Faith Leaders and the Ebola Epidemic in Africa

If you're not on the list to receive headlines from the Anglican Communion News Service or the Episcopal News Service, you may have missed this (it was circulated by both services). Three bishops of Anglican dioceses in west Africa recently visited England where they spoke both to the Anglican Alliance and to General Synod about the church's response to and participation in the efforts against ebola in the recent epidemic. At the link above there is information about their meeting with Anglican Alliance, and also other information about responding to ebola.


One of the resources there that I found especially interesting was Keeping the Faith: The Role of Faith Leaders in the Ebola Response. This publication of Christian Aid is worth reviewing. It reports a study describing how religious leaders, both Christian and Muslim, were critical in gathering community support and convincing anxious communities to accept medical assistance. While the document is quite long, the Executive Summary, beginning on page 8, describes the findings well. Initially, some communities feared the government intervention as much as the disease. After disease had struck a village or a family, there was significant stigma. Initially, the medical workers were not interested in participation from faith leaders. However, once engaged, faith leaders were able to provide educators whose authority was accepted to help communities understand the disease and the necessary help. They were also able to provide support for disrupted families and communities, and to address directly the issues of stigma.

We were anxious in the United States about ebola, even though the risks to the population as a whole were small and manageable. This report speaks from the center of the outbreak, where risks were great and resources for control thin. It's helpful to see how faith leaders, with their established authority in their communities, were able to take the lead in providing care for prevention, treatment, and community need. I hope you'll take time to at least read the Executive Summary.

On Days and Numbering and Other Things

Regular readers know that I am an occasional contributor to the Episcopal Cafe, so it won't surprise anyone that I am a daily reader. This morning, I followed this post, Bishop Katherine Jefferts-Schori contributing to the series on Faith and Science in the 21st Century at Day1, the radio and on-line resource supported by mainline Protestant churches. I certainly commend Bishop Jefferts-Schori's video and her reflection on re-framing and repentance.

And then, looking further in that series, I discovered another contribution: the Rev. Dr. Tom Long reflecting on Psalm 90 and the call to Number Our Days. I was especially interested because the point of his sermon (on the link, and then scroll down past the interview portion. If you're registered with Day1 you can hear the audio of the sermon.) was to reflect on numbering our days in light of the capacities of contemporary medicine. He speaks to a difficulty that I have described by saying, "When will folks understand that Dr. House lied to them? We don't get every patient cured, much less in 60 minutes!" Tom Long points this out himself, if more gently, and reflects on numbering our days and wisdom.

Often enough I have spoken to this myself, frequently addressing (all right, complaining about) the tendency in the media to hype every small study with an apparently positive result, without presenting that result in its longer - and not necessarily so positive - context. Tom Long does it with a bit more grace and a bit more Scripture, and I commend this to you, too.

Extending God's Party: Sermon for Epiphany 3, year C

I had the pleasure of preaching again at St.Mary Magdalene Church in Belton, Missouri (or, yes, Loch Lloyd). You can link to the sermon here.

Just one explanatory note: I also preached there on Sunday the 17th, and, reflecting on Jesus at the wedding at Cana, spoke of God's party, the celebration and celebrating we do that demonstrates the presence of Christ in the world. So, if you're not sure what "party" I mention in the sermon, there it is. God calls us to celebrate by demonstrating God's presence in Christ; and to use all our gifts for the party; and to invite to the party those who most need to hear about the Year of the Lord's Favor.

We're Here to Help

I do still look up health news now and again, considering topics of interest. And, this evening I ran across this story from ABC News.

The headline captures the point well: “Many Doctors Choose End-of-Life Care Differently Than the General Population, Two Studies Show.” In fact the two studies appeared today in JAMA. the Journal of the American Medical Association. You can review them here and here. The points are that doctors are less likely than the general public to die in a hospital, or to use medical procedures and technology at the end of life. Both studies are based on the medical records of literally hundreds of thousands of people, and as we all know, those large numbers mean statistically meaningful results.

Perhaps this would be a surprise to someone, but not to those of us who work in healthcare. Indeed, the second study looked at folks who worked in healthcare who were not doctors; and their results were closer to the doctors than to the general public. The comment in the article is that the general public isn’t prepared to discuss what the limits might be to appropriate care. I think we need to respect the other side of that coin: those of us who work with it every day are more likely to discuss it, precisely because we have seen what those hospital stays and late life interventions do – and don’t -  accomplish.

I don’t want to press these results too far. While the differences are statistically significant, they aren’t absolute. In fact, a lot of those late life interventions in hospitals happen before the decision is reached that it is in fact the end of life. And, of course, there are certainly enough doctors who also have difficulty talking about decisions at the end of life – their own lives and those of their patients.

At the same time, perhaps the opportunity is for folks who don’t work in healthcare to ask those of us who do, whether doctors or not. It would be even better if they were to ask us especially when it isn’t a crisis. I have said often enough that these topics should be discussed over breakfast at home; and that the worst place to discuss the patient’s wishes is at a bedside in ICU at 2:00 in the morning.

So, perhaps the ABC News article can stimulate more of these conversations. It is a bit easier to have these conversations with one’s physician these days, but you don’t have to wait for that annual appointment. Perhaps it would be better to have the conversation with friends and family, especially (but not limited to) any who work in healthcare. We know the stakes. We want to help. And if it does get to 2:00 in the morning at a bedside in ICU, it’s likely to be those family and friends who get asked just what your values would be.

Christmas in Three Movements

My readers all know, I think, that I work in an Episcopal hospital. More to the point, the hospital’s chapel is really not the hospital’s chapel. It is an Episcopal chapel, under the jurisdiction of the Bishop, with me as the Bishop’s vicar. The important aspect of that for this post is that there are certain Episcopal services that are maintained: Sunday Eucharist and Wednesday Eucharist with Healing Service.

During most of the year, preachers at those services are CPE students. However, at times during the year the students get a break and staff chaplains preach. So it was that one of my colleagues came to me and asked, “Do you guys [read “Episcopalians”] actually do John 1 for the Sunday after Christmas?” He is scheduled for this Wednesday, and so  would use the lessons from the previous Sunday, this Sunday, Christmas 1. I assured him that we did – that, in fact, for the third Eucharist of any Christmas (usually Christmas morning) we read John 1 and the beautiful “Hymn to the Logos.” “Well,” he said, “I have to write a sermon for Christmas on Luke. So, on Wednesday I’m preaching on Luke.” I blessed him, shrugged my shoulders, and told him to be sure to let the celebrant know.

We have a rather interesting way that we tell the Christmas story, we Episcopalians, in our Christmas services. (I don’t know whether others do it this way. Yes, the Episcopal Church uses the Revised Common Lectionary; but we use it with some of our own idiosyncrasies.) If one were to do three Christmas services (Eve and Day both), we would actually read three different Gospel passages. At the first, we would read from Luke, but only half of what most people expect. We would read about the census, and Mary and Joseph arriving at Bethlehem, and about angels announcing good tidings to shepherds. At the second service we would read only the second part of Luke, about shepherds going “even unto Bethlehem” to actually see for themselves. Finally, in the third we would read, not from Luke, but from John, about the Word becoming flesh.

I don’t know how often that actually happens. We always have an option at the first two services – and, really, at the third – to read the entire Luke account of Jesus’ birth. It’s the story as everyone knows it, and has all that wonderful imagery and drama. Still, the plan as laid out in the Lectionary is to break the Luke account up, and to include the John. The point is pretty clear: to read, again and again and with different emphases, this sentence:

God did this.

Or, better perhaps, since we do break it into three parts:

God. Did. This.

Let me sort this out. It is an event in three movements, if you will. In the first movement, Luke’s story spends a lot of time on the power of the Emperor, and how civil necessity can make people move. However, the critical point comes when shepherds in the fields are confronted with the angel of the Lord; which is to say, with a message from God. “Today in Bethlehem is born a savior, God’s Messiah” Augustus may make some claims, but it is by God’s plan that David’s heir is in David’s city. It is God who proclaims it, and lets us know that God has done it. In the first movement, our sentence is,

God! did this!

In the second movement, the shepherds investigate. They go, and they find, and they see. The message from God is confirmed, and the faith of the shepherds is affirmed. We have the first witnesses. Sure, they’re not folks who are highly esteemed, nor terribly important; but, then, how many of us are? Rather, they are common folk, people who were, as my mother used to say, “of the earth earthy.” Sure, wise men will be great when they get there, but the first witnesses are witnesses we can trust because they are witnesses just as common as we are. The important sentence turns to,

God Did! this!

Which brings us to the third movement, the movement that takes us from Luke to John. It is John’s opening hymn that really lays out what God did. After all, we’ve all heard those sermons – I’ve certainly preached those sermons – about how the common concept of “messiah” in First century Judea was not what God was about. We’ve also realized often enough just how few people really understood. The Twelve didn’t really understand until the end of the story, much less the Seventy (or Seventy-two, depending). The women come closest, I think: Mary his mother, Mary and Martha of Bethany, Mary Magdalene; but those stories, by and large, are also in John, and so already in the context of the opening hymn. John helps us all to get it: that what God was about on Christmas wasn’t just shaking things up a little. What God was about was wholesale reordering of how God had been doing things. What God was about was Incarnation, about Emmanuel, about no longer being apart but instead being with us. It is in John that the sentence is really completed:

God did This: the Word became flesh, and lived – and lives – among us.

A blessed Christmas Season to all, and a happy and healthy New Year.