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Freed from Slavery to the Fear of Death

October 22, 2008

Dr. James Nelson Gingerich

Associated Mennonite Biblical Seminaries

A number of years ago I was president of the medical staff at a community hospital. In that capacity I participated in a hospital board strategic planning retreat during which the conversation focused on identifying and exploiting the most profitable sectors of the local medical marketplace. Eventually someone asked, in essence, “Could it be that focusing on exploiting the profitable part of the market might undermine the hospital’s stated mission of enhancing the health of the community as a whole?” In shaping strategic planning to maximize profits, were we neglecting some aspects of the community’s health, and especially the health of those who have the fewest resources and face the greatest difficulty in gaining access to care?

The hospital CEO’s response was classic: “No margin, no mission,” he intoned. His point was that only after we ensure the hospital’s fiscal soundness and wellbeing do we have the luxury of worrying about our mission. It was our job to begin by assuring the institution’s survival—its bottom line. Everything else, however desirable, is derivative. This kind of thinking has a “duh” quality about it. Isn’t it obvious that if an organization folds for lack of income, its mission dies, too? Isn’t taking care of the bottom line a condition of pursuing an organization’s mission?

Let me begin by tipping my hand. In response to the CEO’s “No margin, no mission” assertion, I blurted out, “No mission, no mission.” I reveal a kind of binary thinking here: I don’t think an organization can have it both ways. If we focus on margin, we jeopardize mission. As I have participated in a variety of organizations over the last twenty years—whether church or community-based, whether local or regional or state or national—I have become more and more convinced that there are two kinds of organizations: the vision-driven ones and the funding-driven ones. Faced with decisions, the basic impulse, from which all else flows, is to ask either, does this move make us more secure—more financially solvent or more profitable? or, does this move fit with our vision and our mission, our reason for being? Quite apart from the answers we give, our asking of either question sets fundamental direction.

The writer of the book of Hebrews tells us, “Since, therefore, the children share flesh and blood, [Jesus] himself shared the same things, so that through death he might destroy the one who has power of death, that is, the devil, and free those who all their lives were held in slavery by the fear of death” (Heb. 2:14–15). Christians share this conviction that as individuals we need no longer fear death. But I wonder whether we consider applying this wisdom to our church bodies, our institutions and congregations. Do we believe in the power of Jesus to free us institutionally from our bondage to the fear of death? Do we need to focus first on institutional survival, or can we trust our organizations’ future to God’s provision and protection and instead focus on seeking God’s reign and its justice?

I sometimes hear what I would characterize as a kind of Niebuhrian approach to ethics for our institutions. I’m no expert on Reinhold Niebuhr (or on church leadership), and these comments will be simplistic, especially for those of you who are doctors not of medicine but in theology and ethics. My apologies.

As I understand it, Niebuhr saw Jesus as articulating a vision—an ethic, an ideal—of indiscriminate love, of agape. For a variety of reasons, Niebuhr thought Jesus’s love ethic wouldn’t work for modern American Christians who, unlike Jesus, don’t think the world is about to end and who believe they should take responsibility in society and for its institutions. According to Niebuhr, Jesus’s “pure” ethic is still relevant as an ideal that shows the inadequacy of all our efforts and reminds us of our ever-present need for grace and forgiveness. It is also relevant (here I quote John Howard Yoder) as “a principle of discriminating criticism that helps us make relative judgments within the constraints of the possible, so we can do the best we can.” But it is not relevant in the sense that we can or should actually try simply to live by it; in our circumstances that would not be realistic or socially responsible.

Many North American Mennonite theologians and ethicists in the past half-century or so have appreciated Niebuhr’s critique of theological liberalism and his trenchant description of human nature and human sin. But some have argued against Niebuhr’s realism where he turns to sources for ethics that take us away from Jesus and sometimes toward justifying using violence as the “responsible” thing to do. Yet I think something like this realism sometimes operates among church leaders in their exercise of their responsibilities.

I’m not opposed to being practical and fiscally responsible. I make budgets and watch bottom lines carefully; I drive a hard bargain when negotiating agreements with laboratories and Medicaid contractors. But whenever I hear community or church leaders advocating a certain course of action because what is at stake is nothing less than the organization’s survival—then I see red flags waving. Whenever I hear such appeals, I ask myself, “What is being advocated here, that would not otherwise seem justifiable? What are we being urged to do that is not consonant with this body’s mission and identity?”

Twenty years ago, when I was barely 30, completely green and admittedly idealistic (not to say naïve), I began my work with Maple City Health Care Center with a conviction that we could at least explore alternate ways of approaching our engagement in the world, that being engaged in our community as an organization might not constrain our ethic to one of compromise for the sake of responsibility. The vision of the health care center has evolved over these decades, as we have pursued our vision as we understood it. In that pursuit we have experienced new realities and come to understand our past in new ways. Through this process we have come to see new possibilities for organismic development and community.

Tonight I want to offer you a brief survey of the history of the health care center. But what I will tell is not a history of its program development, or its staff development, or how it has become financially sustainable. Rather I want to offer you a glimpse into the development of its vision, a work still evolving—in fits and starts, through failure and anxiety, as well as in renewed energy and excitement and joy. It is a vision for a reconciling and healing community, not principally as a result of programmatic activity but as an expression, an integral part, of who we are becoming. In this vision I hope you will see some relevance for the church, for our congregations and our agencies, and for yourselves as leaders and leaders in training in church and community. And I hope in our conversations this week to learn from your insights and experiences.

From the beginning, and coming out of my experiences of and convictions about the church (as I said in chapel this morning), I approached the work of Maple City Health Care Center as being about creating a space for people in a diverse but largely low-income neighborhood to come together in ways that would bring some measure of healing to us and to our community. The vision was about breaking down barriers—not unlike those that existed between Jews and Gentiles in New Testament times—and fostering a community of wholeness, integration, and healing.

Medical care was certainly part of our thinking about healing, but from the beginning, coming out of my experience in a congregational household in the same community a decade earlier, I was also concerned about bringing together people from various backgrounds. At that time the primary diversity in the neighborhood was not ethnic and racial but socioeconomic. Our early vision statement talked about fostering healthy community in our neighborhood by offering integrated primary care medicine in a way that was neighborhood based and community oriented. But we also talked about offering health care that was “single-tiered,” about middle class and lower class people receiving care side by side, about neighbors standing shoulder to shoulder to support the neighborhood and our fledgling health care center.

One of our early stories was about a college faculty couple and a young single woman who was homeless and on welfare. The couple and the single woman were expecting babies, and they all participated in the same prenatal group at the health center. We recognized big differences in their expectations for their children, their experience of their pregnancies, and in the resources at their disposal. Yet week after week they brought their anticipation, their anxieties. During the group’s final session, when their babies were passed around and admired, and they and the other participants ate together, these parents had come to know each other and identify with each other in ways they could not have imagined before.

From the health center’s beginning we also had a sense that the integration we were trying to foster in our neighborhood had to be manifest in our staff structure—that if we were going to allow a vision for community to become a reality, we would need to keep focused on that vision and let it guide everything we did. So we were not just concerned about making sure health care was affordable for our patients. We also wanted to make sure all our staff members were receiving livable wages, that wage and wealth disparities among our staff were minimized, that benefits were generous and shared, so all could live with a sense of security and of having enough. The importance of making visible in our staff the integration we were seeking for the community was also manifest in that from the day we opened our doors, we not only sought to make services available for Spanish-speaking patients, but also to employ Latinos as part of our staff.

Sometimes matters that were clear to me were much less clear to members of our board, and it took time and careful listening to find common ground. When in board meetings I would talk about preventive care and fostering community, low-income board members would say that the thing they wanted most in a health care center was to have a doctor willing to see their child when she was sick, and to be able to afford to pay the bill.

One low-income board member thought we should accept as patients people in poverty who lived anywhere in town: “I’ve got poor friends on the west side of town. Why shouldn’t they be able to come here?” We had conversations over a matter of months about whether we wanted to be health care provider of last resort, only taking care of poor people, or whether we, having located our center in the town’s lowest income neighborhood, wanted to serve that neighborhood as a whole, regardless of residents’ income. Did we want to be the place people came because they had no alternative, or did we want to be an integral part of a neighborhood? Did we want to be an organization people could feel good about belonging to, because here we work together to build strong community organizations: a great elementary school, for example, and lively churches, and a health care center for the whole neighborhood? Did we want to be a resource the community could take ownership in, or would we be a place where only the desperate sought help?

I suppose that way of framing the alternatives tells you what we decided. Early on, we developed the sense that we exist to serve a vision for community. We wanted that vision to guide everything we did, not just in developing program, but in determining the funding we would seek, how we would structure and recruit staff, and how the staff and board would function. Vision was central, and in our decision-making discussions, an appeal to vision was a trump card anyone could play. On the other hand, any argument that we needed to set aside vision for the sake of survival, in order to avoid financial risk or enhance our solvency, would be immediately suspect. We would not compromise vision for matters of practicability.

A new era in thinking about our vision occurred in the mid-1990s when I was invited to attend a Healthy Communities Summit in San Francisco. It was my first sustained exposure to asset-based community development. Those who adopt this approach focus not on a community’s problems but on its assets. They foster and build on the gifts and strengths already present in a community. As John McKnight has written, “Care is … the manifestation of a community. The community is the site for the relationship of citizens. And it is at this site that the primary work of the caring society must occur. If that site is invaded, co-opted, overwhelmed, and dominated by service-producing institutions, then the work of community will fail.” This approach raised the question: How can we foster becoming a site for relationship among neighbors rather than being a service-producing institution?

Four particular new learnings came from this exposure: 1. A daylong forum with a community organizer from South Central L. A. ended with these comments: “If you remember only one thing from today, remember this: Whatever you focus on is going to multiply. If you focus on your community’s needs and problems, they will multiply. If you focus on the little signs of hope, they will multiply.” 2. This summit stressed the conclusions of several recent studies indicating that social isolation all by itself is a huge risk factor for poor health and early death. Just helping people connect with each other could be a strategy for fostering both personal and community health. 3. A third learning we took from this event was an asset-based approach to hiring staff. Instead of selecting and hiring people from a pool of applicants for positions, we began actively recruiting people who shared our commitments. Our commitment to our staff, then, was to foster their potential for our mutual benefit. 4. A fourth learning was to pay attention to imagination as one of our assets. We began to see the importance of making space for imagination and innovation, of fostering a community of imagination and even risk-taking.

All these learnings fit with where we’d already been, but they consolidated directions and gave us ways of talking about these priorities. In deciding to focus on the neighborhood instead of just poor people we had already been thinking about how we could be an asset for the community, not merely a place for the desperate to bring their problems. We had had a history in fostering groups (like our mom-to-mom program) that connected people and helped them be less isolated. We had already been recruiting staff for their vision and commitments, not just for their competence in doing certain tasks. We had already been thinking imaginatively “outside the box” both as staff and board. But the language of asset-based community development—with its emphasis on building on the gifts and strengths in our community, in our staff, in our relationships—provided a vocabulary for thinking and talking about our work, and helped us refocus with new clarity.

And then in some ways we experienced several years of floundering, during which we tried to figure out ways to more fully integrate these concerns about community and gifts-based engagement even as we spent most of our time on the daily stream of office-based one-on-one physician-patient encounters. Our new way of thinking helped us recognize nontraditional encounters as part of health care and tell them as part of our experience, but we struggled to fully integrate such encounters into our organizational identity.

Although the health care center is located in a low-income community and we store lots of medications on site, we have never had much trouble with break-ins. But some years ago, when we were in the midst of a building expansion, someone broke in one night, and the next morning we arrived to find dirt and glass shards on the carpet inside the back door. Several nights later, a window was broken and a few dollars were stolen from the cash drawer. We notified the police, but the break-ins continued. The intruder seemed interested in our otoscopes (tools for ear exams); he rummaged through our collection of books on pregnancy and childbirth, played with our microscopes. He did little damage and stole almost nothing, but he left traces of himself behind for us to find. We were unsettled and wondered why this person was breaking in to a health center, of all places.

Then the break-ins stopped for several months. But just as our building expansion project reached completion, we arrived one morning to find a new—expensive—metal door ruined; someone had pried it open. The time had come to put a stop to the intrusions. We weren’t inclined to barricade the place but improvised a security system by keeping a telephone line open inside the back door so our director could listen in on what was happening there at night. A couple nights later she awoke to the screech of metal on metal, as our night visitor again used his crowbar to open the metal door. We called the police, and they apprehended a seventeen-year-old, a health center patient, who has significant hearing loss and was struggling socially and academically. His parents had been aware of his earlier night-time roaming and had installed an alarm system to alert them when he tried to leave his room. After several months without problems, they had turned off the alarm. That was when our break-ins resumed.

Dan, one of our board members who often volunteered at the center, had a son who had had some trouble with the law as a teenager. Dan pled with us not just to turn this teenager over to the legal system. With our blessing, Dan worked with the prosecutor, and eventually the court sentenced Tony (not his real name) to two hours a week of community service at the health care center. He came sullenly, and half-heartedly did the tasks we assigned: going through the motions of cleaning gutters and picking up litter, pulling weeds and doing yard work.

As a health center staff, we had been trying to address the isolation of some members of our community by identifying activities they enjoyed and inviting patients who enjoy similar activities to do them together. We had identified some people who enjoy cooking, and had invited them to meet in the health center’s community room on Wednesday afternoons to cook for each other. Some people in the group spoke English and some spoke Spanish, and they were beginning to learn each other’s language as they enjoyed each other’s food.

One week Tony showed up to do his community service on a Wednesday afternoon. A member of the cooking and eating group noticed him and invited him to join them for their meal. He took off, but reappeared a few minutes later with some banana bread from home. From then on, Tony did his community service on Wednesday afternoon, and he stayed for the shared meal. His disposition changed from sullen to sunny, and he began to do his chores wholeheartedly.

Before long Tony had completed his court-mandated community service, but he kept coming on Wednesdays, now as a volunteer and to eat with the group. We laughed when he told us that he’d started to patrol the area at night with his dog, so there wouldn’t be any trouble with people breaking in. One week he announced that he’d made the honor roll at school for the first time, and we organized a party to celebrate with him. Tony finished high school on schedule and went on to study at a local community college. Now he works for the local paper. As a staff, we started out feeling resentment about the intrusion into our space and the messes we had to clean up. Now we rejoice in Tony's success; we feel pride in him and have an investment in his future.

Although health care center staff had been providing standard medical care for Tony for years, his break-ins eventually convinced us that we had not succeeded in addressing his need for healing. He was on a quest, and he kept intruding into our space to tell us so. His way of getting our attention we perceived as an offense, but Dan’s compassion and Tony’s response to what flowed from it gave us the opportunity to see Tony as someone in search of connection and community, which proved to be important ingredients in getting him through a rough patch in his young life. Our contributions to his healing were not the result of our program as much as the fruit of impulses among people—mostly volunteers and patients—who came together at the center to reach out and include one another. In the end, the staff mostly provided space and looked on as patients and volunteers took Tony in and gave him a sense of belonging and purpose.

Although stories like Tony’s things seemed to happen despite our programmatic (medical) activity, not because of it, we were able to recognize them as being at the heart of what we wanted to be about.

Half a dozen years ago I attended a Mennonite Health Assembly meeting which featured Doug Eby, a Mennonite physician who led a restructuring of native American health services in Alaska. Over about a dozen years he helped transform that system from a typical bureaucratic clinic structure, organized around medical providers, into a native-owned and operated system of care. One result was a huge improvement in patient access. But Eby says, "It’s not about access. Access is only a tool that helps create relationships because it breaks down barriers. Relationships are really what it’s all about. It is only through solid relationships that you can begin to get at insidious underlying health issues such as depression, domestic violence, and obesity.”

Through our exposure to Doug Eby’s story we found a straightforward approach to discernment about what we are trying to do, by asking three questions of everything we do: 1. Does it foster long-term relationships? 2. Does it increase integration? And 3. Does it empower people? These themes of relationship-based care, integration, and empowerment were already present in our approach, but this new shorthand gave us a tool to use more consistently and more broadly. We began explicitly asking these questions of all programmatic initiatives, of all funding initiatives, of all policy proposals. We even restructured our employee evaluations around these questions. 1. What about your job fosters long-term relationships with patients, with other staff, with members of the community? And what about your job gets in the way of such relationships? 2. What about your job fosters integration of care for patients? your integration into the staff? into the community? your personal integration (job and rest of life)? And what about your job gets in the way of such integration? 3. What about your job is empowering for you? empowering for others? What about your job is disempowering?

So now we use these same three questions to evaluate everything we do. In itself this evaluative tool becomes a new locus of integration.

Over time we have observed that administrative staff who spend too much time in their offices and lack significant direct interaction with patients don’t feel adequately fed by their work, and they eventually burn out and leave. And so we have developed an organizational principle that all staff should have direct patient contact in the regular course of their work.

The other thing Doug Eby said that has become transformative for us is his call to escape the “tyranny of the traditional physician-patient encounter.” This one-on-one, private, behind-closed-doors encounter, characterized by huge power differentials, is about as unconducive a set-up for building community as one could find. It does not tend to foster authentic long-term relationships, it does not tend to empower patients, and it is therefore unlikely to foster integration between medical encounter and needed lifestyle changes or other aspects of daily life.

So we began to explore more intentionally models for providing health care in groups. We had had groups in various settings before: prenatal classes, mom-to-mom groups, support groups for survivors of sexual abuse, the cooking and eating group, get-togethers for coffee. And our board meetings and staff meetings were group activities. But all these were on the margins of the health care we offer. We had never tried to address health care itself in a group model.

So our steps to begin group care at the health care center did not stem from an effort to be more cost-effective, or more efficient in using staff time, but rather directly out of a challenge to reconfigure our structures to enhance relationships, integration, and empowerment.

We started our group efforts in two areas. First we explored an approach to prenatal care called Centering Pregnancy, a model developed initially at Yale midwifery school and refined over more than a decade. Here 6–10 pregnant women, whose babies are due at about the same time, meet together 8 times. During the two-hour gatherings, one of their healthcare providers (physician or midwife) is present. We meet in the living room of a little yellow bungalow next door to the health center. The first half hour we spend measuring each woman’s belly, while the rest weigh themselves, check their blood pressures, and help themselves to a glass of juice or water and fruit and crackers. Then we spend an hour and a half all together in a circle (some women also bring their partners), talking about the things in this pregnancy that are important to them. The role of staff is not to teach or bring expert opinion to bear on every question, but to facilitate participation of all the members of the group, and help the women see how much they bring to the group from their own experience and background.

We’ve learned to ask open-ended questions. I used to ask, “Are you planning to breastfeed?” The right answer was clear, and if someone ventured to say no, I had lost them for possible breastfeeding. Now we typically ask something like, “What have you been thinking about feeding your baby?” or even “What have you heard or thought about breastfeeding?” Now the group can enter into a lively discussion of their experiences and their cultural assumptions. These discussions don’t always promote the official line, but almost always we can talk with openness and validation of the perspectives of those around the circle.

In the course of these groups, not only does medical care happen, not only is there lots of education in a context that affirms what they know and have learned, but in the course of the twenty hours they spend together, these women form a supportive network of relationship. Especially our Latina patients, who in Mexico would experience pregnancy and childbirth surrounded by mother, grandmothers, sisters, and aunts, often find themselves isolated in Goshen, perhaps with a partner as their only support. Centering groups soon became places for significant friendship and support.

So we started these Centering Pregnancy groups and immediately had a strong sense of their potential. We had hired Beth, a midwife with extensive previous experience with this approach to prenatal care, and the groups were wonderful. Initially we conducted some groups in English, and some in Spanish. Not only did our prenatal patients attend with regularity, but staff came from these groups excited and energized by the interaction and by what we were learning.

But soon we found we did not have enough pregnant English-speaking patients to offer English-only groups. So we decided to try to have bilingual groups, with everything being interpreted both ways. As far as we knew, no one had tried this approach in Centering Pregnancy groups, and we were afraid that all the bilingual interpreting might be cumbersome and ungainly.

But we also saw the potential for cross-cultural bridge-building, and the development of new relationships. I started the first bilingual group by observing that the Anglos and Hispanics in our town have few opportunities to get to know each other, but the children we are preparing for will likely play with each other, go to school with each other, and may eventually start new families together. So as we prepare for these children, we also want to prepare a shared community to receive them.

We were surprised to discover that the discipline of interpreting everything into English and Spanish, far from being intrusive and awkward, helped us listen better. People can only speak about one breath’s worth before they need to wait for translation. And only one person can speak at a time. So people speak with greater care, and listen more carefully. And the subjects of pregnancy, childbirth, breastfeeding, childcare, and parenting, which are processes deeply lodged in a cultural context, stimulate fascinating discussion and provide opportunity for profound cross-cultural learning. Even though now we occasionally have groups where everyone can understand Spanish, we still translate everything, because we are convinced it improves our group process.

Maple City Health Care Center relies on grants to meet about fifteen percent of our budget; the rest is provided by contributions (ten percent) and fees for service (seventy-five percent). Because we are committed to having vision rather than funding drive our work, we don’t ask the question, “What grants can we apply for, for which we can meet the funding entity’s objectives?” Instead we ask, “What are we already doing or planning to do, that we can describe in such a way that a funding agency will recognize it as something they want to support?” It is rare that we find grant applications inspiring, let alone that they transform what we do.

But one day I was writing a grant application and came to the question, “How does your board reflect the diversity of your patient population?” I gulped. “It doesn’t” didn’t seem like a promising answer. It wasn’t that we didn’t want lower-income and non-Anglo members on our board. We did. We had asked a variety of people to serve on our board. When the healthcare center was forming a decade and a half earlier, we had gathered community leaders of various classes and subcultures to form a board: the principal of the elementary school across the street and some parents of children attending the school, a family physician, a lawyer, a nurse living in the neighborhood, a school social worker, tenants working with a community organization to create rental housing standards, people working in local factories. As we generated ideas, made plans, raised funds, and rehabbed a building, there were plenty of ways for all kinds of people to get involved and contribute.

As the years went by, though, the work of the board became a matter of gathering for monthly meetings to oversee operations, approve budgets, establish policies—in short, middle-class institutional agenda. Looking back, I began to realize that what we had tried was a classic approach to board function that relied on middle-class white assumptions about how you do business. You develop an agenda and you proceed through it in an orderly fashion, discussing each item and making decisions where necessary. The non-middle-class members had been committed enough to the healthcare center that they hung in there for a while with a board organization and process that was foreign to them, but eventually they had drifted away.

What else could we do? Did we want to invite people back into a structure they find alienating and disempowering, or could we rethink how we do our work at the board level? We began to ask ourselves, “Where in our organization is cross-cultural and socioeconomically diverse group process happening most effectively?” The clear answer was, “In Centering Pregnancy groups.” Then we asked, “How can we build on that success and carry it over into our board organization and process?”

At that point, we had a board composed of six middle-class Anglos, ranging in age from forty-something to ninety-something. The board included two staff members, Beth (our nurse midwife) and me. All the board members are wonderful people, deeply committed to the organization, and most had served on the board for ten years or longer. Organizationally we were not in crisis and could with openness and some excitement begin to reimagine the board’s shape. Beth and I proposed that we experiment with borrowing from the Centering Pregnancy circle model of group interaction and facilitative leadership, especially as we had adapted the model to cross-cultural groups. For months the board had been hearing the staff’s excitement about the Centering Pregnancy groups, and they responded to the proposal without hesitation: “We have so much to gain and nothing to lose. Let’s go for it.”

We decided to invite four people to join a reconstituted board. All four were patients, and we selected them after inviting our whole staff to consider the question, “Who of our patients is deeply involved in the life of our neighborhood and brings passion and energy to their interactions at the health care center?” The four people staff recommended were an Anglo single mother of seven, a factory worker who had been involved in student organizing as a youth in Mexico City, an employed Latina mother of two who had participated in a Centering Pregnancy group, and another young Latina mother.

In order to include everyone, we needed to function differently. We gave up our typical middle-class agenda-driven meetings and instead started each meeting with an extended conversation around the circle that began with a question that helps us think about how we relate to our community. A meeting might begin with: Tell us about what it is like to be a longtime resident (or a new immigrant) in this community? Where do you feel connected? isolated? alienated? Or the leader might ask, What has been your experience with medical care in our community? elsewhere? All our conversations take place at table, around good food, and they are blessed by the deliberate pace enforced by English-Spanish and Spanish-English interpretation. Translating content is important, but even more essential is the time we take to speak and listen carefully. One board member recently suggested that translating everything into Chinese might work almost as well!

When we get around to addressing what would have been traditional agenda items, we treat them as housekeeping matters, things that need to be done. If we have been attending to our relationships and our mission, our decisions are usually pretty self-evident, and take minimal time. And near the end of each meeting we go around the circle and ask, “So what would you like to have in the record of this meeting?” It takes us two or three minutes to decide what the minutes will say about anything we’ve discussed and any action we’ve taken.

We try to stay within our two-hour time limit for meetings, but invariably people stick around for awhile to help with dishes, or just to chat. One board member told us not long ago, “This is the most civilized part of my life. At work I’m in the jungle. Here we listen.” Several members have remarked that nowhere else do they interact at such depth with people whose experiences and perspectives are so different from their own.

We are now three years into this way of conducting board meetings. And every month I go into our meetings weary after a long day in the office—and leave with a renewed sense that this is the most exciting and satisfying work I could possibly do.

All of us are familiar with the “progression” from idealistic initiative to the inexorable bureaucratic processes of institutions. We even accept as necessary a certain organizational “maturation,” like the one Max Weber has famously described, from the charismatic to the bureaucratic. I wonder whether that progression doesn’t coincide with, or develop out of, a shift from initial clarity of purpose to a focus on institutional survival. That shift I believe is deadly to our imagination and consigns us to a kind of living death.

If we want to avoid that kind of dying, I think we need to name our fear of death and attendant focus on survival as temptations from which we daily pray to be delivered. When we start talking about being realistic, practical, and responsible, we need to consider whether we are moving away from dependence on God and trying instead to secure our own future. We need to recognize and name as seductive that siren song of survival, and listen to those who question where it calls us to go.

I have drawn these alternatives starkly in order to clarify what I think are the dangers. But I believe that any organization that wants to draw its inspiration from and orient its future toward a vision of a new reality needs to encourage and bless those who can help us stay focused on that vision. We need to heed those who invite us to be imaginative about our strengths and resources and possibilities, however insufficient they seem. Then, if my experience is any gauge, we will watch those possibilities multiply and rejoice in the abundance God provides.

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