Blog Title: Episcopal Chaplain at the Bedside

More on Mount Calvary

There's a news story in today's New York Times about Mount Calvary and the monks of the Order of the Holy Cross. You can read it here. (And thanks to Episcopal Cafe for that.)

Please continue to pray for the Order, for the monks specifically of Mount Calvary, and for all the others around them who have lost so much in the fires.

And for my fellow Associates of the Order: there is a Yahoo Group for Associates. There aren't many of us on it, and there isn't much traffic. We'd love to have you join us on the Group. If you'd like to subscribe, email me from the link on my Profile page, and I'll be happy to send the information.

Called to Risk: Reflections on Proper 28 (RCL)

Zephaniah 1:7,12-18; 1 Thessalonians 5:1-11; Matthew 25:14-30

I’ve been pondering the lessons for Proper 28, preparing for my sermon tomorrow (it’s not unusual at all for me to be this late; indeed, it’s more the rule than the exception; but that’s a story for another post.). Central to that consideration has been that story we all know so well, the Parable of the Talents.

We all do know it, of course. The householder is leaving for an extended trip, and wants to set matters in order. He calls his three slaves and gives each of them a large amount of money, different amounts, as Matthew writes, “to each according to his ability.” At the householder’s return, each of the first two slaves had traded with their funds, and each had doubled their funds. The third had instead buried it in the back yard – literally! He lost nothing; but, having gained nothing, he suffered his master’s wrath and was thrown out.

As I looked at what others had written about this story, I found something interesting. Several wrote of the money given to each of the slaves as “gifts.” Perhaps that appeals to our use of the word “talent:” an aptitude, a skill, a capacity, something that we might indeed see as a “charism,” a spiritual gift.

The more I looked at it, though, that idea didn’t make sense. First, these were slaves. Whatever the capacity these huge sums of money might have allowed – and these were huge sums of money! – the slaves remained slaves, not simply responsible to the master but owned by him, body and soul. Second, the money was never the slaves’. It always remained the property of the master, whatever latitude the slaves might have had in using it. After all, when the third slave returned his money the master identified it as “my own,: Third, the master’s clear expectation was that the money would be used. Certainly, he was not at all pleased with the third slave, even though he as master had lost nothing.

No, the money was not, was never a gift. The money was a responsibility, a charge given by the master.

Now, the tasks were not assigned blindly, as it were. The master gave a different sum “to each according to his ability.” So, the master never expected as much of the third slave as he did of the second, much less of the first. The third slave was assessed to have the least capacity from the beginning. We could wonder, then, why the master was so disappointed, when, after all, the third slave hadn’t really failed. He didn’t lose anything, so he didn’t really fail, did he?

But we know that the answer is yes, he did fail. But his failure was not measured by how much money he made, or might have made. His failure was not his failure to profit, but his failure to try. What did the master say? “So, you knew me so well? You found me so frightening? Then you could at least have done something worthwhile, instead of simply sitting on what you had.”

The hard part for the third slave was that he lacked faith. Isn’t that what the master said? Those who succeeded were “good, with faith.” They had the faith to take some risk with their talents. Notably, they had some faith, faith in their master and faith in themselves, recognizing the faith that their master had in them. He had judged them each to have the capacity to manage those large amounts of money. They accepted his assessment, and felt they could take the risks of trading with those large amounts of somebody else’s money. When they took the risk, they had their faith confirmed. The third slave lacked faith in himself, and even in his master’s assessment of his capacity. He felt afraid, unwilling to take any risk; and so he failed in the eyes of his master.

We ourselves do talk about talents that God has given – both talents in the sense of capacities, and for many in the sense of financial resources to live out those capacities. We talk about them as gifts, and express our gratitude. At the same time, we need to remember that these are not really gifts. However great might be the capacities the God gives us, they do not make us God, or even gods. Instead, they are responsibilities. God gives them to us for God’s purposes, however much latitude we might feel in using them. We remain God’s servants, stewards of capacities and resources that remain God’s, to be used for God’s purposes.

And God expects us to take risks with those gifts, those capacities. After all, he has given them to us according to our abilities – that is, God has faith in our abilities to do something good, if we will only take the risk to try. God will certainly expect different things of different ones of us; but of each of us God expects us to take a risk and make an effort. And God will be displeased, not if we try and fail, but rather if we don’t try at all.

Zephaniah brings that home to us. He proclaims the Day of the Lord, and it looks like a difficult day for all. Yet, the target audience, if you will, is really quite specific: “those who rest complacently,… who say, ‘The Lord won’t do either good or ill.’” Those whose homes will be plundered, whose lives will be uprooted and destroyed, are those who simply try to lay low, to try nothing, believing that thus they will lose nothing.

So clearly we are called to take risks with the capacities God gives us, to make efforts to carry out God’s purposes, without knowing whether we will succeed of fail. God has faith in us that we can do it. But, of course, it’s all too easy for us to lose faith in ourselves, to believe that we’re not good enough or strong enough or wise enough or enough of something else. After all, who knows our shortcomings better than we do? And so we lose faith in ourselves, and faith in God’s assessment of us. We can lose faith, too, in God’s promise. Christ has told of us of God’s wonderful promises for us if we walk in faith before him. But there are so many places and so many voices to tell us just how frightening God can be. Like the third servant, we can become immobilized, to afraid of failure, and too afraid of God, to take the very risks God asks of us.

But Paul had a word for us on that. He reminded us, with the Thessalonians, that we are children of the light and the day, not of darkness. He reminded us, with them, that God has destined us not for destruction but for salvation.

So, let us have faith – faith in God and faith in ourselves and faith in the capacities God has given us, however great or small they might seem. God has given to each of us capacities according to our abilities. What God expects of us is that we do something with his capacities, for a while put under our stewardship. And what God expects of us is not a specific measure of success, but a willingness to risk: to take these capacities and use them for God’s purposes. We’re not certain of success if we do; we’ve seen enough history to be aware of that. But we’re certain to disappoint God if we don’t.

Mount Calvary Burned

As an Associate of the Order of the Holy Cross I am among those saddened at the loss of the Mount Calvary Monastery and Retreat Center in the Tea Fire in Montecito, California. You can read an ENS reports about it here, and can see local TV news reporting here. As the TV footage shows, there was terrible destruction at the Center, and yet some things were saved. Strikingly, the garden cross still stands.

The brothers were safely evacuated, and are staying for now with the Sisters of the Holy Nativity at St. Mary's Retreat House. We're thankful that none of them was injured.

I have visited other houses of the Order, including the recently-closed Incarnation Priory in Berkeley (most of whose monks were relocated to Mount Calvary). I had hoped one day to visit Mount Calvary as well. While that hope isn't gone, it is certainly put off. With many others, I look forward to the new monastery that will be built, and pray for the continued ministry of the Order, not only in the Santa Barbara area, but also for the larger church.

More Good Stuff for Chaplains (and Others)

It's a rich week!  I normally point to Episcopal Cafe when I've had something new posted there.  However, my friend and colleague Andrew Gerns has a new post there that I think will be valuable and encouraging reading for chaplains, and at least quite interesting to others.  Before becoming Rector of Trinity Episcopal Church in Easton, Pennsylvania, Andrew was for some time a hospital chaplain.  Take a look at his new piece.  And, if you're interested, you can see other things he's written at his own blog, Andrew Plus.

Another Voice on CPE

Because each summer I look for and point to blogs discussing the experience of clinical pastoral education (CPE), folks periodically look here for information on the CPE experience. With that in mind, I encourage folks to check out this article at PlainViews, the online journal about chaplaincy. The author, DonnaLee Dougherty, is reflecting on her experience of her recent unit of CPE.

While there, take some time to look at current and past articles at PlainViews. For those of us in the business, and for those interested in chaplaincy, PlainViews is worth visiting regularly.

What General Convention (Hasn't) Said: Veterans and Health

This morning I happened to catch the repeat of “The News Hour” on PBS (in my market they run it the following morning). What caught my attention was this report: “Military, VA Confront Rising Suicide Rates Among Troops.” I encourage you to watch it. The information in it, and the concern for high rates of suicide and emotional trauma among veterans returning from Iraq and Afghanistan, are not new to me. This report suggested the Army is working hard to improve the response to these needs, while the Veterans Administration may be lagging behind.

That brought me to wonder what the General Convention had said about care, and especially health care, for veterans. When I searched actions of General Convention since 1976, I discovered that there was, sadly, very little. Indeed, there was only one resolution, dating all the way back to 1976. That year the General Convention passed resolution 1976-B182, titled “Affirm Bicentennial by Resolving Issues Relating to the Vietnam War.” While it did not speak specifically of health care, it did say in part,

1. Commend the leaders of the United States Government for the efforts and programs aimed at restoring to productive lives those who served the nation in the Indochina conflict as well as those who chose not to serve;

2. Urge the furtherance of those efforts by granting to Vietnam veterans benefits fully equivalent to those granted to veterans who served the nation in World War II and in the Korean conflict; ...

On this Veterans Day I would hope that all of us, without waiting for a resolution from General Convention, could support the same efforts for veterans from Iraq and Afghanistan; and, for that matter, of Panama, Grenada, Bosnia, Somalia, and elsewhere. Post Traumatic Stress Disorder isn’t really new. It’s just a medical diagnostic term for how emotional traumas have affected some veterans in any conflict. Thank God that more veterans have not been so seriously affected; but we are still called, both in national responsibility and in Christian compassion, to support appropriate services for those veterans who have been.

Again, I regret that General Convention has not had more to say on this over the last generation. On the other hand, we’ll soon be in Anaheim....

Of Justice and Long Nights: Reflections on Proper 27, Year A

Amos 5:18-24; Matthew 25:1-13. Preached (well, something like this was preached) 11/9/08.

"I hate, I despise your solemn assemblies" - what a passage to get when coming to an Episcopal Church! But, it is all too easy to become impressed with our own solemn assemblies, both religious and civil. We have been through a season especially heavy with the latter. And that season isn't really over. We're coming to Thanksgiving, a holiday both civil and religious. We'll soon enough experience the religious seasons of Advent and Christmas; and we'll hardly be past Epiphany and the Feast of the Baptism when we come to the civil assembly of the Inauguration.

"I take no pleasure in your burnt offerings...
But let justice roll down like water, and righteousness like an ever flowing stream."

For many of us this Inauguration will be special, and special in a way that speaks particularly of justice. Legal slavery ended perhaps 150 years ago; but the legal vestiges - economic and literacy requirements that prevented African-Americans from participating with anything approaching equality in the political, economic, and cultural life of the nation - were only successfully challenqed in living memory. And they didn't happen all at once by any means! Step by step, from Truman's integration of the military, to Brown vs. the Board of Education, to the Voting Rights Act, things changed. Step by step, from the brave children of Topeka and Little Rock, to the Montgomery Bus Boycott, to the summer of the Freedom Riders and the bridge at Selma, old ways were challenged. Not all at once, but step by step; and if, contrasted with 300 years of legal or economic slavery it appeared short, for those who lived through it, it seemed - indeed, it was - a lifetime. Is it any wonder we have heard so many say, "I hoped it would happen someday, but I never thought it would happen in my lifetime."

And so we look to this Inauguration, and it speaks to us of justice, doesn't it? Well, yes and no.

"Let justice roll down like waters, and righteousness like an ever-flowing stream."

Of course there is something of justice about this election and this inauguration, something we can and should celebrate. On the other hand, this is not justice accomplished; it is only one step forward. There is much to celebrate; but if we imagine that this means things are now just, that our work is over, this Inauguration will be just one more solemn assembly - self-satisfying, but insufficient. That’s especially true for us in the Church. If we come to this Eucharistic celebration, as the Eucharistic Prayer says, “for solace only, and not for strength,” this too will be just one more solemn assembly – self-satisfying, but not sufficient. It is important that we recognize that, while we have seen an important landmark, we haven’t experienced a sea change. We celebrate this moment that speaks of justice, but we also recognize that the world hasn’t really changed.

And that can be distressing. It’s all too easy to hope, to imagine that we’ve achieved justice, and to become depressed when it turns out this was only another step forward. And in our distress it is all too easy to become dejected and immobilized.

In a way I think that’s what happened with the wise and foolish virgins. Think about it. There wasn’t any real difference between the lamps of the wise and the foolish virgins. They worked: when lit, they shed bright light. There wasn’t any real difference between the virgins as virgins. All were looking forward to the party, waiting for the bridegroom. However, the foolish virgins weren’t prepared for a long night. They were just as enthusiastic as the wise virgins, and their lights were just as bright; but they weren’t prepared for the long haul.

By the same token, we need to be prepared for the long haul. We can celebrate this step forward, but we also need to be prepared for the fact that the world hasn’t really changed. We are. after all, the people called to proclaim God’s presence in the world. We are called to participate in God’s efforts for justice, to help make the presence of the Kingdom present even in our own time and place. That means proclaiming the presence of God, not just in our celebrations, but also in the long, often dark times between them. That means being prepared not just for the party, but also for the long night.

If we fail in that, our solemn assemblies, however wonderful they are, will indeed be empty show, perhaps satisfying to us, but certainly not to God. However, if we work for justice, if we work to demonstrate the presence of the Kingdom even in our own time, our assemblies will be more than empty parties. They will be landmarks, signs of hope as we wait for God to bring the Kingdom in fullness.

More on Personal Warmth

In my most recent post at Episcopal Cafe I described research on how individuals react to feeling warm or cold, or to thinking about feeling warm or cold, and how it affects the sense of being included. (If you haven't read that, take minute to do so; and while you're there, take some time for other good stuff published there.) Since posting that, I learned about some additional research. I learned about it in this item from NPR's "All Things Considered." The research it's based on was published in the 10/24/08 edition of the journal Science. You can read the abstract on line here.

This research also had to do with holding something warm. Subjects were students at Yale University. In one experiment, subjects were riding an elevator with another student, who would alternately ask the subjects to hold a cup of either warm or iced coffee while riding up. Once upstairs, they were asked to read a description of a hypothetical person and describe that person's personality. Those who held warm coffee generally had a more positive impression of the hypothetical person than those who held the iced coffee.

In another experiment, subjects were asked to hold and assess either a medical hot pack or a medical cold pack. They were then asked to choose a reward for participating. Those who held the hot pack were more likely to choose a reward as a gift for someone else instead of for themselves, as opposed to those who held the cold packs.

Again, I think perhaps we need to take this seriously for evangelism and for incorporating visitors. Certainly, greet them with a warm handshake. But perhaps it's also worthwhile to greet them with a hot cup of coffee as well. Perhaps it's worthwhile to turn up the thermostat, or develop our own sorts of "prayer shawls," to help people feel comfy in the pews. Being warm to people - literally physically warm - appears to have some good results, at least in terms of people feeling welcome. We are an incarnational, sacramental people. It shouldn't be a stretch to take steps to take our spiritual warmth and make it physically manifest.

Reacting to Political Rhetoric, Part 2b

So, having spoken to the theological issues related to this political commonplace of "your money," let me speak to social issues. Ignoring for the purpose of argument any claim of God's universal ownership does make the argument a bit harder. It doesn't make it impossible, just less simple.

Let me begin with my argument about that obnoxious sentence, "Government isn't the solution; it's the problem." As I've written, this is a false dichotomy, because in fact we are the government, at least to the extent we don't abdicate it. By the same token, to say, "It's not the Government's money; it's your money," is to embrace the same false dichotomy. What money we have is money our Government has printed. What money our Government has with which to do business is money from us, through our participation as taxpayers. What priorities our Government has for that business are those we have directed by our participation as voters (yes, perhaps all to often we vote for the persons; but each election they do tell us what their priorities will be). So, there is an inherent connection between "the Government's money" and "our money."

That is one of the consequences of the concept of "commonwealth." While a few states even designate themselves as "commonwealths," I don't think most folks think about why, or about what the word actually means. It means, really, that we're all in this together, politically and, critically, economically. We are sufficiently connected economically to describe and discuss this wealth that we participate in in common.

This isn't some kind of denial of private property (although one could argue that in the theological discussion). It is, rather, denial of any pretense or illusion of self-sufficiency. There are very few (and, as our society becomes more urban and suburban, fewer all the time) who we might consider self-sufficient without support from the larger society. We may talk about rugged individualism; but left to our own devices most of us would be in real trouble.

There are numerous examples of how we live in a commonwealth, but let me give just a few. I attended public schools, from the first grade through my Bachelor's. It's true that my parents paid taxes toward those costs, and we paid tuition toward my BA. However, there's no way those taxes and tuition paid the costs of my education - not even what might be called my "fair share." My seminary was a private school (that might be obvious, but perhaps not to everyone), and the tuition was much higher; but there was still no way it covered my portion of the seminary's expenses. I had to depend on the resources of others, folks who neither knew nor cared whether I got an education.

Another example is that all of us use roads that we haven’t necessarily paid our fair share of. There have in history been private roads, paid for by tolls; but they’re few and far between now. We do pay highway taxes under various titles: gas taxes, commercial user fees, license fees, etc. However, we’re not paying as individuals anything like the full expense. Moreover, since much highway funding is federal, folks in the less-settled western states are paying for highways serving the more-settled east – highways they’re not likely to ever use themselves.

The reason we support these things is that they’re good for the economy as a whole, and good for society as a whole. We benefit individually from things we support because they’re valuable generally. My kids are adults now, and live far away, but I have no regret about supporting with my taxes local public schools. I benefit and will benefit for some time to come. After all, studies have shown that those with more education are less likely to end up in prison (and those who while in prison get further education are less likely to return). And, as I age, I know that I will need the next generation of physicians, nurses, therapists, and pharmacists – not to mention the next generation of engineers, mechanics, teachers, and others. Where can I expect them to come from, if they’re not prepared and educated in schools? Where can I expect them to come from, if I don’t support those schools, even though my own kids aren’t in them? I need commerce to continue. How can I expect that to continue if I don’t support the infrastructure, even of components I won’t personally see? Highways and schools and any number of other government-funded programs were established by others, and paid for by many others, and I have benefited far beyond my own contribution. Don’t I have some responsibility to continue to support such programs?

This web of institutional and economic relationships and connections describe my responsibility. They describe the commonwealth in which we live – the degree to which we hold wealth in common, to which “my” wealth is dependent on the activities of others. Therefore, even if I have some claim to private property, I have some accountability within those relationships and connections to make my contribution not only for my individual good but also for public good. This is even more true of “government’s” money, since we are the government. I have responsibility for how I participate politically and economically, responsibility not just for how it benefits me for how it benefits society generally. So, for those social and political reasons, I find it disingenuous to make this falsely hard division between “your” money or “our” money or “government’s” money.

Reacting to Political Rhetoric, Part 2a

So, having addressed one piece of political jargon, let me address another. This one is difficult enough that it requires both theological and political/economic consideration.

The phrase in question is "your money," as in, "It’s not the government’s money: it’s your money." We’ve heard it a lot, and in these last days before the election we’ll hear it a lot more. It’s a commonplace among those for whom taxes are by definition bad, an imposition, without discussion about how taxes might be spent.

Now, in addressing this, the theological discussion is the easy part. Indeed, at this time of year I usually have a lot of help making the point, even if most folks so pigeonhole their worship as to avoid any connection with politics. That help comes in the form of the hundreds of thousands of stewardship sermons taking place in Christian churches at this season; and while I can’t say with certainty, I’d be surprised if synagogues and mosques didn’t have leaders discussing in one way or another how to support next year’s budget.

All of those sermons will refer to Psalms: "The earth is the Lord’s and all that is in it." (Psalm 24:1) They may note that this reflects what Moses told the Pharaoh in Exodus 9, or that it’s repeated by Paul in I Corinthians 10. The sermons might refer to our call as tenants in a vineyard that we do not own; or recall to us that, while some portion of our life might belong to Caesar, all of our life and labor belongs to God. They might note from the Acts of the Apostles that the model of the first Christian Community looked a lot like, "from each according to ability to each according to need." How, then, shall we speak of "your" or "our money?"

The theme has been taken up even by new leaders among evangelical Christians. They have broadened the recent political perspectives among Evangelicals, realizing a concern for the unborn and for the poor, for morality in the media and for quality in the environment. They have recognized that Christ's concern for the poor must have both missional and political expressions. They are not speaking strictly of "your" or "our money."

Now, we might assume that somehow American separation of church and state might be pertinent. Still, this would seem a significant expression of the values of Christians and of others of faith. Yet, many of those who talk about "your money," also declare themselves people of faith. Somehow, there's a disconnect: for if it is all God's, how shall they (or we) talk about that money as "yours" or "ours?" Or, if they (or we) do, what does that say about the faith proclaimed? No, at least for us as people of faith (including those in politics so quick to proclaim their values as based in faith), this discussion of "your money" seems out of place.

Reacting to Political Rhetoric, Part 1

All right, I've heard enough. I've been trying not to, but I've heard again and again certain catch phrases from politicians that I just have to challenge.

The first one is that oft-quoted sentence, "Government isn't the solution; government is the problem." It is the favorite image of small-government conservatives, especially of a libertarian bent.

I have two problems with this, and the first one is really fundamental. I don't like being told that I'm the problem, that we're the problem.

"Oh, but you're not the problem. It's government." But, you see, that’s really the meaning of the statement. The Preamble to the Constitution begins, “We the People.” President Lincoln in his Gettysburg Address enjoined “that we here highly resolve that these dead shall not have died in vain, that this nation under God shall have a new birth of freedom, and that government of the people, by the people, for the people shall not perish from the earth.” (Don’t we all remember studying this in our high school History and/or Civics classes?) If we take seriously that this government of the people and for the people is also government by the people, to say that “Government is the problem” is to say to us, “You are the problem.”

Now, in a sense perhaps we are the problem. After all, we have an opportunity every two years to significantly change the government (that’s how often all members of the House of Representatives are up for reelection), and over a maximum of six years to turn it over completely (four years for the President and six years to completely turn over the Senate). If we’re really committed to throwing the rascals out, we have regular and relatively frequent opportunities. For good or ill (for good and ill) we don’t take the opportunity. Those who don’t vote have discarded the opportunity. Those of us who do vote frequently enough decline the opportunity. Has it never seemed odd to anyone else that, election after election, polls show people saying both “I don’t think that Congress is doing a good job” and also “My Representative/Senator is doing a good job.” Surely somebody’s Representative or Senator isn’t doing a good job for people to have the impression that most (“but not mine”) need to be thrown out.

And has money taken government away from us? I’d be more persuaded if votes, like bull rider rankings, were counted by money earned. In fact, it’s the votes that get counted, and corporate citizens don’t get to vote. Recent elections have shown, too, that it’s quite possible to raise lots of campaign money by accepting small donations from many donors. Moreover, there was some truth about that wonderful climax of “Mr. Smith Goes to Washington.” Send a politician enough letters, and the politician will pay attention, no matter who’s contributed campaign money. Several real lobbyists of my acquaintance have affirmed that. And these days, between local phone numbers to local political offices and web and email access, it’s a lot easier to get those letters in various forms to the politicians who serve us.

But it remains the case that we chose ‘em, whether by voting for them or abdicating the responsibility to vote against them. We are the government of this republic. So, to say, “Government is the problem” is to lay the blame on us, whether we realize it or not.

Which leads me to my second concern. If “Government is the problem,” who would want to be part of it? How often have we heard that old saw, “If you’re not part of the solution, you’re part of the problem?” Who, then, would choose to be part of the problem instead of part of the solution? And yet the people who want to tell us most loudly that “Government is the problem” want us to vote to make them part of it. Why, then, would we trust them to lead us as part of “the problem?” Isn’t there something remarkably disingenuous, if not downright duplicitous, about that?

So, that’s my problem with the sentiment, “Government isn’t part of the solution, it’s the problem.” Those who use it are trying to convince us to put them in charge of something they believe doesn’t work, and to blame us for the failure - and if they’re incumbents, for their failure! Do you see good reasons to have such persons lead us? Because I don’t.

Articles on Religions and Child Health

I’ve been a bit slow getting back into the flow of writing regularly. So, I went to a dependable source of inspiration.

I took some time reviewing recent issues of the Southern Medical Journal. I have cited articles from that journal in the past because they have particular interest in articles relevant to spiritual care of patients.

In the July, 2008, issue I found two review articles by Sara H. Sinal, MD; Elaine Cabinum-Foeller, MD; and Rebecca Socolar, MD, MPH. The first is “Religion and Medical Neglect.” (Southern Medical Journal:Volume 101(7)July 2008pp 703-706) The authors note that there is little literature on the subject. They cite particularly an article from 1998 reviewing 172 cases between 1975 and 1995 thought to be related to “religion-motivated medical neglect.” The authors also note how few religious organizations might be implicated. “A total of 23 religious denominations from 34 states were involved, but 5 religious groups accounted for 83% of the fatalities: Faith Assembly (64), First Church of Christ, Scientist (Christian Science) (28), Church of the First Born (23), Faith Tabernacle (16) and End Time Ministries (12).” The article discusses the histories of Faith Assembly and Christian Science, and information regarding child health in those bodies. There is also some discussion of issues related to the medical-religious concerns of Jehovah’s Witnesses.

The article also includes a brief review of the issue of religious exemptions from medical care including vaccinations allowed by some states. They note ambiguity in history and practice:

“The Supreme Court ruled in 1944 that “the right to practice religion freely does not include liberty to expose the community or child to communicable disease or the latter to ill health or death.” However, in 1974 the US Department of Health, Education and Welfare required states receiving federal child abuse prevention and treatment grants to have religious exemption in cases of abuse and neglect. Within 10 years the majority of states had exemptions in the juvenile code, criminal code or both. The federal government removed religious exemption from the federal mandate in 1983, but only a few states have repealed the exemption.”

Warm Thoughts at Episcopal Cafe

My newest piece is up at Episcopal Cafe.  I'd like to say it's a hot topic - but others may not have the appreciation of the punny that I do.  Anyway, go take a look.

AEHC Is Back!

The web site of the Assembly of Episcopal Healthcare Chaplains is back. After some time away, we've made the appropriate changes. You can see the new look here. Go over and check it out. And, we hope from this point to add changes and new information more quickly. So, stay tuned....

Into Their Right Mind - Updated

Updated 10-6-08

There’s been an awful lot of attention and debate today about the passage of the mental health parity bill. It requires that if a company with more than 50 employees offers mental health coverage as part of its overall health coverage, it has to offer it at the same level as coverage for physical health. (Sadly, it doesn’t require that the coverage be offered; only that if offered it be equal.)

Oh, you didn’t know that a mental health parity bill was passed today? You thought it was all about the economic bailout?

Well, you’re right, sort of; and most news reports have said the mental health bill was tacked onto the bailout bill. However, in fact it was the other way around. Section 7 of the Constitution of the United States says, “All bills for raising Revenue shall originate in the House of Representatives; but the Senate may propose or concur with Amendments as on other Bills.” So. while the bailout bill was the point, it couldn’t originate per se in the Senate. Senators needed a bill that they could originate and that they could attach the bailout to.

Enter the mental health parity bill. In fact it had already been passed in both the House and Senate, but hadn’t gotten to the President’s desk. In addition, it was a matter of interest to some members of the House who had voted against the bailout plan the first time around. So, being generally acceptable and especially acceptable to some additional Representatives, it made a great vehicle for the purpose.

Parity for mental illness and addictions has been an issue for a long time. Parity had long suffered from the lingering stigma associated with mental illnesses themselves. Insurers resisted it, noting that mental illnesses were often difficult to diagnose, and were chronic, requiring years of treatment. On the other hand, with medical progress many with mental illnesses could be economically and socially functional with appropriate treatment. The same could be said for other chronic, complex diseases, such as diabetes or autoimmune disorders, which were covered. The logic for offering unequal coverage for mental illnesses could not be sustained.

So, today the House passed and the President signed a mental health parity bill, that happened to have an economic bailout bill attached (okay, so it’s not a coincidence). Of course, we’ll be living with the consequences of that economic rider for some time to come. On the other hand, for some the benefits of the mental health parity bill will make a difference for a lifetime.

Update: Yesterday on All Things Considered, NPR had coverage of the history and the importance of passage of the mental health parity legislation. It's an interesting and useful summary. You can read or listen here.

Those Who Don't Learn the Lessons of History....

I've been out of the loop for a while, but haven't been (haven't been able to be) unaware of the efforts to salvage the solvency of the financial markets. It has left me thinking of the question from my seventh grade math teacher: "Now, who has seen my deliberate mistake?" Yes, I know that those who made the decisions would never say they intended this result; but the critical decisions were nonetheless made quite deliberately.

So, what have we learned?

Perhaps we've learned - again! - that laissez faire capitalism cannot be sustained. We thought we had learned this. We thought that, thanks to Sinclair Lewis and other muckrakers, we had learned that unrestrained, "weakest to the wall and devil take the hindmost" capitalism would ultimately injure the community for the sake of a few industries and those who ran them.

Perhaps we thought that in "the new economy" that couldn't happen. After all, after the Depression we added regulation. And anyway, we're no longer in an industrial economy. We're in a service, information, and financial economy. Everything has changed.

Only, we've learned different. Not everything has changed. Some things have changed back, as deregulation became all the rage. Our society has changed as well as we've moved from a "barn raisin' " ideal of community to a rugged individualism. Most important, human nature, especially human greed, hasn't changed. So, our economic goals shifted from optimizing stakeholder benefits (profit, yes; but also full employment, philanthropy, and community investment) to maximizing shareholder profits.

And so we've now learned that laissez faire capitalism doesn't work in the "new economy," either. It has nearly destroyed this service, information, and financial economy as it nearly destroyed the industrial economy a century ago. At great human and emotional and financial expense we will survive and reshape, and call it recovery.

And, please God, we will pass this on. We will study and teach what went wrong. If we do that, perhaps a century from now our grandchildren won't have to ask again, "So, what have we learned?"

I'm Back

Yes, I'm back.  It's been time for vacation, and for CREDO.  At this point, all I will say about vacation is that I needed it, and I enjoyed it.

Learning

You know, there may be something to this process of slowing down.  I'm not very good at it, but I'm learning....

Newest at Episcopal Cafe

My newest contribution to the Episcopal Cafe is up. You can read it here. The topic, or at least the point, is balance, moderation, and self care - something I certainly wrestle with often enough. Indeed, perhaps it's time I took some of my own advice....

Biblical Values for Political Thinking - At Least As I See It

I don’t know about you, but I’m not really looking forward to the coming blitz of political ads and electioneering. It’s not that I’m apathetic about the election: quite the contrary. I’m a committed voter, and have been for a long time. I read about the candidates’ positions in the paper and on line, and listen carefully to the news. I try to be an informed voter, but I don’t expect much in the way of real information from the coming political ad onslaught.

Some time during the fall each election cycle (and they seem somehow to be coming more and more often!) I find myself preaching on voting. I am careful not to tell anyone how to vote. I’m careful to say that no one has to agree with me (knowing that just about anyone who knows me will have some sense of my opinions). I do my best to avoid specific issues. Instead, as I’m sure many of my colleagues do, I focus on faith and voting. Specifically, I encourage those who listen to remember their Christian values when they decide how to vote.

I suppose that doesn’t sound so different from some clergy and some churches who speak about Christian values and voting. I try so hard to be careful not to get specific, whether about a candidate or an issue. I try hard, too, to reinforce again that no one has to agree with me, and that I speak as one (perhaps easily dismissible) individual, and not for the Episcopal Church or for the specific congregation in which I’m preaching at the time. The freedom of thought that I believe has been a hallmark of the Anglican/Episcopal tradition is very important to me. So, I try to be different from those clergy who are so specific as to raise eyebrows and concerns (at least outside their own congregations).

It does, then, leave me thinking about values, about Biblical values as I understand them, and voting. It leaves me thinking about those passages from the Gospels and elsewhere in Scripture that shape my own thinking when I vote.

There are several passages that I’ve quoted a long time. The first is Matthew 25:31-48, Matthew’s parable of the Last Judgment; and I don’t imagine it’s a surprise that this is in my list. I have sometimes said that I can’t imagine hearing this parable and not becoming a radical, or at least progressive. They also include Acts 2:44-45, and Acts 4:32-37. These are the passages in Acts describing the disciples sharing “all things in common.” That might be more of a surprise, but I don’t think anyone who knows me will really be shocked. (I once preached on a Sunday July 4th, saying that I would call ours a Christian nation when our domestic policy was based on Matthew and our economic policy was based on Acts. It took four five years and a change in clergy leadership before I was asked to supply in that church again.)

Again, I can’t imagine those passages are a surprise, but there are others as well that have struck me. I’ve been thinking about those passages, and thought I might do some of that thinking in public. So, let me share:

Luke 4:16-21: This is Jesus reading Isaiah in the synagogue in Nazareth, and claiming that as his mission. In once sense, this might not apply to me. This is, after all, Jesus reading about Jesus. At the same time, if we are the Body of Christ, and this is part of Christ’s purpose, it has to be part of ours.

Luke 10:25-37: This is the story of the Good Samaritan, and the direction that comes from it: “Go and do likewise.” Again, it’s hardly a surprise that this should be here. At the same time, there are nuances that convict me, and especially that direction not only to reach out to those I might fear but also to those who might well fear me.

Leviticus 19:13-18: This includes the well known injunction, “You shall not take vengeance or bear a grudge against any of your people, but you shall love your neighbour as yourself: I am the Lord.” Quoted by Jesus, this has particular importance. However, seeing this verse in context makes clear that it is not only about personal behavior but also about social justice.

Closely associated with this is Leviticus 19:33-34: “ When an alien resides with you in your land, you shall not oppress the alien. The alien who resides with you shall be to you as the citizen among you; you shall love the alien as yourself, for you were aliens in the land of Egypt: I am the Lord your God.” The injunctions for justice apply not only for the neighbors I claim, but also for those I don’t know, those who are in any sense “alien” to me.

I could pick many passages from the Minor Prophets; but perhaps those I recall most often are from Amos 5. Take verse 15: “Hate evil and love good, and establish justice in the gate; it may be that the Lord, the God of hosts, will be gracious to the remnant of Joseph.” Or, take verses 18 through 24, challenging empty religiosity and climaxing with, “But let justice roll down like waters, and righteousness like an ever-flowing stream.”

Now, as my best beloved is wont to say, one can find just about anything one would wish in Scripture. So, while these are passages that speak to me particularly about my political decisions, I’m sure I could find others; just as I’m sure someone else could find other passages to take other positions.

Still, we have been talking for almost a generation now about how Christians should apply faith and values – and for many, especially Biblical values – in making political decisions. These are some that speak particularly to me. What about you?

Grand Rounds Again

The newest edition of Grand Rounds, the carnival of medical/health care blogs, is up here, and my post is part of it. As always, I'm honored by the company I find myself in.

The Rural Doctor is hosting today, and has organized posts according to Shakespeare's "Seven Ages of Man." It's an interesting approach. Scroll through the seven ages to find another good collection of posts. I know there will be more than one you find interesting.

That First, That Hardest Step

What I remember best is her eyes as she was rolled away - so sad, so hopeless. I remember, too, how sad and powerless we felt, we who watched her go.

It was in the early '90's. I met the patient at her bedside. She was in a difficult situation: she couldn't breathe, at least not on her own. She was alert and oriented - she was all there - but she was in respiratory failure. Without the mechanical ventilator she would die.

She understood this quite well, really. She was a Registered Nurse with years of experience. She understood how sick she was. She understood what the doctors told her about her treatment and her prognosis.

All of which made it particularly important to us who cared for her when she said, "I want to stop." She tried first to say it, moving lips the rest of us tried to read. Once we thought we understood, we had her write it, holding a clipboard for her. "I don't want to live like this. I want to turn my vent off."

At the time, we in healthcare were wrestling with patient autonomy with an intensity I think we've since forgotten. Living Wills were relatively new, and uncommon. The Patient Self-determination Act was new, too, so legal standing for these documents was little understood.

Still, we wanted to follow her wishes. I don't recall anyone on staff who was arguing against doing so. Several of us talked to her, "just to be sure;" but once we were sure of her wishes and her prognosis, we were ready to do as she wished. If, after all, we are to respect the patient's autonomy, we need to respect is especially when they make decisions that we disagree or are uncomfortable with.

Which is where matters stood until the patient's daughters arrived. The daughters lived out of state; and while they loved their mother, the patient's choice of where to live and work had made it very difficult for them to be directly involved with her during her illness. When they did arrive, and learn of her decision, they were, not surprisingly, distraught.

We didn't know exactlty why they were so shocked and so resistant. There are issues that come to mind in such circumstances: guilt at lack of involvement with this illness, or for some past event that injured the relationship; differences that had grown up over the years over moral values; or even on occasion financial concerns. Often enough the parent has been distant so as to maintain independence - sometimes justified because "I don't want to be a burden to my children." As I recall, the differences of moral issues were most clearly expressed; but mostly they spoke of their shock and grief that their mother would make such a decision.

But, they were clear who had made the decision, and so they began to appeal to her. They were loud and clear and persistent. They were pleading, they said, for her life, and for the opportunity for time with her. They were her daughters. How could a mother deny them?

And in the end, she didn’t deny them. She changed her mind. Against her own sense of her quality of life, against her own sense of her values, she changed her mind. I will admit that when I think of this, my initial thought is, “She caved;” but that may perhaps be too harsh. Certainly, she acquiesced, and she made her decision, I think, less on the strength of their arguments than on the intensity of their emotions.

She changed her mind. Her daughters, with the help of social workers, found a facility to accept a transfer, a facility not far from where both of them lived. They arranged her transportation, a process made complex by her need to travel with the ventilator and the requisite professional support. They arranged it all to their satisfaction.

And not to hers. She still wanted to come off the vent, even at the cost of her life. But she had made her decision to accommodate her daughters, to continue to live with her limitations, to allow them to try to provide support and care. She had made her decision, and would live with it - literally.

Still, I remember her eyes when she left. I was there when the team arrived, and there as they went through the complicated process of disconnecting here and reconnecting there to make the transfer possible. Her daughters were there, somehow both anxious and hopeful, and happy with her decision. But she was not happy. I could see it in her eyes.

For a long time now I have been teaching about Advance Directives, the documents that might allow us to die according to our own values. I have spoken of the instructions one might put in a Health Care Treatment Directive, and of the agents one might choose to list on a Durable Power of Attorney for Health Care. I have emphasized having those documents where someone could get hold of them at 3:00 a.m. on a Sunday morning.

But what I have come to emphasize as the first step is to have the hard discussion. It is so important to discuss these concerns with those we love most, with those who will be with us in those difficult circumstances. It is important, not just to tell others what we want, but also to learn what they are willing and able to do. That may make things difficult. It may even cause disagreements on the one hand, or accommodation on the other. But it needs to happen first. It needs to happen before the documents are done, and certainly before the sickness unto death. For most of us, it is the hardest step; but for all of us it needs to be the first.

We need for those we love to know what we want, and we need to know what they can do, and we need to know before the crisis comes. I know how important that is. I can still see it in her eyes....

Owners Reps

One of the facts of my life is that I attend a lot of meetings. Most of the time most everyone in the room knows everyone else; but sometimes that’s not the case. So occasionally we go around the room introducing ourselves and saying something about our position.

The thing is, everyone in the room knows my position. Certainly, all employees to: I have my own portion of Orientation to speak about spiritual care in our hospital. But, even those who aren’t employees have some idea. I wear clericals when I work, and so everyone in the meeting has some idea of my title.

With that in mind, I decided some years ago that I wanted to come up with some title more interesting, or at least more fun, to share. I’ve introduced myself as being responsible for celestial engineering, or for metaphysical rehabilitation. However, most often I’ve introduced myself as “the owner’s rep.”

There is some logic to that. Mine is an Episcopal hospital in an Episcopal health care system. My bishop is Chair of the Board of our central hospital, and serves on the Board of the health system. He cannot attend the meeting of the Board of every institution in the system, including mine. So, I made the argument some time ago that I should attend our Board meetings on his behalf, representing him and the diocese.

And, blessedly, our leadership and staff are aware that this is an Episcopal hospital, in no small part because everyone sees me in orientation. They hear regularly, too, that the leadership of the system takes seriously that we are faith-based. So when I introduce myself as “owner’s rep,” I notice that folks laugh, but they listen.

What brought this to mind was the lessons heard not so long ago for the Fifth Sunday after Pentecost. Think, for example, about the story of Abraham. Three strangers came past his tent in the heat of the day. He offered them hospitality – shelter, food, and rest. That was, after all the custom; and for a nomadic herdsman like Abraham, strangers could mean both news and entertainment, stories of the world beyond daily experience.

At the same time, it became quite clear that these strangers were not your run-of-the-mill travelers. It became clear that they were at least owner’s reps. We may go back and forth as to whether they were messengers of God, or God himself; but we can be certain at least that they were owner’s reps. “Where is Sarah?” one said. “I’ll be back this time next year, and Sarah will have a baby on her lap!”

And Sarah laughed. She laughed, she said, uncertain how much to hope for such a blessing: “After all this time, will I really know that joy?” For, after all, those around her would have seen her barrenness not simply as sad but as cursed. And, indeed, she was embarrassed – embarrassed to have laughed and embarrassed to have hoped – so that when the stranger said, “Why did she laugh? Is anything too wonderful for God?” she denied it. But she did laugh, and knew she laughed; and when, within the next year, she indeed bore her son, she named him Isaac – “Laughter.” She laughed, but she listened; for he who spoke was clearly at least the owner’s rep.

In the same way, Jesus sent out the apostles; and when he did, he shared his authority. “Then Jesus summoned his twelve disciples and gave them authority over unclean spirits, to cast them out, and to cure every disease and every sickness.” They became the owner’s reps, sent out “to the lost children of Israel” to proclaim the presence of the Kingdom of the God they already knew. Jesus certainly prepared them for difficulty and for rejection; but he also prepared them for those who would listen, for those who would receive the apostles’ peace. And there were certainly those who did listen, listeners both human and non-human; for if Matthew does not share with us any results, the parallel telling of this episode in Luke does: the “returned with joy, saying, ‘Lord, in your name even the demons submit to us!’.” We can’t be sure whether they laughed, although surely some did; but we know they listened.

We, too, have been called to function as “owner’s reps.” We are, after all, members of the Body of Christ, called, like the Apostles, to continue carrying into the world the word that “the kingdom of heaven is at hand.” We are committed to it again and again in the Rite of Baptism. It’s all right there, especially the commitments tin the Baptismal Covenant, whether we were baptized with these words or simply repeat and affirm them at the Easter Vigil and when the Bishop visits and every time we witness someone else’s baptism. We say we will “continue in the apostles’ teaching and fellowship, in the breaking of bread, and in the prayers.” What could more directly connect us to this mission of the Apostles? We say we will, “proclaim by word and example the Good News of God in Christ.” That is, after all, what Jesus sent the Apostles to do. We embrace the mission when we pray God “Send them into the world in witness to your love.” The them is the baptized – which is to say that the them is us.

Of course, Jesus prepared the Apostles for a lot of resistance as they made their proclamation – resistance in the world, and especially resistance among those who would “hand [them] over to councils and flog [them] in their synagogues.” At the same time, he prepared them for those who would accept them, who would greet them in peace and receive the peace of the Apostles – the peace of Christ – in return.

By the same token, I know we can also expect resistance as we go out in our own time to proclaim the Gospel of Christ, to proclaim that the Kingdom is available now, and that there is peace for those who live in it. The world we live in, the time we live in, seems as little suited as any in history to peace of any sort, including the peace of Christ. It seems so focused on the daily pursuit of this fiscal and political economy as to preclude attention to any other kingdom. I am convicted, however, that if we live out our faith with authenticity, sharing the peace of Christ, others will hear in us the God whom we represent. They will see in us the acts and the authority that proclaim the presence of the Kingdom. They will receive through us the peace of Christ, and learn to share that peace with others.

All it takes is for us, by God’s grace and empowered by the Spirit, to carry out our mission: to proclaim the presence of God’s kingdom, and the love and peace that Christ offers to all who will live in it. If we will do that, they will recognize us, too, as the “owner’s reps;” and they may laugh, but they will listen.

Perhaps It Does Need Some Translation....

My Best Beloved came home from church today (she had gone to her parish, and I had supplied elsewhere), and commented, “The words of worship need to make sense to the people worshipping.”

I answered, “That’s the primary argument for periodic revision of the Prayer Book.”

“Yes,” she said, “but you wouldn’t rewrite the Psalms.” I agreed that, while the translation for the 1979 Prayer Book was original for that book, the basic text would not change. “So,” she said, “much of the language just doesn’t make sense to us. I almost lost it when I heard in the Psalm,

'1 Oh, how good and pleasant it is, *

when brethren live together in unity!

2 It is like fine oil upon the head *

that runs down upon the beard,

3 Upon the beard of Aaron, *

and runs down upon the collar of his robe.'

For Generosity to Result in Sacrifice: the Conversation Grows

It looks like others have thought of this independently, and are starting to talk about it.  Adrian Worsfield at the Pluralist has made his suggestion here.  He stimulated further reflection from Mark Harris at Preludium here.