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The envelope is postmarked September 21, 1961. 6:30pm. Upper Darby, PA. Inside is a letter from a twenty-six year-old man to his younger brother, a young man stationed at Fort Sam Houston in Texas for military basic training. The letter begins with:

Things have happened! 1. I got a driver’s license. 2. Bought a car. 3. Can get in and out of car alone. 4. I start St. Joe’s night school Monday. All of a sudden your lazy brother has regained some of his drive and become a dynamo.

The writer was my father. At the time he wrote his brother, it was almost three years since he had been paralyzed by the polio virus.

The handwriting is scratchy, with blurred and abbreviated words that are sometimes difficult to make out. I am able to read it probably because I learned as a young boy how my dad formed certain letters on the page.

He was proud of himself, despite his matter-of-fact tone. The two page communication shares details of his purchase of hand controls, how he borrowed a car to learn how to use them, taking and passing the driver’s test, and then purchasing a two-door Valiant.

I was a little upset about going so far into debt so that as soon as we got the car home (before I paid any money) I told Carol that if I couldn’t get in by myself – the hell with it.

With help from my mom, he describes figuring it out, first getting in by himself, then getting out by himself (or, as he wrote, reversing the procedure). He concludes his description of relearning to drive with Now all the remains is for me to get some adaptations made to the car so that I can get the chair in and out by myself – then I will be free.

“Free.” In November of 1958, my father was twenty-three and fresh out of military service. He and my mom had a two year-old son (my brother) and barely a dollar to their name. Dad had gotten a job selling insurance for New England Life. Mom was pregnant with me. There was a general plan for more education – for Dad, as a first generation college student. Then a stranger sneezed in his face when he was waiting to use a pay phone. A few days later, a bad flu followed. Paralysis. Eight months in acute and rehabilitative hospitals. And my birth in June of 1959.

This letter is written over two years later. I know from family stories that the intervening time between my birth and Dad’s declaration in a streaky fountain pen of regaining his drive were not easy. They involved my aunts and uncles helping my mom help (i.e. lift) Dad up and down steps, into and out of cars. Wheelchairs that weighed almost as much as he did. Relearning how to do simple things such as using silverware, writing, and, yes, driving. An understanding company that kept my father’s position available for him – for when he was finally able to navigate his way from my parents’ second story apartment to the company third floor office across town.

And being “free”.

I received this letter just two weeks ago. My aunt and uncle are moving from their house and, in the process of sorting through decades of memorabilia, my aunt discovered the letter that my uncle had kept from so long ago. Mom and Dad have passed; other than my aunt and uncle, there are very few people alive who were with my parents in the year that the letter was written. I have only Dad’s written words in this letter, a few old photos, and my own memories of stories he and my mom occasionally told us when we asked about their lives from that time. Mom didn’t especially enjoy reliving those years through remembrances; she would mumble something about living in the present. Dad would get a hazy look on his brow. His eyes conveyed what I understood without words. Once he told me: “We learned how to make it work. That was the only thing to do.”

Now this letter. The second page reads like a simple recounting of mundane facts. He received a full scholarship and enrolled in night school, with a major in accounting. The insurance company was moving their offices into the city – so things should start to shape up. Then, informed by his own basic training experience in the Southwest, Dad told my uncle about a great smorgasbord in San Antonio. Two dollars for all you can eat. He closed the letter with a note to my uncle to take care of yourself and enjoy the sun (Hurricane Ethel is supposed to hit here tomorrow).

We all encounter our moments in life, circumstances that challenge us, situations that humble and sometimes bring us, quite literally, to our knees. Some of us have more to deal with than others: the birth lottery can be cruel; bad things happen to good people; tragedy traumatizes the innocent. Explanations for the seemingly random and fickle nature of fate are few. For me, this found letter from 1961 offers a simple reminder that, when difficulty befalls, the way forward is in front.

Just drive. You never know where life’s journey will lead.

I was talking with a friend the other day about miracles. Also a physician, he briefly described some incredible stories that have been documented regarding people who have inexplicably recovered from advanced illnesses. Disseminated cancers. Progressive neurologic diseases. Conditions that most clinicians would recognize as offering little hope for long-term improvement. Nonetheless, illnesses from which people had – to the medical profession’s surprise – completely healed.

“Spontaneous remissions,” I said.

“Yeah,” he replied. “Real miracles.”

The conversation stuck with me. In my medical career, I have personally seen some amazing things. Sometimes those things have involved dramatic healing responses. Sometimes they have related to clinical instincts and therapeutic actions. All have been unexpected. Each was stunning.

Were they miracles?

Another friend was recently in the emergency room for a problem that required surgery. He was stable but his health, in general, was fragile. Although the procedure he needed was relatively minor, the general anesthesia that would permit the procedure to be done was a major concern for his family. How would his system respond? My friend was not worried. He placed his trust in the surgeon and his faith in a power greater than the surgeon’s. He was calm. He only requested that the Catholic priest visit before the procedure. The priest did and had everyone gather around the man in the hospital bed. People held hands. A simple prayer was said, together. Minutes later a test result was reported to the surgeon that changed the original diagnosis. Surgery was not needed. My friend could be treated without anesthesia.

A miracle?

We use the word in different ways. There is the “Miracle on 34th Street”, a story replayed during the Christmas holidays. There is the “Miracle on Ice”, a tale about the 1980 Olympic gold medal run of the U.S. hockey team. And then there are so-called “medical miracles”, people who beat the odds and get better in the face of remarkable circumstances. The power of our collective spirit is impressive. Astounding things happen when we cheer, support, and implore for each other.

But it is unpredictable. Not everything we wish, hope, and yearn for happens. We are often deeply disappointed and saddened. Despite humble foundations, our most heartfelt entreaties and appeals do not guarantee results. Spontaneous healings from “untreatable” cancers are not so common.

I don’t pretend to fully understand prayer as an engagement distinct from hope. I know they are different; prayer includes a petition to a higher power while hope may be aspirational without being inspired. Still, there is sometimes a fine line between them, especially when the being to whom the intention is focused is not necessarily tangible, physically palpable. Do I have to aim the beseechments of my soul at God, Allah, Buddha, or another concept of the supreme being for them to have a higher likelihood of being heard?

And why should I assume that God, her or himself, does not pray?

It is wrong, I understand, to anthropomorphize the divine. And yet that is how I experience the greater good, the universal positive, the prime moving force of life in the cosmos: through forms. Through others. The world in which we live is not perfect. It may have begun from such a state, or it may be arcing towards such a state, but it appears, from my finite perspective, to pulse at present far from perfection. So if there is a wisdom, a current, a source of eternal love that is somehow engaged with me, with you, and with us – why should it not be capable of engaging in prayer for us? We have freedom of choice; the world does not appear to be deterministic. So why wouldn’t a higher power – God – not want to pray for us and the choices that we make? We have a history of making bad decisions. We need all the help we can get to keep from making too many more.

I am likely spinning within a tumble of poorly formed ideas. And perhaps I am using words such as prayer in a slipshod manner. It reassures me, however, to think that a spiritual consciousness which exists before, during, and after us is somehow able and interested in expressing love for us through even the simplest of prayers. My parents are gone from this life. They continue (I hope) in some form in the next. If I can pray for them, if I can pray to them, and if they might be in turn be able to pray for me, is it such a leap of logic – or faith – to wonder if the spiritual collective of the divine might not, in some marvelous and interconnected way, pray for each other? Is it wrong to wonder if the divine itself might not pray? Could the divine even be unbounded by and through prayer?

I have no doubt that miracles occur. In fact, I think that they may happen more frequently than we recognize. Some are fantastically substantial, such as a sudden healing from serious illness. Others are marvelously missable, such as a decision to do something during a daily routine that leads to an unexpected positive encounter or occurrence. All offer stunning insight into the interconnected nature of life, love, and our capacity to care. All are, from the restricted vantage of science and human understanding, wonderfully unexplainable.

I pray that prayer is infinite.

If you are like me, you may enjoy reading certain books and stories more than once. In my garage, there are a stack of books that I’ve saved over the years, all flung onto shelves with the intent of a second or third reading. Some are superb examples of insight and authorship. Others came along during seminal times in my life. The first type I treasure because I know there are literary gems and secrets to be found via an additional perusal. The second group simply remind me of who I was, where I was, and perhaps what I was when I read them.

Last week, I reread a story that really fit neither category. It was a detective story, set in England following the first world war. The tale was part of a series about a young man who manages to solve murders despite his struggles with post-traumatic stress disorder. It is easy reading. And the detective always finds the guilty party.

But here was a twist: I couldn’t remember who had done it. When I began the book, I assumed that the plot would come rushing back, that I would quickly recall the key characters, and that I would certainly remember the murderer’s identify from the start. I was wrong. I had no idea who was responsible for the unfortunate tragedy described in the book’s initial chapter. And I had no great excuse for not doing so – the book had been published within the past few years.

Yikes! Either I had first read this novel while sleepwalking or my memory lapse was perhaps a sign of something that I’d prefer not to consider. How could I have forgotten how the story ends? Was this a foreshadowing of further cognitive loss to come? Once I decided not to worry about it too much – it was, after all, just the plot line of a mystery novel – the reading re-ride was fun. In fact, it sharpened my attention to the story’s details. I wanted to spot the hidden clues, not so much to identify the culprit, more to awaken the napping neurons in my memory banks that were withholding that information about the culprit from me. Some part of me knew how this novel ended. I waited (with some anticipation if I’m honest) for my slothful side to rouse itself from its slumber and tell me.

We are drawn to stories, aren’t we, especially ones with complex twists and turns. We long to be captivated by uncertainty. But we still want to know how things turn out. In a novel, on the movie screen, even in the yarns we spin for each other, there is always some sort of unveiling, a reveal. Something happens. Someone steps forward. The story resolves.

Not so, however, in every day life. Despite an abundance of drama, there is plenty of unresolved intrigue. Events cannot always be explained. And the primary questions, the big ones, the how-in-the-world-did-the-world-first-begin and where-in-the-world-do-I-fit-in queries, well, those plot lines don’t have easy formulaic or fashionably snug finales. We just don’t know, for sure, the story on the other side of some life climaxes. And we won’t know – until we ourselves experience such other sides.

The seasons of our calendar provide reliably consistent narratives. As do the texts of our religious traditions and heritages. We don’t forget how those stories end. We know the tales and plot points. Some of us can even recite the words of the readings, poems, and songs by heart. It can be reassuring to form the messages with our mouths. We often do so without needing to think about what we are doing.

Sadly, that is where someone like me can get lost. While there is safety in many of the memorized tidings, there can be disconnection between the part of me murmuring without conscious attention and the side trying to find new ways to be awake. I don’t want to be on auto-pilot. I don’t want to be someone who is only interested in discovering how things end up. I need to focus more on the steps and details of the journey. Nonetheless, I can get stuck in the recordings, like a needle in a scratch of an old vinyl LP. I can forget to nudge myself forward.

Surprisingly, that is what I learned from the second reading of the detective story. When I let go of worry about how the story ended, I was able to slow down and notice how it unfolded. I was also reminded that I can do the same thing each day in other, even all aspects of my life. With a bit of breath, the same sense of discovery and freshness is available within everything I read, do, say, touch, and hear.

Have I heard the same seasonal tales and prayers hundreds of times? Without doubt. Have I listened, truly paid sufficient attention, to find something new inside just one part of them each time they are recited? Not enough.

My ego and intellect were reassured: I did remember who had “dunnit”, before the British mystery novel ended. More importantly, my spirit and soul were refreshed: they reminded the rest of me that speed in life isn’t what the journey is about. Participation matters.

The following essay was written by guest contributor, Sophia C. This is her college application essay, which she graciously agreed to share here.

It was the morning of my annual ballet exam. I had been doing the exams for fourteen years. Sitting quietly, trying not to listen to the muted music coming from the exam room next door, my stomach felt as if millions of tiny butterflies wanted to take flight. This year’s exam was different. I felt more pressure than ever before because it was a repeat test from the previous year. That had been a difficult time, one in which I had struggled with ongoing health problems requiring multiple hospitalizations and challenging medical treatments. Unfortunately, I had failed last year’s exam – by one point. Although I was told that coming so close to passing during such a difficult year was a success in itself, it did not feel that way. I had considered quitting the dance program.

Which I almost did. Some friends stopped dancing when they did not pass. Continuing in the program meant that I would no longer be dancing with them and would have to repeat the curriculum with younger girls. I would also have to retake the same exam the following year. This year. 

Deciding to continue, and to ready myself to retake the exam twelve months later, wasn’t easy. There was the social consequence, the embarrassment. And there was the personal consequence, the feeling of failure. However, the decision before me was pretty clear: I either redid the curriculum, the year, and the exam – or I just gave up. Giving up was frankly not a serious option. I was too determined to not let my illness get the best of me and take over the things I cared about. I simply needed to get over my pride. I also needed to stay behind while the rest of my class moved on. And I needed to work hard throughout the year, perfecting the dances to the best of my ability, working through my illnesses in the process, and slowly improving.

Now here I was, one year later, about to take the same exam that I had already failed. It seemed like there was more pressure this time; if I failed again it would be a win for the chronic illness monsters. My experience with chronic medical conditions had taught me that those demons can be destructive, if I let them. I was determined not to do that. Still, when my time for testing came, I entered the exam space with a heart ready to leap from my chest, legs that felt like jelly, and a wobbling confidence.

Then something wonderful happened: I remembered that I loved dancing. As the exam progressed, I was filled with a sense of peace. Releasing to the well-rehearsed movements, memories of past failures and pain were washed away by an awareness of achievement, of perseverance through challenge. My failure the prior year had taught me the importance of living my values. I will not give up on myself, even when circumstances seem impossible. 

That’s when I learned the most important lesson of all. It didn’t matter if I passed or failed. All that mattered was that I continued, that I finished what I had begun. That is a lesson that I can carry with me for the rest of my life. Failures will happen. It’s what I do in the face of failure that really matters.

It is the time of year for giving. The many traditions of the season, be they religious or secular, offer ample opportunities for us to think of and express feelings for one another in the form of physical objects that we purchase or make and then hide inside boxes and beneath wrapping paper. Presents. some call them. Surprises.

Our holiday customs are not just quaint. They can be touching, even eloquent. There is an expressiveness within the selection of the ‘perfect present’ that embodies emotions more fully than words can sometimes suffice.

If you are like me, you may struggle, at least intermittently, with the scheduled routine of some gift exchanges. “Are you ready?” we occasionally ask each other in December. The reference is to the purchase of sufficient items for exchange with family, friends, and colleagues. It hints at the semi-obligatory nature of the season, expectations that must be lived up to, preparations made such that an adequate display of affection and caring is possible at certain times and in certain events. This isn’t just for Christmas. It includes Hanukkah, New Years, Solstice, and other traditions. There are also end-of-year non-profit donations, and tokens of cheer and appreciation at holiday events and parties. During the final two weeks of December, there is no shortage of circumstance for us to demonstrate magnanimity, thoughtfulness, and generosity.

It can feel a bit burdensome, at least sometimes. Which can, in turn, lead to intermittent self-deprecation and cynicism. What kind of person am I that I don’t unequivocally enjoy the annual chance to shower fondness and good will on others?

Well, I am human. Actually, I am one human. In truth, I am one of billions of humans, all on a journey to experience something beyond our individual selves, something that some like to call the divine.

As part of my own journey, I have, in recent years, begun a new personal tradition in December: a visit to the Chapel of the Holy Cross in Sedona. The building is small but structurally inspiring; twenty-eight meters of textured concrete ascend within the red rock buttes of the high Arizona desert. A large iron cross supports both narrow chapel walls and a large bronze crucifix stationed internal to the southern smoked glass side. The aesthetic affect is stunning. The personal impact is stirring.

“Let’s stop by.” Last Christmas Eve, my wife and I happened to be driving in the vicinity of the Chapel and decided to brave what we expected would be significant crowds. We weren’t disappointed, either by the crowd size or the experience. So this year, as part of some inexplicable motivation for renewal, a sort of seasonal homing instinct, I returned. Again, I was not disappointed.

The morning was unusually damp, cold, and moist; clouds floated against the Sedona rocks as if they themselves understood the rarity of the day. People gathered on the walkway and within the walls of the small chapel in varying states of presence. Quietly, I moved through tourists and spiritual pilgrims to the front of the chapel. As a child, when I attended church with my mom, we always sat up front. In memory of her, I did the same. A wooden bench was free, so I used it. A stand of devotional candles was before me, so I made a donation and lit some candles. I did not, at first, look up. I simply sat. I closed my eyes. I was.

It is a remarkable experience to feel loved. In my life, I have been blessed with much love – from my parents, my wife, my family, and many friends. I know they love me. They know I love them. But knowledge is different from experience, from being. Resting beneath the gaze of compassion in that chapel, I felt an acceptance that previously I have been hesitant, even fearful, to let myself feel. To be willingly held by the universe in a state of non-judgmental love is to live a moment of the marvelous, the mystical, the eternal. It is to learn a bit more about the nature of love.

Love is freely given. Love is willingly offered. Love is a gift in the truest sense.

When I opened my eyes, a mother and daughter were standing next to the stand of candles. They offered a donation, identified an unlit candle, and found a partially unused wooden taper stick. The candle they selected to light the taper stick, and hence transfer the devotional flame ,was one that I myself had lit. Minutes later, another family approached the stand of candles. The same process ensued. And second candle that I had personally lit was used to transfer this next family’s own intention to another newly ignited wick.

We are able to love freely. In doing so, we accept and share more than we will ever know. Love is the most precious of gifts.

As a child, you may have learned the custom of giving thanks before meals. In my family, this was called “saying grace”. It was a recited expression of spiritual appreciation for the food set before us at table. I must admit to not thinking much about the words I murmured before grabbing the knife and fork. It was just part of the meal process in our house, the ritual that we followed most evenings prior to eating.

Over the years, I’ve watched, listened, and learned about a variety of customs that people follow before eating. Some of these are tied to religion; my father liked to utter a brief prayer for the peaceful repose of the “souls of the dearly departed”. Others are part of more earthbound traditions; many family members and friends prefer to acknowledge, even briefly, that life, in some form, was sacrificed so that we might be nourished. Regardless of perspective, all pre-meal routines that I’ve witnessed have involved the simple yet profound practice of pausing before action, of reflection, of awareness.

Pushing pause in our lives is a challenge. The globe rotates at the same speed and yet our days seem to move more quickly than ever. There seems no shortage of event, information, and activity for us to monitor, absorb, or keep pace with. Devices enable us to “connect”, to stay up-to-date. And yet the so-called cycle of news spins faster and faster. We can feel more and more disconnected.

It is easy to get caught up in the do of the world, not the be. For me, when I let myself become imbalanced in the do, I find it important to return to ritualistic inaction. I try to sit. I try to empty. I try to say more grace.

But what does that mean? And what is “grace” anyway?

It turns out that I have not understood grace at all. When I researched it, I found many perspectives, most more alike than different. One of them, however, stood out for me. It was a definition from Webster’s dictionary: the “unmerited divine assistance given to humans for their regeneration or sanctification”. I had expected to find definitions of grace as the shower of something soft and soothing. Grace as comfort. Grace as a shaw of protection, not a potential revealing or raw exposure. But within the Webster’s definition, the definition that most spoke to me, lay the dualistic nature of grace’s reality. Qualities of tenderness and tribulation are both inherently part of what it means to experience grace in our lives.

Because grace is received, not said. Grace is freely offered to us, not earned by us. Grace is aid from the outside for our individual internal betterment, not positive fortune that we experience as reward for external good behavior.

The reminder stops me: I don’t necessarily deserve the grace I receive. In fact, the grace I receive is sometimes unexpected or unwarranted assistance focused on my shortcomings rather than my strengths or my longings. The help I need is sometimes not the help I think I need or I want. And so I may miss much grace in my life because the most meaningful moments of grace sometimes hurt.

This can be really hard to accept. “The universe is moving me again.” I say that, externally, when the grace I am given is challenging yet bearable. “I can’t handle this.” I say this, internally, when I simply feel overwhelmed. Both may be moments of grace.

This is not to posit that all bad is good; the ugly things that happen in human lives are not necessarily grace. I cannot accept that the divine would deliberately distribute anguish and misery, abuse and violence, as a means toward personal regeneration. Whatever is the essence of divinity, that essence, be it named God, Allah, Buddha, or the Creator, is life-affirming, holy. It must be. Despite this, I must accept that sometimes change is only possible through challenge, that some troubles are not random trials, that my very human ego and perspective inherently require routine lessons in humility. “Unmerited divine assistance” can take many forms.

So I must listen. Continuously. I must stop, regularly, to ask, probe, and wonder whether some, or even most, of my daily woes are not opportunities for – dare I say – sanctification, in whatever small way is possible. I am blessed to have a life in which the good far outweighs the difficult. I must embrace my fortune but not become complacent, too comfortable.

As we enter the calendar season in which we celebrate renewal, regeneration, and rebirth, I must do more than periodically pause in brief reflection before lifting my fork and knife, do more than simply closing my eyes at table and thankfully “saying grace”. I must remain open to humbly “receiving grace”.

Let us bow our heads together.

Our world seems far from ordinary. Countries are in conflict. Social contracts are in tatters. Global climate change threatens millions of people. Despite this, when I review today’s liturgical readings, I am reminded that we are in the 34th week of ‘ordinary time’. Yesterday, Thanksgiving, held no special significance. Today, Black Friday, is not on the Christian calendar radar. Spiritual solemnity, and feasts of Biblical significance, begin in December. That season starts on Sunday.

This shouldn’t be surprising: the rituals and rhythms of religious calendars have their roots in millennial-aged traditions, not the century or decade-framed view of the modern secular world. Native Americans and Pilgrims did not break bread at the time of Christ. The cycle of the sun did not rotate around consumer purchases, the gross domestic product, and economic indicators when the prophets and founding influences of the major religions walked the earth.

Still, it does seem a bit outdated to call this the 34th week of “ordinary time”. Sure, a little research informs me that this is a mere numbering convention, that the word “ordinary” derives from “ordinal”, and that we aren’t meant to see this and the other thirty-three so-called ordinary weeks as unimportant but rather as continuous opportunities for spiritual engagement separate from the special weeks of Advent, Passover, and Easter. I shouldn’t get caught up on a simple word like ordinary.

But I do. And I am. I don’t feel reassured by an etymological explanation regarding the reason for the terminology.

Because this is not an ordinary time. Too much depends on our recognition of how unique a time this is. The future of our existence, near and distant, hinges on our ability to appreciate the pivot point in history on which we stand.

No, the sky is not falling. But it could, if we don’t care for our environment better.

No, society is not crumbling. But it could, if we don’t care for each other better.

No, the dream of becoming something more is not lost. But it could elude us, if we don’t recognize the fundamental role that spirit plays in our lives.

And that last one, the risk of not realizing our potential, is what challenges me, deep down, when I dive into my discomfort with the word ‘ordinary’. I have not been a religious man, at least from the perspective of church attendance and steadfast adherence to doctrine and dogma. Although raised in faith, I have wandered. However, like most people, there has always been a yearning for grounding, for understanding, for acceptance by a force and purpose beyond the physical.

I do not want today to be ordinary; I do not want tomorrow to be ordinary. I do not want you to be ordinary; I do not want to be ordinary myself.

I want today and tomorrow to be special. I want you and me to be special. I want us to achieve something positive and special together.

To do this, we must reach – beyond our limited mindsets and abilities – to the “extra”ordinary. We must strive for the special, not just during particular seasons of the year or liturgical cycle, but instead during every week of the year.

We have work to do! And that work needs all of us, body, mind, AND spirit. Only then can we realize the wonders that are possible when we, as individuals, look past ourselves and see our collective potential.

Which makes me stop – and listen – to what I have found inside the simplicity of a single liturgical calendar phrase. Perhaps there is more to certain traditions than I understand. I suppose I’ll keep reading. And be thankful for the freedom to learn about time and faith.

I’ve recently been reading and thinking about leadership. It’s an important topic. Much has been published on it. And many insightful people have recordings about it on-line.

Driving to work this morning, the basic components of my leadership philosophy suddenly crystallized in my mind. There was no dramatic event on the roads. I simply turned at a stop sign and what I believed in wished me a calm and calming hello.

“A.C.T.”

The A is for authenticity. For me, this is where good leadership begins. One person’s engaging personality traits are not necessarily another’s. A person cannot mimic his way to effective and valued leadership. He has to know who he is first. Then he has to be who he is. 

Many of us may have been in situations when we tried to wear someone else’s leadership style. I know I have. Intellectually, it seems like a good idea. Emotionally, however, it’s all wrong. It doesn’t fit. People sense it.

Some years ago, I tried a different style of leadership during a stressful employment time. The organization had a new CEO. I was in executive leadership and felt the expectation of delivering results. The new CEO didn’t get me; he couldn’t understand what made me tick, why I was doing the work that I did, what motivated me to be in the position I held. Things weren’t going well. So I tried a more “direct” style of leading. I was edgier. I was less kind. One week into the test, someone whom I “knew” was angling for more authority in the organization asked me why I was acting differently. “What do you mean?” I replied. “You’re a nice guy,” my presumed competitor said. “This place is crazy enough without someone like you getting sucked into the muck. It’s too destablizing.”  Ah, I realized. Not a competitor. A colleague. Someone who relied on me in ways I had not realized.

A stands for being authentic. Don’t ever lose sight of who you are. Don’t ever, ever let someone “above” you in an organizational food chain influence you to be anyone else but who you want to be on your best day. Because that “best you” enables you to lead with “C”: clarity and charity.

Leaders don’t need all the answers. The good ones, in fact, never mislead themselves into thinking that others need answers at all. Instead, people need clarity. What are we trying to accomplish? Why? How can I (i.e. the leader) help you (i.e. the person doing direct work) better accomplish that? Effective leadership knows the answers to these questions because she understands the organization’s mission and vision. Valued leadership translates that understanding of mission and vision – clearly, consistently – to the people who are actually doing the work. 

Yet clarity is only part of the formula for true leadership. Change the “l” to an “h” and we have the other key C: Charity.

When I temporarily wore the ill-fitting management cloak of the new CEO, my words were super clear. An elementary school student could have understood me. What I wasn’t was charitable. I was talking, not listening. I was telling, not asking. I wasn’t interested in the perspective of the person on the receiving end of my communications. Interactions were transactional. I behaved as if the work we were doing was some sort of early industrial-period assembly line. Do this. Don’t do that. No need for variation. No need for individuality. Deliver. I wasn’t offering to help someone succeed. I was managing, demanding that they succeed. No doubt I’m at least slightly exaggerating my attitude and behavior during that sad week of leadership style exploration. But I am speaking truth about the underlying mindset that comes with such a management mantle. It seeks to direct. It does not desire to support.

With clarity must come charity.

And that leads us to “T”. A capitalized and bold T. For trust.

The word trust comes from the Old Norse word treysta  – to make strong, safe. Treysta has its own roots in earlier words and linguistic traditions that referred to help, protection, support, comfort, and consolation. The very word “trust” is not about me. It is about you. To trust me means that you feel that I will help, protect and support you. To trust a leader means that the leader will help you and me keep each other safe. Together. As one, we will be strong. As one, we will make our mission real.

I was startled to learn this bit of etymologic history, perhaps because I always saw trust as a characteristic of the “I” rather than the “other”. Which was entirely wrong. People “trust” a good leader not because that leader is authentic and clear but because that leader is authentic, clear, and charitable. The outcome of the organization’s efforts depends on its people and the trusted leader is someone who actually cares about the people delivering the organization’s promise in the form of its meaningful outcomes. 

But that is not enough. Leadership is trusted when it lives the principle of “us”, yes. However, leadership lives “us” when it recognizes that it is the person in organizational authority who needs to trust everyone else – not the other way around. A good leader is trusted by being authentic, clear, and charitable. A great leader takes it one crucial step further: he or she trusts in others. We all need a leader to believe in and support us. That leader – if she or he is to deserve such the title – must embrace the vulnerability and humility that accompanies her or his trusted reliance on others.

A.C.T.!, my instincts shouted this morning as I turned at a stop sign. That inner voice makes me smile. I never know what awaits me around the next corner of each day.

There is an old saying in health care: “no margin, no mission”. The perspective was not originally meant to be harsh. Instead, it was intended to remind employees within many non-profit systems that mission cannot be pursued unless adequate finances keep the doors open. Money must be considered. A positive “margin” (i.e. revenue exceeds costs) must be achieved. If not, the organization cannot survive very long.

I’ve never much liked the expression, I must admit. Sure, there is truth behind it. But so is there truth to “no food, no life” and you don’t hear too many people saying the obvious about food in countries that aren’t experiencing a famine. It is simply understood. It’s an inherent part of the basic rules of sustainability.

And yet I’ve heard the margin mantra all too often in my career, especially in the past decade. Usually it’s mentioned by a finance person, or a new health system administrator. Typically it’s spoken to physicians, nurses, and other clinicians when a new administration is planning on making some cuts, offered soberly as if the people taking direct care of patients never themselves had to balance their own checkbook or bank statement. There are a lot of health care MBAs out there who seem to think that clinical staff don’t understand the necessity of budgets, operating margins, and cost containment. It must be something those folks are taught in business school. “Doctors don’t care about spending,” they must hear. “Careful or they’ll break the bank whenever they can.” Why else would a non-clinician sigh, hold his hands as if standing in a pulpit, and prophetically declare “No margin, no mission” in response to questions from clinicians about spending?

Please. The person making the most money in the health system is preaching about the importance of margin to staff who are about to be told that their nurse-to-patient ratios are too high? This isn’t about margin at all. It’s about how much margin. Which is a different thing entirely.

Not all hospital administrators or health organization chief finance officers are like this; I’ve met some good ones, people who don’t think about the “bottom line” as a set of spreadsheet numbers or financial goals. However, it’s scary how many actually do. The percentage of people running health care in this country that sit in offices separated from where people get care and pass judgment on waste and cost-effectiveness is frightening.

“What does he do out there?”

That was the question that a CEO once asked about me when, as chief medical officer, I used to walk through the hospital once or twice a day, often before the sun was up or well after it had set. This person didn’t ask me. No, he asked my retiring predecessor.

“What did you tell him?”

My friend shook his head. His eyes looked sad. “You should keep your options open,” he told me.

Ah, my options. Yes. Indeed, I kept them open. A few months later, after tolerating more than a few childish outbursts and lectures about the importance of budget cuts in a system that had operating margins well above the norm, I exercised the one that made the most sense: I left. Any place that wanted me to “choose which side I was on” (i.e. doctors or administration) was not a place that understood why it was there.

No margin, no mission? How about this: no mission, no meaning.

It is seductive, the margin argument, as it is – to a degree – logical, practical, and pragmatic. Margin pays bills. Margin replaces equipment. But who decides in the margin world what count as funding priorities? Who gets to say how much margin is needed to feed savings and investment portfolios rather than after-hour and weekend nurse-patient ratios? It can be shocking, even shameful, how quickly perspective can be lost on what matters when the view to meaning is distorted by the thick and opaque lens of margin.

Mission gets forgotten. Morale sinks. People suffer.

It’s no wonder that there is surging interest in something better, something that makes more sense. ‘Medicare for All’ isn’t some communist plot to destroy health care companies. It is a rational response to the lunacy of what we get when margin motivation goes unchecked. It is a reasonable request for balance in a so-called ‘health care system’ that seems uncertain why it exists in the first place.

Does ‘Medicare for All’ really have a chance in our current political climate? Is it even the right solution? I don’t know. But maybe the debate will help clear some cobwebs from our collective thinking. Why is it we have even developed a system of care delivery in the first place? Do we deliver care in order that it can be financially sustainable or do we do so because we actually want to help each other heal?

No margin, no mission? Left unchecked, that pithy maxim is a Faustian bargain, in disguise. Because, when it comes to health care, margin without mission can be meaningless.

It’s that time again, in the northern hemisphere, when trees shed their leaves, flowers release their blooms, and the winds of fall sweep us through another cycle of change. There is something about the blush of color covering the season, the quiver of yellow, orange and red across nature’s outstretched hands, that makes my skin tingle. I am drawn to surrender myself into the embrace of such inviting wonder.

We talk sometimes about autumnal color as if it is painted atop our environment forms. It is not, of course. The richness of a maple tree’s crimson brilliance or an aspen grove’s golden shaking comes from within. There is a complex chemistry at work, an interplay of light, temperature and moisture with the nutritional sugars running through arboreal veins that generates the unique palette of pigment that we experience every September and October. The magnificence of nature is not something applied by an external artist.

The beauty of the fall springs from the internal.

All living things have an aura, an energy field that surrounds each form of life. Whether plant or animal, the energy radiating from every organism is real. It can be measured – as heat or electromagnetic wave. It can be experienced – as color, vibration, or frequency. It can be visualized, through special photographic techniques. We and the world around us resonate. We exude life.

There are people who report that they can perceive the color of a person’s aura. I’ve never been able to do that; no matter how much I try to soften my gaze, color fields surrounding others, if they exist, are not visible to my naked eye. I can, however, feel when someone’s energy is open, hesitant, or hostile. That sensation doesn’t need my eyes. It is accessible through other channels.

I can also feel when my own energy changes. And, if I pay attention, I can watch how those around me react to that change. For better or for worse, my thoughts and feelings can be sometimes exposed by the flow of energy inside me that, like a tree’s sap, reaches the surface of my physical being in surprising and not always helpful ways.

Have you ever closed your eyes and turned your awareness into your center? This is accessible through various relaxation and mindfulness techniques. For me, I sometimes shut my eyes to see, with my internal vision, what sort of energy is within. The experience can be powerful. First, there may be nothing; my vision peers into an emptiness. What follows may be a series of hazy, almost imperceptible pulsations, as if the images that my retina last received from the external world are dissembling, the nerve cells still twitchy and responsive to that input. Then there is nothing, an inky yet un-inky stillness. I might call it black but it is really emptiness. The retina receives no stimulation. There is nothing to see. There is no light or form to process.

If I open my eyes, right at that moment, the outside world seems fresh. But, if I keep my eyes closed, if I bring no thought or intent, and if I let my vision relax while maintaining something I can only describe as an internal viewfinder, sometimes, from somewhere deep within the optical emptiness, color stirs.

At first, it isn’t really color; there is only a sense of a swirl, of a probing, a release. I am not reaching in, like some painter with a brush. Instead, what is within seems to be shimmering outward. I can almost feel a force within me feeling itself freed to open, to expand. There aren’t thoughts associated with this. There isn’t emotion. It is almost a non-physical energy. It isn’t a memory. It isn’t some sort of sheltered consciousness. It is uniquely itself.

And then, sometimes, if I just allow the experience to be, like a flower in the sun, it opens. Streams of essence enter. Like a non-physical well that spontaneously gushes from depths beneath my physical form, a sense of expansion swells and, with it, color. Orange, green, blue, magenta and a range of the rainbow rushes up and out, as if a celestial fireworks is fired from the most internal place that this form I call “me” can experience. I cannot and do not ask for color. I simply experience color. In the strangest and yet most wondrous of ways, I am color. Or, in an odd yet magical way, color becomes me.

I am light; I am dense. I am expanded beyond my skin; I am life contained within the semi-porous boundary of my physical form.

Is this how a tree feels when it vibrates majestically in the autumnal sun?

There is so much beauty in the world. In the seasons we are blessed to have, may we all continue to learn how to share as much of that beauty as possible.