Why Education is Health Ministry

Fifteen years ago, the principal of Caldwell Elementary School came to me and said, “Our children don’t feel well. Can you help us?”

The Church Health Center established a small clinic in a public school. It was clear children were coming to school ill-prepared to learn. I considered this to be a health problem. As a result, the Church Health Center began Perea, a high-quality preschool that is privately funded yet inside a Memphis public school (now in Klondyke Elementary). We put more than a million dollars a year into the education of very poor children and their parents.

The name, Perea, comes from the place where Jesus was when he said, “Let the little children come unto me.”

The performance outcomes of the children who attend Perea are outstanding. I would argue that Perea is the most successful preschool in Memphis. I am completely convinced of the value of pre-K for both educational reasons as well as improved health outcomes.

Many years ago we saw young children among the poor who didn’t know their given names. They had nicknames, like “Peanut.” I can treat Peanut for the next 50 years for problems that come about from getting an impoverished start, or I can help Peanut get a good start. Poverty often comes with lack of education, and the poor have a disproportionate amount of health issues.

At the Church Health Center we’re already offering an array of internships and a Church Health Scholar program for young adults figuring out their next steps. We know that the choices they make in their formal higher education will affect not only their own lives but also the health in body and spirit of the next generation of preschoolers. Education is on our radar, and the blip is moving toward the center. As we move forward, the Church Health Center will be even more involved in education, and not only for the youngest children.

We can do something to improve health outcomes. Let’s not forget that education, rather than clinical technology, is an effective first step for changing poverty levels, and that will lead to better health outcomes over a lifetime.

10 (Actually 13) Pieces of Advice for Better Living

I think birthdays are terrific because a birthday is the one day a year we remember to celebrate a person just for being, not for doing. As I think back on all the birthdays I’ve had (and the one coming up), a few pieces of advice for better living come to mind.

1. Passion for a cause can cover up a number of mistakes. I came to Memphis to open the Church Health Center when I was 33 years old. I was too young, too dumb, to know that what I wanted to do had no chance at succeeding. But my passion covered up a lot of mistakes, and the same is true for you. If you have passion for a cause, I encourage you to follow it.

2. Never be late. At the Mayo Clinic they have something called Mayo time, which means that if you are on time you are late. The reason I think this is important is because being on time is respectful of other people’s time. Being on time shows you respect other people.

3. Always have a dog. All of us need people and other creatures that are reaffirming in life, and what’s better than a dog? A dog loves you no matter what. Cats, I’m not sure about. Always have a dog.

4. Friends trump money. You all know that money cannot buy you friends, but money also cannot be your friend. Nobody dies hoping they had more money, but people die wishing they had more friends. Friends trump money.

5. Always overtip the breakfast waitress. Some of you have been there. You know exactly what I mean. The work that somebody does is not a reflection of their value. Always overtip the breakfast waitress.

6. Manners matter. My wife taught me this. I’m still learning. Manners matter. At a dinner with a university president, it was all I could manage to keep my elbows off the table, but I did. And I didn’t drop food on myself. My wife was happy about that. Manners are another one of those things that are a reflection of how you value the other people around you.

7. It is impossible to pull yourself up by your own bootstraps. You can’t do that. That is a crazy idea. All of need other people in order to succeed. I don’t care who you are. You will not succeed in this world alone. You are not smart enough to do that. You need other people. And if you are poor—you just can’t do it on your own. It is impossible to pull yourself up by your own bootstraps.

8. The person with the power has the responsibility to be kind. As a doctor I have an unequal power relationship with patients. I see it every day. Therefore it is my responsibility to be the one who is kind. Wherever you end up in life, do not forget that. The person with the power is the one who has to be kind.

9. Uncontrolled anger will destroy your soul. I actually think there is a time for anger, but uncontrolled anger—nothing good comes from that. It will eat you alive.

10. There comes a point in life when you have to decide who you can trust. You can’t be suspicions about everybody who comes your way; it isn’t going to work. Sometimes you have to say, “I will trust you.” You have to, at some point, trust others.

At this point, if I were David Letterman, I would be done. But since I am Scott Morris, I have a few more on my list.

11. How you spend your money reflects the things you value in life. Think about that the next time you’re going to buy something that’s ridiculous. Now, I am perfectly fine with doing things that are fun from time to time, but when other people look at how you spend your money, they’re going to know a lot about you.

12. When you have a life partner, ask yourself, “Did I do my best?” It is so easy with the people you know the most, who love you the most, to just do life half-heartedly. No. Those are the people you should do you best with day in and day out. If I love you, I will do my best.

13. God gave you your body for a reason. You are expected to take care of it. The obesity epidemic in America is a reflection of how we don’t respect ourselves and we don’t respect God. We have to find a way not to be totally enamored of technology, thinking I can live my life any way I want to and it doesn’t matter because the doctor can fix me at the end with some technology when I need it. Honor God by taking care of your body.

Kindness, generosity, passion, connecting with God—it all adds up to a richer life for ourselves and the people we share the journey toward wellness with. We all learn lessons with the passing of time. What would you add to this list from your own experience that might enrich someone else’s life?

Doctor: Don’t Touch

The number one rule for a male doctor who examines a woman in a burqa is, “Stand back and don’t touch.”    

This is more than a slight impediment to doctoring.

A Middle Eastern father brought his teenage daughter to see me. She wore the traditional clothing of her religiously conservative culture. After gathering as much information as I could through conversation, I knew I had to listen to her heart. I find this challenging from across the room. Thankfully the girl’s father gave me permission to approach her with my stethoscope, and the girl started to adjust her burqa to allow me to use it. Removing the first layer revealed another thickness of black underneath. The folds parted again to expose a further swathe of dark cloth. Finally she shifted most of the formless yardage out of the way, and I saw that next to her skin she wore a tee shirt like any American teenager.

Kiss me, I’m Irish, it said.

Over the years, I’ve come to see the Church Health Center, where I practice family medicine, as the United Nations of Memphis. The working uninsured come to our open arms, whether U.S. citizens who move to Memphis for various reasons, lifelong Tennessee natives, or immigrants from around the globe. They may find work in our city, but they don’t have health insurance. The Church Health Center offers care, and where they come from is irrelevant. They come in need.

When I first came to Memphis in 1986, I was determined to begin a health care ministry for the working poor. A lightbulb did not suddenly go on. I dreamed of this for years as I slugged my way—sometimes impatiently—through the training that would make it possible. When the time came, I chose Memphis because historically it is one of the poorest major cities in the United States. I instigated relationships with St. John’s United Methodist Church and Methodist University Hospital in Memphis, found an old house to rehab, and rolled up my sleeves. The next year, the doors of the Church Health Center opened with one doctor—me—and one nurse. We saw twelve patients the first day.

Today 55,000 people depend on us for their health care, and our Wellness facility welcomes 120,000 visits a year. A staff of 220 people shares our ministry of healing and wellness. Hundreds more volunteer time and services. A network of medical specialists makes certain the uninsured working poor receive the same quality of health care as anyone with a Cadillac insurance plan. Fees slide on a scale based on income and family size.

So what sets us apart from other community clinics around the country?

The Church Health Center is fundamentally about the church. We care for our patients without relying on government funds because God calls the church to healing work. Jesus’ life was about healing the whole person—body and spirit—and the church is Jesus in the world. Jesus’ message is our message. Jesus’ ministry is our ministry. Local congregations embrace this calling and help make our work possible. We raise about $13 million a year, but the value of the health care we deliver is $100 million annually. And for every dollar we spend on treatment, our goal is to spend a dollar on prevention.

The church can choose to get involved by reclaiming the biblical mandate to bring healing. Individual congregations can choose to get involved by envisioning their role in the health of members and the community around them. Individual Christians can choose to get involved in changing health care by taking charge of their own health care.  And it has nothing to do with what happens in Washington or who is president.

In the years that the Church Health Center has cared for people in Memphis, we’ve seen that two-thirds of our patients seek treatment for illness that healthier lifestyles can prevent or control. As the health care landscape changes, we know there will still be gaps in access to care, and the Church Health Center will continue to stand in the gap.

But we’ve also realized that if we want to make lasting difference in our patients’ lives, the most effective strategy is encouraging overall wellness in body and spirit. Some of our patients teach us profound lessons, and we carry them into our own lives and relationships.

We can put salve on what hurts at the moment, but what does that change? At a fundamental level, we must transform what the words well and health mean in the minds and hearts of most people. We’ve developed a Model for Healthy Living that communicates our heart for healing and wholeness in body and spirit. That’s what people need, and that’s what we want to help people discover.

Adapted from God, Health, and Happiness by G. Scott Morris (Barbour, 2012).

Does the Sinus Cocktail Work?

One Sunday morning before the church service began my friend, Johnny, the choir director announced, “I need to go tomorrow to get a sinus cocktail. I have to sing on Friday and that will clear me up.”

“Do you know what a sinus cocktail is?” I asked him.

He said, “It’s a shot that clears up my sinuses. My own doctor won’t give me one, but I found a place where you just walk in and it’s done.”

I happen to be one of those doctors who do not give “sinus cocktails.” I first heard about them 30 years ago when I was a resident in Richmond, Virginia, but many people on the Internet claim they started right here in Memphis. My doctor friends in New York and Chicago have never heard of them.

I understand why people are so enamored with the shot. You have a cold, or are terribly congested with pressure in your sinus cavities, and you want quick relief. What could be easier than a shot? Over the years doctors have convinced people that a shot works faster and is more serious medicine than any other form of treatment, and it is even better if it contains an antibiotic.

But here is the sad truth. There remains, as of December 2013, still no cure for the common cold. I know many patients who over the years have asked me for a Z-Pac believing this relatively ineffective antibiotic can cure the common cold. Alas, it cannot. (I do, however, wish I had the trademark on the name Z-Pac; it’s a great marketing brand.)

“Colds” get their name from the notion that the over 200 viruses that cause them prefer cold weather. The truth is these viruses thrive in low humidity. That is why colds are more common in the winter, when outdoor weather is dryer and central heating dries out the air in our homes. Thankfully the body’s immune system relatively quickly fends off these viruses, and within 7–10 days the usual symptoms go away. There are no known effective treatments to kill the virus sooner. A Z-Pac (Azithromycin) is a good choice for a sexually transmitted infection, but will not cure a cold.

“But what if my snot is green or the infection has gone into my sinuses?” None of this matters. Antibiotics only work against bacteria, and virtually 100 percent of these infections are caused by viruses. All any doctor can do is treat the symptoms, and we are not very good at doing that.

Over the years there have been many attempts to convince us that a cure has been discovered. After winning a Nobel Prize in Chemistry, Linus Pauling spent his life trying to convince us that vitamin C is the answer. Unfortunately, no study—and there have been many—has ever shown convincing evidence that vitamin C works. Lately, both zinc and echinacea have been touted as cures. Both at best have minimal effect.

Virtually nothing advertised for colds on TV does any significant good. I would name names if I weren’t worried about being sued.

This leads us to what your grandmother taught you. Mix one teaspoon of salt in a pint of warm water. Squirt it up your nose, or gargle it if you have a sore throat. Acetaminophen (Tylenol) or aspirin type products can help with feeling bad. Antihistamines can help with the runny nose.   And those sinus cocktails? The formula depends on the provider mixing it up, but usually it consists of an antihistamine (such as Benadryl, which is diphenhydramine) and at least one steroid (usually dexamethasone). It might also contain an antibiotic, such as amoxicillin. The antibiotic will do nothing. The antihistamine and steroid may have a short-term benefit of shrinking the mucus in your nose that causes the congestion, but its effect is only temporary relief, not a cure. Plus, you can get the same medicine at the drugstore without having to endure a painful shot.

As is often the case, the best medicine is prevention. Most colds are transmitted by hand-to-hand contact, so wash your hands frequently.

If you get a cold, know that your body will be making antibodies against that virus and you will never have the same infection again. This leaves only 199 other viruses you can get next winter.