In 2014, Atul Gawande, a Harvard trained surgeon and Macarthur Fellow, by then already highly regarded as a medical writer for his essays in The New Yorker, published a classic book on medical care, Being Mortal: Medicine and What Matters in the End. In preparation for the most recent meetings of the Multi-Religious Fellows, devoted to effective healthcare for all Minnesotans, I was drawn back to re-read Gawande’s book. These words of his especially stood out: “We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way.”
To a large extent, the outstanding lineup of professionals who engaged our fellows in conversation over November 11-12 commented on and argued in favor of Dr. Gawande’s observation.
Our two-day session began with a deeply informative, data-rich presentation by Dr. David Abelson, who led Park Nicollet Health Services as its CEO and also served in a senior position with Health Partners.
Dr. Abelson invited the fellows into an eye-opening discussion that illustrated the national trend of soaring medical costs yielding only mediocre outcomes in contrast to countries spending much less per capita on its citizens but enjoying greater well-being. He emphasized the extent to which “healthcare” is only one factor in the achievement of a robust, healthy life. Other considerations are even more significant in helping secure a full, abundant lifespan, especially the individual choices we make, from how much we eat to the scope of our exercise regimen, and the systemic, all-encompassing issues of access to safe housing, good food, and educational and economic/job opportunities. Dr. Abelson concluded his remarks by stressing the important role of religious communities in providing community-based resources that foster good health.
Our other presenters would both echo and elaborate on the role congregational leaders and its membership play in practicing, modeling, and advocating for healthier living. Prof. Tetyanee Shippee, who teaches in the School of Public Health at the University of Minnesota and won its Community Engaged Scholar Awardin 2017, is especially concerned with proper shelter and housing options for our most frail and vulnerable. She stressed the disparities that unfairly impact so many in our society, e.g., the frequent disconnect between what the elderly truly need and want and what either their family members seekor their health care professionals are trained to offer. Those living the experience yearn for satisfying, appetizing food, and meaningful activities to fill up their days, whereas safety, hygiene, and environment are more central concerns of the family and the providers. Dr. Shippee invited us to ponder how best to balance those competing aims, along with the role religious community leaders can play in addressing those contending basic questions of needs and wants.
Our final presenters, Ms. Annette Sandler, who leads senior services for JFCS (Jewish Family and Children’s Services), her husband, Dr. Victor Sandler, who directs the Fairview/University Hospice initiative, and Dr. Edward Ratner, who is professor of geriatrics at the University of Minnesota Medical School, as well as a staunch advocate for home rather than institutional care, addressed the range of services essential for our older, most infirm and frequently defenseless population. Speaking movingly from personal experiences and professional expertise, the panel reflected on the unique challenges facing those at life’s precipice and their caregivers. We ended the day enlightened, emotionally spent, and morally roused.
Alongside the sessions dedicated to those many healthcare questions, under the guidance of my co-facilitator Dr. Martha Stortzof of Augsburg University, the fellows spent almost three hours interrogating their respective community engagement projects. From an innovative proposal to inspire peace-making communication skills, to the goal of establishing a free loan society for the Muslim community of Minnesota, to plans for fostering community-wide colloquia among religious communities about economic disparity and endemic racism, the Fellows are hard at work shaping innovative, meaningful programs that resonate both within their religious community as well as to the larger metropolitan area they call home. One project even inducted the Fellows into the Serious Mirth Society, so we move forward with intention, humor, and grace.