Sunday, July 24, 2011

Norwegian Prayers

I have a Norwegian name and maybe 1/16th of my blood comes from the fierce, noble people who carved a distinctive culture of rock tough land and a cold ocean. I treasure my Norwegian friends that share in the hopes of building a global network of faith-based health institutions.

So I am also proud of a King who can cry for his people as did Harald V this weekend. Every single one of the 4 million Norwegians know at least one of the 92 young and civil servants who will be buried in the next couple days. The people are so tightly bound that most are an extended part of the many extended families who will weep for a long time.

In recent decades Norway has come to be thought of as a gentle wealthy country, so fair-minded as to be confused for neutral, sort of like Switzerland. But their oil wealth is quite recent and like the smart farmers and fisherman they have been for millennia, most of that wealth is in the bank or invested in education and health so that it will bear dividends needed when the oil runs out. And they are not gentle, but fiercely tenacious to what they have always been willing to fight for--their independence and free voice. Their "boys in the woods" tied down hundreds of thousands of Nazi troops in World War Two, keeping Britain from invasion until the Americans decided to show up and join the fight. They were among the first to lend their young men to fight in the frozen mountains of Afghanistan against Bin Laden.

Now they will weep a waterfall of tears for every single one of them and all of us who have come to love and respect them. But Norwegian sorrow will not spill like acid on the sacred documents of their democracy. They will remain recognizably Norwegian. They will love their free and open society and thus protect it against anyone whether it be a crazed evangelical from among themselves, a distant muslim or meddling American (like the Bush era puff who accused them of not being tough on terrorism). They will teach us what it looks like to defend democracy even when the attack comes from within.

Because of who they are, the lament for family and friends will be deep and slow. But so, too, will be their proud refusal to give in to fear, to turn away from the world and into themselves. Our Norwegian friends at Diakonhjemmet Hospital are convening a meeting of global and interfaith healthcare leaders on the Mount of Olives in East Jerusalem in November (Methodist Healthcare is proud to co-sponsor, with Augusta Victoria Hospital as the host)( This is the 120th anniversary of the founding of Diakonhjemmet Hospital, but they thought it would be better to focus elsewhere because it might support a global movement to do so, which is about as typically Norwegian as it gets.

The Norwegian church remains the soul of the people in a way that is hard for Americans to understand, since on most Sundays most Norwegians are off walking or skiing in nature. But the Oslo Cathedral filled to lament and strengthen resolve almost before the dust settled on the rubble a couple hundred yards away. And some of those prayers were instantly and instinctively to preserve the powerful humanistic values Norway represents, including openness to cultures and faiths from around the world. God so loved the (whole) world, pray the Norwegians, and they mean the whole thing. May we pray with them.

- Posted on the journey

Saturday, July 23, 2011

Seeing with our own eyes.

Sometimes it helps to see through another's eyes. This guide is holding up a print of a Georgia O'Keefe painting of those red dirt hills behind her. I'll never walk by a pile of dirt again without wondering what it might look like in different light, through different eyes. It helps.

That was sort of my job with a very smart group of Coloradans gathered at Ghost Ranch this week. I'm not Georgia O'Keefe, but I do see things differently, especially where faith and the health of the public come into focus. Mark Earnest and I unpacked the intersection of the "social determinants of health" and what faith has to do with it, which turned on some new lights of possibility. There is a gathering wave of solid science linking social factors, especially inequality and poverty, to long term health status. During the time when the sixties generation has been doing this and that to entertain ourselves the United States has become a dramatically more stratified society, with a lot less mobility among the strata. I have no idea how my generation let that happen on our watch, but it did. The result is a striking, even shocking, rate of violence, obesity, widening of graduation rates, decline in voting and other things you just would not think would be so directly correlated. But they are.

So what does any of that have to do with faith? For the most part religion in the USA has been and is complicit with those trends. Sometimes it has been actively so. I'm thinking of the ugly and cynical wedding that you'd expect among cousins living up the ideological mountain holler. You can observe this on most any religious or Murdoch TV station. That stuff is so obvious that is will wash away with the first rain burst of rationality.

The more dangerous complicity is passive and mindless; when we have stayed content to do pastoral care and one-on-one kindness decade after decade. Those things are always right, but almost never adequate even for that one person, much less the next hundred or thousand just like them. This is visible in many substantive and worthy models of faith and health--notably Faith Community Nursing. This terrifically smart model holds great subversive promise, but is currently measured and valued by its capacity to provide caring, not social transformation. We have to hold that model--and all of our models--accountable to the powerful new insights provided by the social determinants of health. For the most part, the scientists doing that body of work don't think about faith communities at all as having anything to do with those determinants. But I do.

It is right to worry about the mean chaos alive in the US today. I write this as The Deal goes down in DC; and as the blood goes down in Norway--cold shocks to any hope. But there is some serious science blowing the other way, that helps us see the way toward healing of the body politic, the public. It takes time for that flow to carve new patterns in the social stone, find new channels for the hopeful river to flow.

In the South Western Desert, you just can't miss the astonishing changes wrought over time; and how much time those changes take--oceans up and down, volcanos and then millennia of wind and rain. This cautions and encourages me as I am so impatient for changes that should have already happened (universal health coverage). And then I see such clear evidence of the reality-based science and public will eroding the old rock-like resistance. It might take a couple decades instead of the months I would want. But you can feel the wind.

Meanwhile the powerful work on the ground is happening around rooms such as this one where people are seeing their own power and doing so with their own eyes. People from public and faith-based hospitals, a handful of faith community nurses, some semi-retired clergy and docs, a smart young anthropologist working on AIDS, a psychologist my age helping organize the early steps toward universal coverage in Colorado, another bringing PICO's powerful community organizing methodology underneath a clergy action network and,

most astonishingly, a social worker who attends an evangelical church building community collaboration around... meth addicts. Sometimes hope on the ground is far more wild than the hope we were expecting. I dare you to feel hopeless in this group. I know that I can't imagine giving up until they do. Delusional to hope? Or delusional to quit? I'm staying in and hope my life can be one small burst of wind carving the next curve of the rock ready to catch the light of the new sun.

- Posted on the journey

Wednesday, July 20, 2011

Ghosts and Memories of the Future

God paints and appreciates it when people notice. Light and land, water and wind in constant playful change. Georgia O'Keefe lived here on Ghost Ranch and noticed better than most. I'm pretty sure God gave humanity another hundred years just because of her respectful attentiveness alone.

Since 1955 this magical land has been under the stewardship of the Presbyterian Church, which offers it up as a venue for seeking and seeing for several thousand people year. I'm here this week with 18 Colorado people convened by Chris Adams( and Mark Earnest (MD, PHD, University of Colorado) to explore how people of faith can extend and nurture the common good in the context of health reform. That work begins with noticing what God has been doing in creating the habits of the heart and potentials in human connection.

Meanwhile health reform crackles like a wildfire in DC, a metaphor that has come power here literally within view of the smoke over the ridge to the south. The picture is of O'Keefe's beloved Perdenale, but I suspect she would have loved the rain falling on either side of it today, hoping it will be enough to break the drought and dampened the fires. I wish it would rain in Washington, too, and give our land a chance to heal.

While this is the land of the endless sky and humbling rock formations, there are smaller miracles everywhere to notice. It a photographers rule to never shoot pictures in the middle of the day. But here the light is never so bad justify not paying attention. Mary Oliver said that the most basic task of a human is to pay attention, which does imply that it costs something to notice. Attentiveness is not free. You have to stop whatever else you might do, offer up just a bit of time, stand still and watch.

As I came closer, I noticed more and more and more; almost bursting out laughing to find not one, but two bees doing whatever they do in the middle of the flower covered up with pollen. I suspect it will result in more bees and more flowers,too. Life abounds.

Of course, I am talking about the miracles among us, the strange and wonderful way that even while fires of stupidity rage in Washington, people care for each other. They notice. They care. They create patterns of caring, some of which turn into committees, some of which turn into projects, some of which turn into shelters, clinics, even the random hospital now and then. Sometimes we even organize volunteer fire departments who drop everything they are doing in their little lives and rush together when the common good is at risk.

A volunteer fire department doesn't just show up like a swarm of well-intentioned people. Somebody organizes them and they buy equipment they think they might need. The show up for training, not just fires. And they build commitments among themselves so they know they can count on each other to be there and be competent. And then one day a neighbor's home catches fire. Then the whole community can see what their volunteer fire department neighbors has been doing--they've been preparing for just this moment. Months of mundane labor and a few hours courageous drama. Most of what a congregation does about health is similarly mundane, made up mostly of committees and checking blood pressure, maybe a health message during worship now and then. No big deal. But every now and then....

The last picture is of a cliff formation O'Keefe painted many times. I like the eroding gully at its base which signals that God is still painting, still creating new possibilities. Pay attention......

- Posted on the journey

Sunday, July 10, 2011

Jesus and the tummy-tucking christians

Why didn't Jesus go to church? I know one of the reasons is that he was Jewish; but I can't think of a single time he went to synagogue either, except to pick an argument with the puffed-up religious leaders of his day. When he needed to get to close to God and his own soul, he got as far from religion as he could get, heading out to the desert or across a stormy lake. Or he went for a long walk into forbidden territory (Samaria) and talked to forbidden people. Much of his testament is a long, long list of conversations with people up trees and standing lonely by wells with some so totally crazy they needed demons to be cast out. And he was famous for his parties. But pretty much the only reason he went to "church" was to throw money-counting tables upside down, or to scare the heck out of his home folks by claiming God sent him. He sure didn't sit down in a pew and sing.

For that matter, he didn't show much respect for any religious trappings, which made him an easy and constant target for the healing he did on the Sabbath in very direct opposition to the rules.

This is all so obvious. But it is hidden from us because we usually have heard these outrageous stories of this first century messianic itinerant carpenter Hearing of this wild and unconstrained savior in such tame surrounds wraps the story in bubble wrap so we can hardly feel the hard, sharp edges even when we try to grab hold.

This is on my mind because I visited a church that shall not be named today. I was going because of a special event that promised to blend blues and hard-talking about following Jesus. I could use some of that, so I showed up. Deadly predictable, faux challenging, achingly polite and ancient. Jesus would have headed to the desert at a fast jog and stayed there until he ran out of locus and honey. There is a story of the devil tempting him to jump off a high tower to test God and prove divinity. I think Jesus would have jumped off the nearest steeple just to get all the niceness out of his mind.

How it is possible that this wild, bold man has devolved into the mascot for what has long passed away into harmlessness?

It isn't just the churches that have wrapped Jesus in blandness. It's us--me.

Today there was a most curious article in the Memphis paper about a gorgeous young woman, 23, who was having her tummy tucked and other parts touched up. I think that must happen a lot, but not usually for beautiful young women. What is most bizarre is that she did this to help her career as a...songwriter and singer. My life has a soundtrack largely written by smart southern women (Indigo Girls, Patty Griffin, Michelle Malone, Emmy Lou Harris, Lucinda Williams, Bonnie Raitte, Jewell (Okay, she's from Alaska....)). The whole point is that they tell the truth so vividly that even I can hear it. So it was a shock to think of a smart southern song writer getting her tummy tucked. Who can I trust?

But is it any less shocking to think of people who know a very great deal about Jesus forgetting what a wild man he was/is? We preachers, deacons and evangelists have self-administered theological tummy tucks for decades just to keep up appearances and hide the deeply annoying prophet/God who broke every rule he came across on his way to the Cross.

- Posted on the journey

Monday, July 4, 2011

Equality and Pursuit of Happiness

Two years ago two British public health researchers have written the definitive book about the United States, which I got around to reading this weekend, 235 years after we we threw them out. In "The Spirit Level" Richard Wilkinson and Kate Pickett explore the mystery about why equality makes societies stronger in almost every way and why inequality makes any society weaker.Only in recent years has reliable data been available to allow comparison across many nations for a wide range of health and social issues, as well as detailed measures of the distribution of wealth between and within nations. The subject is relevant on July 4th because they cast an especially clear eye at the United States, and the wide differences between our various states.

The big idea is that once a society has passed a certain level of economic well being (think Portugal or Greece) additional average wealth doesn't make as much difference to the quality of life that you'd think. Once you have generally available clean water, safe food, decent housing and basic medical care other factors have a lot more to do with happiness and well being. The most reliable way of predicting the health of a society--or a particular state in our Union--is the degree of inequality between the citizens.It makes sense that poor people would have lower health. But why would relatively rich people in an unequal society also have worse health than their counterparts in a more equal society?  People in Greece spend about half of what people in the US do on health but they tend to live about 1.2 years longer. Why? And why would I raise the issue on July 4th?

You'll have to read the book to fully grasp their answer to the question (The Spirit Level, Bloomsbury Press, 2009). But just look around to answer the second. In my lifetime the semi-United States have witnessed huge growth in our economy, but nearly all of the benefit has gone to the rich, creating a vast and deepening divide between them and the large number left behind. The United States today is a very, very different pattern of citizens with quite different prospects. I write as one of the accidental winners. A public school kid born to a teacher and civil engineer, I went to Wake Forest back when it was for middle class kids who couldn't afford Duke (or get into UNC!). When my parents passed away, they left each of us five kids about $15,000, which is to say we were born to honorable work, not wealth. I've traveled to many countries for this and that reason, so I know to be grateful for where and when I was raised.

But that nation is largely in the past, as Wilkinson and Pickett gracefully point out. And we face growing sense of conflict among ourselves, constrained by real limits to our growth and real competition for our privileged status.  The fundamental structural inequality taking root in the United States is showing up in predictable rates of disease, violence, anxiety, depression. In short anything related to social phenomenon is acerbated by patterns of inequality.If you doubt this, let me invite you to spend a day in our emergency room, or at The Church Health Center or one of the Christ Community Health Clinics where reality is not ingnored.

While these are big patterns, they are not inevitable or irreversable. For instance, the authors chart the large differences between nations and states in terms of whether people trust each or not. In Norway over 80% of respondents say they could trust pretty much everybody in the country. They noticed, as I have, that it is common for coffee shops to leave blankets outside on chairs so that customers can linger in the cool over coffee. I've seen people leave their babies in strollers outside the window of coffee shops. It would not cross their minds that anyone should think this odd, dangerous or foolish. What could happen? Ask anyone in Mississippi, the state with greatest inequality and lowest trust (17%!)(page 52-3). Does inequality produce lack of trust; or does lack of trust produce inequality? The causal arrow goes both ways, but the result is polytoxic producing generational patterns of problems including a chasm between those trying to fix the problems in government and also in private healthcare such as my own Methodist LeBonheur Healthcare. Inequality produces distance, which produces ignorance, which produces misunderstanding and more distrust and lack of collaboration and and and and. People don't trust their doctors, much less the abstractions called "executives" of huge organizations like hospitals.

There is much to learn here from our British friends, but the most basic is that we cannot expect to merely grow our way out of inequality. And that is simply not possible, especially as we must all make our choices in the context of increasingly clear environmental limits. "Modern societies will depend increasingly on being creative, adaptable, inventive, well-informed and flexible communities, able to respond generously to each other and to needs wherever they arise. Those are characteristics not of societies in hock to the rich, in which people are driven by status insecurities, but of populations used to working together and respecting each other as equals."(p263) Sounds like America to me, at least what it was. And could be again.

This has very practical implications for our work in Memphis where we have built a "web of trust" among 357 congregations to care for members and neighbors and advance the health of the whole community. Inclusion, invitation, generosity, transparency, flexibility, connectivity--all among people dealing constantly with gross evidence of inequality on some of the toughest soil in world.To give health a chance, build trust.

I appreciate the Brits for reminding us of what is worth fighting for as we go back to work tomorrow. Check out their website: