Citizen

Salem Lake

Springtime by Salem Lake

A revolution is breaking out where you’d least expect it: North Carolina. This one started as an accident, as many do. The McCrory administration pushed through a commitment to outsource the NC Medicaid program to managed care organizations, then caught its gender-appropriate appendages in the bathroom door and got laughed out of office the next election. Democrat Governor Cooper couldn’t reverse the policy, but his Secretary of Health Cohen got the national HHS to approve a tweaked version focused on the “social determinants” and accelerating the integration of mental health.

This is once-in-a-generation change in the relationship between the government (city, county and state), the large healthcare providers, public health, social service and the rich ecology of community organization and entities. This bets many billions of dollars on social science relying on a complex array of policy, practices and people negotiated and aligned very quickly.

All of this has to work somewhere first. So, way down in the weeds of the policy is a $650M experiment piloting the social sector integration in a few multi-county regions, one of which is likely to include the rolling hills of the Piedmont ,where FaithHealth happens to live. We’ve been meeting for a year, but last week about 140 people from the hospitals, government and social sector spent a day figuring out what this might mean. We gathered at Salem Lake, a city reservoir that earlier civic minds had created so that the citizens could drink clean water. We think the same way about helping our most vulnerable find other things as important to health.

moment_photo_6a86f46eI am amazed that the winding path of Medicaid transformation has led to this opportunity align and connect these sectors differently. And this pilot comes with enough money to do something new at scale : $2-300M to the social sector partners—not hospitals.

Two caveats give pause. First, while this should be enough cash to do something new, it is only about 20% beyond the run-rate of the social sector in these counties today. It is possible—even likely—that those millions would disappear like water into hot sand, merely filling in the current gap in funding that every social sector organization struggles with already.

Secondly, the money is still tethered to medical Medicaid. It is for members of the program who will experience “case management” for social stuff just as they do for pills. A doctor with a computer prescribes social things from a short list.

Here’s a science tip about social determinants. They are social. If they are not social, they do not determine anything. The state has identified four kinds of “healthy opportunities” to aim hundreds of millions of dollars at very narrow set of predetermined services. They will not be healthy, if the money just triggers computer-directed interventions at people with no names living on streets with no names. Social.

This bold—and noble—social experiment is taking place very early in the field of social determinants. We’ve discovered that you can put social indicators in our computers and spit out lists of things that are missing in hopes that people will cost less and do better. People are not things who just need things. We humans need, above all, to have other humans in our lives when we enter a time of dependency, on our friends, family and the kindness of strangers, such as insurance companies. Wires fool us into thinking we are doing social when we are just doing wires.

Most human phenomenon are more complicated then they seem at first touch. Our current phase of engaging “social determinants” –healthy opportunities—is rather like adolescent sexual opportunities, which are experimental and clumsy. It gets better when the relationship does.

img_2907Salem Lake is ringed by a wooded seven-mile trail because when the citizens needed water, they built a dam and let the forest grow. In early spring you can see the wounded and down trees amid the tall ones. The loam through which the rainfall moves to the lake is from oaks long past. The trees are why the lake is clean. There is another way: you can clean all the crap out of the water with machines and chemicals rather like a hospital does with ill populations. That mind would see the trees as 2×4’s standing as a poorly organized lumber-yard.

James C. Scott, writing about the German Black Forest, described this as “seeing like a state,” which are usually not smart about how living systems produce trees and healthy humans. Citizens and neighbors have to be smarter.

Nobody in the room behaved normally, beginning with Mayor Joines who was the one to guide the leadership of the pilot toward the Piedmont Triad Council of Governments where Blair Percival flipped his skills honed with senior programs toward the moms and kids of Medicaid. All three health directors were involved even though Medicaid is not theirs. Tim Gallagher, a former Deloitte consultant now working through the NC Association of Free Clinics under Randy Jordan (who is helping the free clinics understand their stake in Medicaid transformation). Jamilla Pinder opening with a personal story that turned all the professionals into humans. Hospital folks saying “we.”

The piedmont of North Carolina has been integrating medicine into social and vice versa since the Moravians came South on the great wagon road a quarter millennia ago. One of those 14 men was a physician smart and humble enough to learn herbal wisdom from the Cherokee. The Greensboro Quakers and High Point Methodists had their own way. It is now a crazy quilt of government, schools, industry with layers of immigrants finding how to blend into the old neighbors. The forest of assets mingle and dance with possibilities.

The Medicaid pilot is an invitation to think to the limits of what works and then reach beyond. It would be silly to expect one five-year pilot to heal all the wounds of poverty and race with only $200 million. It won’t do that. For one thing, the members of Medicaid don’t stay in the program very long. Four out of five “churn” in and out every year. Any one of them is a moving target. But while the individuals move, the phenomenon of poverty does not—it pretty much stays in the same, obvious, known neighborhoods. Medicaid, which is still tied paying for services to its members, can’t break the cycle of poverty, because that phenomenon is social. It happens to types of people living in neighborhoods. The current Medicaid challenges are the best our system can do at this time, but not tuned to the real drivers of cost and care.

img_2905We should be grateful for what we have to work with, but not expect this one program to do all we hope for. It doesn’t need to. Dr. Kevin Barnett, who keynoted at Salem Lake suggested that if we get the relationships right, we could unleash way more to weave with. Getting the social, governmental, health and faith systems into alignment would all by itself free up another $200 million worth through efficiencies and synergies currently trapped in our siloes. Then, we might be able to see the neighborhoods as places ripe for investment in affordable housing and economic development.

Hospitals are required to have hundreds of millions of dollars in the bank to guarantee their reliable operations. They can’t give it away with current thin margins. But Wake Baptist, Novant and Cone’s could put 2% of their required investment corpus into community-smart development corporations focused on the neighborhoods that matter most. That would put another $200M in motion—a healthy opportunity, indeed. Forward thinking banks and corporations, of which the Piedmont has many, could see the opportunity to add to the momentum with employment and training.

This is thinking like citizens, not merely professionals trapped in our disciplines and jobs. Seeing like free citizens, we can realize how much we have to work with.

img_2901I’ve had enough birthdays (and another one Saturday) to know what is likely to happen. Expensive water disappearing into hot sand. On Saturday we watched Camelot with one eye and the Mueller report with the other. The people in Raleigh who opened the possibilities of Medicaid also seem to see our neighborhoods less than potential 2×4’; more like mulch for their golf courses. But you may remember that Camelot ends with Arthur claiming victory because one young boy ran free from the cynicism to tell of a time when it was possible to do the right thing and the right people did.

I’m uploading this on Easter, which reminds me that we believe even stranger things have happened.

This is just us citizens, choosing to be more than professionals trapped in our disciplines and jobs. Seeing like free citizens, we can realize how much we have to work with.

 

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The Stranger

john-kilzer-axOne of the things I miss most of Memphis is John Kilzer. Memphis is missing him today, too. After a life larger than life, John found a way to die yesterday in an out of state rehab center tangled one last time in the poison that was his demon since he learned drinking from his railroad father at nine.

Every Memphian has a Kilzer story. I lived there long enough to have some myself, but probably not the best ones. Elvis helped recruit him to play for the Tigers. Teenie Hodges, who played with Al Greene, taught him to play guitar in a trade for his season tickets.

I met John in his more religious phase, when we were both condemned to the weirdly long process of gaining ordination in the United Methodist Church. I was under suspicion because I was a Baptist; John because of his past drinking. We both relapsed eventually. Perhaps my greatest honors was that he told his wife Stacy that he had met his match. He had not, but I found in him the voice of the Leading Causes of Life and a guide into Memphis. A legit scholar, John read everything and walked every day with a lyrist’s mind seeing the whole spectrum, purple to orange, deep shadow and hilarity. All one.

John was the musician intellect who helped create the Life of Leaders along with Scott Morris and TC. Built on the leading causes of life, the experience was for clergy and lay leaders to help them find their place in their own life, including all that bio-medicine could illuminate. That’s about 10% of what you need, which is where the life logic picks up and that John tuned us toward. He and TC toned the experience beyond medicine toward the light of Jung, especially the part about finding a second life, continually emergent. But no happy talk; emergent is not certain. Possible, but nobody gets out alive.

Some–not all–do live before they die. John did. He let me listen to some of the raw cuts that eventually turned into his album Seven as he was finding his musical voice again. All his addictions were tangled into the musical talent that took him so high and then low. So he was feeling his way to how to sing and preach, too. It is that a musician gets better after finding Jesus. They normally turn sweet, dumb and dishonest. John was still getting better. He dropped a new album in January, Scars, which was maybe his best music since Red Blue Jeans in 88. Pull up his whole library on Spotify and savor.

I cried this morning when I listened to The Stranger, off his album Seven: “I’m not one for higher thinking, I’m not one to bend the truth. But when I was sinking, that Man made me move. Stranger, what do I owe you for lifting such a load? Pass it on, brother, to one beside the road.”

John did that until he just could not do it one more time. Nobody, not even John, can save themselves.

I’m sorry beyond all words for John’s death. But so grateful for the life, now that we can see it complete.

john-kilzer-ax

 

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Not done

IMG_2100 2I’m a follower of Jesus, as best one can two millennia on.  Most days, it’s not very impressive as far as discipleship goes. But holidays such as Christmas are like speed-bumps that slow me down to notice what matters most and Who I’m following. The birth is a strange one, of course. It was centuries before the church managed to convert an emperor and get an official national imperial holiday declared. They scrambled, and for reasons historians are still sorting out, decided that December 25th was Jesus’ birthday. None of the gospels cared, although they literally nail his death to the calendar. Walmart and Amazon, stretching the buying season, have effectively moved the birth to Halloween. They didn’t notice the real Christian holiday the next day, when we reflect on the saints and loved ones dead, but still powerful in our lives).  A commercial buzz-kill as prophets tend to be.

The one thing we know of Jesus birth is that it scared the hell out of Herrod, who shut the government down to kill the boy-child when the wise (but politically naïve) men from the East told him about Jesus. From then until they rolled the stone over his tomb, Jesus made those whose life depended on blending state violence and complicit religion very nervous. Who fears a baby in a garage or a wandering preacher with one coat and no donkey? Turns out the God of Jesus provoked fear among those who know they’re killing children with poverty, stealing the fruits of the abundant creation for themselves.

Still does.

More than three hundred thousand babies will take their first breath on this day that we celebrate Jesus’ birth. A very large fraction of them will be just as poor as he was. What does his birth have to do with theirs? Who should be afraid and who not?

Every birth—especially Jesus’—is a sign that God hasn’t given up, is always beginning and then starting over again with a new lifespan of possibilities. These are hard times for optimists and those arguing humans can save ourselves with rationality. The pessimists have all the footnotes from governmental and global bodies. Mary had no footnotes, except God’s promise. So it is not less preposterous for Jesus to say that God will not be denied in his love for the whole people. This or that temporary big man can steal, but not keep. As the prophets hoped and Jesus embodied: “A child will be born.” And all the creative possibilities open up. All castles are of sand. No wonder Mary wept in wonder. No wonder Herod slaughtered.

We only save what and who we love. And we can only be saved by who we love. This is why any time any angels have a chance, they say, “do not be afraid.” Angels are not stupid; they watch CNN and know we have good reasons to be afraid. But they also know we need more than fear. We need love which gives us hope which gives us power to move, do, choose and act. Fear paralyzes. Love releases the imagination so we can see the possibilities. Nothing like a birth to break us open.

Tova table

Tova Coffeehouse “furthering holistic poverty solutions in Lubbock.”  And the coffee is good! We gathered with leaders working with the local Providence Health System affilliate to talk about exactly that.

A month ago TC, Jim and I walked onto the beach near Wilmington after driving 3,400 miles talking with people giving themselves to the work of life and hope. Few would described themselves in big words. They were just doing the next right thing right where they lived with people they knew. Our visit was like a thread connecting beads into a necklace worthy of a young god who loves love, justice and mercy.

Only a month before our road trip a hurricane unlike any other had stalled out over Wilmington dropped feet—not inches–of rain. We listened to the tearful witness of the chaplains of New Hanover hospital as they spoke of their time in the storm dealing with trauma too big to think about. This was not an act of god, but rather nature weirded out by human foolishness.

We only save what and who we love. And we can only be saved by who we love. This is why any time any angels have a chance, they say, “do not be afraid.” Angels are not stupid; they watch CNN and know we have good reasons to be afraid. They know we need something far more powerful than fear—we need love which gives us hope which gives us power to move, do, choose and act. Fear paralyzes and narrows, love releases the imagination so we can see the possibilities. Nothing like a birth to break us open.

three at the beach

We had started our drive amid the smoke of California fires rightly called wild. Only months before I was on the Arctic shore standing on melting ground that had been frozen for two glacial periods.  As in Wilmington, the wind off the ocean behaved without precedent. I could literally see the planet melting. Weird.

When I think of children these days, I think of two grandsons, Charlie and Asa, who will live into a wild and weird century. And I listen to the call of young Jesus to change, to turn from foolish ways, to live in a way that gives the world a chance. If you love, change.

I stood on the Wilmington beach, picked up a broken conch and decided that I would become a vegetarian. What I wanted to do was buy an electric car. As he tends to do, Jerry Winslow, poked a hole in my holiness by noting that I could have the same environmental impact for free by simply giving up meat. So for the last month, that’s what I’ve done. I have learned that almost everything we can do that would help the planet is, like going meatless, better and cheaper for us individually. Like Jesus’ call, it is not a sacrifice, but a turn toward life. This turns out to be abundant and good.

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Linwood Davis and Martha Bassett in Davis Memorial Chapel Christmas Eve.

TC gave me a book by Paul Hawken called Drawdown, “the most comprehensive plan ever proposed to reverse global warming.” It’s actually one page after another of, “well, duh!” Why aren’t we doing this already? Solar, wind, geothermal, biomass, quit wasting stuff, up-cycle, and yes, go electric and quit with the meat. To that last point, it turns out that the big problem with cows and pigs is that they fart so much they will kill us with methane even before we die from the crap in our arteries. I do not digress here, for it underlines the point common to all the components of the plan: it is all for the good. But just have to turn around. Humans are built to do change our minds when we love someone enough to do so.

On Christmas Eve, as we have for many years, we held a service in Davis Memorial Chapel in the hospital. Martha Basset and her band sang, this year with the Dan River Girls. No sermon; just straight up scripture and songs that cut like surgical steel through disbelief. Simple: Don’t be afraid. A child is born.

Later I watched the service out of Rome which also has a nice chapel not to mention many white people in funny hats. In spite of the goofy guildedness, the same revolutionary message  rippled through the air. Multiple languages spoke to the heart with the Pope bringing the most ancient Good News.

IMG_2107God has not given up, not on any one child, not on the mean and melting planet, not on us. Not even on us.

I walked off the Wilmington beach and had a vegetarian enchilada. I was going to make a big righteous deal out of it, but it was pretty good. I haven’t missed the meat since.

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Love in public

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San Diego Harbor across from where the American Public Health Association met.

If hospital systems are like yacht clubs, public health people would live unnoticed in one of the Winnebago’s across the parking lot (that’s ours on the left)). Why would anyone choose a career so likely to end up in a dumpy office filled with data? It isn’t just ancient people with nothing better to do with a drab and pathetic life. Public health degrees are the 5th most heavily sought out of 500 by the current generation of students. Why?

It is normal to want to live a life worthy and helpful to the world. But it not  easy in these days so filled with repellent public behavior among those supposed to be leading us. You have to craft a life on purpose, sort of like a salmon has to swim against the fierce current.

See2See Road Trip began in San Diego precisely because those are our peeps! And because they love all peeps–publicly! In a drab room overlooking the yacht, I shared with a room of public health advocacy wonks some words about love, borrowed and adapted shamelessly from Paul:

If I speak in the voice of powerful people or spirits but do not have loving kindness, I am only a distracting noise. 2If I have predictive data and interdisciplinary analytics that give me confidence to move mountains of poverty, but am not kind, I am nothing. 3If I proudly commit to radical levels of community benefit and take on huge obligations for the health of the public, but am not humbled by love, I do nothing.

4The love that life needs is patient and kind. It does not envy others’ projects, it does not boast of our own ministries, it is not proud. 5It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of who ran up the debt and who got more. 6Loving kindness does not delight in evil but rejoices with the truth. 7It always protects, always trusts, always hopes, always finds a way. (Sounds like public damn health!!)

8Love never quits. Where we have predictions and projections, they will cease; where there are speeches, they will be stilled; where there is knowledge, it will pass away.

9For we know in part and we predict in part, 10but when living complexity comes, what is partial disappears. 11When we were young in our work we talked like beginners, and thought like a beginners, reasoned like a novice. When I became a grown-ups, we put the ways of childhood behind.

12For now we see only dimly as if looking at an eclipse toward the hidden sun, as through a smokey haze; then we shall see it all directly. Now we know a bit; then we may know fully, even as our own lives will be fully known.

13And now these three remain in life: faith, hope and love. But the greatest of these is love.

The Public Health Advocacy leadership is about 150 uber-nerds (our favorites!!) giving their time and resting their hopes on standing up and speaking out for a range of public health priorities. They hone their technical skills at the craft of communicating and persuading. Not entirely like the preachers working 4.8 miles to the south east on sunday morning. One of them said “people don’t care what you know until they know how you care.”

Love is what works; the only thing that works. Especially in hard-hearted times.

 

 

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Hairball

apen one

Aspen on the North Rim. I love this place.

The wind from the second unprecedented hurricane in two weeks was still swirling through the trees. So I paid attention when the United Nations Climate report said we had a dozen years to fundamentally change our lives to avoid runaway melting with irreversible consequences. This wasn’t about the polar bears (already toast), but my grandsons who would not even be out of high school before their prospects were radically diminished.

The UN report focused on the huge difference between stopping the warming at 1.5 instead of 2 degrees centigrade. Nobody you would recognize as human has ever experienced either one, since it’s been about 100,000 years since the planet has been that warm. The scientists could not bring themselves to speak about the implications of 3 degrees, which would melt all of Greenland and the Antarctic shelves, raising the seas by a few dozen feet, altering every weather pattern since there have been mammals to notice. If the world implemented all of the Paris agreements that you-know-who considers too extreme, we would sail into the utterly unknowable range of 3.5.

This is not about the planet. Earth will do just fine once it coughs out us humans like a cat does a hairball. The carbon levels will mean we skip one or two glacial eras while things wobble back into order. But in a hundred thousand years or so, Florida will rise up out of the ocean again while a mile of ice scrubs Detroit off the granite. A few lawyers, rats and encapsulated rich people will have a chance to start everything over, which bodes poorly for the next grand experiment. Or maybe a more adaptive human variation will emerge, more kind, humble and given to wonder. But not me or any in my line.

This is not entirely new, except for the urgency and proximity of the cliff. The National Academies Roundtable on Population Health Improvement held a brave workshop on climate change more than a year ago. You may not have noticed. Every bit of the UN report was known except for the hook about how important it was to aim for 1.5 instead of 2 degrees.

Bill McKibben who has been the exquisitely eloquent prophet long before Al Gore was dismissed as a daft alarmist. McKibben wrote a stunning piece after the dystopian reality of the drowning of Houston last season pointing out that unlike most problems that can be fixed later, this one gets entirely out of control: we lose entirely by going slowly.

My house recycles like neurotic squirrels hiding walnuts. But that is mere symbolism compared to the actual damage to the planet resulting from my platinum frequent flyer status that comes from speaking all over the place about health. There will be no health for anybody anywhere, if we do not change. All of the process improvements by all of the hospitals in the world will amount to nothing, if we do not change.

You can learn a lot from the fellow living in the White House. Just do the exact opposite of everything he does, especially regarding the most important of all his duties—to protect the people.

Step one:  Do not join the what-the-hell-and-who-cares team of millionaires who consider the survival of civilization to be inconveniently expensive–to themselves. They teach us that fear and greed makes one stupid and mean because it shortens our attention span. Do the opposite: don’t be afraid and don’t cling to our piles of stuff. Humanity can live—if we change our ways.

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What could be more amazing than river mud after  flood? Canning River 2018.

They’ll tell you it is already lost, so what the hell? But it is stunning how quickly the natural order rebounds given any chance at all. The Earth Island magazine tells us the lessons from the Elwha River, which for most of the past century was blocked by two high dams; the salmon long extinct as the river ecology warped beyond hope. And then, improbably, a tenacious group managed to get the damns blown up. I remember when it was proposed and thought it was a preposterous thought not worth wasting any hope on. And then it was gone. Everyone—even the optimists–assumed it would take decades for the salmon to find their way upstream and  for the accumulated muck to wash out. Actually, the sockeye headed upstream in weeks as if they’d just been waiting for the humans to do the right thing. It’s not all healed; but they are breeding like, well, salmon and seem to be enjoying themselves. And only three years later the silt has already built a new half-mile delta where once was stone. The whole river and coastal ecosystem is working. Of course it is; that’s how life works. Living systems are radically adaptive and hopeful, never ceasing to watch for an opportunity to explode into life.

This brings me to the second point: we must follow the path of wonder for the world that God so loves. This love is the only thing strong enough to carry us to and through the changes we must make. Only love makes us brave enough.

As I become older and ever more aware of the threats to the world, I find myself more filled with wonder at how it is so wondrously made (Psalm 139). I am overwhelmed by the astonishments on the wing, and not just the arctic snowy owl, but the sparrow out our bedroom bird feeder. In Alaska I was awed by the Brooks Range mountains, but just as much by the countless wonders of the billions of stones in the Canning River in endless varieties of beauty. I can watch the miles of Appalachian hardwoods sway in the breeze for hours, but neither can I look away from the intricate patterns of grain in the cherry burl. I turned a bit of it for a ring on my finger and see new things in it every day. We will only be brave for what we love; so we must pause and fall in love with our melting planet in all its immediate and intricate detail.

Fall in love with place you already are, especially. This summer I was on the Arctic coast of Alaska. I’ve hiked the Grand Canyon seven times. Table Mountain over Cape Town, too.  For that matter, I’ve never hear of a place I didn’t want to go see, taste, listen and feel. But I live in one of the most beautiful places on the earth already. So do you. My brother Ron has fallen in love with an acre of overgrown suburban land next to his church, his love drawing in hundreds of others now aware they live in the amazing Chesapeake watershed.

Follow the stream near you up to the ridge and see your place whole and complete. Notice what is alive and then look beneath into the soil and down into the rocks. We live where Africa once connected, the collision and separation rippling up the Blue Ridge and leaving agates in the streams. Amazing enough to love. Lovely enough to protect.

Thirdly—and hardest for me: Hurry up and slow down. The deadly melting of our planet is driven partly because of our ceaseless urgency. “Ain’t got time for a fast train;” not when Amazon can get my latest desire to my door tomorrow, or Delta get me to a half-day meeting in DC by 9am. Go slower and then add by subtracting. Don’t go at all.

The scientists say we must choose life now. You can’t change everything right away. But every and any human choice can change in a few years, if I, you, we accelerate our turning now. I’ve got air travel booked some months out, but by Winter you should see a different pattern in my life. I promise to shut up entirely, if I’m still Platinum next year. I’m going to learn Amtrak and how to travel within the range of a 200-mile electric car. No more Arctic; more Yadkin. Probably better.

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No big deal shot that could be taken anytime….of a hundred miles of amazement below Fancy Gap, VA.

These are choices of global consequence. And they are choices we have a chance to make by voting for those who can and will heed the science. It’s way too much to expect of you-know-who. But anyone running for any office in the land should be asked how their lives and how their decisions will be shaped by the new climate urgency. This year in Forsyth County a friend and colleague Terri LeGrand is running for the NC House District 74. She’s a longtime environmental activist laying it all on the line against an entrenched do-the-same-ol-thing person who has basically wasted her elective office on piddle. Terri has come out of nowhere to make it a dead heat with a few weeks to go. She’s like a salmon who poked a hole in the ancient dam by herself! There are people like that all over the nation this year, running for our lives. Before you go buy an electric car, make sure you send them a bit of money and tell your friends to vote for them.

I do not believe that we are made for suicide.

We gotta change. And we can.

 

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Gomorrah 2018

Between overdosing on CNN while spending time in Las Vegas and New Orleans, I found myself googling …. Gomorrah. Maybe you can relate.

The story in the 18th chapter of Genesis is about how many righteous people a city needs before God from closing down the whole show. It’s not 51 or anywhere near a majority! Abraham negotiated God down to 10 but that turned out to be eight too many. The mob shows up to violate the house–led by a dude that makes me think of a certain senator from Kentucky—and the story turns ugly and weird. In Vegas style, the dad offers up his daughters to protect the reputation of a guy. That reminds me of a certain Senator from West Virginia; hard to read with four daughters in our fold. Gomorrah burned, although it is unclear exactly who sinned doing what when. Some say “strange sex,” others blame the violence to vulnerable strangers.  Those sins focus on the Kentucky mob.  Jesus, alluding to the story a thousand years later (Matthew 10:14) did not He knew mobs and expected them to act like mobs. He pointed to the failure of the righteous few to protect the strangers from the mobs. Where the heck were they when Gomorrah teetered on the brink?

It is hard to import Jesus’ words directly into the USA of 2018; likely to make us stupid about both. Jesus didn’t know anything about representative democracy as it has devolved 21 centuries after he retold what was already an ancient story about mobs, sin and the vulnerable. I’m sure he would do very poorly as a candidate in our weirded out system. But on this Sunday after the last week’s smoking mess, I am less inclined to blame the mob than I am those of us who have failed to tend to the norms and values of our culture for the past decades. If the city burns, it’s on us.

Gomorrah is us; timeless because it is about the complicity of people like me who who are merely kind. Every city in human history has had mean and vile mobs who would have their way with vulnerable travelers, happy to violate every institutional norm in the process. The question is whether there is anyone else. The city will die the forces of humanity stop at polite kindness instead of stepping forward to be fiercely protective of the vulnerable.

In the wilds of downtown Las Vegas or the tameness of Winston-Salem, cities perish when good people don’t put themselves in the way of the mob. Apparently, it would only have taken 10 in Gomorrah. Winston-Salem might need several dozen, Las Vegas more. But not 51.

We have enough.

In Las Vegas there are plenty stepping forward, some famous and rich like the founder of Zappos who has invested a third of billion dollars to build a new future in the city. The Sisters of Dignity Health never quit, finding hopeless elders living in the storm drains and the women discarded by the hotel trade. You can meet others in PublicUS, the coolest coffee shop east of San Francisco.

Note that much of the weird religious energy around the Court was about abortion. Four daughters makes me want to protect their rights, so I diverge from those who otherwise look a lot like me (white, older, male, Baptist). We are together around other important issues; no reason for Donald Jr’s thuggish call for war. The NC Baptists who helped push through our new Justice did so holding their nose against the scent of he and his dad. Baptists are deeply involved in the clean-up from Hurricane Florence and never say no to any chance to help the poor. Of course, not! It may be possible to build dialogue with many conservative Christians about resisting the hard-hearted drive of the rich against the widows, orphans and strangers. A certain Senator from Kentucky may have less broad support than he thinks, if we focus on the very broad coalition possible for the poor.

I’m sure we’ll see this coast to coast in our See2See Road Trip. The route, running from San Diego to Wilmington is full of people putting their life on the line for mercy, justice and simply equity. And not in the abstract, but in the communities they live in; the places they call home. If you live along the route, I hope you’ll hold a house meeting, joining Stakeholder Health and 100 Million Healthier Lives in rising up and claiming our role as healers.

Even ten houses would be enough.

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Hurricanes

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Winston-Salem as the storms of Florence came near.

Things move fast and urgently in an operating room early on a Monday. The churn of events and flood of people in the hallways are wondering why the nurses are standing holding hands right there in the surgery suite. A dozen family members are hoping for comforting words while a dozen feet away across a couple of gurneys, eight surgical nurses have no words at all, struggling to process the loss of one of their colleagues, apparently shot down dead by her husband right there in front of the kids. Feels like a hole in the eye of the circle with enough emotion to swirl a hundred miles out and around. Hurricane, indeed.

Florence ground slowly from the coast across the sandy flats up and through the rolling Piedmont and is now picking up speed on Interstate 81 like a northbound trucker. The winds could have been a lot worse. But this was a post-modern storm following no pattern at all, inexorably overflowing norms, breaking rules and making entire communities uninhabitable.

Hurricanes are about as big a show as nature puts on. What could be bigger? It turns out that jet streams and oceans are; even a tiny twitch in the speed or warmth of either one and you get the deadly meandering of storms like Florence. When the driving currents collapse, the flood isn’t far behind. So why would a hurricane behave in such an odd and deadly manner? Why would a democracy just forget to bother to follow its own rules anymore, chasing its own inevitable slow collapse? Why would we just forget to try to stem the tide of guns, now so over our heads that any pissed-off husband can just blow away the one they probably still loved? Surgery can’t stitch together what’s broken in this world. Hurricanes, all.

What to do?

Don’t look away.

Don’t look for the answer on a screen.

What can a nurse do as their own heart is breaking for a friend they loved? Form a circle, hold hands and feel the blood and spirit pumping. Let a few tears out, have a chaplain murmur a prayer. And then go scrub in to help someone else.

Last week before the deluge, TC and I went by the Forsyth County Democratic Party headquarters where Eric Ellison gave us our street assignment and over the next two hours knocked on 96 actual American doors. Being 2018 we only met 7 humans. One of them had become a citizen after immigrating from Spain two decades ago. Another grew up in the neighborhood 50 years back. We asked our fellow citizens to remember to vote, now in less than 55 days. A few thought they might want to volunteer, too, so we’ll follow up on that.  Heading to higher ground door by door.

Anyone with a brain bigger than a 22 caliber slug knows it’s probably too late to stop global warming, the collapse of democracy or gun violence. All the data tell us so. But what parent, brother, or daughter would not try? What sentient mammal would not at least stir and try to get their kids to higher ground?

Our hospital has one of the worst parking lots built since the model T rolled out of Detroit. Dark, low ceilings and always oddly damp. The other day I was hurrying to my car and almost knocked down a woman standing in the middle of a lane looking this way and that, glancing down at the paper in her hand. I asked if she needed help and I thought I saw tears of gratitude. The real problem was that her eyes were dilated and she couldn’t even see the paper in her hand, much less her grey Toyota in the grey parking lot. I could help. In spite of my ordination, she trusted me enough to let me do something and we ended up circling six floors in my Mini Cooper, both squinting until we found the car. Probably wasn’t a great idea to let her drive away!

If you look up from the screen in your hand for a bit, you’ll notice people around you, doing this or that, going about their lives. You can’t know if their house is under water, their best friend dead or scared to go home. You probably don’t even know those things about people you work and walk beside every day. You have to make eye contact.

Last Spring my daughter Lauren, now a mom, watched with us all on live TV as Parkland high school students fled from their building, learning shortly that 17 of their friends were dead inside. She writes plays,“so instead of closing my eyes and thinking back to being a junior and watching the news in horror curing my AP US History class and thinking those poor mothers and please god someone do something about this… I posted a query on Facebook asking for help with this play in the wake of this new violence.” Her friend and fellow theatre activist Christina Wallace reached out immediately, read Natural Shocks, and said “Let’s do this.”

Lauren contradicted Hamlet; “the play is not the thing. You are. Your community, your company, yourself. Any play is just the metal that attracts the lightning. We are the lightning – actor, artistic team, audience, community. We are the undeniable force of nature that will light up this darkness and change it forever.”

More than two hundred theaters of every sort and size did the play, including the very best performance in our own Green Street United Methodist by the brilliant Mellissa Jones. Next month a full production of the play will open in New York, keeping the movement going.

That’s how it works. Most of us are not famous. But when the hurricane hits, we move and don’t quit, not when people we love are in high water.

On November 10th the See2See Road Trip will begin making eye contact with about 3,300 miles of people beginning in San Diego with the 100 Million Healthier Lives annual meeting and then the American Public Health Association with our Public Health Law friends. That afternoon we’ll grab a bite at our friend Heather’s home up the coast, then winding through friends and strangers in San Bernardino, Phoenix, Tucson and El Paso where Dr. Arvind Singhal is teaching his band of positive deviates (seriously, check out his book). Then over to Abilene and Lubbock before landing with the friends at Baylor and Parkland in Dallas. Over to Floyd with the astonishing Redeemed Christian Church ….. and over to Little Rock, a hugely creative node in what’s coming next. Memphis, down to the Delta for a nod to the very first community health clinic and activist Fannie Lou Hammer, over to Chattanooga, Cherokee, Hickory and Winston-Salem. Raleigh for William Barber, John Hatch at Shaw University. We’ll ending our discovery where the surge from Florence met the flooding of the Pamlico Sound in little Washington.

We’ll make eye contact with people finding the way to heal their communities. That’s what movements do: they make eye contact, grab hands and move. That’s how the P2P movement is springing up everywhere, ditto Stakeholder Health.

You could just get on the web and watch famous people saying really smart things about it all. These days nothing is quite so urgent as to look at another human and ask about how they are hoping to heal, themselves and the ones they love. For that matter, why are you still reading this? Go talk to somebody, put your hand in theirs and go find somebody who needs you both.

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