Stakeholderhealth.org – Page 3

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.

Mainsail

Charlie Wolfe, among my very favorite humans. His future is not determined, especially by any of the other 7 billion.

Perhaps you’ve met a human. You have noticed that we can be hard to help. Perhaps you’ve been to a planet like Earth and noticed the same thing, except 7 billion different ways. How do you help something with 7 billion moving parts be healthier?

Advancing population health depends on understanding not just the medical problems, but the drivers of health ….at community scale …over time. Those drivers are largely social and they are not determinants because none of the 7 billion of us humans are determined. Words guide our imagination, shape our ability to talk about what to fear and what to hope for. So it is a big deal to see the 100 Million Lives Campaign “determinants” for “drivers.”

It important for every grown up in any position to influence a single life to talk about life as changeable and chooseable—but shaped by power drivers that have to be confronted. This is especially true for the grown-ups in positions to influence the big social structures like hospitals or faith networks. Monday in Washington DC the Association of Academic Health Centers met to explore how their huge organizations can align themselves wit the leading edge understanding of the social drivers of health. This is a huge shift for them (us, as I am a VP of one….). They brought in the big voices including none other than Dr. Michael Marmot the author of the stunningly powerful studies of social position over time (The Health Gap.). And our friend Dr. Denise Koo one of the principle forces behind the new array of useful tools emerging from the CDC such as the Community Health Improvement Navigator. (http://stakeholderhealth.org/cdc-community-health-improvement-navigator/).

salamis The closing panel of the whole conference was our “ground game” in Winston-Salem. This was explained AND embodied by Jeremy Moseley our Director of Community Engagement and Annika Archie the lead Supporter of Health, with Dr. TC laying down the data beat like a bass player in a jazz ensemble. I had two minutes at the end to set a metaphor like a sail to catch the wind of the spirit moving where you wouldn’t expect it.

The social drivers engage the role of an hospital not just as a provider of therapies, but as a social presence—usually the very largest social/political/economic structure in a community and region. This requires us to see ourselves from a community perspective: inside out and upside down. In Memphis we found ourselves in a covenant relationship with more than 600 congregations that pulled us inside out. In Winston-Salem we have followed the deeply grounded intelligence found in some of our lowest wage workers into relationships that are not just inside-out, but upside down or, better, right side up. We were steering toward life, not just away from death.

Proactive mercy is way cheaper than reactive charity. That’s the whole and complete logic of “population health management.” But if you don’t understand the humans, you can’t expect to be proactive. Being proactive depends on the intelligence about– and trust with– the neighborhoods where the costs of reactivity are concentrated. This requires not just the preeminent brilliance of our surgeons, but of all 14,000 humans on the team. Dr. McConnell and Annika Archie embodied this new deep discovery in the video interview he did with her (and me) last week (click here).

That’s what works.

It is new for big organizations to hold ourselves accountable for social factors. That has always been on the side, a by-product, an unintended consequence. Now it is central. Some say we should think of ourselves as “anchor institutions,” but that image reinforces our worst habits of domination. What could be worse than focusing on anchors of determinants? I’m depressed just typing it!

krusenstern_mainsails — The mainsails are the ones low and large. You leave them up so the ship can keep moving even in heavy seas.

We should be mainsail organizations.

The mainsail is the large sail on a clipper ship low and strong that you leave up even amid the heaviest weather and hardest storm. This includes the storm-tattered neighborhoods you can see outside the windows of urban medical center. You leave the mainsail up because in deep and heavy water you have to keep going or the waves will overwhelm you. The last thing you need is to drop an anchor. That’s what you see in Annika, Jeremy and TC and their hundreds of colleagues setting themselves to catch the same wind of Spirit– surgeons, nurses, social workers and revenue cycle VP’s– that share a hope and mission.

You can even hear it now from some our community partners, glad that we have finally joined them in their journey toward health. They don’t want an anchor; they want to go somewhere new.

Last Saturday our own Rev. Dr. Francis Rivers received the major award from the Hispanic League of Winston-Salem honoring him (and the FaithHealth team) for leaning way into the heavy seas of anti-immigrant venom surging currently in North Carolina in creating the ID Drive. Francis’ award honored him, but also his mainsail organization–and not just the tiny part of it called FaithHealth. The medical center put up a big sail amid very heavy seas that helped other key institutions do their critical work. The Sheriff, police, DA, a network of churches called Love Out Loud, many Hispanic organizations and Que Pasa media). And don’t forget the most important FaithAction—the small faith-based organization that does the actual work of validating identity so that an ID card can be issued and trusted.

ship A fully rigged sailing ship is a very complicated thing with many sails and miles of rigging. So, too, is any network of partners committed to helping their community move away from the rocks and into a safe harbor. But none of the partners could have stepped into the heavy wind themselves, much less alone. That role was for the mainsail and a ship built for deep water.

You might be so embarrassed by all the mean hateful things religious people are doing these days that you want to stop the metaphor right there. But you’d be leaving out the most interesting part of sailing—the wind. The sail doesn’t have any power; it only catches the wind. Greek traces the same word for wind to breath and… Spirit.

We know in North Carolina that the Spirit can blow toward or away from the rocks; it depends on the skill of the sailors and the courage of those who climb up the rigging and set the sails. These are days filled with stupid religious venom, so I don’t blame anyone who wants to move culture and institutions and society without faith. But nothing at cultural scale ever happens without Spirit blowing really hard. You can stay below decks and hope for the best. Or you can find someone who know how to set a mainsail and head to deep water. Francis, Annika, Enrique and the others on the edge, live way up in the rigging where the wind blows with raw power. They teach us to its respect power, but not to fear.

Dr. King spoke realistically when he said “the arc of history bends toward justice.” It is a slow bending curve, more tectonic than sharp. We don’t choose this way or that, but lend our days to the slow bend, helping each other keep courage for the long turning. We set our sails for heavy seas and a long arc toward a horizon worth the journey.

Trellis

The Surgeon General of the United States explains why his four biggest opportunities to advance health need relational infrastructure built on faith and community partners.

On Wednesday and Thursday this week, a wildly diverse group of leaders met in the White House to explore how to accelerate the growing alignment so necessary to advancing health and well-being of communities. Surgeon General Murthy laid the foundation with a sketch of a framework he will unwrap later this week in detail. But you could guess the outlines, which are pretty much the same priorities John Wesley laid out in his book, Primitive Physic, years ago, written before germs were invented. The reason this is new today is not because we have a new machine, but because have the possibility of new relationships of high capacity, capable of operating at scale. Keep saying that: building capacities for scale. They require what is now possible; rich interconnection between systems for food, mobility, the more complex systems of legal and illegal substances and the almost infinite array of systems relevant to emotional and mental balance. Oh my!

The challenge is the opposite of what you’d think: too many partners, not too few.

A trellis fits the plant it is intended to help find the light. Plants just need old sticks.

Tom Peterson tells me there are at least five million non-profit organizations in the world today, most of them created in the last half century, and almost every single one formed to do something somebody thinks useful for improving their community. It’s worse than that! Many more millions of for-profit companies have been formed in this same time, hoping to make money, but also to do something good in the process. Just check out kickstarter.com to get an idea. The ecology of human forms of association is rich, complex, interconnected and adapting at the speed of electrons. This is terrific if you need lots and lots of relationships. It is daunting if you think someone should be in charge of organizing them.

The Surgeon General does not aspire to organize 5 million of anything. But he does hope they (we) can organize ourselves in ways that can make it more likely that 21^st century science (including, but far beyond everything Wesley knew about) can get into the lives of people and neighborhoods.

Many trellis builders think a lot more about their wooden art than they do about the plants.

One idea that has been popular, but rarely successful, is forming a backbone organization to achieve “collective impact.” I think it’s the wrong body part for the job, preferring something more like the intelligence of the liver or gut. But it is often useful for relatively small problems with simple answers, such as building a lot of homes in a particular city. When used for big and complex challenges, the backbone is often overwhelmed by all the partners and ends up simplifying things by leaving new ones out. The backbone’s limited number of vertebrae is the same list of privileged partners that always end up around the table. The idea of a table at which things are decided is part of the problem: you can’t fit 5 million people around any table.

On Thursday we tried on a different mental model better suited for organic complexity: the trellis. A trellis is not a miracle; it’s just useful to support the miracles of photosynthesis so that plants do what they want to do—bear fruit. The gardener (and the movement organizer) trusts the process, but doesn’t make the process do all the work. I like wine, and know that good wine needs just the right soil (developed over many thousands of years) and just the right rain (which depends on picking just the right valley and sun, not too hot and not too cold), so that magic happens. But it helps if the vines don’t just run every which way on the ground, so they have developed a near science of trellis design to fit different grapes.

Some trellis are built for the decades the vines mature through.

A movement is more complicated than grapes—and right now we have vines running every which way. It would help if we did the humble work of building some trellis on which could grow a rich array of relationships to bear the fruit the Surgeon General imagines possible. There are four main kinds of trellises:

Conceptual. Stakeholder Health emerged as a learning group, which collectively created a monograph to map the conceptual trellis on which healthcare systems could fulfill their missions. It is really good, but like other kinds of conceptual trellises, it needs to be rebuilt for a new season of work (stay tuned on stakeholderhealth.org). The learning community will need to be much larger and even more interdisciplinary than the intellectual gaggle that did the first one. It will need a relational trellis on which grow (and prune) those fruitful concepts.
Programmatic. The Surgeon General’s call for broad activity is not a call to do 10,000 different things, but to find alignment around four that could be transformational. Thousands of us can find a coherent role in food and we can understand our work as linked. Nobody is exactly in charge of it, but a well-built programmatic trellis helps us we can find power and meaning in contributing to a very large collective change.
Institutional. The YMCA is 3,000 local organizations, which have changed quite radically from the original shelters for young men to today’s iconic role as suburban fitness conglomerates. Now it is changing again, to embrace its extraordinary role very aligned with the Surgeon General’s vision. There are many other examples of old structures finding new relevance. But in every case, it is tough work. The 3,000 Y’s have 900 local Boards!

Some plants (like some types of congregations)(yours, Michael Minor!) are so smart they can grow up a string. But the string still needs some support.

Michael Minor is the midwife of the National Baptist Convention’s 60,000 congregations move toward health; but every one of them has its own Board of Deacons that will need to catch the same wind of the Spirit. So, too, the 33,000 United Methodist churches, hundreds of Jewish Community Centers and dozens of faith-based hospitals. “Can dry bones live?” asked Ezekiel. Can an old trellis bear new fruit?

Narrative. We humans live by story, far more than objective data. A movement with capacity and scale needs a narrative trellis, so that each of us, in our many roles as members, leaders, citizens and healers, can locate our personal story in the thread of a great story. We need the bards, writers and artists to help us tune ourselves to resonate to a greater tone.

Community Health Assets Mapping, here led by Teresa Cutts, makes visible the assets already alive in a place. This enables the community leaders to imagine a new kind of trellis of relationships. And then they can build it. — Community Health Assets Mapping, here led by Teresa Cutts, makes visible the assets already alive in a place–the stuff that wants to grow. This enables the community leaders to imagine a new kind of trellis of relationships. And then they can build it.

We watched the video of the murmuration of the starlings, a mesmerizing image of complex beauty (here). Are we like starlings? They dance in the sky forming patterns beyond words. But they are all starlings and know how to act with each other. We are not alike (Kirsten Peachey said the group is more like a dozen starlings, and a hawk that eats starlings, and a horse, pig and potato). Not as pretty in motion. Or maybe it just takes time to find our common energy. The International Science Times, reflecting on the video, says that the way the birds dance is managed “by constantly avoiding collision. Generally, they were taking their lead from the bird directly in front of and below them, rather than the birds to the sides or above.” If you can’t understand how that metaphor applies to humans, you have never tried to lead a committee.

And we watched a YouTube video about how reintroducing the wolves in Yellowstone are changing not just the wildlife, but birds, berries, beavers and the flow of the rivers—the whole ecology (watch it here). Maybe we can change more than we think! So we howled (literally, we howled, which may be the first time that’s happened in White House since Andrew Jackson let in the rabble from the streets!).

Arvind Sindal used his many creative meeting structures to unleash a torrent of transparent brilliance. This is the "fishbowl" with healthcare providers in the middle. Pretty smart, but the questions from the outside were the real brilliance. — Arvind Singhal used his many creative meeting structures to unleash a torrent of transparent brilliance. This is the “fishbowl” with healthcare providers in the middle. Pretty smart, but the questions from the outside were the real brilliance.

Or maybe we are just human grown-ups influencing our own complex systems as we try to live our way into the new possibilities. Many of us this week find our story in the Great Story of faith; we think we are agents of a redemptive process that has never quit, despite entire centuries of bleak reversal. We think that God is not quite done with our tiny planet or even with us, flawed and tiny people.

As we were meeting, astronomers were reporting more evidence that the ingredients for life are astonishingly abundant in places beyond counting at distances beyond imagination. The vast reaches of reality are swirling with the ingredients of life. The places once imagined as impossibly cold and hostile are just waiting for the right relationships to emerge. “Life finds a way,” said Jonas Salk, who was one of the first who thought that life rode into Earth on the comets.

Life is still finding a way—even in the hostile barrenness of Washington DC. It turns out there is a richer array of the basic ingredients than we’d been led to expect. But don’t make the process do all the work, unless you have a few million years worth of patience to move at the speed of stars.

I turn 64 Monday and need to pick up the pace a bit. It is very good news that we don’t need to invent the life. But we do have to thoughtfully craft the trellis. Let’s get on with it.

Carolina tears

Sprouts find their way through the bullet holes in an old refrigerator in North Georgia.

Hearts break today in North Carolina.

I think of atheists as slightly over-educated modernists who are harmless, almost quaint, in their ardent non-belief. It had not occurred to me that non-believers were inclined to shoot people over parking slots. But now the Associations of Non-Believers have to explain, just as we Baptists have had to do for centuries, how their style of belief in UnGod can make one mean enough to be kill.

Of course, Atheism doesn’t make you mean any more than Islam, Christianity, Bhuddism or Hinduism. But every one of those structures of meaning have given harbor at some time to dangerous people who kindled the energy of belief into the fire of violence. Belief—and unbelief—can warm or burn.

Someone who believes in nothing is indistinguishable from one who says they believe in God but who do not believe in what that God tells them to do toward others. Groups of people, whether Islamic or Christian, can claim to follow God, but actually believe in their guns, banks, drones or grinding, blinding anger.

No French cartoonist, or student trying to park their car can be entirely safe from delusional nutters. Mental illness often hides in the fog of ardent belief and unbelief. It deserves pity, prayer and, often 21^st century pharma. Turning this man’s delusions into a reason for religious or anti-religious rant only serves the demons.

The most dangerous nutters are the ones who gain control over the instruments of state power. The mentally ill man who shot three students in Chapel Hill is not as scary to me as the elected wackos 25 miles away in Raleigh where an unhinged legislature is considering a bill to prevent Muslims from imposing Sharia Law on the good Christians of Northern Carolina. These guys have a whole police force, not just some guns in a closet. They don’t want your parking place; they want the whole enchilada.

We Baptists remember times when we were strangers in this land, too, and know to fear any government that thinks it is holy enough to know who to punish on behalf of God. The first duty of any Christian—or believer of any other faith—is to work to make their own faith safe for the world and especially for anyone who does not share your faith. You or your children might be a refugee someday, too. This is why every religion that lasted longer than a few seasons raising high the priority to care for the stranger, the weak, the poor, the widow or motherless child.

The actual followers of Islam who pay taxes here are mostly students and a previous generation of students now serving as our doctors, nurses, dentists, computer programmers and anchors of our civilized way of life. There is no clinic or hospital in the entire state (or any of the other United States) that could operate an entire week without the medical professionals from many faiths well beyond my own Christian circle. Our community strategy of “proactive mercy” depends on the powerful faith of saalam-seeking healers of Islam. So our grief extends to the families and friends of the UNC students in a double portion because we share their commitment to the healing arts their entire family so obviously embraced.

I’m a Christian, trying to follow Jesus. He said that God would sort out the right and wrong, sheep and goats later on. The twisting plot of the story made clear God’s decision would surprise everyone involved. Don’t guess God. In the meantime, love mercy, do justice and walk humbly.

Cry with us and lend us with your prayers of mercy.

City of Light

Carolos Latuff, one of hundreds of visual jounalists speaking into the horror of Paris.

Every religion is dangerous. Like fire, wind and water, religion is a fundamental element of human life that can drown, blast and burn. Religion guides our fear and frames our shame. And it can also strengthen our capacity for the courage shown in generosity, compassion, kindness and decency. It can be a wicked brew and also be like warm French cider on a bitter Winter day.

What are those of us who find our hopes in faith to do this week? What do we do when faith has been the language for nearly unspeakable acts? Do we just huddle behind the soldiers, or is there any place for our own actions to be as brave and relevant as the cartoonists like Carolos Latuff poking his pencil into the muzzle of terror?

Can mercy be brave as violence?

Although it filled up the CNN cash register this week, violence between religions is relatively rare and getting more unusual year by year. I’ve quoted the finding of Daniel Pink in earlier blogs, but worth remembering that all forms of violence continue to decline year over year over year. Most religious violence is between those who share a religion but find its variations deeply threatening.

While dozens died in Paris because of their secular differences from Islam, hundreds, probably thousands of moderate Muslims died last week because their 1,500-year-version of Islam embodied the radical hospitality, kindness and sacrificial generosity that fills up the pages of Islamic sacred writings. This is true of every religion. John Calvin burned–literally set fire and watched die–Christian theologians that it would take another theologian to figure out the minor differences in doctrine they were arguing about. He killed Christians not Muslims. I’m a liberal protestant writer who not have survived a week in Geneva. I thought about this when worshipping down the hill from Calvin’s towering grey church with an ecumenical gaggle of english-speaking Christians last July. He would have locked the doors of the World Council of Churches, torched the whole place and everyone in it….and than sung a hymn about it. And Presbyterians are relatively nice people. I’m a Baptist…….which I’m just guessing is more common among the Klan than their up-market Christian cousins.

It is always safer to have a radically different idea about god than a moderately different one using the same language. ISIS kills many more moderate Muslims more eagerly than Christians or those who believe in no god at all but humor. Every now and then they may travel to Paris for some especially flamboyant act of horror. But their every day killing is focused on the vast majority of fellow Muslims they find nearby who understand Islam as a faith of mercy and healing.

There is not much a Christian can do about radically violent Islam. But it would help to avoid accidentally strengthening the most despicable by implying they know anything about Islam. The “terrorists” aren’t radical about Islam, which is a religion of hospitality and charity; they are radical about their own projected fears, insecurities and delusions which are then wrapped in a weird and horrible way in the vocabulary of Islam. Christians know all about this process. Christian politicians are masters at wrapping their reptilian greed with Jesus’ words. But we don’t say of our nutters “those folks who blew up the Federal building in Oklahoma sure were radical about following Jesus!”

Do something to strengthen the moderate Muslims, for whom this is a special time of danger, not only from their traditional nut-cases on the far boundaries of Islam, but now from those of other faiths, including secularity, that will fear anyone they think is a Muslim no matter where they’re from (including Sikhs who stupid Americans confuse with Muslims all the time because of their turbans)(Oh, good grief…..).

TC and I took a check over to our friends at the Muslim Free Clinic on Waughtown Street that I’ve mentioned in my blog before. They were today, as they do twice every month, caring for whoever walked in from the neighborhood that needed healthcare, medical counsel or a clue about where to their pill prescription renewed. It is very mundane, as most mercy tends to be. The physicians and volunteers show up and do it because their faith has thought them to do so. They aren’t aiming for martyrdom; just happy to settle for basic grown-up integrity. They are, as a Christian philosopher once said, “grabbing the near edge of a great problem and acting at some cost to themselves.” It is all a Christian, Muslim, Jew, Sikh, Bhuddist, Zoasterian or cartoonist can hope to do with their lives.

Do this.

Soak in the TV, then turn it off and go find someone who isn’t of your tribe, class, color, faith or opinion and be kind to them in some practical way.

Do this.

And the God known by every name any human has ever uttered in hope will heal your fears and count you among the living.

Do this.

New blade

Six decades later I can still hear the screaming whine of this saw as my dad crafted cabinets with it.

I peered through a hole in our basement wall into a cloud of sawdust where my father fed a piece of wood into the spinning blade. The sound was painfully high loud and powerful, such that I can still hear it, now almost six decades later. I was two or so and learned later the wood was pine, as was all the rest of the cabinets in the home I grew up in, crafted with a mixture of love and parsimony by Dad. The saw, made by Rockwell, eventually became mine and used for most of my adult life as I, too, ripped, spliced, joined and paneled every place I’ve landed. The saw was a primal link to Dad, but over time whined, smoked and wobbled more and more. Once, back when I was earning my living with it doing remodeling, I was moving it from a job site when it bounced out of my nearly-as-old pickup truck, breaking on the pavement. Ken Sehested, knowing my despair, found a friend to weld the key cast iron gear back together, so it lived to wobble on in my life. But eventually the damn thing could no longer hold an angle, sometimes cutting a perfect 45, but more likely 50 or, the other day, 60 degrees. This makes very ugly joinery.

Now wobbling, smoking and whining, the saw prevents, not enables, good work. Dad would not be happy.

Dad would have hated the crappy quality the saw made inevitable and surely would have found any link with him something of an insult. I finally had to distinguish between clinging to nostalgia and actually honoring my Dad’s woodcraft. So I went to Lowe’s, channeled his spirit, and bought a solid Kobota table saw. I’m in the last stages of a new bathroom in TC and my condo near Old Salem and now have a chance at doing the finish work in a way that the Moravians and Dad would find acceptable.

Our lives are filled with the artifacts of those in whose shoes we walk, feeling our feet slightly too small for the journey. Just before Christmas I met with the ethics committee of the medical center, which had been established by the iconic surgeon, Eben Alexander, decades ago (he’s the dad of the recently famous one who wrote about “proof of heaven.”) The committee he started is still appointed by the chief medical officer, also a surgeon. Although medicine and the health sciences are less and less about what happens inside the medical hotel called “hospital,” the focus of the ethics committee continues to be almost entirely at the surgeon’s elbow. It thinks mostly about what the doctor should do or stop doing. Our current model of bioethics is not looking at the CFO’s spreadsheet, or COO’s deployment plans, or the Board’s capital decisions voting millions to build another office in the burbs, even those decisions shape the life and death for thousands of people over time. One can imagine Dr. Alexander shouting, “I started it; you go the next step!”

Surely dad is glad I finally put down the nostagia and picked up a decent tool for work that honors him. — Surely dad is glad I finally put down the nostalgia and picked up a decent tool for work that honors him.

Every nook and cupboard among the health field is filled with guilds, national associations (with local chapters!), honoring this and that habitual practice and committee that made some sense long ago. They all have founders and officers—and sometimes even endowments(!)—but have long lost their capacity to cut cleanly or make useful connections. They have not moved with the science that gives more and more power to the integrated strategies managing conditions over time outside the professional enclaves. We live a long time now mainly because of better food and pharma not because we get surguries frequently. So there are way more ethical implications in the price of drugs than when or whether a surgeon does a procedure. They obstruct and no longer aid the joining of good science to good intentions. We need to honor our moral legacy with a new set of intellectual tools nearly as much as I needed a new saw.

We honor those who have given us life by acting with the creative courage they showed in their time; not by doing the same things their courage demanded then, but doing what courage demands now. We grown-up humans build things out of brick and steel. And we craft habits and patterns of power that guide the flow of money and time to the new glass towers. All these artifacts look solid and lasting, but they are as blowing sand at the beach.

Twice a day the tides wash the in-between land of the marshes.

I am typing this at St. Helena Island, South Carolina watching another morning tide move another day’s load of sand a few feet up the shore. These are called barrier islands because they protect the vital salt marshes which the tides wash twice a day, nurturing its wildly generative life. Very little important happens on the beach; all the life stuff happens in the muck and goop where the shrimp and a zillion other things are born and nurtured before heading to sea. The sand islands protect this vitality because they constantly move and adapt dynamically to the next big storm and even the next shift in climate rising the level of the seas.

Old maps tell the tale: the beaches move; the marshes live on.

In the handful of centuries white humans have settled here, the islands have moved miles. From the top of the 132 foot high light house you can see a few miles to the waves north east where the old one once stood. This new one (1889) is built to move again. Geologists know the whole chain of islands have moved back and forth for millennia. They last because they are dynamic; they serve life because they change. They are like tools built for a season of good craft.

The scope points 8 miles away and a quarter mile off shore where the lighthouse once stood.

Those of us holding positions of influence in institutions like to think our work and our organizations are the key to the life of our communities. Smart people at Stanford play to this pretense by suggesting adaptive change is dependent on “collective impact” organized by “anchor institutions.” These ideas are not just wrong, but dangerously misleading. Living communities don’t need to be impacted, but nurtured; they don’t need more anchors but heart, muscle and guts that serve movement. They do need protection from the raw tides, heavy winds and bitter storms, but protection in the service of change, not protection from it.

What else does any leader have to do that protect the creative energy so that it generates life? Do we have something better to do than that. Whether we are stewards of a church or hospital or public health agency or community health center, the life does not come from the edges, but the heart. I learned in Memphis that if I could protect the creative space for those who usually don’t have much power, they would craft beautiful and useful structure perfectly joined to the possibilities the neighborhoods needed. That process is the “Memphis Model” not the specific apparatus that emerged at that point in time. Don’t confuse the craft (mercy and care) for the cabinet (the structure) and certainly not the wobbly saw (me).

Leaders give life a chance by protecting the generative spaces in which life emerges, especially when those spaces need the complex processes over time. Any human community is way more complex than any salt marsh.

This is almost exactly the opposite of the role big institutions want to play. The leaders of the big things like hospitals can always rent consultants who are happy to tell us to tell the neighborhoods how they should live and how they should change, not us. The model for this is the old way that beach engineers tried to build concrete barriers to stop the tides and the natural shift of the sand (sort of like the one now under 40 feet of water a quarter mile from shore). The more we think like anchors, the more we’re in the way of life, which will most certainly have its way with us.

Roots are a kind of anchor that serve for a time and then not.

This is why I find surprising hope in the small stirring of faith and faithfulness in the faith-inspired healthcare systems of Stakeholder Health. Just about the time when you think smart and cynical are the same thing, along comes life to surprise us. In reality sometimes, large institutions such as foundations and hospitals can provide some shelter amid the raw power of the market forces (the “hurricane” in my extended metaphor). We can be barrier islands against the forces of raw money power, preserving the neighborhoods’ function as the salt marsh where life flourishes and creates the next generation. It actually does happen sometimes. It could happen more.

Francis Rivers Meza, one of our faculty in the FaithHealth Division, shared an article by Patricia Fernández-Kelly (2012): “Rethinking the deserving body: altruism, markets, and political action in health care provision,” in the journal Ethnic and Racial Studies. (click here for the article). She explores the way that religious organizations, including the huge ones such as hospitals, sometimes choose to act against the logic of the capital markets, providing crucial buffering for neighborhoods of poor and often stigmatized people. And they do this on purpose with craft and skill year after year. The authors cite one of our stakeholder health friends, Baptist Healthcare of South Florida and their long term work in Homestead Florida, a place that knows all about the need for barriers against storms.

Life finds a way, Jonas Salk liked to say. Jason McLennan, writing in Yes! Magazine this month says, “If there is one thing that’s certain, it’s that the future hasn’t happened yet.” Bingo! Honor both past and future by helping life finding its next way, not by protecting our old way.

The lighthouse just across the inlet above the gull. Everything moves; life finds a way.

Sin and Liberation

Didn’t expect that title did you? liberating structures

There is something about Good Friday coming in the same week as a day-long medical center budget meeting that turns my mind toward sin; and then, just when you least expect it, toward liberation.

Tom Peterson of Thunderheadworks turned me onto the book The Surprising Power of Liberating Structures by Henri Lipmanowicz and Keith McCandless in his brilliant blog about social change (http://www.thunderheadworks.com/liberating-structure/ ). The book is the fruit of years of work by a way smart group of social change-makers focused on making meetings and events smart and liberating. You may have noticed that most organizational meetings are not very liberating indeed, usually deadly.

Human gatherings can be powerful if built on their 10 basic principles and then artfully crafted with some of their 33 tools. It is easier and more natural than it sounds, because we are built for liberation. We use these tools in many of our FaithHealth trainings and retreats. We will use them in the Stakeholder Health Chawumba event in July (http://stakeholderhealth.org/chawumba/ ). We are looking forward to one of the masters of the craft, Arvind Singhal, being with us next month to teach us in person.

The ten principles of Liberating Structures in the book The Surprising Power of Liberating Structures by Henri Lipmanowicz and Keith McCandless.

The point of all this is not better meetings but a whole new world.

As soon as I read the principles I recognized what I experienced in Memphis through Bobby Baker, Chris Bounds and the hundreds of practical geniuses on that tough ground. The Memphis Model wasn’t just liberating meetings; it was a web of liberating relationships built over time in structures held together by trust. As Bobby would say, real work, not show.

The liberating relational structures of Memphis,–and now North Carolina–aren’t happy accidents. They are built on purpose for the purpose of setting people free from the bondage of what are usually called “social determinants” by healthcare professionals. Things like poverty and broken families are bad enough, but are especially insidious when experts believe they are so powerful that they determine lives. Left to drift, the patterns and privileges of race, wealth, education and law will replicate overtime with the predictability of gravity. However, social factors do not determine the future if a community builds liberating structures strong enough to bend Dr King’s “arc of history” toward justice. Humans can stand up on two legs and walk—even run and jump. But we have to choose to do so. And we can invest our time and resources to new relational architecture, but we have to choose to do so.

Do I even need to point out that budgets usually give in to organizational gravity? How often do you see a liberating budget? (Please don’t mention this column to anyone remotely linked with Wake Forest until after my Division budget closes in a few weeks.)

This gets us to sin, specifically the “deadly sins” of the health industry . Catherine Panter-Brick and Mark Eggerman of Yale University and Mark Tomlinson of Stellenbosch University have just published a bold piece in Global Health Action sure to generate a storm of uncomfortableness by looking at the field of global health through the lens of sin and virtue language. They are looking at global health, but every syllable pertains to the healthcare organizations in the United States that usually don’t think of ourselves as part of the world. The authors are tough: “Structurally, global health has broken faith with its core ethical mandate of addressing the root causes of poor health outcomes, falling prey to four main temptations—coveting silo gains, lusting for technical solutions, leaving broad promises largely unfulfilled, and boasting of narrow successes. These are capital sins in the sense that they engender serious misdeeds and careless misdemeanors, and necessitate a change of heart.” Sin does not get the last word, for there are cardinal virtues, too: “A sharper focus on values and dispositions—aligned with the cardinal virtues of justice, courage, prudence and restraint—is needed to transform global health action.”(http://www.globalhealthaction.net/index.php/gha/article/view/23411 )

The opposite of sin is liberation, which needs the human structures so that the waters might roll down into the parched lands as every prophet for several millennia has envisioned. Earlier this week some of our FaithHealth staff borrowed a church bus and road the tougher streets of Winston-Salem where our data indicated many of our “charity care” patients lived (those are Leland Webb’s ears). Even those of us who are strangers to these neighborhoods could see what is missing that determines so much suffering. We expected that. We were more surprised that once you get out and look, it is actually not hard to see the abundance of assets scattered in the very same neighborhoods.

The scattering of good works has not managed to achieve justice, of course. It is never wrong to give a bag of food or box of meds to someone in need. But surely, it is sinful to be proud of the narrow services that merely ameliorate suffering when so much more is possible—Panter-Brick’s uncomfortable point.

With some some humility (another virtue!) we can imagine liberating relationships that are not there, yet, but could be, if we applied art, discipline and time to bringing the possibilities to life.

Morning Star Missionary Baptist Church, a vital health asset co-led by Rev Charolette Leach, one of our CPE residents at the Medical Center. It sits only blocks from apartments considered to be the epicenter of hopelessness.

Could we imagine new structures, pathways and patterns that would amplify freedom and responsibility? Of course, we can. We just have to choose to do so.

It is impossible to think about sin and liberation this week and not notice that the whole point of Easter is that life breaks out where you least expect it; where you had given up all hope. Spoiler alert: he is alive and we are free. Why are you still satisfied poking around in the tomb among the dead?

Mapping Curiosity

These are such interesting days for hopeful people in our wildly dynamic world. Never before in the history of the species have we seen more radical emergence of vast numbers and forms of relational webs. More than two million non-governmental organizations have emerged in the last quarter century. Most of those are now morphing into a complex ecology of financial forms, mostly somewhere in between the old distinctions of faith, government, non-profit and for profit.

The technical name for our current version of we humans is homo sapiens sapiens: we are the creatures who know. And we know we know. I actually think we don’t know….much. But we are absolutely curious!

Jim tells of the curious story of the role of faith in the novel idea of "health for all." — Jim tells of the curious story of the role of faith in the novel idea of “health for all.”

Jim Cochrane leads the leading causes of life initiative. He has long argued that play should be one of the causes of life because from our first breath we poke, explore, crawl, play with our everything we can reach. Yes we do!(leadingcausesoflife.org). In recent months he has pretty much been captivated by…Emmanuel Kant because of the way he places creative freedom at the very center of human capacity.

Hope is possible because we have the capacity to think of entirely new things, and bring them to be. Almost everything nearby you this very moment is product of that creative capacity. The flat screen monitor or iPhone you are reading on which you are reading this are evidence, but indoor plumbing reflects quite a large number of creative moments, too. And there is still profound creativity going on at that end (so to speak) of human process that dwarf the iPhone for life and death significance: check out http://www.peepoople.com/ .

Because it is human, this capacity for creative freedom is social. It is rare for any of us to have a totally autonomous seminal thought of our very own. WE are creatively free, not just me or you. And the root of that social creative freedom is curiosity. When we are young it looks like play, beginning, I think with our body parts: ever watch an infant discover their toes? They are curious about them; study them and then start to figure out. Walking and the long journeys of life come quite later once we learn to talk and read.

We are curious about each others’ curiosity, which is how great creative teams thrive. My favorite new book, “The Surprising Power of Liberating Structures” (www.liberatingstructures.com) is a users guide to the social micro-structures that break and hold open the social space for us to explore what is possible in social webs. What opens up that space is not first imagination, but curiosity about what the group as a whole might discover is possible.

What you know is less interesting than that tickle just over the edge of your knowing just as the eye notices things on the periphery of clarity. The mind notices what moves, quickly ignores anything that stays the same. This isn’t always brilliant, of course. We forget things that matter and are easily distracted. The reason why we have so many rituals and reminders is precisely because we so tuned to what it not known and what might be possible. Nathan Wolfe calls that “adaptive novelty,” suggesting that humans can learn about this strategy for the billions of years virus have used that strategy.

Our most vital relationships and networks form on on a map of our curiosity. This is the terrain we walk from what we know to what we might be creatively free to do. The map of that terrain is rarely conscious, almost never on paper or even scrawled on a wall. Why not invent curiosity maps? Those would be dynamically generative and inviting.

Criterion Institute is a place of such generative mapping, which will be evident as it gathers for one of its astonishing “convergences” in Connecticut this week (http://criterioninstitute.org/convergence/). Later this week a different–but intersecting– map will emerge at the intersection of faith, peace and health at Lake Junaluska in the North Carolina mountains (www.lakejunaluska.com/peace/ ). Meanwhile, Stakeholderhealth.org vibrates with a constant flow of curious new findings about what is possible for faith and mission-driven hospitals to…..do.

Old Salem is still a place where new things might happen.

FaithHealthNC.org is a riot of things nobody thought possible that turn out to be very doable–and that we are creatively free to do. Nobody is planning all of it. We are finding ourselves living on a map of possibilities that is being drawn in real time by unlikely people asking, “what is we did ……together?” We closed the Global Health Symposium yesterday full energy because we were beginning to tune ourselves to the social network emerging from our shared hopes relationships.

Do you want a map of the future? Do you want to know what’s possible?

Map the networks of curiosity. And then live into and on that map with those you find there.

Brick Stone Seed

North Carolina clay is richer soil than you’d think. (Thanks to Tebo Cochrane for the drawing)

On the longest night of the year we humans have always wondered whether we are part of something dying or living. There is an oddly appropriate logic behind the decision of the Christian bosses to move the celebration of Jesus’ birth from the summer, when it more likely happened, over to the winter solstice where we really needed it.

We need a seed now.

It is a seed, not a brick or a stone. Hospitals and governments are good at bricks; witness any hospital or the Wall of China. Bricks are all the same size and have edges the keep them from rolling around so they stay pretty much exactly where you put them. You can stack them and build floor after floor of square rooms. Once bricks are in place they are difficult to transform when times change. People are not like bricks although I have seen some departments of “human resources” spend enormous effort trying to make them so. And then wonder why their organizations struggle with change.

Pilot Mountain is part of the Sauratown range that predated the Appalachians.

Stones are also good for things intended to stay put. Universities like stones but usually carve them up to work more like bricks. Robert Frost admired the way stone fences built of carefully chosen stones worked with gravity to make good neighbors. If you want to build with stone, you let the particularity of that one stone at a time guide you to its place in the overall structure. If you are good at it, you don’t even need mortar; gravity and thoughtfulness can hold for centuries.

God likes to build with stones. The sturdy wall on Pilot Mountain predates the Appalachians and may outlast them, too.

It helps to think of working in community as more like building with stone (and always without mortar)(no, money is not like mortar).

This acorn wants to be a North Georgia Oak tree one day.

If you want something to live and spread, you need to think more about seeds than either bricks or stones. The Jesus Movement, as Clarence Jordan called it, is a seed that surprises us fearful ones every single year (“Don’t be afraid,” the Angels had to say.) It surprises the brick-loving tyrants, too. (The cry of Mary was celebrating their surprising collapse.)

Seeds can be planted, but not made. They can be protected, nurtured, fed, watered and given space. But they are miracles of wonder built for becoming Oak, Kudzu, grain and ideas that live. Seeds last because they create generations of seeds.

Don’t make the metaphor do all the work here. What matters most in our time is to nurture the seeds of hope already alive among us. The seeds of the Congregrational Health Network in Memphis (more like Kudzu now if the New York Times story on Friday is right: http://www.nytimes.com/2013/12/20/health/tackling-a-racial-gap-in-breast-cancer-survival.html?_r=0&hp=&adxnnl=1&adxnnlx=1387548390-ULxVXPXDQ2cxZXdCXfFtHw ). That seed has blown across the mountains onto Piedmont clay, catching root and heading toward fruit fast (FaithHealthNC.org).

Tim McKinney tells Heidi Christensen of HHS about the childrenss' programs in Bithlo: "we never give up on anyone ever...." — Tim McKinney tells Heidi Christensen of HHS about the childrens’ programs in Bithlo: “we never give up on anyone ever….”

Look at the ridiculously improbable seed sprouting in Bithlo, Florida where Tim McKinney has planted himself in the literally toxic soil and finding root, too. (http://stakeholderhealth.org/transformative-partnership/case-study-bithlo/ ). Oakhurst Baptist which birthed Seeds Magazine in my youth and Green Street Methodist and Glide Street open late last night in the Tenderloin of San Francisco—all seeds many, many generations alive and thriving. Look at dozens of faith-inspired health ministries, some grown into huge institutions with a simple hope still in their heart.

These are long nights and short days, but the seeds are in the soil.