The Best Christmas Gift I Could Ever Receive

You never know when one simple act might have long term implications, even long after you’ve forgotten it.

Last week, my wife Mary and I went to the Perea Christmas party, as we always do when the holidays approach. Perea is the preschool in N. Memphis that Church Health has run for almost 18 years. We have 149 three- and four-year-old students enrolled this year, and our teachers make a profound difference in their lives.

The Christmas party was fun, as it always is; after years of parties, Alicia Norman and her staff have perfected the party agenda down to the minute. We begin with dinner, and then the kids present their program. The children sing carols they worked weeks to learn, hand motions and all. Then the Three Wise Men, Mary, Joseph and a baby doll Jesus reenact the Christmas story. Mind you, since Mary, Joseph and the Three Wise Men are three- and four-year-olds dressed in oversized robes and crowns, wardrobe malfunctions are always par for the course. The party is then wrapped up with a competition between all of us as we sing “The Twelve Days of Christmas.” This is when Santa arrives, pandemonium breaks out, and Mary and I take our cue to make a break for the car.

This year I got a very special gift. A woman approached me and said, “You won’t remember me, but 29 years ago when Church Health first opened, I brought my daughter to you. I was a young mother and didn’t know what to do when my child began wheezing. I didn’t have insurance. Someone told me about the Church Health Center. So I came.”

She continued. “You were worried when you examined my daughter, Britney. You diagnosed her with asthma. She was the first child you admitted to LeBonheur. Thankfully, she got better in a few days. I have never forgotten how kind you were to us.”

I felt humbled. I was also embarrassed because she was right –  I didn’t remember any of this. She went on. “Britney is here tonight, and her daughter, Journey, is a 4-year-old at Perea. I’ll send her over to talk to you when there is a break.”

I tried to watch the rest of the performance, but I was anxious to meet Britney. After the show wrapped, Britney came straight toward me and embraced me. It was so powerful. I learned that her husband is the admissions counselor at Memphis Theological Seminary. A few weeks ago after I spoke at the Seminary, he went home and told her about me. She interrupted him. “I know him. He was my doctor when I was a little girl.”

Just then, an adorable Perea student still in costume from the manger scene came toward us. “This is Journey,” her momma said. Britney told me that her husband has been offered a job in Austin, Texas, and they will be moving there after Christmas. I couldn’t help but think that God was smiling on me to have these few moments with them.

I’m honestly not sure what to make of this story. My chance encounter with Britney, her mother and her daughter could have only happened because we’ve kept the faith in the work we do for 29 years. Day in and day out, our staff, volunteers and supporters keep steady in our mission of healing. Sometimes, as a result of that faith, small miracles happen. Maybe “miracle” is too strong a word; maybe it was just what was supposed to happen. Britney outgrew her asthma. Her mother was strong and was always going to help her succeed, and through Britney, therefore, so will Journey.

My part was small, but I do think the impact of Church Health on this family is evident. I suspect they would agree.

We left the party when Santa arrived. I didn’t need to ask for anything. I already had received the best gift possible.

Facing Homelessness at Christmastime

I never give money to people on the street. I became convinced years ago that it was not a helpful thing to do. I am the physician for many homeless people in Memphis, Tennessee, and I know that giving them a few bucks does next to nothing to solve their long-term problems.

Still, last week, as I walked down Michigan Avenue in Chicago, I opened my wallet. It was beginning to snow, and the Christmas lights decorating the street glimmered against in the late-afternoon sky. It was beautiful. The streets were incredibly crowded with shoppers, tourists and commuters hurrying to their next destinations. As we waited to cross a street, my wife, Mary, nudged me and pointed to a woman sitting on the curb with an empty glass jar asking for money. She was rocking back and forth in the cold. I looked over and felt sorry for her, but I was ready to move on.

“Look at her leg,” Mary said.

It was awful. I’d seen open wounds like hers on people in the streets of India, but never in America. Her right lower leg was one big exposed, infected sore. It was as bad as anything I’ve ever seen in my office—and I’ve seen a lot. Her sign said, NEED MONEY FOR BANDAGES. I was drawn to her.

“What are you doing for your leg?”

“I just got out of the hospital. I’m going back to see the doctor in a couple of days.”

She never really looked at me.

It seemed to me that she was on the verge of losing her leg. As we talked, dozens of people passed by without really seeing us. The thought of taking her to our hotel room crossed my mind. Instead I reached into my wallet and pulled a twenty-dollar bill and stuck it in her jar. She thanked me profusely, and then Mary and I walked on. I continued to think about her. The next morning, we had breakfast with my brother who lives in Chicago. We told him about the woman. He said, “She used to sit down closer to the river. She’s been out on the street for a long time. Her leg looks awful, doesn’t it?”

There was no way she was faking her wound. But it made me wonder. I know no one would choose to live like that. Years ago, I was treating a patient and noticed his WILL WORK FOR FOOD sign in his backpack. He was plenty smart, so I asked him why he panhandled instead of working.

“I have a permit, and I make five times what I did with a real job.”

“A permit?” I asked.

“Yeah, you can’t beg without one or the cops will harass you. It’s free, but you have to go downtown to get it.” That was all news to me, but it didn’t surprise me that he made more money begging than working a minimum wage job. Still, that isn’t how it’s supposed to be. Not in America. I’ve learned that it’s actually hard to become homeless. To find yourself truly alone so that you have nowhere to turn when you can’t pay rent, you have to burn every bridge with every person who has ever loved you. Addiction and mental illness often accompany homelessness, making it even more difficult to inspire sympathy from friends and loved ones. That said, I know how difficult and expensive it will be for the woman with the leg wound to buy her medicine and bandages. I don’t regret giving her money, even if she’s been sitting on Michigan Avenue for a year.

Still, the moral dilemma of giving money to someone sitting on the street of an American city is something few of us ever come to grips with. Yes, we worry the person will just go buy beer. At the same time, we aren’t fully comfortable with just walking by, because there seems to be an unwritten tenet that no one in America should be forced to beg. On that, I think we could all agree.

Still, I am disturbed that I have no real solution to the problem. The root causes that lead people to beg are complicated, and I am just not sure what I am to do. And I don’t know anyone who is. But we could start with asking the questions and try to do more than shrug our shoulders at the complexity of the answers.

 

The Poor Will Always Be With Us. So Will Church Health.

For the last few days, I have been asked a hundred times, “How will the Trump election affect the work of Church Health?” or “What if Trump dismantles Obamacare?”

My answer is the same as it was before the election. The outcome of the election has little to do with the mission of Church Health. Our mission has always been to reclaim the Church’s biblical commitment to care for our bodies and our spirits. For nearly 30 years, we’ve cared for working uninsured people and their families. What the federal government does is of little consequence to what people of faith are called to do in order to be faithful to God.

Of course, it’s never that simple. If 20 million people who currently receive health insurance through the ACA were to suddenly lose coverage, that would be a disaster for the nation and for us in Memphis. But it’s my opinion that that will not happen any time soon. President-elect Trump’s stated goal is to repeal and replace Obamacare, but clarity on how and when that might happen has not yet been provided.

A long time ago, I gave up worrying about what the impact decisions in Washington might be for our work. Under President Bill Clinton, people worried there would be no need for the work we did once “HillaryCare” took effect. I hope you can understand my point.

What I know is that the gospels call us to care for the poor when they are sick. I feel that same call has been spoken through every world religion, and even those who don’t subscribe to a particular organized system of faith believe that everyone deserves quality healthcare.

In just over two months, Church Health is moving everything we do to Crosstown Concourse. We will dramatically increase our capacity to care for people who fall through the gaps of America’s healthcare system. Those gaps could widen in the future, but if they do, Church Health will be here to provide the same quality of care you would want your mother to receive.

On that I am certain.

Our job is to continue to talk with people of faith to help them see that caring for the health needs of the poor is a path to draw closer to God. That is our fundamental mission –  not the mission of the federal government. Therefore, whatever President-elect Trump does or doesn’t do will have little impact on the work we have undertaken for the last 30 years.

Jesus said that the poor will always be with us, and for that reason Church Heath will always stay the course we’re on and serve those who are forgotten. Make no mistake: this work is hard, and it requires intense, concerted effort. But the outcome, when successful, is truly sweet.

I will pray every day that President-elect Trump works to care for the poor during his administration. We will work with anyone who desires to stand with us on that journey.

But no matter what, our mission is unchanged and we are ready for the task ahead.

On Victories on the Field and in the Clinic

I’ve been to many baseball games at Wrigley Field to see the Chicago Cubs play. The first time was in 1977. It was at the beginning of the season, a late-April game. I was of course looking forward to seeing the Cubs play, but my real excitement was finally visiting the sacred space that is Wrigley Field and seeing the famous ivy that covers the outfield wall.

My experience was not what I imagined it would be, though. It can be very cold in Chicago in April, and I almost froze to death as I sat in the stands. There were very few fans at the game – this was back when the Cubs were routinely terrible. But still, there was the ivy.

More disappointment. When I looked to the outfield wall, there was nothing but bare sticks totally absent of green. It was ugly, not beautiful as I imagined. How did I not know that the Wrigley Field ivy was deciduous? The leaves fall off in the late fall and do not return until the spring warms up.

I have always remembered that game and my disappointment, but I suspect every Cub fan will remember last night’s extra inning 7^th game win of the World Series with a great deal more fondness. Last night, the Cub’s 108-year history of failure came to an end.

There is something to persevering when all seems hopeless.

This is indeed what makes me love my work at Church Health where we serve those who otherwise would be excluded from receiving the healthcare they deserve because of factors beyond their control. Every day I see people who year after year face insurmountable odds that life has put before them. Just this week in the clinic, we saw an Albanian woman who came to Memphis for an arranged marriage only to find her new husband was abusive. We saw a five-year-old boy whose eye turns out whose mother didn’t know where else to find help.

This is our daily work. It may seem futile, but it is not.

The Chicago Cubs have won the World Series because they spent millions of dollars assembling a superior team and they play in a wonderful city at what is arguably the best ball park in the world. They were always bound to win eventually. But it is not so of many of the people we seek to serve at Church Health. You could even argue that the chances of them “winning” are very small. They will always be talking about the inability to have the life God intended for them. But then, they find Church Health and their lives change. Our lives, too, are changed every day because of the richness we feel from being involved in their lives.

It is not the World Series, but it is in some ways better. The joy they have in having their health restored lasts longer than the fleeting moments of a sports victory.

My brother lives in Chicago and I’m sure he will be there as the Cubs march down Michigan Avenue celebrating their win. I will smile for those who feel a sense of happiness in their victory. But I will most likely be in the clinic when the parade happens.

And that next person whose life we help change will give me true joy in knowing that the power of a healthy life is even better than a game-seven, extra-inning win.

An Open Letter to the Next President of the United States Regarding Healthcare for the Poor

Dear Mr. Trump and Sec. Clinton;

I realize that with only a few more weeks before America decides which of you will be our next leader, you are both busy talking about the things that you believe will get you elected. But for a moment, I want to tell you about some people who are often forgotten: the working uninsured. I doubt you’ll mention them in your campaign appearances or even on your social media – and I understand that – but I still have to make their case.

I will always make their case.

I have worked in Memphis, TN for 30 years as a family physician at Church Health. At our clinic, we provide healthcare for people working in low-wage jobs who do not have health insurance. We’ve cared for over 70,000 people through the years without relying on government funding. I have no desire to make the work we do political, but with all humility and kindness, I ask for whichever of you becomes our country’s next president to please consider the following points when it comes to the healthcare needs of the poor in America.

1. We have a serious problem with issues of mental health and substance abuse. A person with a serious mental health issue will live a much shorter life than the rest of us. These issues cannot just be willed away. Behavioral heath issues disproportionately affect the poor.
2. The number one predictor of health outcomes is education. A poor education leads to an unhealthy life.
3. Listen to the people you are trying to help. The answers are unlikely to come just from smart people in Washington or large institutions.
4. Do not claim the problem is solved by whatever new policy you institute. You can help with policy, but it takes all of us to change our health outcomes.
5. Everyone in healthcare is not out to get rich. Do not be cynical about those of us who work to care for others because we feel called by God or are driven by matters of social justice. I know there is tremendous fraud in the system, but there is also tremendous good.
6. Effective treatments must be affordable for all. That requires lowering costs and finding a means of access for all. It does not mean the government must do it all. In Memphis, we have over 1,000 physicians who volunteer their time for the uninsured and undocumented. Almost every physician I know will state that they went to medical school because they wanted to help people. If you show them a way to care for people who have no other options, physicians will do the right thing. If you assume physicians only care about the money, then they will back away. Everyone needs a pat on the back to thank them for when they are kind.
7. We all need help to better deal with the issues around the end of life. Rich and poor are tortured because we cannot accept that death is a part of life. We waste billions of dollars and cause endless heart break by offering unacceptable hope for the future when accepting that the end of this life has come is the right thing to do. Call on our faith communities to address this issue and we will all become healthier.
8. Health and healthcare are not simply commodities; they are necessary elements for all other aspects of our country to thrive. For all Americans – rich, poor, and every color – to thrive, our health outcomes must improve. If we are to be judged as a great country, people building our houses must be cared for when they fall off the roof no matter what their immigration status is.

In my thirty years of caring for the people who work to make our communities great, I’ve been amazed at the resiliency of people who have so little. The joy they are able to maintain even when they have little money and work harder physically than I ever dreamed of doing inspires me every day. It makes me proud to be an American.

Surely, in the years to come, we can work hard together to assure them that we as a country will give them the benefits of the best health care system in the world. Indeed, doing so is truly part of what makes America great.

With hope for healing,

Scott

Naming the Unnamed: the Important Work of Dr. Lori Baker

Last week, I spent some time at Baylor University in Waco, TX. I admit, Mary and I went with great curiosity about seeing Magnolia Farms, the home of Chip and Joanna Gaines from the HGTV home-remodeling show Fixer Upper. Who would have believed that Fixer Upper-fever had over taken the town? Each month an estimated 33,000 tourists travel to Waco just to gawk at what the Gaines have created.

That was our first stop, but after that we spent time with Baylor students who are very interested in the link between faith and health. Their energy was so invigorating, and hopefully we’ll see some of them come to Memphis and work with us as Church Health Scholars during their a gap year between college and medical school.

What I was not expecting was to meet Dr. Lori Baker, a forensic pathologist based at Baylor. It turns out she has a PhD in anthropology from the University of Tennessee and spent seven years in Memphis. What she has followed as her life’s work is both inspiring and gut-wrenching.

Dr. Baker works to identify bodies that have died in areas of genocide or on the US/Mexican border. She then returns the bodies to their families. She has worked in Serbia and Honduras, but she mostly works in Texas.

Every year, 500 people die trying to come to America. Before the 1990s, our country did not even keep a record of the deaths of these unknown people. On the Texas border, people pay a “coyote” to help them cross the desert, and once across and into Texas, they’re told that Houston is “just a 30-minute walk away.” They are led into barren lands that are mostly privately owned ranches hundreds of square miles in size. There is no water, so the irony of calling these people “wet backs” is disturbing. They will die of dehydration. Most bodies are found about 70 miles from the border, often in the fall during hunting season. They are buried on the spot or in cemeteries with unmarked graves.

Dr. Baker, with a small group of students and volunteers, works to identify the people who never realized their American dream. She then tries to return the bodies to their families. It is heart-wrenching work, but surely the work of the Lord.

She is one of the only forensic pathologists in America trying to identify these tragic souls.

Two weeks ago, I saw a young man barely out of his teens from Honduras. While crossing the border into the US, he became dehydrated. He was admitted to a border hospital and told he had damaged his kidneys and that he would need dialysis. He then came to Memphis where he had family. Thankfully, he is young and his kidneys had recovered by the time I saw him. But he came within a hair’s breadth of being someone who met Lori in the desert.

When I last saw him, he was smiling, ready to go to work building houses with his uncle. But I can’t help but wonder what his smile masks. Did he see people along the way who Lori will examine later this year? Did he know where they came from? Did he know their mamas?

My talks with Lori educated me on a facet of immigrant life that I never considered, but I cannot get out of my head the profound sadness of it all. She gets regular hate mail for doing what she does.

The line between life and death is so very thin. My troubles seem of little consequence when I think of all those who set out on such a perilous journey. I don’t know if I will see Lori ever again, but I do know I will not talk to a recent immigrant to Memphis from the South without thinking about what could have been.

Let’s Talk About the C Word

I have just returned from the Democratic National Convention in Philadelphia.

No, I did not meet Bernie or Hillary. In fact, my agenda had absolutely nothing to do with politics. (Thank God).

But I did have an agenda: to promote the idea that it’s time to rethink cancer.

I was in Philadelphia earlier this week to speak on a panel after a screening of a new documentary film called “The C Word“. The Church Health Center is featured prominently in the movie, which will be in theaters this fall and on Netflix in the spring. It is narrated by Morgan Freeman and produced and directed by the Academy Award-nominated director Meghan O’Hara.

You can watch the trailer here:

The movie is about how cancer can be prevented through improved eating habits, exercise, and stress reduction. Does that sound familiar? It should; the Church Health Center has been preaching prevention for nearly 30 years. The movie centers around a French physician, Dr. David Servan-Schreiber, who developed brain cancer then aggressively began treating himself with the basics of good nutrition, exercise and stress reduction. He then wrote a popular book titled Anticancer: A New Way of Life. He doesn’t advocate a fad diet or his own special treatment plan.

The movie also uncovers ways our lifestyles contribute to the cancer epidemic in the US. But what’s disturbing is that even if we vigilantly do everything we can to avoid cancer, the deck is often stacked against us. Did you know that tobacco companies now own all the major food distributors in America? Or that when a food label uses the term “fragrance” as an ingredient, there is a list of carcinogens that can be included in that term? The movie reveals a great deal of similar information and is extremely thought-provoking.

A portion of the documentary includes several interviews with me, but I am proudest of the Jones family that the movie tracks over a year. Several members of the family lost significant weight by attending our Wellness center and working with our health coaches. They are the real stars of the film.

My hotel in Philadelphia was located downtown near Independence Hall. Staying there reminded me of Benjamin Franklin’s famous quote, “An ounce of prevention is worth a pound of cure.” Franklin wrote that after returning to Philadelphia from Boston in 1735. Impressed with Boston’s fire prevention programs, he sent an anonymous letter to the Philadelphia Gazette with suggestions for how fire prevention could be enhanced in the city. It included avoiding “carrying live coals in a full shovel out of one room to another.” His commonsense suggestions led to licensing chimney sweeps and requiring homeowners to have leather buckets in which to carry coal.

Of course, common sense only seems so in hindsight. It takes an incredible amount of work to make real headway in the way we rethink health and then push for effective implementation of that new way of thinking.

Franklin’s suggestions about fire prevention have parallels in today’s healthcare landscape where we’re constantly talking about prevention of chronic health issues like cancer. It’s my hope that the lessons of The C Word will be heeded.

Disarming Fear

I was watching the Olympic trials last night when the local news broke in showing people blocking the bridge over the Mississippi River. A Black Lives Matter rally had turned into an act of civil disobedience of blocking traffic on I-40. It was remarkable to see this happening in my own city of Memphis.

I grew up in Atlanta during the Civil Rights Movement. I remember seeing people in Birmingham being swept away with fire hoses as I watched on TV. I was 14 and in the 8^th grade when Martin Luther King, Jr. was killed in Memphis. All of that seemed a long way away, and I was too young to be involved. This time, though, I was watching things happen in the city I love, and I am more than old enough to be involved.

But how? What am I to do?

That is exactly the problem, isn’t it? Much of the time, we don’t know what to do, or at least we claim we don’t. Everyone on all sides feels helpless. No one wants innocent people to be shot by the police, and no one wants the police to be shot while doing their job. We all believe that the police should go about doing their job of protecting all citizens, no matter their race. I believe we all want that, so what is the problem?

The problem, as I see it, is that we are unequal in our society based on perceived differences generated by class and race. None of us can fully know what someone unlike us feels or believes because our experiences are very different. That leads to fear, the progenitor of evil.

Fear drives us apart. Fear makes us see the other as a threat. Fear makes our heart pound and want to reach for the trigger of a gun. Fear makes me cross the street when I see someone who doesn’t look like me walking toward me. Fear is the enemy we must repel.

The power of fear is why, I believe, the overwhelming message of the Gospel is “Be not afraid.” This is what the angels say at Jesus’s birth and what Jesus himself utters to those who follow him. The fact that we have not heard the message leads us to the divisiveness we are enduring.

Eliminating fear is not so easy. It helps, though, to follow Abraham Lincoln’s advice: “I don’t like that man. I need to get to know him better.”

Jesus ultimately calls us to love our neighbor. There’s a process in that, and I think it might just start with getting to know our neighbor’s name.

In my city of Memphis, I will offer a kind word to strangers, especially those who look different from me. It is at least a place to start.

Thoughts On Brexit

I spent a year going to school in London. At the University of London, I was surrounded by people from all over Europe and the world. The amazing diversity of London has always been one of its best assets, and I can’t reconcile my memory of London as a place of unity and diversity with the reality that is Brexit.

Turning in seems to be the majority sentiment for a county that once ruled much of the world. I am in no position to judge the British on how they rule themselves, but I am confident that focusing only on one’s own self-interest is never a good plan. Any time decisions are made based on how one party – whether that be a person, a group, or even an entire country – can get more for itself, the result is rarely a strategy that works well in the long term.
I believe that finding ways to be generous to neighbors and engaging with people who are different from ourselves has been the most effective business and social strategy for hundreds of years, and I hope that Britain will find a way to avoid isolating themselves while at the same time exercising their autonomy. Obviously, that’s a hard balance to strike.

Like many Americans, I pray that the British exit from the EU does not lead Americans to say we should follow the same path. We live in a complex world and it is critical that we find ways to better engage the rest of the world, not isolate ourselves from it. I am confident that the Christian path is to welcome strangers into our midst and to go into all the world. Anything short of that is not following the path Jesus set before us. Sadly, too many people who claim to follow Jesus would rather we circle the wagons and only share our abundant resources with those who look just like us.

My experience living in London opened my eyes to remarkable people and powerful ways that others around the world live out their lives of faith. None of us are able to love God fully by just following our own understanding of how God created the world. We truly need each other. If America is to be a great nation, we must open our hearts and arms to all who would want to be in relationship to us. It says it on the Statue of Liberty, but Jesus also says it in the Sermon on the Mount.

I pray we will listen closely to God’s desire for us to engage the whole world in acts of love, justice, and joy. Anything other than that is a path that no Christian should be willing to take.

Remembering Harry Peel

Harry Peel was a drummer. He played what John Kilzer sometimes referred to as a ”big bongo.” I loved to listen to his playing, but I was also one of his doctors.

I have to be honest: Harry was a terrible patient. He would nod along in agreement whenever I told him he needed to improve his lifestyle to better-manage his diabetes and his heart disease, but I knew he was probably not going to do it. He marched to his own beat. After all, he was a drummer.

When John Kilzer started his music-based recovery ministry known as The Way, Harry immediately signed on as the drummer. John called the band “The Harry Peel Orchestra.” It was sort of a joke, but not really.

John and Harry played together for over 30 years. They were like brothers, which was both good and bad. One time when I knew they were not getting along very well, I was talking to Harry about a gig John had played. The  people had not paid John what I thought was reasonable to pay him. Harry indignantly said, “Don’t those people know he is JOHN KILZER?” Harry was true to John even when they were going through a rocky patch.

Because of his diabetes, Harry’s foot had very poor circulation. We tried everything we could to improve the blood flow, including multiple surgeries. Those helped for a while, but then we had to amputate his foot. What could be worse for a drummer?

I would see Harry in the clinic. I could tell he was down but he kept going. The beat kept going.

Then one day he was back playing at the Way. The big bongo was back. It was exciting, and I could tell John was pleased.

Then all too soon Harry didn’t show up for a gig at the Blue Monkey. Who would now keep the rhythm?

Harry died sitting in his chair.

Harry Peel played the drums for almost every successful musician that has played in Memphis over the last 30 years. People didn’t always know his name but they could feel his beat. Harry was a drummer.

I will always remember him playing with John Kilzer. The Way’s band will always be the Harry Peel Orchestra for me. He was never the guy out front, but he proved you can make a difference in life by being the guy who keeps everyone else on track by keeping the beat.

Thank you, Harry, for teaching us that lesson.