Wednesday, January 5, 2011

The Balance of Power

Sitting in the offices of the Orlando Free Dental Clinic Bob, the Director was getting mad. A federal auditor was getting on to him because his outcomes were not pure. The grant that supported a large part of the program only allowed people meeting certain demographic requirements to be served. Bob and his staff had this notion that anybody needing dental care could come.

The federal auditor would have none of it. Rules are rules. She kept demanding proof of outcomes.

“You want outcomes,” Bob spit standing up, “I’ll show you outcomes!”

And he left the room. When he returned he carried this very large jar. He turned it upside down in front of the auditor’s chair and hundreds upon hundreds of extracted teeth showered around her feet.

“There’s your outcomes”!

He was making a powerful point. The shower of teeth represented the real pain and agony of people who may or may not have fit the guidelines. The pain was as much for those who did as for those who didn’t. Shepherd’s Hope, the clinic refused to discriminate even though the federal government paid them to do so.

When you boil my belief system down I believe in Liberation Theology, a belief that God sides with the poor and if we want to hang around God then we need to hang around the poor. It is a theology of the streets.

It doesn’t trust institutions. Any institution --- governments, banks, churches, Synagogues, or much anything else! The reason is institutions exist to perpetuate themselves above anything else. Continued existence of one means more than anybody or anything … including God, justice, charity, and family.

It is a balancing trick to be part of an institution that you know you can never really trust. There is always this tension of doing everything for the sake of the place while keeping one foot over the line. That’s what Bob did when the Shepherd’s Place served people in pain regardless of rules.

Sure, you can’t do everything for everybody. But you can try. Pushing institutions and organizations to do more than they are capable of keeps them honest. Once they become status quo, then the Bank, Church or government exists for itself at the expense of others.

Several years later Bob was at Union Mission with the Robert Wood Johnson Foundation doing a site visit for a grant we had submitted. The grant was for $500,000 to help start the J. C. Lewis Health Center. The meeting had gone well and we were feeling pretty good our prospects.

Towards the end Bob asked, “Have you thought about adding a Dental component? Oral health ranks sixth in why people go to hospital emergency rooms. They can’t afford a Dentist so …what do they do?”

It had never dawned on us. Besides we were already trying to do something incredibly ambitious.

Then Bob the story of showering the auditor’s shower of extracted teeth.

So in the course of a couple of weeks we amended our application to include oral health. Today it is the Peter Brassler Dental Clinic, this area’s only oral health center for the working poor, uninsured and homeless.

I’m no longer part of any of that but I still worry about it becoming too much of an institution that merely adheres to government rules or Income Performa or being content to do what they can without pushing themselves. Pain is pain after all.

Congress returns to session today as though any of us really need that to happen. We all have to be careful in how we approach our work and our beliefs in institutions that we belong; that we do our very best to prevent them from becoming like Congress where everyone works hard to keep it like it is.