having an affluent background, or attaining higher education, or even having white skin - until we work with those who lack those things.  then we become painfully aware of all that we have.  and with that awareness often comes a great deal of guilt.  we ask ourselves, why did i deserve to have these things, while others are suffering because they lack these same things?  over the years, i have learned to shed that guilt and instead work with something much more constructive - empowerment.

what does empowerment mean?  i view it as an uplifting of spirit. it is not something that can be accomplished alone - you will find no proponent of the simple “bootstraps” philosophy writing this blog.  nor is it a simple act of service in which someone does something for someone else, and the recipient of the service benefits.  it is more complex than that.  the recipient perhaps has a goal in mind of what needs to be accomplished, but is in need of something from the service provider - be it resources, knowledge, or support - to achieve that goal.  the service provider helps bridge the gap between the recipient’s current state of need and a future state of fulfillment.  the provider does not simply do something for the recipient.  the recipient is provided with a missing piece of the puzzle, and then completes the project through his/her own devices.  i find this to be the ideal way to engage in any service relationship, and something that i hope to model my future practice after as a physician.  i wish to work with patients at a level and pace that is comfortable for them, having honest conversations about how we can work together as partners to keep their health and well-being on track.  this has been the most effective way for me to enact change in the past, and i envision it as an invaluable tool for ensuring positive health outcomes in the future.

it is this mutuality, this give and take, this partnership, that i strive for in all my service relationships, and i encourage you to explore this if this is a new concept to you.