That Nevada is having its first ever political caucus four days following Martin Luther Kings, Jr.’s birthday has significance. It is also significant that elections around the world have been horrifically blemished with violence, death, assassination, and fear. For what it looks like here, this caucus is the first hands-on opportunity for individuals to feel Democracy in the moment. We get to go somewhere, stand somewhere, raise our hands and be counted. And, no one here is afraid to show up. At the same time, the focus of this election continues to be a toss up between health care and the war in Iraq.

Nevadans for Healthcare has been relentless in putting out comparisons between all candidates of both parties regarding how to solve the health care crisis. It seems that the focus remains pointed to economic solution for what may appear to some to be an economic problem. Leland Kaiser, healthcare futurist, in 1989, said looking to managed-care to solve the health care crisis (as it was then) was like rearranging the deck chairs on the Titanic. That is true to the issue of using the insurance based model we have now. It is also true if the problem is assumed to be money when it is one of values.

Making small changes, however, could optimize the massive investment now made in the US in health care. Single, standardized forms, a single clearing house for insurance payments, and a limit on the profits allowed to Insurance companies would help but are highly unlikely to occur. All of these would still not solve the basic flawed values that have made health care a profit-making, market driven industry rather than one based on service, skill, and the human right to be cared for when ill.

I am interested in how you would solve this problem. It seems to me that denying anyone health care, needed hospitalization, basic health services, and needed medications for lack of insurance is far worse that giving care to everyone, having equal access, and having the public invest in the health of its members rather than shareholders. Further, I am confused about the perceived difference between public health and public health access.

Market-based systems are biased towards those who have the means to enter and meet the market price. Whether this is better than standing in a need-based cue for care, or having the option of public vs private care…one would have to tell me why denial of access is better.

To the legacy of Martin Luther King, Jr, I would suggest that the fact the the poor face more difficult and health-challenged lives would have been his next cause as the next civil right: the universal and equal rights to healthcare.

No, it is not quite over yet but the New Year is starting anyway. I say this because this was my own wakeup year…the point at which I see the world from a perspective of vulnerability, from the perspective of impending transformation, from the perspective of new urgency. Sustainability…a word I have used often in the last two months…is relevant to my persona as well as my world, to my practice as well as my intention, and to my relationships as well as my efforts. What is going on today that did not seem feasible last year? What is going on not happening right now that was a critical issue last year? What hurt and woundedness were inflamed and are still inflamed, but have succumbed to other priorities of the moment?

It is beyond my comprehension to witness the devastation in New Orleans, the fires in California, the flooding and earthquakes and cyclones in Asia… and none of these are “over.” And, some would say “that is last year’s news.” I say, it is this year’s suffering…and this year’s opportunity for healing.

THis year starts with new opportunities to rethink old ways of last year’s world that can be transformed into new futures. WHile we all listen intently to the presidential candidates, my plan is to listen very carefully not only to what they are saying, but to whom they are saying it. Healthcare remains the Rubic’s cube of economic, human, clinical, and social challenges. It is solvable as it is if one wants a Rubic’s cube. However, another model might provide more balanced solutions that having to have ultimate equality and segegration of the parts made so obvious by the perfect Rubic’s model of one color per side.

Maybe we need the Rubic’s Rainbow…a whole that is multicolored where neither front nor back, top nor bottom, can be completed without all issues being dealt with. A thought. Rubic’s Rainbow.

Every year at this time I feel sad. Just the nature of time passing, December being here again…and life passing. At the same time, both the tragic and miraculous show up for me. On the tragic side, the many shootings, here and abroad, star at me everytime I open my email. I always wonder if we have really become so much more violent or the nature of this information age brings us news that just never would be aware of in prior times. There are days when I feel that I have “too much information” about things, people and events, over which I have no control.

Then, on the side of the miraculous…so many good things. In our own house, Lily Upp, our 10 year old daughter of Sue Upp, has successful beaten the big bad wolf of bone cancer. The whole year was the year of Lily…and, finally, such a triumph for her and her Mom, Sue…and for all of us who connected between Reno and Detroit. Sue is our Regional Sales Manager working at a distance only in miles, not in spirit.

Jane Wirth, wife of David Wirth, is also beating the devil of cancer…and healing wins out, with her spirit and body rallying to the task. She is at UCSF Med Center…where she is not at the tale end of the treatment she started a few months ago. There are days when the issue is not having cancer…but, being grateful that whatever it is, is more vulnerable that the human body it tries to conquer.

Then, the war. Painful to think of…year after year, as I wrote in my message this month, it seems that the concerns and fears and challenges remain unchanged. But, this year, we are almost at 4,000 Americans having died…and untold thousands of Iraqis. That history has many more tales of worse wars is no consolation. The loss of a future for each individual…of their potential, their untold legacy…except in the projection of meaning by those of us remaining.

So, each of you, along with me, I am sure can list the tragedies and miracles of 2007. I am willing to go forth into 2008 with great expectations of goodness and healing. An election year…that gives us all one more chance to reevaluate nad mkae choices. That each day offers choices is the truth…but, the end of a year, is like a magnification of the choices…

Have a great holiday, but more important, , I will try to remember that the days and years following are the real gift…

What do Al Gore, the California Fires, Starbuck’s, and the fast-food industry have in common? Well, Al Gore focuses on the global warming; Starbuck’s makes it efforts at offering a $.10 discount if you bring in your own cup; fast-food industry draws from trees and carbon-based plastics to make sure you can walk out with your burger; and the California Fires are burning from a drought that is result of a planet that has heated up without a thermostat control for decades. Coming from Detroit, the tale end of our trip, the weather was unseasonably uncomfortably like spring: trees were hardly turning color; temperatures were in the 70’s; little to no rain in six days. I was born in Detroit. This is a stunning change. Frank Ross, my dear friend and business advisor, predicts that in 10 years Michigan will be a living destination as it may be the only state with water. Literally. Imagine Michigan going through population growth for its water!!

I continue on the issue of sustainability because once climate change became an issue of world peace, it became relentless in occupying my world view and my view of the world. Whether Al Gore is a politician, is 100% accurate in how he puts forth information, is exciting or boring…these are all non-issues. He has continued to try to wake us up.

Interesting movie we saw coming home from Germany: about Evan, turning into Noah, predicting a flood, and was declared insane… Hmm. Sound familiar?

So what does this have to do with healing environments and the C.A.R.E. Channel and HHS? No less than everything. We deliver images..live images tranferred into digital media…of the most beautiful of nature. We provide this so that the confined patient is able to connect to the most basic of human needs, the natural and spiritual. What if all of nature was burned to a crisp? The streams and rivers and lakes become polluted and toxic because of draught? What if the stunning flowers could no longer bloom because it was either too much sunlight or no sunlight? What if the ducks and geese disappeared for lack of water?

I have never been an environmental zealot. However, this is no longer about extremes. This is about looking at the situation burning in front of us and taking stock of what to do.

Please let me know what you are doing so that we may do it. Our goals are about accountability for where we stand…and where we stand is in ICU.

Without a doubt, this word has come to mean something far from its roots. To make this easy, here it is right from www.dictionary.com:

sus·tain /səˈsteɪn/ Pronunciation Key - Show Spelled Pronunciation[suh-steyn] Pronunciation Key - Show IPA Pronunciation
–verb (used with object)
1. to support, hold, or bear up from below; bear the weight of, as a structure.
2. to bear (a burden, charge, etc.).
3. to undergo, experience, or suffer (injury, loss, etc.); endure without giving way or yielding.
4. to keep (a person, the mind, the spirits, etc.) from giving way, as under trial or affliction.
5. to keep up or keep going, as an action or process: to sustain a conversation.
6. to supply with food, drink, and other necessities of life.
7. to provide for (an institution or the like) by furnishing means or funds.
8. to support (a cause or the like) by aid or approval.
9. to uphold as valid, just, or correct, as a claim or the person making it: The judge sustained the lawyer’s objection.
10. to confirm or corroborate, as a statement: Further investigation sustained my suspicions.

What adds to my particular dilemma is that I have come to use the word regarding healing environments: to create and sustain a therapeutic space. Meaning, 30 minutes or one hour, or one day is not enough. This is about continuous…sustainability. However, the word is confusing. Well, maybe not.

Dallas and I recently attended a Sustainability Intensive sponsored by the Fielding Graduate University at the O.U.R. Ecovillage in British Columbia (www.ourecovillage.org). The whole weekend we talked about it, ate it, breathed it, soaked in the rain within in, and talked some more. Knowing that we were not going to suddenly pack up our high-tech, computerized home, rid ourselves of the many electronic technological advances that have allowed us to record our music where we sit, put away our HD television that brings us Sunrise Earth every day…it just was not going to happen. However, something else did happen.

I had not linked it all before. Consumerism = environmental decay because we take one substance born of the earth and transfom it (production defined by Marx)…and have done so in a way that throws it back to the earth, but hardly dust to dust. It is more like tree to paper cups. Or, oil to plastic blister packages. Or, …well, you name it.

So, what kind of definition could I use about sustainability when it comes to compassion, caring, skill, generosity, forgiveness? Is it possible to take it and not give it back? Could we run out of any of them? Well, we have transformed some into economic windfalls. Hmm. Compassion, according to latest television commercials, is offered through your local HMO. Caring is one every mission statement. Skill..a promise to deliver. Generosity…has not yet been found in an ad lately. And, forgiveness…well, short shelf life it seems.

However, all sarcasm aside, having lived for three days among people who are really putting their word into action, I believe and keep saying that the healing environment is, by definition, sustainable, if we sustain it. That, human interactions are consummated heart to heart in ways that are non-disposable.

I am no longer buying paper plates; I am using real cups at Starbucks; I am using my handtowels more than my paper towels; I have already switched our marketing to more online exchange than paper stuff through the mail. Most important, however, I am reassure that global warming and heart warming are related.

How is it for you?