This week our pastoral letter is actually an article written by one of our elders, Dr. Jay Lynch. Jay and his wife, Laura have attended Creekside since the 1990’s. We wanted to send this on to you all to read because it not only has valuable information to hear but it is also a wonderful example of how to integrate faith and work. Enjoy!
By Dr. Jay and Laura Lynch
A community is the mental and spiritual condition of knowing that the place is
shared, and that the people who share the place define and limit the possibilities
of each other's lives. It is the knowledge that people have of each other, their
concern for each other, their trust in each other, the freedom with which they
come and go among themselves. Wendell Berry, The Loss of the Future
Anyone who takes the time to immerse themselves in the writing of Wendell Berry will be rewarded with an education about the nature of authentic community. In the essay entitled “The Loss of the Future”, penned in 1968 while at Stanford, the young Berry offered a philosophical description of community and spent the next 50 years bringing these ideas to life in his fiction. His many stories all take place in the imagined town of Port William where he weaves together tales of all its members; their vocations, relations to one another, their triumphs, failures, joys, their living and their dying. There is a beauty in his writing that underscores the true beauty of community in its fullest incarnations. His work is quite timely since the word “community” itself has been coopted by anyone and anything trying to give a “sense” of belonging, but often without what Berry calls, the true “membership” that we all crave. Such ersatz communities are not wrong, but they leave us undernourished and yearning for more. The COVID pandemic has highlighted how men and women on the front caring for the sickest, often to their own peril, also care for each other. For many of the rest of us, the forced isolation has tutored us about the centrality of deeper relationships to our human flourishing as we are separated from family and those with whom we work. As useful as social media and technologies like Zoom can be, they do not fill the void created by our isolation, but rather kindle hope for the time when we will again be face to face.
The privilege of being part of the UF College of Medicine family has afforded me a chance to watch and learn the essential features of community that Berry describes so elegantly in his fiction. Such communities are more than places of mutual respect and enjoyment, but also create an undercurrent of power that can neither be seen nor measured. Not all collections of people work together and even fewer live as communities, because authentic community must be both voluntary and intentional and cannot be mandated or regulated into existence. Things and people can be counted and described demographically but community is more like the wafting smell of baking bread when you enter a home. Only those present can be intoxicated by the aroma and anticipate the pleasure of eating. This aroma although very real, cannot be easily measured. In the same way, the experience of community creates relational power beyond the probing of our evaluative tools, but nonetheless wielding powerful influence in at least 4 domains I will discuss briefly below.
I. Community has the power to change the world
History is filled with examples of men and women who have come together to address evil and injustice in the world and I will mention just a few here for the sake of brevity. The underground railroad led by Harriet Tubman was a community dedicated to providing passage to safety for African-Americans who had escaped their enslavement in the antebellum south. During the first half of the twentieth century, Dorothy Day after facing down her own demons, confronted the abject poverty of those exploited in New York City. Alongside Peter Maurin, she published the Catholic workers newspaper leading to the creation of the Catholic Workers Movement which has grown to 174 chapters around the world. In her autobiography, Day reflected on the impact of isolation and its remedy. “We have all known the long loneliness and we have learned that the only solution is love and that love comes with community.”
A final example comes from Dr. Martin Luther King, Jr during the Civil Rights movement in the 1960s. While imprisoned for his cause, Dr. King also articulated the centrality of community when he wrote, “Our goal is to create a beloved community and this will require a qualitative change in our souls as well as a quantitative change in our lives.” Perhaps not since then have we found ourselves in a more tempestuous time in need of communities working together to confront and address violence, injustice and health disparities.
Rats and roaches live by competition under the laws of supply and demand; it is the privilege of human beings to live under the laws of justice and mercy. Wendell Berry
II. Community has the power to resurrect the human spirit
Modern medicine, in its obsession with RVU’s and efficiency has created what might be called a “factory for healthcare services” with the perverse tendency to “squeeze the humanity” out of us, as one UFCOM graduate phrased it years ago. Our “family” as we are fond of saying has played a central role in preserving the humanity of its members and patients. Our resolve to know, love, and care for one another reflects another feature of community power; namely reviving our humanity.
Historically, I believe one of the greatest examples of this power comes from POW’s captured by the Japanese during the Second World War. Coerced by cruelty and brutality, these men served as slave labor to build the Burma Railway where many of them were literally worked to death by their captors. In the book and movie, To End All Wars, Ernest Gordon recounts this horrifying story in gruesome detail. Suffice it to say that life in the camp was characterized by the worst kinds of selfish,
subhuman kinds of self-preservation. Gordon became progressively ill from malnutrition and infection and was moved to the “hospital” (referred to by the prisoners as the “death house”) to spend his remaining hopeless days in misery among the dead and dying. But one day, in a complete change of culture, some prisoners came to him offering their help. Sacrificing their own rations and determined to revive him, they moved him to a hut where he could receive care from his fellow prisoners. After weeks of selfless attention he slowly regained his health, his revival paralleling what happened among the other prisoners.
As Gordon tells the story, a radical change in spirit had begun within the camp. Ignited by acts of profound self-sacrifice among the men for their fellow prisoners, what ensued was a near miraculous revival of the spirit of human life, transforming the camp from a place of misery to a vibrant albeit physically malnourished community. The men began to sing while they worked and started caring for, rather than exploiting, one another. They shared their knowledge, books, and talents including improvising rudimentary prostheses for their fellows who had lost limbs and fashioning crude musical instruments. Some prisoners organized religious services and others started a “college” where small groups began teaching and debating one another. They even used their musical instruments to play concerts for their awestruck and bewildered captors. When the prisoners were freed by the allies, they were finally given sufficient rations to satisfy their basic needs. Many of their now disgraced tormentors were locked in crowded railway cars without any food or water. Seeing them suffering, these men abused but not destroyed, physically hungry but full of best of human virtues, shared their rations with their enemies in unbelievable generosity. To quote Gordon,
“Selfishness, hatred, envy, jealousy, greed, self-indulgence and pride were all
anti-life. Love, heroism, self-sacrifice, sympathy, mercy, integrity, and creative
faith, on the other hand were the essence of life, turning mere existence into
living in its truest sense. These are the gifts of God to men.”
We are unlikely to ever find ourselves in such dreadful circumstances, but all of us face discouragement both inside and outside the profession. Unsettling though it may be, it is only when our lives descend into our most desperate situations that we can understand the true power of community to revive our humanity.
III. Community Can Redeem our Suffering
As those who care for the sick, we are not strangers to the suffering our patients encounter and endure. If we listen, we will hear them searching for meaning as they walk through their ordeals. Holocaust survivor Dr. Viktor Frankl asserted that we humans are fundamentally “meaning seeking” beings and that this feature of our lives only comes into full view as we wrestle with meaning in the darkest places. There are many examples of communities coming along side those who have suffered to redeem events that on the surface seem to have no meaning. The recent peaceful demonstrations related to the murder of George Floyd are a highly visible and encouraging example of people coming together seeking changes in our society to bring meaning to his death. We could cite many other examples but to illustrate the special place that is UFCOM, I will briefly tell the story of Dr.’s Mike and Eileen Lauzardo.
In the spring to 2003, the Lauzardo’s lived through what is every parents’ nightmare when both of their children were diagnosed with leukemia. The oldest son Ryan is a survivor and is now in college but his baby sister Keira Grace, despite the best care, died from a rare form of the disease. After dealing with their grief and allowing their faith community to care for them, they decided death would not have the final word. Because of Mike’s interest in global health, they discovered that ALL, the most common and curable leukemia in the first world claimed the lives of most children in the Dominican Republic because treatment was inaccessible to them. As a vision emerged, a community of care formed leading to the Keira Grace Foundation established to “share the cure”. Over these many years the foundation has provided chemotherapy, trained nurses, provided consultation and built facilities both for treatment and to house families while their children were being treated. The sense of purpose and joy in this community both here and in the DR has transformed the care of children with leukemia so that the survival of children has increased from 20% to 80%. Without the continued support of the many people from UFCOM, this vision could not have come to life and could not be maintained. As a result, hope for life has emerged for these families from the deepest suffering of our colleagues.
IV. Community creates a place where we care for one another
Since its founding by Dr. George Harrell, the UFCOM has been described as a family and like all families, ours has its beauty and blemishes. Over the years we have grown in size as well as inclusivity, depth as well as diversity, and compassion as well as academic accomplishments. These realities have fueled our rise to become a top twenty public medical school. None of this would be possible without the courage, dedication and skill of our physicians, PA’s ARNP’s pharmacists, nurses, social workers and other healthcare professionals. No less critical, but often less recognized, are the countless men and women who tirelessly clean and disinfect our facilities, prepare and serve meals, and those unseen heroes who pick-up, deliver and process all the tools needed to live out our calling to care for patients. All this is to remind ourselves of what a privilege it is to be part of the community of care and how firmly we must resist all pressure to convert UF Health into merely a
“factory for healthcare services”. To give in to financial and bureaucratic forces would be to forfeit the most precious part of our college. During my 30 years as part of the institution, I have had the honor of caring of many members of this community, their families and extended families. That much seems predictable and straightforward but I have also seen the beautiful UFCOM community from the other side of the examining table.
In 2012, my mother at the age of 80 was diagnosed with locally advanced breast cancer after a catastrophic fall in her home in Virginia. She was always the outgoing and outspoken member of our family and this did not change when offering evaluations of those giving her medical care. She had no trouble parsing choice words to a medical oncologist who kept looking at his phone during her visit and made it quite clear their relationship was a one and done. On the contrary, she enjoyed telling the story of meeting her surgical oncologist who asked her about her life, family, faith, and showed genuine compassion and care during their initial meeting. During that hospital visit, she mentioned (as my sisters tell me she was fond of mentioning), “Well my son is an oncologist and a professor at a medical school, and he would appreciate your bedside manner.” To which he responded, “Which one?” “The University of Florida” she said with some pride and just a smidge of unhappiness that I did not land closer to home. He then asked, “Is your son Dr. Jay Lynch? He was one of my professors.” Dr. Jason Wilson (class of 2004), truly cared for her in ways unlike any of her other doctors and she lauded his practice of our art to the very end. Sometime later, I did my best to thank Jason in person for how he took care of my mother. Even now, reflecting on this episode, I am unable to adequately put into words the peace it gave me knowing Jason, a member of the UFCOM family was her physician.
My father, the finest man I have even known, was ten years her senior and a devoted husband and father. He confided in me that he was praying God would allow him to remain healthy long enough to take care mom to the end. Undeterred by his ninety years and complicated medical conditions, he stayed at her bedside caring for her throughout her illness until she passed away under hospice care. A little over a year later, he too had a fall breaking his hip and thereafter slowly but gracefully endured the failing of his own body. In one of our last conversations, while smiling gently he told me he was ready to lay aside this life and join mom in the next. Most of the rest of his talk expressed concern for my sisters and I as well as his grandchildren and great grandchildren. Soon thereafter he was moved to palliative care and slipped into a coma.
The complicating factor was his pacemaker that was keeping his heart beating despite all other signs of life having melted away. A palliative care specialist would need to come and turn off his pacemaker allowing his body to come to its final rest. The physician arrived with my sisters Cindy and Shannon at the beside and me having just returned home to care for my own patients. My sister called me and said, “Jay, the physician would like to speak with you.” I was not sure what to expect, but assumed this was a courtesy from the palliative care doctor knowing I was a colleague. Instead, I heard the following words on the phone. “Dr. Lynch, my name is Deborah Morris and I’m not sure if you remember me, but my husband and I graduated from UFCOM in 2005. I am so sorry to be reconnecting under these circumstances and I hope you don’t mind but I am here to take care of your father.” I can still hear Deborah’s tender and precious voice and I will never be able to thank her enough for the comfort it provided me knowing her and knowing she was there at the my father’s beside with my sisters overseeing his care until the end.
But my stories would not be complete without sharing one of the many examples of the way this community has cared my wife, my children and me. As I finished my tenth year on the faculty, I began to suffer from what I now know as were symptoms of burnout, followed by a darkening and deepening depression. Gradually as part of an unhealthy internal game, I wondered, as if I were writing a novel, how a character would plan the perfect suicide. But because of a combination of family illness, fatigue, emotional exhaustion, the burden of patient care and my own isolation, I became engulfed by a suffocating hopelessness and started imagining myself as the main character. Thankfully, within the safe company of my lifelong community of faith, I was able to acknowledge my struggles and when I reached out to a colleague in psychiatry, I was greeted with love, kindness and hospitality as well as superb medical care. Realizing the stigma associated with mental health and with the blessing of the UFCOM leadership, I have since been able to talk and write about the need to acknowledge the prevalence of depression and anxiety to create space for others to seek care. I am convinced my own experiences here has made me a better teacher, doctor and man.
A proper community, we should remember also, is a commonwealth: a place, a
resource, an economy. It answers the needs, practical as well as social and
spiritual, of its members - among them the need to need one another. Wendell Berry
At the UFCOM and UF health, we have inherited a rich tradition of community in the deepest sense of the word. We have had our part in changing the world, reviving our one another’s humanity and redeeming the suffering of our members. From the beginning, this institution has been guided by a clear vision for education and medical care to be centered on our patients. Living this out has created a community of care where we truly do take care of one another, so we can learn, discover, and take care of our patients. The tragic events of the last several weeks have only placed an exclamation point on the importance of treating every person with human dignity and the need for authentic communities gathering together to speak out and “answer the needs, practical as well as social and spiritual of its members.”