It’s the Pain

A guest post from my amazing wife, a marriage and family therapist who happens to deal with chronic pain:

Chronic pain is a funny thing. I’ve had it for years, but not many people besides my husband know about it. In the last 6-9 months I’ve finally been working with doctors on it. That seems silly since I’ve had the pain for so long. But it’s hard to know what pain is “normal” or what pain other people do or do not have. So I guess I just went about my business trying to manage my pain on my own. My back pain started when I was sixteen, so I’ve always just assumed I’ve had a “bad back.” I’ve been to the doctor and then physical therapy when the pain has become unbearable. I’ve had three bulging discs since 2012; one cervical in 2012 after being rear-ended and two lumbar in 2018 with no inciting injury. I’ll be getting imaging this week because the doctor thinks I have another bulging cervical disc. It feels different from last time so who knows. My first rheumatologist diagnosed fibromyalgia because that also explained my ongoing intestinal issues. A second rheumatologist (after we moved) said possibly that and rheumatoid arthritis because my inflammation levels are high. My hands don’t look inflamed but my rings feel tight and they hurt when they bend. I’ve cracked my knuckles since elementary school but man does it hurt now. You’d think the pain would make the habit easier to break, so far no luck there. My feet and ankles get super angry if I’m on them too long, and my shoe collection has seriously changed from cute and dainty to as fashionable as it can be while prioritizing comfort.

None of that is particularly useful information. Chronic pain has an awkward place in our world. People know it exists but they expect it to be visible. They expect to see it or know about it. But they definitely don’t know how to actually respond to someone who has it. That’s a large part of why I don’t talk about it much. I hate the pity, which is perhaps my own pride issue. The suggestions get tiresome. Everyone knows someone who tried something that was a miracle cure. That holds true for migraines too, which I’ve also had since I was sixteen. Some people take my speaking about my pain as complaining and wanting them to fix it. Obviously I know they can’t, and I’m definitely not trying to complain. Why though? Why is not complaining so ingrained in us? Constant complaining is tiresome and doesn’t change anything, but should we not be able to voice our struggles? We tell people to be open about their depression. Reach out because people will listen. People have good hearts but also don’t know how to listen to pain and suffering without labeling it complaining. So we’re stuck not wanting to complain or get advice or be pitied. The resulting silence is far less than helpful. When I tell no one about my pain, how do I explain my absence at an event I was looking forward to? Saying “I’m not feeling well” doesn’t seem to cover “my pain is so high that I’m considering going to the ER but don’t want to clog the system when all they’re going to do is give me pain medicine I hesitate to take because of my family’s history with addiction.”

And how can I possibly complain? Given what is going on in our world? Another black man was murdered because of our refusal to deal with systemic racism. I would take on all the pain if it could make a difference for someone else. Let one of those innocent humans live. What right do I have to complain about chronic pain when black people literally live in fear? Fear that I desperately want to comfort and take away. How can I help? What more can I do? What more am I physically capable of doing? I’ve told my clients countless times that we should not compare traumas or pains. There is no cosmic ranking system. But I can’t get past the fact that what the black community in this country has to deal with is far worse than my chronic pain.

To give voice to my pain or not, it’s a trap either way. Then there’s the trap of feeling like our worth is defined by our abilities and contributions. My doctor told me to rest my shoulder by not picking up my 28+lb toddler… so now every diaper change and bath, etc fall on my husband’s plate. My husband who already does the literal heavy lifting and any task that could piss off my back, which isn’t always easy to predict. My angel of a husband reminds me regularly that my worth is not based on physical contribution. We joked many times before we adopted that he would handle the poop and vomit, and I would handle our child’s emotional well-being (the hard part as my husband called it.) Even with such a thoughtful and loving partner, I still fall into the trap. The worry of how my son perceives it. The feeling when I see people in public (well, before quarantine anyway) look on shocked that my husband is doing far more “parenting” than I am.

Then there’s the uncertainty. Why is my pain worse today? Did I do something differently? Did I just sleep wrong? How do I relieve the pain? Stretching helps most of the time, kinda. Heat, ice, CBD hot/cold topical stuff, medicines, delicately changing positions countless times with temporary minimal relief. If there is relief, what caused it? How do I make it happen again?

And yet, there is so much more to my life. Laughter and smiles and joy. It’s easier to show that to the world. I’m not afraid to show emotional pain. We shared our infertility journey on facebook and with our churches. People should never feel isolated in their suffering. <– I should listen to my own advice right? Right. I KNOW that, but doing it is harder. People don’t suspect my pain so it’s awkward when they’re shocked. “But you smile so much.” “You’d never know it to look at you.” Blah, blah, blah. It’s not their fault they’re shocked. It’s my own for not sharing. So why? Why don’t I share? HOW do I share without being bombarded with pity or suggestions or judgement for complaining? Man I wish I knew. Everyone who knows wants to help, but no one can help. I don’t like making my loved ones feel helpless either.

How do I do my job with chronic pain? Whew, I wish I could tell you. Somehow I manage to set it aside for the hour I’m with my clients and put my focus completely on them. Besides that, I space my clients carefully so I’m not setting my body up for failure. My office is seriously comfortable too. Comfortable seating is always more important than fashionable seating.

Wouldn’t the pain be less if I weren’t so overweight? Probably. I’ve been overweight since I was eighteen or nineteen. How much do you think chronic pain helps with that problem? The percentage is below zero. Chronic pain + poly-cystic ovarian syndrome + intestinal issues + migraines = a very complicated weight loss equation. Yoga is the only exercise in my adult life that made me feel strong and that my body responded to. I’ve never changed shape doing cardio, but yoga helped my body. Can I do yoga currently? No because of my shoulder/neck/upper back issue that hopefully we’ll figure out soon. (Isn’t that hope adorable?) The doctor told me I can only add one minute to my workout per week assuming I’ve been able to exercise without resulting pain for a few days. He wanted me to start at 5 minutes on the elliptical. I’m now up to 9 minutes. It’s infuriating. On the high pain days I have to push myself to move at all. On my good days, I’m desperate to exercise longer, but if I do my body will punish me tremendously. Last week I oh-so-foolishly “sprinted” for my last thirty seconds on the elliptical. The next day was excruciating, and to be clear, we are not talking sore muscles. Sore muscles make me feel accomplished, proud of every step when I feel the soreness. This is not that.

And here we are in a pandemic when so many of our coping skills have been put out of our reach. So many of our self care strategies changed abruptly. I would be foolish to assume the stress of social distancing hasn’t made my pain worse. I miss my family and friends. I miss going to restaurants and wandering the grocery store aisles looking for inspiration. We find joy where we can, and we try to cut each other some slack because pretty much everyone is struggling.

So what is the point of all this? Maybe someone will understand a little more what it’s like to live with chronic pain. My dad joked today that my husband should have married a younger woman instead of an old lady like me. We laughed (I really did find it funny and not offensive). Then I hoped elderly people don’t have this much pain. Then I feared what my pain will be like when I’m elderly. Maybe you’ll remember that just because someone seems ok when doing their job or pushing through the pain it doesn’t mean they are. Maybe you’ll remember when someone shares their pain with you to show empathy and ask how you can be supportive. Sometimes I just need to be heard. Sometimes I need a distraction and/or laughter. Sometimes I need grace when I cancel last minute or when I stop answering my calls/texts. It’s not you. It’s me. It’s the pain.

Anyway, things like this are what keep me going on the hard days…

Single Payer Health Insurance

I wrote the post below a while back and was just about ready to publish it when COVID-19 changed the world . The present crisis brings into focus an aspect of the more theoretical point – there are no players in the field of insurable healthcare who are incentivized and therefore aligned to value and invest in healthy people as a whole. Insurable healthcare is seen primarily as individual responsibility and choice OR as a human right and worthwhile public service. In this system, sick people are a problem that needs to be solved. The only difference in options, to admittedly oversimplify things, is that the right argues the burden ought to be carried by the private sector of individual decisions and market forces, while the left argues that the burden is a worthwhile one to be carried by government obligation, ensuring something like the right to life for all people. 

Plenty of individual actors and institutions within the overall system are certainly interested in and greatly value the idea of healthy people. Countless stories have emerged of the heroic efforts doctors, nurses, and others have made to stay ahead of the virus. My point is not to diminish their effectiveness and Herculean efforts but in fact to highlight the extent to which their dedication and sacrifice actually work against or are at least foreign to the outcomes toward which the system of insurable healthcare is aligned. There is no individual, entity, or institution positioned in the current system with the incentive, authority, and desire to even aim at creating a truly healthy populace. In a moment like this, it is only the collective response and health of a nation that are sufficient to overcome such a widespread crisis. But there is no incentive toward collective action within the insurable healthcare system as it currently functions. 

On the more practical side of the argument below – especially in the early days of COVID-19, there were stories of people debating whether to get tested or treated because of astronomical costs, even with insurance. To rely on hundreds, if not thousands of individual insurance companies to decide their policies, clearly communicate them to the public, all while the government may or may not impose requirements upon insurers for a financial burden they may or may not be able to handle radically slows response time and leads to much greater costs in terms of life and money. In a crisis like this, it doesn’t actually even matter whether the stories are true at all. People are used to having no idea what anything health related will cost till long after the fact. People will at least hesitate based on those kinds of stories because it is very rational, especially in the beginning of a crisis moment, to assume the odds of any individual being infected are much lower than the odds that they’ll be hit with hundreds or even thousands of dollars in hospital bills they can’t afford. 

Without a central player with clear authority to set (or zero out) costs and copays in the midst of a crisis, plenty of people will rationally move much slower toward testing or treatment for fear that their particular insurer may not play by the rules, if any are even set. The government (and essentially the US economy) as that player, is far more highly incentivized, as should be quite evident from recent stock performances, to act quickly than an insurance company that stands only to lose money by making everything free and more widely available to all its customers even if it is the right thing to do. I don’t say that to imply callousness on behalf of insurance companies who are aware of the bottom line even in the midst of a crisis – I say that to highlight the extent to which alignment and incentives define outcomes much more than any individual or even heroic decision made along the way. Especially when every day counts, we need a system that has zero ambiguity as to the financial implications of going to the doctor. 

As long as sick people are a problem rather than healthy people being the point, we will never be able to align the power of free market forces in such a way that would prioritize fast response or long term progress toward public health. Single payer insurance at least puts the right pressure on the right player with the right incentives and powers such that the whole system can actually work toward health.

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Health care in the United States and the corresponding health insurance system are filled with contradictions, problems, and imperfect outcomes despite being one of the most expensive and cutting edge producers of medications and doctors galore. There are far more nuances and problems than I could possibly address here, but I want to offer two reasons that a single payer health insurance plan might cut through some of the stickiest problems of our current system.

More often than not, I see the single payer debate couched in terms like private industry vs socialism or health as individual responsibility vs health as a basic human right. I have no intention of wading into those waters at all. I find the talking points all around to be quite unhelpful or, more to the point, meaningless and undefined. Instead I offer one practical and one theoretical reason why I believe single payer health insurance is at least worth serious consideration.

To express the practical side of the argument I first want to share 5 things I’ve experienced in the process of dealing with health care providers and insurance. 

1. At least four or five times, I’ve received bills that look something like this: 

insurance billing craziness

The “Submitted amount” column is theoretically the cost of the lab work that was done. “plan savings” represents the discount offered merely because of the deal our insurance company has worked out on our behalf. Two charges show discounts of $132.37 from $142.85. If you can discount your services by more than 90% before anyone pays anything, you are clearly just making up numbers out of thin air. 

2. A second issue with the same bill should also be readily apparent. This bill is for 5 tests all ordered at the same time by the same doctor and performed in the same lab on the same visit. Yet two are covered without question and three are not. Those three tests received a code of KU. I fought for a year to figure out what that meant and get it corrected and still have no idea exactly what it means or why it happened. I called both the lab and my insurance no less than 5 times, one time even getting both reps on a conference call together so they could get their act together and make whatever coding changes were needed. I again received a bill asking me to pay the balance with no explanation for what is wrong or what can be done to fix it. My insurance said it wouldn’t pay, the lab said I owed the balance, and I didn’t get any discount on those tests. After the year of fighting, the lab just closed the bill and I didn’t owe anything anymore, no explanation or change ever came.  

3. A third issue highlighted by the same bill is the absolute unpredictability of the cost of receiving medical help. After over a year of wrestling over this lab work I still have no idea what I was actually supposed to owe. The idea of knowing cost ahead of time and thereby being able to make informed decisions about where to go or what I can afford is far beyond impossible. On a separate occasion, a medical provider contacted my insurance company to verify coverage and how much my out of pocket cost would be for a particular medical necessity. It was around $200. The provider charged me based on the quote, provided the service, and then officially submitted the claim with my insurance. Over a month after I’d already received the services, I got the final bill. I owed an additional $900 or so. The provider said the initial bill was only an estimate and no guarantee. Insurance said they don’t quote figures ahead of time. Even when health costs are supposedly confirmed beforehand, they can be completely arbitrary numbers with zero relationship to reality. 

4. A final problem with this specific bill is the three categories to the right that indicate how much I owe – deductible, copay, and coinsurance. These are 3 different types of payments my insurance company expects me to make. I have no problem with the theory that these types of breakdowns would exist. The problem is that it is never entirely clear which categories will be affected for which types of services and visits. These categories unnecessarily obfuscate the amount that will be paid for any particular health service, even assuming the bottom line cost is in any way reflective of reality.

5. Separately from all that, I previously dealt with another absurd consequence of our insurance and billing weirdness. I was billed for a dozen or so of the same type of visits to the same doctor for the same health concern over the course of a few months. Every bill required a copay of $30 or so. But two of the visits also came with a $300 or so ‘hospital room use’ fee. There was no explanation as to why these fees applied to only these 2 visits, but my insurance company denied the charges because they said there were coding issues and the hospital sent me numerous bills. The doctor said they couldn’t change the code, the insurance said they couldn’t accept the code, and the hospital said I owed the money. After more than a year of asking questions, I finally spoke with a hospital higher up who is in charge of customer relations. I explained the situation yet again and he came back a while later and offered to give me a 90% reduction and we’d call it even. I’d owe something like $60 and we’d all walk away happy. I said I’d gladly pay the $600 if someone could just tell me why I was being charged for these 2 visits and no others, but I would not pay a penny until someone had answers. A couple of weeks later, he called back and the bills had been closed – again with no explanation and no change in the stance of my doctor or insurance company.

Each of these anecdotes is only possible within a system that both complicates the relationship between providers, customers, and insurers and obfuscates every cost involved to the point that no one can make a rational decision about anything in the process. To whittle insurance down to a single payer for everyone in the system does not solve every problem, but it at least makes it possible to know and understand the game that we are all playing. At most, any test or procedure or appointment would only have 2 possible costs – full price and insured price. There would not be 1000 different contracts with 1000 different companies that allow providers to make up numbers that have no relationship to reality. With only a provider, one consistent insurer, and the patient involved, it would take infinitely less effort to lay out clear and consistent expectations for who charges/pays what and who may be at fault when problems arise. 

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To express the theoretical side of the argument, I need to offer a brief word on the power of alignment. In companies, different markets and business models lend themselves to different ways of structuring employees, setting up incentives, and a variety of other core decisions necessary to run a successful business. 

A common and fairly simple way to illustrate the importance of alignment is in the difference between a company like Google and one like Apple. Google makes almost all of its profits on advertising, whereas Apple makes its profits from products (most from the iPhone). That difference incentivizes Google to ensure that everyone, everywhere is using Google’s services. More users means more eyeballs, which means more advertising dollars. Apple, on the other hand, makes money from high end computer products with high profit margins. Thus, Apple necessarily limits its addressable market and allows lower cost phones and computers to cannibalize each other. Apple also artificially limits services to its own hardware to increase customer lock in (such as iMessage).

Google’s entire business alignment lends itself to pushing products out the door and iterating quickly through software, which helps explain why they have struggled to make a dent in the hardware space in which a company must sell a mostly final product and can only do so much through software updates. Apple is better than almost any other company at pushing out great hardware, which helps explain why they have struggled to create necessarily iterative and unfinished services like maps or Siri that can match the capabilities of Google or Amazon. Everything down to the decision to have only one profit and loss statement as a company aligns every aspect of the business toward selling specific hardware.

Neither business model or market approach is better or worse as should be evident by the presence of both companies at or near the top of the stock market for quite some time now. They are, however, aligned to run based on very different goals and incentives. 

Which brings us back to healthcare. 

In our current system, insurers are aligned to extract the most money from patients while paying the least to healthcare providers. Insurers, on one hand, must keep patients from getting so much more unhealthy than the patients of their competitors that someone with the power to do something might act. Add in the fact that employers often choose insurance companies rather than direct consumers and there is usually almost no correlation between patient experience and pressure on insurance companies to change. No insurer has any reason other than a vague sense of good will to do more than triaging the worst health conditions (as opposed to offering proactive and sustainable health initiatives beyond a handful of highly cost effective preventative measures like free flu shots). On the other hand, the more likely someone is to be ill, the more likely they are to purchase insurance and vice versa. Profitability for insurance relies on having a great enough number of people involved such that overall risk and costs are predictable even though any particular individual may require nothing and another may require millions of dollars in care. Pushed to the logical extreme, if insurance made people completely healthy, the insurance market would put itself out of business. These two realities are not meant to imply that insurance companies do anything nefarious or wrong in the choices they make – they instead point out that the business model of insurance is deeply incentivized to maintain sick, but not critically ill people. Alignment is not around making healthy people but around profiting off of every individual’s rational concern that one illness could lead to bankruptcy without insurance. Insurance companies do a lot of good, but doing more than the absolute minimum is often actually against the business interests of the companies. 

Providers operate with the same lack of incentive to make people completely healthy because profitability comes through addressing specific illnesses, not sustaining health. Additionally, providers are incentivized to extract as much money from patients and insurers as possible. Providers have every reason to push costs as high as possible knowing the bulk of payment won’t come from the patient who is making acute decisions, the patient can’t know much about the level of necessity for treatment much less it’s cost when making decisions, many patients are told where to go by their insurers anyway, and the billing process is so opaque and complicated that only the most diligent and intelligent patients can even figure out what they should have truly paid. 

Patients are incentivized at least to not die and perhaps to attain some level of health while spending as little as possible. Any patient with an expensive health concern, most commonly diabetes, is often forced to choose between potentially bankrupting themselves or taking the medicine they need to remain stable. Individuals may or may not take necessary steps towards health but staying well for any individual is always a matter of luck as much as it is a matter of personal choices. Individuals also lack the robust information necessary to make the best possible choices.

To align health insurance around a single payer government model makes it possible to align incentives toward insurance as an investment in a nation’s greatest asset – the health of its people. Having more healthy people who are able to focus on anything other than their health and its financial impact on their lives frees up an enormous amount of potential for the growth of all other economic sectors. Knowing the bulk of the healthcare cost rests in the government finally gives someone with a financial stake in the outcome an incentive to understand what causes negative health outcomes and what policies can be adopted for long term financial and physical health. It also places much of the cost of un-health on the only player (the government) that has the broad reaching powers to structure policies, laws, and other incentives toward a healthier society.

With a system set up to invest in people, providers would then be able to offer specific rates for service ahead of time and know with much greater certainty what will be covered and how. The government could (as it already does to some extent) determine what aspects of covered healthcare are essential for creating healthier people and allow providers to build ancillary benefits around which to differentiate their services and costs. The provider market would finally have some semblance of direct market forces guiding its decisions, the government as insurer would be capable of incorporating healthy people as an essential principle rather than accidental outcome of profit, and patients would be able to make real and meaningful decisions about their health and wealth. 

Properly aligned incentives don’t solve nearly every problem with the healthcare system in the US. But alignment is a primary factor defining culture and decision making over time. Alignment and the interrelated incentives and cultures that flow from alignment do more to determine outcomes than anything else in a system. The structure of our current system is a muddled mess in which no one besides an individual patient has any incentive to work towards actual health. Aligning the system around a single payer would at least make it possible for that system to be directed toward healthy people rather than simply fighting illness.

Toward a constructive engagement with sin and righteousness

I find myself increasingly dissatisfied with the nature and consequences of the church’s debates around sin and righteousness in a changing world, especially within the UMC. What often happens is a dispute around where the line is drawn between sin and righteousness. Often more conservative voices draw that line closer to a strict reading of biblical practices and traditional values. More liberal voices are often eager to factor in cultural shifts and societal forces that require a more broad interpretation of scripture to find coherence between biblical principles and human flourishing. 

The process results in something like a spectrum of potential positions upon which anyone’s respective view is placed. No person is truly conservative or liberal on any and/or every topic and there may be a multitude of ways to assess the relative position of any particular view. But so often in debate, a thousand factors and choices are flattened into a spectrum pitting something like “tradition” against something like “progress” and then further flattened by the arbitrarily binary choice of ‘sin or not’ as though doing so could possibly clarify what godly action is.

What rarely happens is a conversation regarding the shape and direction of the love and community toward which our actions and ideas ought to be guiding us. Thus, we get moments like General Conference 2019. After 40 years of arguing about what the church ought to define as acceptable, we did not even attempt to offer a positive view of Christian community, action, holiness, or relationship that could potentially bring our respective views under a coherent umbrella. We only expected that our place on the spectrum of sin and righteousness were different and that we would ultimately draw our lines in different places. 

I greatly respect the desire for a biblical, traditional, Christ centered life. I have at least as much respect for those who, out of a desire to honor their present reality and avoid doing harm, choose to engage in a more generous orthopraxy. For this reason, I often find myself in agreement with the logic of one side and the conclusions of the other. I find the distinctions and lines in the sand between these sides to be false choices more often than not. 

Every option fails to relegate sin to a secondary existence after the community sin breaks. Treating sin as the more fundamental reality fails to account for the core good news that it is love and community by and for which we are created.

To constructively engage in conversations of how Christians are to live, we must first ask what love and community are and then seek to define sin as that which breaks love and community. If we can’t first define love and community, sin means nothing. If we can’t define how a potential sin breaks love and community, we should hold loosely our conviction that this particular action is worth calling sin, much less policing. That we so often hold fast to our traditional lists of sin without any positive conception of what Christian community is leads us into our most intractable, harmful, and pointless debates.

A positive constructive engagement would necessarily evaluate word and action through our expectations of relationship qualities like consent, intimacy, vulnerability, trust, empowerment, teamwork, attachment, mutuality, authenticity, commitment, public accountability, personal growth, sacrificiality, and respect.

Otherwise we’re just modern day Pharisees. 

How I Read the Bible

I hear all the time in United Methodism that our seemingly inevitable march toward schism is caused or at least significantly hastened by the fact that we don’t all read scripture in the same way. But very rarely does anyone offer a further comment on how any particular group does or ought to read it. For a long time now I have desired to articulate how I read scripture, both to clarify my own understanding and to offer something constructive to the conversation at large. What I am posting now feels deeply inadequate as a viable alternative means of reading, but I don’t know when or if I’ll ever have the time to research and say what really needs to be said. I feel compelled at this point in time to at least offer some sense of the framework out of which I seek to make sense of faith and truth and life.

For lack of a better descriptive term, I would name my primary lens of engagement as a thematic reading of scripture. Thematic engagement is neither literal nor figurative, neither obsessed with verses nor limited to vague impressions. Thematic engagement is a challenge to explore the stories that wrote us in such a way that we can most faithfully write out the next chapter in the light of God’s continued love and action in the world.

At the moment, I would offer these assumptions as the foundation upon which thematic reading is possible.

  1. A thematic reading values ‘why’ over ‘how’ over ‘what,’ consistent themes over specific verses, storied illustrations over propositional truths, contextual correctives over eternal specifics, and communal life over objective argument. 
  2. Context is the most basic unit of truth. We usually read stories to get down to the nugget of truth within. But truth is only truth in the context of the story in which it is told. The process of thematic reading does not extract a final “objective” meaning of any word or concept but assumes truth is only possible within the actual stories that give birth to meaning within the communities that remember and tell those stories. This approach is the operative framework of proverbs, in which nuggets of truth require an understanding of context in order to know which proverb applies and how. 
  3. Who illustrates a theme and how often it arises are proportional to how serious and central that theme is for understanding the point and purpose of scripture. As Christians, the themes most clearly articulated and fulfilled by Jesus take precedence, but are not intelligible apart from the whole.
  4. The entire Bible is an exploration of who counts as the family of God and what are the implications for faith and life. Thematic reading is an invitation and attempt to further explore those implications for our own life and future. The ethics of thematic reading do not attempt to take any concept or idea out of scripture but to shape our habits and choices by our identity in relation to the family of God and the implications thereof. 
  5. The Bible is to be read altogether or not at all. There are enough words and stories in scripture such that we can find a verse or two that justifies almost anything if read in isolation. Thematic reading assumes that we cannot ever divorce a single word, command, or story from the rest of scripture. When there is tension between the meaning or implication of two scriptures, we gain more from leaning into that tension than we do if the tension can be resolved. A simple example is the difference between the sermon on the mount in Matthew and the sermon on the plain in Luke. We could assume Jesus just preached two similar sermons in different places but it is more instructive to refuse streamlining into one simple story and instead learn from the nuances or differences each author chooses to incorporate.
  6. The questions asked and answered by the Bible are far more significant, central, meaningful, determinative, and crucial than the questions we bring to the text. It is tempting to think the Bible can answer any possible question we might have about life and faith, but the more we stray from the concerns of the Bible itself, the more likely we are to justify what we already believed than to be challenged and changed by God.

Reading with the above assumptions in mind, the biblical themes I find most significant and important are found below (keeping in mind that this list is extremely tentative and that any concept is intended as a way to point back to scripture rather than be meaningful apart from it). The main reasons I haven’t made this post until now are that 1) I hope one day to read through the Bible with an eye toward indexing the full list of stories and verses in which these themes find their coherence and meaning, and 2) there are plenty of other major themes that I would consider essential and are certainly worthy of much more engagement; but I have no idea when/if I’ll have time to tease out the meaning of those themes or their relation to those below. For now, this list will have to do. 

  1. Before we are anything else, we are loved, we are accepted, we are enough. Each and every one of us. Each and every part of us. Though our discussions of sin and holiness usually start with notions of right or wrong thoughts/actions and the consequences thereof, the bible begins with the assumption of the love and relationship for which God created us. Anything about sin, holiness, forgiveness, community, identity, duty, morality, etc. is only intelligible or significant as it relates to the relationship for which we are created and the prevenient grace of God at work to restore that relationship even before we have any awareness of or input in the process.
  2. Power is kenotic. Philippians 2:1-11 most clearly and concisely articulates the nature of real power in the world. Power is born through humility and self giving, not military, political, or physical strength. Ultimately, the vulnerability of God is the power to transform everything. [The near sacrifice of Isaac, John 3:14, 2nd Corinthians 12:9] 
  3. The wrong people tell the right story. While we often look to people with the right level of authority, credentials, or knowledge, biblical truth often finds expression only through the most unexpected character in the story. Thus, the widow with two copper coins is lifted above the rich. The good samaritan is lifted above the religious leaders. The women are the first to preach the resurrection, not the disciples. Scripture constantly upends our expectations about power and authority by choosing the weak over the strong, the outsider over insider, those who know nothing over those who think they run the world. [Luke 7:36-50, Rahab]
  4. Us for the sake of all. The concept of election or chosenness is essential to the Bible but deeply misunderstood. There is an insider and outsider, but those chosen are chosen for responsibility, not privilege. To become part of the inside crowd is to accept the call to share the gifts of chosenness with the rest of the world. The more we receive, the more those blessings necessarily overflow. The more set apart, more holy, we become, the more we necessarily participate in God’s work to heal the world. [Jonah, Jesus’ consistent rebuke of the insider and embrace of the outsider, Romans 2] 
  5. The goal is to learn how to love right, not to attain the right words and beliefs. We often treat faith like it’s a contest to see if we can create the best arguments or proofs to convince minds about Jesus. But nothing good happens when those words and arguments become the goal rather than being an attempt at articulating the experience of following Jesus. The embrace of community and the embodiment of God’s love always comes before rational understanding or objective truth. 
  6. To live right is to love as God loves, not to create a list of dos and don’ts. When Jesus was asked about the greatest commandment, he said love God and love neighbor; on these two commandments rest all the law and prophets. Like healing on the Sabbath, the corrective offered in Galatians, or Paul’s discussion of whether or not to eat meat sacrificed to idols, the point of moral imperatives was never about getting right the practical, specific, objective list of things to do and not do. Without referencing specific action, we cannot illustrate the shape of love; but love is who God is and actions either reproduce and/or witness to the love God is or they don’t. Every list we create is tentative and time bound at best. [Micah 6:6-8, Romans 8:1-11]
  7. Salvation is not “get me saved,” it is “participate in God’s work to love and transform the whole world.” Recentering the work of the church on community formation rather than individual guilt and forgiveness provides the foundation upon which we can begin to say why the church exists and how we ought to live in service to that broader mission.
  8. Scar born healing. Someone once said scars are not a sign of injury, scars are a sign of healing. The type of healing witnessed in scripture is one in which God does not throw away the old and broken body; God renews, heals, and transforms what is already present. In our disposable culture of shame and isolation, this may be the single most radical corrective offered by scripture. [John 20, Ezekiel 37]
  9. There is no if in the love of God. Deuteronomy is notable for its repetition of an if then formula. Roughly, if you are faithful, God will bless you. But even the story arc undermines its own formula as the people are not faithful but God remains faithful anyway. From creation on, there is always a hint of expectation that God will follow the if, then logic. But no matter how often or how deeply we are unfaithful, God remains steadfast, ultimately showing in the cross that there is no if in the love of God.
  10. God breaks out of every box. God’s people constantly think they have figured out the nature and shape of following God. But God always breaks outside of every box the people think is right. No matter how angry the insider becomes or how much God challenges preconceptions, God keeps pushing. [Jonah, Zaccheus, Peter and Cornelius, Ruth, Ethiopian Eunuch, Luke 4:25-30]
  11. Freedom from is freedom for. Freedom is not the lack of any possible thing to constrain our choice or desire. Freedom is from shame and fear and brokenness. Freedom is for overflowing the love that God first had for us. 
  12. Abundance in the face of scarcity. The world implies all the time that we are in competition for scarce resources and power. In the Bible, God is the source of an abundance of blessing and there is always more than enough. [John 6:1-14 (loaves and fish), Matthew 15:21-28, Manna in the Wilderness]

I am confident that the application of these themes to our present divide in the UMC is not self evident. To a significant extent, my argument hinges on the notion that the way we engage in the conversation about what sin is and how to respond to it is fundamentally and hopelessly flawed. That reality means I cannot offer a simple point by point acceptance or rebuttal of the more common arguments. But I feel compelled to at least offer some hint as to how the way I read the Bible informs my understanding of how to live and how to move forward. Again recognizing the insufficiency of what I am able to say coherently at this moment, I’d offer these several contributions to the conversation related to a few of the themes above. 

  • With respect to theme 1 above, conversations regarding human sexuality never meaningfully grapple with the nature of prevenient and unconditional love. The first question in evaluating action is usually something like, “is this a sin or not?” The only first question worth asking for Christians is something like, “what is the shape and nature of the love that God has for us.” And the second is like it, “how is that love reflected (or not) in our relationships?” Sin is a secondary concept that can only be defined to the extent that words or actions break the covenantal love for which we are created. Only as it relates to the potential for breaking the love that God is does it even make sense to explore the extent to which same gender loving persons are capable of living into the institution of marriage. It is often argued that to expand our definition of marriage is to dilute the meaning and significance of the marriage relationship. However, I would argue that we do great damage to the institution of marriage through our unwillingness to wrestle with the extent to which the institution is now defined more by specific practices and traditions than by an attempt to witness and embody the kind of love God is. We should always define our practices primarily by the extent to which they attempt to live into the bigger love of God and only secondarily and if necessary by the extent to which those practices fit neatly into a traditional taxonomy of sin and righteousness. To guide our future actions more by historical practices than by God’s prevenient love is necessarily to dilute and distract from our attempts at more faithful living; to do so reproduces the error corrected in Mark 2:23-28 regarding work on the sabbath.
  • With respect to theme 2 above, every authoritative moral pronouncement from the church presumes and reinforces a distinct hierarchical posture – the church is atop that hierarchy and below are those who break from that authority or wish to challenge the church’s moral teaching from within. Kenosis implies that those with greater power and authority must act in such a way that the less powerful or more marginalized people are empowered in some concrete way. That is not to say sin cannot be called out but, building on #1, the result of calling out sin ought to be a demonstrably more “as we are meant to live” life. The logic of saying don’t steal, for instance, seeks to at least root out envy and to create the ability for people to trust one another more fully. Thus, saying don’t steal concretely and demonstrably creates certain conditions for a better life. If those conditions are counterbalanced by the need to steal so as to meet basic needs, a different calculus is required by those in positions of power to understand the effects of our prohibitions and punishments, as well as the culture we have created in which stealing could make sense as an option in the first place. To determine how we ought to understand and respond requires us to assess whether our assertions of authority are empowering healthier lives and relationships. To faithfully articulate a stance on same sex marriage requires us to consider the effects of prohibition upon same gender loving persons. Assuming exertions of power ought to make lives and relationships better is not some sort of incidental or relativistic consideration – that assumption seems to be one of the most consistent means of understanding how and why expectations for how to live change throughout scripture. To be sure, sometimes requiring what is right does not result in obvious and direct benefits. But if we cannot see clear evidence that lives and relationships are made better by an exercise of power and authority, we must be extremely cautious and wary about whether we have drawn the right line in the right place in the sand.
  • With respect to themes 5 and 6 above, the point of Christian faith is not to get the right wording of beliefs onto a page or to make the right list of actions and prohibitions – the point of word and action is to experience and embody the love and grace of God. When seeking to understand the nature and acceptability of certain forms of relationship, we must therefore consider vital characteristics of that relationship like consent, intimacy, vulnerability, trust, empowerment, teamwork, attachment, mutuality, authenticity, commitment, public accountability, personal growth, sacrificiality, and respect. If gender is the only criteria we are capable of evaluating with regard to the validity of a potential marriage, then we have already gone hopelessly wrong, both in terms of what marriages we prohibit and in terms of the marriages we already foster and condone. 
  • With respect to themes 9 and 10, it baffles me how often more conservative voices imply that the church’s continued adherence to its current understanding of marriage is an issue upon which the possibility of a faithful and effective church rises and falls. It sounds to me like we are concerned that if we get our understanding of marriage wrong, we will hopelessly break the church and hopelessly/uniquely undercut its ministry. But there is no ‘if’ in the love of God. One of the most common themes in scripture is the breaking of every box that God’s people thought contained a faithful, holy, Godly life. Even if we get it wrong by changing the definition of marriage, God will still be faithful and will still overcome all our failures – just like God has always done from the beginning. We must operate from an assumption that we will get most things at least partly wrong most of the time. To start with that assumption requires that we be extremely cautious about what we are willing to consider essential and why we would do so.

Scripture and Change

“People don’t fear change. People fear the loss that inevitably comes with change.” I don’t know who originally said these words, but Dr. Jaco Hamman offered the quote in a conversation with me and a group of fellow pastors.

I can think of no more succinct way to describe the animating energy of the final few hours of our 2019 Annual Conference than this quote. One particular speech stuck with me. A resolution was submitted to remove the restrictive language in the book of discipline regarding homosexuality. Speaking against that resolution, a delegate said, “I have to take the Bible as it is written. I have based my whole faith upon it. I have come to Christ through it and follow it. And the Bible is very clear when it spells out marriage as a covenant relationship to show how Christ loves His bride, the church. And it’s very clear that God created men and women to be in this exclusive relationship. It is what guides everything and if I go against this, how do I define where in scripture I have to [live], how I have to be with my husband, how he has to be with me. I just want to make it very clear that I have to follow what the Bible says…” 

I have heard time and again the same kind of argument spoken from those who wish to maintain the language in the discipline. Last year I heard against a similar resolution, “This resolution would create a separation from almost 2000 years in the universal view held by the ecumenical and the global church on the issue of marriage.” The WCA phrases it as follows in their moral principles regarding marriage – “In keeping with Christian teaching through the ages and throughout the Church universal, we believe that marriage is the uniting of one man and one woman in a single, exclusive union.”

In each argument and in many others, the common assumption is deeply present that the primary way to be faithful to the Bible and to follow church tradition is, necessarily, to continue to do things the way the bible says to do them and, therefore, the way we’ve always done them. What stuck with me about the annual conference speech and what I appreciate was the vulnerability with which the plea was made. There was no pretense of absolute scholarly certainty or a facade that faithfulness is easy, safe, or simple. The speech was a powerful reminder that the more significant and foundational faith becomes in our lives, the more we risk losing if some part of that faith is challenged or changed. If one thing about the way we have read, interpreted, or implemented the Bible is challenged, there is no way to know ahead of time how much else may come into question in the process of developing a new understanding or course of action.

I deeply empathize with the fear of loss that leads to the kind of statements made in this speech and in the variety of other speeches and arguments I have heard over the years. There is a famous family story about me that recounts the time I spent about 2 months doing nothing but crying because I was forced to move away from the place and people that I loved. The loss that comes with change is no small thing and may just be one of the most significant challenges that we all face in the course of a lifetime. 

I do not in any way wish to downplay or belittle the real and profound loss that would accompany a decision to remove incompatibility language. Any change to something as significant as how to live a faithful life is bound to feel like the ground is shifting beneath our feet. Any attempt to pretend like change does not necessarily lead to the loss of something significant denies the reality of human life and ignores the experience of countless men and women throughout the pages of scripture and church history. At the heart of our faith is a God who did not pretend like life will be easy or pain free, but offered to be by our side no matter what tomorrow brings; a God who is faithful until all will be set right even though we don’t yet experience the fullness of the victory that is already sure. Change includes loss. Loss is painful. People fear the loss that would inevitably come through a change in our biblical, historical views on marriage. Those fears are not unfounded.

However, my problem with even incorporating this reality into determining how we are to view marriage today is that I cannot read the Bible without seeing that the single most consistent strand throughout scripture is change. Page after page we are confronted with a God who overturns our understanding of the way things have always been and reshapes our expectations of the way they ought to be going forward. No theme is more consistent than God’s constant desire to break out of the boxes that we assume contain a faithful life. God is with us, absolutely. God is faithful and constant to the very end. But the flipside of that coin is that ‘God revealing a different or more full expression of who God is and how to most faithfully follow God’ is often one of the primary forces leading to the painful changes with which biblical men and women had to learn how to cope. I just don’t know how to read the bible and come away with the expectation that the way things have been done for the last 2000+ years is the way we should always expect them to be done.

It starts with the very shape and purpose of covenant relationship. Adam and Eve were given a single command. Abraham was simply called to get up and go wherever God led. He was then challenged with the covenant of circumcision. Moses brought the extensive and detailed law that gave shape to life. Joshua followed the command to purify the promised land of people. God relented to give the people a series of kings when they insisted one was needed. The temple became the locus of God’s presence and the center of life and worship in Jerusalem after years of bringing the tabernacle along for the journey. An intricate system of sacrifices was put in place to ensure obedience to God. In exile, the focus of worship and sacrifice became less centered on location and more on ritual and memory. In Jesus, we are offered relationship no matter the time or place, the sacrificial system is completely gone, and he claims to be the fulfillment of the law.

In between all these massive changes in the shape and implications of covenant, God overturned expectations left and right. First, that birth order was destiny. Women like Rebekah used deceit to help along the process of passing down the blessing to the “wrong” child. Membership in God’s people shifted from descendents only, to adding a few outsiders like Rahab along the way, to grafting in gentiles through Christ. Women like Deborah, Ruth, and Esther led in ways that only men were allowed to lead. Jonah was swallowed by a fish for thinking God should only be for the Jews. Judah became the center of political power even though it was the smallest tribe. David was a small kid chosen to be King in a time when physical stature was highly prized. Women preached the first resurrection sermon after finding the empty tomb. 

Outsiders were offensively lifted up as examples or recipients of God’s faithfulness. Jesus brings up the widow at Zarephath and Naaman to explicitly challenge the boundaries of God’s people. He ate with Zaccheus, let the children come to him, spoke with a Samaritan woman, made a Samaritan the hero of a parable, healed on the Sabbath, directly challenged countless religious authorities, conversed with prostitutes, gleaned on the Sabbath, and challenged the way things had always been enough to make multiple mobs angry enough to kill him. Peter’s understanding of dietary law was upended in his encounter with Cornelius. The Ethiopian eunuch would have been unwelcome in the temple but Philip saw that he could not withhold the water of baptism.

The founding of the church itself was a radical shift in the lives of God’s followers. The church was born at Pentecost when the focus shifted from Jerusalem to the ends of the Earth. At Pentecost, the people were amazed that they could speak in native tongues they did not know. Paul makes very clear that circumcision is no longer essential for church life in Galatians. In Corinthians, he explicitly says that God chose the foolish things of this world to shame the wise. Paul himself underwent a radical transformation upon conversion to following Christ.

The Bible contains deep rejections of many habits and patterns of action we take for granted today. Luke’s gospel contains a radical emphasis on eschewing material wealth. Acts speaks of the absolute importance of close, covenant community and sharing resources with stories like that of Ananias and Sapphira. Jesus says the first shall be last, the meek shall inherit the Earth, and blessed are the poor. Philippians states clearly that it is the humility of Christ that expresses his power.

Jesus in Matthew includes a series of very direct challenges to prior interpretations of the rules by saying, “you’ve heard it said, but I say unto you.” He stopped a stoning by saying the one without sin should cast the first stone. He rewrote the meaning of Passover to refer to himself and, in John, named himself as the lamb for the sacrifice. 

On top of these actual changes, transitions, and challenges, there are a variety of unresolved tensions within the Bible for how to live and think. Proverbs offers a very transactional and clear method to a faithful life whereas Ecclesiastes repeats the phrase, “all is vanity” to imply that nothing we do matters in the end. Kings tells the story of the monarchy as a cautionary tale in how corruption destroyed the kingdom whereas Chronicles offers a much more positive and hopeful reading of history. Paul is convinced that grace through faith is the essential ingredient for salvation whereas James says faith without works is dead. A great deal of scripture seems to long for the end of war even as parts of it speak to God being on the front line of the battle. Paul and Barnabas had to part ways because of their unresolved arguments about the faith. Revelation leaves an inherent tension between images of Jesus as both lion and lamb.

Sometimes when a complete change does not occur, there are simply counter narratives offered to the official party line. Amos pushed God’s people to see it was not the sacrificial system God longed for but mercy, justice, and kindness. A mob in Acts sees more clearly than the disciples how revolutionary Jesus is by claiming his followers “have been turning the world upside down.” Palm Sunday already anticipates that Jesus will not be a military conqueror even though that is what his followers expected. There are four distinct gospels laying out the details of Jesus’s life that each have their own slightly different order, assumptions, details, and intent.

This list is nowhere near complete and a variety of complex changes covering a multitude of biblical books and themes have been condensed into single phrases for the sake of brevity. This list also represents a variety of different types of challenges to the status quo that variously affect personal, relational, or societal habits, choices, or expectations. My point is not that each change is the same or even directly comparable to a change in our language regarding sexuality – quite the opposite in fact. 

My point is that changes in how we live and relate to God are, at every level, more like the air we breathe than a rare occurrence in the Bible. Every single box that seemed to contain God or a Godly life is shattered at some point in scripture. This reality does not mean that anything goes. This theme does not imply that any particular action must be accepted or that it is capable of expressing a faithful life. But it absolutely baffles me that anyone can read the Bible and conclude that the way things have always been is the way they must always be. I cannot imagine why anyone would assume the God who is at work throughout the Bible could not do a new thing some 2000 years after the church was born. If anything, reading the Bible should make us shocked that God has not more radically turned our world upside down in every practical application of what it means to be faithful. 

I don’t believe it does any good to deny the real sense of loss that comes with a change in how we understand faithful living. But the most biblical thing I can think to do is stop presuming that 2000 years of church history means that we no longer have to question how we are called to most faithfully live. Rather than simply asking what the Bible says and assuming the same rules apply in the same way, here are the kind of questions I would rather us ask regarding sexuality – What is the shape of God’s love that we discern through the Bible? How does sexuality in general relate to and derive from that kind of love? What specific forms or practices of sexuality are capable of embodying that kind of love? To what extent do our current practices of marriage and understandings of sexuality fall short of that image of God’s love? To begin with these sorts of questions is to create the space in which we might begin to discern how and where our definitions of faithfulness may need to be challenged or changed in light of the God who, throughout scripture and history, has constantly forced us to adapt and grow.

Apologetics

Christian apologetics (roughly the scientific, philosophical, and objective search to describe and prove Christianity) was very appealing to me in college. I no longer find the discipline to be particularly helpful or meaningful. My concern is not with the arguments that are offered, but with a particular assumption necessary to make apologetics meaningful. 

Apologetics searches for facts and arguments that prove the truth of the Christian story. This effort works exactly opposite of the way the mind, rationality, and knowledge production work. Humans are fundamentally story telling creatures. We go to incredible lengths to fit facts and evidence into the story of reality by which we coherently view the world. Only when facts and evidence dramatically differ from the story we tell are we forced to learn to tell a better story, and even then it may take a generational change to fully embrace a new paradigm.

This concern is so problematic for my understanding of Christian apologetics because the Christian story is necessarily one of the primary stories into which Christians place our experiences and arguments. To “prove” the truth of Christianity through the tools of apologetics is to presume there is some other more fundamental story of reality or rationality into which we can fit the Christian story. To do so is necessarily to treat scientific, philosophical, and other forms of knowledge as more essential, objective, or true than the knowledge the Christian story is capable of asserting. Thus, in the attempt to find a more objective grounding of faith, apologetics cannot help but subvert the fundamentality of the faith it seeks to prove. 

I still find plenty of what apologetics has to say to be fascinating and potentially important. I simply think the Christian faith is the context in which apologetics becomes compelling, not the other way around.

A Prayer

A Prayer by Kings Kaleidoscope is perhaps the most perfect musical encapsulation of the gospel message for our day and time.

In content, the song both lyrically and musically moves from a place of fear and doubt to the assurance of God’s response. God’s response does not reinforce the logic of the beginning questions and instead offers a new foundation of faith. God is not primarily worried about personal action and accountability, but instead goes to incredible lengths to say #metoo as the means by which God makes all things new.

In effect, the song is a critique of the way that evangelicalism tends to focus on a list of dos and don’ts rather than on the goodness of God. The lead singer wrote the lyrics as an authentic expression of the anxiety that his evangelical faith fostered inside of him. That anxiety is powerfully captured and then beautifully challenged over the course of the song. Jesus’s lyrical response is a rejection of the very works focused theology in which the singer was raised.

In response, the song was received by the Christian music world about as warmly as Jesus was received by the religious leaders of his day. Rather than receive any attention for the beauty and depth of the music and message, the only thing most folks cared about was that the song twice includes a single cuss word in the midst of a desperate prayer to God. The band was kicked off of tour stops and radically rejected for merely having recorded a song that includes a cuss word. As so often happens in churches, we look for the easiest identifiable thing to call sin and absolutely reject anything that seems to cross that line. We thereby only have time for superficial talk of symptomatic problems and never get to the point of addressing actual brokenness. In our haste to define sin, we rarely pause long enough to explore the freedom and power of the life that really is life.

In reality, the honesty and vulnerability of the lyrics represent one of the most authentically Christian prayers that can be prayed. At the heart of the gospel is the vulnerability of our God. If we are to love as God taught us to love, we are required to bear all that we have and all that we are to God, from the most pristine and righteous thoughts to the most raw and heartfelt pleas. To muzzle the cry of our hearts is to put up a wall of arrogance that hides behind feigned self sufficiency; it is to reject the point and purpose of the cross.