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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.

Speak Life

Oh, it’s available on Amazon for $15. Here.

I wish I was handing you this in person in a decent restaurant with a bit more ceremony involved. But I didn’t want to wait to get my new book in your hands.

Speak Life: Crafting Mercy in a Hard-Hearted Time, is written for you, who have given your life to advance the health and well-being of the places and neighbors you love. Like you, most of the people captured by such a movement persist year after year for decades sustained by shared spirit, intelligence and sweat. I hope this new book will deepen and strengthen your energy for that movement.

Speak Life is being released in Orlando June 20^th at the Distinguished Lecture Series sponsored by Florida Hospitals, one of our Stakeholder Health partners. Most of the speakers and all of the audience are distinguished by their people and places they care about and the Spirit that carries them. If you’re anywhere nearby, please come (You can register here.)

If you’ve read my other stuff, you’ll recognize echoes of Boundary Leaders and the earlier Deeply Woven Roots. And of course, Leading Causes of Life and the Fellows Jim Cochrane leads. Speak Life is a more radical take on both leadership and Spirit. I’m quite sure you’ve experienced the same dramatic move yourself in these hard-hearted times.

Thank god for critical readers, editors, fact-checkers and proof-readers! Ray Tetz’s amazing team led by Alberto Valenzuelea and Becky De Oliveriera and our home team, especially Tom Peterson, Jim Cochrane, Maria Parries and, of course, TC.

Speak Life is published by Stakeholder Press and all the profits go to Stakeholder Health. This is a learning group tracing back ten years to the tough streets of Memphis, Detroit, San Bernardino, Bithlo and several times at the White House (back a couple of years). Speak Life is, in a sense, a radical view of the life of leaders that undergirds our earlier book, “Insights from New Systems of Health.” Nearly all of those practices demand grit and courage to cross over many lines of discipline and institutional politics.

The learning is accelerating: we will be releasing a third in the Fall that is more technical exploration of how the Leading Causes helps us understand how to organize and set priorities for our work in community. And then we really do put the pedal down in November in a bold “See2See Road Trip” traveling from San Diego to Raleigh: the move in movement.

Jerry Winslow, the Chair of the Stakeholder Health Advisory Group, writes in the forward: “From one perspective, the movement might appear to be merely the sharing of smart approaches to what is now called population health. But a more careful look, with focused attention to the spirit of the work, reveals something deeper and more lasting. It is life-giving joy in the hard work of the journey toward social justice. The real fuel for this movement is the conviction that together we can build communities in which every person counts, where no one is left out, and no one suffers needlessly because of institutionalized unfairness. To speak life, then, is to adopt the ways of life so that every person is celebrated by a community that genuinely cares.”

Rev. Larry Pray, the prophetic genius of Big Timber. He taught me that life has a language, which he is still speaking in his hardest of all days.

I want you to see Speak Life in the light of all of that highly collaborative learning. Writing is about the least impressive—undistinguished—thing you can do with a large number of hours. It is typing, often with a lot of silence between the clicks. When I slowed down, I thought of all the astonishing people who were generally not typing, but lending their lives to the urgency of mercy and justice. I tried to see what matters most through those many eyes.

I’m like one of the nameless grey neurons way back behind the eyeballs trying to connect the signals those many eyes are seeing. I’m not qualified to do very much useful most days, but I am privileged to work among wide extended webs of those who know what to do in the middle of the night standing with the First Responders at a suicide with weeping parents, who build a school for young women in the fire and dust of Kabul, who do surgery, administration, therapy, research and discovery into the mysteries of molecules and neighborhoods. Some of those agents are named Big Dog (the benevolent gang leader in 38109 of Memphis) and R. Ernest Cohen, the Jewish Integrative Medicine Chiropractor who runs a free clinic in Wilkesboro so frugal it borrows its Wifi signal from the tattoo parlor next door. Richard Joyner with his anointed prophetic tractor, the weekly amazements of Oakhurst and Green Street and so many more. You can get a sense of this in the new article about Soma Stout 100 Million Lives, which NewsWeek is smart enough to cover, too.

Taize France, early on the morning when Jim Cochrane, TC, Masana, Shingai and I spoke life.

Through this collective eye we can see life, tenacious and fiercely protective of its most tender edges.

And together we find the words to Speak Life.

I hope you like the book. Oh, it’s available on Amazon for $15. Here.

Gary

Finding Our Bearings

mapbig How do we find our bearings when we are so far off the known map? Last week I reflected on how bearings were the things we rest our weight on when times are mean. We humans simply must bear each others’ burdens. This is the essence of being human, rather than some other animal that only hurts, breaks down and takes what they can grab. Those lesser mammals are scary, but easily and always defeated by the kind that bears each other up, that tends to our wounded to inspire confidence and coherence.

Bearing means another thing, also helpful in this deeply confused and anxious time. We’ve lost our bearings, wandered off the map. The mariners drew dragons on the edges of their maps to warn the lost. We can see dragons from where we’ve drifted; just turn on the TV. Where do we find our bearings in these uncharted times?

You wouldn’t think it would be possible to lose our way on such a small blue marble of a planet. The problem is that the planet is so small that we can’t find any place where there are only people like our little tribe and no others. We need to find our way into working relationships with those who do not share everything and that we cannot beat into line.

Billy Graham dedicated his every breath to persuading everyone on the blue marble to agree with what he considered life and death and obvious: Jesus. At the end of a century of very serious effort, he got nearly everyone’s attention, but not their agreement. And many who did agree do not yet show they understood the kind and forgiving Jesus that animated Billy through his years.

People of such certainty as Reverend Graham are like a Rorschach test, telling us more through our response than their own witness. Some remember him helping pay Dr. King’s bail out of the Birmingham jail; others remember his voice like a sledgehammer on their teen ears. Gene Matthews, my health policy lawyer buddy from UNC-Chapel Hill, came from the same place as Billy. His dad knew Billy’s dad and remembers in elementary school in South Carolina that his teacher stopped class and had them put their heads down on the table to listen to the very young Billy on the radio. Gene turned out alright, serving as the General Counsel for the CDC through six Directors over nearly three decades. But many who heard Billy still wince.

I’m guessing that Reverend Graham would be more open and kind than many of the politicians eager for a photo op by his casket. Most religious leaders are more creative thinkers than their followers, especially the ones that turn their ideas into “fundamentals.” Of course, every faith leader should be expected to believe their own stuff enough to want others agree. But every religion has a mean and dangerous side, as well as an attractive and transformative one. Thee Smith, one of my colleagues from Emory, said that one of the key tasks of any religious leader is to try to make their religion safe for the rest of the world who do not share it.

Nobody—not even Billy Graham—can convince everybody on the Blue Marble to believe anything close to the same thing as long as it keeps spinning. Many religious leaders die at the hands of somebody who agrees with them on almost everything. They die for showing tolerance to somebody slightly more different than one of their own finds tolerable. Jesus, Gandhi, Martin, Malcolm were all killed by people who worshipped the same way. Some Lutheran clergy can still get fired for praying in public at the kind of community events we’ve seen following Parkland horrors.

Religious identity remains a useful blunt instrument with which to pummel others who stand in the way of something some 1% wants. However, we humans continue to diversify even as we become more intimately entangled with each other. We eat food grown by, work on machines made by, drive on highways shared with, fly on planes piloted by and are nursed by those we do not expect to worship like us. Not in 2018.

Foothills Free Clinic in Wilkesboro, NC. About the most mundane place for miracles since the Pool at Bethesda. I think Jesus would have liked that the clinic borrows the Wifi from the tattoo parlor.

These days you just never know whose hands you might find on the the plough next to ours. The Foothills Free Clinic in Wilkesboro, NC is driven by the generous practicality of tough hill people of faith. The key volunteer is Dr. Ernest Cohn, an integrated medicine practitioner and chiropractor who is Jewish. More than a thousand of his neighbors—probably not Jewish—owe their lives to this clinic, now a working partner of the hospital called Baptist that I work for.

Any agency, public, private or faith-based who has a mandate to care for any real place–any real city, any real state, any real neighborhood—must figure out how to make this radical diversity an asset. On the ground where the poor are trying to find any hope at all, the people who care need every type of person of every persuasion to share the care. The practical daily labor involved in advancing the health of that place depends on aligning all the assets of all those motivated to help.

Weaving difference is an essential competence of anyone trying to heal anything more complicated than one organ system on one occasion. Even there you may damage the human involved even as you get the surgery right, if you make unfounded assumptions about who they are. Pause the knife to ask if the person’s faith is an asset or complication in what you are hoping to do with their organ. Do they believe something that will interfere, or perhaps accelerate, the healing modality?

As soon as you try to do anything beyond one event in one organ in one human, you simply must use the arts of collaboration with eyes wide open for the durable complexity of human populations. Here you look for the social structures of faith that mediate the dynamics that might keep us apart. Those social structures of faith—some 300,000 communities of Spirit in the United States alone—not only buffer, but nurture the capacities for collaboration and compassion.

Counsellor Anita Holmes in the main hallway of Leonard Hall, built as a medical school, not the Divinity School of Shaw University.

How do we work with those social structures of faith in collaboration with government and private entities such as hospitals? Good question. That’s exactly the question that the National Academies of Science Roundtable on Population Health is addressing on March 22^nd in a special workshop exploring faith-based assets and population health. The free, one-day public workshop will explore challenges and opportunities for health sector actors that engage with “faith-based health assets.” These organizations and social structures, in the form of congregations and religious community service networks, collaborate with others in communities, including health systems and public health agencies, to improve the conditions for health and well-being. There will be voices of many faiths including Muslim, Jewish Sikh, B’hai and varieties of Christian.

Please visit the registration page to sign up for the workshop or the live webcast and visit our meeting page for more information (additional resources will be posted before the workshop).

Leonard Hall, Shaw University, Raleigh, NC.

Shaw University is the perfect place to explore this beyond the chirpy happy talk that often marks discussions of collaboration. Shaw sprung from the bitterly tough minded hope of the post-Civil War black faith, barely around the corner from slavery at the hands of white Presbyterians. They knew racism of every kind–structural, informal, legal, illegal, cultural, subtle and full-bodied screaming, complete with the strange fruit of lynching. And so they created a school. This included a school for preachers, but those preacher-students helped lay the bricks for a school of medicine. Almost at the same time Harvard did, Shaw had a four year school with a hospital on campus. That school was closed by the Flexner Commission, which was charged with standardizing medical education, but went one lap further, taking the opportunity to scrub out nearly all the annoyingly persistent and impertinent Black schools. Wake Forest, up the road with a far lesser story, made it through, so we have the $3 Billion medical center today, not Shaw. Strange institutional fruit, indeed. Yet Shaw persists in its hopeful work today as the embodiment—not of an institutional lynching—but of tough-minded, “gonna-find-a-way” equipping of the People.

Consider coming to Shaw on March 22^nd. Who knows what will happen? Who knows what we’ll be able to see together? I suspect we’ll help each other find our bearings.

Tender

Things are seen in in the terrible intimacy of the ED every day that should not happen once in a thousand years. Except they happen in entire zip codes, too; the same damn ones for decades. This morning I presided over our hospital “safety huddle” where we report to each other about events, concerns and needs, often using abreviations and acronynms for highly technical and fraught things that happened; “peds abuse procotol” instead of whatever the true story would be in the life of a child hurt by whoever was supposed to protect her. Those break this grandfather’s heart (Charlie turned 3 yesterday).

Last week I was in Atlanta at the advocacy leadership table of the American Public Health Association—the health colleagues at the exact opposite end of the professional continuum from the two child abuse cases reported out in our hospital safety check-in today. Last week John Lewis opened the APHA with words both fierce and tender about justice and kindness as the zillionaires try to walk off with another trillion or two.

Big numbers and repetition can make us hard and dull; but they don’t have to. We live in such a hard-hearted time. Today the sharp edge of medicine was felt by a nurse who is also a mom with a high school son taking chemo. Later at Green Street church, we lifted Aaron up even as we were still wordlessly aching for Cole, our six-year-old who died only last Sunday. How can we can we keep our heart from closing down?

Cole Weaver’s friends decorated the church in his honor.

In my Christian tradition, we have Paul’s words on love, written to the contentious gaggle in Corinth. These are mostly wasted on romance when we need them in the bitter struggles to give hope a chance one patient and a neighborhood at a time.

“If I speak in the voice of powerful people or spirits but do not have loving kindness, I am only a distracting noise. If I have predictive data and interdisciplinary analytics that give me confidence to move mountains of poverty, but am not kind, I am nothing. If 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.”

“The love that life needs is patient and kind. It does not envy others’ projects, it does not boast of our own skills, it is not proud. It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of who got more. Loving kindness does not delight in anyone’s failure but rejoices with the truth. It always protects, always trusts, always hopes, always finds a way.”

“Love 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.”

“For we know in part and we predict in part, but when living complexity becomes visible, what is partial disappears. When we were young in our work we talked like beginners, and thought like beginners, reasoned like a students. When we became a grown-ups, we put the ways of childhood behind.”

For now we see only dimly as if looking through a smoky 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.”

“For only these three remain in life: faith, hope and love. But the greatest of these is love.”

God, our simple prayer; keep us tender.

Kathryn (my kid) shows Charlie (Lauren’s kid) his cake that she crafted .

Crafting life together

fullsizerender-8 It can all fall apart, this democracy thing. It’s not like gravity that makes rocks fall, even if you don’t believe in it. Democracy only lives in the mind and spirit and evaporates when we forget it. The belief that people can elect people who care enough to more or less do what they said they’d try to do rests on a fragile set of behaviors and values. For instance, that elected ones won’t lie and laugh at the same time. Basic stuff; it’s a low bar but one we have dropped below.

I was on a Delta flight to Denver Wednesday on my way to a meeting of the Stakeholder Health Advisory Council. Trapped in a middle seat between two suits who immediately turned the inflight video monitor on Fox News inches from my face. The guy on my left opened up a vast laptop with a powerpoint about the 10 things you need to know about illegal immigrants, including the “fact” that 79% of food stamps go to illegals. I’m pretty sure that in North Carolina half of food stamps go to Baptists, because half of everybody is a Baptist. I didn’t know how to begin the conversation, so I just turned on CNN. I’ll do better next time.

How do we craft a working democracy again; one where we can talk to each other? In a nation where hardly any of us came from here, you wouldn’t think that would be that hard. We are all a muddle, all some kind of mutt. My last name is Norwegian, but 15/16^th is something else. Nobody is the same, even those that think we are. All the Evangelicals and Catholics turn out to have abortions and divorces at nearly the exact rates as the liberals, who are presumed to not be Evangelical or Catholic, even though many are. We are all just doing the best we can to be decent parents, brothers, sisters and citizens, the whole time we know we are not doing a very great job of any of those roles.

Loma Linda University’s San Bernadino Campus includes a community health clinic and a stunning gateway school for high school students to begin their journey into health professions.

In such a motley group, it is important to avoid letting someone else tell you who to be afraid of. This is especially important when by any rational basis you have never actually met one of the fearsome people. I’m thinking, of course, of the many Muslim physicians without whom our hospitals named Baptist would have to close. And the many, kind family-oriented Spanish-speaking men and women who have found refuge in our city, rebuilding the south side of town with an entrepreneurial earnestness. Why be afraid of them? I’m more afraid of the people trying to make me afraid.

Of course, others want me to be afraid of white small town Baptists, who did, admittedly, vote for our current White House occupant, which I find mystifying. In my actual experience, these folks are kind and generous to any request for mercy, willing to drop anything to go build a wheel-chair ramp for a total stranger. The rural churches are naïve about the ecumenical nature of opioids addiction, alcoholism or poverty. If I needed food, I’d head to a church, confident they’d help no matter how inconvenient.

Here in gentle Winston-Salem, we had some very ugly, but predictable, outbreaks of threats against the two Muslim Mosques where our doctors worship. We don’t know who did it; but I’m sure they’ve never met a Muslim. I’m certain that, if we asked the Baptist Men’s groups to turn off Fox News and head over to provide protection, they’d do it. If they brought their wives, everyone would quickly find pull out grandchild pictures and complain about the teenagers. The kids would play soccer together as they do at school.

Sometimes, all it takes is an invitation to do better. Many of those claimed as friends of the mean have simply not been invited by to do anything else than put a dumb red hat. Shame on us for not asking more.

Jerry Winslow is the chair of the Stakeholder Health Advisory Council. He and I were together a couple of weeks ago at Loma Linda University Health’s institute for Health Policy and Leadership. Amid the heavy policy discussion we found some time to turn a gorgeous piece of maple burl and reclaim a piece of chestnut bowl I had managed to turn a hole in the bottom of. Jerry, the son of a German immigrant home builder, has been a master craftsman of wood for decades.

Jerry Winslow, teaching as always, this time at the lathe.

On Saturday Jerry took me over to the 1909 Gamble House, the epitome of “craftsman” architecture in Pasadena. It is a revelation in simplicity. Every single joint, lamp, door, handle, light, stair tread and attic beam was thought about and then crafted to express a perfect blend of form and function. The two architect brothers, Greene and Greene, were part of a vibrant global movement that saw in craftsmanship the hope for democracy, the possibility of a human culture. This was no small thing to believe amid the turn of the raw and violent century where industrial bigots had their way nearly unfettered. Something as modest as a well-crafted cottage might seem hopelessly irrelevant against the unstoppable tide of crass exploitation. But not if that cottage, or chair, or perfectly made lamp is an expression of integrity, consistent with a whole way of relationship to other people and the created order. What if such people outnumbers the mean crass ones? What if they—we—crafted a democracy?

Just a few of the billion perfectly crafted details designed into the Gamble House.

In fact, the craftsman movement was a strong signal about what mattered most, a thoughtfulness about how to live a well and worthy life. Frank Loyd Wright (a man of no small number of peccadillos) said of the movement: “Do not think that simplistic means something like the side of a barn, but something with a graceful sense of beauty in its utility from which discord and all that is meaningless has been eliminated. Do not imagine that repose means taking it easy for the safe forest, but rather because it is perfectly adjusted in relationship to the whole, in absolute poise, leaving nothing but a quiet satisfaction with its sense of completeness.” (Architecture and Machine, 1894).

It is time to craft democracy again with the same thoughtful attention to form and function as our earlier teachers lent to working with wood and home. Some of the old tools work fine, if sharpened again. Jerry still uses tools he acquired decades ago, now sharpened to a fraction of their original length. I just bought some 100-year old Sears Craftsman tools on EBay for $25. Old tools still work: Precinct 601 met in the Single Brothers House of Old Salem where democracy has been argued for a couple centuries. We elected a new party precinct chair, Kate Hayden, who looks for all the world like Bernie’s granddaughter, but knows the craft of elections. First job is to get to know each other, have a party for the party, read some books and talk like humans who are capable of caring and thinking about what matters.

I have some very modern carbide tools, too. Likewise, we need to craft to the relational technologies like twitter that are too powerful to leave to the mean and desperate. This is how I think of 100 Million Healthier Lives, the unprecedented collaboration led by Dr. Soma Stout of the Institute for Healthcare Improvement. The craftsman movement has something of the same challenge to figure out what to do with industrial machines; but democracy is played for much higher stakes than any lathe. Respect the medium; watch the density and grain if on a lathe; watch the pattern of need if crafting public policy. If you don’t love the wood or the people, go do something else.

When there was much to fear in a culture gone to mere machinery, the craftsman movement trusted thoughtfulness and beauty from integrity and the life well-lived. These democratic and communitarian values stayed alive in the culture expressing themselves later in the practical compassion of the Civilian Conservation Corps (which turned Jerry’s German immigrant father into a craftsman), Social Security, the policies favoring religious hospitals and non-profit health insurance. They crafted institutions that removed abject fear of penury from aging and made it possible to fight a skirmish, if not war, on poverty itself. Think of it as graceful joinery the Greene brothers would have liked.

Jerry’s old tools fit for the craft. “Life is not a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside thoroughly used up, totally worn out and proclaiming, “wow! What a ride!”

Democracy can all fall apart; But it can also heal and find its heartbeat. I think that is what is happening.

The meanest bully by the beach that we find so shocking today is nothing compared to the raw and untethered industrial power a hundred years ago. We have seen worse bluster fail before well-crafted policies and institutions built by people no smarter than us who wanted their life to simply be good.

They even left some tools behind that just need to be sharpened, put to the grain by hands willing to learn. Find your party precinct meeting, show up and get ready for the next cycle of voting. Make an appointment with your congressman just to tell them what you care about. Take your state representative out for lunch with a couple friends. Volunteer for a church mission committee and go find somebody to help. Plant a couple hundred trees like my brother did at his Presbyterian Church along with some Muslims up the block. Go read a book to a kid. This is how you craft a community, a culture, a life.

Let’s do that.

Body politic, limping

Life through the bullet holes — Sprouts find their way through the bullet holes in an old refrigerator in North Georgia. Maybe life can sprout after an election, too.

Ninety or so days from now our body politic will be on the other side of the most dangerous passage since the Civil War. (Here’s an exact countdown.) I think that Mr. Trump will have found a way to abandon the process between now and then (he’ll think of it as firing democracy). I’m not interested in what he’ll do on November 9th, but very interested in everyone else in a position of public responsibility and how we play our roles in a bruised and disoriented body politic. Every elected official in every county and town, every public officer responsible for public health or law enforcement, all of us with public roles in key institutions such as hospitals, major companies, press and religious leadership face the question: how do we do public work in a broken public body?

Our social and political body will walk with a limp. We’ll have a split mind with both sides almost incomprehensible to the other; like symbiotic twins of different species unable to find any words or gestures that are not interpreted as hostile. Forty percent of our fellow-citizens resonate to Mr Trump’s views, even if they might hope for better manners. But the intransigence could continue for a long time.

This is why we need to shift our attention from the battle, to how we live together afterward. Nobody has a bigger stake in this—or is in a better position to do something useful—than those of us working health, prevention, public health, healthcare systems. In gross financial terms, we are more than a trillion dollars of the economy, with millions of people working as nurses, janitors, researchers, doctors and the whole panoply of roles across our thousands of institutions. Those of us in faithhealth are even more relevant, because we live across so many boundaries of both faith and health.

river emergent COVER ART — Kathryn’s sketch of the many channels the Mississippi cut over time, always finding a way.

There is hardly any more possible diversity of faith and politics than inside one of our institutions, so we don’t have to go looking for someone who doesn’t agree with us. The nature of our work puts us in the midst of the most profound moments of hope (birth!) and shock and lament and sorrow on the human journey. We don’t just see the traumas. We can see many of them simmering in grinding poverty and the brokenness that passes from one generation to the next, the predictable implications of the insults of race, class and stigma.

As health organizations, we find ourselves right in the middle of the most contentious public policy issues. All of the third-rail issues run right through our buildings. We care for the undocumented immigrants (of course, we do) and the beaten up women, and the veterans with all the wounds that you can’t see. We know the eyes of those who can hardly recognize themselves because of addictions and dependencies. We know those surprised by vulnerabilities of age and the disconnections of the 21^st century family. Those of us in public health know the streets where all these patterns live and we ache with the knowledge of how much of the suffering could be prevented or buffered.

mandela cave — Sprouts find their way through the bullet holes in an old refrigerator in North Georgia. Maybe life can sprout after an election, too.

We know a lot about bruised and broken people. Now we need to focus on our role in a bruised and broken body politic. To heal that body requires a new humility in our language and a quiet tenacity in our work.

Gene Matthews, now faculty at UNC School of Public Health, spent many years as the General Counsel for the Centers for Disease Control, many of them working for Dr. Bill Foege. I also worked for Bill at The Carter Center, so when I came to North Carolina a few years Gene reached out to me. Gene introduced me to the writing of Jonathan Haidt and his recent book The Righteous Mind, which turns on very bright lights on the way to much healthier public dialogue about the things that matter most. Haidt, a professor of moral psychology, says there are six “moral intuitions” that function like taste buds for all people. Liberals (my people) tend to have a taste for caring and fairness (meaning equality) which we prefer with a touch of liberty. Conservative have a broader pallet, which includes caring and fairness (to the surprise of we liberals). Conservative have an equal taste for the virtues of liberty and also loyalty, respect for authority and “sanctity.” This last one is not just religiosity, but a sense that some things are sacred and deserve protection. Haidt argues that conservatives—and conservative political movements—have an advantage in that they can appeal to all six, while liberals aren’t even trying on three of them. This was true at least until the Democratic convention last week with all the flags, religious singing and Mr. Khan whipping out his pocket copy of the Constitution.

It’s not a perfect book. Haidt wanders off the rails in his description of religion as a kind of social Elmer’s Glue. As much as he values sanctity, he left the whole field of faith somewhat less than sacred. And he takes some odd detours to pick an argument with Kant. You can skip those parts. But don’t skip his core gift to us, which is a hugely helpful framework that helps us see and talk across our otherwise impossible divide.

Haidt argues that we humans are prewired for righteousness so deeply that we can sense these six moral flavors intuitively way before we shape logical moral arguments. This is basic to how we humans form highly complex social bodies far beyond the simple ties of blood and clan. And this is also how we can map the pattern of traumatizing bruises which mark our body politic today. And this is how we can see the need for urgent humility by which those of us in positions of influence in our complex human body can create a new pattern of deep listening and dialogue about the things that matter most. Haidt begins and ends his remarkable book by quoting Rodney King’s immortal question, “can’t we all get along?” Less quoted, but not overlooked by Haidt, was King’s follow-up counsel: “we’re all stuck here for a while, so let’s try to work it out.”

Some think our only common language is money—what things cost and who should pay. I’ve even watched churches collapse under the heavy and highly visible hand of economics squeezes the air out of otherwise adult discussion: “be realistic and act like a business.” Health organizations often succumb to this even though our daily life is filled with evidence that when life hangs in the balance, money often matters the least. What we actually have in common is not money, but the human journey of health, frailty, dependence, pain and the fear of pain, loss and the fear of loss. What we actually know is how our life is shaped by those we share it with, those who care despite all boundaries of blood and coin. This is why I think those of us in the health fields–including the massive number of community and faith partners—are in such a profoundly key role in this moment when our body politic suffers so deeply. We can understand each other because we are all on the same short and fraught journey.

SONY DSC — The first celebration of July 4th was held in Old Salem while George Washington was passing through. It’s reenacted every year as a service of prayer for peace.

One thing health people know is that words are not enough. Words are not even the beginning and they are hardly important at all at the end. We may need Haidt’s counsel to talk among ourselves and then again when we have the chance to explain ourselves in public. But most of the time our eloquence is quiet. We keep our doors open to anyone all day and night. Despite the fabulously expensive technology and astonishingly prolonged training of thousands of staff, every non-profit and faith health system gives away tens of millions of dollars of care every year on purpose. We are required to do so as part of public trust, but most everyone of us goes well beyond the minimum bar. This passive waiting in readiness kind of witness is part of the glue that holds society together, that defines us as a moral people at all. It is good, indeed very good. And it is not enough for this broken moment. For we know we can be proactive with our mercy; we need not wait, we know better.

The Stakeholder Health book, “Insights from the New Systems of Health,” looks like a kind of textbook based on our collaborative learning; and it is. I expect dozens of courses to use it in the next few years (TC and I will be teaching one ourselves at Wake). But more than a textbook, it is a collaborative witness that is map for healing out social body. Its 44 authors wrote about the social drivers that shape the health of people and neighborhoods. They wrote of population health as the common ground for those professing public health and those running healthcare organizations and hospitals. The book did not quite say the obvious and most profound thing. The social body itself is bruised, but resilient. The social body itself is defined by biological, psychological, social and spirit aspects, inseparable as the facets of an emerald. The social body itself cries out for the practical, on-the-streets intelligent love found in the daily walk of community health workers. The social body itself thrives when generosity is humble and smart.

This is already happening all over the nation and world everywhere I look. The wild organic sprawling testimony of 100 Million lives is hitting on all six of Haidt’s cylinders. There was not a syllable in the Stakeholder book that you could not go and see on Monday morning. We were describing, not imagining.

Even in fractured North Carolina the heart of the body politic is beating even as the political bruising continues. Every single day I see a truly astonishing level of serious collaboration quietly crossing over all the supposedly impossibly treacherous chasms. Competing hospitals share data and teach each other about how to come alongside the poor. Black, white, liberal and conservative Baptists are working together on the meanest streets–some paved, some not. Republican sheriffs and way liberal Hispanic activists are quietly helping each other keep faith with all six of Haidt’s moral intuitions. With just a little bit of humility and decency very different kinds of people find a way when the work is about real people. That’s the NC Way.

Haidt would ask us to describe our work and witness not just in the liberal flavors of care and fairness (as we usually do). We could—and thus should—embrace a more robust and compelling witness that resonates with the broader values that honor the sense of loyalty so typical of healthcare teams, the sense of respect for authority of many kinds that govern the practice of medicine and public health.

And we should claim in humility our deepest intuition that our work is sacred because we humble ourselves before the ultimate human mystery of life and death and the life of the common body that goes on beyond us all.

Dawn over Winston-Salem. It happens every day, if not always this pretty.

New systems of health

Sometimes when you’ve been walking a long time you forget how far you’ve come and far you can see from the crest. This happens more in the folded and forested Blue Ridge than in the wide open west. But even there above the tree line where it seems you can look right around the curve of the planet, you still have to remember to look up and notice the view.

That’s what I felt when I held the new book Stakeholder Health, Insights from New Systems of Health. It is collaborative learning at its best, edited by Teresa Cutts and Jim Cochrane, two synthetic thinkers who make everyone around them smarter. They were surrounded by 44 authors who were already pretty smart, but together the voice is brave and sure.

Dr. Teresa Cutts at the Rolling Release of the book at Chicago Theological Seminary.

In a time of fear and anxiety, Stakeholder Health writes with collective confidence that we—a very big we—are already well on the way to being new systems of health. We are certainly far enough along the way that we can see what we have to work with: a deep well of tested intellectual tools, street-smart tools for mapping community assets, clarity about the powerful integration of body, mind, spirit and social.

What is new about the new systems? Nearly everything. The new systems are marked by realizing they are systems, not just structures. And we are systems of systems interwoven in complex ways that are impossible to map neatly. But the chapter by Maris Ashe describes the tools we are finding useful in living into such complexity. The next chapter (not as smart, but not bad)(I led the writing team) describes the new ways of leading rapidly emerging in the upper reaches of hospitals today. The next, led by Dora Barilla and Eileen Barsi dives deep into the electronic connectional apparatus, which is how these sprawling systems find coherence and get work done at very large scale. Information technology (IT) is giving way to Relational Technology (RT), which changes everything.

Kirsten Peachey, of Advocate Health Care, outlining the chapter on Integrating Care to Improve Health Outcomes: Trauma, Resillience and Mental Health

The next three chapters are a sweet suite on intellect and testimony vibrating with hopeful, practicality. Nancy Combs of Henry Ford Health led the chapter looking through the lens of community navigators and the radicalizing affect they are having turning the new systems of health inside out. Teresa Cutts (“Dr. Honey” in our home) led a global quality team laying out the extraordinary depth of logic and practice allowing up to map community assets with as much rigor as we’ve long had to map needs. This chapter by itself will change the future of “community benefit” and its tame model of Community Health Needs Assessment. The chapter on integrating trauma, resilience and mental health, led by Kirsten Peachey, will likewise radicalize the thought and practice of “integrated health.” The three chapters together are positive bombshell with energy and intelligence released because of who is in a position to act on the new synthesis. It is profoundly good news, except for the old in-bred guilds trying to hold their power.

Kevin Barnett led the team building the case for a new financial accountability; indeed, a whole new financial logic that synthesizes all of the above so that we are a whole new business—health, and at large scale. This is taken to another radical edge by Doug Easterling and Alan Smart’s chapter on philanthropy. Between the two chapters, we can for the first time see the flow of money at the level of the whole system called health. We can begin to see how the old patterns of tame complicity can be cracked open to let the money flow through to the biggest opportunities.

Jim Cochrane led the writing for the chapter that puts all this American chatter into global context and thus accountable to world class intellect and practice. So much of what is old and creaky in our systems is peculiarly American; so much of the new now emerging is global. This sets up the chapter led by Jerry Winslow – a global citizen who happens to live in California—on mission and the heart of healthy community. Every bit of the book is a call to bold mission, not because of who started them, but because of who needs them—the world that God so loves. All the science, technique and technology fit the work of mercy and justice. Let it roll down.

Even the appendices have some bright lights where you wouldn’t expect them! The first appendix lays out the learning journey of Stakeholder Health, which began in a blizzard in Memphis, turned into the Health Systems Learning Group and found our way through an extraordinary array of learning experiences. I don’t think any of us realized how many steps we had take to the get to the the view (hence the mountain metaphor above). Appendix two is a rich collection of population health screening tools, sure to help many hospitals—and no small number of graduate students. The last appendix has numerous mission and vision statements new guiding hospitals and religious bodies in the field.

The book is in a “rolling release” in Chicago, Winston-Salem and next Tuesday in Oakland. Each bounce gives voice and visibility to the local authors and engages the networks most relevant to the local institutions. You can track it all, of course, on the stakeholderhealth.org website.

Most of the authors work for one or another of the new systems of health, so there is optimism but no happy talk. Most of the new systems are surprised to learn they are new because all of us spend the vast majority of our working days engaged in very old problems. Even when you are near the clearing at the summit with the great view, you have to watch where you put your feat rock by rock or you’ll hurt yourself. I happen to know that is true. The caution is not the whole story, however. It is significant that those of us inside the beast(s) can see the new emerging.

The book will be available for free download chapter by the chapter on July 1, which makes it a kind of textbook likely to be integrated into courses of many disciplines. And it is also available now to purchase on Amazon for $19.95. Just click here. Today.

CS010816-050 (1) — Rev. Francis Rivers, the Faith Health Division’s lead organizing an Identity card drive for the Hispanic/Latino community. Part of what is very new in our New System of Health

The cover picture was taken on a chilly morning in Winton-Salem where one of the New Systems of Health—our own little Wake Forest Baptist Health—found ourselves in the position of having done something really smart and right. We had lent our name, presence, religious voice and political weight to a program offering validated picture ID cards to hundreds of undocumented Hispanics. They were part of the new system of how our city works and who mattered. They honored us by trusting us enough to show up. We were helping each other find our way into the future we were already partly living in.

That’s why that gorgeous picture is on the cover: we are far enough along that we can learn from the journey, pause and testify that we’re on the right path.

Runaway heart

My daughter Lauren is about to give birth to my second grandson, which, with her sense of dramatic timing will probably happen on Mothers’ Day. This also kicks off Nurses’ Week in hospitals. My wife and my (now former) first wife are both clinical professionals and moms. Most of my staff in the FaithHealth Division are women and the men are in touch with their feminine side or they couldn’t do their work of care for the bio-psych-social-spiritual dynamics of the thousands about whom we care. For ninety years our largest partner–the NC Baptist State Convention–uses Mothers’ Day to collect an offering for our most vulnerable patients.

So I’ve been thinking about the expansive caring going on; and the unknowable, but real limits to our reach.

Last Saturday it was my turn to lead the Medical Center’s daily “safety huddle”—the mundane miracle in which every operating unit of the health system from chief medical officer to security to food services and everything in between gathers to report on whether each of us has an event, concern or need to report. Even if we don’t, we have to say so out loud to our colleagues. Usually it moves fast, but sometimes it just stops the heart. Someone reported a situation with a runaway kid who had been compelled to come to the ED by her mom, who promptly run away herself, leaving the kid in our care. Except then the kid ran away from us, too. Everyone hurt hurt. We all dealt with our sense of profound limitations even when the 14,000 hospital people were multiplied by the police and social services. I couldn’t get it out of mind, so the next morning slipped in a prayer amid all the operational chatter:

As Jerry Winslow has noted, it takes a lot of sawdust to find the second life of a tree.

“Mother God, we pray today with thanks for the big heart and strong muscles you have given us so that we might be healers amid so many lives. Every morning we see how big a family of colleagues we have that is constantly present to do what is possible for all who come. Today we pray for all events that raise our concerns for all the needs we cannot satisfy that we cannot get out of our minds, hearts and bones. The runaway kid from yesterday with the runaway mom who left her. All the husbands without words sitting next to their wives with cancer about to leave the whole world behind. All the people who have lost their way to any hope except for the medical miracles that lie beyond us, too. Keep our hearts tender like a mother for all that love lets in. But keep it beating and open for each other and your great spirit so that we might be smart, gentle and kind for this one more day.”

The first cut through the pith lays open the astonishing grain of the burl.

The British Medical Journal has been thinking about this, too, although in grim language of “multimorbidity:” “Across the world healthcare systems are struggling to cope with increasing demands and costs. Rising life expectancy has been accompanied by an explosion in the prevalence of long term conditions and multimorbidity.

“Clinicians are working within legacy systems that were developed to deal with 19th century problems—they provide specialised responses to acute illness and infection. At the same time daily practice is strongly influenced by an ever expanding array of disease centred guidelines that don’t map neatly to the realities of clinical practice, in particular the ubiquity of multimorbidity. The result is fragmented, poorly coordinated health services for those most in need—vulnerable patients with multimorbidity. Today’s healthcare professionals are faced not only with rising disease-disease, drug-drug, and disease-drug interactions in multimorbid populations but with the increasingly evident consequences of socioeconomic disadvantage.

The rough and twisted bark hints at the pattern.

“Meanwhile, patients, their families, and their extended social networks experience not only the burden of symptoms but the burden of treatment. This is an emerging but underi-nvestigated phenomenon. It has received increasing attention recently, and interest has been growing in how to define and better understand the concept.” ( (BMJ Published 10 November 2014)

We could join the public chorus of complaint and rage about what the world is doing to us and demanding of us, as if expanded life span were a mean trick on all of us. Or we could work on what lies between us, the weak ties that could be strong, the empty spaces that could be filled with compassion and carefully tended connections. Even in our mean and stupid time, we are witnessing the dramatically hopeful emergence of webs of trust where you’d think they would be impossible—North Carolina, where you can’t even pee without the government telling you how or where. Good grief. But even here—maybe especially here, where powerful elites have told stigmatized and despised people where they could drink water and pee for generations—webs of compassion spring up on the bitter soil like desert blooms in random rain. Don’t ever be surprised by what a privileged but anxious elite will do badly. And don’t ever be surprised by the fruits of compassion, either. That’s what we are coming to call the North Carolina Way and it is big, strong and unafraid of tough neighborhoods and runaway everything.

When I hurt myself last June, I was drawn into being a partner in the healing of my own body. I have been learning in wonder how we – even me!—are made for healing. Of course we are, since we are also made to be bruised, wounded and broken. All of us, sometimes at others’ hands, but usually a mélange of our own mistakes along the random human way. (That dumb overreaching tennis decision wasn’t my only one!). I’ve been learning to turn wood on a lathe as I healed and found myself drawn to the wonder of hardwood burls, the growth that emerges where a tree has been broken or violated with some sort of trauma. The wood in the burl has a weirdly complex grain pattern, twisty, dense and wondrous. The mysteriously beautiful grain reduces me to respectful awe as the smooth cherry takes a beeswax polish. I think, of course, of Lauren’s pain and that of every woman in my life, of every nurse in every hospital, of every broken heart that manages to stay tender to the pain of the world.

No mom I know stops at the pain. They lend their life and every fiber to what remains possible for those they love. They never cease forgiving and hoping. They teach us not to stop at lament even though so much of what we see is deeply lamentable. They teach us that compassion is the heart of prophesy, of lovingly holding up what remains possible for each person, neighborhood and peoples alive.

The burl is what grows around the trauma experienced by the tree.

Faith with

Across the street from The Garfield Conservatory, a block away from the L, a gaggle of geese find their away amid the urban mysteries. — Across the street from The Garfield Conservatory, a block away from the L, a gaggle of geese find their way amid the urban mysteries.

There were years when I was across the ocean that I would tell people I was from Canada to avoid explaining US politics. People in more normal countries dumbfounded my people would be found dumb enough to vote for a California actor obviously reading someone else’s lines to fill the most intellectually demanding job in history. Some Americans still talk of him with reverence, which is hard to explain. But since we elected our Harvard lawyer, it’s been a lot easier to travel.

Its not any easier being a Christian than an American. I work in fields with lots of science going on so am occasionally held to account for my faith. Nobody cares enough enough to hurt me for it, as in olden days. But for those who otherwise like me (sometimes including my children), it bears explaining how an apparently intelligent person would identify as a member of Jesus’ or any tradition of faith. Like claiming Canada next door, it is easier to say something vaguely ethical rather than saying I go to that most odd of all human assemblies, a church.

Francis has helped. But even in a week in which it would really hard to screw up being a Christian, we have had nutters from Arkansas chattering away near microphones embarrassing generations of Christians. If Francis watched any TV while he was here last week, he probably thought about taking his robe off to just blend in with the homeless.

We think of programs as independent and accountable, but actually they weave, influencing each other and shaping the whole. — We think of our traditions and learning groups as independent and accountable, but actually they weave, influencing each other and shaping the whole.

I think of our traditions—mine being Christian—as learning groups more than knowing groups. My most powerful relationships are like that, such as the Africa Religious Health Assets Program (ARHAP) led by Jim Cochrane, Steve DeGruchy, Paul Germond and now Jill Olivier. A whole literature has emerged from its thoughtful journey, now thousands of pages. Groups don’t learn in a straight line and sometimes wander into dead ends (especially when they put on conferences with papers). But if we keep our learning grounded, we can find our way back out. AHRAP accumulated epic stories of finding, naming and mapping. But its most useful tools are those for optimistic searching (such as the assets mapping now about to be trusted by hospitals, public health and community partners in Tacoma).

That curious community spun off another one pursuing just one of its questions, about the Leading Causes of Life. Those Fellows cross the strangest boundaries of intellect and miles, as great questions always have and will draw us.

Stakeholder Health was originally the “Health Systems Learning Group” and remains useful when in learning mode. We’ve are drawn to the questions that lie in between hospitals and their neighborhoods, borrowing and bending the language of clinical, public and population health. The questions look technical, but draw us into deeper waters.

Technical kinds of answers are not the most interesting or obvious thing being learned. Along the way we have been learning about the defining characteristic of our group—most of us as both individuals and institutions were of faith. But not all of us are officially faith-ish, which is what makes the whole group so interesting. We’ve talked and sometimes argued about whether Stakeholder Health is “based” on has “faith.” What we mean by those words? Is it important? Does Henry Ford Health System have enough to count just because it has among the very largest network of faith community nurses in the nation? It reflects the man named Henry Ford, not Jesus, but sustains an often sacrificial mission finding innovations where a mere corporation would flee. What’s the name of that driving spirit? Most hospitals with religious names on their buildings don’t think or act any differently toward their patients, neighbors or employees—and many much worse—than massively profitable Cancer Centers of America. But some do find the wells of compassion to give their life away decade after decade. Iconic little Bon Secours in West Baltimore sure does and, yes, those are nuns all over that history, just as surely as the Pope is Catholic.

Many of our organizations are now merged and morphed—Brooklyn Lutheran part of staunchly secular academic NYU. The blended hospital and medical school called Wake Forest Baptist Medical Center will discover the cure for cancer before we figure out what to do with that middle word in our name. These complicated relationships are being carried by what we are learning, not by what we are based on; faith more like a sail to catch the spirit than anchor to hold us back.

We are who we walk with along our learning way. (Kevin, TC and me. Jim Cochrane holding the camera.)

People from outside hospitals notice that interesting things are happening inside. Peter Berger edited a special edition of “Society” looking at the complicated dynamics of faith in modern hospitals. Some of the pieces are not brilliant, even borderline snarky. But Berger’s introduction is tantalizing as he speaks of those of working inside the places: “They cope with reality in both secular and religious terms and they find ways (not necessarily coherent theoretically) of applying the two discourses in different parts of their lives. Is that feasible? We already know it is. The interesting question is how it is done! The question suggests a fascinating research agenda.” (Society, October 2015, Volume 52, Issue 5, pp 410-412)

Last week the learners of Stakeholder Health convened in the Garfield Conservatory in West Chicago, which for more than a century has protected space for the flowering of learning about plants. Its human story is as exotic as the plants, especially how they won’t quit when surrounded, literally, by gangs or rapacious politicos. Or when only a year after the massive dome was built, thousands of panes of glass protecting the tender palms had to be replaced because the wood frames were rotting (cheap wood). You’d think God would protect arboretums along with fools, but it turns out not.

It often takes a learning community decades to flower, especially when the questions outlast the curious. Jerry Paul, who led Deaconess Hospital in St. Louis and then its equally faithful foundation, formed when the hospital was no longer needed and lent his intellect to the founding of ARHAP, died suddenly in May of fast-moving cancer. Steve DeGruchy died in fast moving water before he even wrote his real book. Larry Pray has lived through another and then another and another stroke stealing his memory even as his spirit is defined by poetic appreciation for life. I’m not so young myself.

Faith is a fellowship, not just a bundle of ideas; marked more by with, than what.

We find life in the questions that outlive our answers.

We are defined by those with whom we seek.

We are what we find in each other.

We are what we think about and how we help each other learn.

We are what we ask of each of other.

We are what we notice in other groups also finding their way, by how we lend and borrow.

We are not the first or smartest humans to do all this.

We find nobility in humility before faith and its mysteries, complicities and community formed and still forming across the years.

It’s Sunday morning after the two big storms have passed; I think I’ll head up to church.