Adventures of an armchair activist: Gratitude, generosity and greed

One of my greatest pleasures at the moment is to spend an hour each morning in quiet contemplation, gazing out of the window. It is the height of summer and the garden at Breathing Space is flourishing. The bees buzz busily among the flower heads; the tall grasses wave their heads in the morning sun (or glisten in the gently falling rain); the raspberries and blueberries are starting to take over from the strawberries and currants to give us our breakfast fruit; everything is lush, vibrant and green.

Building Barns

It was in the midst of all this abundance and generosity that I read, the other day, the hard-hitting parable of the barn builder:

The farm of a certain rich man produced a terrific crop. He talked to himself: ‘What can I do? My barn isn’t big enough for this harvest.’ Then he said, ‘Here’s what I’ll do: I’ll tear down my barns and build bigger ones. Then I’ll gather in all my grain and goods, and I’ll say to myself, Self, you’ve done well! You’ve got it made and can now retire. Take it easy and have the time of your life!’

Just then God showed up and said, ‘Fool! Tonight you die. And your barnful of goods – who gets it?’

(Luke 12: 13-21 The Message)

When I took early retirement I thought we might need to do some very careful budgeting to live on a much lower income. In fact, Lois and I have found ourselves in the strange position of having far more than we either need or want. My financial adviser will tell me that I have to invest wisely to get a good return, to set aside contingencies for the future, and to ensure I pass on a good inheritance to my children. But all of that seems rather hollow: self-congratulatory; resting on my laurels and my well-endowed profession; dominated by excessive comforts; and adding to the already gross inequalities in our society.

It seems to me that the counters to the consumerism, self-absorption and sense of entitlement that seem to dominate our culture are gratitude and generosity: gratitude for all that we have, for the simple things in life, for the goodness and beauty that is all around us; and generosity with what we have been given – learning to share and to bless others as we have been blessed.

Learning to live with gratitude and generosity

So how do we live with gratitude and generosity in a culture of entitlement?

As with so much, we can only ‘make the road by walking’. So here are some of the things we are exploring:

Getting close to nature. Lois and I are blessed through where we live – being able to enjoy the garden at Breathing Space and to share it with others; spending time working with the soil and the plants; putting out food for the birds and creating havens for wildlife; going for walks in the countryside around us.
The ‘prayer of examen’. We often end each day by each reflecting on the two or three things for which we are most grateful in that day. It generally isn’t hard: even when one of us has had a bad day, there is usually something we can find for which we can give thanks.
Living simply and within our means. I recognise that we are wealthy and privileged, and not everyone will be in the same place. For us, though, it is fairly easy to live within our means; it is less easy to resist the constant drive to acquire more things, to get the latest gadget, or to treat as essentials what are really luxuries.
Enjoying treats and celebrations. We do try to make a point of taking opportunities to celebrate and to enjoy special treats: going to the theatre; relaxing with a nice glass of wine; having a special meal with family or friends… We have been blessed, and I don’t want to spend my life feeling guilty about that, but rather to be grateful, enjoy the blessings we have, and share them generously with others.

I am reminded of the story of the pious woman, who lived a life of austerity and spent her life in constant service of others. Arriving at the gates of heaven, God met with her and asked her just one question: ‘Did you enjoy the world I made for you?’

Conspiring to bless others. We came across this wonderful phrase in one of Brian McLaren’s books. I love the idea of looking for ways to bless other people – whether through gifts or little acts of service. We try to give generously, recognising that we could do more. We have been blessed with the generosity and support that others have shown to us, at different points in our lives, both individually and now through Breathing Space. Now, at this stage of our lives, we have both money and time and want to use those to bless other individuals and causes.
Supporting charities that promote justice, compassion, and care for creation. It is always hard to choose which charities to support – with money or time. There are so many out there – all good causes. We have tended to look for smaller, local charities that are clearly making a difference: ones that are involved in supporting vulnerable families and individuals; ones that are addressing deep-seated problems such as homelessness and poverty; ones that are working for our environment; and ones that are engaging with local communities in less wealthy areas of the world.
Investing ethically. One of our biggest challenges is deciding what to do with the extra capital that we have. We don’t want to just be sucked into the trap of feeling we need to insure ourselves against any possible bad-outcome scenario; nor do we want to buy into a system that ultimately just benefits those who are already wealthy. So we have opted for ethical banking through Triodos, and we are exploring the possibility of partnering with Hope into Action – a charity that provides affordable housing for vulnerable people, linked in with support from local church communities. Someone once said that the process of discernment is not so much about choosing between good and bad options, but about choosing between different good options. So there will be those who promote investing wisely for a high return with which we can then be more generous in our giving; others who take the opposite view of ‘sell all you have and give to the poor’. Perhaps we can find a middle way, which stems from both gratitude and generosity.

December 12, 2015

Presenteeism and the culture of indispensability

After stepping down from my clinical work in November, I received a lovely card from one of my patients thanking me for being his doctor and expressing his hope that ‘my new doctor will be as nice as you’. Six weeks on, and we are no closer to finding a replacement, nice or otherwise! So, while I don’t regret cutting back on my work and dropping my clinics, I do feel both saddened and frustrated: my decision is leaving my patients unsupported, my colleagues stretched, and my secretary struggling to troubleshoot and keep things ticking over. I knew this was a possible, perhaps even likely scenario, but inevitably I feel some responsibility for that.

And yet, I am not indispensable.

Why doctors don’t take sick leave

A leader in this week’s BMJ highlighted how doctors tend to have much lower sickness absence rates than other healthcare workers (typically 1-1.5% compared to 4-5% for all healthcare staff). There are many reasons why this might be so, but one of the most significant ones is a culture in which doctors avoid taking time off sick so as not to let others down – whether their patients or their colleagues. This is admirable to a degree, and yet it betrays a deeper, potentially destructive culture of indispensability. We have a tendency to believe that the service won’t function without us. That, in turn, feeds a driven-ness that leads to long hours, apparent busyness and a kind of bizarre pride in always being overstretched.

This isn’t limited to doctors but seems to be a culture that pervades all professions.

It seems to me that this is an inherently dangerous and damaging culture. Clare Gerada, medical director of the Practitioner Health Programme, commented that

“a common personal impact on doctors who are ill is that what goes isn’t their competence, it’s their compassion for patients”

Being overstretched

I suspect the same is true, not just for doctors who are ill, but for all of us when we are overstretched. We can carry on performing our roles, but find it hard to offer that human touch: something that has perhaps been reflected in some of the scandals in care homes for the elderly and vulnerable adults in recent years.

I suspect that another element that goes by the board when we are overstretched is humility. When we are constantly struggling to get things done it becomes increasingly difficult to acknowledge our own limitations, to take time to reflect, to learn and improve, to accept our need of others. And ultimately, to recognise and value the very real contributions that we, uniquely, bring.

Ultimately what goes is also competence, though typically this comes some way down the line. The reality though is that a driven culture of indispensability threatens effective working and patient safety. I still remember the feeling, half way through a 104 hour shift as a junior doctor, sitting at a nursing station to calculate a drug dose, and realising that I couldn’t even think straight enough to carry out a simple 2-digit addition without the aid of a calculator, and recognising just how easily I could make a potentially fatal mistake.

That is why I am supportive of my junior doctor colleagues in their dispute with the government over a new contract. The proposed industrial action is not just about pay – I would find it difficult to defend if it were – but about patient safety, and about challenging this pervasive culture with all its inherent dangers.

Challenging the culture

And I, too, will continue to challenge it, in my small way, by attempting to live and work in a way that isn’t indispensable. I know I will continue to feel some responsibility for the gaps created by my cutting down my hours. But I know, too, that since doing so I have felt more motivated and inspired, and been able to give myself more fully to those aspects of my work which are continuing. I hope, ultimately, that will be of far greater benefit to my colleagues and to the children and families I am seeking to serve.

May 17, 2015

Pride

Yesterday, Lois and I watched Pride (BBC Films, 2014), a truly inspirational film which I would highly recommend (thank you Kevin Finnan for your recommendation). A small minority group, hated and victimised, struggling with their own weaknesses and infighting, choose, in spite of that, to look beyond their own problems to recognise and do something about the needs of another oppressed group. In doing so, these ordinary, vulnerable human beings find something of their true selves, the immortal diamonds within. They, and the group they choose to help, discover within themselves, the capacity to show compassion, to see beyond the stereotypes and prejudices, to identify with others who are, perhaps, not so different from themselves. And, in doing so, they make a stand for justice that has an impact.

Continue reading “Pride”