Category: Vocation

Bridging the gap between healthcare and wellbeing #2

Photo by Jon Tyson on Unsplash

So last week we saw that the UK National Health Service, groping its way to being a Neighbourhood Health Service, is seeing the value of directing people from GP surgeries to community groups. Faith groups–and especially in the UK, Christian churches–are the main source of community groups, and they are everywhere.

In a report about all this, the Theos thinktank notes that some GP practices employ social prescribing link workers (SPLWs, because the world needs more acronyms) to make and maintain these connections. So far so good. But the people at Theos make these observations:

  1. Where there’s a high turnover of SPLWs, many of the links are lost.
  2. When SPLWs merely ‘signpost’ people to things a lot of the potency of social prescribing is lost. (This is true generally with the dread word ‘signposting’. People are often refused help by one agency or another and ‘signposted’ elsewhere. This is fine for the people who are turning people away, but not so good for the people who are being turned away). It’s much better when SPLWs get to know groups personally and also take people along to them. The personal relationships matter much more than a listing of providers.

As the report said:

..We found a number of challenges … There are communication challenges because faith and health communities use different language to talk about very similar things. It is challenging for faith groups to connect and maintain relationships with the ever-changing social prescribing system. Similarly, link workers and local health practicioners don’t kow where to go to connect with local faith groups. Furthermore, there are administrative challenges that slow processes down and a lack of funding to keep activities running. (p15)

Further, ‘one explanation for poor integration between faith groups and healthcare workers … is stretched capacity in the NHS’ (p61).

But social prescribing is a ‘thing’ and the NHS has a long term plan for every person in England to access social prescribing through their GP eventually. 1

3. While there are relatively many hospital chaplains, there are relatively few ‘GP chaplains’ and this is a missed opportunity. N0t only so, but a qualification in social prescribing takes about 5 months’ study 2. No doubt lots of people have thought of this, but a GP chaplain who was also a trained social prescriber could make themselves very useful; if they were funded by a collaboration of churches, they would be less dependent on the vicissitudes of government provision.

Obscurity

The engine of revolution.

Photo: Author’s own. ‘When you ripe fields behold’; just near our home.

‘The future is already here, it’s just not evenly distributed’ (attributed to science fiction author William Gibson). Nowhere is that more true than when you think of the subject of obscurity. Today, somewhere, some group of students or ex-students is hatching something that one day will be mainstream, part of the landscape. (Think Microsoft or Apple, which were startups one day. I believe Apple is worth more than all the FTSE 100 companies added together.)

The Christian Church has its fair share of that which is obscure becoming mainstream. Think of twelve in an upper room… or the handful of ‘enthusiasts’ called ‘Methodists’ in the early 18th century, or worldwide Pentecostalism (now 600m strong) tracing its roots back to some rustic, chaotic meetings in Los Angeles’ Azusa St or to Charles Parham’s Bible school in Kansas. Or think of Robert Morrison, early Protestant missionary to China, in 1807 having to take a ship from San Francisco because nothing from Europe was suitable, being asked by a shipping clerk, ‘So, Mr Morrison, do you expect to make an impression on the great Chinese Empire?’ ‘No sir,’ he replies, ‘I expect God will.’

The Bible mainlines on the obscure. Especially when twinned with faith. Think of the virgin Mary, a teen who believed, or Abraham, whose descendants became more numerous than the stars in the sky or the sand on the beach only because he believed what God said to him. Thousands or millions of other nomads passed into history: this one alone became revered as the father of many nations.

There is incredible romance here. I wonder if faith is largely the possession of the obscure. I wonder if there is some woman somewhere, packing her shopping in the cupboard, and then getting alone with God and trusting him for … what? a mass turning to Christ among Gen Z, for example, new churches in every town? Or some mass political change that opens a nation or a people to spiritual change? No-one will know her, but heaven will know her. The anonymous prayer-er, the unknown soldier.

Extend that even a little. What if there’s a clamour of prayer and faith rising from obscure people — as there is — day and night towards God. What if in that spray of prayer are droplets of mountain-moving faith? What if all that is shaping history as much as any of the documented historical events which (on this analysis) are merely the outworking, processed by God, of all that asking and believing, of all that straining towards heaven? There’s a hymn famous in some circles:

Wherever you ripe fields behold,
Waving to God their sheaves of gold,
Be sure some com of wheat has died,
Some saintly soul been crucified;
Someone has suffered, wept and prayed,
And fought hell’s legions undismayed. (A S Booth-Clibburn, There is no gain but by a loss.)

Ambition, its evolution and fulfilment

Still the great prize

Photo by hannah grace on Unsplash

Recently the church calendar shone its spotlight on the Presentation of Christ at the temple, and our attention was drawn to those two old codgers, Simeon and Anna, who had been separately hanging around the temple, for, like forever, waiting for the Consolation of Israel.

Then one day along come Mary and Joseph with the early-childhood Jewish routine of presenting the child at the temple. Surely Mary was a little anxious about her eight-day-old being circumcised, like nowadays when your kids have their first jabs. What if he cried? What if he didn’t stop bleeding? What if they got it wrong with the knife?

Anyhow, presumably before any knives are wielded, up jumps Simeon, followed closely by Anna, and starts prophesying. All my life I’ve been waiting for this, says Simeon. Indeed that was my life. And now I’ve seen this baby. He’s the one. I’m done here.

Which raised the question, what am I waiting for? What am I hoping for? What is yet unfulfilled? This is a question you can ask periodically through your life, with, perhaps, different answers along the way. In my case: I’ve worked as a writer all my life. I fell in love with a girl and thirty and more years later she still brightens and fills my days. We raised two wonderful children. We paid for our house and saved up, some, for our retirement. I didn’t die along the way. What more could I want?

It turns out that the more that I want is craftsmanship. I think that, and not dying yet, are my remaining ambitions. OK, those and loving people and hanging out with my wife and family and continuing to be a disciple of Jesus.

Craftsmanship: doing things beautifully and well. For better or worse, I live behind a keyboard. I inhabit a world of books and words and ideas and images. I don’t smell, like some men do, of engine oil or rural pursuits. Flakes of sawdust don’t fall from my hair. Craftsmanship for me is writing beautifully and well. And it’s still a bright shining, guiding (and maybe distant) light.

What, I wonder, about you?

Community can heal

I was gob-smacked and jaw-dropped, if you can be both, when I watched this this week:

As well as a few side-benefits – a second revolution, saving the NHS, that sort of thing – it was a glimpse into what the future could be like for all of us. And what a happy, healing place it looked like.

At root it what’s being described is, I think, an NHS GP practice in one of the most deprived areas of London, that has realized doctors only get to a fraction of illness. The rest is caused, or cured, by things like employment, education, environment and creativity.

With that realization taken seriously, what has evolved is a thriving community with an NHS medical practice (and, as it happens, a church) at its heart.

I do recommend you put this on next time you are cooking or driving or working out or something. (You don’t need to see the video and the pictures anyway add little to the story.) Instead of a clinical setting, think cafe, community, art, creativity, fun … it’s just really something.

Craftsmanship

Photo by Anne Nygård on Unsplash

Those of us who read the Bible in a year are probably deep into the Pentateuch by now, or just emerging from it. I’m not currently on a Bible-in-a-year scheme but I do now and again listen to our the audio one-year Bible that we downloaded from Audible, one of the better bargains on the site.

The passage I listened to recently was about the Israelites constructing the tabernacle in the desert. What struck me was the project scope and the ambition:

  1. The cost, all that gold, acacia wood and other precious metals and materials.
  2. The artistry, those carved cherubim above the Ark
  3. The craftsmanship: tongs, shovels, forks, basins, altars, tent-poles, curtains.

It was a national investment, costly in materials and time, built beautiful, and built to last. And it was the best they were capable of.

Every profession and trade that I can think of can be subject to loving, careful craftsmanship. Every profession and trade contains people whom other people in the same trade respect as excellent at their job.

This excellence is an option for all of us, I think. Even constrained by budgets and deadlines we can lavish craftsmanship into whatever it is we do. Even the traditional cry of newspaper journalism– I don’t want it good, I want it by 4:30— didn’t prevent journos from journalistic excellence.

Some things do get in the way of craftsmanship: bad management, for instance; repeated changes in project scope; a certain disrespect for the final customer; perhaps relentless cost-cutting; perhaps the sheer impossibility of doing a job to be proud of within the time and costs available; perhaps the pointlessness of the thing attempted. All of these things make for a mush of shoddy, of half-baked, of poorly constructed and badly finished products that we find ourselves swimming through every day.

Then we come across things that sit comfortably in the hand, that do their job perfectly, that take our breath away with their elegance, things done with great skill, and we think… beautiful.

And he carried me away in the Spirit to a mountain great and high, and showed me the Holy City, Jerusalem, coming down out of heaven from God … The glory and honour of the nations will be brought into it (Revelation 21:10, 26 NIVUK).

All the things you won’t die of

Nothing to fear here. Photo by Rostyslav Savchyn on Unsplash

‘You’ve got liver disease,’ my heart consultant said recently. ‘But you won’t die of it.’

This is a surprisingly comforting thought. Not least because you can add to it all the other things you won’t now die of:

  • Trying to land a spacecraft on Mars
  • Ballooning
  • Swimming the English Channel
  • The guillotine
  • Flying a light aircraft under a bridge
  • Being eaten alive by piranhas
  • Trying to break the world record for jumping a motorcycle over 42 double decker buses.

Really, it’s liberating. When you are a teenager, and happily raised in a land when you have some opportunity to express yourself, the possibilities are enormous. You can’t totally rule out, for example, being trampled by a herd of zebras or finding the end of hostile bayonet, or disappearing in a caving accident, or finding your attempt to cross the ocean on a giant rubber duck going horribly wrong.

It’s true that when young, if you’re lucky, all sorts of possible lives seem to present themselves, but they are accompanied by even more sorts of possible deaths.

Instead, as you ripen, with any luck or grace, you may be happy enough to find youself settling — into a life with people you love, things you love, work you love and times you love. Leaving those will be hard, and you will not want to let them go, even though some banal and workaday illness will finally prise your fingers away. But at least you found them and had them for a season, and thus perhaps, as I believe, sampled eternity.

A friend of mine

A friend of mine for more than 25 years has just died. He was a soldier, then a taxi driver, then in his final couple of years he worked at our local hospital, helping clear the rubbish from the wards and driving a vehicle than carried all this waste, snaking through the underground corridors. He struggled with health conditions all his life, a chest that wouldn’t sweep out infections, and he had been given just a few years to live when a teenager. He swallowed antibiotics every day. He sometimes swelled with arthritis until a new medication was found, and for many years plugged himself into a C-PAP machine, like a vacuum cleaner, every night.

He stayed a soldier in civilian life, gleaming shoes, immaculate taxi, always on time. For several decades he had contracts to shuttle materials between Addenbrooke’s hospital in Cambridge and the nearby Papworth Hospital, the pioneering transplant centre. The contract only ended when Papworth become the Royal Papworth and moved onto the Addenbrooke’s site. Carrying radioactive materials for transplant purposes, he never let the patients down, and took on extra work, like taking mail between departments that otherwise might miss the collections. He told me once of a girl he’d taken home from the city centre, almost too drunk to give her address, certainly too drunk and incapable to pay her fare. He took this vulnerable girl home, knocked on her door, handed her over to her father, made sure she was safe, like she was his own daughter, and went on his way.

He was the beating heart of our men’s breakfast group, instigator of our weekends away in the Lake District, organizing them himself for many years, army style, with rations allocated and he would have had us travelling in convoy if we’d let him. He sought old army friends out and welcomed them in. He loved a curry. He loved his family and quietly fought his infirmities, every day, to keep going for them. His self-medication took him hours in a morning, and yet he was early to work every day. He had an encounter with Christ almost the first time he walked into our church (his daughter was at Sunday School) and followed him faithfully ever afterwards. I love his example of an ordinary life, each ordinary day, like his shoes, burnished, gleaming with grace.

The inside-out church

Solid at the core, fluid at the edges

Reshape to renew

I don’t know where I’m going, but I’m going. Image by Marianne Aldridge from Pixabay

We were talking with a couple recently who were part of a church that had turned itself inside out. They had sold their (Baptist) church building, and moved into a community centre that was owned by a mental health charity. The charity, a non-religious outfit, had been set up to provide community-based care but were short of volunteers. The church had volunteers but no building. Bringing the two together brought two half-formed visions together. Fascinating (even if I’ve somewhat garbled the story).

Much more could be done. I have sometimes wondered if a church, instead of employing a family worker or a youth worker, could employ a professional mental health nurse. She or he could supervise lay work in the community and provide professional backing. Many community mental health needs can be met by lay people. They are often at the level of dropping in on someone for a cup of coffee, or phoning them to make sure they’ve taken their meds, or helping with cooking, shopping or budgeting. Such community concern (also known as ‘friendship’) can be transforming in the life of someone struggling alone with mental health issues.

Similarly, I am very impressed by the work of legal aid charities, who provide free legal services. Some of this work doesn’t need trained lawyers – for example helping people get justice via disability or Special Educational Needs tribunals. It just needs suitably skilled and trained volunteers. A church could easily pay a legal professional to manage a community law centre who could in turn lead a team of enthusiastic (though trained) amateurs and perhaps the odd intern.

Imagine a community legal centre or mental health centre that became a worshipping community on Sundays and the evenings!

These are all examples of churches turning themselves inside out, or perhaps more strictly, dissolving their outer structures and seeking fluidly to fit themselves to pre-existing vulnerabilities in the community. Solid at the core, fuzzy or fluid at the edges. Becoming less like bacteria and more like viruses perhaps. The churches get to do all the good they want to, the community gets served. Better, surely, than worshippers in a building, and needy people in their homes, each alone in their own way.

Why electricity is just as good as miracles

Feels better already. (This is a photo of Singapore by lee junda on Unsplash)

Again I’m writing about healing, partly because I’m living it, partly because what I picked up from many years as a Christian now seems so wrong and there is so much rethinking to do.

I’m still rethinking, and I’m still breathing, both of which I feel are important.

The last few weeks: we bought a disabled buggy, a wonderful little thing, and took it on holiday. (It folds into the car.) We were with our daughter and son-in-law and grandchildren and there was much walking on the prom and the cliff-tops, all of it now painless and easy. Nor was anyone needed to push me around in a wheelchair. And I could give the kids rides. So now in God’s riches I have an electric bike for longer journeys around Cambridge and an electric buggy for when I am with others.

Then yesterday I took the train down to my specialist heart centre in London where they retuned the pacemaker in my chest. A week or so before that, after phone calls from me, I had downloaded the pacemaker data and sent it to the hospital via a piece of kit that lives under our bed. The hospital looked at it and called me in and did the necessary reprogramming. Amazing. It is early days for this treatment but I feel less breathless and my wife tells me I am no longer blue to look at. Those guys at the hospital (both female guys as it happened) don’t just measure your ECG; they modify it and tweak it. They don’t take an ECG lying down. They press buttons and see what happens. Such fun!

This techno-assistance, though, seems a far cry from the New Testament where the Lord Jesus or the apostles did their stuff and immediate physical transformation appears to have happened. My electric buggy and the retuning of the extraordinary electronics that supply my heartbeat seem a different order of a thing to that. Why can’t (as Naaman asked) a prophet just wave his hands over me and make me well? Does this techno-medical intervention really count as ‘healing’ at all? Or is it a second-best solution for those whose lives are so cold and lacking in faith and zeal that the real healing stuff never happens to them? What is healing after all?

The New Testament contains hints that what I have heard doctors call the ‘psycho-social’ parts of healing are important, just as are the physical deliverance parts. Ten lepers were cleansed: only one came back to say thank you. Was there a lingering psycho-social unhealing among the healed lepers? Body fine, head in wrong place. Demons are driven out of the Gaderene demoniac. He is seen sitting clothed and in his right mind. But Jesus tells him to go home to his family, rather than joining the band of disciples. Is that to complete his healing? To address the pyscho-social roots of what got him in such a state in the first place? As it is, Mark records that the former demoniac takes up a speaking ministry in the Ten Towns, and Mark is silent over whether or not that was what Jesus really intended for the man. Interesting.

Then I watch friends, with a cancer diagnosis say, put their lives on hold until the treatment is completed. I observe, I think, I might be wrong (I hope I am), that they are putting all their eggs in the physical healing basket. Zap the cancer, go back to the life we had before. Nothing else matters.

I am so not so sure that this is right. (Of course I have to allow for the fact that I am sitting in my garden, at my ease, contented, writing this, not suffering some medical emergency or hospitalization which would indeed require a lot of effort and focus.)

But still. I am coming to believe more and more that healing is life today, bread today, thriving today and that it is entirely God’s business how he delivers that. All good gifts come down from the Father of lights who does not change as the shifting shadows: buggies, pacemakers, holidays, instant miraculous physical transformations, play, vocation, nice food, people you love and good relationships with God and others.

I am coming to believe more and more that healing is life today, bread today, thriving today and that it is entirely God’s business how he delivers that.

Of course, you have to qualify that idea. There are seasons of emergency actions, long wintry paths of mourning, times of brute endurance of the deeply unpleasant. It’s hard to speak of ‘thriving today’ in the face of those. But still. Healing is thriving. Healing is enjoying our lives, nourished by God’s daily bread, despite everything, in these ramshackle tents of ours, before they are replaced for good with the eternal mansions of glory.

How the Japanese live long and prosper

‘Keep busy and see friends, even over a drink or two’

The view from Yamanashi is pretty good too (credit: Pixabay)

Fascinating Economist article about Japanese efforts not just to live long but to live well, long.

(As a subtext the Economist in recent months has come to see Japan as a harbinger of all our futures and rather than being an economy to fix, they are an economy to watch as they tackle problems that many developed nations will face in coming days.)

They mention some novel ideas: a step counter on your phone that gives you discounts in shops related to how many steps you do. But then they focus on a district called Yamanashi, ‘a bucolic prefecture at the foot of Mt Fuji’ that is one of the top two prefectures for healthy life expectancy. They say this about it:

Helping people stay healthy, rather than simply alive, involves looking at broader social and environmental considerations. Jobs are essential. Working longer keeps people physically and mentally active, but also keeps them connected to others. Yamanashi has the second-highest elderly-employment rate in the country.

Social networks—the real-world kind—play a big role, too. Strong ties with friends, family and neighbours make for better mental health, more active lifestyles and better support. Investments such as upgrading cultural facilities or creating mobile libraries to serve remote communities may not appear to be health-related, but can benefit public health, says Kondo Naoki of the University of Tokyo.

In Yamanashi, many public-health specialists point to mujin, traditional local microcredit associations which have evolved into something more like social clubs. Members chip in funds for regular gatherings, often over noodles and sake (some prefer tea or mah-jong). Mr Kondo’s longterm studies have found that those who participate actively in mujin stay healthier for longer, even when controlling for wealth and other variables. The group activity offers a sense of purpose, and also acts as an informal safety mechanism, with other members noticing when someone is absent or looking worse than the previous month. “Being lonely is most detrimental to health,” says Nagasaki Kotaro, Yamanashi’s governor, who recently started offering subsidies for mujin. The secret to a healthy life, then, is similar to a happy one: keeping busy and regularly seeing friends, even over a drink or two

Economist, February 4 2022

It’s lovely they get to the same conclusions as I did in Bread: networking and vocation being the very stuff of life. Makes me think there might be something in them.