It was a grand conference in a grand hotel in a grand city. I was there to learn; to engage in a national debate over the future of healthcare. Thousands of attendees milling like cattle with their badges placed in colorful lanyards and hanging neatly around their neck. Celebrity speakers motivated and challenging, pitched their latest books. Breakout sessions ~ with all manner of topics ~ adult forms of show-and-tell. One went so far as to speak for thirty-five minutes about all of their industry accolades and devoted less than fifteen to what they were doing to affect patient care.

I politely walked out prior to the wrap-up in silent protest.

We began early and ended late. The wisdom-thirsty few (me among them) listened for insight, solutions, nuggets of innovation and possibility. There was precious little of any of it. More questions that answers. Perhaps that is where we begin though, with dialogue. I felt lost in a sea of self interest in an industry so desperately seeking selflessness. There was more discussion of margin that mission; more debate over partisan agenda that patients; more selling of goods than challenge of what might actually create value for the sick, diseased, and struggling. Expensive suits, expensive rooms, and expensive meals and nights on the town seemed to have more attraction than the agenda so much in need of attention.

All the while I thought of my daughter. During these same days she is volunteering at a hospital in the mountains of Nepal. A hospital devoted primarily to leprosy patients. A condition, highly treatable and even curable, but not so among those living in ignorance and poverty. She spends her days providing wound care to an outcast segment of society. Those with little to no means. She spends her hours assisting a staff of physicians and nurses with precious few resources to treat the condition of their calling. They are grateful for the most basic and crude of medicine, supplies, skills, and those with a sense of humanity in a place people go to die or, at best, survive. I thought how the price of one attendee at this mega conference would likely fund the hospital’s operations for a month, maybe more.

I thought of how providers and insurers and operators and the legislators fight and jockey for political position and debate and joust just to create paper trails of speeches and the illusion of a campaign promise honored or a protection of an element of “liberty.” It made me sick (pun intended).

We have much to do in this country to make healthcare something that is offered with equity and dignity and good evidence and compassion. We have miles and miles to go in offering healthcare that is WITHOUT judgement, disparity, extraordinary waste, and harm. We can do this, but it will come at a cost. The cost of ridding ourselves of the idea that healthcare is a source of profit without dividends paid out to society. Our technological, pharmaceutical, informational, and human innovations may not be producing a healthier planet. Granted, we know more and can treat more than ever before in history; but are we healthier?

Today, in a southern California city, executives and providers alike are leaving sessions early to attend group galas and local shows. Today, in Nepal and in the urban and rural and even suburban pockets of this great country patients are arriving with hopes for care that is offered without motive other than to return quality of life for the patient.

I expressed my internal struggle to a new colleague during a Vendor Sponsored Continental Breakfast prior to listening to the keynote session from a speaker known to draw $20K for a speech. His response: “You must be a socialist.”

The response in my head was a mash up of Jesus and what I imagine Jon Stewart of the Daily Show might offer: “Forgive him, for he knows not what an ignorant moron he really is.” Yes, I get angry at this. I watch the debate in congress ~ a form of self torture ~ and wonder if there might be a drug or protocol for the symptoms I experience: nausea, dizziness, brain cell dilution, spontaneous laughter coupled spontaneous crying, and the strange feeling that I am actually living as Bill Murray’s character in the movie Groundhog Day.

I am here to create change. There are days when I wonder if my DNA was even present. There are days when I feel I facilitated a proverbial dent in the rusted steel of a system that is failing, but has such possibility. This week, I found purpose again. Not because I was inspired, but because I was disgusted at what I saw among my peers. My revolutionary self is riding a treacherous and beautiful path. I am surrounded by a posse of gifted, equally committed and passionate humans who show up every day to make a difference.

God and Jon Stewart help me.

There is a tribe in South Africa with a grasp on something that we in this country, and much of the world for that matter, have lost sight of: looking for what’s right. I discovered them through Christina Baldwin’s Storyteller. “I have read the story of the Babemba tribe in which a person doing something wrong, something that destroys this delicate social net, brings all work in the village to a halt. The people gather around the ‘offender,’ and one by one they begin to recite everything he has done RIGHT in his life: every good deed, thoughtful behavior, act of social responsibility. These things have to be true about the person, and spoken honestly, but the time-honored consequence of misbehavior is to appreciate that person back into the better part of himself.” To “appreciate a that person back into the BETTER PART of himself.” What a delightful departure from most of humankind’s response to someone doing something wrong. My days as a healthcare junkie are filled with responses to the life-changing actions of a system whose mission it is to bring people to a healthier part of themselves. When we fail, when we let them down, there is often a quest for who to blame. No question that accountability in medicine, and in life for that matter, is necessary. What is so curious to me is how quickly the default position goes to fault and blame. Does it somehow ease the pain. I don’t think it really does. To this day I don’t understand how a dollar really serves to reduce “pain and suffering.” It is a legal myth. It is our world though. It is a symptom of a society whose focus is more on managing risk than living life. What if people blow it? What would happen if instead of calling them into the proverbial principal’s office, we called them in to bring up all they have done right? Would people be less paranoid about trying to do the right thing? What if we looked at the whole person and what they bring to the planet and our work and not just what they missed? I wonder if our perspective on the world would change. What if we assumed – just for the Hell of it – for a moment that greed wasn’t at the center of corporate America; or personal America, for that matter? I think there are a bunch of us out there who believe that understanding and giving people the benefit of the doubt are good alternatives. This world is tough. For those of us in this country, this experiment of Democracy, we have a chance to believe and even live a dream. Right now the dream has too many elements of a nightmare. This isn’t created by a party or a man. Let’s dream from a place of what is right. Let’s find out how to bring people back into a better part of themselves.

I’ve been to the forest after the burn.

The seemingly lifeless earth thrives. Below its scarred surface is a renewal in the making. Nature’s perfection seeding new life. Open to the sun and the rains and the life-giving elements of a next generation. If it’s “just nature” then why do we struggle so to understand that we humans also go through a purging, a burning, and a renewal of our own – as hard as it may be?

The wildfires burn and change direction. One day we find ourselves in their path, with no apparent escape. We burn. We fall. We recover. We renew.

Looking forward to new life. Saddened by the scarred earth left behind. It gets better though. It will.

I see those signs of life in the colorful words and time and space shared with people I love and who love so deeply.

“God, I hope they don’t play another James Taylor song,” she said.

I was sitting outside at the Village Bistro (my dining room, basically) enjoying a spinach salad, a glass of fruity Pinot Grigio, and the sounds of the acoustic trio on the patio when I overheard these words from my table neighbor. I was disappointed since I dig his music so much. It was a nice piece mixed between a Nickleback tune and a Dave Matthews classic.

Her date said, “You don’t like James Taylor?” I wasn’t trying to eavesdrop, but I could help but lean a little to catch her response. “I used to” she said, “but ever since I found out he supports Obama I decided I don’t anymore.” At first I just shook my head, in my head. Then I thought about it…then I started shifting in my seat…then my breathing got a little deeper…and the voice in my head said, “DON’T YOU DO IT.” I couldn’t help myself. There are times when my tolerance and appreciation can only go so far, for crying out loud. James Taylor is at stake here!!!

Yes, sarcasm can slither its way into my conversations now and then, and with the wine and the tough day and need to express, I went for the jugular.

I called my waiter over and asked if he would make arrangements for me to pay their bill. He smiled and said, “Sean, what’s up with that?” I just asked him to go with me and bring me their bill when it was time to wrap it up. He obliged.

Ten minutes or so later they were ready to leave. They sat only 3 or 4 feet from me. Jason pointed to me from their table and said, “The gentleman here would like to pay your tab.” I raised my glass. “Huh?” the woman said. Jason repeated the offer.

Her date politely invited me to join them. They denied the offer for me to pay the tab, but did suggest we share a drink. The woman asked why I made the offer. I said, “Well its not as nice a gesture as it is a charity case.” They both looked confused; understandably. I continued. “You see, I overheard you talking about how you really didn’t like James Taylor music anymore because he supported President Obama. Frankly, I was so shocked to hear of that level of ignorance (pardon my candor) and just felt like I should contribute because I kind of feel sorry for you.”

Her man immediately burst into laughter. No chivalry here, he was cracking up.  She curled in her bottom lip in preparation for what was sure to be a verbal left hook. One I deserved. Instead, she began to laugh too. She lowered her head and raised it back up along with her Corona with lime and said, “Touché.”

We sat and talked about our President (although she says he isn’t “hers”) and about the general state of things. I expressed my views and my support of him – although I disagree with much of his policy right now – and, more importantly how James Taylor’s music has stood and will stand like a rock through presidencies past and those yet to come. On that, we found common ground. We laughed more than we argued. We found we had more in common than difference. We moved on to more delightful topics like our kids and the new wine list. We became friends.

I excused myself and walked up to the band with a request. “Will you guys play Shower the People?” The vocalist said, “Here is another from Carolina’s own, JT. This goes out to the fine couple right over there.” I raised my glass. When it was time for the chorus, the whole place sang together. My new friend, while wildly off key, was the loudest in the bunch. 

Cheers.

I listened to an interview on NPR recently where the guest looked back on his life and contently said, “I have no regrets in my life.” His comment stayed with me.

I can’t imagine a life without regret. Despite how beautiful it might be, are there things I wish I hadn’t said or done? Rhetorical to the extreme.

I regret not spending a million more moments with my precious kids.

I regret the times my selfishness and flesh hurt those I loved. I regret not getting to know Dad. I regret not having the self-confidence to follow my passion versus a logical career track (although I am thrilled with the current state).

I regret that the depth of so many friendships was left wanting. I regret unkind words leveled at those I love regardless of reason for argument.

I regret spending more time building than experiencing.

I regret that I didn’t attend the funerals of some who made a difference in my life. I regret not writing the songs I wanted to write (though I am making up time now).

I regret I didn’t take that lay-up my junior year against Port Saint Joe.

I regret that I didn’t read more fairy tales to Logan and Chelsea. I regret that I didn’t take the leap into politics, just to see if I could have made the difference others told me I could. I regret I didn’t live in the mountains.

I regret so little, all things considered, but they haunt me. My glass-half-full side is saying, “What are you waiting for?” I am only fifty-percent through my years (based on my scientific calculations and determination). Stop regretting, dude. Get with it and learn!

I knew I was gonna say something. I told myself, “No…don’t…you won’t win…you can’t win.”

It was outside of a Starbucks of all things. I stopped on this beautiful day to sit outside, catch up on my book and wind down after a tough day. The three guys sitting at the table next to me, leathery old men with jeans and oil-stained shirts and caps. Hard-working, good men. They were lamenting a news story about a discussion that was taking place uptown tonight on the subject of the second amendment. As they carried on about the world going to Hell with all the liberals who want to take away their rights, their voices got louder.

One of them turned to me and apologized for getting so loud while I read. “Sorry, friend. It’s just fuckin’ crazy. Don’t you think so?”

Okay…the moment of truth was at hand. I smiled and said, “No worries. You’ve gotta have a voice on this stuff. Mine isn’t one you really want to hear on that one though.”

Jim (the name on his shirt) gripped the arms of his chair and turned it a few degrees my way. “Awe, tell me your not one of those freaks who thinks our guns should be taken away.” I laughed and said I don’t know about the “freak” part, and I support the second amendment; but that I think it has been misinterpreted, abused, and used for evil and not good.

“Oh shit, we got us one here, boys” he said. I replied, “You asked.” “So, what is your excuse for taking my gun away?” he asked. I asked if he really wanted to talk about it. “Sure, why not?” I’ll give him credit for not writing me off at that moment. Hope for Democracy and the First Amendment as well. I explained that my worry was over the abuse of the amendment in this era; assault weapons, background checks, all the usual suspects for those of us “freaks” on the more left of the double-barrel of the draft from 1791.

I asked, “How many guns do you have?” My table mate replied, “Oh, I would say fifteen or twenty.” I asked if he had any automatic weapons or any that might be considered assault. “Hell yeah. I want to line up the liberals like you and mow ya down.” We all laughed. “Just kiddin’” he said. (I’m not so sure) I asked what he thought the purpose of the amendment really is. Glazed, he said, “To allow me to protect myself.” I let him know that that was only one of a host of reasons the amendment was created, and hardly ever a factor in today’s society.” “Hell yeah, it is,” he argued. My recollection of the entire set of variables was weak, but I spit out what I knew of the general intent. “No, it had a lot to do with the possibility of the need for a militia in the event of an invasion; protecting against a government gone undemocratic; and helping in law enforcement. I acknowledged that there were others, but that my constitutional recollection was hazy at the moment.

I then asked the most rhetorical question in the world: “How many times have you used your guns for any of those purposes? More importantly, how many deaths in our country have been attributed to the use of arms for THOSE purposes?” He looked at me like I was Sasquatch. “It don’t matter; it’s my right.” I said, “You’re right, it’s your right. And it’s mine to think we should make it a little harder for those who abuse that right to get a gun.” I thought we would have an amicable and appreciative parting.

“Well, I hope ya never come to Lancaster County. You might just get shot.” He didn’t smile. I ended with this parting, and ill-advised shot of my own: “What were you doing in 1964?”

He replied, I was just a young pup, you know that, boy. But I would have fought just as hard then.” I asked, “Would you have fought just as hard for the rights of humans and their civil rights as you do for your gun today?”

Sasquatch, again. “Oh shit. You’re one of those too,” he replied. “I rest my case,” is all I could say.

I closed my book, looked up at the sky in tribute to my father who fought for the rights of humans around the planet, including the small-minded and ignorant who sat outside of this little coffee house.

An earthquake shakes countries and we respond en masse. Tsunamis come ashore and are followed by waves of dollars and volunteers and government aide. Our planet’s capacity to reach out is sometimes overwhelming. At other times it is strikingly absent.

I have spent the last few days on the water with sea life and river life and people whose lives move with the tides. We slowed the boat on our way to Daufuskie Island to let a pod of Bottlenose dolphin play. They jumped and danced and wrestled and glided all at the same time. They put on quite a show before smiling and moving down river. The pelicans moved stealthily in for the evening catch under a rising full moon. They perched on the buoys and the abandoned pilings and watched the boats and birds and waited the next course. The rhythm of the coastal breezes moved the marsh grass in wave after graceful wave.

I tried to imagine a dark death, like a plague, moving slowly in to suffocate all of this precious life. I visualized our  Pelican and Seagull friends diving and unable to return to flight from the thick coating on their wings. I saw the deep greens and browns of the marshland turning black and dying and taking with it the lives of the birds and the fish who live and thrive there.  I saw the banks of the river at low tide coated in this mess. The crab no longer able to run and burrow along the mud and the rocks.

Months ago the headlines were full of the response of humanity to other disasters. Where is that same humanity when the disaster is one of corporate doing? Does this make it any less a candidate for attention and response from those beyond the boardroom? Did other oil companies rush in with their best minds and resources? Where has been the humanitarian response from corporate and government organizations alike? Is it because many of the victims are not…human? Reality is that the livelihood of so many is threatened by this catastrophe. What is getting much less attention is that LIFE is at stake here too. An entire ecosystem is threatened and dying.

So, I grudgingly turn on the news. Instead of finding headlines filled with national and international response, I see a BP executive spending most of his air time answering to prosecutors from every possible group, agency, district, and agenda. The podium has no lineup of those who have come to a rescue. He stands alone. This isn’t about feeling sorry for a corporate exec. It is absolute sadness over the lack of collective good to save lives. To save livelihoods. To fix a terrible and accidental wrong that not only claimed eleven brave men, but is claiming more life with each creeping inch.

I’ve never boarded a Greenpeace boat. I don’t have a Save The Spotted Owl bumper sticker on my Jeep. I’ve never stood defiantly between a bulldozer and a Redwood. At one point I think I was even critical of these types as if they were all lunatics. But in these middle years I find myself drawn away from concrete and into the woods; from the airports and to the river; from the office and to the forest. So, here I was at dawn this morning, rowing my kayak down Richardson Creek along the marsh and feeling an even stronger conviction to preserve and protect this glorious life around me.

I am a lover of life. All kinds. Tonight I become what I once judged. I don’t want my legacy for the planet to be left to my reusable Harris Teeter shopping bag or a weekly recycling run. That is pissing in the proverbial wind. I am going for “cause” level. Too much at stake.

Sean

P.S. Save The Spotted Owl

“Move legs. Move, damned legs!”

I was crossing a bridge along the greenway. The morning was gray and cool, like today. Void of humans…full of life though. Small creatures making crunchy sounds as they moved through the leaves that carpet the floor of the woods in late Fall.

My hand rested on the wooden rail of the footbridge that crosses over a small creek. There was a trickle from the hills to the pond just feet away from the path. I couldn’t move. I leaned forward and turned with a swing hoping that gravity and a little momentum might create a step. Nothing. I felt like a salvage diver on sea’s bottom tethered to lead boots. Tybee was on the path ahead of me. He lounged under the shade of a River Oak.

I woke. It was a dream.

For just a moment I couldn’t feel my legs. The Wonder Dog was lying down next to my bed, his tired old body stretched across his orthopedic bed and the shag rug underneath. He smiled up at me as he does every morning. But his eyes looked worried as he seemed to sense that I was out of sorts.

He worked slowly to rise from his slumber and greet me with a nose nudge that is part “good morning” and “Let’s go for our sunrise stroll.”

His front legs extended and his chest worked the lift. His back legs followed like tent poles…straightened and immobile. They collapsed under his eighty-three pounds. He panted a moment and went for a second take. Collapsing again as I got up and tucked my hands under his hips and said, “C’mon pal…need a little lift?” He steadied and his tail wagged in appreciation. I threw on my jeans and grabbed a sweatshirt and said, “Let’s go, little man.”

I walked down to the landing at the bottom of the staircase and looked back up at him. He stood ready and calculated his descent. I waited in a catcher’s position on the landing. He began, slowly at first. Momentum turned a careful walk into a slide by the time he made it to me. I caught him, as I do, and we enjoyed a laugh. It’s a bit of a kooky tradition now. Tybee navigated the two bottom stairs from the landing to the wood floors of the den. He stopped at his water bowl and lapped away as I grabbed my boots and his leash. He stood at the top of the three stairs that lead to the front door. He waits for me to open the door before going down the wooden stairs. That way he can sail right through the entry way and on to the patio.

We are now ready for our morning walk.

He loves to walk. He compensates. His front legs working, at times, in a full canter. His back legs, stiff, but steady now serve more as a rudder.

I am convinced that my dream came to me as a medium of empathy. For just a time, in my unconscious state, I was aware of the nature of a chronic disability. I felt–or didn’t “feel” in this case–what it must be like to live within a body that doesn’t work like we want it to. This wonderful companion of mine shows me that spirit and determination can trump limits of the anatomical kind.

I will be there one day. My body’s Early Warning System offers pings of what will surely be more acute in the days ahead. A pain here, a kink there, a “where did that come from?” moment. I look at my best friend of 17 years and realize that he wants to leave me with his wisdom and inspiration for living through all manner of trials. He climbs the stairs of my three story village town home several times a day. If I go up, he comes with me…despite my encouraging him to stay downstairs. It takes him a while, but he gets there on his time. He comes back down. Gravity does most of the work while he uses his front legs for brakes. Then he finds his place on his deck bed and lounges in the sun near a River Oak.

Thank you, my perfect pal.

I choose to live. I choose to live well. Despite these damned legs.

We are going to do some cleaning and purging and rescuing in my mom’s garage this week. I have green dots and red dots for things to go or stay…for good. If not for this week (years in the making) this space would be prototype for an episode of Hoarders.

As I thought of project and the stories sure to come, I was reminded of this original post. I offer it back as head and heart prep for the time ahead.

_________________________________________________________________________________________________

March 26, 2012

GOODWILL HAUNTING

I took a bunch of stuff to Goodwill tonight. Bags of clothes and boxes of things. Things from a life before. Things that needed a new home.

There is an emotional stew that accompanies the journey from pile to trunk through the drive and into the outstretched arms of a volunteer on the loading dock. Jeans worn through later years with kids in the woods and on the beaches and playtime with the Wonder Dog. Lamps that threw light on a thousand books that opened or closed or then reopened my mind and my soul. Art that seemed to strike a chord of relevance at the time or whose colors worked nicely with the pillows on the old worn leather couch (also going) or the dining set or just because they said something. Shoes and t-shirts that like tree bark represent eras and philosophical shifts and attempts at identity.

And yes, the books themselves. Those paper works that absorbed the oil of my hands. Pages torn and bent and highlighted and underlined and noted. My teachers. My silent debate partners. My friends. My enemies and allies. My muses.

Knick Knacks of all type. Some that had meaning and others whose motivation for collecting completely escapes me. Fewer of them made the journey to Goodwill than were packed originally. With each touch and turn a memory would trace its way back. I smiled. I cried a bit. I stood and put one here and there on my bookshelf or on a table or back in the box pulled from its attic home. A pause in the proverbial handoff of an heirloom. These inanimate things have so much life. Ghosts in their own right. Speaking to me as they were toted and offered to another. Reminding me that like photographs and cards and rings and other things all had a place in my history. Haunting me now that I know I have left them. Tonight sitting on metal shelves in rows with like kind, awaiting their next caretaker. My hope is that the things worn will warm a body. My hope is that other things warm hearts as they surely did for me once before. New day. New era. I’m not afraid of ghosts. Visit me as you will. Finish the journey with me…with others whose life I hope you touch.

Mom has been visiting me for a week or so now. In keeping with our tradition,the time during dinner or later is spent considering the mysteries and jewels of life. At four-score and something, she is more interested in learning than offering the wisdom of generations of experience. She does that too, but her curiosity always trumps her need to jive memoirs or wax nostalgic of “back in the day” (which I also dig).

“Always have something to look forward to.” Patti Keyser

Mom and Dad didn’t have a lot of those lines that became a staple of their conversation from my youth to adulthood (whatever that is). But this line has been a part of mom’s counsel since I can remember. In the midst of a conversation about relationships and politics and my continuing education and who remembers what else (we were well into a bottle of Pinot), she smiled and said, “Always have something to look forward to.”

I paused and appreciated the gift of optimism. I’ve been called an eternal optimist, an idealist, a prototype for ‘rose colored glasses,’ and even once, a Pollyanna. In her role as the Maternal Optimist, she has been reminding me all week –unbeknownst to her — that life has great possibilities. Hell, she is working on her next decade.

As we discussed her new interest in yoga and her desire to return to painting, she said to me, “I need a plan. Will you help me with one?”

I can only only hope that thirty-six years from now that I have a plan for the next ten.

Joy in the little things is what was to be my lesson from her this week. I had to drive to one of our hospitals about a hundred miles away this week. I offered to have her join me and to drop her off at a mall for a hair style and some shopping while I attended meetings. She enthusiastically accepted. But you see, the mall and the shopping didn’t matter much; she told me she was just looking forward to the drive. On the way home, I was talking about the features on my iPhone (which she was uber interested in for a moment). She listened for a moment and then drew my attention to a really cool cloud formation and went on and on about the color and the shape. “I’ve never seen a pattern like that,” she said. Later that night, I spoke of the beautiful Napa Valley varietal we enjoyed after dinner. Mom was fascinated in the recycled glass wine glasses we drank from. We skipped primetime drama shows in order to watch and virtually empathize with those whose lives were entirely changed by an angry storm. We talked of our country’s resilience, despite storms and whomever occupies the White House. I stayed on the porch and reflected on simple joy…a life less complicated.

My thoughts were drawn to the generation two down from mom. My hope (already very high) was Red Bulled.

My nephew, David, pastors youth and travels any chance he gets to war torn regions of the world to build things…to grow things…buildings, hearts, spirits. My niece teaches. She teaches those with challenges. Like most teachers, she is part educator, part therapist, part advocate, and all in! Their mom (my sister) is another one of those what’s-right-with-the-world people. ALWAYS looking at possibilities and not barriers. It carries.

My daughter pulls from her formal education and her experience in poverty immersed villages in Nepal to offer counsel and compassion to those who struggle with demons of the mind and spirit. Her smile crushes the most aggressive cynicism. And my son studies night and day and then attends his clinicals in preparation of a life dedicated to healing. His scientific mind mixed with his Montana-sized heart for people will make healthcare better.

You see, my point in this epic post is this: I look around me…at this group of DNA, and think of just how much there is to look forward to. I think we are in good and capable hands. I have so much to look forward to. This new and full life. Full of unknowns and joys and mysteries to be solved or at least observed.

Thanks, Mom. Love always.