Health Care (mine, this time)

Well, its been a rough week.

Last Saturday, I woke from an afternoon nap with pain in my left arm. Since I thought I had slept on that arm, I didn't think much of it, and went and preached Saturday evening, as usual. (See below.) The pain got stronger that evening, but receded after I took some Ibuprofen.

The next morning, as I dressed for church, the pain returned, but very faintly, this time in both arms. At church, it got stronger as the liturgy proceeded. As I started to drive home, it got even stronger and now also included my left shoulder and upper chest. Until this point, I hadn't connected this with my heart, because I expected that would include shortness of breath, a crushing tightness of the chest, none of which I had. But, this scared me, and I remember saying to myself, "I just want to get home." When I did, my wife immediately asked what was wrong. When I told her, she said, in a no-argument tone of voice, "We're going to the hospital." I didn't argue.

It took only a few minutes to get to the Perry Hospital's ER. It was nearly empty and when my wife told them my problem, they took me straight back. I was quickly hooked up to an EKG, blood was drawn and I got an aspirin, a nitroglycerin pill under the tongue (yes, they do cause headaches, but I didn't care!), and a nitroglycerin patch on my right shoulder. The ER doctor said my EKG was fine, but my enzyme levels were elevated, so they were going to transfer me to Macon where the specialists could look me over. I'd probably have a catheterization on Monday. I was apprehensive, but not that scared, in part because the ER personnel low-keyed the situation a little to calm me. I remember thinking that the lack of constant attention in a quiet ER had to be a good sign. My pain was diminished, but I knew I wasn't simply going home. We arranged for a friend of my wife's to bring her up to the hospital in Macon, since she hadn't been there before and her friend had.

After a 30-mile ambulance ride to the Medical Center of Central Georgia, I was taken directly into the catheterization lab ("Do not pass go, do not collect $200"). A team of 6 or 7 nurses (I didn't keep a close count) bustled around me and explained how catheterization worked. I would be given a tranquilizer (Versed (sp?)) to calm me, then, after a local anesthetic numbed my right inner thigh, an incision would allow the doctor to run a probe up my femoral artery and into my heart to see what was happening. I would remain conscious throughout and was to tell them if I felt any pain after the deadening shot. And off we went...

Meanwhile, as I found out later, my wife and her friend had made the trip up from Perry and were now discovering that no one seemed to have the slighthest idea where I was. Her friend was adequately aggressive and extracted the information they needed. (Remember they didn't know that I'd been taken straight in!)

I may or may not have dozed off during part of the procedure; I'm not sure. I remember listening to the team working on me, but not having the strongest interest in it. Versed is strong stuff! I opened my eyes and glanced around a couple of times, but after a moment or two, I lost interest and closed my eyes. There was never any pain, just a tugging sensation on my skin as he moved the probe back and forth and every once in a while, I'd feel an odd sensation that something was moving around in my chest. Finally, they started moving the equipment away and the doctor came up to explain that they had found a blockage and had inserted two stents in my right coronary artery. It had been 99% blocked! He said that he felt there was a hereditary predisposition, since my father had a heart attack at age 56 while I was in law school.

I was rolled down hallways to my room where my wife and her friend were waiting. The doctor explained the situation to them (they were much more interested at that point than I was). As the Versed wore off, I took more interest in the proceedings. I had to keep my right leg still for a couple of hours to make sure the incision sealed. My wife handed me my cell phone so I could make few calls. One to each of my children to assure them I was improving. Which I was, the arm pain was gone. One to my priest, who was shocked. After all, I had been in church that morning. He would come by the next day. Then to my boss, who was just about as shocked. I asked to notify the Federal court why I wouldn't show up for jury duty the next day. Since he lived in Macon, he planned to come by on the way to work the next morning.

My wife fed me dinner, surprisingly good for hospital fare--salisbury steak, mashed (real) potatoes with gravy, corn (I think) a roll and even Jello with whipped topping. (I think this was because I hadn't been set up for the cardio yet; this would be fixed by breakfast.) I definitely lucked out 26+ years ago when she married me. After a while, I sent her home with her friend. As the evening went on, things got removed--the IV system, the continuous monitors--which allowed me to get out of bed and go to the bathroom. Don't underestimate that until you've had to use a plastic bottle while lying down.

From this point on, I felt fine, with an underlying edginess as I wanted to be out of there. Sleeping was challenging as hospital beds don't bear a whole lot of resemblance to real ones; there's an underlying noise level that I'm not used to, a vital signs check and to top it off, I was awakened at 3 to have blood drawn and EKG taken and at 5 for the nurse to check to make sure my incision was healing well. Also, I had to make several trips across the hall to the bathroom. Apparently some of the stuff I was being given was a diuretic.

Monday was boring. I felt pretty good and was getting tired of the place. My boss came by early for a brief visit. My wife spent most of the day (clearly boring for her) and two co-workers came by, one with flowers from the office. I also got a few phone calls, and I appreciated them. Father Anderson came by mid-morning. He told me that the parish rumor mill had me having a "massive" attack as I drove home from church. (I would learn after I got home on Tuesday that I had also "driven myself to the ER in Macon"!) He reminded me that the prayerful thoughts, not the factual details, were what counted. He prayed with us and said he'd see me Tuesday afternoon if I were still there.

The food quality took a serious dive. Breakfast was artificial eggs, toast with Promise substitute and OJ. Coffee was provided, but I don't drink coffee and I never found out how to request hot tea. Lunch was pork, a roll with Promise, an unremembered vegetable, and chocolate pudding (!). Dinner was grilled chicken, another roll, anonymous vegetable and Jello. (At least I like Jello--on occasion.)

The internal medicine doctor, Dr. Sultan, came by in the afternoon and said that, as far as he was concerned, I was good to go home that afternoon, but the cardiologist had to approve and he never came by. My GQ (Grumpiness Quotient) increased as I realized I wasn't going home that day. I agreed that my wife should go home rather than wait any longer that evening. She had our animals (dogs, cats, and chickens) to attend to. Just before 10, Dr. Teherani came by. He said I was doing well and could go home the next morning. I would need to see him in about 2 weeks to start rehab. I thanked him for his work and he told me to thank my wife, presumably for getting me to the ER. I told him that I do, very much.

Another uncomfortable, interrupted night gave way to Tuesday. Breakfast same as on Monday.

My wife showed up and the morning dragged, waiting for clearance to leave. We waited long enough that the lady from Food Services showed up with lunch. I politely (probably because my wife was present) told her, no thanks, I was getting ready to leave. Finally, about 1 pm, I was rolled out and on my way home.

Our little house, not the best, looked wonderful! The dogs and cats were happy to see me. After a light, low-fat lunch, I took a nap (first getting a face wash by Herbie, our cairn terrier) with Herbie and Max and Jewel, two of our cats watching over me. I was home!

But it's not quite the same. We had 7 prescriptions to fill: blood thinners, a beta blocker, chloresterol controllers. (The co-pays were $113, which meant the full price was $452. Except, I'm sure Blue Cross has negotiated good deals with CVS and an insurance-less person would have paid more. I'm still troubled by that.) I'm awaiting the real bills, but not with the anxiety an insurance-less person would have.

My diet is changing. General ejection of fried foods. More fish, turkey bacon and sausage, less sugar. As I get stronger, more exercise. When I return to work in 2 or 3 weeks, my boss has said he will help me get to use the fitness center. My wife and I have both undertaken to lose weight and get fitter together.

I've been amazed by the expressions of concern from people at work and at church. I knew that my relatively gentle disposition kept people from disliking me, but as a co-worker said to my wife today when she brought a huge fruit basket, "Everyone loves Paul..." Wow... I sent an e-mail through my colonel asking everyone to use this as a free wake-up call for themselves and fix their own health issues. I've already received an e-mail from one of them saying he's already changing his diet and exercise regime. Neat!

And yet, I'm different than the guy who went to Red Lobster 7 days ago and got the fried seafood platter. (That's the end of that!) I have had one of the ultimate scares. But, I'm looking forward to changing things and going for 52 more years!

Going Home and Being Called

[Our lessons are Acts 7:55-60, 1 Peter 2:2-10 and John 14:1-14.]

Our Gospel and Epistle readings today evoke strong feelings of home and calling.

Home is an important place for us. It can be a building, large or small, fancy or poor, new or old. It can be a shelter from the storm, a refuge.

It’s more than a building. We say that home is where the heart is or it’s where we hang our hats. Robert Frost wrote, “Home is the place, where when you have to go there, they have to take you in.”

It is human nature to want a home. In fact, studies on children raised in institutions have shown that, in the absence of a home, children grow up psychologically damaged. We all want to go home.

St. Augustine wrote, “You have made us for yourself, and our hearts are restless until they rest in thee.” How true that is! We are always looking for somewhere else than where we are.

In today’s Gospel, Jesus speaks directly to this longing: “I go to prepare a place for you, I will come again and will take you to myself, so that where I am, there you may also be.” Our true home is God.

How wonderful this sounded to the persecuted Christians at the end of the First Century! How wonderful it sounded to the Disciples when Jesus told them this as he prepared them for his death.

Even though we won’t see this in its fullest form in this life, we can know now this relationship. We can experience now a preview of our eternal home. When we do the things that Christ commands us, when we love one another as Christ loved us and gave himself for us, then God’s love dwells in us and makes a home in us. When we comfort the broken hearted, God makes a home with us. When we lay down our lives for one another, God makes a home with us. When we invite all of God’s children to God’s table to share in his body and blood, then God makes a home with us.

Sarah Dylan Breuer, a preacher and student I often read, writes,

What would happen if we really took to heart Jesus’ words, “believe in God”—the God Jesus proclaimed—and “believe also in me”? What would happen if we believed Jesus’ message that the time of fulfilment for scriptures proclaiming good news to the poor, release to prisoners, sight to the blind, freedom for the oppressed, and the year of jubilee has come? What would happen if we believed that Jesus sent to come upon us the same Spirit which empowered him to feed the hungry, heal the sick, prophesy to the powerful, and proclaim God's kingdom? What if our lives proclaimed a God who is at work in the world as Jesus’ followers saw him at work among them?

For starters, our age of anxiety might finally be able to take in Jesus’ exhortation, “do not let your hearts be troubled.” When everybody wins, the rats can stop racing. There’s no sense in suing for property or privilege when the year of jubilee is at hand. The God who created the universe is at work in Christ, the Christ in whom we abide. God’s kingdom, God’s dream, is no fantasy; it’s the most fundamental of realities.

Never forget that the Kingdom of God is not supposed to be “Pie in the sky when we die”; it is meant to be here and now and we are called to do all we can to bring it into being.

In the words of a song that came to my mind when preparing this

All God’s children get weary when they roam,
Don’t it make you want to go home?

In the first letter of Peter, part of which we read today, we are reminded that there is something special about us. We are a “chosen race, a royal priesthood, a holy nation, God’s own people.” How wonderful that is! We are part of something so wonderful, that it gives us a sense of being called.

And we are called to be a church together. We can not truly be the Body of Christ as individuals. I once heard an English priest talk about a sign he saw in front of a church: “You don’t have to go to church to be a Christian!” He thought this was a stupid way to get people to come inside, but more importantly, it is wrong.

You can’t truly be a Christian—a member of the Body of Christ—as an isolated human being unconnected with anyone else. We do this instead as a member of a community in faith—in our case, here at St. Christopher’s and in our Diocese and in our national Episcopal Church and, hopefully, in a continuing Communion of national churches. Together, we are baptized into the Church, nourished by the weekly Eucharist, we come together to rejoice at weddings and we come together to grieve, support and rejoice at funerals. All these things we do together.

Some appropriate words were spoken by Pope Benedict to the American bishops in Washington this week:

In a society which values personal freedom and autonomy, it is easy to lose sight of our dependence on others as well as the responsibilities that we bear towards them. This emphasis on individualism has even affected the Church, giving rise to a form of piety which sometimes emphasizes our private relationship with God at the expense of our calling to be members of a redeemed community. Yet from the beginning, God saw that “it is not good for man to be alone”. We were created as social beings who find fulfillment only in love–for God and for our neighbor. If we are truly to gaze upon him who is the source of our joy, we need to do so as members of the people of God. If this seems counter-cultural, that is simply further evidence of the urgent need for a renewed evangelization of culture.

In our country, we often emphasize the individual. The heroes of our culture have often been rugged individualists who rely on no one but themselves, as in the Western movies. While there is critical importance in the rights of individual men and women, when we overemphasize them, we lose sight of our need to be part of a community. For example, we may say that we shouldn’t have to pay school taxes, because we have no children in schools. We overlook the role that we have as members of a community to support an institution that benefits the community.

As members of a community of faith, we have a duty—we are called—to support that community. Now when we hear that, we often think of pledge cards. They are important, of course, but the financial resources we provide must always be insufficient on their own. We all have our own differing spiritual gifts and we are called upon to use those spiritual gifts to build up the Church. And if we don’t use them to build up or strengthen the Church, the gifts aren’t much use to us or the Church.

There is so much we are doing here and there is so much more we can do here as a community of faith—as that chosen race, that royal priesthood, as God’s own people.

Health Insurance--Part 2

Last month, I talked about my unhappiness that so many people are excluded from potentially life-saving diagnostic procedures, like colonoscopies, because of cost.

I had brought to my attention an article in the New York Times yesterday, "Co-Payments Soar for Drugs With High Prices." The articles talk about how insurance companies are creating fantastically high co-payments for some of the new, very expensive drugs which can save lives or slow the progress of diseases. One example was of a woman who was prescribed Copaxone for multiple sclerosis. Her husband's insurance company, Kaiser Permanente, had been charging a $20 co-pay for several years. But, when she went to refill the prescription in January, her co-pay jumped to $325 for one month.

Another case was of a man who was presribed Sprycel to control his chronic leukemia--a condition my father had. (I have no idea what he was prescribed.) Sprycel blocks the growth of the cancer cells. He had what he thought was good insurance through AARP, but his 90-day co-payment is over $4,000!

(I checked through my plan's website to see what it would charge. The news on Copaxion was better, if not good: $451.61 for 90 days. For Sprycel, the co-payment for 90 days is $3,255.53, not much better than the AARP insurance in the story. My company has a mail order pharmacy at a flat rate of $35 for 90 days and listed it as an option for Sprycel. But not every plan has mail order.)

This practice, called "Tier 4" and "Tier 5" (for even more expensive stuff) is designed to shift the cost of the most expensive drugs to the patients that use them, sparing the rest of us any need to support them. Isn't the idea of insurance to pool costs so that we share the costs among us? I'm convinced that something about universal medical care coverage needs to be done. One of my co-workers is opposed because that will erode our current fairly privileged position. I can live with that to a degree if that will help situations like these.

Don't assume that your insurance, when you do have it, won't slide "Tier 4" pricing in on you. If you have any choices, look carefully at drug coverage. And, if you have choices, be thankful that you do... and stop to think of those who don't.

The Good Shepherd

[Our lessons were Acts 2:42-47, Psalm 23, 1 Peter 2:19-25, and John 1:1-10.]

Just in case you haven’t figured it out from the collect and the lessons, today focuses on Jesus as the Good Shepherd. Now, there is no reason to believe that Jesus was literally a shepherd. The tradition of the Church is that Jesus learned his father’s trade and worked as a carpenter. When we speak of Jesus as the Good Shepherd, we are not speaking of him as one who actually stood on a hillside, vigilantly watching over grazing sheep.

We are speaking of how the relationship between us and Jesus is, or would be, if we would allow it. A shepherd is to the sheep as Jesus is to the faithful. It’s more than just protection, although that is critically important.

The sheep have to trust the shepherd to lead them to a place of good grass and clean water. The sheep need to know the look and the voice of the trusted shepherd so that they don’t follow an imposter. (Sheep aren’t necessarily the brightest of God’s creation; their best hope is to find that good shepherd.) The shepherd also must have a clear idea, a plan or program, of what is best for the sheep. Being a shepherd is obviously a very responsible thing.

So, for the people to whom John is writing, these three things describe their relationship with Christ—recognition and trust, so that they can follow a plan for more abundant life. Remember, John wrote this around the end of the First Century, so he is writing for those, like us, who “have not seen, and yet believe.”

As an aside, this “abundant life” is not simply meant to be the next life. Jesus actually didn’t spend a whole lot of time on the afterlife. “Abundant life” is meant to be here and now. However, it doesn’t mean materially prosperous either. It is to be abundant in the things that matter—justice, love and the like.

Jesus is that trusted leader who calls us out by name, and leads us to places that will bring us to a fuller (more abundant) life. Now, following Jesus has some risk. We are called to give up the wisdom of the world, a trivial and meaningless life, abundant in things but meaningless in anything of true importance. If we are fortunate, the world may consider us a little odd. If we aren’t, we may join the long line of martyrs, stretching even to our time, who have died for Christ. There are things worse than death, and Martin Luther King, Johnathan Daniels, Archbishop Luwum in Uganda, and many others knew that and lived—and died—that.

A shepherd has a flock and Jesus has called us to be his flock. What kind of sheep are we? You can get a good idea of the shepherd from the sheep. Not all who look like sheep are sheep. Remember the phrase “wolf in sheep’s clothing”? We hear of cults whose leaders carry their people sad, meaningless ends, like Jim Jones in Guyana. We hear about Christians massacring others, sometimes falsely claiming the approval of God for their actions. We hear about leaders of Christian communities who abuse the people under their care. This is not the work of the Good Shepherd; rather it is the work of a wolf who snatches and scatters.

If Jesus is the Good Shepherd, what should his flock look like? Remember in the reading from Acts today. They devoted themselves to the Apostles’ teaching, fellowship, the breaking of bread and prayers. They did not hold back what they had from those in need. You don’t have a few fat and healthy sheep and a lot of skinny starving sheep. The flock of Jesus is marked by Generosity. Everyone looks out for each other. We aren’t asked to give what we don’t have, but when we do, as in the loaves and the fishes, God multiplies it. The flock of the Good Shepherd puts others first, placing the needs of others before their own.

By the way, the early Christians in Acts “spent much time together”! To understand just how amazing that is, remember that at that time, spending much time together with Christians could be a death sentence. The good and civilized people of Rome would hunt you down, lock you up, and send you to lunch with the lions, with you as the main course.

The flock is generous and self-giving. Do you see signs of that here at St. Christopher’s? I do. We don’t always agree, we fuss and we fight, but when it counts, when a parishioner loses a family member, we step forward and act. We can always do better, we can always improve, but in the actions of this flock, we can see just who is our Good Shepherd. May it always be so!

What Really Matters...

The Anglican blogworld has been fascinated with questions about bishops and dioceses, even numerology prophecies by the Bishop of Pittsburgh! Our last week at St. Christopher's has been focused on something far more important--the sudden death of one of our relatively young parishioners (although as years go by, "relatively young" changes meaning to me).

On Monday, March 31, Terri Wukasinovich, 44-year-old wife of Tom and mother of 8-year-old Ashley, began to feel unwell. The next day, she began to feel better, but in the afternoon she started to feel worse. Tom was summoned home from work. Soon, Terri was rushed to the hospital and she died shortly after midnight. We don't know the exact cause, but it seems to have been a virulent form of pneumonia.

The word flashed around our parish on Wednesday, often using the more modern means of e-mail. When I read the message Wednesday afternoon, I was stunned. It was so unexpected that my thought was, didn't I just see her in church? I wasn't necessarily very close to them, but we knew each other, spoke to each other and sometimes saw each other around Perry. Now she was gone.

I can't imagine the grief, pain and fear Tom felt. I don't know if it helped, but in our other funerals, the person was older and death was not so sudden; there was clear grief, but the stunned shock wasn't there.

I assisted at Terri's funeral yesterday on a grey, cool morning. On cloudy days, it seems that the church's lights don't really brighten the church much and maybe that was appropriate this day. Our theology of funerals being a celebration of resurrection ran headlong into the grief and pain of loss and I'm not sure which won out.

I doubt that if I live to 100, I'll ever forget the intensity of the pain on Tom's face or even more, the stunned, dazed look on Ashley's face as she sat in the front pew next to her father, clutching a large stuffed animal for comfort. I'm sure part of her knew this HAD to be a nightmare from which she'd wake up and her mother would be there. A week before, her mom was with her, now she sat next to her casket.

Tom and Ashley have two families who are trying to help: their natural family and their church family. Add in his workplace family, who was also supporting him, and there are plenty of people to help. But, almost instantly, Tom has lost his companion in life and Ashley has to grow up without her mother. And Tom has to now be both father and mother to his daughter.

And this is what really matters: these two children of God bereft and searching for answers. We reject that this was in some way God's will or that Terri's death was some punishment for something she might have done or even something someone else might have done. We don't know why one person dies in her 40's and another lives to her 80's. All we do know is that Terri has been reunited with those who have gone before here and some wonderful way and now she waits for Tom and Ashley to join her in God's good time.

Father in heaven, we praise your name for all who have finished this life loving and trusting you, for the example of their lives, the life and grace you gave them, and the peace in which they rest. We praise you today for your servant Terri and for all that you did through her. Meet us in our sadness and fill our hearts with praise and thanksgiving, for the sake of our risen Lord, Jesus Christ. Amen.

PB Writes to House on Global Health

Here's the text of a letter that the Presiding Bishop of the Episcopal Church sent to the members of the House of Representatives:

April 2, 2008

Dear Members of the House of Representatives:

As Presiding Bishop of the Episcopal Church, I write to offer our Church’s strong endorsement of the U.S. Global HIV/AIDS, Tuberculosis, and Malaria Act passed by the Foreign Affairs Committee and awaiting House floor consideration. The committee-passed bill builds on the successes of our nation’s efforts to fight deadly disease around the world over the past five years, and forges a new bipartisan consensus for expanding and intensifying those programs in the years to come.

The Episcopal Church is a member of the worldwide Anglican Communion, more than half of whose members live in countries hardest hit by AIDS, TB, and malaria. Through our relationships with churches around the world, we are deeply aware of the suffering and upheaval experienced by communities affected by deadly disease, and we are actively involved in efforts to restore health and healing through prevention, care, and treatment. A world that has conquered AIDS, TB, and malaria would be not just healthier and more prosperous, but more stable and secure.

As vital as the work of faith communities and other private actors are in the fight against poverty and disease, however, true transformation can only come when the resources and energies of governments are brought to bear. That’s why the United States government’s efforts over the past five years–along with the work of multinational organizations like the Global Fund to Fight AIDS, TB, and Malaria–have been so vital. The historic $15 billion dollar commitment passed by Congress in 2003 has saved more than 1.4 million lives; provided care for more than 6.6 million people suffering from AIDS, including 2.7 million orphans and vulnerable children; and brought counseling and testing to more than 33 million people, including 10 million pregnant women.

Together with our partner churches in other parts of the world--some of whose efforts to fight HIV/AIDS and malaria have benefited from U.S. government funding--we have rejoiced in these successes. Even as we see life restored in so many places, however, we continue to be moved by the magnitude of the challenges that lie ahead. Each day, more than 8,000 new HIV infections occur and more than 6,300 people die of AIDS. More than 15 million orphans in Africa are created each year. At least 16 million additional people will need access to treatment by 2013. Of all the commitments to fighting extreme poverty and disease contained in the historic Millennium Declaration of 2000, the targets for fighting HIV/AIDS remain farthest off track.

This is why passage of the U.S. Global HIV/AIDS, Tuberculosis, and Malaria Act of 2008 is so vital. By passing the legislation adopted by the Foreign Affairs Committee, the House has an opportunity to build on the momentum of the past five years, while expanding our nation’s resource commitment dramatically and incorporating lessons learned not just from our successes, but from our challenges as well.

First, and most importantly, the committee-passed bill more than triples our nation’s resource commitment, pledging $50 billion over the next five years to fight HIV/AIDS, tuberculosis and malaria. Additionally, it ensures that HIV/AIDS programs are linked to, and integrated with, other vital U.S.-backed efforts to fight global poverty and disease, and allows HIV/AIDS testing and counseling to be provided in the U.S. government’s international family-planning program. The bill also expands the U.S. commitment to the vital efforts of the multilateral Global Fund while establishing new benchmarks for the Fund’s transparency and accountability, and ensures a new and more pronounced emphasis on prevention and treatment for women and girls.

Finally, in an area that has garnered a great deal of attention over the past five years, the Committee-passed bill moves toward greater flexibility in the way U.S. HIV-prevention efforts are tailored to local communities. Since 2003, U.S. prevention programs have been balanced according to a formula known as ABC (Abstain, Be Faithful, use Condoms), but have required that at least one-third of prevention dollars be spent on programming that excludes discussion or distribution of condoms. This proved onerous to many local efforts, including the efforts of faith communities. The new bill passed by the Committee strikes an important compromise: it continues to require balance in our nation’s prevention efforts, but allows deviation from a strict percentage formula in cases where local needs dictate it, so long as those deviations are reported to Congress for oversight.

The bipartisan compromises contained in the committee-passed bill are particularly gratifying given the very strong views of lawmakers, implementers, and advocates on all sides of this debate. I am deeply grateful for the patient, transparent, and thoughtful negotiations between members of both parties that led to this historic compromise bill, and I am pleased to offer the Episcopal Church’s strong endorsement for the bill as it goes to the House floor.

The prophet Jeremiah, in describing a wise leader of nations, tells us that “he gave the poor a fair trial, and all went well with him.” At a moment in our world’s history marred by division, conflict, and great suffering by so many, the U.S. Global HIV/AIDS, Tuberculosis, and Malaria Act offers an important step toward healing and wholeness for the hundreds of millions of people enslaved by deadly disease and poverty. I urge you to pass this vital legislation as quickly as possible.

Please be assured of my continual prayers for you. I remain

Your servant in Christ,
Katharine Jefferts Schori

Women Bishops in Wales?

In my lifetime, women have become full members of the Episcopal Church. It wasn't that long ago when they couldn't be deputies to our General Convention. They could become priests and bishops only in the 1970s. And now, our Presiding Bishop is a woman! There are still some places in the Episcopal Church (the Diocese of Fort Worth, for one) that believe God is limited to calling only men to the priesthood, but most have seen how richer we are for allowing women to play a full role.

In the Church of England and the Church in Wales, women can become priests, but not bishops. The Church in Wales is addressing that issue today, and the Archbishop of Wales, Dr Barry Morgan, wrote an article, "At odds with the Gospel," in today's Guardian newspaper about it. Here are some excerpts:

In an age when women have broken through the glass ceiling in most professions in Britain, it is strange that they still face discrimination in a church that believes there is "no male or female" in Christ. Women can become judges, surgeons, chief executives and heads of state, but in the Church in Wales--which waited until 1997 to ordain women as priests--they are as yet unable to become bishops.

I do not see how, having agreed to ordaining women to both the diaconate and priesthood, the church can logically exclude women from the episcopate. That is why I and my fellow bishops will be asking members of the church's legislative body today to vote in favour of a bill to allow women clerics to become bishops. It's a move that Anglican churches have made in other countries--Scotland, Ireland, New Zealand, Canada and the US, though not yet England. I believe Wales is now willing to embrace this important change too.

***

At the heart of the Christian gospel are values of integrity, justice, wholeness and inclusion: "In Christ there is no bond or free, male or female, Jew or Greek" (St Paul). How, therefore, can a church, which claims to set people free and treat all as equal, refuse even the possibility of considering whether women can be called to the episcopate? All this is not irrelevant to the mission of the church, for when women are barred from even the possibility of being elected bishops, it makes the gospel inaudible in our world. As the late Robert Runcie said: "It cannot be irrelevant to evangelism that so many unbelievers think that the place we give to women is absurd."

***

If the Church in Wales refuses today to ordain women to the episcopate, it will be in danger of giving the impression that: the maleness of Jesus is more important than his humanity; only men can really represent God and his church to the world; men are the really important members of the human race; the church does not value the gifts and talents of women; and the church is not interested in testing the vocation of women, or even willing to consider their suitability as bishops, because their gender has automatically debarred them from such consideration.

None of these things may be true, but try explaining that to a class of sixth-formers who are interested in what the gospel may be offering them, but for whom that gospel is proclaimed by a church that refuses even to consider the possibility of opening up the episcopate to women.


I can't say it any better than that. Thanks to the Episcopal Cafe for bringing the column to my attention.

[Later today, the Church in Wales failed to pass the legislation for wonen bishops.]

Climate Change

Religious bodies are becoming more aware that a concern for the environment is not only consistent with Christian doctrine, it may be considered an essential aspect of it. The changes in climate caused by global warming normally have the greatest impact on the poor. In that light, here's a letter to U.S. Senators from the Presiding Bishop of the Episcopal Church:


Urgent action by the United States in response to global warming is long past due. As the Presiding Bishop of The Episcopal Church, I urge the Senate to take up climate change legislation at the earliest possible moment. As one who has been formed both through a deep faith and as a scientist, I believe science has shown us unequivocally that climate change and global warming are real, and caused in significant part by human activities. Climate change is a threat not only to God’s good creation but to all of humanity.

I am pleased that bi-partisan legislation introduced by Senators Joseph Lieberman and John Warner successfully moved through the committee process with many improvements and now awaits Senate debate. Senate bill 2191, America’s Climate Security Act, is a strong step forward in achieving carbon emission reductions. At the same time it includes measures aimed at addressing the needs of the world’s most vulnerable: those, who for demographic reasons such as health or location are most susceptible to the effects of climate change, and those living in poverty at home and around the world. I strongly support this legislation. Our nation, historically the world's largest greenhouse gas emitter, has a responsibility to lead the way in addressing the impact of climate change.

Climate change exacerbates extreme world poverty and poverty is hastening global warming. Most people living in poverty around the world lack access to a reliable energy source, forcing many to choose energy sources such as oil, coal, or wood, which threaten to expand significantly the world's greenhouse emissions and thus accelerate the effects of climate change. That need for resources to purchase energy must be addressed in any attempt to lift a community out of poverty. This cycle—poverty that begets climate change and vice versa—threatens the future of all people, rich and poor alike. The poverty cycle driven by climate change will only add to political instability, social violence, and war. Our own domestic tranquility and security are intimately tied to the well-being of the poor both here and abroad.

I am grateful for Congressional attention to climate change, and I challenge the Senate to support measures to further strengthen S. 2191 during floor consideration. I want to be absolutely clear that for those living in poverty, inaction on our part now will ultimately be the most costly of all courses of action. I am grateful to the members of Congress who have recognized and spoken out on that very important truth.

Many in the faith community have long been aware of the ways in which our lack of concern for the rest of creation results in death and destruction for our neighbors. We cannot love our neighbors unless we care for the creation that supports all our earthly lives. I join my fellow Episcopalians in urging the Senate of the 110th Congress to pass the strongest climate change legislation possible. The acknowledgment of global warming and the Church’s commitment to ameliorating it are a part of the ongoing discovery of God’s revelation to humanity and the call to a fuller understanding of the scriptural imperative to love our neighbor as ourselves. I remain

Your servant in Christ,
Katharine Jefferts Schori
Presiding Bishop and Primate

On Left Handedness..

[I wish I could claim to have written this, but it's attributed to an anonymous author from 1994. It appears to be a document from the Sacred Congregation for the Doctrine of the Faith, then led by a Cardinal Ratzinger, who has since gone on to greater things. Any reader of Vatican documents will recognize the style. By the way, I'm left handed.]

DEXTERA DOMINI
The Declaration on the Pastoral Care of Left-Handed Persons

THE RIGHT HAND of the Lord has adorned his spotless bride, the Church, with many wondrous gifts, not the least of which is the supreme ministry of defending the arsenal of Christian truth. Through the wisdom of a provident God, this congregation, the watchdog of the household of faith, exercises diligent custody over the sacred deposit of doctrine, guarding it like a talent buried in the sand (Matt. 25:25). To this richly satisfying task it brings the feral instincts of a lioness protecting her cubs and the dispassionate zeal of a raptor pursuing its prey, so that the pearl of great price may be safely gathered up with the wheat and deposited in the nets of Peter's bark (Matt. 13:46; 13:30; John 21:6). Wherefore it seeks to infiltrate the entire Catholic world, like leaven mixed into a lump of dough (Matt. 13:33), and so, like yeast, to ferment the pilgrim Church with its viscid and fungal spores so that the entire mass may swell into a frothy, pulsating, gelatinous ooze of faith. Thus, like a prudent householder, it may bring forth from its storeroom both the true and the old (Matt. 13:52).

Having already disposed of other perversions, it becomes necessary to speak out with the profound disgust regarding yet another aberration which, like the pulling of a polyester fiber, threatens to unravel the seamless garment of faith.

This particular menace has been propagated by those who, basing their opinions on spurious sophisms of the psychological and behavioral pseudo-sciences, claim that it is acceptable, or even normal, to use the left hand when engaging in manual activities. In the face of tradition and right reason, they point to a small but vocal minority of individuals who primarily use their left hands or purport to be bimanual. With callous disregard for the natural order they judge indulgently, and even excuse completely, sinistral behavior, that is, the indiscriminate use of the left hand in the place of the right. Such an insidious abuse is defended as though there were no difference between right or left, Jew or Greek, male or female, slave or free (Gal. 3:28).

For while it is neither possible nor desirable at present to decide whether this disorder is genetic in origin or merely the result of repeated nasty thoughts, in either case one may never argue that left-handedness is compulsive and therefore excusable. It is, of course, necessary to take note of the distinction between the sinistral condition and the individual left-handed actions, which are intrinsically disordered and utterly wrong.

And although the particular inclination of the left-handed person is not necessarily a sin, it is a more or less strong tendency ordered toward an intrinsic moral evil, and thus the inclination itself must be seen as an objective disorder. Therefore, both the condition and all acts flowing from it are to be condemned, as are all those who suffer from it or engage in it, and everyone who thinks like them or defends them or befriends them, into everlasting torments in the lowest pit of hell where the lake of fire is never quenched and the worm dies not (Mark 9:48).

I. General Principles

INDEED, CATHOLIC TRADITION has constantly taught that only the right hand may properly engage in manual activities. The left hand must remain curbed and passive or, at most, ancillary and subservient to the right hand, analogous to the function of a pallet in respect to an artist, or the operation of a dustpan to a broom, or the role of a wife in relation to her husband. Hence, the use of the left hand, either principally or indiscriminately along with the right, has always been held to be an abuse, a sin against nature, and intrinsically disordered as an unnatural vice.

Right reason itself argues for this arrangement. For reason is properly called right reason inasmuch as it emanates from or tends toward the right. Hence, in all things reasonable, the right is right and is to be preferred, with the sole exception of the wearing of earrings of men, wherein, left is right and right is wrong.

The very use of language, even in pagan times, confirms that what is on the left side in unfavorable and perverse. It is no linguistic accident, but rather a natural manifestation of the divine will, that the Latin word for "left" (sinister) has come to connote evil, malevolence and villainy, while in common speech a left-handed compliment is no compliment at all.

The aesthetic argument, to be sure further reveals the uselessness of left-handed activity. For who can gaze upon the handwriting attempted with the left hand without sensing that it is tilted the wrong way, that is, as if blown off course by a malign east wind (Exod. 10:13; John 4:8). In the nearly unanimous estimation of humanity such scrawling is a cause of wonderment and no little aesthetic scandal.

Moreover, the Scriptures themselves amply attest to the preeminence of the right hand and the depravity of the left. Thus the right hand confers blessing and signifies strength, while the left hand is treacherous and deadly (Gen. 48:13-20; Exod. 15:6; Eze. 21:22; Rev. 1:16-17; Judg. 3:15, 20:16; 2 Sam. 20:9-10). A place at one's right hand is the seat of honor and dignity (1 Kings 2:19; Ps. 45:9, 110:1). Sagely does Qoheleth teach that "a wise man's heart inclines him toward the right, but a fool's heart toward the left" (Eccles. 10:2). In like manner, both the passivity and the inferiority of the left hand are apparent in the solemn injunction forbidding us to let our left hands know what our right hands are doing (Luke 22:50). And it is by no accident that the elect are to stand like innocent sheep at the right hand of the Eternal Judge, while the reprobates cower and whimper like noisome and tick-infested goats on His left, awaiting their dizzying descent into sulfurous fumes and unfathomable miseries in the mind-bending agonies of eternal damnation (Matt 25:31-46).

In a similar vein, the Fathers of the Church eloquently denounce sinistral behaviour in many and varied texts. Thus, Origen writes that "the perverse, because of their sinister deeds, tend toward the left," while Augustine unambiguously teaches that "the Lord strongly forbids the left hand alone to work in us" (Origen, In Matth. 23,70; Augustine, Serm in Mont. ii,2,9). A multitude of other Fathers and Doctors would have written in like manner had the thought occurred to them.

But by far the strongest and most persuasive argument for the Church's position is drawn from the so-called "teleological proof," wherein it is demonstrated that the purpose of having hands is twofold. The lesser and secondary use of hands is to handle things, or, within limits, people. The greater, or primary, end is to reflect the divine activity itself. Thus manual endeavor is said to be "procreative" in that it mirrors the creative work of God. And God, as is obvious, uses only His right hand, as Scripture clearly teaches (Exod. 16:6-12; Deut. 33:2; Ps 17:7, 18:34, 74:11, 110:1, 139:10; Is. 48:13, 62:8, Lam. 2:3; et al.) In fact, this congregation, privy as it is to the intimacies of the Godhead, is presently studying this very matter and intends to issue a definitive determination regarding the exact number of fingers on the Deity's right hand and how they are adorned.

Therefore, it is obvious that left-handed activity, or sinistrality, lacks an essential and indispensable finality. Such a deficiency marks each and every sinistral act, rendering it defective and incomplete. In short, sinistral behavior, like contraceptive sex and theological dissent, is about as useful as mammary glands on a male bovine [Tr. note: the typica is somewhat more graphic].

Let it not be said, moreover, that left-handed activity is fundamentally private or harmless to society. In a world where the common cold is spread principally by manual contact, such arguments are patently groundless and futile. Manual activity is always social in nature, that is, oriented toward and affecting the lives of others. In view of this, the following practical applications are presented for the religious submission of the minds and hearts of the faithful.

II. Pastoral Norms

SINISTRALS, THAT IS left-handed people, should always be made to feel the depth of compassion that the Church wishes to extend to all contemptible deviates.

It is deplorable that sinistral persons have been the object of malice, prejudice and bigotry in the past; the dignity of each person must always be respected in word, in action and in law.

Having amply touched upon this point, however, it is necessary to add that at times good Christians can and ought to regard such persons with aversion and abhorrence as cheap, vulgar, degenerate, perverse, errant, depraved, vile, warped and base, and totally undeserving of opportunities belonging to right-handed people. Some, of course, may erroneously object that the Church's position could tend to encourage feelings of animosity and intolerance against such maggots. Special care must thus be taken to point out the finely nuanced distinctions operative in this situation. It is, for example, quite possible to love people while simultaneously hating everything about them, including the fact of their existence, just as it is possible to uphold and defend the dignity of an ant while in the very act of crushing it underfoot. History is replete with many sterling examples of this Christian principle in action (See, for example, the decrees of Gregory IX and Sixtus IV establishing, respectively, the Roman and Spanish Inquisitions.)

On a practical level, the faithful may legitimately deem it necessary, and even laudable, to discriminate against sinistrals in the following areas, among others:

• the adoption of children and the employment of teachers and coaches, lest, by work and example, the impressionable young be exposed to shockingly offensive manual options;
• housing, since it would offend Christian piety that innocent people, who rightfully protect their homes against vermin and pests, should have to live next door to such human debris;
• the military, for in conformity with the intention of our warrior God, who trains for battle (Exod. 15:3; Ps. 18:34) morally correct guns and weapons of war are fittingly designed only for the right-handed lifestyle;
• the workplace, given sinistrals' well-known tendencies to proselytize, overtly or covertly, and to warp the unwary into a left-handed lifestyle;
• life in general, since the sufferance of sinistral behavior, like a contagious disease, is both a menace to the right ordering of the cosmos and a deterrent to universally accepted natural activities like handshakes and manual transmission driving.

WHEREFORE, BISHOPS ARE to be especially concerned to defend and champion authentic morality, not only in family life and in the prompt transmittance of the Peter's Pence, but also in the regulation of manual activity. While promoting the joy of virtue for its own sake, let them not disdain other effective means to coerce proper manual behaviors among the faithful. Such might well include the occasional homiletic reflections upon an afterlife in company with grotesque fiends, as well as richly detailed accounts of unimaginable torment, excruciating heat and unrelenting pain and putrefaction amid rock-rending shrieks of anguished despair in the bottomless chasm of Gehenna. Above all, they are to remind sinistrals that manual activity may be undertaken only by right-handed people within the context of a lifelong commitment to right-handedness.

Therefore, let sinistral and bimanual individuals be instructed to disguise their sinistrality by keeping it repressed, although under no circumstances are they to keep their left hands in their pockets. For a vice that is truly repressed is no vice at all. To this end, hypnosis and mind-altering pharmaceuticals may be licitly administered so as to render their left hands useless.

If such individuals are indeed incapable of being cured of this disorder so as to properly use the left hand only in a secondary role, if at all, they must refrain from all manual activity with either hand. For God, who is bountiful to his loved ones in sleep, has blessed inactivity for the sake of the kingdom (Ps. 127:2; Matt. 19:12).

Additionally, insofar as these sinistrals still lack the capacity for, or obdurately resist a lifelong commitment to right-handedness, they are to take more urgent measures to be cured. In this connection, it is altogether licit and harmonious with the principle of double effect to resort to the therapeutic use of amputation in accord with Scripture: "If your [left] hand causes you to sin, cut it off, for it is better to enter the kingdom maimed" (Matt. 18:9), etc.

Finally, all sinistrals, to whom bishops and pastors of souls offer the solace of holy religion, should be assured that despite their best efforts they will probably go to hell anyway for thinking left-handed thoughts. Let them thus be encouraged to know that, after a life in which they have basically considered themselves worthless, they will at last find themselves entirely worthy of something; to wit, eternal damnation in the slime-infested miseries of the abyss, where horribly disfigured imps and little red demons with pitchforks and tridents will perform unremitting acupuncture upon their most sensitive bodily parts as they roast in the searing embers of hell. About which, most assuredly, this Congregation will happily have more to say in the future.