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 BY: BRIAN M. KANE, PhD

A tiny virus, COVID-19, has dramatically challenged, and changed, our perceptions of power, government, personal relations and health care. The refrain, as the first wave is diminishing, is collective grief at our losses of human life, autonomy and safety.

Catholic health care has been on the front line of this pandemic from the beginning. As the virus spread across the country, Catholic hospitals and long-term care facilities immediately answered the call to care for thousands of COVID-19 patients and their families.

The prompt and heroic response to the nation's unprecedented health crisis was the result of careful plans developed by thoughtful people over the past decade to deal with pandemics like COVID-19 in a manner consistent with the social teaching of the Catholic Church. Although some parts of the country have suffered more outbreaks of COVID-19 than others, thankfully we have not had to invoke "crisis standards" of triage treatment thus far.

Despite the many challenges health care systems will continue to face in combating the pandemic, perceptive leaders are envisioning new ways for their organizations to be more nimble in addressing community needs and creating new models of excellence in health care.

I'd like to explore how Catholic health care can continue to pursue excellence in this extraordinary time of change. Although it may at first seem that pursuing excellence is an elusive chase after an ethereal ghost, there are, in fact, concrete steps we can take toward that goal.

To begin, I would like to share a story. In 1937 in midtown Manhattan, a 33-year-old writer was headed home after his 27th rejection by a publisher for his new book. By coincidence, as he walked down Madison Avenue, he met a college acquaintance who asked him what he was carrying. He told his story, and his friend responded that only that morning, he had been made editor of children's books at the Vanguard Publishing Company. The book was purchased that afternoon, and Theodor Geisel, who most of us know as Dr. Seuss, began the writing career we know him for. Geisel later said, "If I'd have been going down the other side of Madison Avenue, I'd have been in the dry cleaning business today." ¹

Certainly, his work was successful (more than 650 million copies of his books have been sold), but it was also transformative². He helped to teach generations of children to read, and was an advocate for social issues like racial equality, environmentalism and anti-authoritarianism.

I think, in his heart, that he knew a fundamental truth that is timely now: to be excellent means to be willing to fail, specifically the kind of failure that comes from taking risks, from making yourself uncomfortable. Why is it that those who best demonstrate excellence understand failure in this way? It is because, unlike most people, they don't associate it with negativity. They see it as a step toward success. They commit to a process where short-term failures and risk-taking lead to long-term excellence.

The same lesson applies to Catholic health care. By the prevailing American measure of successful organizations, Catholic health care might be viewed as a failure because profit is not the primary goal of our mission. We don't fit the standard of the capitalist marketplace in which we compete. We offer care for patients who sometimes cannot afford the services. We advocate for health care for all, even when everyone cannot pay. We fight for the poor in a society that wrongly can believe that poverty is tied to personal failure.

But long-term vision could lead to a greater kind of excellence, where every person is cared for, and where we build a society that values the needs of the most vulnerable among us. Our "failures" motivate us to the challenge of understanding these gaps as opportunities for change. So, in re-positioning Catholic healthcare for this new world, we must keep in mind that failure – both practical (in that some ideas will ultimately not work), and culturally (in that we operate in a culture that may not always agree with our values) – are part of a pattern of excellence.

Excellence isn't arrived at random, but is achieved with a plan, tools of thinking and a willingness to learn from failure. There are three main steps that enable both individuals and institutions to move toward excellence. The first is the ability to imagine; the second, the ability to translate that imagining into a "language" that others can understand; and the third is the ability to re-create or to invent.

True excellence starts with imagination. To imagine is to immerse oneself in a world of wonder and truth. The act of imagination is not pursuing movement into a false world, but rather indulging an intense captivation by what one encounters.

Certainly, the American Catholic health care system was created through the imagination of the dedicated orders of sisters and brothers who began this ministry of the church. They encountered persons who needed their care to remain alive and healthy. They were dedicated because they were fascinated by the humanity that surrounded them. And, they created health facilities that grew into larger systems that have cared for millions of persons in the years since. To recognize the person in front of you, and her or his needs, is the first step toward this excellence. Pope John Paul II mentioned this in his address to the leaders of Catholic health care in his 1987 pastoral visit: "All concern for the sick and suffering is part of the Church's life and mission. The Church has always understood herself to be charged by Christ with the care of persons who are poor, weak, defenseless, suffering and those who mourn. This means that, as you alleviate suffering and seek to heal, you also bear witness to the Christian view of suffering and to the meaning of life and death as taught by your Christian faith." ³

Imagination in Catholic health care is recognized in the women and men who have already committed themselves to caring for others. The first steps were taken by the religious orders of sisters, and sometimes brothers and priests, who saw their ministry in caring for the physical and spiritual needs of the communities that they served. They entered into their ministry with energy and purpose and remain inspiring examples to help us imagine what the future will be. Their successors are the clinician on the floor who is an empathetic leader, the custodian who takes a moment to talk with a patient, the social worker who works to find a solution to transfer a patient to appropriate care, and the long-term care staff who listen and care for their residents. They are all persons of imagination and compassion who are resources to us in these changing times through their intense interest in those whom they serve and in their ability to understand goals and problems on a visceral level.

The second step of excellence involves a "translation" of what is seen, so that the experience can be shared. Albert Einstein was consumed with thinking about the physics of the universe. He wrote: "The words of the language, as they are written or spoken, do not seem to play any role in my mechanism of thought … [Instead the] elements are, in my case, of visual and some of muscular type."⁴ In other words, he created images in his mind's eye, and once he was sure of its truth, he sought to find a way to express it. Many people would be surprised to learn that Einstein had to collaborate with others in the mathematical formulation of his proofs. As he said to one colleague, "Do not worry about your difficulties in mathematics. I can assure you that mine are still greater."⁵ His strength was in the imagination, and he had to work hard on the translation so that others could understand him.

A second example is the encounter between Helen Keller and Martha Graham, one of the greatest dancers and choreographers of the 20^th century. In the 1930s, Keller visited Graham's studio, and she asked Graham what jumping was. As a blind person, she had never jumped or run, because it was too dangerous. Graham described the encounter in this way: Calling the dancer Merce Cunningham over, she placed Helen's hands on his waist. Then, "Merce jumped in the air in first position while Helen's hands stayed on his body. Her hands fell and rose as Merce did. Her expression changed from curiosity to one of joy. You could see the enthusiasm on her face as she threw her arms in the air and exclaimed, 'How like thought. How like the mind it is.'"⁶ Helen Keller could imagine this act of jumping in a different way and thus translate it into a truth which we can all share – dancing, or jumping, is a kind of thinking with your body.

So, the process toward excellence involves these first two steps. First, immersion into the beauty of the people and the world we encounter. Then, working to communicate that experience into a common language, so that others can share the experience. Sharing is an essential part of a process of transformation, where the experience of one person shares in the creation of a common good.

That "translation" remains a challenge for American Catholic health care. In spite of the excellent work that Catholic health care does, and perhaps because of other cultural elements in the development of American culture, there is often a wall of misunderstanding between our efforts and how that work is valued. When our positions against abortion, birth control or assisted suicide are not understood, perhaps we need to take our imagination to find new ways to translate our message to a culture that has been ambivalent or hostile to our beliefs.

That last step of excellence – re-creation or invention – eludes most of us who aim for it. The reason is that it is not just a matter of individual determination, but also of circumstances, which the person who aims for excellence is able to interpret and seize. Composer Igor Stravinsky, in his book The Poetics of Music, wrote "…the act of invention implies the necessity of a lucky find and of achieving the full realization of the find. What we imagine does not necessarily take on a concrete form and may remain in a state of virtuality, whereas invention is not conceivable apart from its actually being worked out."⁷ So, as much as we would all like to be the inventors and re-creators of the future, that is a harder step to take.

If we reflect on the people mentioned here, we can see that excellence is not a solitary activity. We count on others to inspire, collaborate, explain, carry out. Individual effort to understand reaches its fulfillment in the common good.⁸

As Stravinsky said above, the moment of discovery and of re-creation implies a happy circumstance of the hard work of imagination and translation, along with the right moment in time. This means the right person (or community of persons) at the right time. It is not just happenstance.

What we do know about those who possess creative excellence is something for which we all can strive. A person is much more likely to recognize that right point in time if they imagine and translate through different kinds of experiences. Or, as the French physician Armand Trousseau wrote, "All science touches on art, all art has its scientific side. The worst scientist is he who is not an artist; the worst artist, is he who is not a scientist."⁹

So, be a clinician, but also be a dancer. Be an economist, but also read novels. Be a nurse, but also be an athlete. Be a health care executive, but also be an artist. Be a priest, or a bishop, but understand the secular culture that surrounds you^10. In other words, explore different aspects of beauty and truth and seek to understand them. Learn to accept short-term failure as the price of long-term excellence.

The pandemic has highlighted already existing disparities of care in vulnerable populations. It is certain that change will follow our experience of COVID-19. By committing ourselves to a process of imagination, translation and re-creation, Catholic health care can transform our present health care system so that we can address these disparities, and achieve excellence in bringing the healing mission of Jesus alive in the world.

Brian M. Kane is senior director, ethics, the Catholic Health Association of the United States, St. Louis.

NOTES

1. For this story and other details, see Judith Morgan and Neil Morgan, Dr. Seuss & Mr. Geisel: A Biography (New York: Da Capo Press, 1995).
2. Brian Grazer and Charles Fishman, A Curious Mind: The Secret to a Bigger Life (New York: Simon & Schuster, 2015), 113.
3. John Paul II, "Address of his Holiness John Paul II to the Leaders in Catholic Health Care," Phoenix Convention Center, September 14, 1987, http://www.vatican.va/content/john-paul-ii/en/speeches/1987/september/documents/hf_jp-ii_spe_19870914_organiz-sanitarie-cattoliche.html.
4. Robert Root-Bernstein and Michèle Root-Bernstein, Sparks of Genius: The Thirteen Thinking Tools of the World's Most Creative People (Boston: Houghton Mifflin Company, 1999), 3.
5. Root-Bernstein and Root-Bernstein, Sparks of Genius, 3.
6. Root-Bernstein and Root-Bernstein, Sparks of Genius, 162-64.
7. 7. Igor Stravinsky, Poetics of Music: In the Form of Six Lessons, trans. Arthur Knodel and Ingolf Dahl (Cambridge, Mass.: Harvard University Press, 2003 [1942]), 53.
8. Pope John Paul II makes this point in his encyclical Laborem Exercens, especially section 10: "All of this brings it about that man combines his deepest human identity with membership of a nation, and intends his work also to increase the common good developed together with his compatriots, thus realizing that in this way work serves to add to the heritage of the whole human family, of all the people living in the world." http://www.vatican.va/content/john-paul-ii/en/encyclicals/documents/hf_jp-ii_enc_14091981_laborem-exercens.html.
9. Root-Bernstein and Root-Bernstein, 11.
10. Notable, here, is the work of the Pontifical Council for Culture that has engaged artists, athletes and others in a conversation concerning the wider culture. If the reader is unfamiliar with their work, please see http://www.cultura.va/content/cultura/en.html.