Life is messy, take part

James Baker's political vocation sheds light on why character counts in this networked world.

Emerson Csorba

Emerson writes on geopolitics. He is also a business executive and holds a doctorate in theology.

Two men in seats adress a pyjamap-clad Ronald Regan.

James Baker, left, briefs a recovering Ronald Reagan, right, in hospital .

White House via Wikimedia Commons.

Few White House Chiefs of Staff have been better than James A Baker III. Nicknamed the ‘Velvet Hammer,’ Baker was originally a Democrat, and only introduced to politics in his forties. But he made up for lost time, serving as the original catalyst behind President Ronald Reagan’s time in the Oval Office. He later served as Secretary of State, helping maintain peace following the Cold War.

In their recent biography of Baker, The Man Who Ran Washington, Peter Baker (no relation to James) and Susan Glasser write that, when called out of his retirement to lead the Republican strategy in the Bush-Gore 2000 Florida vote recount, ‘Baker’s reputation was so formidable that Democrats knew they would lose the moment they heard of his selection.’ More precisely, Baker ‘was not defined by his era; he helped to define it.’

And yet, the calm, cool and collected former Texas lawyer was – by the end of his tenure as White House Chief of Staff – broken. In Chris Whipple’s The Gatekeepers, a history of American White House Chiefs of Staff, a former Reagan staffer reflects that in a conversation long after their tenures, ‘Baker’s eyes filled with tears. He told me what it had been like for him to be chief of staff in a White House riven by different philosophies and ideological outlooks. And every day various people would try to take Jim Baker out.’

Baker, a problem-solver and political moderate, battled with his more ideological counterparts for the ‘soul’ of the Reagan presidency. This battle was ‘more emotionally grueling and deeply painful than almost anyone around him knew.’ His struggles were a harbinger of the more divisive American politics to come. Surrounded by long-time Reagan loyalists, he was an unexpected selection for the Chief of Staff role. He ran the Gerald Ford and George Bush presidential campaigns against Reagan but was recognised by the Reagans as the right person for the job. Baker kept focused within the Reagan Administration despite team members undermining him.

Baker shows that responding to a call requires that a person engage in the world as it is. This realism helps us to reform the world through service.

Through his participation in the world, Baker reminds us that life is messy. This is especially the case when engaging in communities involving competition between multiple worldviews, philosophies, or ideologies. Keeping the ship steady amid such variation comes with emotional cost. But participation is better than withdrawal from the scene of action, and into the safety of technology.

Balancing between perspectives requires a personal sense of restraint. Peter Baker and Glasser note, for instance, that ‘one of the keys to Baker’s success over the years was knowing when to back off’ in meetings. This balancing is difficult. Baker succeeded in his political vocation in part because he participated in this swirling mix of perspectives, but the balancing involved suffering.

What can we learn from Baker on the messiness of life? What does he show us about the living-out of a vocation? Baker was clear-eyed about his calling: that of serving his friend Reagan (and afterwards his close friend George Bush). He put his strategy and negotiating skills to good use as part of a larger life project. This calling strengthened Baker’s persistence, despite the trials and tribulations of participation in the world. Baker shows that responding to a call requires that a person engage in the world as it is. This realism helps us to reform the world through service.

‘Once we remove ourselves from the flow of physical, messy, untidy life… we become less willing to get out there and take a chance.’

Sherry Turkle

How did Baker discover his political vocation? And what is a vocation? The philosopher Robert Adams defines vocation in his Finite and Infinite Goods as ‘a call from God, a command, or perhaps an invitation, addressed to a particular individual, to act and live in a certain way.’ The theologian Oliver O’Donovan defines vocation somewhat differently in his Finding and Seeking. He describes it as ‘the way in which the self is offered to us…. The course of our life that will come to be our unique historical reality.’ O’Donovan focuses on service, where vocation is ‘not a single function, but an ensemble of worldly relations and functions through which we are given, in particular, to serve God and realise our agency.’

Sometimes, as O’Donovan suggests, a calling captures our attention, even if we only know the immediate next step, as if stepping from a quayside onto a boat (a helpful metaphor used throughout O’Donovan’s work). For Baker, it was the death of his first wife that precipitated a call from his friend George Bush. In this conversation, Bush asked whether Baker would be interested in volunteering for a campaign, to help take his mind off his grief. What was initially a way to help keep his mind off a trauma became, over time, a life project.

Baker thought carefully about the world and the people around him as precursor to action. He epitomised the thinking of Dietrich Bonhoeffer, who writes that individuals should participate ‘in the times and places which confront us with concrete problems, set us tasks and charge us with responsibility.’ We must remember that people are multidimensional. This is not easy, Baker as a case in point through his political vocation.

Unfortunately, while recognising this is a realm of considerable debate, aspects of our culture discourage genuine engagement in the world. Sherry Turkle, Professor of the Social Studies of Science and Technology at MIT, describes ‘networked life,’ where individuals use technological devices (we might think today of WhatsApp or Instagram) to withdraw from hard, in-person conversations. She says that people nowadays tend to communicate with others on their own terms. It is easy for people to engage – or disengage – others whenever convenient.

Yet, as Turkle writes, ‘Once we remove ourselves from the flow of physical, messy, untidy life… we become less willing to get out there and take a chance.’ Networked life is for Turkle an escape from the messiness of life. It prevents encountering others as they really are. This leads to weak personal foundations: personal characters built on sand rather than on rock. It helps to be tested by conflict with others that are different than ourselves. This testing helps to reduce narcissism, in which we think more about ourselves than about the wider world.

Marshall McLuhan, in his Understanding Media, reflects on the Greek word narcosis meaning numbness. The service of networked technologies, to which Turkle alludes, is in McLuhan’s eyes a worshipping of these technologies as God. This numbing via the worshipping of technology is contrary to Baker’s more engaged way of life – encountering others in person in their complexity.

We can remind ourselves that life is messy. What we think we see upon first impressions may evolve upon continuous examination. And what is previously unseen may become evident over time. Jesus states that ‘For nothing is hidden that will not be disclosed, nor is anything secret that will not become known and come to light’ and later, that ‘Nothing is covered up that will not be uncovered, and nothing secret that will not become known.’

The genius of James Baker was found not in academic intellect, but in his ability to understand others through real engagement in the world. This understanding of others, serving them, was the cornerstone of his vocation. Former White House speechwriter and now-columnist for the Wall Street Journal Peggy Noonan once commented – as reported in The Gatekeepers – that Baker ‘was a guy who didn’t seem to move forward with a lot of illusions about life or people or organizations or systems.’ Baker embraced the messiness of life, but also the importance of taking part to serve others and help restore the world.

Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.