BY: BRIAN SMITH, MS, MA, MDiv
Illustration by Jon Lezinsky
During the past few months we have heard the word "unprecedented" used to describe the coronavirus pandemic. Others have referred to this time as "disruptive" and "chaotic" as the health care world we have known has been turned upside down. No one believes that we will ever go back to the way things were. Everyone seems to be asking, "What will our new reality be?"
Through the years, I have found whenever I feel like I am in uncharted waters, it is helpful to ask, "Where do I find a similar example in sacred scripture?" Is there a story or passage in the Bible, that with prayer and reflection, may shed some light on the current situation and give a sense of direction and new order?
Reflecting on Creation and Pentecost
Two scripture passages that have come to mind lately are the first chapter of Genesis, the story of creation, and Acts 2, the coming of the Holy Spirit at Pentecost. Christian scripture scholars point out the two are related.
"In the beginning, God created the heavens and the earth. Now the earth was formless and empty, darkness was over the surface of the deep, and the Spirit of God was hovering over the waters…" (Gen. 1:1-2, NIV).
The author of Genesis paints a picture of disorganization and uncertainty, because at the beginning of time the world had no order. Everything was "formless and empty."The Hebrew words here, tohu wa-bohu, suggest that there was confusion, emptiness and waste. And it was filled with darkness. Those are words we have heard to describe the current pandemic.
But the "hovering" of God's Spirit changes everything. The Hebrew word used here is ruach elohim. The picture is one of watching carefully and deliberately. The Spirit was brooding…studying…examining…lingering. And only after this hovering did God take action and start to bring order. "And God said, 'Let there be light.' And there was light." (Gen. 1:3). Could it be the Spirit is hovering over our current confusion, chaos and darkness?
The story of Pentecost can also be seen as the Holy Spirit bringing order from the chaos and confusion that followed Jesus' death and reported resurrection.
"When the day of Pentecost came, they were all together in one place. Suddenly a sound like the blowing of a violent wind came from heaven and filled the whole house where they were sitting." (Acts 2:1-2).
An alternate translation for ruach elohim is a "great wind." The author of Acts 2 uses both the image of a hovering spirit and a driving wind. The Holy Spirit brings new light in the form of tongues of fire to the disorder the disciples are experiencing. The driving wind can be seen as a force that blows away what is now no longer useful in order to create a new order and harmony - a new creation. As the Acts of the Apostles progresses, we see examples of the old order being blown away: dietary restrictions, mandatory circumcision, animal sacrifice and the belief that salvation is only offered to the Jews. The new creation is the birth of the church.
Pope Francis appears to be drawing from these images of the Spirit in a recent interview he gave to Commonweal. Francis was asked what effects the pandemic crisis is having on the church and what are new ways we may need to rethink our ways of operating. What he said strikes me as particularly important for Catholic health care to consider:
"A tension between disorder and harmony: that is the church that must come out of the crisis. We have to learn to live in a church that exists in the tension between harmony and disorder provoked by the Holy Spirit. If you ask me which book of theology can best help you understand this, it would be the Acts of the Apostles. There you will see how the Holy Spirit deinstitutionalizes what is no longer of use and institutionalizes the future of the church. That is the church that needs to come out of this crisis."
The Health Care Ministry that Needs to Come Out of this Crisis
During the last few months, CHA staff have spoken to hundreds of senior executives, sponsors, trustees and frontline care providers to see how our ministry is faring during the pandemic and what we are learning. Many leaders have shared that the pandemic has forced them to look at issues that were always there, but they never had the time or resources to fully address them. For example, a few systems shared that they had delayed utilizing telemedicine and now it has become the main way they are delivering primary care. Clinicians report the experience has been surprisingly positive. It has led some to ask if there will be a need for the same number of in-person office visits and the same amount of physician office space going forward.
Several systems have found that associates who work in shared services --engaged in administrative, financial and some other functions in system offices-- can effectively do their work remotely from home, and that their productivity has actually increased. What does this mean as shelter-in- place orders expire and people can return to their worksites? Will associates continue to work from home or will they return to system offices? Will system offices need to be as big as they currently are? How will employee work-related costs be reimbursed when they work remotely?
The pandemic has shined a spotlight on disparities in care for minority populations, people with disabilities and impairments and impoverished communities. Will this crisis move us as a ministry and as a nation to say the old order does not make sense and it is time for a new creation – a new health care delivery system?
A high percentage of COVID-19 related deaths have taken place in long-term care facilities and other types of senior living centers. This segment of the continuum of care has been underfunded by Medicare and Medicaid for years. What reimbursement changes are necessary for eldercare so that senior citizens and their caregivers never again have to feel as if they have been abandoned by our broken health system?
It is still too early to know what this new creation will look like for Catholic health care. However, it is not too early to lean into practices that will allow us to follow the promptings of the Holy Spirit. Now is the time to be praying, reflecting and listening more intently to God's voice. Our ethical decision-making models should be used with greater intention as we navigate the future of our ministries. Our sponsors, senior leader and trustees need to practice prayerful, communal discernment so we know what God is asking us to discard and what needs to be embraced.
One executive mission leader recently shared with me that he feared decisions were being made too quickly within his ministry. "I see us furloughing associates and laying off others. At the same time, we are restructuring our system, eliminating some services and adding others. Sometimes, I wonder if we are letting go of associates who may have the very gifts we need to create the new health care reality we are imagining."
These are some of the initial questions we hear members asking. They are good questions and we need to recognize we are currently in our own Pentecost moment. The Spirit is hovering over this time of crisis, chaos and confusion. We are in "a tension of harmony and disorder," Pope Francis reminds us, and we need to live through this tension. From this tension, the Holy Spirit will show us what needs to be deinstitutionalized and discarded. If we are faithful and open to being moved, the Spirit will also shed new light, bring new tongues of fire and allow a new creation of harmony and order to emerge. Come Holy Spirit, come!
BRIAN SMITH is vice president of sponsorship and mission services, the Catholic Health Association, St. Louis.
Copyright © 2020 by the Catholic Health Association of the United States
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