Lunch Discussions at Siloam

Whole-person care is a word that gets thrown around inside the walls of our clinic daily.  Inspired by the way that Jesus healed in the Gospels, we recognize that when a person is ill, more is ill than only the physical denominators of their health, but their feelings, emotions, heart and spirit also play a part.

Dan Fountain illustrated this brilliantly in an address he gave to the World Congress of the ICMDA in Durban in July 1998, drawing from a case study found in Mark 5: 25-34 – the healing of the woman with the hemorrhage.

Considered unclean by the social structure that surrounded her, her daily condition was one of abandonment, rejection, and despair.  Her life became defined by her illness and her hope for a cure had long been extinguished.  Yet hope was awakened the day that she heard stories about this man named Jesus and the accounts of the way He healed people.  With no other direction out, she knew that she needed to somehow encounter this man for her healing.

One day she hears that He’s passing through her town and she steps outside of the boundaries of what was allowed by her society.  She, unclean, reaches out as Jesus walks by and touches the hem of His garment, instantly healed.

Painting by Howard Lyon

Painting by Howard Lyon

Dan Fountain continues the narrative: “He [Jesus] knew she had been physically healed. We doctors are usually delighted when we have healed someone physically. Could Jesus not be content with that? No, because the woman herself had not been healed; her life had not yet been restored. Jesus wanted to heal her as a whole person, so he called her back to him. As she lay prostrate on the ground before Jesus, waiting to hear words of condemnation, she heard instead two absolutely incredible words [“My daughter…”], and these two words healed her.

… What heals the broken heart and the wounded spirit? What heals the heart is simply a word spoken to the depths of the spirit of the sick person. It is a word that is understood by the spirit of the person in such a way as to resolve the psycho-spiritual pathology – the fear, the conflicts, the anxiety, the guilt, the despair. When this word heals the inner pathology, the whole person can be healed.”

The question is: Is it possible for us to heal our patients in this way?  And if so, how?

Beginning November 18th, Siloam Family Health Center will be featuring a lunch discussion on whole-person care every 3rd Tuesday of the month.  All members of Siloam staff, volunteers, trainees and members of the Nashville medical community are welcome to attend.

An article will be selected that focuses on what it means to offer whole-person care with Dr. Morgan Wills facilitating a discussion around the topic presented.

If you are interested in attending, please RSVP to me at Rachel.lantz@siloamhealth.org to receive the reading for the discussion and bring your lunch to join us while we discuss what it means to offer whole-person care.

This week we will be spending time discussing “The Healing Team” from Dan Fountain’s book God, Medicine, and Miracles.

If you would like to read the full length of his 1998 address, we encourage you to read the article here: http://www.cmf.org.uk/publications/content.asp?context=article&id=694

Upcoming Event – Grace Prescriptions

save the date website version

As a Christian medical professional, treading the waters where faith and medicine intersect can seem murky with the feeling of being ill-equipped to approach the topic of faith with patients.  Yet it is this patient–provider relationship that provides such rich ground to plant seeds of spiritual hope in patients as they face their hours of deepest hurt and fear.

On the weekend of February 6-7th, Siloam will host Grace Prescriptions – a conference designed specifically for Christian medical practitioners to become equipped to integrate their faith with their practice.  Formerly known as “The Saline Solution,” Grace Prescriptions is a training paradigm pioneered by the Christian Medical and Dental Association.  Written by Bill Peel and Dr. Walt Larimore, the curriculum is designed to explore the topic of spirituality in healthcare and equip those of us in the medical profession to integrate faith into our practice.

We invite you to come and be a part of this weekend of gathering with other Christian healthcare practitioners and their teams from around the Nashville region.  For more information, please visit our Events page as we announce further updates.

Registration opens October 6th.

Biopsychosocial… spiritual?

Guest blogger Lauren Roddy, one of seven students in this summer’s Community Health Immersion, writes…

Several of my friends and family have been astounded that a place like Siloam exists, where the individuals who need it most not only receive excellent health care, but also are treated as whole people, like the beloved children of God that they are.Whole Person Care

Why is it so hard for us to think of care in these terms? After all, as Christians, we are called to care for and love the poor, plain and simple. This is certainly not to say that those not of a Judeo-Christian faith tradition can’t or don’t have a heart for the poor, but we have specific Biblical instructions and moreover the framework to do so.

“…we are trained…to compartmentalize our lives.”

I don’t think that the problem is necessarily that not enough health care providers are Christians, but rather that we are trained, in America in general but in medicine in particular, to compartmentalize our lives. Our work, family, and church are kept separate, and we are encouraged to leave all personal ideas, passions, and faiths at the door. How can we expect to help prepare individuals for their unique purpose as children of God’s kingdom if we don’t claim our place there as well?

I am grateful and blessed to be a part of the Community Health Immersion Program at Siloam this summer and to have the opportunity to shadow providers that bring their whole selves into a holistic model of healing. Patients not only have access to a Behavioral Health Consultant and to Pastor Doug, who make sure the patient’s social and spiritual needs are met, but they experience God’s love from the front door to the back.

I have witnessed providers over and over again spending a few extra moments to make certain that patients feel heard and that their unique experiences are validated. In return, the patients have a deeper trust in the medical expertise of the providers, and, sometimes, express a deeper hunger to know the Lord.

Roddy, Lauren - next to Compassion sign

Lauren Roddy is a rising senior at in the pre-medical program at Baylor University.

I challenge each of you to interact with others as whole people loving whole people. I pray that I can emulate what I’ve seen and learned so far in my future medical career, and I hope that everyone at Siloam knows that I want to be y’all when I grow up!

God with us…

An incarnate God is beyond my comprehension. Yet, that is who Jesus is…God with us, the Incarnate One…choosing to become human to suffer with us – a God of compassion.Jesus_in_Golgotha_by_Theophanes_the_Cretan 4-2014

As we move through the final days of Passion Week for the Christian community (Jesus’ final days that include his crucifixion, burial, and resurrection), I wanted to share another of Siloam’s core values that guides us as a ministry: Compassion.

Active, compassionate care means caring intentionally for the whole person—body, mind, and spirit.  The biblical concept of health—rooted in words like Shalom (Hebrew) or Sozo (Greek)—implies that man is a unified being, who is not so easily reduced to component parts as we might like.  In fact, both of these words can be interpreted to mean not only health, or well being, but also convey the concept of “salvation.”  Compassionate care for the whole person means seeking to alleviate suffering, and this may occur on many levels.  As we begin our relationships with our patients, we will seek to be genuine learners of their suffering.  This includes learning about their various social, religious and cultural backgrounds as we “incarnate” ourselves into their special contexts.  By building a base of mutual respect, we commit to explore issues beyond their presenting medical issue, asking permission as appropriate.  We do not condone forcing any beliefs on anyone—biomedical, Christian, or otherwise—but rather, from an early stage in our relationship with a patient and with the humility of Christ, will seek to discern where God is already at work in their life.  Compassionate care then means being prepared to help them take the next, appropriate step with God—or to refer them to someone who can.  In the meantime, compassionate care also means being willing to enter another’s suffering and share it with them when it can’t be alleviated.

The good news is that the incarnate God is still with us through the Holy Spirit…helping us to be compassion to the world!  Have a great weekend!

How Whole-Person Care Fosters Patient Engagement

Lauren Holmgren, former 4th year ETSU medical student who completed her rotation at our clinic in March 2014

Lauren Holmgren, former 4th year ETSU medical student who completed her rotation at our clinic in March 2014

Leaving Siloam yesterday was bittersweet.  Not only was I leaving a clinic I have come to love and people who had truly made me feel like part of the team, I was leaving behind my role as a medical student.  Yesterday was the completion of my very last clinical rotation of medical school.  I will never again walk into a patient room and introduce myself as “the medical student working with….”  Instead, the next time I walk into a patient room I will introduce myself as “Dr. Holmgren”.  As I reflect back on my time at Siloam, there is no doubt in my mind that as I transition to “Dr. Holmgren,” the way I practice will be shaped by the time I spent at Siloam.  I have, somewhat selfishly, spent a lot of time this month trying to figure out what it is that allows the patients and providers at Siloam to create such a nurturing and health promoting environment because it is exactly the type of relationship I hope to one day have in my practice.

The conclusion I have come to…. it’s a combination of a number of things.  First and foremost, the providers at Siloam are interested in the whole person rather than just the medical complaints of their patients—their dedication to providing care for all aspects of a patient’s life from their medical needs to their spiritual needs to their social needs.  This focus and dedication allows the providers to make the best recommendations for their patients but that alone is not enough to care well for their patients. The patients have to take an active role in their healthcare.  The care and dedication of the providers to take care of the whole person is something patients recognize and I think that greatly contributes to patients taking an active role in their own health, but Siloam also requires their patients to be responsible for their healthcare.  I see this as a critical part of the success Siloam sees.  Patients understand that the clinic is not going to ask them to contribute more than they can afford but at the same time, the patients understand that they have to be invested in their own care.
Additionally, the patients of Siloam are a wonderful group of people.  They have a wide variety of experiences that have shaped their lives but they are all grateful for what they have and the care they receive at Siloam.  All of these things together have made an exceptional place to learn and a great place for people to get exceptional care.  I am truly grateful to have had the opportunity to be a part of such a wonderful clinic.

 

Guest blog post courtesy of Lauren Holmgren

Whole-person care…is GRRREAT !

Tony the Tiger recently sought care at Siloam.  Listed as “Tony Tiger” in our electronic health record, Vanderbilt Medical Student Enoch Sizto was given a patient’s perspective on the entire clinic process.  Preparing for his new patient appointment, Enoch remembered to bring his identification (see accompanying photo). Tony Tiger - Enoch Shizto 2-2014

We want our trainees to see that in our attempt to provide whole-person care we need a team committed to making that experience possible.  The best practice examples of whole-person care extend beyond what goes on in the exam room between the patient and the practitioner.  Every staff member plays a role in caring for the whole person…from taking a patient phone call, to check-in, to triage, to the lab, and eventually to check-out…how staff address and care for patients is critically important.

This is not merely a “good customer service” technique, although I certainly do not knock the need for customer service training.  Whole-person care starts with the heart of the individual providing the service.  They must know themselves to be deeply loved creations of God…and, be encouraged by team members and leadership…and, supported by organizational policies and procedures.

Some ways we carry this out at Siloam is hiring staff that understand deeply our mission and can abide by our core values.  It follows with daily moments of renewal of spirit in prayer huddles to seek God’s blessing upon the shift ahead of us.  It is supported by a weekly staff meeting that allows us to form community (team-building) and reflect upon our purpose and study the scriptures.

Making whole-person care “Grrreat!” is not a destination but a process.  We continue to learn as we go.  What systems, processes or people have you experienced that make whole-person care possible in your life?

Instruments of God’s Love

For Valentine’s Day, it seems appropriate to feature Siloam’s core value on Love.

“Sharing the love of Jesus is an intentional process which begins with the Siloam board and staff knowing and experiencing Christ’s love themselves.  As a medical center dedicated to sharing this love in a variety of ways, we have a constant need for the grace and truth of the gospel to overflow from our lives to others.  As God pours out this love through us, it is vitally important to attribute it to the original source–the sacrificing love of Jesus as God in the flesh, and not just the goodness of our own human hearts. “This is love: not that we loved God, but that he loved us and sent his Son as an atoning sacrifice for our sins.”  (1 John 4:10, Bible).  Consider how Jesus approached the healing of the blind man at the pool of Siloam in John chapter 9.  The man was physically healed by the touch of Jesus, but Jesus did not stop there.  Jesus pursued the more complete healing of the man by revealing to the man who He really was—the Messiah. It is our hope that Siloam patients will, in due time, both experience God’s love through our care and grow to know the Great Physician who provides it!”

Click here to see all of Siloam’s core values.

Mercy…brings hope

Core values have served Siloam well since its founding. One of Siloam’s founders, Mick Antanaitis, beautifully reflected on the core value of mercy before a meeting of Siloam’s Board of Directors. Here are his remarks.

Mercy is not a passive concept
Mercy is the active companion of compassion
Mercy is the energetic response of love
Mercy is not pity…It is regard moving in concert with compassion

Mick Antanaitis, one of Siloam's founders, continues to volunteer on Siloam's Board of Directors.  He is employed as a physician assistant at United Neighborhood Health Services and also is on the pastoral staff at Belmont Church.

Mick Antanaitis, one of Siloam’s founders, continues to volunteer on Siloam’s Board of Directors. He is employed as a physician assistant at United Neighborhood Health Services and also is on the pastoral staff at Belmont Church.

It is not mere empathy…it is kinetic
Mercy is not a feeling…it is an expenditure
Mercy is shown
Mercy is bestowed
Mercy is given
Mercy is extended
Mercy is provided

Those who need mercy are vulnerable…and they are unable to cover their vulnerability
They are exposed to pain…and suffering…and want…and damage…and destruction…loss
They have no recourse…or solution…or protection…or benefaction
And they fear the worst…because they are familiar with the worst
Mercy is a grace that provides a remedy…an option…an access to shelter from dire outcome

One of Jesus’ best friends (Peter) once wrote that we are to administer grace in a variety of forms
Mercy is one of the most profound and consequential forms of grace
Siloam is called to be an extender of that kind of grace…And in so doing,
To dispell fear…to quell anxiety…to provide a loving remedy to those who have no other remedy.

There was a time in Israel when 15,000 had died of a plague
Many tens of thousands more were already sick…
They had no medicine…they were all completely exposed…men, women, children, grandparents
And they were fearing the worst
It is not hard to imagine that many of the not-yet-sick were abandoning the sick
They were running away from the vulnerable and the unprotected…
in an attempt to preserve themselves

But one man ran right into the middle of the sickness and toward those who needed healing
Someone needed to bring the energy of mercy to the most vulnerable and the most needy
And so Aaron took the holy fire from the tabernacle,
and ran toward those who had no other hope
The Bible says that Aaron stood between the living & the dead…and the plague stopped (Numbers 16:48, Bible)

Siloam has been constituted to extend the energy of God’s mercy to those who have no other hope…
and to those who have no other option
We are administering grace in a profound way to the vulnerable…
To those who have nothing else to hold onto
Mercy…the work of Jesus…
Mercy…the providing of GOD’S love through our hands.

Click here to see Siloam’s core values.

Getting in Rhythm

The University of Washington 1936 Olympic rowing team wins the gold!

The University of Washington 1936 Olympic rowing team wins the gold!

Heading into this new year and new season, Dr. Morgan Wills’ comments taken from the 2013 Winter Edition of Healing Waters are fitting:

At a recent Siloam staff retreat we offered an “unplugged” session where team members could ask any question they wanted of me as their new CEO.  Seizing the moment, one intrepid staffer asked: “Where in your life do you feel completely incompetent?”

Yikes!  Although there were many things I could have shared, a reflexive answer quickly tumbled out of my mouth: “On a dance floor.”

Truth be told, musical rhythm eludes me.  Like many men with two left feet, however, I have learned over the years to compensate.  Can you say, “Line dancing”?!  Yes, it is easier to find rhythm as a part of a group.

I found this to be particularly true in college as a member of the freshman crew team.

Dr. Morgan Wills, President and CEO, Siloam Family Health Center

Dr. Morgan Wills, President and CEO, Siloam Family Health Center

With eight large men, each pulling on 12-foot oars in a two-foot wide racing shell, there is little margin for error.  Hitting the water out of sync with your teammates can cause an oar handle to smack you in the midsection – called “catching a crab” –  slowing momentum and potentially even knocking you out of the boat altogether.

Those first few months on the crew team were awkward – especially for the novice rowers like myself.  But after getting over the initial learning curve, something cool began to happen.  Our ragtag group of oarsmen began to row as one.  When rowers move completely in rhythm, they can generate a phenomenon called “swing,” when boat speed exceeds the sum of the individual rowers’ contributions.  A team with swing can outperform more frenetic crews rowing at a much faster rate.*

We have seen major transitions for our team at Siloam recently.  Many staff are new – or in new positions.  We have been learning to navigate through the “wake” of health care reform, and we are experimenting with new tools – such as a new website, a new annual fund campaign, Health Assist Specialist services, and a nurse-driven home visit program.  At times it has felt like an all-out sprint with new rigging amidst choppy waters.

But after a challenging start, our team is starting to settle into a rhythm.  We are learning how to pull more in sync with one another, our patients, our volunteers, and our partners in the community at large.  Maybe even sensing a little swing!  The objective?  To provide exemplary, affordable, whole-person health care for the roughly 5,000 uninsured patients God has given us.

These patients are some of the most vulnerable in the city – and among the most challenging to care for. To move effectively amidst such challenges, it helps to have someone else set the pace – to enter into a rhythm that is bigger and steadier than your own.

For the Christian community, the Advent and Christmas season offers such an opportunity.  It is an invitation to get our lives in rhythm with God’s healing activity in the world.

Perhaps it is unsurprising then that one of the keys to our team’s newfound swing comes from these words of Jesus, which we pondered at our staff retreat:

“Are you tired? Worn out? Burned out on religion? Come to me. Get away with me and you’ll recover your life. I’ll show you how to take a real rest. Walk with me and work with me watch how I do it. Learn the unforced rhythms of grace. I won’t lay anything heavy or ill-fitting on you. Keep company with me and you’ll learn to live freely and lightly.”  (Matt. 11: 28-30, The Message)

As we head into a new year, please keep Siloam in your prayers.  With uncertainties afoot and so many moving parts to consider, we are prone to wander off the beat.  Whether in the all-consuming business of “religion” or health care (or both!), it’s easy to look around, get anxious, crank up the pace, and burn out prematurely.

It is so much better to keep company with the Master!  As we go about our work in 2014, may we all learn to live freely and lightly, to keep time with “the unforced rhythms of grace.”

*(For a fascinating glimpse at this dynamic and an inspirational slice of history, check out the award-winning book we’ve discussed in staff meeting, The Boys in the Boat: Nine Americans and their Epic Quest for Gold at the 1936 Olympics.)

“Before God, We Are All Poor”

Run with the Nations - sorting homelands

The homelands of some of Nashville’s refugee populations are cued up for the Run with the Nations 5K.

It has already been a week of being home from the project and I am not totally sure I have realized that it is over. Seeing everyone at home has been an enormous blessing and it has done more than enough to quell the homesickness I felt the last few days before leaving. I am very glad to be able to once again spend time with my family and to share all of my experiences but something about being here just doesn’t seem right.

There is something in the way that I don’t have to budget, pay for, and prepare my meals; something about the television being on (having lacked one for six weeks); something about the safety from mice and cockroaches; something about not having a daily opportunity to see the smiling faces of people from all around the world; and something about having more than $10 in my wallet that seems too…normal.

My entire summer so far has been spent “reframing” my point of view and looking at things from a different perspective by experiencing it myself. We learned how to survive and how to live without a life of plenty and now that I have left that experience and the intentionality of the program I am fully starting to grasp how much I have changed throughout those six weeks.

Burmese friends enjoy a meal with CHI students - 2013

CHI students, Madison, Jane, and Elias enjoy the presence of friends within the local Burmese community.

The simplicity of living and the absence from distractions gave me a better focus and was actually quite enjoyable! Because I had never willingly chosen to sacrifice or reduce my standard of living, it was a freeing experience. Any constraint placed on the experience due to monetary limitations was quickly forgotten as a result of the joy I found in the relationships that I was building in the group, in the congregation, and in the clinic.

Since being back, many people have asked me what it was like living with little to nothing. Honestly, it was not bad at all. I forgot about what I did not have and instead focused on the blessings that I did have. Fulfillment was not coming from material possessions but in satisfaction with where I was and who I was with: those we were serving and learning from. After this experience I have experienced that while it is possible to be physically “poor” and in need, it may be easily overcome and defeated with love and through hope.

The Community Health Immersion instilled in me a fresher and greater passion for service and a clearer direction for my aspirations as a Physician Assistant as well as a follower of Christ. By removing myself from worldly distractions and abundance, I now see distinctly where I would like to end up – whether that is what God has in mind is another story!

Nonetheless, I am very thankful for Siloam and the adventures they took me on this summer. It was a wonderful blessing to learn from and watch them work in the clinic as well as the opportunities they gave me outside of their walls in the community and in the congregation. As I continue to evaluate what I have seen and begin to apply it to my life I am thankful for the experience and for relationships that I have made.

Manzella, Elias - nearing the finish line at Run with the Nations - 2013

Elias Manzella, a participant in Siloam’s Community Health Immersion, makes a strong finish as he completes the Run with the Nations 5-K supporting work with refugees being resettled in Nashville, Tennessee.