Preparation

Advent is a season for spiritual preparation. It's the coming of the new liturgical year; it is a period of expectant waiting; it's an opportunity to connect once again - or to strengthen connections to the G-d that chooses each of us and desperately wants to be with us. Advent calls us to prepare a place for G-d in our lives - hopefully at the center. All too often that gets lost in all the preparations for Santa Claus and other secular holiday distractions which cause us to lose our way and to focus on things other than our spiritual health and well being. I have been in a state of preparation for the last three years - and I didn't know it. I thought that I was being called to begin a non-profit focused on re-integrating all faith communities into the broad public health system - and healthcare system. Indeed, this seemed to be all that it was and I went on my merry way filling the days with meetings and obtaining IRS 510c3 designation, etc, etc, etc. However, I was being prepared for something much more by the indwelling Holy Spirit. I was being prepared for the reality that I couldn't transform healthcare alone. I was being prepared for the reality that the charity would not be financially viable. I was being prepared to have to discern again what it was that I was being called to do. This last year was wrenching and painful and necessary. Now I stand on the cusp of a new calendar year with a new perspective on what it is that I am supposed to be doing. I have accepted that I'm called to seminary and have gone back to work full-time as a pharmacist to allow this to happen. The seminary I am planning to attend has created a new venture that seeks to re-create the Memphis Congregational Health Network in the greater Washington DC metropolitan area (what I've been trying to do). They are looking for a Program Manager part-time, and I've applied. Anyone want to suggest that G-d is not active and has not been preparing me for this exact mission? Hard to sell that one at least to this believer. What is G-d preparing you to do? It is hard to see the activity when you're deep in the mix - but slowly the plan shows itself. I pray this Advent season for each of you that you will be lead to discover G-d's plan for your lives. It is truly amazing. Peace for the journey, Dan

Advent

Haven't written in a while - still struggling to find the new rhythm in my work patterns. I think that I'll be moving to writing once weekly on Saturdays instead of twice weekly as I have been for the last 2+ years. So, if you're setting your notifications, look for my musings on the weekend from now on. It's Advent, the start of a new liturgical year and the season of anticipation. I'm musing on that, especially as I have a number of things on my heart now days. I'm finding that I'm identifying with the young Mary who had overwhelming things happen to her and yet we're told that she "treasured up all these things and pondered them in her heart." I'm amazed at the spiritual maturity of someone who is thought to have been around 14 years of age when all this happened. It is easy to be overwhelmed at this season. Much busyness and parties and shopping and..... It seems to never end until we are so worn out and cynical that we can't enjoy the season for the great gift that it is. Maybe we should return again to the simplicity of Mary and Joseph and the living G-d who comes to us naked and helpless and urgently requesting our love and attention (as only babies can do). Maybe we should look again at the grace and the peace that is promised as well as the coming of the new convenant. It is much to treasure...it is much to ponder. So, during this Advent season I offer this prayer for all of you that the light of G-d might descend once again to your heart. That you might be "strangely warmed" as John Wesley was, and that you might ponder who G-d is for you, and what G-d coming to Earth might hold for your life. May the peace that passes all understanding be yours now and forever. Amen! Dan

Willpower

Finished a very one-sided conversation with my almost 19 year old son just now. Classic interaction with a member of the so called "Entitled Generation". Not making enough money 'cause he's working at a Mom & Pop hardware store for minimum wage. Spends all his free time when not in college classes stuck somewhere in the internet, living virtually. It struck me as I was talking about the need to actually start living and deciding about what he was going to do (including finding another job, registering for next semeter's classes, etc) that the internet has become this generation's drug-of-choice. They've decided to "tune out" of life by living in a fantasy land of someone else's making. Growing up in the 60's and 70's at the tail end of the Boomer Generation, illicit drugs and alcohol were our ways of tuning out. Big decisions which were quite anxiety provoking could be avoided by smoking some weed, drinking, popping some pills or a combination of some or all of the above. While scientists have delineated the hazards of these activities, we're just now starting to come to grips with the societal implications of this massive escape into virtuality. Colleges are teaching classes to their students on how to talk to each other. Few people walk or run without music blaring in their ears - ignoring everyone they pass. Communities suffer because there's no one left who is paying attention to them. When asked what the real issue was, my son posited that he needed "willpower". He is addicted (dependent really) on the virtual world. It allows him to escape to a land that he can control and that he can regenerate when he makes a poor decision. Real life is certainly harsher than that - but it doesn't have to be. We can recreate a world that is engaging and supportive. We can overcome this new "drug" problem. It's going to take all of us and our collective willpower to break free from this habit. Do we have any willpower left - or is it too late? Time will tell, won't it. Peace for the journey, Dan

A parable

Sorry for the delay in posting - can't believe it's been almost exactly a month. I've recently started back to full-time pharmacist shift work and it's thrown me for a loop scheduling wise. I offer a parable as an act of forgiveness. I used this parable in a sermon yesterday about eternity and eternal life. Thanks to my dear frined Karen Michaels for sharing the story with me. From: Rebbe Zusha, a much revered Hassidic teacher from the 1800's... G-d created all people and loves them very much. However, some of G-d’s children do not love G-d as much. To differentiate those that love G-d and choose to follow G-d from those that don’t, G-d made all people without elbows. G-d then created a large banquet for all G-d’s people and invited them to sit and eat their fill. Two distinct patterns emerged among the guests, those in hell thought only of themselves and were frustrated because they couldn’t bend their arms to get food and drink to their mouths. They railed at G-d over their predicament and yet made no changes in what they were doing. Those in heaven sat down across from each other and shared the meal. They lifted their arms full of G-d’s bounty and gave each other food and drink until they were sated. They praised G-d for G-d’s love and gracious abundance and for the other child of G-d who loved them enough to see to the needs of another first. Great parable isn't it?! I promise you that the visual of people trying to eat without elbows will stick with you. We talk a lot about how bad things are and how they never change. Maybe it's not the "things" that need to change! Peace for the journey, Dan

Minimizing

Sorry I missed posting on Monday - I've got a new work routine and it's throwing a wrench in my "usual and customary" schedule. Today's musing is all about the problem of minimizing. Psychologists and behavioral therapists know that the process of minimization is one of a set of disordered thought patterns that humans get into. Minimizations are those thoughts that do what the name implies - it takes a situation and falsely reduces the impact of it on others. One of the problems in healthcare, especially with physicians, is the common practice of minimizing the impact of procedures on the lives of those they are acting on. Case-in-point, I've had two conversations in the last week with folks about the benefit/burden of surgical procedures on loved ones who are nearing the end of their lives. In both cases, physicians have told the families that a given procedure is straight forward and easy to perform. In both cases, they are absolutely correct - the act of the procedure in both cases is quite easy for an experienced physician to accomplish. However, the burden of living with the procedure is never discussed. This is one of my main problems with the way that our healthcare system currently operates. There is no real informed consent - decision makers are only given one side of the story and are expected/led to make a decision without full disclosure of the likely long-term issues. Couple this with the fact that in both cases the patient in question had done no end-of-life planning or advanced directives and the situation quickly becomes a nightmare for an already stressed out family unit. The mantra of Medicine "first do no harm" has been co-opted into don't harm the patient with an intervention, but don't tell them the real burden of living with the intervention. For example, one of the people needed a tracheostomy to facilitate mechanical ventilation. This is an "easy" surgical procedure, but the burden is then living with long-term mechanical ventilation in a skilled nursing facility probably bedridden for the rest of the person's life - at significant societal and family cost. The alternative is no procedure, extubation without reintubation, being kept comfortable and pain free as the person breathes their last surrounded by family and friends. Which would you choose for yourself or a loved one? I urge all of you to make and Advanced Directive and Medical Power of Attorney soon. Discuss your wishes and make clear what you feel is important to being alive. If you don't the medical minimizers might just come calling. Peace for the journey, Dan

Generativity

Musing today on the ability of G-d to create things and to take those things already created (us in particular) and transform them/us to make them/us new. YHWH is THE Creator and as such has the unenviable task of putting up with all that the children are doing to that creation (and other creatures). I marvel these days at the endless patience and persistence it takes to continue to work against all the wrong-headed (and hearted) things that we do to each other and the world. Jehovah is keeping the promise made to Noah and not just throwing us all out with the bath water (again). Hard to believe that this isn't our fate...but it's not. We're at the beginning of the Jewish New Year, year 5300+; G-d is nothing if not faithful. I was talking with a friend just a short while ago about a critical illness and the realities that lie ahead for the loved one in question. The ill person is a life-long Catholic and believer, yet that person did nothing to plan for the end of their life. One could argue that believers are taken care of by our loving Creator and thus don't need to plan (that's a Calvinistic predestination approach), or that G-d will miraculously intervene, or that heaven is as good as we're told and we can't wait to get there.... More likely it is that we avoided the decision as long as we could and now we have to pay the piper. After all, all of us will die at some point in the future - life is 100% fatal. Difficult decisions present us with opportunities to discern what's important and what's real. How do I really feel about the choice between long-term mechanical ventilation through a tracheostomy (hole in my throat) versus extubation and being treated comfortably while I breathe my last breaths in this life? How does my view of YHWH influence this decision? Granted, I've seen this scenario played out thousands of times in the last 25 years so I know something about the suffering associated with the former choice. Spiritually, it comes down to whom do I trust? Do I trust my generative Creator who "knows what plans I have for you" or do I trust a fallible human physician who can't know the future? In G-d all things are possible, even the very hardest of things. Hope comes when we look to G-d to do the things that we can't and to create the outcomes that we most need. This week, look to G-d to generate new things in your life. Take a moment to think about what you'd like at the end of it as well. Some planning and advanced directive creating will be invaluable to you (and your decision makers) down the road. It will generate conversation and a new thing for you and your family - thanks be to G-d! Peace for your journey, Dan

Just an Ounce

My professional world is healthcare. I have worked in it steadily since the mid-1980's and have seen much change. However, much of the change has been in the form of new technologies and therapies for diseases that are a direct result of the life choices we as Americans make. Stuffing down endless amounts of junk food and red meat, washed down by sodas and/or juice and/or alcohol, all while living an increasingly sedentary life. Really, what do we expect our bodies to do with that kind of mistreatment? This week as I cared for the next in a long line of physiologically broken people, a couple of old adages came screaming back into my mind. "An ounce of prevention equals a pound of cure." Very similar to "a stitch in time saves nine". The sayings contain great wisdom that was hard won. By getting out ahead of the issue, one can prevent in large measure (9 to 16 times from these sayings respectively) future misery. This is not to suggest in anyway that everything can be cured through prevention and planning, however, there is a compelling amount of rigorous scientific data to show that vaccinations, good dental care, controlled use of alcohol, not smoking, modest and consistent exercise and seatbelts save a tremendous amount of lives and money. Since none of the medicines that we currently have actually cure any of the most common ailments (asthma, high blood pressure, high cholesterol, heart disease and stroke) it appears that the only cost-effective approach to these diseases is to do everything we can to prevent them in the first place! The main poblem is that we lack the self-discipline to do what it takes to become healthier. The other problem is that our healthcare system and insurance carriers do not value prevention as highly as they should. In fact, many plans do not incent or often cover the very basics of prevention and promotion of communal health. Couple that with the mythology surrounding vaccinations and the relative risk associated with them, and there is a perfect storm that wrecks prevention before it can even get started. Morally and ethically this is wrong - both at an indivdual level and communally. When we don't care for ourselves we show a uge lack of gratitude for the lives that have been given us. We should be ashamed! This weekend, think about all the prevention that you've let slide. Make an action plan to get the information that you need and implement one new healthy activity or preventative act. You'll be very glad you did - and so will all the rest of us who ultimately have to pay your healthcare bill. Peace for the journey, Dan