Embracing discomfort for the sake of others

Physician Tom Catena offers powerful reflections on the joy of service at 2025 Rev. Bernie Clark, C.S.C., Lecture

November 19, 2025

Everything was looking up for Tom Catena upon his graduation from Brown University in 1986. A first-team All-Ivy defensive lineman on the Brown Bears football squad, he graduated with a degree in mechanical engineering and a job offer in hand for a lucrative career with GE. 

“I wanted to go to college, do my four years, get out, and start making a bunch of money,” Catena told a capacity crowd on November 12 at the Institute for Social Concerns’ 2025 Rev. Bernie Clark, C.S.C., Distinguished Catholic Social Tradition Lecture. “So what did I do? I went to school for the rest of my life, and I don’t make anything.”

A cradle Catholic, Catena learned about mission work from a group of evangelical Christians on campus while he was still a student. Sensing a call to the mission field, Catena turned down his job offer and went back to school to become a medical missionary.

Catena attended medical school on a Navy scholarship and eventually made his way to Kenya, where he worked in a rural hospital for two and a half years before moving to Nairobi, where he spent five additional years as a consultant at St. Mary’s Mission Hospital. 

While in Kenya, he kept meeting people coming from Sudan who would tell him, “If you think Kenya is a challenge—if you think there’s a need here—you should see what it’s like in Sudan.”

“Being a glutton for punishment and somebody who really wanted to go where my limited services were needed,” Catena recalled, “I thought, ‘That’s the place I want to go to.’”

Now having worked for 17 years as the only full-time physician at Mother of Mercy Hospital that serves over three million people in the Nuba Mountains of South Kordofan, Sudan, Catena shared that he has no regrets.

Which is not to say that he faces no challenges. 

The people of the Nuba Mountains have been oppressed for centuries and are now caught in the middle of a protracted war. There are regular bombing raids, requiring hospital personnel to seek shelter. Most of the men in the region are enlisted in the war, returning to the hospital with some of the worst injuries imaginable. And, as the only physician in the region, Catena works long hours and is always on call for emergencies.       

Moreover, in his talk—styled as a “fireside chat” with Suzanne Shanahan, the Leo and Arlene Hawk Executive Director of the institute—Catena joked that if you type “end of the world” into an online search, “the Nuba Mountains will come up.” He explained that there is neither mail nor phone service. The hospital has to order a year’s worth of supplies from Kenya or South Sudan all at once, and it takes them months to arrive by truck traveling a treacherous route that is only passable for a couple of months out of the year. 

And yet, through all the challenges, Catena finds true joy in his work. Reflecting on the distinction between happiness and joy, Catena described how the emotion of happiness waxes and wanes based on everyday circumstances, but “joy is the feeling that you are where you’re supposed to be.”

“You get up in the morning saying, ‘I am where I’m supposed to be. What I’m doing today has meaning. What I’m doing makes my life meaningful. I have a job which is fulfilling.’”

Catena told his rapt audience in the Eck Center Auditorium, “If you can have a job or can have something which gives you meaning, you can get through anything.”

Drawing on Austrian psychiatrist and Holocaust survivor Viktor Frankl’s classic text Man’s Search for Meaning, Catena described how people in the West suffer from “existential boredom.”

“I’m doing all this stuff; I can’t get any meaning out of it,” Catena paraphrased. “Everything is kind of bland and cardboard and tasteless—like the food in the Nuba Mountains. It’s just not fulfilling.”

In contrast, Catena said, “If you have meaning, you can have joy.”

Catena’s remarks were fitting for a lecture series that honors Fr. Bernie Clark who died young but influenced students with the life lesson of a “theory of enough,” a philosophy that encourages people to shift from a mindset of endless accumulation to one of sufficiency and gratitude.

In his introductory comments, Dr. Donald Zimmer recalled the welcome message he received from then-president Rev. Edward Malloy, C.S.C., when Zimmer entered Notre Dame as a wide-eyed first-year student in 2000. 

“Welcome to the University,” Fr. Malloy told incoming students. “You are not here to be comfortable.” 

Zimmer recalled thinking that Malloy meant “that organic chemistry was going to be really, really hard.” He later learned what Fr. Malloy meant when a philosophy professor asked whether you should help a child somewhere in the world if it would only cost you the small sacrifice of ruining a pair of shoes, a backpack, or a laptop or losing a bit of your time.

“I remember being so struck by that thought-provoking question, but I wanted to know whether the premises could be true,” Zimmer said. “Could you really save someone’s life for such a small personal sacrifice? So that question led to the Institute for Social Concerns and ultimately, to my international summer service learning program in Honduras, specifically in San Pedro Sula, and later to Kenya and Haiti.

“And what I have found is yes, the premise is true. The argument is sound,” said Zimmer. “The question then becomes, ‘What’s next?’ Our speaker tonight, Dr. Tom Catena, has spent his life living the answer.”

Dr. Catena’s life, said Zimmer, “embodies what it means to embrace discomfort for the sake of others—the very challenge that Father Malloy offered to all of us.”

During his remarks, Catena confessed that his work would be impossible if not for his faith.

“If I were not a practicing Catholic, I would not still be there,” Catena said. “There is absolutely no way you can stay in that job—do it day in and day out—if you’re not a person of faith. I don’t think it’s possible.”

For Catena, the psychological trauma of seeing people he loves and cares for die on his watch is only possible to endure because of his hope as a Christian.

“Without that Christian hope that there’s something else beyond this world,” said Catena, “there’s no way I can stick it out. I couldn’t do it. It’s too much.” 

Asked whether he ever experiences burnout or a crisis of faith, Catena responded that there’s “never a question if this is the right place.” Despite having endured the 30 or 40 worst days of his life in the Nuba Mountains, he said, “There’s not any one time I felt, ‘I want to be anywhere else in the world but here.’”

Drawing on insights from Dr. Farr Curlin at Duke University, Catena described the two main reasons physicians face burnout. First, their practice is not varied, and, second, their practice falls short of the high expectations they had for themselves in medical school, as they end up spending more time doing paperwork than caring for patients. 

“Those two things Dr. Farr brought up, we have in spades,” said Catena. “Every day is a huge variety of cases—sometimes too much variety—and I never expected I have to do all these things, so I’m always at the limit of my knowledge, always having to study and learn more and keep current on things.”

“It’s a constant battle to keep up, which is tiresome and exhausting,” he shared, “but it doesn’t lead to burnout.”

Dr. Catena concluded by offering direct advice to those aspiring to become physicians who find his path inspiring but might feel that they are not able to follow in his footsteps.

“First, pick your profession, if it’s medicine, based on your love of medicine and not for any other reason—not for money, not even that you want to do mission work.” For Catena, the desire to study medicine should come from love of the sciences and love for working with other people, not because of a desired placement after graduation.

“Second,” he said, “is picking your specialty based on what you like.” Instead of picking a specialty based on a perceived need in the developing world, he counseled finding a specialty that fits what you love to do and then finding ways to use that specialty to help others.

Finally, instead of going straight to the Nuba Mountains or another war-torn area immediately upon graduation, he advised students to “go for a soft landing” and get acclimated there before working their way up to more difficult placements.    

The annual Rev. Bernie Clark, C.S.C., Distinguished Catholic Social Tradition Lecture was created in 2009 to highlight justice issues and themes from Catholic social tradition related to human dignity and the common good. It is one of the institute’s signature lecture series. Past lecturers include Bryan Stevenson; Sr. Norma Pimentel, M.J.; Rev. Greg Boyle, S.J.; and Sr. Helen Prejean, C.S.J., among others. The event was also part of the 2025–2026 Notre Dame Forum, which is organized around the theme “cultivating hope.” It was co-sponsored by the Berthiaume Institute for Precision Health, Center for Health Sciences Advising, College of Arts and Letters, College of Science, Cushwa Center for the Study of American Catholicism, Department of Africana Studies, Department of Biological Sciences, Department of Theology, Eck Institute for Global Health, Keough School of Global Affairs, Kroc Institute for International Peace Studies, Hillebrand Center for Compassionate Care in Medicine, Pulte Institute for Global Development, and the Office of the President.

All photos by Peter Ringenberg for the University of Notre Dame.

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