Efficiency versus Meaning

Today's post is a reflection on a keynote address video that I watched by Dr. Bill Thomas who founded "The Green House Project" (TGHP). TGHP (see: www.thegreenhouseproject.org) is a revolutionary living arrangement for the elderly where up to 12 elders live in a home-like environment, cared for by dedicated caregivers (Shahbazzim). Elders are given control of the daily life and allowed to flourish. For all of you with elderly loved ones, you really need to check this project out, and I encourage you to view Dr. Thomas' keynote video. The concept is akin to the L'Arche living model for disabled persons and their caregivers.

Many things struck me a "right" in Dr. Thomas' keynote, but the one that really resonated was his comments around the fight between "efficiency and meaning". Having worked in health care institutions for most of the last 25 years, I understand what he's talking about. In fact, much of the last 25 years in health care has been focused on increasing efficiency and decreasing waste (think Managed Care/Cost programs, etc) to the detriment of providing care. Dr. Thomas was reflecting on the need for efficiency in the average Nursing Home which has to serve many residents with a relatively small number of staff.

He contrasts the search for high efficiency leading to a decrease in meaning for both elders and staff. Meaning here being a spiritual concept that the elders are institutionalized to the point that they actually regress or increase their decline - and their caregivers are never allowed to progress either. TGHP elders and their Shahbazzim, however, show increases in functional capacity and their "developmental potential" (his phrase) is maximized. They find meaning in being given the reins to their elder years and life, and to having meaningful relationships which provide stimulation and love.

I was struck by how our faith communities have opted for efficiency over meaning as well. My own spends an inordinate (in my opinion) amount of time fussing with the budget, and relatively little time focusing on what it means for us to be a community of faith both internally and externally. We're supposed to be intentionally building community, instead we are intentional about building barriers to discipleship - and we aren't the only ones.

Dr. Thomas' words called to something that has been building inside of me - the reason that I created Possibilities Journey, Inc. (www.possjrny.org) I am searching for ways for folks to find meaning in their path towards health, wellness and wholeness. Now I've received an expanded vision that says that all stages of our lives, finding meaning where we are is a key point for finding wholeness.

So follow that link and watch the video keynote. If you're like me, it will give you much food for thought. It also may spark a search for meaning for you.

Peace,
Dan

Creating a Life with Margins

Today's post is a reflection on an exercise contained in the book, "The Good and Beautiful God" by James Bryan Smith. The exercise is on creating "margins" in our lives, and the positive effect that can have on our health, wellness and wholeness (HW2). Margins in this use, is not a financial term (the net profit) but rather that space on a written page that helps to focus our eyes on the words.

Mr. Smith suggests that our lives are so filled that they resemble a page of writing that totally fills the page - no white space at all. Think about what that would look like - how overwhelming that would be to read. If you can't imagine it, go to your word processor and set up your margins so that they are as small as possible, then type some text. It doesn't feel right or good, does it?! We move from one item on our "to-do" lists to the next without a pause. We run behind because something gets in the way of our carefully crafted schedule that doesn't allow for the vagaries of life - for that unexpected turn of events. Once that inevitable event occurs, our whole day/week/life is thrown out of balance and we feel enormous stress and frustration. Does this ever happen to anyone out there in Blog-land? You can put down your hands.

So, how do we create margins? It starts by being realistic in looking at our days. How much can we really cram into the allotted time without driving ourselves nuts? Once you have the skeleton of what has to be done (be honest about "has to" versus "could be") then build in 15 to 30 minutes of down-time in the morning and the afternoon. This might involve getting up a few minutes earlier in the morning, or turning off the T.V. a few minutes earlier at night. It might involve taking a walk outside or even just around the building between meetings or projects. Be creative, and be ruthless about protecting this time.

With some space injected into your day, I suspect that you'll at first feel guilty for "goofing off" or "playing hookey", but my guess is that you'll also find a sense of peace and calm. If I'm a betting person, your co-workers will also notice that you have a different demeanor, and might even comment on it. Feel free to share your secret - in this way you will make their lives better too, and the HW2 of your community will improve.

I'd love to hear how this works for you. Comment back to me, either positives or negatives on creating margins in your life. Oh, and if you really want to do something good for yourself, get a copy of Mr. Smith's book and work through it during those margin times.

Peace,
Dan

Love versus Fear

Today's post is a reflection on our current living situation in the U.S. We live in the most affluent country that the world has ever known. Our standard of living is higher than anytime in the history of humankind. Yet, many (if not most) live out of a mindset of scarcity. We hoard - buying or building ever bigger houses, buying storage to keep all the "stuff" we buy that we can't fit into our larger houses, and then we purchase a "security system" to safeguard all our stuff (and possibly ourselves - though that threat for most is not realistic).

We are like the body when it develops insulin dependent diabetes mellitus (IDDM) - the body starves due to the inability to produce insulin which can move sugar into our cells to produce energy needed to live. Without insulin, no matter how much sugar is in the body, the body starves to death. So it is with us when we live out of fear (psychological IDDM) rather than love (psychological insulin). Fear makes us not appreciate the bounty that we have, and thus we are unable to utilize that bounty to do great things (or even good things) and our spirit starves to death. With the death of our spirit, we produce ever greater iniquity (inequality and injustice).

All of the Abrahamic religious traditions talk clearly about the love of money being at the root of our human donwnfall. When money becomes an idol, it demands ever more of us - our time, our thoughts, our actions and eventually our children and their children, etc, to pay the debts we have accumulated. Our children's children might attempt to exist on a planet almost devoid of any life other than human and "farmed" or "zooed" animals. Our continued rape of the planet for our own greed and gratification will lead to this unless we learn again how to love.

We need a love infusion - just like that person with IDDM needs insulin. We need it multiple times each day for the rest of our lives. The good news is, we don't need to go to a Pharmacy to get love infusions, but we do need to regularly attend a faith community and to get involved in loving G-d and our neighbors (read: all other humans) as ourselves. We will then find that we live out of abundance and not scarcity.

So, find a way to get your love infusion today and everyday. It is one great way to improve your health, wellness and wholeness and to change the way you live in the world.

Peace,
Dan

Health, Wellness and Wholeness and the EIP

Today's post is a reflection based on re-reading the book "House of God" and on 25 years of working within the so called "Health Care System" (HCS). The HCS, on the whole (as pointed out by many) is not about health, nor care, nor is it very systematic in anything but capturing charges for reimbursement. A few years ago, I did a purchasing analysis for a 35 hospital system. Hospital size ranged from 50-beds to more than 1000; from rural to inner city; from community-focused to large tertiary, university-affiliated monoliths. What I discovered (what I had assumed to be true) is that there was no coordination in purchasing or use of medications. Using this as a surrogate marker for system health, I saw a 35 hospital organization that ran as 35 separate and distinct entities. I have come to term this part of our "system" the "Episodic Intervention Portal" or EIP. To my knowledge, this is a term I have coined - we'll see if it gets any legs. ;-)

The EIP is accessed by well meaning persons in search of answers to health needs/questions. These well meaning persons (WMP's) get to see a practitioner for approximately 7 minutes, usually no more than twice yearly. Thus, all of their care is episodic, and in large practices where they may see multiple practitioners depending on scheduling, disconnected and uncoordinated. Layering into this the vagaries of what insurance will pay for/allow, one is reduced to a series of interventions per episode, without the benefit of a longitudinal view of the WMP's health trajectory. Health, wellness and wholeness (HW2) are beautiful casualties of this type of approach.

Nowadays, we have empowered patients who are trying to change the landscape of the EIP. Information is much more accessible, though not anymore understandable to the average WMP. Direct-to-Consumer advertising creates a desire to have a certain medication/procedure/conversation without the requisite knowledge of pharmacology or physiology. Law firms suggest that anytime you are injured by a chemical or practitioner that you have the right, nay the obligation, to sue to recoup money for you and the lawyers. But no matter how empowered the WMP's become, they are still stuck with the EIP - and the EIP is not changing. Yes, there is rhetoric about "Medical Homes" and "Accountable Care Organizations", etc, but current legislation and payment models will keep us in the status quo, irrespective of the outcomes of the mid-term elections (my bias and opinion).

So, what is the effect on our HW2 and is there anything that we can do within the current EIP? The answer is that our HW2 is dependant upon us to find ways to empower, enable, ehance and engage ourselves and others in its pursuit. This is what Possibilities Journey Inc (www.possjrny.org) is doing. With our "big picture" view and ability to facilitate relationships, we are helping to improve the WMP interaction with the EIP. Better interactions along with some much needed reforms (tort, structure, perspective) of the EIP will lead to a more just and useful entity in which we can pursue HW2. This is our vision, and we are doing our little part to bring it to fruition.

Come join us in our journey to change the EIP into something that works for everyone.

Peace,
Dan

Dialogue vs. Directive

Today's post is a reflection on this week's initiative to speak from "abundance" language rather than "scarcity" language. It also stems from more than 25 years in the health care field being one who, on many occasions in the past, has been quite paternalistic in my apporach to others in their health, wellness and wholeness needs.

Quite often in healthcare we as practitioners "know" what is best for others and are not afraid to share. ;-) This has brought about the patient empowerment movement in response to "our" not listening nor trying to be in relationship. In other words, we have been directive - telling people what to do rather than engaging them in dialogue. Healthcare professionals because of our training, and also the time pressures placed upon us (and honestly, the lack of reimbursement for "dialogue") will cut to the chase and try as efficiently as possible to diagnose and prescribe what we feel will solve the problem at hand. Is it any wonder that 50% of the prescriptions written in the U.S. each year go unfilled?

In order for us all to be healthier, more well and whole, we need to have the opportunity and reform to be albe to once more enter into relationship. When I have a supporter in my corner, someone who holds me accountable for the things that I'm trying to accomplish, I'm much more likely to make progress towards my goal(s). I'm quite sure that this is true of you as well. This is what Possibilities Journey, Inc, is all about (www.possjrny.org). We are trying to engage people in a dialogue about their needs for health, wellness and wholeness.

Help us in this initiative. Tell us what you most need from your health care system (or as I refer to it, The Episodic Intervention Portal [EIP]) and the folks who work within it. Ask your governmental leaders to continue to move forward with more than health insurance reform.

We look forward to hearing from you!
Peace,
Dan

Making time for silence

Holidays are good days to have silence. At least they were prior to my having children. ;-) Even though mine are now firmly into their teens, there's still not a lot of silence. My children believe it's a form of capital punichment to deprive them of their beloved "I" devices - even to go out into the wilds and poke around.

Ah well, I know it was a simialr event with me, car radio cranked up, 8-tracks in and bass turned all the way up. However, we didn't have all the options with cell phones and I-devices and internet. We were able to get away and be in silence - we didn't have any options.

It wasn't until a few years ago that silence took on a deeper meaning - one that was healing as well as quiet. My introduction to contemplation and contemplative prayer forms revolutionized my interior time. Prayer before that time had always been about noise and finding the right words to say. Now it became all aobut silence and listening for the "still small voice". It brought me back to a knowledge of my interior self, and the power that lies resident in each of us.

So, I hope that you find time for silence. Try the book "Soul Feast" by Marjorie Thompson or "Celebration of Discipline" by Foster for more help. Healing can come from small moments of silence. You don't have to take a retreat (though this helps) for a week, 5 to 10 minutes each day will do. Try an examen prayer (a review of your day) as you settle in to sleep. Say thanks for the good things that happened, and offer heartfelt apologies for those things that didn't go well. I find that I sleep much better having done this.

Peace and silence,
Dan

Magnanimus

Today's post comes from some discernment of a chapter in Dean Brackley's book, "The Call To Discernment in Troubled Times". It is a book on the Ignatian Spiritual Exercises that takes the reader through these very useful spiritual disciplines. The chapter that this is drawn from is called, "Expanding the Soul". He has been leading the reader through the process of self-emptying in order to be in better and closer communication with G-d.

The word magnanimus (literally: great spirit) comes up in the chapter as a response to the great challenges of our time. Instead of the "shrinking violet" or "meek" approach, Brackley suggest that the idea of magnanimity be re-captured. Being great in spirit should not imply that one is overly prideful, rather, the greatness of spirit allows one to be humble, but to act decisively to combat injustice. To quote from the book page 109, "The great challenges of our time - poverty, the environment, war - should inspire humility, but also creativity and bold action. They cry out for large-minded generosity - that is, the magnanimity that springs from wholesome self-esteem. Without humility, we elbow others aside. But without magnanimity, we bury our talent in a napkin."

There is not a lot of this characteristic alive in the world today. Our world (primarily the "developed" part) is individualistically focused and out to get as much as possible for as long as possible - to "elbow others aside". They oppress and humiliate others in order to make themselves appear more powerful and successful. This happens in the Church as well as the surrounding world. In my own congregation, we make ourselves feel better once each month as we hand out USDA food (poor nutritional quality) and a hot meal, after making our brothers and sisters wait outside in a line that stretches around the building. Magnanimous - I think that we have a ways to go!

Our path to health, wellness and wholeness are all wrapped up in our ability (or inability) to become greater in spirit. To see ouselves and others as the flawed humans that we are. To not sell ourselves short, and to not over-inflate ourselves. The path is not a path we can walk alone, because it is very difficult to see ourselves as we really are. Find yourselves some caring and honest friends and begin to study works like Mr. Brackley's. It will be your doorway to improved health, wellness and wholeness.

Peace,
Dan

What do you see?

I'm a day late on this posting due to being out of the office yesterday, sorry. My reflection today is on vision - specifically, what we see inside as well as outside. Now, this is not a vision test as administered in an opthalmologist's office, but rather a test of how much we perceive of what is going on in the world around us.

Spiritual teachers over millenia have commented on our ability to deceive ourselves - to see what is not really there. The path to spiritual health, wellness and wholeness (HW2) therefore, is to have our vision become real and true. That is, to have our vision clarified by focusing on things other than our own self centered world view. For many years (more than 25 now) I have been near sighted to the extent that I've required glasses to see things at a distance. I become a certain age and have had to move to "progressives" which allow me to see both near and far. Though corrective lenses have allowed me to view things at a distance, I find that often my "inner eye" has not been corrected enough to do the same.

How is it with your inner eye? How do you view the things that are going on in your inner self? How is it that you perceive the world around you - and how does your vision help you to interpret what you see?

It may be time for corrective lenses for your inner eye. There are many resources for this. One of the most helpful for me is to unplug from the noise of the world and to reconnect with the Other outside of me that has the ability to show me the truth. I wish the same clarity for each of you.

May your vision clear and your HW2 improve!

Peace,
Dan