stakeholder health – garygunderson Blog

Bee sex in Texas

Humans get so many things wrong about honeybees. I’m sure they are a bit confused about us, too. But they must be especially mystified by the way we call the one who sows all the eggs in the hive a queen, which implies the off-putting and inefficient pomp of human royalty. Mother is closer, given her role in laying many thousands of eggs; but also wrong given her lack of maternal qualities. She lays eggs but has no role in raising them. And the first thing she does when she emerges with her impressive stinger is to kill her competitors. Not like my mother.

The one we call queen is more like a sower of seeds. She is not even a gardener that carefully plants a seedling, making sure the roots are nestled just right in the soil. Let’s call her Sower.

Honeybees have successfully flourished for 30 million years precisely because they have no royal qualities at all. We have no idea how 60,000 bees in the hive think collectively, but we know it’s not the queen. Every single worker bee—all girls—have the identical genetics of the Sower. The hive every egg “royal jelly” for three days before switching to the more mundane “bee bread.” But the hive feeds the Sower special food her whole life turning on the genes that make her much bigger and living 10 times as long and, of course, able to lay a thousand eggs a day. But she isn’t any smarter than the other bees. Her most consequential decision is which egg to lay in which cell and doesn’t really decide even that. She sticks her tentacles into the cell to see which one the architect bees intended (the 10% drone cells are slightly bigger).

Why is this important for humans? We have long fallen for the idea of the Elevated Decider who receives ridiculously disproportionate privileges in exchange for making big decisions. The honeybees make those decisions collectively without the process skewed by privilege. Flat democracy so perfect humans can’t even recognize it.

Now and then humans approach smart by accident, such as recently seen in Texas of all places.

Honeybees typically produce way more honey than they can possibly consume, leaving plenty for us. They can also produce more hives, which is why they are so adaptive, able to explode into almost any niche given the chance. The Texas department of agriculture triggered an explosion of bee hives by granting agricultural tax abatements to any “farm” over 5 acres with 5 or more hives. Texans are not known for environmentalism, but they known a lucrative write-off when they see it.

Honeybees are insects, as TC reminds me, with little emotional bandwidth. They don’t care about dubious Texan morality. Suddenly, there were bees everywhere! And the people dumping poisons suddenly were surrounded by tax-incented Texans. (Here’s the story.)

We are so used to complaining about environmental decline that we overlook the natural superpowers like the honeybees’. They can make a new Sower and thus entire new hive when they need or want to do so. Normally, this is when the old Sower starts to show signs of wearing out and getting erratic. The hive puts some promising eggs in larger cells and feeds those eggs nothing but special food. In about 16 days a Sower will emerge. (She isn’t nice: as I mentioned, her first act is to kill the other potential queens.) She’ll fly off to mate with six or ten drones and returns to lay eggs in the dark for a couple years.

Often in the Springtime the the hive will find itself thinking of reproduces itself. Honeybee sex involves the whole hive. The existing Sower is chased around the hive to lose weight so she can fly one last time. About half the bees in the hive pour into the air in a swirling ecstatic cloud bringing the old Sower with them. They pause in a tree branch to give the scouts a chance to find a new permanent location in the neighborhood. While they are pausing an opportunistic human can persuade them into a box they may find it acceptable.

Kelly Carpenter’s bait hive for Methodist bees. So far it has captured four swarms that have come from his church rafters.

Kelly Carpenter and I have captured three Methodist hives this way in the past couple weeks. Combined with some Texas-style splits, 5 hives are now 16. The process is risky and wild. They bet everything on expansive possibility which has worked for thousands of millennia.

Last year about half of all hives in the United States did not make it through the gauntlet of toxins, sprays, overcrowding and stupid human behavior that magnify the threats of mites and such. But it is important to note that most of the hives that failed were the ones kept by humans.

Many natural species are also capable of exuberant expansion once humans quit pumping poison into their neighborhood. Nature out-generates death every chance it finds. Humans can help the most by removing the financial incentives to poison. Just imagine if we gave tax rebates for planting butterfly and pollinator flowers. Do we really need Texans to show us?

Why five acres? Our townhouse community has one acre of sanitized fescue vacuumed in the fall. The city council could change the game for bees and bugs and songbirds with a 5% property tax rebate. Of course, we could just do it. We not legally bound to spray neurotoxins on ourselves.

Too small to matter? One of my favorite organizations is Homegrown National Parks. “Homegrown National Park® addresses the urgent biodiversity crisis with a simple, science-based solution to a global challenge. We are a grassroots call-to-action to regenerate biodiversity by planting and preserving native plants that support critical ecosystem services and removing invasive plants that do not. We are catalyzing action that will have meaningful, tangible, measurable, and immediate results. We can do this NOW, without waiting for legislation.”

We are not inherently smart as honeybees. We have to think hard and do things on purpose. Somebody had to notice that there is more private land currently planted in lawns than in all the national parks put together. And think about what that means.

We can just stop behind stupid. Start choosing abundance.

Nature just won’t quit trying. Here’s an eager dandelion emerging from our parking lot. Never quit trying….

Community Perspective on CalAIM

Life is generous, although most humans don’t notice.

*Sunrise in God’s Acre in Old Salem, March 31, 2024*

I offer evidence, if you failed to notice the azaleas, not to mention the rising sun. I’ll point to a full bloom of creative generosity where you might not expect it—in a complicated partnership between government, healthcare and hundreds of small community-based organizations in California.

This week Stakeholder Health released some careful research into a radical innovation in how the state of California is providing health care for the poor.

Here is the link to the webinar.

Here is a link to a two-page summary of the research.

Here is a link to the full report.

In most places government and healthcare are built proudly with nonchalant acceptance of the fact that the poor live demeaning lives and then die in humiliating pain. Sorry, there’s just not enough to go around, says the hard-hearted god of the castles. Even when the poor can slither through the doors into the emergency rooms, they have little access to 21st century preventive medicine. For decades it has been clear that most of the drivers of disease and suffering are not medical and need relatively inexpensive preventative care. Most conditions that look medical are best managed by something social, mental or spiritual before leaping to the expensive pill or carving up a body part.

This is technically called the social determinants of health (SDOH) which is unhelpful language because they go way beyond social work. Everything that happens in human life has biological-psychological-social-and Spirit drivers and implications. Duh. Humans are complex and wonderfully made (Psalm 89). Even straightforward medical problems—say a broken leg, which my kid is still recovering from— has a four-fold a healing path. It works the other way, too: childhood trauma shows up as wickedly complex biological issues decades later.

The healthcare industry is not organized this way. Governmental programs usually take the head off the body and put it over in the mental health agency, then detach body parts in thousands of reimbursable codes. Everything outside one’s skin goes under a totally different set of social services agencies leaving a scrap for public health to inspect the food, chase rats and get ready for the next pandemic.

BUT now California launched the first really large-scale trial (CalAIM) using Medicaid to treat humans as they actually are—complex and wonderfully made and living in communities that are complex human systems that can care for each other. The technicians in government (usually called bureaucrats) leaned into all that complexity and got the federal government to grant a “waiver” to spend Medicaid money on a wide range of SDOH drivers. North Carolina had been lauded for talking about this. California has done it in a state five times larger following science to embrace 10 times the range of SDOH factors. Bold.

AND they are spending that money through the extraordinary array of community-based organizations. In reality, these groups have only had scraps of money from bake sales or philanthropic largess (social justice one chardonnay at a time, says Dr. Suzanne Henderson). CalAIM has put $4 billion in motion, which, even in California, is a lot of chardonnay.

AND the innovations continued by investing millions in helping community organizations strengthen their capacities to interface with governmental funding procedures. This would be impossible except for the last innovation—the government folks listen, adapt in real time and change their way of doing things, too. Note the research was paid for by CommonSpirit Health, one of the largest healthcare systems in the nation. It is rare for such systems to even be curious about the reality of community organizations, much less partner in learning. It is head-breakingly difficult to blend institutional cultures and ancient practices. Easier to shame, blame and whine. Not here.

The initiative has released creative energy and imagination through changing the work of many hundreds of organizations. Many of the groups were built from faith, which is supposed to believe in generosity and even resurrection, but settle for much less. The Stakeholder Health panel included Lutheran Services, which has been doing this kind of work for many decades, now accelerated with the partnerships. And it includes “Pneumacare” (spirit—get it?)—a collaborative that grew out of a ministerial association, now managing millions of dollars to provide care that that cares in partnership with CalAIM. And yes, the healing is for everybody of every kind of faith and no-faith, skin and language. It’s California.

You have to watch the video to hear the story of real resurrection going on and be amazed at the technical skill making it work. (Here’s the link.)

This is smart generosity, not dumb give away. It is obviously smarter to invest in what people actually need when they need it will prove less expensive than the obviously dumb current idea of waiting for their life to blow up so completely, that they then end up in an emergency room. This kind of work is hard with many technical challenges. You have to do the right things right. It breaks every day and is fixed in real time. The research reveals a bold effort still underway.

California chicken from a generous california hen.

The only unforgivable sin is to accuse God of creating a world broken from the beginning without enough for everyone. All the disciples of every religion can’t work around that because it assumes that inequity is inevitable; God’s fault, really. That sin is the root of every angry political movement. If they would open it, even You-Know-Who’s $60 Bible tells of a God who did a good job for everyone and expects us to do so, too. Turn on the lights to the most the most obvious thing in the world– there is enough for everyone. Everything works—politics, faith, family, health, food systems, housing, education—if you begin with that most obvious fact. Witness California.

That Jesus

We pause on a day almost certainly not his birthday to consider a strange carpenter-teacher who lived two millennia ago. He was always inconveniently good news. Long before germ theory, telescopes or electricity, Jesus lived a short life before dying as a political criminal. We know about his life through scraps of stories and vignettes no longer alive to us except through translations of translations. The stories of the birth that “magnify my soul” are all radical signals of protest and defiance against the oppressive cabal of religion and empire.

Said to be the oldest baptismal pool. Naples, Italy.

Jesus was not a member of any Christian group and would probably not recognize most of the religion that claims him. Paul, whose writings shaped much of that religion, villainized and persecuted Jesus’ earliest followers before converting, never met him. Although a student of the Jewish texts, Jesus was not a writer. No home, much less an office. No wife, apparently, or kids. We don’t know his sexuality. He apparently had a brother.

He healed people seven days a week with no business model. The only times he showed up at worship, he got thrown out. He never voted or sought political power. But he was regarded by Empire and its religious toadies as a threat to order. He had no school, but did accumulate disciples. Before his movement backslid into bishops, those following him were said to follow his “Way.”

That’s the clue. I want to move through life in that “Way” and with those on that Way.

He prayed some, mostly by himself, apparently to strengthen his capacity to stay on the Way.

He said that Way was narrow and difficult, which some think means we should go single file through life. I think it means we are to walk like the Reindeer we associate with Santa, but who are also symbols of radical resilience. The early Mediterranean Christians thought of Jesus as the Lamb of God, stressing the sacrificial metaphor. They didn’t know anything about Caribou and how the herd saves each other.

Caribou–they who move through impossibly difficult circumstances following many paths that weave together and then apart and together again. I have walked their narrow, braided paths on the tundra shelves flanking the frozen Alaska rivers beneath the Brooks Range. They are called Caribou in Alaska but have the same Way that they have followed for thousands of years, moving as a company of thousands, trusting each other to find the paths across and through to where the Spirit of life draws them.

The mesh of trails suggests a social complexity beyond our simplistic theory of networks.4 This helps me imagine the adaptive possibilities as Spirit sets us free while remaining social, safe while remaining kind.

I, too, pay attention to my trusted ones on the Way: Chris and Bobby, Enrique and Maria, TC, Jim, Tom, Fred, Jeremy, Jerry, Dora, Ron and a cloud of witnesses on the move. We trust each other to stay on the journey and in sight, sometimes protecting, sometimes finding safety. The world is a dangerous place. Safety only in motion, together, on the Way.

I wonder what Jesus would say about all this. I suspect he’d wonder about all the churches from which I was not thrown out. And all the clutter I’ve accumulated beyond his one cloak and borrowed mule. My offices. All the stuff I did not give away. All the healing kindnesses left for other obligations.

I hope for grace.

And pray for a Spirit to move me onto one of those narrow paths closer to the edge of the herd as we move together over tough land for another season of life.

//// adapted from my book, “For God and the People: Prayers for a Newer New Awakening.”

*Sunset from Monkey Valley, South Africa*

Soul sick

Lisa Lumb, artist. In dialogue with her twin sister.

I am not sick to my stomach. I am sick to my soul.

The first job of any religious person is to try to make their own religion safe for the world. Every religion has a dangerous side which has at various times in the evolution of the tradition provided cover, sometimes even encouragement, to the most obviously horrible facets we humans are capable of doing to each other. Every king, thug, despot, gang leader and e-gazillionaire has a chaplain willing to cheer them up when they are sad and encourage them when angry. Every castle had a chapel, even when it did not have flush toilets.

As a follower of a Jewish man named Jesus, I am sharply aware that people have done, in the name of my religion, some of the same repulsive things done in Israel this week. Hamas didn’t do anything that the Crusaders hadn’t wraught a millennia ago on the very same land.

My daughter is married to a Jewish man, with both my grandsons raised to respect and participate in the rituals of Jewish life. We just built a Sukkah shelter together that we bought on Amazon. They are San Francisco moderns, sophisticated and proud of lots of things no longer believed. They let a Baptist sit in the Seat of Elijah for the circumcision. And those kids are more likely to go to Burning Man or a trance music festival in Israel one day than church.

I am sick to my soul.

This weekend a couple dozen authors and scholars from Africa, Europe and the US will gather at Wake Forest University to blend our thinking toward a book published next year about religion and health. We meet in sharp awareness that many would wish for no religion at all.

I can’t blame anyone who looks at history and concludes that we should try a culture with no religion of any kind. I thought we were heading that way, as rational secular science-based logic was all the rage way back at the end of the 20^th century. It turns out that there is something in the human being that simply must tether beyond ourselves to ultimate meanings. Call it Spirit. Homo sapiens spiritus. We all have an ember that will flame for good or evil beyond all imagination.

Any of us brave enough to accept identity with one of the great traditions is responsible to see that the others of that tradition do not use that religious cover for heinous actions toward people of other religions; or those who are simply going about their life down the street in Hroza, Gaza or Winston-Salem. We say clearly that any religion—especially our own–that is comfortable with gross inequity in the distribution of things God intends for everbody should be rejected by the larger world as fraudulent. If one’s religion is not good for the whole world it obviously is not linked to the God who created the human species with nearly infinite variations of thought and imagination. Any religion that is not good for the whole world is dangerous to our small planet. Let us not leave that to secular people to say; it is our responsibility.

Practically, only a Christian can engage a dangerous Christian. Same for every other religion. This is not without risks, as some of the most virulent emotion is between people who share the same religious identity. But only an older white male Baptist can deal with the leadership of the minority group of older white male Baptists showing dangerous tendencies in public toward people within punching range. No Muslim, Jew or Sikh can sort out a crazed Baptist. That’s on us Baptists. And I’ll count on y’all to keep your extremists away from my grandsons.

The heinous savagery degrades all religion. Every faith favors humility, hospitality, kindness, generosity and peacefulness—especially toward strangers. And every religion violates every one of those time and again when it fails to hold itself accountable to its own teachings.

Today a kind of prayer beyond words lives in my soul, sick with sorrow.

Social, now

The top floor of Baylor Scott and White hospital is dark wood, deep carpet and lots of glass, out of which one can see Dallas stretching to the dusty horizon. A physician noted that the people visible to the southeast near the Ferris wheel tend to die about 12 years sooner than those on the other side the same distance from the hospital. This is why I was there talking about the “social determinants” of health and what religion has to do with them. You’ll notice the phrase has two problems, “social” (when it really means “non-medical”) and, worse, “determinants” (when it really means variables). Hospital leaders hear about these factors a lot these days, but nearly all the problem and possibilities called social lie on the other side of the sidewalk outside their control.

The school is way more important than the hospital. Two scholars (Case and Deaton) sifted life expectancy data to clarify that people who don’t graduate from college tended to die 8 years younger. It’s not because the books would have taught them health-related tips. College is a social marker, mainly about one’s parents social position which is a big boost toward the student’s. Hospitals are pouring money into new IT to see what social determinant things such as food and short-term housing that their patients need. That is nice but misses the point. And it misses where to work.

It may surprise the well-educated, but not those on the downside of the data. The two thirds of Americans who did not go to college know all about early death; no wonder they are angry and vote with fury.

Social is the thing that happens when people talk to each other. In this case, at Tova Coffee House in Lubbock, TX

In 2008 the World Health Organization commissioned a global study on these poorly named factors, led by Dr. Marmot, who was famous for noticing that life expectancy decreased in a step-wise factor with each click down in social position within bureaucracy. The 2008 report said sharply that “social determinants can be more important than health care or lifestyle choices in influencing health.…studies suggest that SDH account for between 30-55% of health outcomes. ….the contribution of sectors outside health to population health outcomes exceeds the contribution from the health sector.” We’ve wanted to blame the doctors and the hospitals when the problem falls on all the rest of us.

The critical role of social drivers has two inconvenient implications for hospitals and one for people of faith. Hospitals have been happy with the assumption that they are the key to extending the health to everybody who can see their large buildings. Modern healthcare is mind-numbingly expensive. The business model draws from a deep well of borrowed money from nervous bankers requiring vast reserves to ensure they are paid back. The weird irony is that hospitals look like they have a lot of money, but it is reserved for the banks, not the neighborhoods. Everybody hates this.

Hospitals are legally obligated to provide “community benefit” but nearly all of it pays for expensive free care offered inside their tall buildings. Some count medical education (of doctors, not the patients). In some states they count the loss between what government pays for Medicare and Medicaid and the actual cost. Less than a nickel of every community benefit dollar goes to anything in community. Everyone involved hates that, too.

We should release the hospitals from the unrealistic expectation they can do what they’re not designed to do. They deserve tax benefit for giving so much care to people who can’t pay. We don’t want citizens dying, writhing on the streets. But—and this is the inconvenient part—we should no longer pretend that hospitals can solve what all the rest of us need to be accountable for. If hospitals can’t do it, they shouldn’t get political credit for pretending to try. Let the money follow the science to where health is created: especially the schools, social supports and public health that advances the health of everybody.

The day after speaking in Dallas, I was on a Stakeholder Health Zoom, a sophisticated group that knows all about this cruel reality. We we talked about how to get the money and attention out the door and into the streets. One promising clue is the rapid spread of communities using the Vital Conditions and the Thriving Together document to approach the radical complexity of assets in community. This has already sparked an extraordinary 53-agency Federal Working Group to advance health for “all people, no exceptions” at that level. We just have to do the same at the local level.

As I was preparing for the Dallas lectures, I came across a note that President Carter sent me when I was leaving his Center to go over to Emory University. He was not impressed. And he would not be any more impressed with my recent move to Wake Forest University Div School.

He hates needless theory when there is something practical to do. And he hates pretending that someone else should do what we can do any Saturday. Science says that health comes from people being in the right relationship to each other. It always has.

That the power of the social.

Dirty Politics

Rulers have held conferences about food, hunger and health since the land between the Tigris and Euphrates rivers was farmed 11,000 years ago. Now every five years the United States Congress passes a comprehensive Farm Bill in that great tradition of balancing complicated and conflicting ideas about how to feed another generation. Governments have usually gotten their citizens enough calories in the short run, but screwed up the long run, turning farms turning into deserts. Mesopotamia, now Iraq, was “the fertile crescent,” just as northern Africa was the grainery of the Romans, just as Iowa is for us. Doesn’t bode well for Iowa.

At Joe Biden’s White House Conference on Food, Hunger and Health last week I sat behind Dr. Dean Ornish, the cardiologist who was derided for showing that one could reverse heart disease with nutrition, exercise and, even more controversially, social/spiritual support. On my left was the President of American Soybean Association, which has so successfully lobbied for their bean that it is second only to corn syrup as the most common ingredient in the American diet, including many products that are only barely identifiable as food. There were many such ironies in the room: food bankers munching on lunch provided by Google. Hospitals like mine highlighting community food initiatives in the shadow of our massive surgical towers that Dr. Ornish proved unnecessary decades ago. Meals on Wheels executives jostling with Instacart lobbyists. Organic farmers next to pesticide people. Chef José Andrés, the electrifying Puerto Rican Chef sounded the call to simply feed everybody…now; just do it.

The last time food rated a White House conference was under President Nixon 53 years ago when I was in high school. He opened the door to China, just as he opened the kitchen cupboards to food stamps, now called WIC and school lunch programs. He also had Earl Butts as Secretary of Agriculture who considered small farmers a silly distraction in favor of industrial behemoths. The mishmash of noble and industrial programs had all sorts of unintended consequences that their advocates understand need to be corrected. New York Mayor Eric Adams (sitting next to Dr. Ornish) wanted the health experts to be responsible for designed school lunches to be about nutrition, not calories: “we’re just feeding the next health crisis.” Donna Martin, The head of Burke County Georgia school kitchens asked for the same thing: “come to school, work in our kitchens, feed our kids.”

Food doesn’t come from a warehouse or even a kitchen; it comes from soil. The kitchen just links two astonishing complexities, the soil biome and the one in our gut where food turns into…us. We know now that the human gut biome determines much of our resilience and lifespan health. Many even speak of the “gut brain” to describe how the biome shapes our choices, emotions, patterns of behavior. The only thing more complex is soil itself. Bad dirt, bad gut, bad health.

Those complexities of soil and gut are largely shaped by the third, politics. Perhaps as complex as food and soil is the social biome; how the 8 billion of us love, fear and choose over our lifespans. Our social choices emerge from our social soil, not surprisingly these days producing poorly nourished decisions. Our civil society, Congress and courts are like children raised on Twinkies and Red Bull; our democratic process staggers in puff and bluster.

It is easy to be cynical about events like the White House Food, Hunger and Health Conference. But this is how democracies muddle our our way, and nearly infinitely smarter than letting the rich royalty dither. The day before the Conference, the White House released a thoughtful national food strategy with 5 pillars—the first one focusing on economic stability. This thoughtful document is only paper until it gets translated into the 2024 budget and the $1.1 trillion Farm Bill. That legislation will determine how many soybeans get subsidized, what kids get free lunches, what moms watch their kids grow healthy or smaller. As President Joe said, “if a mother can’t feed her child, what the hell else matters?” A handful of contested house seats will decide whether that legislation will will be shaped by the people who put together the White House food strategy or people with no strategy at all. Food policy shapes generations; Wendell Berry thought we should enact 50-year Farm Bill’s to break the dangerously short-term thinking. ( Jackson, Wes; Berry, Wendell (January 5, 2009). “A 50-Year Farm Bill”. The New York Times.)

The food conference should make everyone uncomfortable a half century after the last one. Different decisions could help our community systems produce much more health. But we have to include capital investments on the screen, which is especially sensitive for hospitals and industries such as soybeans and food chemicals. Once you’ve built something, you have to pay for it. Better scientific critique would prevent us making extravagant and unfounded investments that produce little real gain in health. Our non-profit industry has shielded our capital investment side from visibility to the community benefit legislation, so I don’t sense we have a lot of moral high ground on the soybean people. Like fixing the food stamp and school lunch programs, the hungry would have us fix community benefit legislation, too.

President Joe Biden bringing the word: “if a mother

Most politics is mostly projected out of the past, not the future. The arguments focus on keeping privileges, not getting new ones. That’s how the 3/5th of a citizen idea got into our founding documents: it kept slavery and made inevitable the Civil War. This is also how the subsidies for cotton, sugar, soybean and petrochemical industries end up the Farm Bill cycle after cycle. I was representing Stakeholder Health which has dozens of healthcare non-profits, so I was not comfortable about our illogical privileges, too. We give away a lot of free care. But we could be way more scientific about our investments, including the vast sunk cost of buildings. If we stacked all our bed towers next to all the soybean silos, I think ours would be higher, more expensive and harder to defend.

The day before the White House Conference I was part of a workshop convened by the Stand Together Foundation—a child of the Koch Brothers Foundation. It would have been easy to be cynical about this one, too. But the invitation was just as hard to turn down as the White House Conference, as the subject was just as fundamental: “social dynamics of health.” The two were windows on opposite side of the house peering into the same phenomenon.

The link between the tiny San Diego workshop and massive WH Conference is hard to miss as both events raise fundamental issues of how to achieve fundamental public good. One of the big changes since the last WH Conference is the huge expansion in the non-governmental non-profit sector, especially in healthcare. Neither meeting was about more charity. Rather, the issue is how to appropriately recognize our part of the community systems that create the population scale patterns of health. Whether we are big hospitals or soybean farmers, we should thoughtfully subjecting all of our community-facing policies to basic science critique, especially procurement and capital planning.

The place to start is the same place as doctors do, “first, do no harm.” Wendell Berry was a young man during the Nixon Conference. He was already famous for taking on the agro-industrial machinery that found small farmers so inconvenient and illogical. “What I wish to speak for here is the discipline in the Human character that makes him able to forebear and restrain himself when he’s doing obvious damage to other people.”

Bad food and bad food policy comes from ravaged social soil. Ours is worse than depleted; actively poisoned. Carpet bomb spraying of pesticides makes it impossible for bees to fly or think. Anyone who would do that has drunk their own poison. Dirty politics? I only wish that politics were as healthy, resilient and self-cleansing as dirt.

The maven at the heart of the San Diego meeting was Tom Romeo, VP of the Charles Koch Foundation. Tom had gathered a group of thinker-doers working with the homeless, in public housing developments, with police and troubled kids and two surprisingly cheerful economists. Tom gifted the participants with copies of Ivan Illich’s 1973 book, Nemesis and Deep Economy by Bill McKibben. The third hand-out was a paper TC, Jim Cochrane and I wrote for the National Academies of Sciences about “the health of complex human systems.” These are not what you’d expect of a Koch workshop; a signal that something very basic is changing in the idea soil out of which grows the social dynamics.

Illich, McKibben and my team argue that we have to see human health as the fruit of nested complex systems, just related as soil and gut. This is not a metaphor; this is why things happen as they do. It is why the planet is melting, bees dying and neighborhoods go hungry. If we do not think, analyze and dialogue in the complexity of the nested systems, we will break those systems. The farms will turn to desert and our children will grow small, theirs smaller still.

The data say that we are well beyond the tipping point and that we should despair. However, the natural systems testify that they rebound once the poisoning stops. The ozone hole we thought our doom two decades ago, is already half healed. The Monarch and the Honeybees will thrive too, as will all that comes from healthy soil, meadow and forest. The only question is whether our grandchildren will be here to enjoy it.

Winston Churchill used to say that you can on Americans to do the right thing…after we have exhausted all possible alternatives. Surely we have arrived at that place now since there is still a chance for the children. Bill McKibben, in his latest book, The Flag, the Cross and the Station Wagon notes that there aren’t many things an old person can do better than a young one, except getting arrested on behalf of their grandchildren. We have to try, take risks, be bold for those we love.

Trying in complex human systems means grown-ups talking to each other, especially those expecting to disagree. That’s why I reluctantly went to the San Diego conference and found myself among new friends. Trying means thousands of committees, some dealing with the trillion-dollar Farm Bill, some about the neighborhood school kitchen, some with the homeowners’ association figuring out how to stop spraying dumb chemicals.

Complex human systems seem overwhelming. But they invite us to be part of the complexity because everything matters. Just as every quart of poison spray matters, just as does every choice, every vote, every conversation with someone you thought opposite. Every kindness is honored; no love wasted, no healing intention lost. Chef Andreas is right; we have all the ingredients; we just have to try.

Two citizens, Dr David Beckman who led Bread for the World. And me, from Precinct 601 in Winston-Salem NC.

Honeybee Way

Some of the wayfinding women of Stakeholder Health as we met at Salem College in Winston-Salem Thursday and Friday: Heidi, TC, Dora, Amy, Anya, Somava, Shelly, Lauran, Anna. Women have learned how to do that at Salem for 250 years.

Honeybees are the most successful species of the most recent thirty million years. The honeybee in the fossil record is essentially the same as you can find on your nearest batch of clover. Humans, inexplicably proud of our brief ten thousand years, should pause in wonder. We are doing poorly as a species, unlikely to see more than a few generations. Ironically, is common to read stories on the human internet about the demise of the honeybee! These stories are based on the widespread collapse of commercial hive operations, which often ship hundreds, even thousands, of hives on trucks to pollinate vast almond orchards. The bees die by the billions as disease spreads easily in the unnaturally weakened hives, especially from the dreaded varroa mite—the “destructor.”

Dr. Thomas Seeley notes that in nature, hives are usually dispersed two or three per square mile and seem to be rapidly adapting the behavior to resist the mite. Smart money would be on the honeybee to outlive humans by another several million years.

So perhaps we should pause and ask what we might learn from the bees about ourselves. Bees are highly evolved with every body part honed to perfection. My favorite is the middle leg joint which has a little notch through which the bee pulls the antennae to clean them when they become clogged with pollen. My knees barely permit tennis.

It is not the body parts that teach us; we are stuck with two legs and no wings. In any case, you can’t build a strategy on what we do not have. What do we have?

The main distinctive of the honeybee is not its body, but the wonderous social structure of the hive. The hive—the same 3-pound weight as a human brain—is social, intelligent and highly adaptive. It makes complex decisions, including where and when to send out the mother and half the workers create a whole new hive. For 30 million years in a row they have made that decision with stunning success. Its most experienced foragers switch from looking for the daily nectar to become scouts or, I like to think, wayfinders. They find the way, help the hive decide and then literally lead them. They couldn’t find our home; we need our own wayfinders.

What do we two-leggers have to work with as we face a tougher challenge– finding a new way to live on the one and only planet we will ever have. Despite the fantasies of a handful of delusional narcissists with so much money they can’t think straight, we can’t go anywhere. Mars? No honeybee would think about it for a nano second.

Honeybees have a vast advantage in that their social life emerges from a shared purpose every single bee will give their life for. Just this afternoon I noticed as a bumble bee found its way into my backyard Warre’ hive, which has an observation window that allowed me to watch her being chased by a guard bee a tenth its size. Humans, cursed with social media can no longer distinguish common threats, easily distracted by individualized fantasies and fears. Bees never take their eye off their common future.

**Wayfinders!** Dr Kimberly Dawn Wisdom receives the first Stakeholder Health Dr. Ruth Temple Award from Dr. Dora Barilla as Dr. Jerry Winslow watches from Loma Linda University (Dr. Temple’s alma mater). All of them brilliant, brave with eyes on the future of us all.

Humans do have Spirit, which some think gives us the capacity for wisdom, social imagination and common courage when facing a true discontinuity as we are now. No hardwired species would have a chance. We still do because we have Spirit, which gives us the subsidiary capacities for lamenting the lost beauties and then deep accountability for making the choices that lead to life. We can do that and have in other times of radical challenge. It is not enough to be homo sapiens, or even as we like to claim homo sapiens sapiens ( the species that knows it knows). Our only hope is to claim our capacity as homo sapiens sanctus-the Spirited species. That one might be capable of metanoia—the Great Turning so obviously required.

A tiny step in the Great Turning happens these next two Wednesdays as some wayfinders gather on Zoom for a workshop based on a book under construction. I’m delighted to be doing this with Threshold Retreat and Farms, itself a worthy harbinger of the possible. We’ll also gather in July at the farm for some in person mingling with the honeybees. We’ll help each other be a little less afraid of our wonderful world and a bit more clear about how we might live with it—especially the magnificent honeybees.

Register here. The $75 goes entirely to Threshold Retreat and Farms, of course. I’ll even sweeten the offer by making sure that anyone who registers gets a pound of the wonderful single hive vintage honey from Warthog From Hell Honey—made by fierce southern Italian bees on our porch. If the registration keeps you away, let me know and we’ll find a way, of course.

In humans even drones can help! Arvind, Rick, Ed and Terry lend energy as we met in the Innovation Quarter .

Adults, flunking

“We will live together, or not at all. We will build hope and wholeness, or watch our children grow small, surrounded by ineffective barriers against their fears. We know that acts of compassion, nobility, faithful caring for the earth and her people are all we can do. It was once thought that acts of virtue, conservation and care were only of personal consequence. But surely it is the most fundamental adult responsibility to build and nurture systems that carry our hopes forward. (Faith&Health, The Carter Center 2001).

On national bee day (May 20) twenty leaders from Atrium Health met at The Carter Center to see how we might align our efforts to “To improve health, elevate hope and advance healing – for all.” This is a very large organization—some 70,000 people—serving 400 miles of rough Southern country. If the FTC allows, the circle of care will grow to include even rougher neighborhoods in Chicago and Milwaukee as we combine with Advocate-Aurora. Most of the people work inside traditional hospitals and clinics, but increasingly both science and mission draw us over the sidewalk and into the neighborhoods where elevating hope is like pushing a glacier uphill. Despite superabundant healing science and technology to see disease at the molecular level, the fundamental drivers of ill health remain mired in ugly patterns of race and poverty, often in the very same census tracts for many decades.

Adults are flunking adulthood; our children are growing smaller.

Many of my best thoughts were born at The Carter when the oak trees were smaller. The very first major project of The Carter Center was called “Closing the Gap” which asked, “how much of the current burden of premature mortality could be prevented based on what we already know.” Turns out the answer is about two-thirds. Who can act on what we know? Formal healthcare and public health are only a small part of the answer. The knowledge must come alive in the hundreds of thousands of non-profits, businesses and….faith networks. My Atrium Health collegues and I have made reducing live expectancy gap by 2030 our top level goal, so I am back face to face with the same great and still unsolved opportunity that started me in FaithHealth, still difficult for much the same reasons. The ideas that grew out of The Carter Center soil, with major help from our partners at Advocate 30 years ago, included the basic ones we are still working with today: strengths of congregations, boundary leadership, leading causes of life, religious health assets and now the prayers of the people. These ideas were like bridges across troubled water.

One idea we had at The Carter Center was “not even one,” the name from Dr. Fred Smith. Simple public health logic matched with fierce faith that refused to look past even one gun death of a child. We thought adults could be organized at the level of their town to investigate where they—the adults—had missed a chance to prevent each young persons’ gun death. It would take a lot of adults talking to each other.

The oak trees are now much larger and I find myself less hopeful than at any point in my life, sobered by war and melting planet and, most of all disabling political vitriol. So it was good to be at The Carter Center where preposterous things are made practical through tenacious and smart work: eliminating polio and guinea worm. Elections in places they are obviously impossible: Zambia, Liberia, Ghana (where I helped once). Again, diligent and non-naïve preparation, training of thousands of volunteer poll-watchers. Work in the service of noble values. Tenacious. Qualities that national Bee Day brings to view.

Yascha Mounk writes in The Atlantic about the doom spiral of “pernicious polarization”—when a society becomes fearful of its fellow-citizens, expecting ill-will and hurtful actions unprotected by law or norms that can interrupt the most ordinary days, say shopping in a neighborhood grocery story. The research indicates that the spiral is only broken by a cataclysm. You’d think losing one million people to a pandemic would do it, but it seems to have only accelerated the polarization.

Who is crazier, the shooter of children or millions of adults who allow themselves to be radically polarized?

Nobody at The Carter Center has ever been naïve about religion as both an asset and profound barrier to boundary-crossing labor. There was a time when religion itself was the agent of polarization, but that seems quaint now, replaced by raw political anger untethered by any traditional norms or rules. Our children grow small. Some are shot.

On National Bee Day, I wondered, “how do the bees avoid our kind of doom spiral?

Thomas Seeley is an impeccable researcher and professor at Cornell who has written graceful books about how bees make decisions. He has focused on the most profound risky decision of all, which is when a hive splits, sends out the current mother/queen with about half of all the workers to form a new hive. In “Honeybee Democracy” he describes in mesmerizing detail how the oldest members of the hive switch from seeking flowers to scouting for a new homesites and weigh the options. If they choose one too small, they won’t have enough honey to make it through the winter; too big and will be too cold to survive. There are six life-death criteria. The bees get it right more than 90% of the time. They have for 30 million years.

We face no less perilous a passage in finding our way toward a new political, healthcare system, economic and, yes, faith systems even as the natural systems writhe, shudder and buck. We can’t get it wrong. Seeley says there are five clues from the honeybees. The scout bees tell the truth about the many alternatives over 40 square miles. The process takes whatever it takes, maybe an hour, maybe three days. No leader warps the process. No bee lies to another.

Bees use their pin-sized brains collaboratively to scout for the alternatives and compare them to make a choice. (p100) It helps that the idea about “good enough cavity” is hardwired into those little brains. And, as in many things bee, there seems to be no detectible pride at the individual bee level. They share, then release, their individual perspective so the truth comes clear. Not shooting grandmothers and children is hardwired into even human brains. So we at least what not to do. Bill Foege, who led The Carter Center and led the field of public health to embrace gun violence as a disease once said that it is easy to have a brilliant idea; think of the dumbest thing possible and do the opposite. How do we choose the opposite?

There is no future when leaders warp our ability to talk to each other. Nothing works, choices become random and disconnected from reality. We cannot see each other or our children. We are absolutely certain to perish.

Humans do have Spirit to work with, which seems like a slim reed on which to lean. Since we have little hardwiring to move us toward common purpose, we can only hope Spirit is stronger than venal stupidity. We do have a few mature humans, so we know it is possible. But it seems like a slim hope amid the manipulated deluge of divisiveness.

The oaks at The Carter Center grow a little each year. About 15 years ago the Carters planted a small grove of American Chestnut hybrids selected from among the tiny handful that have not succumbed to the blight that wiped out millions. Real science. Tough hope. Carter—then 80 years old–knew he would not see if the experiment “worked” to again blanket the Appalachians. None of us can know any more about the seeds we are planting with our lives.

He is 95 and the trees are still growing. Listen to the man: “I have one life and one chance to make it count for something… My faith demands that I do whatever I can, wherever I am, whenever I can, for as long as I can with whatever I have to try to make a difference.”

Strong

I rocked back in my chair as Becky brought the prayer to life in her voice. I actually heard my own prayer as if for the first time. We had gathered on a gorgeous Connecticut afternoon at Round Hill UCC using my book God and the People as a magnet. A dozen of us had convened to talk about “prayer as if for the first time.” Although mostly life-long church folks, everyone was more than a bit curious and wary of this talking to God thing. Becky read my prayer, “between clarities,” which in her voice was like opening a Springtime window: “Ever unfolding one, We live between clarities about the most important things. It makes it hard to pray. We are not clear if You invented us to have some to talk to or if we invented you for the same reason.”

That’s not something that would happen with a bowling team. Probably not many of the ten million “nonprofit organizations” in the world, either. Congregations are different social beasts. Their DNA holds distinctive strengths to find, form and express Spirit. Staggering out of COVID amid a European war, with dozens of other countries including our own simmering at the civil boiling point… we need prayer. Not religious chatter. No abstractions. Certainly not just about certainties. Prayer as honest dialogue, listening more than talking. Together.

Congregations have eight strengths which have long held my interest and kept hope alive in my life. I wrote about this nearly a quarter century ago at The Carter Center in Deeply Woven Roots, still in print and used in multiple seminaries. I name the eras of my life by the names of the congregations that held me: Milford Mill, Knollwood, Oakhurst, St John’s and Green Street. I usually sat near the door with friends outside wondering what I was doing within; and those inside wondering why I was not further in. My best thoughts grew here as doubts matured into commitments that have endured woven like threads into fabric.

Ed, Shannon, TC and Gary in the sanctuary of Round Hill Community Church

The idea that congregations have strengths is surprising to some (especially clergy!). On this side of COVID we are remembering that we have more than Zoom and social media to work with. We have things that bring humans together, woven like roots too hold us up and find nurture. We—together—have strengths. And those strengths are adequate to the vast challenges of our melting contentious planet.

These eight strengths have been tested for nearly a quarter century in many communities and congregations of many varieties and traditions. They are there for hard work, built for heavy lifting of entire neighborhoods. The National Academies of Sciences Roundtable on Population Health used this model to help grasp the role of faith-based health assets in communities. The logic of strengths is the taproot of the Memphis Model, which is about congregations, not the hospital. The strengths are the foundation of the large scale faithhealth ground game growing in the Carolinas. They are the positive power of the social determinants.

The strengths of congregations mainly function on the other side of the sidewalk from the hospital. This is why the FaithHealth Division of Atrium Wake Forest Baptist Health is part of the population health group, not solely in the clinical hospital group. We have superb chaplains who are there in the radical crises of the hospital and the poignant times of transition. But most of the time, Spirit and the congregations that nurture and express Spirit flex their social strengths in the neighborhoods where life is happening. This is why the videos based on those strengths are on the FaithHealth.org website that drives our broad “ground game” improving health.

A quarter century after discovering the framework of the eight strengths and writing Deeply Woven Roots, we’ve put up a short set of videos to help you discover your strengths and your roots. The videos are edited so you can take in the logic, or focus on each strength that seems most relevant. Prayers strengthen Spirit; the strengths give the Spirit form, sinew, muscle.

Round Hill Community Church on strong Greenwich Connecticut rock

My experience has mostly been among those trying to follow the Way of Jesus, but it turns out that the strengths are present in any temple, mosque or ashram. They are, I think, the way God has made us strong when we are humble enough to gather as we understand ourselves in the presence of the Ultimate.

We—together—are strong enough. Let me know how your strengths are expressing in the neighborhoods you love. Drop me a note at gary.gunderson@gmail.com

Hurricanes

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.