BY: MARY ANN STEINER
For years I worked at the Saint Louis Art Museum, where people often paused before an intriguing modern sculpture called The Breaking of the Vessels. It's a towering, dark bookcase made of lead, wire and glass, whose heavy tomes lean precariously off its shelves and hundreds of glass shards litter the floor in front of it. The German artist Anselm Kiefer conceived the sculpture as an interpretation of a story in the Kabbalah about the chaos, danger and destruction that ensued when God yielded to creation.
Kabbalistic lore recounts a tale of creation different from the familiar story we know from Genesis. It proposes that long before the ordered progression of six days and the haven of Eden, God's pure goodness, pure wisdom and other divine essences were contained in pristine vessels, making them safe from anything "other." According to the story, however, the divine love for others, on whom love could be lavished and with whom it could be shared, was even stronger than protecting the perfection of the divine essences. So God smashed the vessels and tore open the books of wisdom to begin the great onslaught of creation — a tumbling forth of unimaginable diversity.
The currency of diversity is difference, which also is the currency of disparity. In diversity, difference is cultivated and celebrated. In disparity, difference is denigrated, even punished. When the serpent of Genesis proffered fruit from the tree of the knowledge of good and evil, it was trading on the sinister use of diversity for divisiveness — us and them, power and weakness, sickness and health, haves and have-nots. The manipulation of difference from the goodness of diversity into the evils of disparity must be part of the original sin.
This issue of Health Progress explores diversity and disparity in health care. That includes diversity which truly is present and merits celebration; diversity to which we aspire and work toward; disparities so entrenched that they are ugly reminders of how far we stray from the image of God; and recognized disparities being addressed with intention, strategy and commitment. The articles reveal that disparities are found at all points in the health spectrum, from the poor health status of individuals and populations (often due to compromised determinants of health like poor air quality, unsafe neighborhoods, limited options of nutrition and minimal prenatal care), to the delivery of care in hospitals, clinics and home settings, to C-suite offices and board rooms where health care priorities are set and long-term strategies mapped.
Catholic health care attempts to carry out its mission and carry on its business with the practices and vocabulary it knows best. When confronted with instances of disparity — whether the person comes to us ill or injured or badly treated — it knows to heal with its right hand while its left hand reaches for solutions to the larger problem. We gather data, identify trends, commission task forces, train for cultural competency and sponsor initiatives for equity and inclusivity. Unlike the admonition in Matthew's Gospel (Matthew 6:3), our left hands need to know what our right hands are doing, or we don't have a chance of addressing the real evils of disparity or approaching the great good of diversity. Our means of upholding and promoting diversity are those very REAL (race, ethnicity and language) databases, educational programs, task forces and initiatives. They function as the vehicles, or the containers, for our commitment to diversity.
Let's not be surprised, then, that there will be more breaking of vessels. Not, we hope, the smashing and burning that happened in Ferguson and Cleveland and Baltimore over the past year, but a breaking of the containers of assimilation that Fred Hobby described so poignantly in the first article of this magazine. It's just a metaphor, of course, but if the God of creation — the God of diversity — was willing to sacrifice the container for the profusion of content, then we in Catholic health care will do well to be as flexible as we are committed, listen hard, and yield often to the goodness of diversity.