Health Care Access: Two Stories

health care handsHealth insurance exchanges launch next week.  To honor the occasion, a couple stories feel like they need to be told.  One was a story I heard on NPR about a Yale University professor.  She cut her hand in a freak accident when cleaning a glass bowl.  She told the Yale hospital emergency room physician treating her that she was a knitter, and that fine motor control was important to her.  He assured her he knew what he was doing and she would be fine.  Unexpectedly, one of her students interning in the emergency room happened by and exclaimed, “Professor, what are you doing here?”  Her attending physician stood rigid.  “You’re a Yale professor?” he asked.  When she affirmed she was, he stopped and called in a surgical hand specialist.

Moral of the story:  We don’t have equal access to health care.  Even the affluent.

The other story I heard last night in jail.  An inmate was a passenger in a car wreck six months ago.  She was rushed to the nearest emergency room where surgeons operated on her right hand.  She needed more surgery, but she didn’t have insurance.  The day after the accident, doctors amputated mid-forearm.  The following day, she was discharged with 30 pain pills.

Nothing hurls someone recovering from addiction into relapse like fresh trauma.  That’s the arc of this story.  Traumatized by the accident and in excruciating pain, she turned to drugs.  She was arrested on a drug charge two months later.  It was in jail that her cast, bandages and stitches were removed, revealing her stump to her for the first time.  She shed a grateful tear when describing the officers’ care for her in jail.

Moral of the story:  We don’t have equal access to health care.  Especially the uninsured.

Lest we be tempted to disregard this as an isolated case affecting only the poorest, let’s look at the numbers.  It’s a sad fact that Texas inmates receive better health care than the 26% of Texans who lack insurance.  Uninsured Texans outnumber the entire population of Yale’s home state, Connecticut, by a factor of almost 2.  One in 4 Texans could reasonably expect this level of care.  Only because the woman became incarcerated did a caseworker recognize her need for additional medical care, trauma counseling and rehabilitation to help her learn things like writing with her left hand, buttoning her pants, and slicing a bell pepper.

That’s a bright spot, I guess, but I have to add, time and time again I see people in jail who wouldn’t be there if they had access to health or mental health care.  The lack of access puts a terrible strain on jails, to speak nothing of the strain on people falling through the cracks and landing in jail.  And for the cold hearted out there unmoved by the human toll (you know who you are), our de facto jail-as-a-last-resort system costs taxpayers more than access to appropriate care in the first place.  Would a surgical hand specialist have saved this woman’s hand?  I don’t know.  What I do know is recovery in jail costs more than recovery at home, and now she qualifies for disability for the rest of her life.

Access to health care will never be equal.  Some will always have more.  I don’t begrudge them that.  Here’s the salient point: starting next week, no one else has to live this inmate’s story.  That’s a relief.

Join the conversation.  Where do you draw the line between a person’s responsibility for his own health and our responsibility for each other?

Copyright 2013 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

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Spiritual Maintenance

It takes spiritual maturity to recognize dependence on God when things are going well—either before we hit rock bottom or after salvaging life from a broken place.  When we have been saved from that broken place, and when we have experienced some healing and perhaps some spiritual growth, embracing redemption means leaving the past in the past.  We can look inward to see if we are being called to further life change without rehashing the past.  Introspection can focus less on one’s past and more on one’s present relationship with God.

A regular practice of inner inventory will keep us moving from intellectual awareness into action.  Many spiritual traditions rely on introspection to keep us from settling into a comfortable rut.  The Catholic tradition has a practice of confessing weekly before celebrating mass.  Early Buddhist texts indicate monks confessed individual faults to a superior privately twice a month at the full and new moons.   Jews observe Yom Kippur, or Day of Atonement, annually with prayers of confession spoken aloud in community.  Outside of ancient religious traditions, Twelve Step addiction recovery programs rely on the power of introspection in the Fourth Step, searching and fearless moral inventory, but also as an ongoing practice.  The Tenth Step calls for frequent inventory in order to make prompt amends.

What is the optimal interval?  It’s individual, of course.  Some Twelve step recovery programs encourage nightly examination.  Several protestant traditions incorporate weekly confession into Eucharistic prayers.  When we look at our challenges with a daily or a weekly focal length, however, we can overlook patterns.  Most of us have to step back from what occupies us day-to-day and week-to-week to discern the major themes at work in our present journey.

Jewish and some liturgical Christian traditions also give a framework for annual self-examination with Yom Kippur and Lent.  For a truly searching and fearless moral inventory of the patterns in my life, I find that a yearly interval is practical.  Embracing your own new life alongside others in your faith community can intensify the experience.  Traditional symbolism can deepen meaning as well.  Alternatively, confessing annually on the anniversary of a first confession or, in the case of addiction recovery seekers, the anniversary of one’s last drink may have special meaning.

An American commentator (and I am hopeful an alert reader will remind me of which one) drew the analogy that a white fence grows black over time unless it is repainted every year.  We, too, are in need of spiritual maintenance at intervals.

Join the conversation.  How do you know whether you need spiritual maintenance if you don’t stop to look?

Copyright 2012 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

Spiritual But Not Religious: Meet Me Where I Am

Growing public discussion about the decline of religion, and Christianity in particular, highlights to my mind many things that the Twelve Steps of Alcoholics Anonymous do right.

Most poignant, perhaps, is that no one is left out.  There are no excluded or castigated groups.  Everyone is accepted as they are.  Christians may be thinking, “Gee, that sounds a lot like Jesus,” but serious observers of religion know that every Christian era has had its pariahs.  The Twelve Step tradition meets people where they are, no matter how despicable or lowly that place may be.  It doesn’t tell anyone what they must believe to be included.  Rather, it simply encourages openness to spiritual possibility.  It says, “Healing is possible if you’re willing to reach for it.  Here are steps that worked for us.”

The huge irony is some of those most in need of saving grace want nothing to do with God.  They’re mad.  So mad, they ignore his presence whenever possible, and failing that, they face God with seething resentment.  “I was an innocent child!  How could you unleash unspeakable abuse against an innocent?  What kind of almighty monster are you?”  The incidence of childhood trauma among substance abusers has tragic proportions.  Is it not logical that, if healing proves elusive, one might at least find an anesthetic within reach?

The Alcoholics Anonymous founders were sensitive to this spiritual hostility, namely because they were agnostic at the beginning of their journeys to recovery, and they didn’t want to discourage other alcoholics from beginning the steps.  “We find that no one need have difficulty with the spirituality of the program. Willingness, honesty and open mindedness are the essentials of recovery. But these are indispensable.”  They knew what looks preposterous at the journey’s beginning morphs into profound truth after spiritual awakening.  The Twelve Steps don’t foist the unbelievable on the unbelieving.

For the sake of inclusion, most Twelve Step programs recognize God across many faith traditions, and many interpretations of God are respected.  The “higher power” can be understood as the consciousness of the fellowship, in that the group consciousness may offer recovery seekers some power to do what they cannot do on their own.  Others find the higher power in nature, a la Mother Earth and Father Sky.

Religious traditions coalesce around common experience and belief.  Some are rigid about belief, behavior and belonging while a precious few treasure the richness of their diversity.  It seems to me that some of the ancient religious institutions experiencing a decline (moral, cultural, financial….pick a category) could learn something from the Twelve Steps.  The steps recognize addiction as a spiritual malady at its root, and thus they invite spiritual growth and intimacy with God.  Isn’t that also the aim of religion?  Or at least, isn’t that what religion purports its aim to be?  While the Twelve Step tradition goes to great lengths to avoid dictating beliefs, it goes to equal lengths to encourage people to expose their lives to the transformational power of God, however they might experience that.

Join the conversation.  What could your house of worship learn from the Twelve Steps?

Copyright 2012 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

Fourth and Fifth Step Healing

“The First Step was easy.  If I’ve gotta do all twelve, then the Second and Third can go pretty quick too, whatever they mean.  But Step Four, that’s where the real work starts.”  The Fourth Step is a searching and fearless moral inventory, and the Fifth Step is admitting aloud the exact nature of one’s wrongs to another human being and to God.

I asked one recovery seeker about his biggest obstacle starting the Fourth Step, and he laughed, “The Fourth Step dread that formed instantaneously the very first time I laid eyes on the Twelve Steps!”  Another recovery seeker, focusing on the quickest possible cure, bought one Twelve Step guide and did the first three steps, but the guide didn’t provide a simple prescription for the Fourth Step.  He bought a second book and did the same.  Disappointed in how the second book approached the Fourth Step, he got a third book.  After repeated disappointment, he realized there was no quick Fourth Step answer.  It had to come from within himself, not from a guide.

Both responses are utterly human.  This blog’s regulars will recall the fable of Sufi Mullah Nasruddin and his house key.  Nasruddin searches frantically for the key to his house outside under a lamp post.  His neighbors come to his aid, and after hours of searching, one asks where he was when he lost the key.  Nasruddin replies he lost it in his house. The neighbor asks, “Why are you looking outside?” Nasruddin responds, “Because the light is better out here under the lamp.”

Like Nasruddin, we find it infinitely easier to analyze external conditions than to take a candid look inward.  Healing, however, requires us to leave the light of the lamp post and to go deep into the darkness of our own houses.  What impedes our journey is less fear of what anyone else will think of us than fear of what introspection will bring to light for ourselves.  As we embark on introspection, the prospect of facing our less than best moments is uncomfortable.  For those who suspect that they won’t like (or can’t live with) the person they find, it is terrifying.  If I have negotiated an uneasy peace with my past, introspection might feel like opening Pandora’s box.

Some report the work of introspection, although painful and exhausting, to be cathartic.  They want to get the ugly secrets they have been hiding exposed to the light of day.  Where the Fourth Step can feel cathartic, the Fifth Step can be intensely emotional.  “Acknowledged in AA literature as one of the most difficult steps to take (and one often avoided), the Fifth Step is also one of the most necessary to long term sobriety and genuine peace of mind,” observes one Twelve Step guide. The guide quotes a life-long Roman Catholic, a priest who had experienced the religious sacrament of confession innumerable times, about his experience of confession in the Fifth Step:

In retrospect, I associate it with a turning point in my life: an experience of inner healing, an event that revealed to me a loving God who had always been so near and yet so far.

Join the Conversation.  Which of the Twelve Steps do you think is hardest?

Copyright 2012 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

Spiritual Steps to Life Change

Easter celebrations bring an end to Lent, a season many Christians observe with contemplation and disciplines designed to prepare ourselves for the newness of life that Christ’s resurrection promises to all who surrender themselves to God.  A relatively small subset of Christians practice introspection and confession in particular as powerful steps toward making needed course corrections in life.

In contrast to ancient religious practices, another influential and well-established tradition offers a more contemporary take on practices for finding life change and spiritual awakening.  The tradition is spiritual but not religious, and celebrated Franciscan priest and author Richard Rohr describes it as “America’s most significant and authentic contribution to the history of spirituality.”  It is the Twelve Step tradition pioneered by Alcoholics Anonymous.

Every year, millions of Twelve Step recovery seekers embark on a searching and fearless moral inventory and admit their wrongs aloud to God and another human being as essential steps towards profound life change.  What do these recovery seekers know about spiritual transformation that millions of religious seekers don’t?  A lot, as it turns out.

First is that life change starts with recognizing the limits of our own power.  Consider the difference between a religious seeker who approaches introspection believing he had the power to make better choices (but simply chose not to) and a Twelve Step seeker who acknowledges that his defects of character took away his power to make better choices.  Although we can find a false sense of security in our own power, it leads us towards unrealistic expectations for ourselves (and unwarranted derision).

The second thing Twelve Step recovery seekers know is that life change is possible but only with God’s power.  Some religious seekers don’t really believe in the transformation that is being offered to them, or they walk away from confession unchanged but determined to make better choices in the future without genuinely depending on God’s power to make them.  Acknowledging that God has this power, that we don’t have to change through sheer force of will alone, is the kernel of hope for healing.

The third thing recovery seekers know is that we have to create a power vacuum in order to make space for God’s power to enter, and that actually relying on God’s power instead of will power is incredibly difficult.  Relying on one’s own will is easy.  I want what I want, after all.  Being demanding or strong-willed about what I want takes little strength of character.  Laying down my will, conversely, takes enormous spiritual strength.  Religious seekers sometimes approach God in search of a little auxiliary power without taking the difficult step of creating the power vacuum.  They may want God to be almighty, but on their terms.

These three truths align to the first three steps of the Twelve Steps.  Like the first three, the remaining steps outline a path to healing, life change and spiritual awakening that is much more specific and instructive than much of what religious doctrine offers.

Join the conversation.  Do you think God cares or do you actually trust God’s care?

Copyright 2012 Stephanie Walker All rights reserved. Visit www.AcrossTraditions.com.

Engine Conversion: No Hybrids in Heaven

How do we respond to the gift of salvation?  We respond by living in a completely new way.  I’m not talking about a conversion from one faith tradition to another but rather a transformation of inner motives and values that drive all of our actions.  

Although we wish it not to be so, the motive conversion is binary.  It is like a car engine.  It either runs on gasoline or on an electric cell.  We are driven either by the grace of God or by earthly stuff.   We are running on recovery fuel or relapse fuel.  We can’t be motivated by both at the same time.  Many of us want to be hybrids, running mainly on gasoline but occasionally going electric to get better mileage.  Or we want the outward manifestations of change without doing the inner work.  Slightly better is not what God pines for.  He’s not in it for the outward appearance, either.  He wants our whole hearts without restraint as a reciprocal response to what he gives us of himself.  If we seek true healing and life change, we need nothing less than a spiritual conversion. 

Scripture testifies to the disconcerting truth that we cannot orient ourselves around both grace and worldly things, and that if we orient ourselves to worldly things we can expect conflict to result.

1Those conflicts and disputes among you, where do they come from? Do they not come from your cravings that are at war within you? 2You want something and do not have it; so you commit murder. And you covet something and cannot obtain it; so you engage in disputes and conflicts. You do not have, because you do not ask. 3You ask and do not receive, because you ask wrongly, in order to spend what you get on your pleasures. 4Adulterers! Do you not know that friendship with the world is enmity with God? Therefore whoever wishes to be a friend of the world becomes an enemy of God. (James 4:1-4) 

When pondering grace versus worldly things as fuel, those of us among the 5% of Earth’s population who reside in North America—consuming 25% of Earth’s energy and eating enough extra calories every day to feed an additional 80 million people—can’t escape confronting our abundance.  While 925 million people in the world do not have enough to eat, making hunger and malnutrition the number one risk to health worldwide, the leading health risk to the poor in the United States is obesity.  It is indeed the  land of plenty. 

How we respond internally to the abundance around us informs what we do externally with our resources.  Both matter.  “From everyone to whom much has been given, much will be required; and from one to whom much has been entrusted, even more will be demanded.” (Luke 12:48)  Are we humbled by the abundance of opportunity and reward, wondering what on earth could be expected of us that would in any way measure to the abundance before us?  Or have we grown so accustomed to worldly things that we feel entitled to them and, in fact, want more?  Our response reflects what fuels our souls.

Join the conversation.  What did you watch on TV last night, and what fuelled that choice? 

Copyright 2011 Stephanie Walker All rights reserved.  Visit www.AcrossTraditions.com.

Emptiness

How many of us have asked, “Is this all there is?”  We burn the candle at both ends with work commitments, volunteer commitments and family commitments (sometimes in that order), and on top of that we work hard to schedule time for ourselves, for exercise and for entertainment.  Weeks dissolve into months, and at the end of it we’re exhausted and perhaps overwhelmed by the multiple simultaneous sound tracks creating noise in our heads.  We feel like there has to be more in life, but in reality, there is already too much. 

How can we step off the treadmill and find more meaning with less doing?  Many traditions embrace the idea of emptiness—both emptying the mind to encounter the soul and, more especially, emptying oneself of one way of being to make space for a new way of becoming.  There is a Jewish saying  that you can’t pour into a full cup.  “Islam” translates roughly to “surrender.”  Eastern traditions employ several meditation practices to transcend self.  Even in nature many things cease to be one thing in order to become something else.  A seed ceases being a seed in order to become a tree.  Emptiness may hurt, but it is also our best hope for the healing and life change we seek. 

Recent posts explored what it means to rely on God-help rather than self-help when seeking life change and renewal.  The Twelve Step addiction recovery tradition offers special wisdom on this point.  Recovery seekers know that one has to create a power vacuum in order to make space for God’s power to enter.  They recognize this wisdom as the Third Step, or making “a decision to turn our will and our lives over to the care of God as we understood Him.” 

As logical as this emptying sounds, it is incredibly difficult to do.  We can become deathly attached to our own desires.  Pharaoh is the Bible’s biggest loser.  He was willing to endure any number of plagues and to lose everything rather than doing a Third Step.  When talking about surrendering our earthly desires, attachments and plans to make space for God’s power and care in a Third Step, recovery seekers invariably talk of “taking it back” at some point in the journey. 

At least recovery seekers recognize that it’s either God’s will or their own will in the driver’s seat.  Many religious seekers hope for a little auxiliary God-help without taking the difficult step of surrendering their own will.  Sometimes we want God to be almighty on our terms. 

Join the conversation.  What practices help you empty yourself and surrender your will?

Copyright 2011 Stephanie Walker All rights reserved.  Visit www.AcrossTraditions.com.