Stakeholder Health – Page 3 – garygunderson Blog

Praying for a new new

I can’t imagine you’ve noticed amid the various pandemics and meltdowns but I have not been on social media very much. I have been typing and to the surprise of some of my friends, typing prayers—enough to form a decent book. Maybe my best, actually, published by Stakeholder Press, my favorite community of thought and practice. You can find it on Amazon here. And I’ll be posting some of the prayers here, of course. Here’s a taste:

“Teach us to pray,” they asked Jesus, expecting instructions. He disappointed and annoyed, as usual. But two thousand years later almost anyone attending a funeral can mumble along with the handful of phrases he offered. We have also heard it in religious places by proper people with sonorous voices, so we miss it’s radical simplicity. He spoke Aramaic in which the prayer was stark, with no temple polish at all. This is what he said, paraphrased from Matthew 6:7-13 (God save me):

“Mother, father, sister, brother and friend, Who makes everything sacred, and all life possible,

we ask only enough for today.

Release the burdens of yesterday as we release the debts of those we have burdened.

Protect us from distraction and anything that is not of life. May it be.”

That’s it.
That’s all he said.
Doesn’t seem like quite enough.

It wasn’t his only prayer, of course. Most were even shorter. “Forgive them, they know not what they do.” And, “take this cup from me.” Sometimes he just wept for what the city did not know.

He prayed most eloquently with his life, as spiritual people do, full of healing and groaning and weaving. The life resonated with intimate knowing of those he met on dusty paths and marble palaces. He told easily remembered, vivid stories that tended to mock the powerful and gave hope to those they thought beneath them.

He healed so many people in so many unauthorized ways that it drove those in politics and religious power to kill him. What kind of healing gets one killed? It starts with a simple, honest, humbling presence before the ultimate; prayer without the presence or performance. There grows an ember of something more disruptive than our schemes, programs and gizmos. That kind of prayer opens space for clarity that untethers and propels. Who knows what happens next?

Praying is not the highest expression of spirit, just as writing is not the highest expression of thinking. Doing is where we integrate muscle and mind, sweat and spirit. But there is honor in word and voice as long as both serve; a cup of cold water or a visiting somebody in jail or the “good trouble” that gets one in jail.

You’ll notice that I capitalize God and You, when I turn toward the ultimate. I’m showing respect, but do not presume chumminess. I know a 14 billion year continuing explosive phenomenon is not a buddy.

But the spirit breathing through it seems closer to a “You” than an “it.” This book is not the one exploring the cosmological theology that difference implies. I’d like to read that book, but am not attempting to write it here. These are spiritual sketches, not hard- core systematic theology. I think it best to pray first.

Maybe we can pray together, you and me. I don’t mean by you reading my words.
I hope they trigger your own Spirit to find language from your life and labor. Maybe songs or
images. The pages that follow have some of my prayers. Because I am careful with words, some of them look like poems, laid out on paper that you can scan with your eyes. Voice would be much better; you could hear their tentative offering, my uncertainty seeking faith. They are sketches in spirit, which is why they are accompanied by sketches in pen by my friend Cagn Cochrane.

Better prayers are offered in sweat, not words. Spirit woven of broken threads into something new and useful for the world. That kind of doing is a kind of thinking, sometimes even a kind of praying where words come long after. You’ll find traces of that in these prayers typed and edited, but shared work would be better.

I hope we’ll get to pray that way someday.

May that be.
May we become part of what is trying to become.
Protect us from distraction from anything that is not of life.

That’s what I’m praying for.

Any profits from the book go to Stakeholder Health. You can buy the book on stakeholderhealth.org or on Amazon here. If you purchase on Amazon, please leave a decent review to lay down breadcrumbs for others to find the book. (Thanks!)

So many to thank, which I’ve done in the actual book, but have to acknowledge Cagn Cochrane for the illustrations, Jim Cochrane for design and edits. Tom and HK for making it happen. Stakeholder friends and Wake Forest colleagues. And, of course, TC, for pretty much everything. Oh, and Jesus (prayers, after all!).

Pause

As we look to DC this weekend, it would be good to breathe in and out a few times. And in doing so, pull a bit of the anxiety out of the civic breath. It’s a good time to appreciate the likelihood that the expected storm of angry violence will pass unremarkably like many winter storms do. There are, of course, entire media channels whose livelihood depends on keeping us anxious about storms of various kinds. Let them whip up somebody else. The couple thousand aged-out men (and occasional fading women) with fantasies of overthrowing our government will dissipate now that the US Army has shown up. Let them go back to wherever they came from. Let them chatter among themselves, all couple thousand of them.

The violent ones are tiny fraction of the 74,221,744 (the total voting minus two thousand) who supported our sitting President. Some are mad, some afraid, a large fraction confused, and probably half already gone back to worrying about the kids and dog next door. The 81,283,485 who voted more like me also scatter across the spectrum of elation, but all have also mostly gone back to worrying about the kids and dogs next door. Image both spectrums as one, and I’m pretty sure that the largest glump in middle have anxieties and hopes with very little to do with anything near any capitol. This is good. Democracy doesn’t work well by exaggerating the emotional implications of every twist and turn. There’s a reason bureaucrats are boring; government work is supposed to be boring, clunking along without the rest of us worrying about it.

From time to time, though, it’s not boring. Whatever you think about the election, everyone should pause to lament those dead from a tiny virus that has killed more we lost to the Third Reich. Almost everyone knows a family that has lost a member; I sure do. Focus there. And then focus on getting everyone vaccinated and the deeply bruised institutions back on their feet: the churches, schools and restaurants.

Don’t give any breathe to anyone who wants to talk about anything else, especially if it makes you angry at somebody who has not actually hurt you. If you hear that coming, walk away and find someone ready for actual human words. Don’t argue, instruct, or magnify; for God’s sake, don’t retweet or reply all.

Now is the time for grown-ups, bringing non-anxiety and non-judgement. Counsellors get paid a good hourly wage to do that, but if you’re old enough to read a blog, you’re probably capable of giving away some non-anxiety for free. That’s much more valuable than your reprocessed opinion.

It’s possible that tens of thousands of armed goobers will swarm our streets like killer bees. But probably not. I’m confident the US Army and cops can sort that out. The rest of us should figure out how to share our tiny blue planet with people who do not vote like we think they should.

Pause. Quiet. Listen.

Do it again.

Notice that days have more light. If you look closely, you’ll notice the early buds are getting ready for Spring.

Camellia bloom in the winter. Good thinking, God.

Drive

I didn’t know there was a Winnumeuca, Nevada, but less an East and West one, too. People live there.

Six thousand miles through and around fires, hurricanes, political conventions and seven shots in the back. Red states and red parts of blue states in a Mini Cooper with a “Make America Kind Again” bumper sticker. I drove and pumped gas next to several thousand pick-up trucks through Tennessee, Arkansas, Oklahoma, Texas, Arizona, Nevada, Utah, Colorado, Kansas, Missouri, Illinois, Kentucky and West Virginia. I was taken by what did not happen and what I did not learn.

You’d think somebody somewhere would have at least muttered something. I never saw two hands on the wheel, so there was plenty of opportunity for gestures. I’d be an easy target and, well, sort of deserved it, what with my bumper sticker. Nothing. Not a peep or cross-eyed glance. I saw a couple dozen Trump/Pence signs—about one every 200 miles and maybe 6 for my guy. Hundreds of signs for citizens running for Sheriff and county commission. A few for Senate hopefuls who had lost in the primaries. More COVID signs than all of these combined.

People are sick of political sugar and spit. Maybe ready to stop shouting, go vote, do what we need to do to beat the virus, teach our kids and go back to work.

I-80 could be named for its average speed. 15 seconds equals a day on foot.

When I was planning the trip, I had, well, overlooked the nearly thousand miles of Utah and Nevada. To dodge the fires I ended up crossing their former ocean basin on US 50, the “loneliest highway in america.” From 37,000 feet in years past I had liked to pick out the Grand Canyon and been curious about the the tiny bright green dimes surrounded by brown rock to its north. Through my windshield I could now see that the pivot irrigation machines making green hay as well as rainbows in the morning light. But I would have to stop to learn anything about the people who tend them, what they hope or fear, where their kids are and how many cows the hay will feed. Driving back on I-80 I found myself following the California Trail which one wind-blown Nevada rest area explained was a walking path for thousands. Why would someone would walk Nevada with their kids? What were they leaving or seeking? How could I say anything about Nevada until I walk, too?

Ruby Mountain near the border of Nevada and Utah. Up close it is many colors, a rock rainbow.

US 50 road goes through through St. Louis and across the Mississippi, though no longer a lonely road. I had forgotten Illinois and the beautiful rolling forests gifted by glaciers on both sides of the Ohio. I jotted down the names dozens of museums I hope to stop at someday, constant reminders of the thousands of miles of things I did not know.

Sutro Tower out Charles and Asa’s bedroom windows. It ain’t fog. Smoke.

I did learn a lot about smoke. The brown acrid smoke of the Haight in San Francisco persisted in clouds, high haze and columns of fire till east of Denver. A continental-sized phenomenon that literally took my breath away. Not a thousand mile wall of flame, but the drifting smoke is clarifying things in the minds of people you might not expect. YHWH promised Noah no more floods; he didn’t swear off smoke.

On the high plains Sequoia-sized turbines are spinning by the thousands with hundreds more under construction. In the Kansas night they blink in unison from one horizon to the other, blades nearly touching. Only nimble birds make it to Canada and back and those only if they avoid looking into the glare of the solar arrays. Don’t buy oil stock. And don’t let them drill the arctic for oil we won’t need.

Among the things I know I don’t know is how to live our human lives when our machines are so powerful. My Mini gets 47 miles to the gallon, but still sucking my grandsons’ future from their air. Greta is right: we’re not trying hard enough. Get out of the planes and not because of the virus.

Charles in “school.” Easier to find Waldo than the teacher.

School was pretending to open as I drove. I watched my way-too-smart grandson try to pay attention to a screen on a wall, picking out the teacher’s voice amid a cacophony of chattering kids. It’s easy to say the kids aren’t learning much. I’m sure the adults are no better picking out the lessons from noise. Our kids watch as we pretend to notice the screams of our burning planet.

We’ll have lost about a quarter million Americans by Election Day. And a few more cubic miles of Greenland ice. And a few million acres of trees, including bristle cone and sequoia that finally met people too dumb to survive.

“Go back to your screens and don’t bother us,” our kids see us say. They notice. COVID invites some adult behavior.

Door hangers! Not much help, this democracy stuff. But our best and only hope.

Saturday morning after I got back a handful of citizens met at our garage door over a precinct map and box of election door hangers. Some of us headed to the apartments near the highway, another and his two grandsons headed to Washington Park. It went quick without the door knocking and conversations. We had instructions to only poke the Democrats awake, but we think everyone is paying enough attention to remind them to act like citizens. It is possible that all the wheels will fall off our cultural wagon; that we are too late with too little wisdom to make the choices that give life a chance. But maybe cultures and democracies, like ecosystems, rebound when the grown-ups show a tiny bit of respect for each other and their place.

Another thing I did not see in 6,000 miles of American pavement: “Jesus is coming back; prepare to meet your doom.” But maybe Jesus is already back, teaching us steps one and two of Shalom: Don’t shout at people you don’t know. And don’t give up on the world that God so loves.

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.

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.

Thanks for the fish

Sunday morning I found myself, an incurable optimist, preaching perched on the chasm of doom, 46 hours into a Trump presidency. Green Street United Methodist is the archetype of the raggedly dogged social action church. The kind that Newt things is dead, when, actually, it’s not even tired. But Sunday was still a tough sell for hope.

The first lectionary text for the day was better suited to the more triumphal congregations; it’s the one from Isaiah, about how the light is now shining out of deep darkness. I skipped that one, muttering. Here’s the thing; nothing in the scripture helps us much right now, if the subject is democratic process. We are way off the biblical map, since the canon closed 9 centuries before the Magna Carta, 13 before European convicts settled the Carolinas, 14 before the Moravians came down the Shenandoah to what is now precinct 601 in Forsyth County. It was 16 centuries before anyone but white men could vote in anything worthy of the name democracy. Jesus didn’t vote and nobody voted for him.

So there is no relevant political guidance to found, although I will point out that there is a lot in the Bible that the absolute rulers found comforting. Every king since Constantine had their very own Christian chapel and Christian chaplain. John Wesley isn’t a lot of help either. He thought his American followers were way off the rails with the democracy thing. He opposed the revolution, supported the King and scolded all of our founding fathers for their childish overreaching.

It’s only quite recently that it occurred to any theologian that people of faith could create a democratic government with qualities of mercy and justice. And they never would have imagined that once we had it, we would let it float away on a froth of nonsense. How has the brief American experiment come to this? Especially now amid a vast tide of rootless suffering on a melting planet. This is simply beyond the imagination of any of the biblical authors except maybe whacked out Ezekiel and the inscrutable dude who wrote Revelations.

I don’t know about you, but I’m attending the Democratic party precinct 601 meeting next month. I’m ashamed to say it will be my first meeting. Perhaps you have many such missed citizen opportunities, too. Quit missing them. Programs and policies laboriously put in place over decades are about to evaporate at the clumsy hands of people who know not much of anything, much less what their actions will do those with the least capacity to absorb one more blow, one more insult, live with one more burden. Put your phone down and show up.

The Bible doesn’t help us know how to fix democracy; but it does have a lot to say about how to live without having power and even more about not needing it.

You don’t need Ezekiel or the Revelations dude at a moment like this. Head for Jesus. Look at what he did right after his mentor John was arrested by Homeland Security. Herod didn’t need to tweet his move; everybody knew his appetites and paranoia; it was just a matter of time till he went after John like someone we know went after John Lewis. Jesus was part of John’s movement, so wasn’t surprised by the arrest. When Herod made his move, Jesus headed for the hills. Then in utter vulnerability he came back down, started forming and collecting his confoundingly unexpected movement. His was not like John’s, except in its radicality. Jesus’ radicality went much farther and in a different direction than your normal righteous protest. It was marked from the first by a ridiculous amount of healing and radical generosity that made no sense. It was almost as if Jesus was declaring an end to religion, not just offering a new flavor. This was confusing from the start and unsatisfying to revolutionaries and rulers ever since.

What did Jesus find in the wilderness? In the second half of my life, I find myself going to the wild places more and more. Two weeks after the election I was in the wilderness end of the Grand Canyon down a mile from the rim near the river. On the way back up, I learned a lot as we were caught in a winter storm.

As we picked our way up the trail, we heard stone move high above us, then bounce once, twice, three times and, after a long silence a swinging sword, a sharp crack more like a cannon far below. Even through the sleet and wind, the sound cut hard with menace even though we knew the Canyon wasn’t thinking about anything but gravity.

Nature and the fundamental drivers of large scale change do not care what humans think, feel or tweet. The Colorado plateau tilted up over millions of years, draining an ocean that cut like a saw through a billion years of rock in what by geologic standards was a relative handful of years. It carved a cathedral. But, I don’t even think the Canyon knows or cares about its own beauty.

Don’t worry about the Canyon. The climate deniers will be long gone before another few rocks fall; we will all be entirely unremembered before the river cuts another quarter inch from the basalt floor. This is the natural fact Jesus would have learned in the wilds east of Jerusalem.

I think Jesus went to the wild places to remember another natural fact more preposterous than all the canyons on earth; that amid all the harshness, fragility and loss, loving kindness survives. Humans care and care for each other, even as blood, race, wealth, politics, religion and ethnicity fall like nameless stone from the cliffs. The rocks fall, the kindness survives.

What could be more obvious than the fact that everyone who has ever lived died, felt pain and knew sorrow. We know it for ourselves and we know it for all those we love, too. Bitter resignation makes sense. But generation after generation, we find lovingkindness.

Life is fragile, short and harsh, THEREFORE be radical in your love.

My Mom died a few days short of 18 years ago. She was a practical person not given to symbol. I’m more of a romantic, so when she was near death, I took her hand and asked her if she had last words for me. She looked at me and said, “no, I think you’ve got it. You’ll remember what you need when the time comes.”

Today is a time for us to remember what Jesus told us. We need it now. Wayne Merritt, a Baptist drinking buddy who taught me Greek, said that Jesus’ message was that you will know the truth and the truth will make you odd.

Jesus came out of the wilderness and gave himself to healing —and never stopped, even for the Sabbath. He said that he would stop healing when his Parent did. How preposterous; how human, how holy; we don’t know whether to laugh at him or cry for how strange that is to us.

And what did he do beside healing pretty much everyone in sight? What does he tell his movement to do? He doesn’t give them a box of tricks to win anything at all, but a way to live; And what a crazy way! How happy are the humble, those who know sorrow, who claim nothing, who are starving for goodness. Here it shifts: How happy are the merciful (not desiring to show mercy, but doing it); and so too those who are actually sincere and those who do the work of peacemaking. And, here it gets even worse: happy are those who suffer persecution for the cause of goodness, especially when people tweet about you and make things up entirely. If you suffer for living a true life of radical generosity, how lucky you are!

This, Jesus says, is what salt is for, what a light is for, what we are for.

He keeps the radical pedal down, which must have been a shock to those just looking for some free medical care or to get some demons released. Jesus said that anger is as bad as murder! Anyone who calls someone a fool commits a serious crime and that anyone who says someone is lost is himself heading straight to the fire. Recently, I happen to frequently call a particular group lost fools, which makes me guilty of both of those. I wish Jesus would be more reasonable and supportive of our movement.

But he didn’t get more reasonable; he just keeps getting worse. Don’t tell people that God will guarantee your promise, no eye for an eye, no hitting back and if the cop makes you do one mile, give them another. And give to anybody who asks anything (I can tell you that’s dumb; that’s why I ended up in the pulpit!).

On and on, page after page, without a single tip about how to beat Herod, his deeply annoying glameroti and his horrible ever-grinning children. “Jesus…..is…..impossible,” every king and king-hater has said for two millennia.

“Comfort my people, for in the darkness we have a seen a great light.” But the light of Jesus is not the light we want. It is not a way out or a way over, but a way through; a way to live day by day, year by year, even generation after generation after generation, if we have to, waiting for the promises of god for mercy and justice to be realized. And what do we do while we wait for the big show? Go do mercy and some justice, that’s what. Jesus’ promise is that you and I can live this way, The Way, the only way which gives life a chance at all.

Come and be part of the end of all fear, especially the fear of all death and all that claims the power to kill. Come and give your body and mind to The Way that leads to life. Give yourself away, every bit and you will feel the life flow where once you held tight to your little fears and hopes. Give it away, every bit. Be part of the healing and don’t start big. Before you make a big holy show of it, think of your brother, sister, former spouse or left-behind friend; go make peace with them first. Come away from the anger and scheming. Quit bargaining and holding your minor gains as if they will last. Live this way now and you will find life flowing freely, abundant, overflowing beyond all measure at all.

You might point out that, technically, it didn’t work out so well for Jesus or those who bet their lives on his words. Herod won without a recount. Pilot, two clicks meaner; he won, too. Most kings do. But take a look at the end of Jesus story.

The story of the boats and fishers is so good that it show up in all four gospels in four different ways. John puts the story in the tender days after the assassination and scattering, when the fishermen went back to fishing for fish. Simon Peter, Thomas, Nathanael, Zebedee’s sons and two other disciples were hiding at the lake north of Mt. Airy. Peter announced that he was going fishing and since nobody wanted to be left behind, they all tumbled in. They stayed out all night, and caught nothing. They headed back in, even more discouraged than when they started, except now hungry, too. Jesus watched from the beach across the early still mist and then called, “children, have you caught anything to eat?” (No, of course.) “Cast on the right side where its deeper and you’ll find some.” They netted so many they couldn’t haul them in. John reports that it was 153, which is like counting the beer bottles left on the lawn after beating Carolina. Peter, sure didn’t count the fish. Naked, he jumped out of the boat, pushing his way a hundred yards through waste-deep water to get to his beloved friend.

Jesus had started a charcoal fire going on the beach, expecting the haul, toasting some bread. “Bring me some of the fish; y’all need some breakfast.”

Listen to the tenderness of the one who calls us into a preposterous Way of generous vulnerability. This is a savior who knows we need to eat as much as we need hope; and that we need hope as much as we need breakfast.

Be as careful with each others’ hearts and spirits in these tender days as Jesus was that morning.

Jesus does not give us a way to beat the mean and violent, but neither it is a counsel to give way to the liars and schemers. He gives us The Way to not be like them. So do not let your fear draw you toward them or their way. They have no power over you and they have no power to stop you from living The Way of Life. Their castles are as froth on the waves. You are drawing from a deeper place, carried by a deeper current, that can cut through stone like the Colorado.

The healer is here among as we fish, and type and give away our lives in healing, or teaching or raising up the voice of hope through art or kindness. Give yourself to life-giving now, not later; save nothing back for a safer or smarter time. The Reign of God is at hand, says Jesus. I think he meant your very fingertips.

“Hey,” says Jesus, “do you want some fish?”

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.