by Susan Gust
Northwestern Hospital began in 1882 in a humble abode with a simple mission —to serve the community by aiding its women and children. This is truly a well-intended and honorable goal. It is not that different now from the many human service nonprofits in our community which begin with the singular, compelling and well-meaning goal of service to specific populations or need in the community. But, even with the best of intentions and most stellar delivery model, there is a power imbalance in the “service” model. There is a community or specific group of people that need to be served and those who are deemed to be the “servers”, usually because of their relationship to privilege, race and/or class.
This seems to have been true as one reflects on the development of the health care industry that is so rooted in the Phillips Community, in particular. The health care-providing institutions changed, evolved and grew bigger, not always any longer addressing the needs of the surrounding geographic community but often addressing the needs of people in a 5-state area. But, the surrounding geographic community changed, evolved and grew bigger, too. The relationship between the institutions and the geographic community waxed and waned, struggled and achieved over the decades. Agreements were made on how many square blocks could be consumed by the buildings for delivery of health care. Agreements were broken. A Community Advisory Committee (CAC) was formed by Abbott Northwestern as a place to have debates and dialogue. Now it has been disbanded. People come, people go. Sometimes harsh words were aimed from various sides of the spectrum with the intention to do harm.
The institutions had power through place and size and by virtue of being an institution dealing with the health of people, no less. The very essence of dealing with people”'s health elevates an institution to a towering place of authority. But, the surrounding neighborhood also had power through place, size and by being “of the people”. Appearing to be the proponents of practicing democracy presents a justifiable righteousness over the economics of a corporation, nonprofit or for profit.
Regretfully, there was never much talk directly around the issue of power and the dynamics of power and how to serve a community together. The neighborhood tended to use the same “power over” strategies that it saw institutions use on them. The CAC was an attempt by A/N to recognize the power that the community had and to provide it with some voice. But, again, the CAC was established largely by the institution with input from individual community leaders. There was not a direct conversation about the balance of power or shared power or how to work together for the common good or the health of the community.
Maybe that won”'t be possible because human beings and the institutions they create are so accustomed to the “power over” model. We learn this model over and over again just growing up. We see it practiced by corporations and capitalism or experience it through oppression, violence and/or abuse. We have plenty of opportunities that help us internalize this approach.
My hope is that the Backyard Initiative will either directly or viscerally teach us all about creating a new, shared power process whereby there is a common understanding that what is best for the community is the best for “us”, whether it is an individual, a family or an institution. The jury is out on whether that can happen. Yes, there has been a lot of dialogue so far. But, there was a lot of dialogue over many years, too. The difference is that this dialogue seems aware of the context of the conversation and the issue of the responsible use of power. We all have power. It is our understanding of how we use it that matters in the end. I am throwing my hat into this ring full of purpose and commitment to think and learn alongside of others, building a model of shared power that will hold the work that is bound to come.
