In Search of Epiphany

In these 12 days of Christmas, the Christians among us are tracking towards the Epiphany. Traditionally, Epiphany is the feast celebrating the occasion of the Three Kings who came to worship Jesus. More Orthodox traditions have Epiphany marking the baptism of Jesus, but is there a broader concept of epiphany that can help us as we try to find ways to be engaged spiritually in the world? Merriam-Webster's Online Dictionary has one definition of epiphany as: "(1): a usually sudden manifestation or perception of the essential nature or meaning of something (2): an intuitive grasp of reality through something (as an event) usually simple and striking (3): an illuminating discovery, realization, or disclosure." I think that this is helpful as we search for meaning and understanding of our world and our role(s) in it. Aren't we all searching for the essence of something - of life? Wouldn't it be nice to have a better grasp of how we can make a difference in the world - through a simple and striking event? In this season of light, aren't we all in one way or another searching for illumination for our paths? The quest for epiphany is as real and as meaningful today as it ever has been. By this time next year we will have chosen another President; many disasters will have befallen the world; many millions will be born and will die; new scientific discoveries will be made - some of them revolutionary. Will you be any different in your understanding of who you are and what your purpose is in this world - will I? How is it that you will search for meaning in this new year versus years past? There are many ways to open the inner life to explore how G-d is moving in your life. I recommend a spiritual director (www.sdiworld.org) or good cleric. Make one of your resolutions to open your mind to the possibility of epiphany in 2012. This is a choice that will make all the difference in the world and in you. Peace for the journey and have a blessed 2012! Dan

What am I Worth?

I hope all had a wonderful Christmas celebration yesterday (or for those who don't celebrate Christmas, a wonderful and relaxing day off)! We are entering the last week of 2011 and I wanted this post to reflect some of the struggles that I'm having with the big issues in health and wellness both personal and societal. One aspect of this crystallized yesterday as I was washing dishes and having a wonderful discussion about the cost of healthcare. The bottom line comes in when making payment decisions on a macro level, what is the life of a person worth? What am I worth in dollars and cents support from the government and other payors? I've done a lot of work over the last six months with investigational cancer drugs. Some of them are pretty far into the future and some are relatively close to market. All of the compounds show promise in controlled clinical trials, but we clinicians know that practice life is far from the controlled trial environment of drug development. This is one of the reasons why drugs perform less well in actual practice than they do in research trials. Once a compound is approved in the U.S. a prescriber can use it in any way they deem appropriate given their level of understanding of the compound (think Avastin or NovoSeven for example). The other problem is the euphemisms used as markers for success in cancer trials (e.g., disease free interval, progression-free survival, objective response rate, clinical benefit rate, time to treatment failure, invasive disease free survival, overall survival). Saddled by a lack of curative compounds, cancer drugs are evaluated on their ability to keep the disease below our crude level of detection. Many of the new compounds I've reviewed are not replacing anything, they are additive to what is already being used - so they are adding significant cost to the equation. The compounds in question cost many thousands of dollars each month (up to $10,000). If, as one compound I reviewed last week, an agent on average prolongs overall survival by 4 months - is that a "good" investment? It begs the question, what am I worth? Not just to my family and friends, but to society as a whole and to those who will share the burden of my treatment. Most drug manufacturers have patient assistance programs to offset some of the cost burdens of these therapies, but as a society we are coming up against a most difficult dilemma. No one wants to use the "r" word (rationing) but the reality of the cost burdens of these new targeted therapies is too big to ignore. The Center for Medicare and Medicaid Services (CMS) is already dealing with programs that are impossible to maintain financially (due to poor management over the last decades), but those costs to maintain are increasing at an unsustainable rate. John Q. Public is asked to fund these programs from payroll taxes, but no one ever envisioned a cost scenario like what we are currently living. What is my life worth? Huge societal dilemmas like this one can not be answered easily or gently or quickly. It takes great courage to open the debate and dialogue on how to even begin to approach somehting of this magnitude. One has to be able to suffer under the slings and arrows of rhetoric (think "death panels") and come out the other side with self intact. We need to be able to approach these large issues from a place of openess and honesty - love for each other. On one hand, each human life is precious beyond measure and should be nurtured in ways to help it meet its intended reason for being created. However, we can not afford to spend $10 million on 7 billion...there has to be some rationality and social justice. At the end of the year, I offer this musing to begin the dialogue with you on how we come to grips with huge truths. I don't have answers, and I struggle daily with these questions. Together, however, we can find a way to deal with that which confronts all of us. Peace for the journey, Dan

What Paradox Teaches

I've been reading more of Parker J. Palmer's "The Courage to Teach", and was moved by his thoughts on paradox and how it can help educate. Merriam-Webster's Online Dictionary has one definition of paradox as: "a statement that is seemingly contradictory or opposed to common sense and yet is perhaps true." There are many paradoxes in our everyday lives as well as oxymorons (Reality T.V. leaps to mind for the latter). To highlight the role of paradox in my life I offer the following examples: One of the things about being a trained scientist and a healthcare practitioner (and possibly soon an educator) is the need to read and evaluate new research. One of the aspects of this that has been a difficult truth is that there is much about the way that research is undertaken and reported that lead to falsehoods. One paradox in scientific research is that we study a small subset of the human population (800 to 1000 persons out of 300+ million in the U.S.) and extrapolate the findings to the rest. Another is that we scientifically examine complex human physiology and pathology using univariate (studying one aspect of something) modeling and then try to extrapolate the findings. It's not surprising therefore to see how we fail when drugs come into broader use (Xigris and Avastin only two more recent examples). Yet, once and awhile some truly remarkable discoveries are made that in the beginning seem incongruous - because they fly in the face of "what we know". The idea that the world is round, that the Earth revolves around the Sun, that the world is getting warmer, that a single child can and did change the world, that Christmas isn't our birthday. Religion is often seen as an inconvenient truth at best, and as a self-indulgent fantasy at worst. How can a G-d be everywhere and nowhere at the same time? How can G-d (in the Christian view) be three things in one? How can a good G-d allow evil to be in the world (theodicy); and the corollary, how can that same G-d give us free will - when G-d well knows we don't use it wisely? We can shrug these and other questions about faith off and ignore the questioner, but if we avoid these paradoxes then we miss the educational potential in each. In my own spiritual journey it has been uncomfortable to hold paradox lightly and to stay with it until it teaches me. Some of the "truths" I have discovered only after many years of discernment (use of koans and other spirital disciplines) others still evade me. Yet, the power of paradox to teach is that when one allows oneself to be in relationship with the tension of not knowing, then one finds an expansion of the mind and the soul. It becomes less important to find an answer than it is to live into the question. Certainly, my life as a healthcare practitioner demands that I come up with answers to health questions and to try to give the best and most evidence-based recommendations that I can. When I'm called to care for the spiritual aspects of the illness or dis-ease, however, I'm called to be in a place of paradox and to hold that up to the person who is searching. There are many paradoxes in this holiday season - the need/desire for Currier and Ives versus the reality of poor family systems, the brokenness of humanity versus the wholeness of spirituality, the need to become childlike to access heaven on Earth, loving neighbor as self. I ask you to hold your personal paradoxes lightly this season and spend time with them. They have much to teach you about you and the world in which you live. Peace for the journey, Dan

Asleep at the Wheel

I opened the news this morning on my computer to see the obituaries of two diametrically opposed men. On one hand there was the death of Kim Il Jung of North Korea, on the other, the death of Vaclav Havel of the Czech Republic. It is unfortunate that so much press will be given to the former versus the latter. The rhetoric of "ding-dong the witch is dead" over the North Korean leader and opinion pieces of how wonderful it will be for the world that he is gone will totally supplant the quiet news of the passing of a truly great man. Many of you might not recognize the name, Vaclav Havel. He was a poet and playright who came to fame as a dissident voice against Communism. In the "Velvet Revolution" he was a key player and served as first President of both Czeckoslovakia and the Czech Republic. Havel was insightful, humble, spiritual and morally sound. His ability to name the ills of his land in the post-Communistic rebuild were keys to how that nation built itself into a stable force in middle Europe. He wrote seemingly constantly, and there is a collection of his essays entitled, "Summer Meditations" from 1991 that are truly wonderful and spiritually meaningful. One quote struck me as I was musing over his life and his accomplishments. Here it is: "Time and time again I have been persuaded that a huge potential of goodwill is slumbering within our society. It’s just that it’s incoherent, suppressed, confused, crippled and perplexed — as though it does not know what to rely on, where to begin, where or how to find meaningful outlets. In such a state of affairs, politicians have a duty to awaken this slumbering potential, to offer it direction and ease its passage, to encourage it and give it room, or simply hope. They say a nation gets the politicians it deserves. [...] At the same time – paradoxically – the opposite is also true; society is a mirror of its politicians. It is largely up to the politicians which social forces they choose to liberate and which they choose to suppress, whether they rely on the good in each citizen or the bad." "Slumbering goodwill"...it echoes Martin Luther King Jr's. sadness at the reticence of good people to become engaged by the wrongs that they see. In this time, though these words are 20 years old (at least) don't they still ring true? Hasn't our goodwill become "incoherent, suppressed, confused, crippled and perplexed"? One just needs to look at the current debates on any political topic or social ill and see that there's no guidance, no compass, no cogent thought processes. In a democratic society, we get the leaders that we deserve and they are truly a reflection of who we are at the time. Can the current crop of politicians really "awaken this slumbering potential" or are we all just going to continue in our self-induced stupor towards ruin? The writings of Havel give us a view towards a revitalized and fully aroused state: "There is no simple set of instructions on how to proceed. A moral and intellectual state cannot be established through a constitution, or through law, or through directives, but only through complex, long-term, and never-ending work involving education and self-education. [...] It is not, in short, something we can simply declare or introduce. It is a way of going about things, and it demands the courage to breathe moral and spiritual motivation into everything, to seek the human dimension in all things. Science, technology, expertise, and so-called professionalism are not enough. Something more is necessary. For the sake of simplicity, it might be called spirit. Or feeling. Or conscience." Hmmmm, the "courage to breathe moral and spiritual motivation into everything". He suggests that secular education and re-educaiton are not enough, he suggests that we also need to engage equally in reconnecting our spiritual and moral selves so that we can make decisions based on graeter ideals than our own petty selves. Can a dedication to spiritual disciplines arouse our sleeping goodwill and set us on a better path? Well, I'm not sure, but it seems prudent to say that what we're currently doing is not working and look for another option. Spiritual disciplines such as prayer, fasting, journaling, spiritual direction, worship and spending time with sacred texts have opened the eyes and minds of countless people over the millenia, maybe it's not too late for us. Peace for the journey, Dan

Institutional Fear

I picked up a book that my wife had been given some years ago by Parker Palmer called, The Courage to Teach". In it he devotes a whole chapter to the fears that both teachers and students need to confront when they come together (A Culture of Fear). It got me thinking about fear within institutions, and then I continued along that path and thought about other human created institutions and idols and how fearsome they can be. Think for a minute about some that are at the forefront of the news right now...government, the economy, and health care. These are enormous institutions that are quite broken (at least in practice) and also quite fearsome. The fear comes because they have been made into idols that are worshipped instead of the broken human creations that they are. I've blogged before on the power of idol worship and the demonizing that happens when a good thing is elevated to an ultimate thing (i.e., becomes and idol). The creation of institutions which exist only to foster their own continuation, creates these idols that then become inviolate. Think about the vitriolic rhetoric that accompanies anyone who tries to say that there's something wrong with one of our idols...does the name Dr. Donald Berwick come to mind?! Here is a brilliant man who had the courage to stand up and say that CMS is terribly broken and needs to be radically altered to become something both functional and affordable (two things it currently is not by any stretch of the imagination). It cost him his job - though his reputation is still intact. Idols and institutions that become idols (and are thus seemingly above reproach) are fearsome. We choose not to challenge the status quo for fear of what will happen to us. We fear being sacrificed in public for our contention that something is wrong with 50 million people having inadequate health insurance, and 16% of the population being unemployed or underemployed. We fear the recriminations of being the ones who say that indeed the king is parading around buck naked. Our fear of things continuing in the same broken manner is balanced by the idol worshippers who fear the loss of their idol and wonder what will replace it. They continue their idolatry because their fear of change and the unknown paralyzes them. We have a way to overcome this paralyzing fear. It is called faith, and it is at its core the means and the grace that allows us all to move forward in the face of fear. It is a common quote that courage is not the absence of fear, rather it is the ability to do what needs to be done in spite of our fears. That kind of courage comes from a place outside of us. Our faith in a power that is greater than us, in a wisdom that dwarfs our own, in a way of living in right relationship with each other where all are of equal value, is what has toppled all the idols of history. During this holiday season then, where are you finding the faith to move forward to conquer your fear(s)? What institution(s) in your life have become idols that need to be named and changed? We at Possibilities Journey Inc (www.possjrny.org) believe that it is time for the idol of health care to meet the power of faith in order to be transformed into the life giving service that it was created to be. Thanks for being with us on this journey. If you are looking for end of the year donation opportunities, we would welcome your support. You can donate at our website and we thank you in advance. Peace for the journey, Dan

A House Divided

Interesting how ideas come for both sermons and for this blog. Inputs from disparate places such as e-mails from my mother, sermons from dear friends, readings and my own prayer life all come together (at least often enough) to give life to a concept. My spiritual journey (which greatly informs my worldy journey) is all about becoming unified in my beliefs, and allowing that unity to permeate my interactions with the world. This is more and more a unique way of being in the world. Our current world is very dissociated, individualized and polarized. Idols are created and they require blood sacrifice (e.g., working 80+ hour weeks and neglectiing the rest of our lives) and they are never satisfied. That's where we are in the world right now - serving self-created idols and never being satisfied. We live in houses that are divided - and as Abraham Lincoln noted, a house divided can not stand. How different it is when we view the world from a place of integrity. Integrity has synonyms of completeness, soundness and incorruptibility (Webster's on-line Dictionary). When we are complete or whole, then we are able to live into the chaos and vagaries of everyday life without being judgemental and reactionary. If I have integrity, then I am comfortable with who I am and how I see the world, and I am comfortable enough to meet others where they are. I may not agree with them, I may find them uninformed or misguided, but I can still love them enough to continue to be in relationship and community and try to help them find themselves. The integrity that comes from a right relationship with G-d allows me to be in right relationship with everyone else. That right relationship allows me to be less corruptible than I otherwise might be - the old saw is applicable, "If you don't stand for something, you'll fall for anything". Integrity allows us to discover how to have a unified life and house. When we are working towards completeness and wholeness, then we are first looking inward to see how an interaction is making us feel. We respond to an interaction inwardly before we react outwordly. We ask ourselves, "what teaching does this interaction offer me?" If it is unfounded and judgemental, then it offers us very little and we can shrug it off and go on. However, if it is offered in truth and in love as a constructive teaching, then we can take it on and learn from it. The learning becomes transformational and enhances our ability to be relational. This week, explore your own integrity. Where are the holes, the incompleteness, the judgemental areas in your life? How is it that you can get in touch with those areas and find ways to make them more integral? One way is with a spiritual director. There is a wonderful website listing spiritual directors across the world (www.sdiworld.org) and I encourage you to engage one as a gift to yourself and the world this holiday season. Peace for the journey, Dan

The Missing Link...

A new physician survey has just been completed that shows quite starkly the missing link in our current healthcare system. (see: http://www.rwjf.org/vulnerablepopulations/product.jsp?id=73646&cid=XEM_2809280). It seems that 80% of physicians surveyed understand that the social needs of patients is just as important as any medical therapy. After all, if the patient can't afford the medicine, has no place to store it (because they're homeless), does not have a stable life, then it will be next to impossible to be compliant and adherent with any prescribed therapy. This is the missing link in healthcare. It's one of the glaring holes in the ACA legislation. That is, it's one thing to cover everyone with health insurance, but if many of those 50 million are homeless or semi-homeless then they can not eat properly, get sufficient rest, etc. There will be no overall improvement in health, or if there is, it will be incremental not transformational. A long time ago, a researcher named Maslow developed a heirarchy for human behavior that noted unless foundational needs are addressed and taken care of, no development happens. Analogously, if basic needs for health (good quality food in sufficient quantity, adequate rest, safe place to live) are not addressed, then people will not be optimally healthy. The really good news is that the Robert Wood Johnson Foundation (RWJF) has invested money into a program called Health Leads that trains colege students to work in physician offices to provide basic social service needs. In this model, a physician can write a "prescription" for any social service that a patient needs, and the Health Leads person in the office will help to "fill" it. It works really well and has grown over the last few years from its humble beginnings in Boston to now up and down the East Coast. What a fabulous leveraging of a renewable resource (college students) to meet a real need in the system. More of this transformational thinking is necessary if we are to overcome a healthcare system that is often not about health, and more often doesn't seem to care. This week, look for those things that could be changed in your life. What change, large or small could you develop that would transform what happens in your world? Really beneficial to spend some time discerning about things like this. I'd love to know what you find. Peace for the journey, Dan

Heat vs. Light

You all know the saying "more heat than light" when referring to a debate that allows anger and venom to win out over informed dialogue. I find myself musing today (not for the first time) about the prevalence of angry diatribe versus informed and socially appropriate debate. At one point in the not too distant past, Debate Teams were seen as an important part of High School education. Nowadays, if a High School even has a Debate Team, it is relegated to the deepest, darkest part of the High School experience and there it languishes. The learning that comes from building and debating a topic is lost to the whims of personal opinion and technological savvy. If I can get my viewpoint out faster and broader than my "opponent" then I will win in the court of public opinion. Case-in-point, the current news "reporting" about child abuse in Penn State and Syracuse atheletic programs. Child abuse and pornography are hot button issues to be sure, and are serious issues that we as humns need to deal with appropriately to ensure healthy and safe enviroments for our children to grow. However, when we allow our "need for news and gossip" to outweigh our need to know facts, then we run the real danger (and current reality) of trying people before they've ever had their right to a trial of their peers. I don't know what has happened in either of the situations mentioned, even though there's been an outrageous (IMHO) amount of news coverage devoted to these issues. When news becomes focused on headline making rather than balanced investigative reporting (lots of work and longer time frame results) we all become victims of abuse - abuse of our intellect and humanity. Time and again in scripture we are cautioned against judgments. We are encouraged to forgive - not to forget nor to act like hurtful things never happened, but to forgive and to release the power that the perpetrator has over our view of the world and our ability to live our lives freely and fully. Forgiveness is an individual act that requires nothing of the other party. This is why forgiveness is so challenging...we want the perpetrator to be "brought to justice" and to "suffer as we have". Vengence appears to be sweet and healing on the surface, but the reality is something altogether different. Justice never takes away waht happened, nor does it allow for the transformative love of God to intervene and heal the situation. Certainly, people who hurt other people must be stopped, and that often requires judicial intervention, but healing is not part of our criminal justice system. News people and editors have forgotten that everyone deserves a fair shake - and our current delivery system for news is not focused on balance and fairness. Life is not like CSI nor NCIS, issues do not resolve themselves in 60 minutes into nice tidy packages of right overcoming wrong. We need to remember that life is messy and difficult and requires a lot of work to relate to each other in healthy and wholesome ways. The internet is not helping that process. Do yourself a favor and find your way to decent reporting that doesn't seek to vilify or promote guilty until proven innocent. The longer I live, the less judgemental I become, the more latitude I allow for the fact that I don't know everything - and I never will. I do know, however, that God is God and I am not - and I find myself thankful for that reality as it provides much light for my path. Peace for the journey, Dan

Surrendering Ourselves

Today we complete the muses on Mahatma Gandhi's Seven Deadly Social Sins with thoughts on "Worship Without Sacrifice". The Mahatma was not referring to ancient forms of animal or human sacrificial killing as a form of worship - rather he was suggesting that if we're just going through the motions, then we're not truly worshipping. I'm a leader within my United Methodist congregation and time and again am confronted with the 20-80 rule (20 percent of the people doing 80 percent of the work). The rest either show up or not, and the average pledge to keep the church open is less than $500/year (in a town where the average income tops $80K)! People do not come to church regularly either, in fact, the largest church in the Methodist denomination sees congregants attending worship an average of 1.7 times each month. Hmmm, do we have a problem with comittment?! Why is worship without sacrifice a deadly social sin? How does our lack of sacrifical worship lead us to sin in a social context against each other? Now remember, I'm defining sin in a broad theological sense as any action which disrupts our connection to God. Sin is not one of the 7 deadly (not contained anywhere in the Christian Bible by the way), it is that action or set of free will decisions that keep us from loving God above all else and neighbor as self. Sacrifice is defined in many ways, but the one that I think is closest to where we want to go is "destruction or surrender of something for the sake of something else". So if we are attending a faith community and/or worship service and not surrendering ourselves (our worldviews, our judgemental natures, our need to control, our brokenness, etc) for something else (i.e., God) then we can not be transformed. If we are not transformed, then we can not see the needs of the "other" and feel a call to do something about it. If we can not see the needs of others then we allow the world to perpetuate the social injustices (yes, Glenn Beck they exist) and status quo that leads to upwards of 50 million people living at or below the poverty line in the U.S. I have found that the more I commit myself to the exploration of my spirituality, the less judgemental I become - the more tolerant I am of difference, the kinder I am. This is true no matter what doctrine you practice. Immersing yourself in a spiritual discipline and practicing the same diligently and intentionally, will lead to a new vision and a new way of being. In the Christian tradition God says, "see I am making all things new." This new vision is what lead me to create Possibilities Journey, Inc (www.possjrny.org) which seeks to re-integrate all faith communities into the healthcare system. The reason we are convinced that we need to do this is because of the lack of attention to spiritual aspects of illness and recovery. Also to the lack of meaningful after-care and elder care in our current system. Surrendering my worldview has allowed me to see something much greater to work for than a paycheck. What is it that you need to surrender to combat some of the myriad social sins of our world? Peace for the journey, Dan

Scientific Idol Worship

I hope that everyone had a wonderful Thanksgiving holiday break - I know that I did! I was blessed by a friend who reminded me that we are called to give thanks in all things (not for all things). That means that no matter how "good" or "bad" things are at the moment, giving thanks during the journey is critically important to how we move our way through the situations we face. Really good reminder and an interesting seque into our topic for today. Mahatma Gandhi came up with Seven Deadly Social Sins - we are on the sixth "Science Without Humanity". What does it mean to have, or to practice, science without humanity? Isn't scientific exploration all about bettering the human condition and solving the insolvable problems that confront us? Look at the tremendous beenfit that Science has brought to this planet. Human lives are saved everyday through the result of scientific experiments and discoveries. Humans are living longer and better, crops grow better and are more fruitful, buildings are safer, water is cleaner, new labor saving devices are continually developed and brought to market, diseases common just a few generations ago are all but eliminated from the Earth. It's hard to argue that the contribution of Science to the world has been anything but transformational. Gandhi died before most of the scientific discoveries of the last 60 years. He did live to see the horror of atomic weapons realized and utilized. He knew of poison gas and other human atrocities - of concentration camps and genocide. He witnessed two world wars and the associated growth to dominance of the military-industrial complex. I think that this is what he meant when he saw science without humanity - the exploration of science that lead to discoveries which were then used against other humans for political gain. I wonder how he would view the discovery of DNA, the human genome project, test tube babies, cloned sheep, artificial intelligence, designer crops....? We set ourselves up for idol worship when we take a good thing (e.g., earning money) and make it an ultimate thing (making earning money the only thing we work for). I am a highly trained scientist who worshipped at the idol of the scientific method for many years. I was convinced that science could and would answer all the unanswered questions - it was just a matter of time. Then I began to work in intesive care units where technology and "life saving" devices were employed and deployed to "save" people who were critically ill and/or injured. I saw and participated in the application of science, often without regard to the humanity of the situation. I now realize that it is inhuman (or inhumane) to apply technology where there is no reasonable hope for a return to functioning humanity. I have helped to create hundreds if not thousands of "living dead", those who are fed and watered artificially and require turning every 2 hours to prevent the development of bed sores. One man's journey through the application of science without humanity - science without dignity for human life and the reality of human death. It is a burden that I struggle to balance and to justify. Pursuing scientific answers to human questions is still a large part of my life. However, I inform my science with a broader view of how I'm called to love my neighbor as myself. In this way, I'm continually in dialogue with myself and others regarding how new chemicals and technologies will actually benefit people. The mantra in Medicine of "first do no harm" is one we would do well to apply across the spectrum of Science - "designer" tomatoes may not seem a bad idea on the surface, but when viewed with a more loving eye, the risks come further into view. This is what drove me to create "Possibilities Journey, Inc", a 501c3 public charity dedicated to re-engaging faith communities in health care and public health. Without the doctrine of selfless love and the development of healthy communities, we are quite possibly doomed to live with science without humanity. Something to consider as we come to another Holiday season. Peace for the journey, Dan

Just the Facts, Please

Today I'm continuing my muse on the Seven Deadly Social Sins of Mahatma Gandhi. We find ourselves confronted with "Education Without Character" - hmmm, I wonder what the Mahatma was going on about?! Certainly in the U.S. we have a very good educational system overall (with well known issues of lack of pay for teachers, poor quality schools and inequality in education) but not a perfect system. Children today receive their mandatory education and make their way into the world. By standard test scores (SAT, ACT, SOL's, etc) they are well prepared to go out into the world and continue to pursue their roles as adults. However, standardized tests do not measure character. I wonder...are we educating people without attending to character development? In this connected world, there is never an unanswered question. Someone wonders about an issue, and smart phones launch browsers to find the answer. The only question is who has the fastest internet service on their phone/I-Pad. Answer(s) are found and the issue is laid to rest. What I find, however, is that seldom is there a critique of the quality of the answer(s). As is true of so much of the information out there on the internet, some of it is incorrect or misleading - answers without any depth of knowledge. There is a difference between information and knowledge (and certainly wisdom) that seems to escape people nowadays. So we can easily find facts, but can we find out about our character both individually and communally? Take a look at an on-line Dictionary and see what it says about the definition of character - it might surprise you. Dr. Martin Luther King, Jr, in his "I Have a Dream" speech noted that part of his vision was: "...I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin, but by the content of their character...." Are we educating our children in a way to accomplish this dream? Beyond not bullying and teaching children to not be rude or malicious either in person, or more frequently through technology, are we educating our populace about character development? With talk show personalities and T.V. violence, "real world" looks at people behaving badly and without regard to others, can we really say honestly that we are educating anyone how to build character? What is the content of your character? Educating for character is not something that belongs soley in the purview of the school system. It lies with the families and the faith communities and the larger community as a whole. When we all sit by and allow our children to watch shows that denegrate others, shows that promote worldly vices, violence, rudeness and disrespect, should we be surprised that we are living in a world where these behaviors are rampant? Educating with character is a responsibility of all of us. Building healthier communities begins with holding each other in higher regard - by loving another more than we love ourselves. Healthier communities are built when we hold each other accountable to a higher standard of behavior. Wholeness comes when we conduct ourselves morally and ethically in a manner that is beyond reproach - when we judge each other on the content of our character. Peace for the journey, Dan

Self Satisfied

In the continuing saga of exploring Gandhi's Seven Deadly Social Sins, we find ourselves confronted with "Pleasure Without Conscience". Staggering to me that Gandhi saw the world around him in the 1930's and 40's and saw quite clearly that the world was headed towards a time where it lost its conscience. That's the world we live in right now, isn't it?! Corporate executives rape the businesses they run and then get multi-million dollar buy-outs. Global enterprises find the cheapest labor to produce the worst quality products that they can sell, and they don't care if it means tearing the top off of a mountain to get the raw materials. Humans in the U.S. are pursuing their own interests and satisfactions without regard to the impact of their decisions on others. It's all about the libido, all about pleasure, all about the self. It's a well known psychological fact that if we feed the Ego long enough without balancing it with empathy (i.e., narcissism), the Ego takes control and becomes a wicked task master - demanding ever larger sacrifices of time, money and self-worth. The world is constantly telling us to "just do it", to get all that we can because we only go around once, that there's no reason to deny ourselves anything - whether we can afford it or not. Movies and television reinforce this creedo showing us celebrities behaving badly and "Friends With Benefits" (a recent movie where two friends use each other for sex). "Hooking up" or "booty calls" are common, and not just among the young. I'm finding that recently divorced persons are also engaging in this kind of behavior - rather than opting for the effort it takes to form lasting relationships. People exist as objects for another to use up and throw away - we've become disposable! Relationships, especially healthy ones, require a great deal of effort and commitment, and the world tells us that we'll only get hurt again if we do that. What the world doesn't say is that if we really pursue pleasure without conscience, we will never, ever be satisfied - there's never an end to the uninhibited desire. Self satisfied...that's really the goal that we should be pursuing? All of the spiritual teachers over the course of millenia have warned against this self indulgence. They saw the decay of Rome and so many other "powers and principalities". They saw the ruin of uninhibited actions - actions that had no thought for the worth of others. They tell us of a differnet way, one that is disciplined and empathic. One that humbles the needs of the self for the good of the other. One that loves others more than it loves itself. One that searches for a message that brings peace and grace and wholeness. This week, examine what is driving your decision making. What are you spending your time, energy and money on? Are you finding yourself seeking ever bigger pleasures that bring you an ever smaller level of satisfaction? If you are, then you have become addicted to the thrill and have lost the ability to be satisfied. There is a different path and a different world view. You can find it if you try - it's as close as your nearest faith community. Peace for the journey, Dan

There's a Sucker Born Every Minute

The third in my series on the Seven Deadly Social Sins of Mahatma Gandhi is "Commerce Without Morality". It is alleged that the great showman, P.T. Barnum, uttered the words in this post - and given his history, it's quite possible. He was always trying to push the envelope and bring in more money. Treatment of the people and animals in his circus was secondary to their ability to fill the tent (so to speak). With all the recent goings on in the world of business and finance, one has to wonder if we've really learned anything at all from our past. Wendell Berry has a lot to say on the issue of the growth of enterprise and the loss of a moral compass. Whether in his books or poems, he skewers the large conglomerate that is the agricultural industry; the govenrmental subsidies that promote the improper growing of crops; and the effect on the global economy and on small farmers worldwide who can't compete with unfairly priced commodities. In fact, when crops became commodities and began to be future traded, we started on a long road to social injustice and immorality. Business without a sense of right vs. wrong will always lead to injustice. When a business becomes so large that it loses its place in the fabric of the locale in which it's located (and the concomitant accountability) then it becomes all about profit margin and share holder return-on-investment. One just needs to review the policies of many large employers nowadays that do not provide benefits (health, retirement) to part-time workers. The greater Memphis metropolitan area has 50,000 people who are working but do not have adequate (or any) health insurance due to this policy. Right or wrong - where's the moral compass? The lack of morality in our current world view has been written about a lot. A study of 18 to 23 year olds in the U.S. showed that most felt that anything was right as long as an individual thought it was right. Thus, individual views trump societal values and morals. The idolization of the self leads to the demonization of everything else. For when I take a good thing, like business, and make it the ultimate thing (make it an idol that I worship), then everything that does not help my idol become mroe powerful is demonic. This happens all the time in our world - just listen to the political rhetoric in this country right now. When we lost the absolute truth that all people are created in the image of a loving G-d, then the resulting world can be nothing but satanic. The views of right and wrong from a spiritual sense are absolute. In order to recover our sense of morality in business, we first have to recover it in every other part of our world. Businesses that operate without morals are not demonic as much as they are lost. It is our duty as shepherds to go and find these lost sheep and return them to the flock. This week, take a hard look at the places you do business and evaluate their moral compass. Engage with your own compass to make sure that it is functioning well, and then take action on what you find. Whether it's Quran, Torah, Bible or other sacred teaching, recommit to it today so that we can repair the damage to our world tomorrow. Peace for the journey, Dan

Money for Nothing

The second deadly social sin according to Mahatma Gandhi was "wealth without work". This was highlighted in an old song by Dire Straits "Money for Nothin'" where the idea was that guitar heroes "get their money for nuthin' and their chicks for free". The concept of wealth without work is a common theme in our day and age. Think about the ageless "Publisher's Clearinghouse Giveaway" or any of the myriad lottery offers. If you just spend a dollar, you could win millions. The studies of the winners however, yields a portrait of despair and destruction, instead of the beautiful and carefree life that ticket buyers envision. Funny how money doesn't change the person that you are and the decisions that you make. Money for nothing shows again the truth in the adage "there is no free lunch"; or as Christian scripture says, "where your treasure lies, there your heart will be also". Wealth without work - it really is a problem, isn't it?! When one doesn't earn a living, doesn't have "sweat equity" or is truly invested in the job, then there is often a lack of committment. It is a common finding among Habitat for Humanity home owners. They are given a house that they often have spent only a modest amount of time building, and they go about treating it poorly afterwards. Their newfound "wealth" is meaningless and hasn't changed their life or their lack of training on how to keep a house - many often have had little or nothing of their own for their whole lives. Handouts often keep people down rather than raising them up. There is a mantra in social services agencies that says "never do anything for someone that they can and should do for themselves". In other words, teach them to fish rather than just giving them fish. This philosophy is why microcredit organizations like Oikocredit are so popular and so effective. They give micro-loans to persons across the globe (mostly women) to spur businesses that otherwise wouldn't be albe to get off the ground. The Heifer Project is another initiative that comes to mind that gives wealth in the form of livestock - but then teaches the receipients how to care for and make profitable the raising of animals. This week I'd like you to take a good long look at the charity(ies) that you support. Which one or ones are lifting people up - helping them find wealth through work? Many of us look at year's end to give some of our money away. This philanthropy is the life blood for so many non-profits. However, make sure that your largess is not creating more problems than it is solving. Support programs and groups that seek to lift people up and improve the lives for all. Peace for the journey, Dan

Deadly Social Sins

I received a mailing last week that highlighted Mahatma Gandhi's "Seven Deadly Social Sins". I was fascinated to look at the list and note again that "the more things change, the more they stay the same." I think you might agree - here's the list: "Politics without principle; Wealth without work; Commerce without morality; Pleasure without conscience; education wihtout character; Science without humanity; Worship without sacrifice." How many of those resonate with you? I've struggled with all of them over the last bit of my life, and some of the social action we are seeing both here and around the world are dedicated to addressing these truths that Gandhi noted more than 60 years ago. It is striking that the concept of politics without principle is topmost on his list - and on my mind on the eve of an election day here in Virginia. More broadly, we are just one year before the next Presidential election, and the rhetoric and propaganda machines are already kicking into high gear. There does appear to be an acute lack of principled people who are elected to lead us. The operating philosophy appears to be "what's in it for me?". That's certainly an understandable worldview, but it is not a principle that leads. That worldview results in 50 million persons without adequate health insurance, a 27.4% reduction in Medicare payments to physicians (of note, Virginia is currently ranked 49th in Medicare payments to doctors) - patients are being let go from physicians who can no longer afford to treat them, increased spending without increased revenue, lack of a socially responsible vision. Lack of a set of guiding principles that are focused on socially acceptable outcomes is providing us leadership without vision. What are we to do about this lack of principle? There certainly is no quick fix to the problem - we're not suddenly going to see a slate of politicians (especially at the national level) who are focused on principle over self. The change has to come from the electorate. We have to change our worldviews into a more principled demeanor and approach. For we just elect those who reflect what it is that the majority believe (at least the majority [of the minority] that decide to vote). We need to re-discover the priniciples that have lead to healthier and more socially conscious communities. We don't have to look very far - the principles that work are contained in the Bible, Quran and Torah (to only name the three major tomes). I'm not beating a conservative and literal translation of the texts, rather, I'm advocating for a return to loving something more than we love ourselves. Reaching out to the least and the lost - the widows and orphans, and doing something meaningful to make their lot in life better. Providing healthy and wholesome communities for all people, not just the one's who resemble us and our views. This week, as you go to the polls (which I hope you do), look for opportunities to support candidates who act out of principles instead of out of self-interest. Break out of the habit of voting for a Party and research the person. Vote for principles and we will all be better off. By-the-way, take a good long look at your own guiding principles and see where they might need some improvement. Peace for the journey, Dan

Lies, Damn Lies and Statistics...

Familiar piece of a Mark Twain quote - but oh so true! I doubt that there's any need to say much more about this to anyone who's ever looked at a published research trial or tried to make sense of budgetary numbers or political propaganda. There's basically nothing that one can't do with numbers to prove that the sky is really purple, or that geese really fly north for the winter. Same is true with health information and research reports. It's not enough that alcohol use is hard to control, but now there's two new studies that look at the effect of ethanol on our bodies (http://www.washingtonpost.com/national/health-science/good-news-and-bad-news-on-alcohol/2011/11/01/gIQAaz6odM_story.html). How do we make sense of conflicting issues when it comes to our health choices? Clearly, too much ethyl alcohol is a poison that kills heart cells, liver cells, brain cells; causes changes to most organs in the body; makes us do stupid things; causes death and destruction of families, homes, cars and lives. No one is quite sure, however, how much is too much. I was appalled by the "science" that showed a "moderate" amount of ethanol can actually be beneficial for one's heart. A glass of wine (or maybe two if you're male) each day seems to be cardioprotective. The problem is that daily alcohol use tends to start with one and continue to grow until it's out of control. Binge drinking is rampant, and not just among the younger crowd. How many people do you know who routinely drink 3 or more alcohol containing drinks at one occasion? It's such an issue in the Washington, DC, area that we stopped asking people if they drink alcohol, and how much. I've watched countless people in the ICU have withdrawal reactions even though the family swears that they don't drink. ("It's only one glass a night - but it never gets empty!") The acoholic beverage industry is a powerful lobby. The promotion of the health benefits receives a lot of T.V. time, while the damage done by alcohol (and the exorbitant costs generated) receive little or no play time. It is quite likely that you know someone right now who struggles with appropriate alcohol use. I encourage you to click on the CDC Widget to the right of this column to get more information so that you can begin to address the place that alcohol has assumed in that person's life. This week, take a measured approach to statistics and medical research reports. Make sure that your looking at both sides of the issue - not just the one that is receiving all the press. The truth is often sandwiched somewhere in between the "good" and the "bad". The old adage, "if it sounds to good to be true - it is!" rings true again. Peace for the journey, Dan

Facing Our Fears

Not surprising that my post today (on All Hallows Eve-day) would have something to do with fear. While I'm not going to write about zombies (huge right now) or other terrifying figments of our individual and collective imaginations, I do want to write about two fears that get in the way of our health, wellness and wholeness (HW2). The fears that I want to bring to light today are the fear of the unknown and the fear of things we can't control. Now, it doesn't take a huge intellect to see that the fears I've named are two sides of the same coin. Obviously, we can't control things that are unknown (and maybe unknowable). The unknown fears are things like, "how long will I live?", "what will my legacy be?", "what am I going to be when I grow up?", "will I make enough money to retire and not run out beofre I die?", etc. Uncontrollable things include items like "will my children grow up to be decent citizens of the global society?", "will my wife leave me for someone else?", "what's going to happen to me today?", etc. While we all have these fears, they become problematic when they start to interfere with how we approach living our lives. Fears can make us ill - both mentally and physically. Fears increase both our individual and communal dis-ease. Humans have always feared the unknown, especially the big one - "how long will I live?". We have created theologies to help us explain the "slings and arrows of outrageous fortune" that beset us. We have come to the conclusion that all we have is us and we should grab as much as we can get while we're here. Nothing that we have created has done a lot to calm the fears of what lies ahead for each of us, and for all of us. We live in an enlightened time with many resources. We live in a frightening time with many challenges to our continued existence. How can we come to grips with the fact that much (if not all) of our public and private policy and discourse has its root in fear? Fear continues to be an issue in our unhealthy choices because we will not confront it. We will not name that which causes us to be afraid - partially because we believe that if we admit to fear then we are weak. This only serves to foster fear and to create an ever smaller and more dysfunctional world. If I fear the outside world, then I will fortify myself behind every gadget and lock there is. I will surround myself with bodyguards and weaponry to "protect what is mine". I will attack those who seek to get "my treasure" and in fact, I will invent a reason to first-strike to eliminate any perceived threat. Is it any wonder that we in the U.S. spend so much on the DoD, personal security devices, safety deposit boxes, safes, etc.? We are a fearful people who have barricaded ourselves behind our security devices so that we can die with all of our things around us. Hmmm, fear is a potent force limiting our HW2. So, this week in the midst of ghouls and goblins of all types (yes, zombies too), I'd like you to list your top 5 fears. Once you list them, I'd like you to do some work on where they come from and what you can do to illuminate and discard them. I've found that an intentional prayer and spiritual life really help to alleviate my need to fear and to control. This freedom has allowed my world to expand. I wish the same for all of you! Peace for the journey, Dan

It's All About Choices...

True words, right?! Isn't life really all about the choices we make? Those of us that have lived a few years realize that the weight of the choices we make really does help to determine what happens to us - both good and bad. Spiritually speaking, those who believe in God realize that we were created with free will and that ability to decide right from wrong, etc, helps determine how spiritually healthy and whole we are. Same is true for our physical (and to an extent mental) health - choices we make work with our basic genetic make-up to help determine the amount of dis-ease we suffer. Yet we find ourselves in a time where people seem to expect that they can make whatever choices they want (whatever seems "right" for them) and that they will have a "get out of jail free" card in the form of medical technology or medication(s) that will allow them to go on their merry way without a heavy consequence. In many ways, that perception is truth. We have a great deal of wonderful technology that's been created to help us live longer and better - same is true (if not more true) with medications. Being a pharmacist, I know that the discovery of new chemicals over the last 25 years has been nothing less than amazing in many ways. There are very few major disorders that have not had at least one breakthrough drug over that time period, and for the main diseases of humanity, there have been numerous revolutionary compounds developed. However, these breakthroughs seem to have fostered a belief model that there is a "pill for every ill" and that science will triumph over poor decision making. Not true! A simple check of the facts show obesity at unsustainable levels, asthma and other respiratory diseases on the rise, diabetes at unprecedented levels, and on, and on, and on. Science seems to have given us a new crutch that allows us to not take the correct amount of responsibility for our choices. Because people with health insurance only pay a fraction of the cost of medications and physician/hospital care, some feel empowered to engage in risky behaviors "knowing" that they can be rescued by the healthcare system. Many have begun to realize (finally) that this type of behavior feedback loop is too expensive to maintain. They've also realized that they don't want to do the really painful work of changing the system to allow for good behaviors to be rewarded and bad behaviors to have natural consequences. Same is true spiritually as well...we can't simply ignore our spiritual lives and expect that all will work out well. Choices we make determine how much "hell on earth" we suffer - and might possibly determine heaven or hell beyond this life. I suspect that a God that gives us free will while we're living allows us the final choice of what we choose for the hereafter - it simply makes sense to me. So this week, what choices are you going to make for your physical and spiritual health, wellness and wholeness? Are you going to choose a faith community to attend - or are you going to become active in the one you're already attending? Are you going to start that walking program, weight loss, giving up of drugs or alcohol (or at least cutting down), go see your physician (or choose one to go see), etc? The choice is yours, but it really does affect all of the rest of us - so choose wisely. If you don't know how to choose, we're here to help at Possibilities Journey, Inc (www.possjrny.org). Peace for the journey, Dan

Silo Mentality

Today's post is a reflection on the pervasive approach to finances that most organizations fall into as they grow. They adopt an institutional process of "silo-ing" money. The money goes into line items or into departmental accounts and then is carefully guarded against all comers. It doesn't matter that all are working for the same organization or the same basic purpose, everybody needs their own piece of the pie - and God forbid that one is asked to share any of it! I've seen the same mentality in faith communities - especially larger ones with more resources. If the faith community develops a habit of "ear marking" funds for special projects or is not transparent in its handling of the money given to God, then the silo mentality can develop. A lack of relationship and trust is at the crux of the problem. When the people in charge of the funds forget who their working for (i.e., God) and for what purpose the money is given (to further the works of God here on Earth), then the human tendancy toward pettiness and fear sets in. Fear of the future, especially in troubling financial times, can derail the best intents of well meaning people. Did you ever wonder why the men who created the United States Treasury decided to inscribe each coin with the statement "In God We Trust"? Certainly, they heeded the scripture which told them that placing their trust in humans was apt to be problematic. They certainly had no idea what the future held, and therefore had to rely on their faith to give them the vision to move such a monumental task (creating a new country) forward. Was the moniker placed on every coin a subtle reminder to them (and to us) that we are operating for something larger than ourselves? For a God that wants our love, but also wants us to love each other more than we love ourselves. There is so little that we can actually control in our lives that at some point we must come to the conclusion that working only for our interest doesn't ever work. The only way to break out of the silo mentality both in budgets and in practice is to get to know one another to the point that we can build a level of trust. Trust build slowly and can be destroyed in an instant - but without it, nothing happens. You only need to look at the behaviors in the House and Senate (and other governmental leadership) to see a case study of this. Without right relationship and trust, we all suffer needlessly, and seemingly endlessly. Who do you trust in your life? So this week, get to know someone better. Seek to develop a right relatinoship that will foster trust and the ability to see the world through each other's eyes. Remove the silo mentality and replace it with a mentality of love and mutual respect. Peace for the journey, Dan

Occupation

Reflecting today on the "Occupy" movement that has caught fire over recent weeks. One month ago today, a protest began with 2,000 people that has now become the "Occupy Wall Street" movement. I encourage you all to go to both (www.occupywallst.org and www.occupytogether.org) to stay on top of the "progress" that is being made. Whether it's Wall Stree or Atlanta or St. Louis or any of the other venues where Places have been "occupied", I find myself wondering at this moment in time about the concept and its potential to empower and enable change. Movements have a life of their own. Some become so popular and do so much good that they become institutionalized (thinking here of the Methodist movement). Is the "Occupy" movement truly the reawakening that we've been hoping for in a culture that has been narcotized into adolescent and ego-centric thought and action for so many decades, or is it just another anomaly of the information age that springs to life via Twitter, etc., and has no infrastructure to carry forward (also no meaningful leadership). Forty years ago (or a little more) there were protests and sit-ins declaring the Vietnam War to be wrong. At the same time the Civil Rights movement was occurring and there was a wave of civil disobedience that spread across the country. The pressure exerted by these movements brought about social change. Most of the actions were non-violent in nature, and most "leaders" were focused on change not on their own needs. I'm musing to myself how the "Occupy" movement might be able to truly catch fire and to bring into the public discourse some of the social injustice that is so rampant in our world today. They have a tag line "We are the 99%" in reference to the wealthiest 1% who "control" the country and its policies. While the banking industry certainly has its share of greed issues; and the governmental policies regulating them have been poorly thought out, should they be the only groups occupied? What about a healthcare industry that is beholden to the insurance corporations? What about a subsidized food industry that doesn't grow the things we need to be healthy and to promote better nutrition? What about a new industry that "dummies down" news and has lost its mandate to really investigate and report news instead of gossip and entertainment? What about the oil and gas industry in cahoots with the automobile manufacturers to hold back innovation and to continue to rape the Earth of natural and irreplaceable resources? And on, and on, and on... What's my point? My point is that as long as we point the finger at someone else (even if they deserve it) we are practicing dualistic thinking (I vs. It, We vs. They, Us vs. Them). Dualism leads to judgement and that leads to demonization (you're opinion is not just wrong, it is evil). Richard Rohr in his book "Falling Upward" puts it this way, "Sualistic thinking is the well-practiced pattern of knowing most things by comparison. And for some reason, once you compare or label things (that is, judge), you almost always conclude that one is good and the other is less good or even bad." He goes on to talk about the "normal sequencing of the dualistic mind: it compares, it competes, it conspires, it condemns, it cancels out any contrary evidence, and then it crucifies with impunity." We can not move forward to real societal change until we also point the finger at ourselves and our overindulgent lifestyles and begin to change our views as well. Can spirituality once again play an important role in this change - because as Father Rohr points out, the unified vision of G-d is the only vision that can heal division. Food for thought - may it occupy your mind and your discernment this week. Peace for the journey, Dan

Extravagant Generosity

Life is busy as evidenced by the lack of blog posts over the last two weeks. I'm currently in a three week cycle of preaching every Sunday. It's good for me to see what real "pulpit preachers" do every week - and the pressure that comes with the fact that Sunday is looming. I wanted to take time out, however, from this week's sermon prep to comment on generosity (or lack thereof) and its effect on our health, wellness and wholeness (HW2). Extravagant generosity is lacking in our current "me centered" world. Charity, philanthropy, giving with no strings attached, is rare nowadays (says the guy who's trying to run a small 501c3). ;-) In the Christian tradition, the parable is told of the "Good Samaritan" (Luke 10: 30-37). A man travels a road from Jericho to Jerusalem and is robbed, beaten and left for dead. Two notables from the temple heirarchy pass by and do not stop to help (a Priest and a Levite). The man who stops and helps is an outcast in Jewish society - a Samaritan. The Samaritan not only stops, but tends the man's wounds and takes him to an inn where he can continue to heal. The Samaritan pays for his "hospital" stay and tells the innkeeper that he'll cover any extra expenses on his way back through. Look at the current healthcare debate through the lens of this parable. We have more than 46 million persons in the U.S. without access to health care (many of them children). We have many more "working poor" who have inadequate insurance coverage. Preventative medicine is not a standard, but rather it is an after thought in many situations. Free clinics are seeing budget cuts and restrictions on the care they can provide. My local free clinic uses a lottery system to provide care as they do not have the resources to tend to all the people who need their services. Our current system is not extravagantly generous. It is extravagant and way too costly in the way it provides the care for those with insurance, but it is not generous - even considering the non-reimbursed care given by many institutions. Extravagant generosity...is it possible to be like the "Good Samaritan" especially when we so bound up in insurance regulations and capitated payment systems? I think that it is, but it is going to take a drastic and courageous series of changes in order to get there. The carnage in the current system would be extreme, and it would be very painful in the short term (5 or so years). The long term benefits of such a change are what is envisioned (in some ways) by the "Obama Care" legislation. The mindset change would be from our current "priestly" view of "what happens to me if I help the beaten man" to "what happens to the man if I don't help him". Our current system is predicated on the continuation of the institution, not on the caring for all people. It is focused on using the newest technology and creating a market share for my institution/group practice/health system rather than on looking into the needs of the community I/we serve and doing the hard work of societal change - becoming change agents. So this week, think about extravagant generosity. How can you in your life do one thing each day (or week) that is extravagantly generous and truly helps another person with their life? How can you change your midset to the Samaritan viewpoint? I'd love to hear your stories. Peace for the journey, Dan

What's Love Got To Do With It?

Some of you are of an age that you recognize the title of a Tina Turner song in my title for today's post. You might be wondering what love has to do with improving our health, wellness and wholeness (HW2) - or to improve the possibility that our HW2 can get better? Interestingly, love (or lack thereof) has never once entered into the discussion of what is wrong with our current system of healthcare. Information abounds on the various discrepancies, injustices, deficiencies, poor coordination, lack of services, lack of caring, isolation, etc., in our current delivery system. Yet, no one seems to want to confront a basic truth in much of our public discourse nowadays, the lack of love and caring for each other; an almost total lack of kindness and generousity. Love, unconditional and extravagant, is what is described as an ideal or the goal of living by all major religions. It is "the narrow way", the "path of enlightenment", the way that leads to abundant life. In our current adolescent and narcissistic (I know, redundant wording) society, love of self and self interest has assumed a level of primacy and all else pales in comparison. My own needs and desires take precedence over the needs of the other whether that's at a local, national or international level. See any of the current debates in local, state or national politics - who's needs are really being served in the discussion? The self interested and dualistic mindset (I vs. It, We vs. They, Us vs. Them) which characterizes most of the developed world has led us to a place where without significant personal and communal transformation, we are destined to fail in our moral and ethical duties to each other. We can not make difficult or painful decisions from a self-interested place, because everything is seen as a win-lose scenario that I must always win in order to be succesful and self-fulfilled. Love, unconditional and extravagant, has everything to do with changing how we live this life that we've been gifted. Agape love brings us to a place of, as Victor Frankl put it, self-transendence which leads to self-actualization (see "Man's Search for Meaning"). To put it in other words (albeit Christian) by becoming more than our small selves we become abundantly alive and become all that God wishes us to be. We also create a community that is focused more on other's needs than our own. In this way, we see the other as fully human and as much in need of blessing as ourselves. We create new programs and policies that lift people up instead of keeping them down. We use money as a tool instead of covet it as an idol. We take pride in the advancement of all, even if we are left behind in the process. What's love got to do with it (?) - everything! This week, look for ways to be more loving. Search your religious texts for examples and live them out. Support just causes and organizations that are trying to make a difference through love and understanding. Look for ways to get out of yourself and into someone else's shoes for a time - it will be uncomfortable, but it will be remarkable. Peace for the journey, Dan

The After-Care Hole

I just had to spend some time with the subject of the huge hole in the current healthcare system - that of a lack of decent after-care. After-care is that time following a hospital stay (classically) when a person is discharged with a bunch of new instrucitons for care (and usually a host of new medicines) and has to make sense of this new way of being in the world. In the rush to get folks out of the hospital, discharge instructions are typically left to an overworked nurse and are given the barest of review with the patient. It is hoped by all involved that the patient can understand and follow the instructions. It is assumed by all involved that medication reconciliation has occurred and all medication issues have been resolved. It is assumed that the patient will call if there are any problems. Many assumptions - we all know what happens when we assume. My mother who is in her early 70's received a new knee last week. She had this procedure done (her second) at a world famous medical center. She went in on an early Monday morning and was discharged by noon on that same Thursday. My mother has the typical issues of someone her age, hypertension, metabolic syndrome, overweight, and over the summer had carpal tunnel surgery. My mother has no memory problems, but was receiving narcotics for pain control. In the early afternoon on Friday of last week I received a phone call from my mother who was totally confused by the discharge instructions that she received. Attempting to sort through reams of uncoordinated paper, she couldn't remember what she was supposed to do with her medicines - nor could my father make sense of it. Luckily, she has a son who has a Doctoral degree in Pharmacy and who understands the holes in our current system of care. It took 45 minutes to straighten all this out, and my mom had neglected to take her warfarin (blood thinner) the night before. Where's the after-care? Warfarin is a difficult medicine to manage and the result of too much or too little can be life-threatening. What happens to the people who do not have a resource like a pharmacist son? What happens to people that go home to an empty house, or to a home where they are the primary caregiver? What happens if they aren't clear mentally, or have their mental capacity dulled by narcotics? We know very well what happens, these persons return quickly to the hospital. The so called "bounce back" costs each of us a lot of money each and every year. The almost total lack of a coordinated system of care, coupled with the financial imperatives to get people out of the hospital sooner (and sicker) before the capitated insurance payment is used up, has proven to be a recipe for cost overruns and personal disaster. Even when an after-care program is implemented, there are barriers to receiving care such as persons who don't know or trust who comes to the door, and won't let them in (a situation encountered in Memphis, TN, in the LeBonheur system). Creation of caring communities where everyone looks out for everyone else is the essence of all religion - and a moral mandate. Hospitals originally began out of this basic need to care for one another and to do it with more resources and trained individuals. Unfortunately, in creating institutions of care, we have lost the mandate to do what communities used to do - to care for each other always. This is what we're working on at Possibilities Journey, Inc (www.possjrny.org). The re-creation of caring communities that link faith and healthcare to leverage the best of both for the betterment of all. This week, look around your neighborhood for someone who needs your help. You'll be surprised by the level of need and the possibilities for improving lives. Peace for the journey, Dan

The Illusion of Control

Part of my role in the world right now is to lead support groups. I have overseen my church's Stephen Ministry program for 11 years, and have recently broadened this outreach to include a DivorceCare program. I began the second group last night and was struck again by the suffering engendered by a perceived loss of control. A major life event had occurrred for the people attending (divorce/separation) and they were rocked by the disorientation which accompanies this life transition. I listened to the pain of lost dreams and the fear of unknowing. One persons quipped that he was most bothered by the loss of control in his life. That really resonated with me at this juncture in my life. Much of our development from childhood into adults is about making choices, living with consequences, and pursuing a goal/dream. Along the way we develop a sense of self and a sense that we are in control of most everything that happens to us - with the exception of some degree of chance. I can plan my life, but a natrual disaster can come along, or a car accident, or a major medical issue (e.g., cancer), that are the "slings and arrows of outrageous fortune". In other words, "bad luck" can happen, but otherwise I'm in control of my future and as long as I live my life in accordance to the rules, I can do ok. Yet, when I'm beset by outrageous fortune, I lose all sense of myself and my understanding of the world and how it operates. I'm surrounded by friends and family who are well-meaning, but who run out platitudes and cliches seeking to help me, but all they do is drive me deeper into the abyss. The illusion of control is very harmful to our health, wellness and wholeness. All of the religious doctrines deal with this delusion in some way or another. We believe, in our adolescent and narcissistic way, that we are the masters of our universe. That all good things have come from us, and that we ourselves control what occurs. I'm able to accomplish my success due to hard work, intelligence, and good luck. We don't often acknowledge that being born in a developed country, of parents who are doing ok, in a nuclear family (as I grew up in), in a family with strong moral values and sense of right/wrong, is not in our control. In fact, it is an act of grace bestowed on us by a loving God who wants the best for us. So when the illusion is shattered, if we are unclear of who God is for us, we have no place to turn - we have lost control. Thus the suffering that occurs for these children of God who come to DivorceCare and other support groups. It is the same for our health and wellness when we are confronted ultimately with our fraility and finitude. There is another narrative that can restore our sense of self and our place in the universe, however. Those of you who are observant in a faith tradition know what I mean. This week marks the celebration of Rosh Hashanah. The foundational story being one of a child who squanders his wealth and wanders for so long that he loses the ability to speak his native language when he finally returns home. The blowing of the shofar mimics his cry of pain and frustration - but G-d knows his voice and let's him back into the kingdom. So it is with persons who have lost their illusion of control, they need to be heard and let back into the kingdom. This week, listen for those who need to hear that they are loved and known. Listen for those who are lost and out of control. Share the narrative of a loving and forgiving God. Return them to a place of health, wellness and wholeness. Peace for the journey, Dan

Stewardship of Pain

It is a particularly painful time in my life as I write this. Not pain of a physical or physiologic nature, but rather pain of a psychic or life choices nature. The Buddha stated that all life is suffering - one of the four Noble Truths. I have not found that to be true in my own life, but I have suffered some and am suffering now. Certainly, my time as an ICU practitioner brought me into daily contact with the realities of suffering for critically ill and injured persons and their families. I have witnessed countless thousands die, and countless others who through the "miracle" of technology left the ICU to exist neither living nor dying in residential facilities across the U.S. Sometimes in this life there are things out of one's control that cause suffering. All of that suffering which was out of my control has wounded me...but it has also blessed me. How is that?! My favorite preacher is Frederick Buechner whose best sermons have been collected in a work entitled, "Secrets in the Dark: A Life in Sermons". I highly recommend it as a wonderful look into a truly gifted man and his attempt at making sense out of life. One of his sermons called out to me today as I contemplated my current situation. It is entitled, "Adolescence and the Stewardship of Pain". A seemingly obtuse title linking becoming an adult, with being responsible for something, and pain - something we all try very hard to avoid. Reverend Buechner does a marvelous job of weaving his story with that of the parable of the five talents and the lifelong learning that we are called to. Life teaches us, if we not only have our eyes and ears open, but the courage to accept the lessons that are presented. One of those "teachable moments" is that it is difficult to be fully responsible for our pain and by being fully responsible, to live into it and through it and come out the other side transformed. It is easier to bury painful lessons, at least for a while. Those of us who have lived a bit understand that sooner or later those painful lessons emerge. Becoming a good steward of our pain, both personal and collective, is what a spiritual life seems to be all about. Being able to share with one another both good and bad, and to seek wisdom from those events, seems to be the point of all major religions. We are not created to be alone, nor are we created to suffer alone - we need right relationships to help us move through our adolescence. Like the parable of the five talents, we are good and faithful servants when we invest what we are given - even when that investment is fraught with peril and fear. Having the ability to invest my pain instead of holding on to it is a life lesson that is proving invaluable to me right now. What a blessing! This week, find someone to share your pain with - or someone who needs to share their pain. If you don't know how to do the latter, investigate programs like Stephen Ministry, spiritual guidance or pastoral counseling. Learn how to be in right relationship with another. Be a good and faithful steward of the whole of your life. In this way you will be blessed and a blessing. Peace for the journey, Dan

The Power of Perspective

It was a busy week last week. The week started off as a real struggle, but gained terrific momentum so that by yesterday, life was relatively easy and I felt back in synch with things. Community does that for me - real spiritual community where one knows that one is supported in more than just words. Sincere people who are lead by a world view that finds value in others and is empathic, truly allows hurting people the space to just be. I was amazed on Tuesday when I was going to a meeting at the local hospital that I ran into a friend in the Lobby. She does not live near to the hospital, but volunteers in the Pastoral Care department. I was coming to discuss some of the issues curently going on in my house, and how it was going to affect my ability to participate in my volunteer work. I was feeling down and was inwardly focused on my troubles. Then I see my friend, first time in a while, and her words to me were, "I was just praying that God would send me some help, and there you come." She started to cry and gave me a big hug. My perspective changed immediately and I sat down and listened to this person's pain and struggles. I gained some much needed perspective and was able to address my challenges from a new and larger viewpoint. The meeting that followed was a good one and I left it with an invitation to lunch on Thursday with a consortium of six churches that call themselves the "Interchurch Community Health Initiative". They work together to leverage each congregation's gifts and people to work on health and wellness issues. The friend that I saw in the Lobby was running it, and when she found out I was coming she wrote me an e-mail. Turns out that her speaker for the meeting had to cancel at the last minute, and she asked if I would be able to fill in. Her note stated simply, "I wonder why I cry." (A change in my perspective.) I attended a wonderful meeting of these pastors and their programs and talked about how we might work together. It sparked my thinking about how to put this kind of group together with other faith communities. Another change in perspective. Perspective. Insight. Attitude adjustment. Whatever the term you choose to apply to these life situations, it is clear to me that much of what is going wrong in the world is due to a lack of perspective - or a very introverted and self-directed one. In contrasdistinction to this world view, I walked into the small and unassuming church where the consortium meeting was being held. On the entry hall wall were hung two large posters (3' x 4'). On these posters were written the expectations of congregants and for congregational leaders. It was clear that when one joined that you wouldn't just come for an hour on Sunday morning and then leave to go on with your life. This was a church that had a clear view of what they were about. They had a "Family Life Center" across the street along with an "Aquatic Center". Additionally, they were instrumental in developing two blocks of low-income apartments that are 100% occupied. Phenomenal leadership, vision and perspective. It made me think of the lack of clarity that so much of organized religion has nowadays. My own church is in desperate need of this kind of perspective and I believe we would benefit from it - as would our greater community! This week, examine your perspective(s). How do you view the world and your place in it? What are you being called to do within your faith community to improve the lot of those less fortunate? How can you look to your faith traditions for guidance and perspective? I look forward to seeing what comes from your discernment. Peace for the journey, Dan

H.R. Woes

I've been working for myself since 1996 - two private consulting businesses and now a 501c3 public charity. I had a conversation with my Senior Pastor on Monday around the difficulty of managing other humans - he asked me if I'd ever managed anyone. It reminded me of why I left institutional employment and management level positions - I got worn out by dealing with human resources issues instead of doing my job as a pharmacist. At one point, I had management responsibilities for 90 FTE's and I found myself spending inordinate amounts of time serving as a glorified babysitter. There I was doctorally trained and I was having to counsel other professionals about why it was necessary to follow the rules, show up on time, behave themselves and get along with others. Amazing, frustrating, disturbing, sad! My pastor was in the same place - his staff is not working well together, don't have a high level of trust, and some are still laboring under a philosophy of work and approach to spirituality that was resident for 25 years. Additionally, he's dealing with some staff who are also long-term members of the church - well-meaning people, but possibly not a good fit for their jobs. They've been used to having their own way and to doing whatever they felt was right. My pastor's guidance is seen as opinion to be ignored, rather than edicts from the boss. He's frustrated and I could empathize. Human relations are the toughest things that any of us engage in everyday. What's the way out of these H.R. woes? Not sure I have an answer, but I do have an approach for faith communities. In the Christian tradition there is a section of the book of Matthew (5th Chapter) known as the Beatitudes or the Sermon on the Mount. Jesus talks about who is blessed by God, and one of those who are blessed are the peacemakers - for they are God's children. Max Lucado in his book, "The Applause of Heaven" notes that peacemakers are those "architects who build bridges with the wood of a Roman cross". Beautiful imagery and so necesary to the proper and healthy functioning of a community. When we seek to build bridges based on our best characteristics, instead of moats or fortresses based on personal need, we create space for the "other" to meet us. Much of what manager's deal with on a daily basis could be undone with a view to bridge building. So this week, seek to build a bridge with someone who is challenging. Tackle a situation that seems too big by enlisting support from others. Build a bridge of positive communication with your direct reports and see what happens to their demeanor. I wish you well. Peace for the journey, Dan

The Power of Blessing

My sermon this coming Sunday will be about blessing and the effect on us individually and communally. I've been working through the book, "Leading Causes of Life" by Gunderson and Pray, and have come to this leading cause. I think that blessings are, for the most part, overlooked nowadays. In the past, receiving a blessing from a father or father figure was an important part of the maturation process. Blessings, in some cases, determined what one would do in life - or what one would have to work with (think of Isaac's blessing of Jacob). We don't see blessings in the same way now - in fact, many people are not even aware of how blessed (how graced) they are. My wife has been traveling for business in Indonesia and India on two separate trips over the last 3 months. The disparity in standard of living, the crowded conditions, the lack of comfort and the feeling of insecurity were almost constant companions. Coming up hard against the social injustices of different cultures calls many ideas and ideals into question. Yet, she marvels at the humor and joy, at the ability to share, at the sheer delight in living that she has also experienced. Some blessings are hard, and some are difficult to understand, yet all are powerful and transformative. Blessings come in many shapes and sizes, and some take years to realize. The power of blessing lies in its ability to transform us and our life narrative. Difficult times, challenging people or situations, poor choices, unforeseen tragedy all carry with them the seed of blessing. Our ability to live into each situation, some times just day-to-day, yields a treasure trove of experience and wisdom. It is often difficult if not impossible to see blessing within challenging situations (I'm in one right now). It takes faith to know that all things come to an end and that we will ultimately come out the other side of the issue. A dear friend is still struggling with her experiences of 10 years ago. She is still wrestling with God on this and hasn't yet come to the place of asking for the blessing in the situation (think again of Jacob). However, she is closer to the dawn than she ever has been, and though she still struggles with the meaning for her, she doesn't doubt that there is a blessing hidden in the experience. So this week, take a look at your life and note your blessings. Also note the places that you struggle, and spend time discerning about how that experiencing is blessing your life and the lives of those around you. Peace for the journey, Dan

Lack of Empathy

I attended a meeting this morning with a group of health professionals and leaders of NGO's in my community. We get together monthly and discuss social justice issues and lack of healthcare access. Today our conversation took an interesting and unexpected turn. One of the group bemoaned the lack of interest by physicians who would volunteer time or who would provide free services. The chorus of similar stories was overwhelming! It seems that over the last 10 years or so, all of these groups that depend on gifts of time and service are seeing providers turn away. It got me musing on why we seem to be encountering a decrease in empathy - or as my colleagues put it, a lack of community engagement. We certainly are living in a time where we are overwhlemed. Busy-ness is the by-word right now, and we all seem to have too many irons in the fire. This distracts us from what is really important - taking care of each other and thus our communities. It's possible that the relative lack of attendance and participation in faith communities is playing a role as well. If the dominant narrative is that we should do whatever we can to get our "share of the pie" then it stands to reason that we would not help out another. Giving something away for free is not in our best interest, because it takes money out of our pockets and distracts us from getting ahead. Could this be the case? I have noted in my own children the tendancy to want to hold on to what's theirs and to compete with everyone (even siblings) to get their share. It is a dominant narrative - one that is hard to overcome even in people who attend a faith community almost weekly - and who are leaders. Certainly all the major religions have at their core a model of behavior that promotes simplicity, honesty, empathy and love. My own Christian tradition is full of loving neighbor as self and sharing freely what I have. My friend Dr. Christina Puchalski, who runs the George Washington Institute on Spirituality and Health (www.gwish.org), noticed the lack of spiritual focus in her students and has designed medical school courses to try and change that. My conversations with her have been around how to get those same physicians-in-training to become an active participant in a faith community. Without that (my opinion) the course in spirituality is just another class with no reinforcing narrative. Thus, the transformational piece of belief and faith never occurs, and we have another group of medical professionals who lack the desire and moral imperative to give freely. Lack of empathy is a major issue in our world. When we cannot walk a mile in another's shoes, we cannot fully appreciate them. If they are not appreciated as unique and valuable, then they become just another competitor, and we all lose the race. This week, as we celebrate the 10th anniversary of the terrorist attack, see if you can practice some empathy for those who performed the act and those who are left behind. Peace for the journey, Dan

Side Effects of Life

We're coming up on the tenth anniversary of September 11th. The news media, the made-for-TV-movie and documentary makers, the ever present images will be overwhelming for many. Messages will be all over the media from Facebook to Twitter to YouTube to other forms of internet communication will in many cases be unhelpful and often will increase the hurt that people are feeling. Side effects of great trauma are long lasting and can become resistant to treatment if left unaddressed. All people can be affected by these life events - even those too young to remember great traumas can be adversely affected by the responses of those around them. How can we deal with these side effects of lfe? I'm about to embark on a new support group for teens entitled "Life Hurts, God Heals" from SimplyYouth Ministry. This program deals with people who are especially vulnerable to life's hurts and who are ill equipped due to lack of life experience to deal appropriately with it. Add into this mix that very few of them are affiliated with a faith community or have any tether to a narrative that gives hope, and you have a group of people who find themselves at a loss to deal with difficult issues. Side effects in this population include cutting, excessive drinking, prescription and other drug abuse, promiscuous sex, addiction to pornography, or combinations of these. They are overwhelmed and at a loss to deal with life's hurts. Their parents, who also are largely unaffiliated with a faith community (Washington DC area only 30% report attending) have no narrative to give them hope or a firm foundation. Program like "Life Hurts, God Heals" can provide much needed perspective. We spend a lot of time dealing with side effects of medicines (much of my professional life) yet we don't adequately deal with the side effects of living. Our world hurts us, and if we continue to become more and more isolated, we will have few resources to bring to the process of healing. Self-help gurus and made-for-TV doctors and therapists are largely unhelpful because they do not know the situations or the people. While it is true that we can help ourselves, often we just succeed in deluding ourselves more - we need an outside pair of eyes and ears to clue us in. We also need true friends who will tell us when we've made mistakes (think of Nathan and King David) and help us get back to where we need to be - in right relationship with each other. Life does hurt, it's a side effect of living. How we deal with those hurts makes all the difference to us and to those around us. So this week, provide a listening ear and caring heart. Speak the truth to someone who needs to hear it, and offer unconditional love and forgiveness. Speak of a different story than the world provides. Speak of a love that is unconditional and never ending. In this way, healing can begin. Peace for the journey, Dan

One Day at a Time...

Life is busy - I know that I'm preaching to the choir, and that those three words are so commonplace as to be trite. However, it has come home again to me as my family trends back into another year of organized school. Busy-ness is all around us whether it is church activities, sports, jobs, friends, life events - there's always something that could be done (not to mention yard work). Every so often, I find myself overwhelmed by the pace and the number of issues at hand. It is easy during those times to fall prey to anxiety and helplessness. My work with contemplative spirituality however, has shown me a different and healthier path. Humans have a tendancy to look ahead and to plan. This in and of itself is a good trait, but often we fall into the trap of "what if?" in our future-view and we lose sight of the precious thing that is today. Often, and this is the case for me currently, life events can get so onerous that we lose sight of the fact that the only thing we have to work with is today. Many years ago, Kris Kristofferson and Marijohn Wilkins penned the song "One Day at a Time, Sweet Jesus". It entered my mind as I was reflecting on what to write today, and how to write it. For those unfamiliar with the chorus it goes like this, "One day at a time sweet Jesus, that's all I'm asking from you. Just give me the strength to do everyday what I have to do. Yesterday's gone sweet Jesus, and tomorrow may never be mine. Lord help me today, show me the way, one day at a time." Beautiful and healing sentiments for those times when we get a little too out of control and are being battered by the sea of life. For me, and for those who I come into contact with at challenging times in their lives, it is such a wonderful gift to stop the mindless doing and to just breathe. To slowly inhale and exhale, to count heartbeats, to simply "be". Slowing down to the point that you are truly present to the moment allows for the wonder of living to be apparent (at least to me). This allows for relaxation and healing, and for the opportunity to be whole - not fractured or scattered, as is the norm nowadays. It is my contention (in a long line of contemplatives) that this type of mindfulness and stillness could heal the world. For more on this try Thomas Merton, Theresa of Avila or John of the Cross, Richard Rohr, to name just a few. This week when life gets out of control, just stop and breathe for a few minutes. See what happens - I think you'll like what you find. Peace for the journey, Dan