In 1991 in a small town in upstate New York—New Berlin, physician Bill Thomas became the medical director of Chase Memorial Nursing Home. That Home cared for eighty elderly and disabled residents. Bill Thomas was not really drawn to nursing homes—it was more like Chase Memorial was in the right place, he lived in New Berlin already, the pay was right and a new job would be a change of pace for him. He was tired of working at the New Berlin hospital. He soon regretted his decision. Life at the nursing home was depressing. The residents were despondent and despairing. And that made the staff despondent and despairing, too.
Since Bill Thomas is a doctor, the first thing he did when he started his new job, was to try to perk up the residents medically. He reviewed the patients’ files, paying special attention to their medications—were they over-medicated? In a stupor? Did they need MORE medication? Anti-depressants maybe? No, the problem at the nursing home didn’t seem to be related to medicines.
Then, out of desperation really, Bill hit on an idea. To perk up the residents and staff, he would bring NEW life into the Nursing Home! Lots of new life. With some resistance from the nursing home staff, they knew Bill to be a dreamer-- he applied for a federal grant to try an experiment. The proposed purpose of the experiment was to bring plants and animals to Chase Memorial. To the staff’s shock and then consternation, Chase Memorial won the grant! And so began Bill Thomas’ experiment, which would eventually change nursing home culture around this country.
The experiment: Bill Thomas and the nursing home staff threw out all the artificial plants and replaced them with REAL ones. Then, because Bill Thomas didn’t believe in doing anything halfway, or in increments, he forged ahead, moving in four dogs, two cats, a colony of rabbits, a flock of laying hens, and some parakeets.
The fiasco over the parakeets gives you some idea about how Bill Thomas operates. A methodical planner he is not. He ordered 100 parakeets. These were delivered all on the same day. But there were no birdcages—yet. And so the parakeet delivery person released all 100 birds into the nursing home’s beauty salon, shut the door and left. The cages arrived later that day. But they had to be assembled. Talk about putting life into a nursing home! The staff spent hours on their hands and knees assembling cages—then they had to run around the salon catching birds, feathers flying. Describing the situation later, Bill Thomas says that the residents stood outside the salon’s picture window, watching the fracas and according to Thomas, “laughing their butts off.” Finally, all 100 birds were caught and deposited into cages, and the cages delivered to the residents’ rooms. Whew!
At first, the nursing home staff felt incredibly overwhelmed, to put it mildly. There were plants to water, bird cage and rabbit hutch floors to line with paper, kitty litter to change and dogs to walk. And, of course, all the animals had to be fed and watered. But that was just at first. Slowly life got better—actually, A LOT better for both the staff and the residents. That’s because the nursing home’s residents began (pause) coming back to life. They offered to help with the watering, the cleaning and the feeding. Bill Thomas says, “People who we had believed weren’t able to speak started speaking. People who had completely withdrawn and were non-ambulatory started coming to the nurses’ station and saying, ‘I’ll take the dog for a walk.’”
Just to give you some idea of how people responded to the change…Mr. L, and his wife had been married for 60 years. When she died, Mr. L despaired mightily. Then he crashed his car, and the police who came to the scene suggested to Mr. L’s family that that crash could have been a suicide attempt. The family decided to move Mr. L. to Chase Memorial Nursing Home. He sat by himself in his room all day, every day, staring at the walls. But then came the experiment. The staff brought to Mr. L’s room, a cage with two parakeets. He listened to the the birds chirp. He watched them hop around their cage. He watched them eat. Eventually he began telling the staff, which bird seed HIS birds seemed to like best. Finally, Mr. L. took over the feeding of his birds. Then, one afternoon, Mr. L walked out to the nursing station and offered to take Chase Memorial’s greyhound dog for a walk. That became routine. Three months after he began walking the dog, he checked out of Chase Memorial and returned to his own home.
Since this experiment was funded by a grant, the staff had to keep records--records of things like conversations between staff and residents, medicines dispensed. Guess what? The number of prescriptions the residents required dropped by half. Death rates dropped dramatically, too. And Bill Thomas? Well, he was as surprised as anyone.[i]
Other nursing homes around the country are now taking seriously Bill Thomas’ findings, and many have or are in the process of adopting his practices. Chase Memorial is still at the forefront, though, turning nursing homes into active, thriving communities. Today Chase Memorial boasts even more plants and pets; it has added a daycare center for the staff’s children; and it has a partnered with a nearby elementary school. Residents at the home provide afterschool tutoring and mentoring to the students. Cool huh?
Now, with that background, I want to share with you something called Maslow’s hierarchy of needs. Abraham Maslow was a psychologist. In 1943 he presented a paper in which he described what it is that motivates people to do what they do. That paper circulated the globe and his theory is probably in every psychology 101 textbook that has been published since the late 1940’s. It’s often presented as a triangle divided into horizontal strips. Do you know what I’m talking about? What is Maslow’s hierarchy of needs?
Let us imagine that you have always been drawn to the water, to the ocean. You learn to sail and then, you buy a sailboat. One day you are out alone, sailing; a storm comes up, your sailboat wrecks. You are lucky enough to wash up alive on some island. It seems to be a deserted island. The first thing you are going to do is search out food, water and shelter. That’s your primary motivation—meeting your BASIC NEEDS. Basis needs is first on Maslow’s hierarchy of needs. It’s the bottom strip or rung of the triangle.
So you search out and find that food source, that water source. And you find a cave to shield you from the hot sun, and storms. For awhile life is pretty wonderful, but then you think, “Life would be a lot MORE wonderful, if I didn’t have to worry about being attacked by mountain lions every time I stepped out of my cave.” Your next motivation, then, is SAFETY. Again, that’s exactly what Maslow says. First comes basic needs, bottom of triangle, then comes safety—little bit further up on that triangle. So let’s say you make a bow and some arrows to protect yourself from those mountain lions.
Again, life is pretty wonderful until…..you decide, “I sure am lonely!” You pack up some food, and your bow and arrows, and you follow your water source, a stream, and low and behold, you discover a tribe of pygmies living on the other side of the island. They invite you to live with them. You soon learn their language, and eventually you marry one of them. Congratulations! Maslow says that all human beings need love and they need to belong.
But we are still only half way up the triangle, that is, Maslow’s hierarchy of needs.
We have two motivators to go. You are fairly certain that this pygmy tribe is unknown to the rest of the world, and those pygmies don’t know how to write. So you go about interviewing them, and writing down their stories. Did I mention that you just happened to have rescued a pen and some paper when your sailboat wrecked? Your hope is that one day the island will be discovered and then you will become a world renowned explorer and writer. Abraham Maslow says that after our basic needs are met, after we feel safe, after we know the supreme joy of being loved, we all strive for recognition. You, we all, want to be well-regarded, and valued by our peers.
But we’re not done even yet. The one thing you were drawn to early in life, is sailing. Now you decide to return to that. Over many years you design and build yourself a sailboat. It’s the perfect sailboat. You give sailboat rides to your pygmy friends and family members. Life is very wonderful indeed. You have reached the very highest motivator on Maslow’s hierarchy of needs. Drum role. The apex of that triangle is “Self actualization.” Self actualization. By that Maslow means reaching one’s full potential. To be the most you can be. It involves mastery.
That is where psychology textbooks usually leave off, but actually Abraham Maslow didn’t. Late in life he realized that self-actualization really ISN’T the be all end all. There is something else that humans strive for, that completes them—something that we are made for, that tops even self-actualization.
So let’s imagine that NOW you are living the perfect life. All good things eventually come to an end, though, right? The people on that island are hit by an epidemic. It’s serious. People are dying. You know it is up to you to find help. You pack your sailboat with food supplies. Then you sail off into the sunrise, waving goodbye to the islanders, your friends and family members, who have lined up on the shore to see you off. Maybe you’ll find help, but if not, you will die trying.
That is what completes you—us—giving ourselves to some higher goal. Sounds vaguely religious, don’t you think? Maslow called it transcendence. Transcendence. He says the self only finds its actualization in giving itself to some higher goal, in altruism; in spirituality.
And that is what Bill Thomas ultimately came to understand in his experiment at Chase Memorial Nursing Home in New Berlin, New York. Men and women, with all manner of health concerns and disabilities, found ways to work around those, in their care for plants and animals, and later, elementary school children. They came to life giving themselves to some higher purpose. As Bill Thomas himself said, “There is a fundamental human need for a reason to live.”
And that of course, is also what Jesus knew, and what he tries to get across over and over again. We can store up treasures for ourselves, but to what purpose? The only thing that completes us, the only thing that has lasting value, is the gift of ourselves in God’s service.
This very day our lives are being demanded of us. And the things we have prepared, whose will they be?
[i] This story is told in much greater hilarious detail in Being Mortal: Medicine and What Matters in the End, a book by Atul Gwande, published by Metropolitan Books; Henry Holt and Company, New York; 2014.