Monday, September 24, 2007

Connect, connect, connect (what congregations do)

The National Council of Churches discovered this week that people of faith care about the bodies and minds of each other and their neighbors. You wouldn’t think this would be big news, but the scale and ubiquity of the health-related programs conducted by congregations is striking. Released the same week as Hillary Rodham Clinton’s health reform proposal, it is important to understand what the thousand of churches, mosques and temples are doing and can do around health lest it become one more reason for politicians to duck the serious debate about the government can and should do.

The report has some serious limitations, most importantly because it outlines self-reported activities. It’s like judging a school by interviewing the smart kids who sit at the front and raise their hands. And, the congregations reported on the volume of activities with no way to evaluate the quality of services, accuracy of education or effectiveness of advocacy offered.

The best way to understand the report is that it shows what congregations would like to do and are beginning to do, which is encouraging, if not staggering. The NCC, not surprisingly, misunderstands why it is happening, casting the phenomenon as the trickle down of national and denominational leadership. Actually, the sheer volume of health activity shows that congregations are intimately aware of the terrible impact that an inadequate health delivery system is having on their congregants and communities. They do not—cannot—turn from the reality of a deeply broken, irrational, non-system of health that leaves people so exposed and vulnerable. So 51% of the congregations report helping to pay the medical bills of people in need. That is staggering, but those bills are even more staggering.

The data show that congregations are intimately connected to their members and available to their neighbors that results in a remarkable array of activities. The NCC suggests that denominations and public health agencies should work on increasing the capacity of congregations, but fails to mention the actual treatment providers/prescribers, which is where all the money and politics actually are. In Memphis we like to describe religious congregations (about 2,000 of them) as the true “health” system while the city’s hospitals and clinics are more appropriately called the “treatment” system. The health and treatment systems are highly disconnected, even though we know that almost 70% of our emergency room patients report having attended worship within the last month. We’re at the early stages of a serious effort to build a broad-based relationship with a critical mass of congregations (maybe 400 or so) that would share the ministry of health with Methodist Le Bonheur Healthcare. Their members and neighbors are on a journey of health that, from time to time, requires them to be our patients.

Most of the time, our patients are not in the medical system, they are in the congregational system on which their health depends in all the ways the NCC reports: 85% volunteer to visit and provide rides to services, 65% do some kind of health education focused on prevention (28%), elder care (28%), as well as end-of-life issues (24%). Direct service provision included counseling referrals (32%), screening (27%) emergency medical funding (25%) and mental health counseling (22%). Congregations don’t do any of this because of the national policy debate or because a Bishop tells them to. They are small organizations (average attendance 159) who know each other and their neighbors. Every person who gives and receives care has a name and, usually, a history. So congregational bodies can’t turn away when the cancer shows up or a child falls into a deep depression.

In New York or Washington health looks like programs aimed at what people don’t have. On the ground health looks like people helping each other to connect what they do have. You can’t build health out of what isn’t there. So we have begun to use a process to map the “religious health assets” in Memphis that was developed by friends in South Africa and Emory University along with the World Health Organization ( In a neighborhood widely regarded as “poor”, we discovered a rich fabric of assets that includes the schools, beauty parlors, churches and mosques, clinics, parks and 23 other kinds of things (including our community hospital). Congregations are life-giving, not because of their direct services, but because of the people they connect to each other.

The report suggests that congregations naturally blend referral and provision of physical and mental health that is far, far in advance of any suggested national policy. One great example is a new bill sponsored by forward-thinking Tenn. House Rep., Gary Rowe. Inspired by what congregations in his district are already doing with almost no funding, his bill outlines how we can transform community-based mental health and substance abuse treatment by partnering with local African-American pastors to “get the message out” of understanding mental illness, decreasing stigma and offering treatment options, supervise counseling and other support services in such churches and employ and train “indigenous community navigators” to conduct outreach efforts.

Nobody will be more surprised by the scale of the health activity than the clergy themselves, who are usually most painfully aware of the vast volume of needs they can’t meet, the truly staggering scale of medical bills they can’t help with, the profound social disarray that dwarfs all their programs. But at least they look into the eyes of need and act at some real cost to themselves. This is a lot better than what is happening in Washington.

Wednesday, September 5, 2007

Life on the road

Well, in case you're wondering how the world works these days, I'm blogging this on a live broadband signal at 78 miles an hour zipping through an illiniois cornfield. How how in the heck is that happening? But it is. So there. We're wired, linked, cross linked in real time all the time everywhere. And sometimes this even makes us connected in the way we mean it in the Leading Causes of Life. All this linking only gives life when it helps us talk to each other about what matters, for we are still powered by stories, roles, narrative. It is connection in which we find coherence, express agency, experience the web of blessing and know hope. And all of those float untethered without connection. But we should reflect a bit on what kinds of electronic connections bring life and which distract from it; which substitute for it, which accelerate its growth. It does not help to reject it like a Luddite. I remember fondly that one of the very finest South African Syrah I've ever tasted is named Luddite (I digress). We use technology for very old purposes--to be in relationship to those that matter and find many that matter in ways that were impossible to know and to have an informed coherence richly fed by knowledge easily gathered once we get the questions right. We experience an expanded reach for our agency.

And now I will go back to talking to John and Niels, sitting in the front seat on our way to Chicago.


Sunday, September 2, 2007

Lectionary Readings for September 9, 2007

Lectionary Readings for September 9, 2007
Twenty-third Sunday in Ordinary Time

Jeremiah 18:1-11 with Psalm 139:1-6, 13-18 or
Deuteronomy 30:15-20 with Psalm 1 and
Philemon 1-21 and
Luke 14:25-33

Life has a language.
And Scripture has a word for us.
These two thoughts guide these Lectionary reflections.

Life is speaking as we sense the Sabbath's approach long before its arrival.

We read over the texts that connect us with God.
We discern their meaning and trace the tread of coherence that runs through them.
We know they are intended to influence our words, our actions.
We are grateful for the hope they inevitably give.
And we anticipate our study, our worship, our observance of the Sabbath will be a blessing.

Life continues to speak we, we make a choice. Will it be Jesus' admonition that we are to "hate" interfering relationships? Does he really mean "hate?" Or is it a Semitic way of saying "prefer?" Is the text linked with Deuteronomy because it also asks us to make a choice for life? And isn't an embrace of life the gist of Paul's words concerning Onesimus? And that clay in the potter's hand, isn't it the clay of creation? Where to begin.

I go to the clay.

Jeremiah 18:1-11

The word that came to Jeremiah from the Lord: 'Come, go down to the potter's house, and there I will let you hear my words.' So I went down to the potter's house, and there he was working at his wheel. The vessel he was making of clay was spoiled in the potter's hand, and he reworked it into another vessel, as seemed good to him.

Then the word of the Lord came to me: Can I not do with you, O house of Israel, just as this potter has done? says the Lord. Just like the clay in the potter's hand, so are you in my hand, O house of Israel. At one moment I may declare concerning a nation or a kingdom, that I will pluck up and break down and destroy it, but if that nation, concerning which I have spoken, turns from its evil, I will change my mind about the disaster that I intended to bring on it. And at another moment I may declare concerning a nation or a kingdom that I will build and plant it, but if it does evil in my sight, not listening to my voice, then I will change my mind about the good that I had intended to do to it. Now, therefore, say to the people of Judah and the inhabitants of Jerusalem: Thus says the Lord: Look, I am a potter shaping evil against you and devising a plan against you. Turn now, all of you from your evil way, and amend your ways and your doings.

Like you I can't help but first ground the text in experience.

There is a hymn based on the lines of this text. Its melody is easy, its harmonies pleasing. Much as I find it soothing, I realize it misses the raw power of God's formative words to Jeremiah. I had a plan for you, but it spoiled. So we started again. Chose life this time and let's see how it turns out. If it turns out well; good. If not, I will reshape it again. I am the planter; I am the builder; I am the crusher; I am the reshaper. Turn from your evil ways and amend your doings.

First an experience flashes through my mind and then a thought. There were few parts of church life I loved more than working with seventh and eighth graders as they came to own their faith. What had worked for their parents might or might not work for them. And so their confirmation experience had to be authentic. For each one of them there came a Sunday when they were to give the sermon after a year of preparation in which they considered the intersection of the Word with their lives.

I had an admonition for them. "You can be good; or you can be bad; but you must not be cute." They inevitably took the words to heart and Sunday after Sunday, the congregation inevitably reached for the tissues beneath the pews to wipe away their tears. An easy choice is often no choice at all. Following Jesus; taking the Deuteronomist's teaching to heart; running against the prevailing norms of slavery—these choices are too deep, too wonderfully complex to not receive serious attention. The reshaping of life, on the part of an individual, or on the part of God is a serious matter.

And now the thought.

A pastoral application of the Leading Causes of Life requires an appreciation of time. No institution is better suited for such an appreciation than the church. When you are born your church receives you. When you graduate your church celebrates with you. When you wed your church clarifies the moment. When you did your church lifts your name in prayer. When you have an argument with you pastor your pastor does not abandon you. When a committee meeting appears to be the very last straw, your church stays with you and you stay with the church.

A piece of clay.
A plan for that piece of clay.
A piece of clay, misshapen.
A piece of clay reworked.
A piece of clay fired.
A piece of clay warned.
A piece of clay shaped yet again.

"There will be times in your life that you fall away from the church," I'd always say to the kids. "But your church will never fall away from you."

Is it as true as it sounds? Not quite. Ministry has an intent. Ministry falls short. Ministry is reshaped. Ministry makes choices to begin anew.

Thanks be to God for the gift of time that allows us to take the word to heart over, and over again.


Trust extended and kept is hardware

Trust extended and kept is hardware

In the medical environment of the early 21st century we spend tens of millions of dollars on hardware every year. We hope the extraordinarily sophisticated tools (mostly computerized and interlinked these days) will control mistakes, make the flow of patients through the hospital more efficient and quick and make our doctors, payers, staff and patients happier. It’s a lot to ask of silicon and electrons, even really, really expensive ones.

Robin Swift, who runs the brand new Duke Divinity School project on “thriving clergy and thriving congregations” was in Memphis this week and she gave me an article by Rob Thomsett, the author of Radical Project Management (Prentice Hall, 2002). The article, “Causes, patterns and symptoms of project failure,” analyses 20 major projects that clearly failed and discovered three problems at the root in every case: people, people and people. More to precisely, the problem with the people fall into a pattern any student of the leading causes of life could guess without the computer even being plugged into the wall.

Thomsett identifies three early signs of failure:

- “Lack of project plan, especially updates as things change (coherence)

- “Lack of stakeholder communication (connection)

- “Lack of external quality assurance (I’ll put this down to blessing for the moment)

And he identifies four fatal signs of failure:

- “Excessive hard work, mainly in the form of constant long hours (wasted agency)

- “High staff turnover” (lost agency, hope)

- “Aggressive and defensive behavior” mainly signaling a bunker mentality and loss of reality (coherence, connection)

- “No fun.” He notes that a successful project offers “challenge, learning and enjoyment for team members” so we’ll give this to all five: coherence, blessing, hope, agency and connection.

The causes of Life explain the human dynamics out of which all hardware emerges, is implemented and is sustained. Any group of humans has qualities of life or it quickly dissolves (fails). The word trust is not one of the leading causes of life, just as love or faith is not. They are qualities that resonate throughout the five causes, recognizable in each and among them. In the working of living teams that Thomsett analyzes, trust extended and kept is hardware.