The Language of Grief and Loss, and Living in the Afterloss

I learned a new word from an old friend:  "the afterloss."  It's what he calls the new stage of life we enter after a loss, an era of grief and change.  I'll say more about it later in this post.  I've been doing some grief work lately--it's that time of year for me between my wedding anniversary and the anniversary of Everly's death.  In the process I've been thinking about some of the language we use to describe our loss and grieving, and maybe stretching and extending it to help me understand my own situation at this time.

The imagery of a "broken heart" is powerful to describe some of the struggle of dealing with loss through death or broken relationships. The heaviness in one’s body, the dark cloud invading one’s thinking, and the erratic welling up of tears all give the sense of something broken. Difficulty thinking about what comes next and the inability to focus on plans or complex tasks are all features of grieving that imply brokenness in my experience.

Of course, figurative language of this sort has its limits. Literal breaking usually applies to solid, rigid items or to machines or processing mechanisms of some sort. While the image of breaking does fit well enough with what loss and grief are like, it also seems that mixing the metaphors is common and helpful.

Grief as a "wound" is another image. This language makes a more direct connection to the organic, fleshy nature of our humanity and its bodily experience of grief.  In this case, rather than breaking, the image of ripping flesh, or a deep cut into our bodies speaks vividly about the pain and trauma of loss and grief. A loved one’s death, or events or conversation which change or end a beloved relationship, can feel traumatic as if tearing open a wound in one’s body.  In the same imagery, we often think of the healing process as stitching a wound and forming scars on our hearts.

I want to riff on what may be another aspect of this image of a wound. Beyond the initial ripping or cutting, there is often also a slow, subsequent, repeated tearing that extends our woundedness.

Very common for people who suffer loss is the experience of turning to speak to the loved one who is not there anymore. Or it may be the thought that constantly pops up, “I need to talk to her about this,” followed by the remembrance that it will not be possible.

The constant little tearing may occur when the grieving person remembers plans already made. There may have been a trip planned, tickets for a concert, dinner plans, a party, a hike, or some other outing. But these will not happen.

Longer term plans also rip the wound a little more. For me, Everly’s untimely death meant she would not be present for our children’s future graduations, and even more painful, their potential marriages or birth of children. In all losses, people lose not only concrete plans, but also imagined futures.  These are dreams of a joyful future which have not always even been expressed.  Perhaps buried in one's hopes are dreams of times spent in travel, in couple time not available during the hectic middle years of life, or seasons with family or friends who have been out of reach in the midst of one’s work life.

My friend Benjamin Allen, whose website and Facebook sites both are about grief and healing in the afterloss, insists above all that we not try to think of grief as a finite process. To be in grief, especially but not only after a death, is to enter a life era that he calls “afterloss.” In this era, we learn and adapt to a new stage of relationship in which who or what we have lost is still present to us and in us, but in new ways. At least this is how I’ve interpreted what he is saying. I walked with him for a short time through the horrific tragedy of loss from illness that eventually took the lives of his wife and two children. I was very young still--in my mid twenties. It was difficult for me to comprehend the depth of his pain. I remember times that I said awkward things to him out of the pat answers I had overheard while growing up, dumb cliches that it took me many more years to unlearn.

This stage of living in grief while also healing brings many complications. It's the era in which those smaller, later ripping events revive and repeat grief.  My greatest loss, the death of Everly, means that all of my remaining years include her presence in making me who I am and in shaping my dreams. Her absence and losing her affect my work and my relationships, and in a way the pain of her loss is mixed with all the other losses, small or large, that follow.

The painful failure I went through in my mid-thirties as I saw a church breaking apart around me and myself impotent to make a difference also lives with me.  In that time, I lost the naïveté that told me I could be a leader whom people would enthusiastically follow because of my "brilliance," my skill in speech and writing, and my sincerity in presenting my vision.  Naïveté both overstated my talent and understated the struggle that we have in our communities when we try to see truth together in the midst of our divisions. That loss makes me less sanguine about leading change, less confident in my gifts, and rightly less messianic in my self-estimation.

The variety of losses one endures are intertwined. Thus each little tear of the heart intersects the ones that preceded it.  All my memories of leadership failure are linked with the ways that Everly held me up when I was stumbling and helped me see when I was blind.

Part of the afterloss, for instance in my era of widowhood, is recognizing what is lost and stays lost. I do not have the same yokefellow that Everly was to hold me up when I stumble. I don’t mean that there is no one. Many friends have been present to keep me from staying on the ground when I fall. My adult children have had to learn that their daddy needs them in ways they previously did not have to face. 

Besides help when I stumble, it is also clear how deep the loss of Everly's discerning eyes and insights is for me.  I am constantly reminded how I miss those gifts, and that I do not have a clear way to replace them.

In the almost six years since I have been without her, I have faced numerous difficult life decisions. I usually feel that I am walking blind. I do my best to call on people who know me and care for me and believe in me for guidance and help.  They do help.  And I habitually work through comparisons of options to try to weigh what is best.  But I have yet to press forward into such important decisions without finding myself surprised, even disappointed or shocked, perhaps misled by my self-focus or by my rosy-glasses vision.  I have convinced myself that I have a glimpse of what may come next, only to find out I am blind to what probably should have been obvious.  These new losses are among the continuing tears at the wounds of the heart.  At this point in my life, at my low points, it sometimes seems the best description is that I have become an old fool.

Now let me qualify that. I'm just sharing a feeling I have had, but not the general stance toward the world in which I live.  Most of the time I feel highly competent and able to offer a great deal to my family, my friends, and the world. So I’m not saying that I don’t ever believe in myself. I’m not asking for people to call me up to remind me how much of a blessing I have been to them. I fully believe that it is true that my life blesses others and is fulfilling for me; therefore, I press on toward the high calling, to take hold of that for which I was taken hold of. So no need to get worried about Mikey today.

However, in the afterloss, I would say it’s pretty much expected that low times will come. I reckon that's true even for people who have never endured a great loss, but in a different way.  And it seems to me that in the struggle to restore some equilibrium, to find some new path, and to fill in some of the holes in one’s life, the era of grieving can often seem to be repeating what already happened. New losses overlay the old ones. To revert to the wound metaphor, old scars reopen, and pain returns to the very place where it was most intense.

I’ve had almost six years of widowhood. Throughout my life, I’ve known many women and men whose widow years have meant they stayed alone until they died.  My dear grandma lived 29 years after the death of my granddaddy. She moved around to stay with family members, mainly her two daughters and her sister. That meant she lived in our home part of each year the entire time that I was growing up. I was a kid and never gave much thought to what her loneliness might have been like. Now I wonder more. I was her darling, and we often sat and talked while she rocked in her rocking chair.

She found a way to share her life with others that gave her a level of satisfaction that I never really questioned. Partly, it seems that her generational outlook of being a mother who cared for a household found some fulfillment in still using those gifts and that calling toward her children and grandchildren even after her beloved husband had died too young.  She cooked and cleaned and cared for us, and she also spent her time reading, traveling, and doing what she wanted to in her "retirement."  I don't recall her talking about wondering what comes next.  Now I wonder what she would have said had I asked those kinds of questions.

In my years of a widow's grief, I find myself regularly wondering and questioning what comes next. That’s what got me started writing again last week, as a beloved colleague and I were discussing her own search for direction in the next season in her life.  Every once in a while I think I may have uncovered a treasure what will fill some of the space that grief and loss have opened up. I think that maybe I have discovered a salve that will help scars continue to heal.  I think I may be looking down a path that could calm my restlessness and make me feel more at home.  So far, it’s mostly still more stumbling, a glimpse of beauty that remains just out of reach. The beauty is real. The treasure is priceless. The path was a possibility. Yet I had expectations that were too great for what could happen.

I’m probably describing what the current cultural memes call first world problems. I do remind myself that a steady job, caring friends and colleagues, healthy and happy children, opportunities to study and write—all of these are graces far and above what one person should expect.  Knowing and affirming that truth of grace abundant does not, however, take away the longing that is part of what living in grief and loss carries with it. 

Some might say that the longing itself is what I should set aside.  I'm not sure I can agree, nor that I think it is possible.  I do recognize the danger of lustful cravings, and I don't think that is what I am describing here.  I believe, and hope I am right, that what I'm calling longing is an embedded passion within humanity to be in relationship, to love one another, to find fulfillment in the beauty and richness of creation, and to rest in the divine presence.  It is the notion that we have been made with purpose and meaning that calls out to us and presses us forward. 

At the same time that I embrace the longing as part of what urges me on toward being what I am made to be, I also acknowledge and affirm the Apostle Paul's claim that he has learned to be content in whatever circumstances he finds himself.  I am moderately good at living that way, but maybe not as good as Grandma was.  Somewhere in between longing and contentment--that has to be where I strive to live.  I don't want to settle for less than the good that awaits me, nor to be grasping after what I do not need.

In her novel Lila, Marilynne Robinson narrates the inner thoughts of the title character as she tries to reconcile her fears with the possibility of two people caring for one another, with these words, "It felt very good to have him walking beside her--good like rest and quiet, like something you could live without, but you need it anyway; that you had to learn how to miss, and then you'd never stop missing it."  That's a good description of the slow and partial healing that accompanies the ongoing tearing of our hearts in the afterloss.  To close out this ramble of more words than I intended, I thank you for your time spent reflecting with me.  Let’s all of us keep walking forward together, thankful for every companion who is willing to join us on the journey, learning not to miss the goodness that their lives bring to us. 

An Outpouring of Thanks for My Last Post: Here's What I Think It Means

When I posted last Friday about dealing with my emotional/intellectual/spiritual/material struggles with professorial and professional work, I kept hearing in the back of my head some advice about preaching and teaching I received long ago.  I believe it is good advice, which is why I keep it close in mind.  I was warned not to let my sermons and teaching presentations get too focused around my own experiences.  First, it betrays a kind of egocentrism (even egotism) that seems to think of oneself as the prime example of whatever topic is at hand.  Second, it presumptuously asserts that one's own experiences are the same as those who are hearing what one says.  I do agree that these are dangers and temptations.

Yet there is another side of this question about whether to use one's own experiences in teaching and preaching.  That side is the one that recognizes preaching and teaching is in part about building a relationship of teaching-learning between the teacher and the people in the classroom or other setting.  That relationship itself becomes a powerful part of a teaching-learning process.

In the past few days, some of the most encouraging words of appreciation I received were from fellow academics, people who find themselves in a similar functional role as I do.  Although I did not get too heavily into details of my own struggle, I tried to reveal enough to make some sense of it to readers.  Apparently it did make some sense, and there have been a wide range of responses.

Through the past two years, one of the most common responses to my writing about Everly, cancer, struggle, death, loss, and faith, have been those from people who told how my writing honestly about the struggle helped them to think about and deal with struggles in their own lives.  Over and over people have encouraged me to keep on writing, as many of you did this past weekend.

One colleague who wrote some beautiful encouragement to me sparked me to think about how dealing with this struggle has affected my teaching.  So I'm going to post here a response I sent to him about what I think it means that students are finding blessing in my current teaching.  Again, for all who teach and preach, I hope this will give some insight into why a certain kind of telling one's own story and reflecting on one's own faith can make a great difference in teaching and learning.

Thanks.  It has emerged through these two years since Everly's diagnosis in April of 2012 that my lived theological reflection is among the most important parts of my teaching.  As you indicated during your presentation last week, a personal story is powerful for impact and memory.  Add to that my sometimes raw emotions, and the students find this part of my reflection to serve their learning in many ways. 

At perhaps the first level, my up-to-date reflections as I "go through" are an example of how theology operates in a lived context with real questions people are asking.  So I will keep writing and bringing my reflections to the classroom as I make this pilgrimage that will not end until I end.

At another level, my reflections become a mirror to them.  While they are not going through the same thing (although sometimes it is very close with a terminally ill spouse or other family member), they are finding analogies to my story in their story.  Sometimes this has led to powerful testimony or confession on the part of a student in class who becomes willing to let her or his struggle become part of our conversation.  I have to say that they get a bit less "respect" from their peers, in that classmates feel more permission to comment on one another didactically than they do to comment in that way on my stories.  But that gives me a chance to talk about how we listen and do not rush to offer easy answers. 

Maybe it's a third level at which they find themselves in a new relation with me, walking along as a fellow struggler.  There is no small amount of recurring reference to Claypool's sermons in my ongoing reflections, as you may have noted in my refrain about walking one step at a time.  I don't doubt that this third element is significant in my being asked to preach by one of our students for the first time in fourteen years of teaching at the seminary.  Over the years, there have always been a small cadre of students who saw in me a colleague or mentor, someone whose overall faith and walk they might hope to emulate.  But they have been few, and it has much to do with my personality and background.  That seems to have changed as I have changed during this crisis.  Many more see in me an example of faith from whom they would hope to learn, not just a guy who knows about so many things and so many words and so many people. 

So I will, as best I can, try to let this season reshape me as a teacher.  It's strange that some of my most effective classroom teaching may be going on when I am by habits and performance so far from what I ought to be as a professor.  Bringing some of those good habits back into my daily life can perhaps give me a decade or so of teaching that will be the best of my career.

On Chitchat

For much of the past few weeks, with snow and cold weather around NC, I have kept to myself.  The solitude has been comfortable. I have been able to concentrate on some reading when I can settle down to do it.  I have followed through on some of the assignments I need to do at work.  I've stayed up with my classes and made appropriate reminders to keep students on pace.  I've come up with new ways to teach subject matter for my standard courses.  I've thought about and tried to keep up with family matters.  I've missed my Everly and teared up as the moments demand.

But I must admit that I have felt guilty a few times about the self-imposed solitude.  I have many friends who would be glad to sit down at coffee or lunch to visit, and I don't mean to be unappreciative of their friendliness.  I've never been very good at chitchat, and in the past few weeks I think I have been avoiding it.

I don't mean that I have not conversed with people--friends and coworkers alike.  But most of those talks have been pretty intense, and several have gone on for a couple of hours and more.  The thoughts that are on my mind tend to spin powerfully toward big questions.  Some of it is about how I will discern the next steps in my life now that Everly's work and comfort are no longer part of how I think about the shape of my life.  Some of it is about grieving Everly and the everyday pain that missing her brings. 

I think that one reason chitchat is not very easy for me right now is that for so many years it was something I did with Everly.  She learned quickly that I was not a great casual conversationalist.  On her own, she was often the life of the party, talking, joking, teasing, and acting silly for everyone's entertainment.  With me, she was gifted in bringing out my words and good humor.  She could get me started talking.  She could help me find the people in the group who might be interested in whatever obscure or heavy topics I had on my mind at the time.  And around the house, we would deal with our everyday chitchat topics intermingled with long bouts of listening to serious and intense matters we were thinking about in our work and vocations.  In consequence, easing into a friendly chitchat at this time in my life is also opening a window on my grief over losing those daily conversations.  I know that is not a very good reason to avoid my friends, and now that I'm thinking this through, maybe I can be more ready to face it.

I also don't want to diminish the significance and good that comes from chitchat.  There are many ways of smoothing the path of getting along with people, of greasing the rails toward building relationships.  Friendly chitchat is one very important one.  Laughing together is another.  For those of you who follow research on human behavior, it is not news to find out that about 90% of our laughter has little or nothing to do with humor.  It is a communicative behavior that breaks psychological barriers between people.  It smooths the edges of getting to know people.  We laugh when nervous and it dispels some of the anxiety.  We laugh simply to fill space when we are not sure what to say, and everyone gets a little emotional relief. 

Unlike the nonverbal communication of laughter, friendly chitchat shares intellectual content that helps people to become aware of who we are and to gain a sense of our assessment of them.  The verbal is mingled with body language that may convey a great deal.  Do we seem to like them?  Do our stories convey that we feel superior or inferior to them?  Much is transacted in chitchat that verbally and non-verbally shapes how people will understand their relationships.

Aristotle's list of virtues in The Nichomachean Ethics includes one that is often translated "wittiness."  It is the virtue of being able to carry on pleasant conversation, to speak tactfully, to tell proper humorous stories in a proper manner.  It is contrasted with boorishness and buffoonery as its deficiency and excess.  To be able to make others comfortable in conversation, to treat them well, even to entertain them, is a virtue for Aristotle's well-heeled Athenian male.  I think it is not hard for us to see the value of excellence in chitchat. 

We all have observed those persons in a group around which others gather to listen intently, giggle and laugh, and generally enjoy themselves.  Maybe others of you, as I have at times, have jealously wished to be that person.  That feeling itself may help us recognize the good in having ready wit.  It may not be, as some would criticize, one of the most important virtues of a moral life.  Yet it does not, on the other hand, appear to be a vice, nor even something not worth the trouble of developing as a habit.

I have probably become more habituated in "wittiness" over the years, largely because of knowing Everly.  She might not have thought of herself as having this virtue because Everly sometimes underestimated her strengths as a person.  But I do think she would agree that our partnership had benefited me a great deal in this aspect of living.  From her I learned to be more aware of the people with whom I am conversing rather than tightly closed up in my head with the matters on my mind.  From her I learned to be a better listener and not use others' words as a jumping off point for what I wanted to say anyway.  From her I learned to enjoy people for the good they are bringing to my life and the lives of others.  I don't mean that I've learned to be as she was, but I have loved who she was and embraced the glimpse of seeing the world as she saw it.

My mix of intellectual overconfidence and social shyness found a fascinating and intriguing partner in Everly's gregarious way of making friends, her quick intellect, and her impatience with abstraction.  We also found in one another traits we shared and valued: devotion to God, moral intensity, and a drive to make a difference in the world.  Hanging out with that person:  that's my chitchat heritage.  I miss it.  But I look forward to many more coffee and kitchen and hallway conversations with the rest of you.  Y'all all know you are not Everly, and you were not trying to be her.  Now I need to pay attention to who you are, listen to what you have to say, and offer the wit I can bring to the moments we have to find some joy together in this life.

Community Organizing Process

The following is a speech I gave recently at a community organizing meeting. It is a brief description of the cycle through which our community organizing work moves periodically as we reorganize to address new issues.

Good Afternoon, and welcome to this Durham CAN Internal Assembly. I am Rev. Mike Broadway, associate minister at Mt. Level Missionary Baptist Church and a member of the Durham CAN strategy team.

As we begin today, I want to answer two questions: “Why are we gathering today?” and “What will we be accomplishing in this meeting?”

Durham CAN does its work on a flexible timetable, but according to an intentional process. As a system of discernment, planning, action and evaluation, it can be thought of as a circular process, what we theologians might call a hermeneutical circle.

By following this purposive process, our organization is able to reorganize and re-energize ourselves. As has been said before, “All organizing is REorganizing.” So that is why we are here.

At least three, if not more, times Durham CAN has been at this point in our process. We have achieved significant victories, accomplished the goals we had set in education, crime prevention, youth services, living wages, housing improvement, health care access, environmental cleanup, and more. That is why we are here today, to keep the wheel turning, to move on in our work toward new goals, new growth, new maturity, new actions, and new community-building.

Take a look at the image projected on the wall. It is one way of describing our process.

Everything begins with building relationships. You are here because of your relationship to people in an organization, congregation, or neighborhood, and because your group has built relationships with these other groups present. We don’t start by reading the headlines or answering the mass mailing about politics. Issues we take up come from our relationships. We listen to one another in relational meetings, in house meetings, in planned listening sessions.

The house meetings give us new institutional priorities. Watts Street Baptist Church, Monument of Faith Church of God, Nehemiah Christian Center, Immaculate Conception Catholic Church, Watts-Hillandale Neighborhood Association, Judea Reform Congregation, Ar-Razzaq Islamic Center, and all of our member organizations have arrived at a new set of priorities based on listening to one another. We also learn where the energy of our people lies in these meetings. To what are we ready to give ourselves? Who is ready to lead on these priorities?

These institutional priorities cover a wide range of issues. They may have started as a laundry list of issues, then were narrowed down by each institution. Then these narrowed-down institutional issues must be brought into a collective vision for the broad-based organization of Durham CAN. It is a process of conversation and even debate at times. It requires compromise, and it guides our collective action. That discussion is part of what we are doing here today.

When we have set our collective priorities, we do so because this is where we are ready to generate energy for action. These will be our next issues. We will work on these first.

That does not mean that other issues which emerged from a congregation or neighborhood are unimportant. It only means that for now, we will narrow our focus so that we can accomplish something for the good of our community. If we try to do everything at once, we will surely fail. But when we succeed, we build energy to move on to the things we have not yet done.

Another part of what we are doing today is activating leaders. We will begin the formation of action and research teams around the priorities we set. If we want to make a difference, our priorities must be linked to a group of people committed to making a difference. These action teams will do research and make recommendations to the larger membership of CAN through the Metro Council. They do not work in isolation or set the policies, but they guide the rest of us in identifying our action agenda.

These teams help turn a priority into an issue. That means that it becomes actionable—it becomes something we can act on by being specific, measurable, and achievable. It becomes winnable. We can rally behind an issue. We can take it public and negotiate for its achievement.

These teams then move from research to action by identifying targets through a power analysis. Who has the power to make a difference for our issues? Whether it be elected officials, business leaders, public administrators, or someone else, we plan actions in order to get a reaction.

One of the ways we seek a reaction is in a public assembly. We do our homework and preparation so that we can bring our targeted public officials before CAN delegates to react to our proposals. When all has gone well, we know that they will support our issues even before they arrive. Sometimes, it gets a bit uncomfortable at an assembly when they are not sure they want to do what we ask. But either way, we have gotten the reaction we need, and we proceed to hold them accountable and if they are reluctant, find ways to get them to change their minds.

When we have received the commitments we asked for, we follow-up and make sure that it all comes to pass. And when we have achieved victory on our issues, we evaluate our progress. We look over how we did our work and find what we did well and what we did not do very well. It is kind of like digestion, as we break it down and make use of what we can learn. As the saying goes, “Insanity is doing the same thing over and over and expecting different results.” We want to know how to do things better, and not to repeat our mistakes. We want to learn as an organization. We want to grow.

This internal meeting today is all about getting us from our institutional priorities to be almost ready for our Delegates Assembly with the candidates for City Council and Mayor on October 18. Today we will be sharing stories, setting priorities, bringing leaders into teams, and making agreements in a way that will get us ready and moving for a new cycle of successful organizing.

So let’s get busy reorganizing to make a difference in Durham today.

Building relationships across community lines is the surest foundation for social change that lasts and serves the common good. This past Sunday, the results of several years of relationship building began to bear fruit publicly in Durham, NC. Durham CAN (communities, associations, and neighborhoods), a community organizing group, gathered for a Delegates Assembly on the campus of Duke University. Holding the meeting at Duke was a major symbol of the relationship building that has been going on.

One of the priorities of Durham CAN for four or five years has been improving the economic conditions of all Durham citizens. One strategy for doing that has been promoting a "livable wage" policy with major Durham employers. Sometimes it is called a "living wage." It is an effort to make a more realistic assessment of the basic costs of a household, revised from the widely used "poverty line" figures which do not accord with current costs of housing, fuel, transportation, communications, education, etc. Over several years of work, Durham City Government (original ordinance preceded CAN involvement and amendment with CAN involvement), Durham County Government (policy in minutes of June 14, 2004 meeting, pages 12-14), and the Durham Public Schools all adopted the livable wage proposals put forth by Durham CAN and negotiated through the relationships built with leaders in those organizations and the community.

Students, professors, employees, and administrators at Duke University have been discussing issues relating to wages, job security, and health care for some time now. Some of the students and professors have for even longer been part of member organizations that make up Durham CAN. Duke University was also aware of these changes, and on their own set a "Duke wage" as a floor for Duke employees, much higher than the minimum wage and very close to the "livable wage" adopted by the city, county, and schools. At the same time, Duke students, professors, and employees began to organize more formally into a group called Duke Organizing. For about a year, Duke Organizing has been a member organization of Durham CAN, and together we have been engaged in conversations with Duke University administrators about employee wages and benefits. As anyone might imagine, the conversations and relationship building have not always been smooth, and the local paper highlighted some of the conflictual history. People on all sides have at times taken positions that did not immediately lead to agreement. But the persistence in building the relationships has been the key to getting results.

On Sunday, Duke University Vice President for Campus Services Kemel Dawkins, announced that the Duke wage and health benefits would immediately be a stipulation for all food service contractors who do business with Duke. It is a major step to help another 140 employees in low-wage jobs. It is also a major precedent which should continue to affect other employees at Duke. Finally, it is a major challenge to other employers in the Durham area to consider the way they compensate employees if they want to be able to retain them. In the long overview of the process, Durham CAN has led at many stages of the process, but we have also been blessed to be working with institutions and leaders who have shared our convictions of making Durham a better place for all its people. Together, we can see even greater things happen for Durham's workers, communities, businesses, and public institutions.

Another relationship building process also led to a public announcement at the assembly. The number of uninsured workers in Durham is rising, as it is all over the country. The County, the hospitals, the doctors, the clinics, the social services--everyone is working to do what they can to see that people have access to medical care. Yet there are many gaps. For instance, access to primary care is much more available than access to specialty care. To address this crisis, Durham CAN and a critical mass of major players: The Durham-Orange Medical Society (doctors), the Department of Social Services (records and referrals), the Lincoln Health Center (free and low-cost clinics), Durham County (health care funder), Duke (major charity care provider), and major insurance providers, have agreed to participate in Project Access. It should make available specialty care for thousands of patients a year who might otherwise let themselves get so sick that they end up in the emergency room getting crisis care, or even worse. It is an effort to fill gaps that could only happen if people start making relationships for the purpose of serving the public good.