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ROAMIN' CATHOLIC

Contents © 1999
by Jim Holman.
All rights reserved.

We Are Here for Life

SKETCH OF A CATHOLIC HOSPITAL

By James McCoy

There's pain that can be caused by pinched nerves; there's pain that can be caused by fractures; there's pain that can be caused by cancers. But there's no pain like no pain, said Dr. Michael Minehart, an expert on pain. "When you take pain away, you also take away the protection of that patient to know what they were doing was hurting them," the pain management clinic director said. "Our purpose in this field is to make half of the pain go away."

If half a pain is better than none, physical pain cannot be the ultimate evil. "The opposite of salvation," wrote Pope John Paul II in his 1983 meditation on redemptive suffering (Salvifici Doloris) "is not ... only temporal suffering, any kind of suffering, but definitive suffering: the loss of eternal life, being rejected by God -- damnation. The only-begotten Son was given to humanity primarily to protect man against this definitive evil and against definitive suffering."

Whether the suffering be physical or spiritual, Santa Teresita Hospital in Duarte is able to grasp both as it continues Christ's mission of healing. But that ability to embrace simultaneously that which the modern mind considers contradictory is not the only reason the hospital run by the Carmelite Sisters of the Most Sacred Heart of Los Angeles has been described as "medieval." "First of all, our religious garb," said Sister Michelle, the associate administrator, "I mean that's obviously a factor." The 60 sisters attached to Santa Teresita (named after "Little Therese" -- St. Therese of the Child Jesus was a Carmelite nun) can be seen doing everything in their Carmelite habits, from answering phones to cleaning up after surgery. "Even inside the convent we wear it," Sister Michelle said.

The habit is a reminder to the religious of her consecration to Christ, just as the religious is a reminder to the layman that there is another, eternal life. This habitual reminder, far from being a pharisaical nicety, seems to have steeled the sisters, ranging in age from early 20s to 91, for the fight for their hospital's Catholic identity. "We won't compromise," Sister Michelle said, "and some are being forced almost to compromise in what they do in Catholic health care. A [Catholic] hospital told me earlier this year that they were trying to find a loophole to do sterilizations; and I said, there are no loopholes."

The U.S. bishops said the same thing -- of course, more pastorally -- in their 1994 document entitled Ethical and Religious Directives for Catholic Health Care Services. "We'd close," Sister Michelle said, "if we were forced to do something that was against the Ethical and Religious Directives, against Church teaching."

There are 142 patients in the 156-bed long-term nursing facility; acute care, which includes maternity, surgery and intensive care, has 97 beds but currently only 20 patients staying an average 3.2 days. "The financial picture of hospitals is very precarious right now," Sister Michelle said. "In the realm of health care, we're in the same boat.

"Say, for example, we have a Medicare patient come in," she went on, "the government pays us one price for that diagnosis; that's all we get.... We receive about 43 cents on the dollar." So how do you scrounge up the other 57 cents? "We have to reduce our hours of staff," Sister Michelle said (there are 470 paid employees, not all are full-time). There are "a lot of volunteers," said Sister, "like maybe 250; right now we have 150 young volunteers from 34 schools in the area," she said, smiling proudly. "We cannot have too much labor. We also have a lot of trust in Providence. We have what we need; maybe not what we want.

"We always pay payroll," Sister Michelle went on. "But sometimes vendors have to wait for their payment. When cash falls short ... well, we continually pray."

Both volunteers and staff are invited to a pro-life in-service every Monday. "We have a program Monday at noon for a half-hour talk and free lunch."

"This week's in-service," an older Carmelite Sister said the following Monday, "is on embryo stem-cell research. It's very controversial and very intense.... We want you to be well-versed in defending human life, and embryo stem-cell research is an attack on human life." About 30 lay people, sitting at long tables with burgers, salad, and sodas before them then watch an EWTN-TV news show on a giant screen. About 15 sisters are also eating and watching Raymond Arroyo interview Dr. Edmund Pelligrino of Georgetown University's Center for Clinical Bio-ethics. "Stem-cells are pluripotential," Pelligrino explains, "they have the capacity to develop into all sorts of cells." They are pirated from frozen human embryos, of which there are more than 100,000 in this country. "The fact that it's an early, early human being doesn't take away [the fact that] it's still murder," Pelligrino says.

"We live in a sick society," one sister mutters. The video is a half-hour long; when it's over, the first set of sisters and health-care professionals file out and another set, equal in number, comes in to see the second screening.

The following Monday shows that attendance at these pro-life in-services holds steady. I ask Luz Anguiano, an activity coordinator, why she and her fellow hospital employees come back week after week. "I guess we learn from it," she said.

Just outside the "Pink Room" where it's held I run into Mike Costello, the former administrator of Santa Teresita, who now serves as a consultant (Robert Shell is the current administrator; before Costello the hospital had the same administrator, a sister, for 54 years). California Governor Gray Davis recently signed into law bills mandating that HMOs and insurance companies pay for contraceptives just like any other prescription drug. Catholic activists who opposed the legislation said that it would force Catholic institutions to drop prescription coverage as a benefit for their employees; but Santa Teresita hospital, which has its own employee health insurance plan, managed thereby to be exempt from the new law. "It's a federal exemption that allows employers to provide certain benefits like a self-insured health plan," Costello said. Normally, "an insurance plan has to be owned and operated by an insurance company" -- and such are subject to the new law. Although the hospital's employee health insurance plan has been approved by the state and provides the same services, it's not an insurance company -- and therefore gets out of paying for contraceptives (including the FDA-approved RU-486, which is an abortifacient) on a technicality. Costello smiles: "And that's a good thing."

"I think most people who come here know what our philosophy is," Sister Michelle told me in her office in the administration wing. Once or twice a year, however, in their application of a Catholic healthcare conscience to difficult situations (a work of mercy which the U.S. bishops have especially charged Catholic healthcare institutions to do), the hospital has to deal with someone who thinks otherwise. For example, a relative of a long-term patient being fed intravenously "wanted everything stopped," Sister Michelle said. "Well, the real reason wasn't the feeding tube; it was the pain management." After the patient's pain was better relieved, the relative was relieved, too.

"Our job as a healthcare facility is to relieve people's pain in a way that helps them to function better, not to take away their life," Sister Michelle said. "We do what we can. We have a pain management program here." Dr. Minehart practices the latest in therapies, such as actually freezing nerve endings, she said. Too much pain makes it too hard to pray. And that makes Catholic patients lose contact with "the captain of their salvation made perfect through sufferings," as St. Paul puts it.

"The first one we can look to is Jesus on the cross -- His response was acceptance" of suffering as his Father's will, Sister Michelle said. "Our mission here is to bring people to the kingdom, to tell them the good news of the Gospel. We are here for life."

When I tell Sister Michelle about the pope's letter on what he calls "the Gospel of suffering," she straightway turns to her computer and tries to find it online. Sister Michelle closes about a dozen windows in which she has been working to free up the computer to receive Salvifici Doloris. "Oooh," she exclaims, "there's a whole Latin document, an apostolic letter." She begins printing out the pope's meditation for her own meditative reading (the sisters pray daily in community from 5:20 to 7 a.m. every morning, and that includes meditation, Mass, the divine office; afternoons they make a holy hour, including the Rosary). "He's so profound," Sister Michelle says. "We love every word that comes from him."

Medicine, Pope John Paul II wrote, "as the science and also the art of healing, discovers in the vast field of human sufferings the best known area, the one identified with greater precision and relatively more counterbalanced by...methods of therapy." I asked Dr. Minehart whether medicine will one day be able to counterbalance every single possible pain, and he replied with a surprisingly absolute affirmative.

Minehart grew up in Panama (though Jewish, he went to a Catholic elementary school run by nuns) and went to Columbia to get his M.D. in anesthesiology. He came to the States in 1986, interning at Los Angeles County Medical Center, which is affiliated with the University of Southern California. "The field of anesthesiology always interested me," said Minehart, who is Santa Teresita's chief of anesthesia, "but the field of pain management was always a field of interest to me since I would be in contact with the patient more instead of just giving them anesthesia, putting them to sleep."

It was at County that Minehart began research into pain management as part of the team testing "the different analgesic drugs that are today used," such as Advil. He found such research rewarding "because we had only Tylenol before, and some of the patients' [pain] could not be controlled" since they could take neither Tylenol nor aspirin. "It was very rewarding to have the opportunity to see someone get better. We have to remember that our field is only limited to our current medical knowledge and there are many conditions that we can't totally correct."

What is pain, from a medical viewpoint?

Dr. Minehart reads from a document published in Seattle, Washington by the International Association For the Study of Pain: "'An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.'" He looks up, smiling: "Another definition is, whatever the patient says hurts.

"The most important thing is to listen to what the patient is telling you," Minehart went on, "and to try to determine what areas need to be treated, for the purpose of diagnosing."

As far as treatment goes, the latest in pain management is blocking certain nerves; "it's a progression of our specialty to block more and more specific nerves," Minehart said, pointing to the spinal chord of the skeleton on his desk.

What's it like working for the sisters?

"Very pleasant," Dr. Minehart replies, "because I went to Catholic school and I'm very fond of the nuns who throughout the whole country -- and the whole world -- have helped humanity significantly."

-- from the Los Angeles Lay Catholic Mission, December 1999

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