Look at this from Private Eye‘s wonderful ‘MD’ (aka Dr Phil Hammond) (15-28 October 2021 p 8)
The model of general practice – trying to manage multiple complex risks and needs in very brief encounters – has long been unsafe and unsustainable. You have 10 minutes to help an 80-year-old woman who is arthritic, breathless, recently bereaved and on 12 tablets. It takes three of those minutes to walk her from waiting room to consulting room.She wants to talk about her late husband; you want to ensure her breathlessness was not a red flag for a life-threatening condition or a side effect of the pills you have prescribed.
It takes another three minutes to undress her and get her up on the couch to be examined. And yet her main reason for coming was loneliness.
A study of Norwegian health records, published in the British Journal of General Practice, found that — compared with a one-year patient-GP relationship — those who had had the same doctor for between two and three years were about 13 percent less likely to need out-of-hours care, 12 percent less likely to be admitted to hospital, and 8 percent less likely to die that year. After 15 years, the figures were 30 percent, 28 percent and 25 percent.
Healthcare depends crucially on relationships, and staff knowing and understanding you.
Imagine a GP being resourced enough to combine a vocation as a doctor with the time and stability to develop relationships with patients. Vocation and relationships … just like in a book I recently wrote, which I may have occasionally mentioned in this blog. And which is still ‘forthcoming’…
Just a single statistic caught my interest recently. In the early 1970s, traded goods were about 30% of world output. So, two-thirds of goods were made and used locally. In the early 2010s, that traded-goods figure had risen to 60%, meaning two thirds of goods were made elsewhere and shipped to where they were needed.1 Locked away in that little statistic, maybe, is loss and sorrow and Brexit and Trump and populism and nationalism.
When I was growing up in 1970s England, to see ‘MADE IN ENGLAND’ stamped on a thing was a thing. And it was everywhere. Slowly that ended. Now, the handtools and toys we buy are mostly made in China. This expansion of trade has brought prosperity to much of the world and cheap prices and more and better stuff.
But in the (thankfully) now past agonies over Brexit in our country, I observed nostalgia and loss over the way we don’t make our own stuff any more. It may be that that sense of loss has driven populist or nationalist politics all over the former stuff-making regions of the earth. In it is a hint of gaining the whole world (the free trade economists were right) but losing our soul.
Then I look at things editors pick as good news stories. Building windfarms the size of Yorkshire in the North Sea, for example. People who build and repair windfarms spend weeks on ships, climb creaking columns in gales, replace sprockets, rehang blades, loosen corroded big-end bearings — I don’t know what they do — but it is hard physical work to be proud of. Or someone else, further down the coast, is growing herbs in a vertical farm.
These are good news stories because they are about people saving the earth, but they are also hands-on, tiring, providing for your local community, reducing our dependence on others and fostering independence and self-sufficiency and they feel good.
Kind of like finding your soul again. Interesting.
If you’ve been with me over the summer, you’ll have seen that this book is about how adversity and suffering can change your life for the better. Better still, you can change your life for the better without the adversity and suffering (by reading the book). Suffering makes you realistic about you are — strips you down, perhaps. But two things can then build you up. Belonging — the art of belonging — is one (see last week). The second is vocation — doing something beautiful. Which is what this extract is all about.
My search for what really matters (8)
Don’t die with your music inside you
Vocation is about intentionally not dying with your music still inside you.
I was very ill when I first came across this thought and it was galvanizing. Since ‘galvanizing’ means ‘using electricity to coat something with zinc’, it wasn’t literally galvanizing, but it was a lifeline in the forever-January experience of convalescence. Then, and since, the idea of vocation has lit something in me that helped me fight to be well and stay well.
Don’t die with your music still inside you. Ask yourself. Other things being equal, feet still roughly on the floor, need for realism acknowledged, what would you love to do? I love asking this question of people. What gives you energy? What is fulfilling? What do you love? What would frustrate you if it were never let out? A famous theologian described vocation as the meeting point between ‘your deep gladness’ and ‘the world’s deep need’. Where does that sit for you?
I hesitate to give it an upmarket name like ‘vocation’ because for some people it means cheerfully and faithfully doing ordinary things. For others, though, it might seem a long way from what they are now and you would never guess it. A person with a career in software wants to turn wood. A researcher would like to be a receptionist in a hospice. Others have found a love of counselling. I know a couple of people who find sanity and happiness through making time to paint. I know that in horrible places of infirmity I have been buoyed by the thought of writing something original, creative and quirky. This is vocation knocking: the chance to take something that belongs to you, and to give it out. Breathe deeply of it, and you oxygenate your soul.
Vocation has designed cathedrals that will last a thousand years and spun melodies that the world will sing forever. It has squeezed goodness and grace out of places where only the banal should exist. Vocation is God’s fingertips brushing the earth through the actions of people. And when we live out our vocation we furnish our lives with satisfaction and happiness. Vocation is bread for the hungry soul, a satisfying meal.
I love watching people in their vocation. Someone came to our home to do some carpentry. His first love was restoring antique furniture. His eyes lit on our dining chairs, things that had tumbled to us down through our family as heirlooms. He knew which 19th century decade they were built in and named the style. He told us what he could do to them if he had them in his workshop for few days.
My son and I both have physics degrees. My physics degree helped me to ascend a few small hills and look across at mountain peaks of human thought. My son, though, climbs these peaks for fun. He knows how partial differential equations work, for example. He understands Maxwell’s equations, beautiful things that describe all of classical electromagnetism. I see him in a team experimenting on lone atomic particles that are in near-perfect vacuum and nearly at absolute zero. Even as a child he loved maths problems.
You stumble into vocation all the time. You wander into an office and find people who have time for you and all the resources you need. Someone bakes you a wonderful cake. You see a mum organizing her children or a teacher with her class interested and working hard and happy or arguing furiously with each other about finer points of maths.
Fine, you may say, but a vocation is a bit of a luxury if you’re a single parent just holding everything together or someone already buckling under the strain of just earning enough, or you are battling pain and depression, or you are in a toxic workplace, or you are retired. I am not so sure that you are right. For these reasons:
Thinking about vocation at least enables you to set a direction for where you’d like to go and what you’d like to be.
It probably also points to something you’re quite good at.
It points you to a higher ambition for your work than just as a vehicle to being solvent or (worse) rich, respected or lauded. These false gods shrivel your soul. Vocation nourishes it.
Even if you don’t change career, thinking about the work you love may change how you spend some of the odd scraps of time you already have. If you can’t be a professional musician or artist or footballer, be an amateur one. It still will feed your soul. Who knows where these small beginnings will lead? Take a step.
Change to your current circumstances might not be as impossible as you think. If, God forbid, you got a serious illness, or a divorce, you would change things around fast enough. Emails and schedules that tower above you now wouldn’t look that way then. They don’t matter so much really. The world won’t stop even if you stop. If you died tomorrow, someone would fix all the emails or finish the jobs. But that thing which is you, that thing you can give to the world, no-one else can do that like you do it.
Negotiate a compromise between vocation and career. This is why artists become graphic designers or would-be session musicians become tutors, or novelists get paid as journalists. Wiggle a little.
Remember life has seasons. The pages turn. Kids grow up. Debts get paid down. The rush to complete qualifications passes. Workplaces change. If your life is a busy river, abuzz with boats and criss-crossed with bridges, so hooting with shipping that you can’t take it all in, it may not stay that way. This river will probably evolve into something fat and lazy as it nears the sea, weaving slowly through the bulrushes like a jazz solo. Maybe your vocation awaits a new season. But start it now.
Your vocation is your chance to be big, beautiful you. Do you really want to miss this? So take some steps. Do something. Do something. Don’t die without giving us a song.
Here’s some aspirational stuff on what the Christian faith can do for those of us who work with others. This is fromKatherine Alsdorf who herself used to work with Tim Keller’s Redeemer Church in New York, and co-authored a book with him.
If we as the people of faith can work with purpose, partnering with God in his love and care for the world, if we can admit our mistakes more readily because we experience God’s grace, if we can love others and serve them because we’ve been loved and served, if we can find hope that helps us persevere because we believe in his kingdom that will end all brokenness and wipe away every tear, then, I think the faith and work movement will be the forefront of evangelism.
Are you jealous of your coworker? The gospel can change that. Do you fear that you’ll fail at what you’re doing? How does the gospel calm your fear? Are you having trouble getting up in the morning to face work? Or trouble stopping work in order to rest. As a matter of fact, work is a bit of an idol factory. It leads us to overvalue success or money or security or recognition or comfort. And the gospel helps us to root out those idols and turn to Jesus for our salvation. And when we do that, we change. Our hearts change. I love it. I love it when it happens to me and when I see it in others. I see people change from hating to loving their colleagues, from fearing failure to stepping out in faith. This gives a good start in applying the gospel to work and our work lives.
‘The one thing that can keep communities alive and health services viable.’
I am one of those who has enjoyed the pandemic journalism of Private Eye’s ‘MD’ who being both a practising doctor and a human being can understand and communicate stuff that journos (who often lack the right number of degrees) and politicians (who might be a bit detached from the truth) may not be so hot on. In pandemic-world, I think, journos and politicians are both talking about face-covering while actually attempting to cover something else, and I don’t mean the story.
So. MD (real name Phil Hammond apparently) on health in this week’s Eye (I mean the week I am writing this blog, which is about two weeks behind you reading it. I don’t blame you for this. It’s hard to ask readers to read stuff that hasn’t been published yet.)
The basic ingredients of health are well-known, well-evidenced and fairly easily remembered using the mnemonic CLANGERS, as in: Connect; Learn; (be) Active; Notice; Give back; Eat well; Relax; Sleep.
Friendship and a feeling of belonging; an ability and curiousity to learn and adapt; purposeful physical and mental activity; observation and appreciation of the environment; compassion for others; food that is both delicious and nutritious; an ability to switch off and relax and regular, restorative sleep — collectively these daily joys of health are more powerful than any drug. The privileged can do them every day, even in lockdown. If we all managed them, we would barely need the NHS. But if you’re living with debt, discrimination, depression, domestic abuse, drug addiction, dementia, etc, they are much harder to achieve.
The focus on prevention, helping others and lifestyle medicine is a lot cheaper and more enjoyable than medicating for diabetes and depression. Indeed it’s the one thing that can keep communities alive and health services viable.
MD has put some of his wisdom into a cheery YouTube video just here:
And if you are a regular reader of MD you can parenthetically notice that writers are often different in person than they are on paper, often gentler, as here.
The solution to weariness and world-weariness, it seems, is not ‘no work’ but the right work. ‘Come to me’ says Jesus, if you are weighed down and tired out by the loads you’re carrying, and I will give you ‘rest.’ But the ‘rest’ he offered was a ‘yoke’. (He must have raised an eyebrow or two when people heard this. Mostly the word ‘yoke’ is about slavery.) But Jesus redefines his yoke as ‘easy’ or ‘kind’ or ‘kindly’ and the burden he asks us to bear is lightweight, a non-burdensome burden, like a day-sack rather than a full pack.
The ‘rest’ is a yoke. This speaks so strongly to the idea of vocation. We all have seen examples of when someone gets a job and it is exactly the job they always wanted. Or it is, at least, quite near to being the job or role they always wanted. They wake up, look around at the day, and feel happy. Mostly. Circumstances have aligned well for them. This is so freeing and brings such contentment.
It’s also makes us re-evaluate things like ‘rest’ or ‘retirement.’ Real rest is an easy yoke, a harness but not a heavy one, a work that suits, a work that to us, seems easy and light. It would seem.
A lesson on self-isolation from the Cappadocian Fathers
I am reading a book called Trinity by Roger Forster. Forster, bearded, successful early, kinda trendy, around forever, is the evangelical equivalent of Richard Branson. A little bit anyway.
Forster points out so helpfully that the classical Greek view of God–thanks Aristotle–was that because he was perfect, he couldn’t change.1 Being the Uncaused Cause, on that analysis, made you like a classic sculpture: a perfect 10, but made of marble.
Forster–whose learning is impressive even if he veers around a little like a car with a puncture–compares this cold Greek slab with the God of the Cappadocian Fathers. They joined a fourth-century theological ruck alongside Athanasius, pushing back the Arian heresy and making sure a trinitarian God was a mark of orthodox Christianity. Forster writes: ‘The doctrine of the the trinity is truly important because God is personal, He is communal, He is loving, He is altruistic – and He is all of those things forever and ever.’2
It so happens the Cappadocian Fathers were themselves a trinity: Basil of Cesarea; his younger brother Gregory of Nyssa; and their big friend Gregory Nazianzus.
They were an example of inspired and super-smart Christians fighting the mighty Greeks on their home ground–a battle which, a thousand years later, people we now know as scientists had also to do: people like the devout Johannes Kepler, who freed natural science from its Grecian obsession with the perfectly circular.
The Cappadocian Fathers saw the Trinity as a kind of dance: as Forster says, ‘where the partners move around one another, each giving way to the other and then changing the direction, or changing the lead, but each one always in perfect symphony and synchrony.’3. Their word for this was perichoresis, which is a word I look forward to you using when you next see a dance routine.
It is a lovely picture though: God interdependent in his self-sufficiency. No wonder, then, that the creation that sprang out of the divine bosom, if we believe it, was itself a perichoresis of mutual service and supply. We breathe out; plants breathe in. Male and female he created them. We are one body, with many members. Perichoresis is everywhere. Which is why human thriving is not centred on achieving alone but on belonging and contributing.
Here’s the Apostle Paul: brilliant, intense, battered. Gnarly. Well-travelled, and when imprisoned, sending letters instead of sending himself. Eventually executed.
What happened to the letters he left behind? Surely people kept them. And some copied them. Some enterprising people probably wrote to other churches and asked for the copies they’d also collected. Maybe some people took a set with them when they travelled, so they could share it with other churches they met. Slowly, by hand-copying, collections built up. It must have happened by word-of-mouth. People knew spiritual treasure and kept it and shared it.
FF Bruce writes:
We know, for example, that about the year 95 the cupboard somewhere in Rome which was the Vatican library of that date contained not only Paul’s letter to the Romans (as we should expect in any case) but also copies of his first letter to the Corinthians and (possibly) one or two others. It also contained copies of the Epistle to the Hebrews, which had a close association with Rome, of the First Epistle of Peter, which was written from Rome, and of some Gospel writings, not to mention the Greek version of the Old Testament commonly called the Septuagint.1
In the analysis by FF Bruce, the same happened with gospels: Mark’s in Rome, Matthew’s in Syria, John’s in Ephesus, Luke’s perhaps already designed for wide circulation. Eventually a four-fold gospel was circulating, as were collections of letters, and Luke-Acts could be split and Acts used to connect the four-fold gospel with the letters of Paul and others.
In this way, the New Testament was formed, a word-of-mouth collection that, sifted by all the Christians who were using both it and other documents, gained traction.
Later developments caused church leaders to codify what was already on the ground. And so the New Testament came into being in a similar way to an Amazon bestseller list. People left writings, the Christian community used them, or didn’t. Then add a dash of politics and you have a New Testament. And Paul’s letters, after his lonely execution, took hold, and now no hour passes in the world without multitudes reading and pondering Paul. By any measures of publishing success, Paul is the greatest and most successful writer ever to scratch ink on papyrus. ‘See what large letters I write with my own hand’.
This is so different from seeking to build a following through advertising, free offers, campaigns, special deals, commendations. Just pour your life out, be faithful to your heavenly vision, and let God and the future generations do the rest.
I’ve just returned from four days of investigations at a hospital, trying to see if I’m a candidate for a heart transplant. I also talked to other patients on my hospital corridor, who have walked farther down the trail of suffering and patience than I have ever ventured. This is the second time I’ve gone through this exercise and I have come home with my head rather full, and the introvert’s need to sit at home for a long time and think about it all.
Somewhere in all that, I asked the question, What am I for?
Trying to answer that doesn’t involve me attempting to respond objectively and rigorously, even if I had the equipment or the courage, which I don’t. Instead, that question is a prompt to motivations and perhaps to temperament or psychological health. Another way of framing the same question is something like how do I feel about going on living? Or how much do I want to continue to exist and contribute?
There’s an answer to this around the idea of knowing and glorifying Christ, and that is my answer too, there is no meaning outside of him, but within that general answer there must be specific route-maps for each person. The tug of love, pulling us to go on living for someone else’s sake or some others’ sake is certainly a huge component of the vector.
I find another part though. I want to make beautiful things. In my world, this has to mean writing, and it has to mean writing something that someone reads, five minutes from now, or five weeks, or even five centuries, and that person’s thoughts and mine connect over all that distance, and the thing that has lit me up lights them up too.
I wonder if this isn’t the impulse behind all art, both the tawdry and the epic, and perhaps lots else too. Make something beautiful. Add to the stock of our herd’s insights, creativity, beauty and overall wealth. I’ve often envied a musician’s ability to dream up a melody that previously didn’t exist but that the whole world comes to know and indeed may even continue to know until the end of time. Think Hey Jude or Beethoven’s setting of Schiller’s poem in his Ninth Symphony. Using words to combine thoughts in attractive forms is a micro-scale enterprise compared with that, and I do not say I am good at it, but it is what I have.
The Christian hope for history is the fulfilment of all things and one of the pictures is the New Jerusalem, the city of God, the fulfilled human community, lit up by the light of God’s face. A feature of the New Jerusalem is that its gates are always open. Nothing evil or mean or superficial is allowed in but what does flow in is the wealth of the nations, the baking and the architecture and the engineering and the melodies and the elegant theories and the eloquent art. The patiently and lovingly constructed treasures, dusted as they are – as they must be- with sprinkles of divine pleasure. What am I for? A piece of that.
I think Paul saw it too, when he wrote about ‘Gentiles, who do not have the law, do by nature (or naturally) what the law requires…’ 1.
These are people who do things because they are good or beautiful in themselves. Characteristically, staff in the UK’s national health service, in my experience, and teachers, and people in other areas of public service, do what they do to serve others rather than to gain prestige. Not all of course; but some.
The other day I heard of a property developer who, if he was deciding where to spend money, invested in good materials, high ceilings and big windows. Other housebuilders prefer fancy kitchens and bathrooms in what are otherwise cramped and mean buildings. Fancy kitchens might generate a quick sale; but the other developer is focussing resource on a home whose light and space will be delightful for generations.
It isn’t true of everyone, and all of us can be be public-spirited in one breath and mean or malicious in the next. But still. I meet a lot of people who are committed to public service, quietly doing their job with love and devotion, but they don’t share my faith or at least don’t speak ‘Christian’ the way I do. They have come to do what they do by some other route: personal choice, or nature, or instinct, or following the culture they learnt.
I like to think they are walking in the foothills of the Kingdom of God. They might not call it that, or recognize it as that, or even associate with that thought, but they feel the goodness in their bones.