An Open Letter to Healthcare’s C-Suite

I didn’t think I was going write anything more about my cancer experience – at least in the near term. I’m just kind of done with it. I finished my chemo and now I have to conjure up whatever “mind over matter ninja magic” I can to keep it at bay for the foreseeable future. My next blood test is in a couple of weeks and we’ll see how things are, but I don’t anticipate anything negative. Even with a positive result – that’s no prediction of the longer-term though. I didn’t think I’d have to go back through this two years ago after the last set of infusions in 2015. But I did. So now I’m realistic. I’ll do everything in my power and that’ll have to be enough.

This year has been anything but fun. Cancer is just one part of it. Living in a world with Donald Trump, Mitch McConnell and Paul Ryan having anything to do with my well-being has me in constant state chemo-aided anger. My resistance to nonsense is at an all time low. For all my talk of self-efficacy, mine also often wains. Enough of this though. I’m still an optimist and I have to look at 2017 as just another one of those pothole ridden stretches of road to my Perfect World. It’ll get smoother.

What I do want to do is take one last stab (at least for the foreseeable future) at turning this experience into a positive for other people who may be going through something similar as I am. And selfishly so … maybe it’ll help me too.

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This is my Open Letter to all those who are tasked, or have made it their profession to be part of our worlds during these precarious times of health we face.

I’ve come to realize that few people outside the “I have or have had cancer” club really have any idea of what the experience is actually like. I assumed the doctors, nurses and administrators in the exalted cancer centers of our community-dominating clinics would. I assumed once you walked past the donor walls you were given membership to some secret society where every one was in the know, empathetic and waiting to literally and figuratively take you by the hand as you waded into the deep end of this murky physical and emotional pool. Such is not the case. Having a life-threatening, debilitating disease or not … we’re all thrust into to the same malaise of issues plaguing healthcare in America. Just because hundreds of thousand of dollars and thousands of lost hours of patient productivity are siphoned through the system – we’re all relegated to the same level treatment and customer service. It’s the same experience for everyone. Obviously I’m naive to think it would have been different.

As response to my personal frustration, I have vented over the couple of years through my blog. I’m not going to rehash the content I wrote now. The links are below if you want to yourself. And it wasn’t that things went so bad, even though the chemo treatment didn’t hold the first time and within two years I was back in again for another six month regiment. And it wasn’t any one person. For the most part, the people involved in the treatment regime did what they were tasked with. They did their job. But maybe that’s the problem. My idea of what their job should be and what it is as defined by their employer, my healthcare provider, are two completely different things.

Maybe my problem is that I’m idealistic and see things how they can be not just how they are adhering to the crippling paralysis of the status quo of diminished expectations. Maybe I’m just not tolerant of  organizations who don’t make it their mission to first set the bar as high as they can for the customer. Maybe I just don’t get what health means in the context of a healthcare provider.

We live in world infected with silos. And I don’t mean silos that hold corn and wheat. The obsession with specialization and being an expert has been thrust upon us for decades now. And it shows no signs of letting up. And nowhere is this more epidemic than in the medical field. Did you notice I didn’t say health field. When specialization enters the discussion, the two are not necessarily synonymous. For example:

Many young American surgeons have a strong desire to do humanitarian work overseas. But their good intentions usually don’t match up with the skills, such as performing cesarean section deliveries and fixing broken bones, that they’ll need in poor countries. But only 0.1 percent of general surgery residents in the study had been trained to do a C-section. Yet it’s the most commonly performed surgical procedure in MSF projects.

The skills necessary for work in the developing world used to be universally taught in American surgical rotations. But training has changed to reflect increasing specialization. (NPR)

I assumed when I descended down the rabbit hole of a cancer diagnosis I would be enlisted in a collaborative effort to battle this condition. I assumed we’d have discussions about the role I would be expected to play over the next few months during treatment and afterward. I assumed we’d talk about how I could support the efforts of my doctors for my benefit. I assumed we’d have discussions on diet, exercise and mental issues as well as the physical ones. I assumed we’d talk about my life in the real world and the effect the cancer would have on those around me – those expected to provide help as well as those I’m currently providing help to.

I assumed there would be a “we.”

There is no “we.” There was no talk of my life outside the walls of the hallowed halls of the cancer center. Obviously my treatment ends at the bottom on the computer screen containing the results of my latest blood panel. Every doctor visit or infusion session began the same way: “Any pain?” My answer was pretty much the same every time: “No, but I have chemo brain, I’m tired and I have thermometer as my constant dance partner.” But since my answer didn’t reference to the pain question and wasn’t in the affirmative: it was brushed aside. It didn’t fit into the boxes on the EHR software that operates as the equivalent of a malignant shadow government in most healthcare providers. The interface design of Epic and its competitors covertly dictate our relationships with our doctors, PAs and nurses.

Well, I hope my journey of “Any pain?” questions has come to an end, at least for now. So anything that may come from any of this post will be for the benefit for those that follow me. And I’m good with that. That being said, this is my letter to those in charge of our healthcare system in this country – the ones that run the clinics with the walls filled with donor boards.

First, quit reflexively calling yourself healthcare providers. This is a title that is earned. Most of you are human body repair shops. Nothing more, nothing less. If something breaks, hopefully you’ll fix it after the fact. At least when it comes to our cars they instill the importance of changing oil and taking other preventive measures. In the six years of attending doctors appointments for either myself or my two elderly parents, not once has the questions of diet, exercise or cognitive stimulation been brought up. What’s the hell is up with that!

It’s bad enough these foundational health and well-being issues aren’t being stressed with my parents, but you’d think they would be with me being a cancer patient and facing the ravishing effects that not only the disease but also the chemotherapy has on me. Shouldn’t there be a concerted effort to attack this with all resources available – especially ones that I may be able to bring to the game. I consider myself pretty tuned into my body and mind and work hard on my self-efficacy. I firmly believe what I do will make a difference in my outcome in battling cancer. I’m not going to sit idly by and think the only component to my success is administered through an IV on the fourth floor of the Billings Clinic infusion center. But what about the other cancer patients who have only blind faith in the bag of chemicals? Will they do anything for themselves to help out their own prognosis? This disease that we’re living with is not yours – it’s ours. We have to be involved in our own future. Our parents and grandparents may have been content with turning over the prognosis of their future to you – but we’re not. This is a collaborative effort and if you as both physicians and the institutions you run aren’t prepared to accept that, relinquish some of the control … get the hell out of the business and make way for some that will. 

And another thing, don’t treat us like victims. We have lives to live that transcend our disease so don’t lump together as just survivors. Survivors are those stakeholders who have lost a loved one. We don’t have any time to relish in the fact that we are still alive. We’re too busy trying to live. And believe it or not, our lives take place outside the walls of where your paycheck comes from. 

If you want to truly deserve the name, “healthcare provider,” come to grips that health means more than what you do for us in your clinic. Get past the body repair shop mentality. If you really want to raise the bar; take a walk around your community, and not just the gated one you live in. Take a walk around the streets where those people who have entrusted their lives with you live. Do you like what you see? Do you see enough parks and places to walk? Do you see playgrounds filled with kids afterschool? Do you see a farmers market down the street from where you park your BMW; or a farmers market where a cancer patient like myself can use a prescription for fresh produce? Do you see opportunities for children and the elderly to serendipitously interact with each other … exchanging stories and dreams; of the past, present and future?

My definition of health is being able to pursue the life I want to live and having an environment that is conducive to it. If my healthcare provider wants to consider itself one in more than just name on a letterhead, it has to lead the charge in the community to make this definition a reality. Not everyone is in perfect shape, especially people who have recently gone through what I have. Help us make a pursuing a good life, or at least a decent one – one that doesn’t involve massive stakeholder preparation or driving endlessly a monumental undertaking. Physical serendipity and engagement is our friend … if not our salvation. A healthcare provider most often has more community clout on several levels than any other entity. You have the stage – use it. If you’re not going to, pack up and make way for someone who will.

I’m sure a lot of you will brag about all the wonderful things you’re doing for the community. Invariably most all have to do with building stuff though. Ribbon-cutting ceremonies generate big press, big donations, names on big buildings and more names on big donor walls. And if it’s not shovels in the ground – it’s technology. A plethora of accounts on my Twitter feed are salivating over artificial intelligence and its possible effects on the healthcare field. But it seems like healthcare is a zero sum game. The more money spent on buildings being built and technology being put in play, the less on human interaction. Investing in caring for people as people is nebulous and hard to quantify going out and especially hard obliquitously coming back around.

Salutogenesis, Engagement and Self-Efficacy

Salutogenesis is a term coined by Aaron Antonovsky, a former professor of medical sociology in the United States. The term describes an approach focusing on factors that support human health and well-being, rather than on factors that cause disease (pathogenesis). More specifically, the “salutogenic model” is concerned with the relationship between health, stress, and coping. Antonovsky’s theories reject the “traditional medical-model dichotomy separating health and illness”. He described the relationship as a continuous variable, what he called the “health-ease versus dis-ease continuum.”

In 2008 Scotland, specifically Chief Medical Officer Sir Harry Burns, adopted salutogenesis as national public health policy. Burns helped Scotland conceptualize health improvement differently, being aware that the small gains that resulted from a range of interventions can add up to produce significant overall improvements. Much of these interventions were and are aimed at empowering the populace through engagement with their own health outcomes.

Engagement creates agency and self-efficacy. Self-efficacy is defined as the extent or strength one believes in their own ability to complete tasks and reach goals. The more a person believes their actions will help their situation, the more likely they are to try. The more a person does, the more they’re likely to do. And the more they do, the more they feel what they’re doing is helping … creating a cascade of positive results and well-being. And at the center of this is engagement, whether it be personally, socially or civically.

Isolation And Our Nation’s Declining Health

A report came out last week that generated a tsunami of follow-up articles. Julianne Holt-Lunstad from Brigham Young University presented the results of two large meta-analyses on the connection between loneliness and premature mortality at the 125th Annual Convention of the American Psychological Association. 

“There is robust evidence that social isolation and loneliness significantly increase risk for premature mortality, and the magnitude of the risk exceeds that of many leading health indicators,” Extracting data on things like social relationships, health status, pre-existing conditions and causes of mortality, the team was able to quantify a difference between socially isolated people and those with stronger relationships. Those with strong social relationships were 50 percent more likely to survive longer than those who were isolated. 

“The magnitude of this effect is comparable with quitting smoking and it exceeds many well-known risk factors for mortality (e.g., obesity, physical inactivity),” they write in the study.”

Being alone, often due to declining marriage rates and fewer children, is literally killing us. We don’t engage with each anymore. Not only have our communities not compensated for these changing demographics – suburban sprawl and the invasion of box stores has added to the problem. The neighborhoods America has always relied on for social support have become the exception not the norm. Rather than walk down to the local park and feed the squirrels or play chess under the oak by the playground – our isolated senior citizens watch Fox News hours on end. And not just our senior citizens, it’s anyone facing months or years of chemotherapy or similar treatment. Have we been relegated to lives of polarizing cable news ideologies or driving to Walmart?

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Well-being, Hope, Role of the Healthcare Provider

“I believe that the community – in the fullest sense: a place and all its creatures – is the smallest unit of health and that to speak of the health of an isolated individual is a  contradiction in terms.” Wendell Berry

What if we designed our communities around the idea of maximizing engagement. The more engaged our residents are … the more empowered they are and feel they are more in control of their health and their futures. Imagine if a chance to engage, whether it was physical, mental or social was just around the corner. And what if opportunities to help others realize the same were part of the fabric our daily lives. And imagine if our storied healthcare providers felt their mission and their duty to be at the forefront of this effort.

What if engagement and well-being was how a community measured itself, not obtuse economic activity often distorted through the one-dimensional filter of irrelevant statistics. What if we fixated on what we “could,” rather than what we “can’t.” And what if getting up in the morning was a chance to nurture our hope … and engage with other to help them do the same. And again what if at the center of this new enlightened measurement were those allegedly in the business of keeping us healthy. Then maybe they would truly deserve the words on their letterhead.

Life doesn’t have to suck just because you have cancer, have any other hardcore disease – or are just getting old. But it sure can be if the so-called leaders or our communities, especially the ones perched in the ivory towers of storied healthcare providers, don’t step up and help us out.

We need you to lobby for our communities to be places that prioritize people and engagement – not cars and box stores. We need you take some of the money you don’t pay in taxes and invest it in community gardens, farmers markets and street fairs that showcase local art that encourage creative engagement. We need you to lead the way on healthy eating by including cooking and nutrition as an integral part of our treatment. And while you’re at it – include our stakeholders. We need you to be advocates for engagement and “getting out of the house.” Communities that encourage something as simple as allowing dogs in parks will boost their residents’ collective health and well-being.

We need you to reach out to us with transportation, especially when we live more than an hour away. I’d like to see how many CEOs go through a twelve-hour chemo infusion session only to drive themselves an hour home to two elderly parents they have to help caregive. Probably not many. The life of a cancer patient is seldom one of a giving extended family waiting at the beck and call. Often it’s flipped. Cancer affects anyone and everyone … regardless of the burden of their obligations and responsibilities.

We need you to be vocal when you see politicians and government not doing what they should to improve the human condition of our communities. You should be a regular contributor in the OpEd section of the newspaper. You can’t hide behind the nonpartisan label just because you’re afraid of losing a few ideological wayward customers. Losing them is nothing compared to losing your integrity and human decency.

Most of all we need you to use your stage for us – not just for the construction workers and contractors you hire to build your buildings. I always say that there are few things worse than being rewarded with a stage, a platform to make a difference – and doing nothing with it. People’s time and attention is the one thing that is scarce and money can’t buy more of it. To squander it is criminal. People not only listen to their doctors and healthcare provider – they often don’t act for their own well-being unless given the go-ahead by them. This is a responsibility you personally shoulder, whether you like it or not. If you’re not up to the job … there are other ways to pay for that BMW. Or even more so … you can trade it in for a Taurus.

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Rebuilding Alexandria

About twenty years ago, my daughter Alex and I were living in Marin County above San Francisco. During this time I became addicted to reading. I don’t know if I was trying to make up for lost time or what; but a pile of five books (all in various stages of completion) became a permanent fixture on my dining room table. At least once week, and more often more than that, I made the trek to my local independent bookstore in Corte Madera down the road to see if there were any new current event titles I could add to my menu of cerebral digestion. Normally a book stayed a couple of weeks until I was done with it – only to make way for another to take its place. There was one book however that stuck around a lot longer. The 100: A Ranking of the Most Influential Persons in History by Michael Hart written in 1992.

Hart’s book was fascinating to me. Since I was in grade school, I’ve been a history buff – even reading the entire encyclopedia sitting on the living room floor when sub-zero temperatures and three-foot snow banks put a damper on outdoor activities (obviously it was a pre-video game era). What intrigued me about “The 100” was that Hart didn’t pass value judgement on whether the influence the person had was good or bad – just that the person had influence. Jesus and Sir Issac Newton figured prominently, but Hitler and Genghis Khan were also ranked. He also went into copious detail on why he ranked them where he did. A lot of the reasons weren’t obvious, but once brought to light – made complete sense. George Washington for example, was ranked in the top 40 not because he was the first president of the United States, but rather because he chose to voluntarily relinquish his office after only two terms, setting a precedent that would remain intact until Franklin Roosevelt 150 years later.

Being immersed in the printing industry as a headhunter, I loved the fact that Johann Gutenberg and his printing press mad the Top Ten. But the one person that took me by surprise was the one Hart ranked as Number 10 overall. That was Euclid. I didn’t know who Euclid was – even with my encyclopedias and three-foot snow banks.

Euclid and Alexandria

Now for those of you who are as uninformed as I was, Euclid is known almost solely for writing the math text, Elements.

Euclid (fl. 300 BCE) was a Greek mathematician, often referred to as the “father of geometry”. He was active in Alexandria during the reign of Ptolemy I (323–283 BCE). His Elements is one of the most influential works in the history of mathematics, serving as the main textbook for teaching mathematics (especially geometry) from the time of its publication until the late 19th or early 20th century.

But the most interesting part about Euclid was that Elements wasn’t really that much of an original text. He didn’t make any groundbreaking revelations like Newton or Copernicus. He pretty much just took the works of other scholars, many of which lived and worked in Alexandria, and synthesized into one book a comprehensive guide to geometry. In summary – Euclid was a curator; and a prolific enough of a curator that Michael Hart had him ranked Number 10 in the list of the most influential persons of history. Holding a curator in such high regard, especially at that time in history where personal contact was really the main way to spread knowledge – brings up an interesting point. Euclid was a product of his geography and those who resident in his civic proximity. Euclid embodied the very essence the of Alexandria, Egypt … the diverse cross-pollinated intellectual melting pot of the world. Rather than beset by religious and societal division, it was a bastion of inclusion and open thought. Thinkers worldwide traveled from afar to participate in the collectivism.

In January of 1989, my wife Mitra and I found out she was pregnant. I vividly remember the discussion of names. Before we knew the baby’s gender, we picked both a boy’s and girl’s name. We didn’t necessarily agree on the boy’s name (which I don’t even remember). The girl’s name was a different story. The decision on Alexandria came quick as our first pick, even though our reasons different. Mitra liked the name itself (as did I). But I really liked what it stood for. It’s hard to set the bar much higher for your child than being named after arguably the most prolific center of learning in the history of the world. If some of that rubbed off on her … all the better.

On October 11, 1989 in Burbank, California – Alexandria Noelle Forsberg was born.

Two years ago, as part of my series on community-based societal evolution, I wrote “Silos.” “Silos” outlines the need for communities to rise above their provincial jingoism in order for them to truly pursue sustainable policies. Cross-pollination; whether its gender, sexual-preference, ethnic, racial, age-based or especially geographic – must be fundamentally encoded in a community’s civic DNA. All to often however, especially where I live, the opposite is often preferred. How far back your Montana roots go back somehow makes you a better person – not more geographically myopic which is actually the case.

Community and the Value of Diversity

Everyday the environment we live in changes. These changes are a response to external stimuli. Darwin’s theory of evolution states that the flourishing and ultimately the survival of a species (or any other anthropological entity) is based on its ability to adapt to these stimuli. Diversity is an advantage if not a necessity. Lack of diversity makes itself open to disease (literally and figuratively).

My daughter Alexandria breeds exotic snakes, specifically Rainbow Boas. She goes to extreme lengths to make sure the gene pool of her breeding stock is as diverse as possible. It may be a lot easier and less expensive to acquire stock domestically – but due to inbreeding (often unintentional) by less diligent breeders, genetically based pathologies often occur. To counter this, Alex has imported snakes outside the genetic pool from Finland and Great Britain. It’s much more difficult and more expensive – but it’s her only option with the bar she’s set for herself and her projects.

Your community really isn’t a lot different from Alex’s Rainbow Boa community (aside from the preponderance of scales). Any community is the product of its residents. Social inbreeding creates weak species and weak communities; vulnerable to adversaries, internally and externally. Inbred societies rely on decision-making and responses founded in a narrow historical perspective – severely limiting its response to challenges and opportunities.

The fact is that if you want to build teams or organizations capable of innovating, you need diversity. Diversity enhances creativity. It encourages the search for novel information and perspectives, leading to better decision-making and problem solving. Diversity can lead to unfettered discoveries and breakthrough innovations. Even simply being exposed to diversity can change the way you think. This is not just wishful thinking: it is the conclusion I draw from decades of research from organizational scientists, psychologists, sociologists, economists and demographers. Scientific America

A community is the collective sum of the value of its individual inhabitants multiplied by the community’s ability to synergize these individual parts (by curating organized and random encounters). Every encounter or engagement has an opportunity to be a synergistic one. Empathetic cross-pollinated engagements are the key. The city of Alexandria during the time of Euclid was a perfect example of this. Even though there were organized discussions and forums, just walking down the street could lead to a serendipitous encounter that might result in a groundbreaking discovery.

Every member of your community is unique and adds to its fabric. Everyone has something to offer and everyone should be heard – no matter their age or social standing.  It’s up to us to find it and help them see it. The more expressively diverse a community is, the more resilient it is and more potential it has to invoke change – both inside and outside its walls. Our focus must actively be on inclusion, not retreat into personal protectionism and paranoia of those different from us. We must resist the temptation of the comfort of “sameness.” Nothing happens in our comfort zones. If we don’t venture into the land of wonder … we’ll never see, let alone realize the possibilities life avails to us.

Designing for Serendipity, Synergy and Collaboration

Cross-pollination doesn’t happen easily though. People of different fabric may inhabit the same locale, but that doesn’t mean their views and ideas will synthesize and your community will be built on Alexandria-type collaborations. You have to reach out and try to understand these people not like you. You first need to empathize with them. The most effective way to do that is through shared actions – specifically shared community-beneficial actions. For example, building a school playground with your neighbors of different ideologies can bridge chasms that would otherwise be uncrossable. It’s amazing what work for the common good can do. This is what happens in disaster relief efforts. I doesn’t matter if you’re a Republican or a Democratic, everyone bands together to help rebuild the town they all live in. We just have to not rely on disasters to bring us together. Community commonalities are everywhere. We just have work to create opportunities for everyone to share in them.

From these opportunities and resultant actions will come serendipitous relationships; relationship that can create synergies that move your community ahead in ways no one envisioned. That being said, we have to design environments; physical, social and personal so that these opportunities, actions and relationships become baked into our society. In business applications we strive for economies of scale. These efficiencies are mainly mapped on vertically axis or are niche based. Building for serendipity takes community economies of scale and expands their opportunity on the horizontal axis across defined multiple niches and focuses. This solution thinking stemming from diverse thought breaks through conventional siloed vertical constraints.

Imagine if your community had a Department of Horizontal Integration, where its primary role is to break apart the silos of the status quo power structures and connect dots from the pieces. This department wouldn’t need to be housed in the government. In fact it would be best if it wasn’t – for obvious hierarchical reasons. It could rely on your community’s true assets; its people and where they congregate, the Front Porches of the small business network.

Rather than abide by a top-down governance model run by those embedded in the status quo of mediocrity – we must create a platform of serendipity where matchmaking happens organically through interaction uncovering commonalities between the participants. Think of a synergistic mixing bowl of opportunity; obliquitous, indirect, organic relationship building.

Now imagine organizing set gatherings where this serendipity is on the menu. While there’s no guarantee your group will change the world – increasing that chance through proximity of diverse thought and motivation sure increases its chance. And what if the overarching goal of your gatherings was to improve the human condition in your community. How this is accomplished would be determined by those in the room not by a top-down bureaucracy mired in inefficiency and out-dated procedures. Everyone is here for the same reason and they are here because they WANT to be … not have to be because of an overriding need to fuel ego. 

For arguments sake let’s call your gathering, Serendipity. Serendipity could be a petri dish for how to solve civic and social problems directly rather than through government. It would be the platform for inclusion and experimental benevolence. The bar would be set so that no area of community need would be untouched. If something needed to be fixed, or something needed to be done – there would be no questions and no siloed jurisdictional squabbles … it would just happen.

In 1986, John Gage, then of Sun Microsytems, organized NetDay in California. NetDay was historic grassroots effort in the classic American barn-raising tradition. Using volunteer labor, their goal was to install all the basic wiring needed to make five classrooms and a library or a computer lab in every school Internet-ready. If the same work was financed by taxpayers, it would cost more than $1,000 per classroom. Volunteers from businesses, education, and the community acquired all of the equipment and installed and tested it at each school site. As a result 20,000 volunteers helped to wire 20 percent of California schools to the Internet. In addition, by bringing together these diverse elements, NetDay established a framework for lasting partnerships among business, government, educational institutions, and local communities provide ongoing support for the schools to this day.

What if we designed our communities around the idea of maximizing engagement from those in the streets? The more engaged our residents are … the more empowered they would be. They would feel more in control of their health and their futures. Imagine if a chance to engage, whether it was physical, mental or social was just around the corner. What if our physical security and well-being was not dependent on government assistance or the whims of a fickle market driven economy. What if our neighborhood was our safety net, a safety net that knew best in our time of need. What if the streets of our community became melting pots of diversity-driven serendipity – places where curiosity was bred. What if engagement, well-being and self-efficacy was how a community measured itself, not obtuse economic activity often distorted through the one-dimensional filter of irrelevant statistics. And what if getting up in the morning was a chance to nurture our hope … and engage with others to help them do the same.

Building Your Own Alexandria

It’s obvious the human species must evolve. The ascent of Donald Trump to the forefront of our attention has presented us with some hard facts. We all have to take look in the mirror and ask ourselves how we got here. We will have to change our thinking – or maybe just start thinking. Instead of relying on past expectations, and cultural assumptions and metrics as our guides — we have to envision what could be, not just what always has been.

But vision is only part of the journey. We have to look past how things in past have been done. No longer should government and traditional institutions be looked at as the first line defense … rather should be looked at only as a last resort. Our reaction should be to assemble our friends and neighbors at our local Front Porch, organize and do what has to be done — developing self-efficacy along the way. And we best accomplish that by inclusion and reaching out to those around us who normally we may feel uncomfortable doing so. These outliers of our social circles may be the exact people who ensure the very survival of those social circles.

We can make the change we need — but it won’t be by thinking the way we’ve always thought and doing what we’ve always done — the way it’s always been done.

If you’re interested in moving on from the status quo that will inevitably take anyone and anything down with it … please check out Community 3.0, my vision of an evolved society where self-efficacy and the well-being is priority. Or even better email me, at clayforsberg@gmail.com and we can set up time to have a conversation.

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Building Community Through “Green” Student Engagement

“Creating communities for the future created by those of the future”

That seems like common sense. Shouldn’t those who will live in the future have a say in what is looks like? Pathetically so, seldom do they. On the contrary, the future normally is designed by those near or at retirement age often mirroring what the past was like seen through their rose-colored glasses. Young people, especially those not yet of voting age, seldom get a say in the matter. Minors are looked at more as pieces of property with few rights rather as than active civic participants with voices to be heard.

Everywhere communities systematically lose their “best and brightest” as they graduate and go off to college. This is especially problematic in rural areas. Communities can only hope they will return or they can recruit other communities’ “best and brightest” to fill their pipeline. Communities attempt to attract outsiders by mortgaging their towns with subsidies and promises to attract businesses from elsewhere – only to create unsustainable “houses of cards” supported by the fleeting benevolence of these corporate carpetbaggers concerned only for their own pocketbooks. This competition amongst neighboring towns for false hope of prosperity leads to nothing but broken relationships and broken dreams where there should be cooperation and collaboration.

From early ages our young people go to school, school they’re required to attend by law. Isolated in irrelevant silos seven hours a day, often behind locked doors – they are cut off from their community and its prospects of a future there. The connection between school and community is nonexistent. After over a decade behind these locked doors, the top students graduate (hopefully) leaving to go to college – probably never to return. They leave behind a community they never knew, not really knowing what it had to offer. They leave behind potential opportunities, opportunities often right outside the locked doors they couldn’t wait to escape from.

What if this didn’t have to happen? What if the brain drain was replaced with nurture and development? What if irrelevance was replaced engagement? What if the future of your community was built on those who were raised there? And while still young and accessible (mentally and physically), what if these future leaders had a say in what their community was going to look like? What if they had a vested interest, ownership, in their community from the start? Would they still leave? Would you have to try to attract others from elsewhere? Probably not.

Lake Mills cafeteria

The Center For Green Schools

Recently I was introduced to The Center for Green Schools via Mark Swiger. Participating “green schools” reduce the environmental impact of school facilities, both buildings and grounds, while having a positive effect on student and teacher health, and increasing environmental literacy among students and graduates. Working directly with teachers, students, administrators, and their communities, green schools create programs, resources and partnerships that transform schools into healthy environmentally conscious learning environments.

Green school learning environments show students how the connection to their environment both in school and in their community, is not only important … but imperative. And hopefully they take this awareness from their years in school and turn into to a lifetime of environmental stewardship. And through the Green Apple Day of Service program The Center for Green Schools is taking this instruction to the streets through inclusive community service projects, often those organized by students. 

Using School Sustainability as a Tool for Community

Up to this point in my discussion of Community 3.0 and my concept of community empowerment, I’ve focused on the core of civic engagement being small business. These Front Porch gathering spots are the focal point of Community 3.0‘s model for direct participation societal evolution. While I still stand by this – maybe my thinking has been too limited … stuck in one of those silos I so dread. While I’ve included schools and students, they’ve normally been limited to being recipients of the Solutions I’ve presented through the model. However one youth concept I’ve modeled is “Millennials Rising”.

“Millennials Rising” is an opportunity for a community to listen to and utilize the younger generational perspective. Under the model young people, often students, are given an organized to debate, formulate and present issues relevant to not only them as an age group but also the community as a whole. Through the Anti-Congress, younger generations are given a physical forum to strategize how they can be a positive part of their community, beyond the walls of their schools. These students will have the opportunity to beautify their community and make it more sustainable. As “foot soldiers of change,” the young participants of “Millennial Rising” will be empowered to create a community that fits their needs and desires, not just those of their parents and their parents’ friends. 

Our idea of civic infrastructure needs to be broadened. Think more of it as a Cerebral Infrastructure.” By this I mean accommodation for the physical and mental spaces self-employed and small business owners (young and old) need to congregate, collaborate and create – molding the future for themselves and those around them. They want coworking sites and makerspaces. The Millennial generation wants bike paths and sidewalks and trees. They want places. They want their towns, cities and neighborhoods designed for them and their fellow residents … not for cars. They don’t want to be an afterthought, a nuisance to the automobile culture of their parents and grandparents. We need to look beyond tradition and what worked in the past to “now and ahead.” What might have worked a decade ago, may be obsolete today, let alone tomorrow. Hell, maybe their parents and grandparents would even like these new places too given the opportunity.

It’s easy to envision the benefits a project like “Millennials Rising” would have for the young people and students involved. These benefits would also extend to their peers since their futures and needs coincide.

But we can’t understate the benefits that would be had by the community as a whole.

Not only would the community be best positioned to prosper in the future, increased community retention rates in the younger generations would fill employment pipelines. This is especially important in smaller towns and rural communities where much of the work force is reaching retirement. This fact is amplified by the demographic realities of the extraordinary large Baby Boomer generation and their average age being seventy years old. Combine the thinning of the labor pool and increasing health needs of this age group – the health industry in particular is in the middle of an employment shortage crisis. Darren Walker, St. Vincent Healthcare vice president for human resources, hears from job candidates that Billings (where I live) lacks the infrastructure they expect. St. Vincent is the second largest healthcare organization in the Montana and Billings has a population of 100,000. Imagine the problems smaller communities have retaining or attracting young talent.

At present in Billings, Montana, the lead city planner is composing a twenty year long-term plan for the community. While on face value this process may seem prudent, a closer look shows it to be very problematic. To begin with, the planner is retiring later this year. What accountability does she have in it if she’s not going to be around to see its execution? Shouldn’t the one doing the creating also be the one implementing it?

During the course of the plan’s creation, she’s held public input meetings. In a recent meeting she was surprised at the public’s insistence on the inclusion of sections on education and conservation, neither of which she included originally. This is alarming, especially in regards to young generations, where these two areas hold very high priority. In addition, there’s been no indication any efforts to include these younger people in the drafting of it. These are the people who will have to live with this plan (if they chose to stay).

The Billings’ head planner, and indirectly the rest of the city’s leadership, is taking an approach that is the antithesis of what I’m proposing here. And it’s not a stretch to imagine the adverse effects it will have on the retention of young talent in the future.

While “Millennials Rising” attempts to include young people in civic decision-making and placemaking by giving them an organized voice, there is still the process of reaching out to them – extending that welcoming hand from the community. This is easier said than done. But what if they came in unison – as leaders in their own right coming from a place that was an example of progressive sustainability and forward thinking. What if they came from the green schools they attend or have attended bringing with them their knowledge of “how to do it” in an environmentally positive manner. And what if they came as active participants willing to help the community for everyone. Two excellent examples of how this can work would be a collaborative between a Green Apple Day of Service program and the worldwide clean-up effort put together by Let’s Do It! World, of which I’m coordinating for the United States.

Building Community through Student Engagement

What if we took “progressive sustainability and forward thinking” to include all aspects of a community’s well-being. What if we created a systemic approach of integrating the future needs of the community with those of the students as well as the current adults. And what if we made it a priority to identify points of engagement that would connect each individual student with an aspect of their community where they feel they can involve themselves with and make a positive contribution. These “points of engagement” would represent ownership in their community, present and future. They would then want to see it through to the end while becoming a long-term fixture in the community … a community they helped design and build from the time they were young.

Suppose you were designing a school to help students find their own clear end — as clear as that one. Say you were designing a school to elevate and intensify longings. Wouldn’t you want to provide examples of people who have intense longings? Wouldn’t you want to encourage students to be obsessive about worthy things? Wouldn’t you discuss which loves are higher than others and practices that habituate them toward those desires? Wouldn’t you be all about providing students with new opportunities to love? (“Putting Grit In Its Place” David Brooks, New York Times)

Now imagine if these “opportunities to love” where connected if not embedded in the community where the students live. The concept of triadic closures stresses the importance of a three-way bond. Relationships that extended to three connections are much stronger and more resilient. The triadic relationship between students, small businesses and the adult residents in a community provides the foundation for a community – today and tomorrow. Building off the knowledge they learned in their sustainable green schools, students can cement their bond with the real pillars of the community, locally owned business through collaborate civic projects or Solutions. These relationships will also serve in a mentoring and apprenticeship capacity, to be taken advantage in the future as employment and entrepreneurial opportunities. This triad closure will create an integrated partnership that will form the basis of a community’s well-being efforts.

“Just as important as the actual accomplishment of creating a new asset for the community is the message sent to people living there: Good things can happen in this place. One of the biggest problems for poor communities, is that “we teach young people to measure success by how far they can get away from these neighborhoods.”

It’s absolutely crucial to let people know, “you don’t have to move out of your neighborhood to have a better one.” (Majora Carter — a strategy consultant, entrepreneur and grassroots real estate developer who played a pivotal role in bringing back New York’s South Bronx)

Solo flower

The Roadmap to Your Community’s Future

Imagine your community not populated by silos and generational division. Imagine your community being designed and built for all its citizens, regardless of age or status. “Building Community Through Student Engagement” is a plan to do just that.

  • Increased school performance: Create an environment for students that seamlessly connects schools to the outside community resulting higher engagement and performance (i.e. graduation rates).
  • Higher talent retention levels: Create an integrated community building platform that breaks down silos and connects students with adults for collaborative activities that transform communities into future looking places students will build on after they graduate.
  • Enhanced elderly care resources: Create an integrated community perspective that transcends generations ultimately helping older residents as much as younger as more elderly health care is needed due to demographic changes.
  • Increased environmental resourcefulness: Play off Green Schools to create a community mindset of conservation and resource maximization regardless of generation.
  • Expanded worldwide contribution: Create a foundation for students to build a better world as a whole for themselves and others by introducing them to sustainable practices and connection to the community and beyond.

Not all communities look to the future. They want to remember the past, even though that past may not have been quite as rosy as they would like to think. Change is hard. Handing over the reigns to the next generation is not a science, but an art. But whether we know it or not there is an artist in each one of us. Sometimes we just have to let those coming after us with their naive optimism, show us.

Let’s take those rose-colored glasses we’ve used to look to past … and give them to our children and grandchildren so they can point them to the future. We may even enjoy the ride.

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You reach me on Twitter at @clayforberg and the Center for Green Schools at @mygreenschools.

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As a part of the Community 3.0 platform we’ve put together a roster of several examples of what can come from Front Porch collaborations. These examples represent Solutions to many common needs and opportunities a community may encounter, Solutions that can bind the relationships between the generations – young and old alike.

 

Why ‘The Curious Incident of the Dog in the Night-Time’ Matters

Over the course of my recent blog series, “On the Road to Your Community’s Perfect World,” one of the main tenets I’ve stressed has been that every member of a community, no matter who they are, has value and should be recognized for their unique gifts. Everyone adds to the fabric of your community.

In the piece, ‘Empathy and ‘Shared Experience,’ I stressed importance of individual relationships and empathy in building the foundation of a community. In ‘Cross-pollination and Creating Your Own Personal Renaissance I suggested that not only do we need to accept all of our neighbors, but it’s our duty to show them their talents even when they can’t see themselves. In both these pieces, as throughout the entire series, the concept of the ‘Middle Ring’ and neighborhood connections reigns supreme to the success and prosperity to any community.

Also over the years I’ve also written about the stigma of mental illness and addiction and the toll it takes not only on those affected, but on our society as whole. The preconceptions, very often perpetuated by the media and family generational ignorance, is a disease in our society that must be eradicated. These attitudes are prevalent with the lifelong Scarlett Letter given to those with alcoholism or drug addiction where one is never truly better but always in a state of recovery or relapse, and the macho ‘suck it up attitude’ towards the effects of PTSD in the military. 

Well society, or should I say the entertainment side of it, may have taken a step towards walking a little more upright on Sunday night. Yes, we pulled our knuckles off the ground (if for just a bit). Sunday night the Tony Award for the best Broadway play for a drama went to ‘The Curious Case of a Dog in the Night-Time. ‘The Curious Case…’ is a play based on the 2003 book written by Mark Haddon which follows the investigation of a suspicious death of a neighbor’s dog. Haddon’s main character, Christopher John Francis Boone, suffers (and I don’t even think I should use that word) with Aspergers Syndrome, a form of Autism.

Curious Incident

Asperger’s is characterized by significant difficulties in social interaction and nonverbal communication, alongside with restricted and repetitive patterns of behavior and interests. But it can also result in high functioning specialized area of expertise, such as math in the case of Boone. In fact as only a teenager, he performed at college level. Boone is a perfect example of an outlier in our communities who would be looked at as odd and nothing but a liability. But in truth, he’s the exact type of person that we need to not only accept … but celebrate.

Last fall, on my last trip down to Los Angeles to see my daughter, Alexandria, I read ‘The Curious Incident of the Dog in the Night-Time’ At times it was difficult to read. In fact I had to put it down several occasions because it was just too much. I became immersed in Boone’s decision-making. He methodically described his thought process (including diagrams) – so it felt like you were there as I went though his daily activities and all the preparations, or rather the rituals, he depended on. I was there when he justified decisions I knew were going to go wrong … and did. But to him they made perfect sense and you felt for him. I had empathy. I was put into his world, however different that world was from mine – or anything I could conceive.

We need more books like ‘The Curious Incident of the Dog in the Night-Time.’ Or maybe they’re out there and they don’t get the recognition. Even the so-called experts predicting the Tony winners gave the play little chance and it was barely mentioned in conversation. Apparently they hadn’t seen it or read the book. But then again it’s the media, why should we expect anything from them but to aspire to the lowest common denominator. This is exactly why we, the people in the streets and in our communities, need to search out these outliers in our society and see what they’re all about, not just automatically dismiss or worse yet brand them with a Scarlett Letter. These are the people who add the color to our lives and unexpected experiences we’ll remember. But it takes effort to break past the stereotypes and societal norms that cloud our visions. It takes exercising our minds, breaking outside of our comfort zones.

I don’t want hold my breath, but I hope this acknowledgement of ‘The Curious Incident of the Dog in the Night-Time’ will start a dialogue on the virtue of being different. I’ve even decided to refrain from calling conditions like Asperger’s and Autism illnesses. Maybe should we all take note and follow. Maybe when we encounter people like Christopher John Francis Boone, we should view it as a challenge to make ourselves better people. Maybe we can look at it as an opportunity to give our bloodied Neanderthal knuckles a chance to heal.

It takes taking a break from the looking for the ‘sameness, if yet for just a little bit. And you never know, if you try … maybe that little bit will become a habit.

And that would be a good thing.

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I invite you to travel with me on my journey, “On the Road to Your Community’s Perfect World,” as I attempt to articulate my vision of how we can create better, more inclusive, unique communities as the solution to our society’s pressing issues – both problems and opportunities. Consider each week’s post a mile marker (MM) of sorts, a cerebral off ramp, taking a you little further down this road until sometime in September when we reach … well you can decide what we’ve reached for yourself. Also please subscribe so you can receive the weekly installments.

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You can follow me on Twitter at @clayforsberg and on Google+

“Resource Maximization” … and The Art of MacGyver

Apollo 13 was the seventh manned mission in the American Apollo space program and the third intended to land on the Moon. The craft was launched on April 11, 1970, at 13:13 CST from the Kennedy Space Center, Florida, but the lunar landing was aborted after an oxygen tank exploded two days later, crippling the service module upon which the Command Module depended. Despite great hardship caused by limited power, loss of cabin heat, shortage of potable water, and the critical need to jury-rig the carbon dioxide removal system, the crew returned safely to Earth on April 17.

The astronauts of Apollo 13 had to do what they had to with limited resources, none of which were designed for the task at hand. But all the same, they made it work and gave us one of the great examples American ingenuity. It’s now time for this ingenuity to come home … home to our communities.

During my time on this planet, I have never seen a more appropriate occasion for this metaphor. Our government, whether it be in Washington D.C. or at the state levels, has never been more dysfunctional. And with the increasing polarization of the country’s electorate, I can’t see it getting any better. America’s leading pollster, Nate Silver of FiveThirtyEight.com, has said only fifteen to twenty of the 428 Congressional districts are open for party electorial change. Because of gerrymandering and hardened ideological views – over ninety percent of the districts will remain in the same party hands well into the future. The only contests will be in the primaries, not the general elections.

Through the checks and balances of the three branches of government the constitution created, our founders prevented the takeover of government by a single faction or ideology. They also assumed that elected officials would act as representatives of the people who elected them and govern on their behalf. What they did not see is the takeover of government, not by a single party, but rather by the phenomenon of narcissism and self-interest fueled by outside corporations and special interests. And this phenomenon is not one that can just be voted out of office and replaced by a different candidate. It has thoroughly infected both parties.

And government is not the only institution that has failed us. Public education is pathetic. After decades of “flavor of day” reforms, whether it be “Outcome Education,” “No Child Left Behind,” or “Race to the Top” our world standing has stagnated in the middle of the pack amongst developed nations. Now we’re getting ready for the “Common Core Standards” implemented by Secretary of Education Arne Duncan, whose claim to fame was a shepherding a failed, dismal Chicago Public School system.

I could continue on and talk about higher education and its skyrocketing costs, or a host of other alarming institutional failings – but it’s safe to say they are not what they were … and sure should not be depended on for our wellbeing and future success.

macgyver

I read an interesting piece last week by Heather Fleming, CEO of Catapult Design. Catapult Design are designers, engineers, and educators working with forward-thinking organizations using technology as a means to drive social change. Their process involves; product and service design consulting, and training and design education of teams and individuals who want to know more about employing a human-centered approach to social challenges.

In other words, they’re doing some pretty lofty, cool stuff. The piece I read follows the same train of thought as the Apollo 13 example I used above, but only its metaphor is based on the ’80s TV show MacGyver. Below, according to Ms. Fleming, are MacGyver’s “four enablers of creativity” or as I call it “Resource Maximization,” utilizing what you have to its fullest and not worrying about what you don’t have.

  • He is a do-er. It’s easy for teams to sidestep creativity when taking on a new endeavor by quibbling over objectives. Ambiguity is uncomfortable. MacGyver uses action to work through the ambiguity. He could sit and have a discussion about his options, or create a tradeoff matrix, but he chooses to learn by doing.
  • His resources are defined. One of the first things he does at the start of a design project is figure out what he knows and what he doesn’t know. He makes constraints. It’s a contrast to what we associate with creativity—which is blue-sky, free-thinking, no rules. But the lack of constraints, or lack of a creative process, is in fact a deterrent to producing innovative results.
  • His goal is clear and a deadline is imminent. For MacGyver, the bomb is always ticking down. He has a defined amount of time. Failure is not an option. It’s similar to that feeling you get the night before a deadline, when the creative adrenaline rushes in at 2 a.m. The pressure is necessary to drive action.
  • He doesn’t have to ask for permission. Imagine if MacGyver had to stop with 15 seconds left on the bomb ticker to get clearance to use a set of pliers. Creating an enabling environment—tools on hand, creative ‘places,’ ‘time’ for creativity, diversity in thought—is what helps him get the job done.

You can read the entire piece by Catapult Design here.

Every community has an abundance of resources. To identify, uncover and “maximize” these resources, is the trick. A top-notch web designer could be sitting in a high school English class. An unemployed electrician could be at home just be waiting for an opportunity to help his community rather spend another day sitting on the couch watching home improvement shows. A neighborhood card club might want to deliver homemade food to a shut-in rather play that hundredth hand of pinochle.

These days, times are difficult for a lot people and in turn, a lot of communities. Unemployment is high and underemployment is even higher. Local municipalities are strapped and it’s only going to get worse. Anything not deemed as critical services have – or will be, cut to the bone. The community safety net is torn and the proverbial seamstress has been sent packing and is in line at the food bank.

Now is the time to take examples from MacGyver and the heroes of Apollo 13 – take what we have … and “maximize” it.

Now is time for your community to come together – and instead waiting for help … HELP ITSELF!

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I can be found on Twitter at @clayforsberg and on Google+

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