No One Dies Alone
A faithful hand in life and death
by Maddie Pillari; illustration by Charlotte Wall
I pray on airplanes.
Two times—once right before takeoff and once after landing. I say one Hail Mary and one Our Father. I cross myself the way I was taught, the way I have since I was young. I don’t believe in God anymore, at least not in the proper, liturgical sense. I don’t know exactly when it changed. Maybe after I watched Sister Beyeman march to the squirming eight-year-olds during Mass to scold them. Maybe it was the triumphant anger on her face when she caught them giggling to each other as the fumbling priest shakily bowed to the altar, a wrinkled hand gripping the edge of the wood. The way some of the spittle of her shushing remained on the corner of her lips as the young girls’ backs immediately hit the back of the pew, the way their are hands instinctively clasped together in their laps and their heads bowed, shrinking away from this sister of God, this servant of Christ, this deliverer of the good news. How she walked away after, head high and a weird smile on her pursed lips. The way she relished her small victory. I watched her lips purse again after receiving communion, Christ’s flesh dissolving in her mouth like salt on ice. I know I’m being unfair, but I can’t shake the image.
When I pass car crashes, I cross myself, kissing the thumb of my fisted right hand. When people ask if I believe in God, I tell them I am a spiritual agnostic, or maybe a spiritual apatheist. I haven’t been to Mass in four years, not even on Christmas or Easter, and I miss it sometimes. The first chapel I’d stepped in since high school was the one I visited a week ago, at Penrose St-Francis Hospital. It is the Sacred Heart chapel. From 5th-12th grade, I went to Convent of the Sacred Heart. Funny how I’ve somehow come full circle.
I found myself talking to Leslie Schwender, the assistant to the South State Vice President of Mission and Ministry, Lawerence Seidl. Schwender had been working at Penrose for 23 years. She misses the Sisters who have passed away and showed me photographs of some of them from when they were young, standing in front of a chapel that has since been torn down and replaced by the one we were sitting in. Its aesthetic is modern, angular and bright, so unlike the pictures Schwender showed me of the older version, with its marble alter. We sit in chairs, not wooden pews. This chapel will be replaced again next year. The $100 million renovation and expansion of Penrose St-Francis has already begun. The hospital’s sponsor, Catholic Health Initiatives (CHI) provided $60 million. CHI has already spent over $200 million in the opening of Penrose-St. Francis. The new project is estimated to be completed in 2018 and will feature an additional 134,000 square feet.
CHI is the country’s third-largest nonprofit health system, operating in 18 states and sponsoring 103 hospitals. In 2015 alone, CHI provided $970 million to its hospitals for programs and services like free clinics, education and research. The health system officially began in 1996 when 10 congregations of sisters merged. 20 years later, the health system has total assets of approximately $23 billion. CHI also reports providing care for 7.2 million outpatients and 503,285 inpatients. Their mission statement: “To nurture the healing ministry of the Church, supported by education and research. Fidelity to the Gospel urges us to emphasize human dignity and social justice as we create healthier communities.”
Statistics show the number of Americans who identify as Christian shrinking as fast as CHI is growing. In 2007, 78.4 percent of America identified as Christian. In 2015, the number dropped nearly eight percentage points to 70.6 percent. The same study found that the number of those who did not identify as religious has grown six percentage points from 2007 to 2014, from 16.1 percent to 22.8 percent.
CHI has four guiding principles: Reverence, Integrity, Compassion and Excellence. Integrity, compassion and excellence are all arguably secular. Reverence, however, not as much. CHI defines Reverence as “Profound respect and awe for all of creation, the foundation that shapes spirituality, our relationships with others and our journey to God.” In their online “Corporate Responsibility” packet, there is a section named “Ethical and Religious Directives,” which is divided into six parts and “provides guidance in applying the moral teachings of the Catholic Church when handling select ethical issues in health care.” It is in this section that CHI addresses abortion. The fourth division in the Ethical and Religious Directives section of the Corporate Responsibility packet is, “Issues in Care for the Beginning of Life—Catholic health care ministry is rooted in a commitment to respect the sacredness of every human life from the moment of conception to death.”
But, inevitably, modern medicine and religion have clashed. When Jeremy Stodghill’s wife and unborn twins died on New Years Eve in 2006, Stodghill filed a wrongful death suit against CHI on the grounds that his twins could have been saved by an emergency C-Section that doctors did not perform at the time. CHI won the six-year legal battle, with a defense based around the argument that in Colorado, the law states that fetuses are not people with legal rights because they are in the womb. In a Huffington Post article, Stodghill’s attorney, Beth Krulewitch was quoted saying, “They won, and they won with an argument the Church said publicly—and they agreed publicly—was immoral.” And they did. In a statement released February 4, 2013, CHI writes,
CHI has agreed that attorneys for St.Thomas More Hospital will not cite the Wrongful Death Act, which does not allow fetuses to sue, in any future legal hearings of this case. Although the argument was legally correct, recourse to an unjust law was morally wrong…CHI pledged its firm commitment, as always, to the best interests of patients and its adherence to the moral obligations of the Church, which were not strictly followed in this case by attorneys for the hospital.
According to an article in The Gazette, in the United States, one in every six people hospitalized are taken care of in a Catholic hospital. Penrose-St. Francis hospital, and Catholic hospitals run by CHI or other Catholic health service companies do not perform abortions. The same article cites Rev. Thomas Paprocki, an auxiliary bishop from Chicago, primed to be St. Louis’ next archbishop, commenting on the issue during the United States Conference of Catholic Bishops in Baltimore. “It would not be sufficient to withdraw our sponsorship or to sell them someone who would perform abortions. That would be morally unacceptable cooperation in evil.” He also said that if a law were made that forced Catholic hospitals to perform abortions, all Catholic hospitals would be closed. All 624 of them. Such an action would displace 600,000 employees, not to mention the tens if not hundreds of billions of dollars required to open new hospitals to service patients. Basically, it’s not an option.
The American Civil Liberties Union (ACLU) states in their most recent report, “In America, religious freedom is a fundamental right. But it does not grant hospitals the right to force their religious beliefs on patients or discriminate by closing the door to patients.”
But there are emergency situations, as in Stodghill’s case, and similar cases, in which doctors have to make the call, and make it fast, in order to save a life.
All of this begs the question: what place does religion have in our legal system, specifically in healthcare?
Penrose St-Francis is a religious hospital, and does not hide the fact. There are obvious negative complications that a faith-based or religious hospital encounters. Stodghill is the perfect example. But, without this religious start, there would be no hospital in the first place.
The hospital was once run almost entirely by nuns. In 1958, under the direction of Sister Cyril Mahrt, the hospital cared for 37,265 patients, making Penrose-St. Francis the largest hospital in the Catholic Archdiocese of Denver. It was under Sister Cyril that the hospital rose to national standing. The sisters lived on the 12th floor of the hospital.
The main entrance of Penrose features a statue of St. Francis and a massive glass wall with a verse from the Book of Matthew: “Come to Me, all who are weary and heavy-laden, and I will give you rest” (Matthew 11:28).
Penrose, as well as its sister hospital St. Francis Medical Center in Colorado Springs, along with many hospitals across the country, offers a service called No One Dies Alone, or NODA. The volunteer-centered program that started in Eugene, Oregon at Sacred Heart Medical center by ICU nurse Sandra Clarke. On Clarke’s website (www.how-we-die.org), Clarke states that her inspiration to start NODA began with a single patient, an elderly man with an end-stage multi-organ disease with a DNR and no family. Clarke remembers,
“One rainy night at Sacred Heart, I had a brief encounter with a man whose name I cannot recall, a man I shall never forget. He was one of my seven patients, near death and a DNR. During my initial rounds, he asked, barely audible, “Will you stay with me?” He was so frail, pale, old and tremulous. I said, “Sure, as soon as I check my other patients.” Vital signs, passing meds, chart checks; assessments and bathroom assistance for six other patients took up most of the next hour and a half. When I returned he was dead. I reasoned he was a DNR, no family, very old, end-stage multi-organ disease; now he was gone, and I felt awful. It was okay for him to die; it was his time—but not alone.”
The reasons Clarke began NODA, which officially started in 2001, were not religious, despite the Catholic hospital where she was employed. On her site, she says, “I am not an especially pious person,” but she does have “a strong belief in human rights, particularly when a person is most vulnerable.”
St. Francis Medical Center implemented the service in 2009 when Chief Nursing Officer Kate McCord learned of NODA at a conference and decided to try to bring it to her hospital. She worked with chaplain Theresa Gregoire in getting the program up and running. NODA is run through the Spiritual Care Department at St. Francis. Gregoire is currently in charge of NODA, and her commitment to her faith is evident in the way that she runs the program. I met with Gregoire at St. Francis, and she showed me the Medical Center’s chapel. Similar to the chapel at Penrose, there were chairs, not pews. Gregoire informed me that the hospital decided to replace the pews with chairs when the chapel was built in 2008 so that the space was more “interfaith.” Gregoire explained that the chapel is a space for anyone and everyone, and although there is a Catholic Mass at noon four days a week, the chairs transform the chapel into a different kind of religious or spiritual place.
“People who come into that chapel, my guess, it might not be so much for gratitude but it would be for prayers,” Gregoire said. “But I think they find comfort. And especially people whose faith tradition is part of that belief, to be able to come into our chapel brings comfort.”
As head of NODA, Gregoire spends time with people of all different religions and belief backgrounds. She wears a pager 24/7, except when on vacation, in which case she delegates the task to a volunteer. She runs a group of volunteers, “around 40, and just like any organization, maybe 25 are really active.” She describes the group as “incredible,” and invaluable to the service. They have five to six gatherings a year, and again the theme of “interfaith” is prominent. “In July, we had somebody from the Native Americans come and speak about Native American beliefs,” Gregoire recalled. “And in October, we had a gentleman who is a professor at UCCS who came and talked about the beliefs of atheists and agnostics, and we had someone from the Buddhism faith come, from Muslim, just so we’re acquainted with and understand the different customs.”
St. Francis Medical Center provides extraordinary measures for patients who want to receive communion but cannot make it to Mass. Mass is televised and broadcast on channel 15 so patients can watch in their room. As a chaplain, Gregoire is in charge of helping to run these services, along with the NODA program.
But not all patients, as Gregoire notes, are grateful for the Chaplain’s presence. “They do lash out at you,” Gregoire said. “If they had a positive experience with the church, being the chaplain is a good thing. If they’ve had a bad experience with the church, then you get a bad reaction. My hope always is that I can be present and offer that care and compassion.”
Despite being the scapegoat for some of the anger and frustration that grief inevitably incites, Gregoire tries not to take the insults she has received over the years personally. She noted the “vulnerability” of a person in the hospital.
“You find sometimes you become a container for the people,” Gregoire said. “When I first started I thought about this a lot. Especially the ones that are angry, and of course, grief is a hard thing and everyone manifests it in a different way, but a lot of people get really, really angry.”
As a Chaplain, Gregoire is called to the Emergency Room whenever there is a “trauma,” which the hospital and medical center define as damage to one or more organs. Gregoire’s job is to be with the family. She often takes them to what she calls “the quiet room.” It is in this room that distressed loved ones sometimes lash out at Gregoire or beg for information she cannot provide.
“The family is usually freaking out, ‘just tell me, just tell me,’ and that’s hard.” Gregoire said. “But it’s also a sacred time to be with people. We are with people at the beginning of life and the end of life, and those are hard times.”
When I asked Gregoire if she found a clashing of science and religion, she said that her job as Chaplain had less to do with Catholicism and more to do with providing compassion, and making sure that she can be as emotionally and spiritually supportive as the patient requires. She views the hospital’s religious affiliation as a positive. “I think the fact that we are a faith-based organization helps a lot because chaplains are an integral part of the team that works with the patients, and so for the most part, people are happy when the chaplain comes.”