Wednesday, November 30, 2016

A Centenary

Today is my mom's 100th birthday.  Her death in May 2009, six months short of her 93rd birthday was sudden but hardly unexpected given her extreme old age to say nothing of the medical problems that were beginning to crop up.  I am grateful for her life.  I am also grateful that I arrived home about an hour before she died and was able to give her absolution and last rites.  She died about twenty minutes after the anointing sitting in her chair at home.  Below is the homily I preached at her funeral.  

It is amusing, in a bizarre way, that while there is plenty of time to write a homily for a wedding, or a baptism, or the 25th Sunday in Ordinary Time, writing a funeral homily for a family member or friend, a time a significant stress and emotional upheaval, has a deadline (no pun intended) measured in a day or two.  Added to the challenge was that mom's funeral was only my second as a priest, my first having been my college roommate Chris almost a year earlier.  There have been about a dozen since, several for family members, a few for close friends and mentors, and some for people I didn't know.  It is never easy saying a funeral Mass but it is a consoling and affirming moment as well.

The photos below were taken at ordination in June 2007.  Mom did not exactly like having her photo taken complaining each time she saw a camera pointed her way about a) her hair  b) her dress  c) both  d) any other excuse she could find.  My niece, her only grandchild, is pushing the wheelchair for her to present the gifts to Sean Cardinal O'Malley, Archbishop of Boston, who was the ordaining prelate.  I only realized after communion that one uses the right hand rather than the left (I am very left-handed).  
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HOMILY

It would be difficult to summarize a life spanning more than 92 years without taking lunch and supper breaks.  If I were to include the kind of detail for which mom was well-known it would take even longer.  Many of the major events of her life, beginning with her baptism, were marked here in St. Mary's Church. As a family we have gathered in this sacred space many times over the past decades for occasions both joyful and sorrowful.  Baptisms, first communions, and weddings were among the joyful gatherings.  Funerals represent the bulk of the sorrowful occasions.  But even at the funerals the sorrow of grieving was, as it is today, tempered the joy of knowing that though we are sinners, we are loved by God. The weight of sadness is balanced by optimism in the mystery and gift of the cross.  The burden of grief is eased by hope in the promise of eternal life.  Those who believe cannot help but take comfort in their faith in Christ, Son of God and Son of Man; Jesus, who redeemed us from our sins.  Jesus, whose death saved us from death.  

The first reading from Habakkuk  describes the situation of all who, like mom, lived to great old age.  It describes the life of all those who gradually watch everything they have and hold diminish and disappear.  It details the stripping away of everything until only the strength given to us by God remains. 

As most of you know, we never had fig trees, blossoming or not blossoming, on the corner of Turner and Main.  But, for mom, as middle-age turned to old-age turned to extreme old-age, walking briskly or zipping up and down the steps multiple times daily became walking more and more slowly and cautiously.  Then came the cane. Then the walker on wheels.  Then later the stair glide.   Then came the wheel chair. Finally, the recliner that helped her stand.  Independence became partial dependence.  Partial dependence was becoming  total dependence when she died.  That dependence was hard for her.  That was the cross she bore.

There was no herd to disappear from the stalls at 327 West Main.  But there was the modern equivalent: a car in the carport.  And one day it disappeared.   Though she chose to quit driving on her own it was still a difficult moment for a women who liked to drive and who, despite the little bit of lead tucked into her right shoe, was an excellent driver.  She was legendary for her ability to parallel park the Chrysler New Yorker in a spot barely large enough for a Toyota Corolla.  And she usually did it with one backup. 

As loss followed loss she adapted gracefully and allowed the boundaries of her life to gradually constrict.  What she never lost was the quickness of her mind,
the depth of her memory for people, her sense of humor or her faith. 

For Mother’s Day last year I gave her two pewter framed photos from ordination.
One of her presenting the gifts to Cardinal O’Malley of Boston  and one receiving communion from me.  She got a bit weepy.  And then she said, “These are beautiful frames.”  I replied, “They should be they were made by Martha Stewart.”  She responded immediately, “I wonder if she made them in prison?”

Even as her legs became weak and painful, barely able to carry her, God enabled her to go upon the heights, swiftly and easily.  Those were the heights of joy, of love, of friendship.  And of faith.  When she could no longer manage to get to Mass, her prayer book, which was held together with rubber bands, and a rosary were never far from her grasp.  Over the last few weeks she sometimes seemed to be in a different place.  She was perhaps, preparing to take her place at Jesus’ feet, now more Mary than Martha. 

Luke’s Gospel of Martha and Mary outlines the two primary relationships we have with Jesus, the active and the contemplative, the busy and the prayerful.  Ideally each feeds—and feeds off of—the other.  In the words of the great Jesuit Jerome Nadal,  prayer drives our work and our work drives our prayer.  Prayer and action must exist in a balance.  I think mom managed that balance most of her life, particularly as she got older and the distractions and demands became fewer.

Prayer is an ongoing conversation with God, a dialogue of speaking to and listening to.  It does not require heroic effort, a special place, or a particular posture.  Prayer requires only one thing,  attentiveness to Jesus’ word.  It requires only that we be disposed to be at Jesus’ feet, listening as Mary did, even if we are  bustling about in the manner of Martha.  We need only to be willing to listen to the Word of God as we go about our daily tasks. We need only to listen to the Word of God and enter into the mystery of Jesus’ presence in the Eucharist at Mass.  Being busy or even overwhelmed does not exclude prayer. I often marveled at, and even envied, mom’s ability to pray sitting in her chair.  I wish I could know what she said to God.  And what God said in reply.  If I had to guess I would suspect that on Thursday evening God welcomed her with, “Well done, good and faithful servant.” 

Grieving is neither quick nor easy.  Despite the popularity and dreadful overuse of the word there is no such thing as closure.  It is a fake concept that does not exist.  Each of us must grieve in his or her own way.  It will be strange.  At times we will feel like the psalmist who said,

“Out of the depths I cry to you, O Lord; Lord, hear my voice!”

In the end though, we can take comfort in St. Paul’s prayer for us in the second reading:

“that Christ may dwell in your hearts through faith;
that you, rooted and grounded in love,
that you may have strength to comprehend
with all the holy ones what is the breadth and length
and height and depth,
and to know the love of Christ
that surpasses knowledge,”

For now, we can only know this partially. Mom now knows the love of Christ in its absolute and perfect breadth, length, height and fullness.   With her we can only say, To Christ Jesus be glory for ever and ever. 

Requiem aeternam
dona ea, Domine,
et lux perpetua luceat ea!

Eternal rest, grant unto her, O Lord
and let perpetual light shine upon her.






+Fr. Jack, SJ, MD

Sunday, November 27, 2016

1st Sunday of Advent

Veni, Veni Emmanuel!
Captivum solve Israel!

O come o come Emmanuel! 
And ransom captive Israel!

The first day of Advent is the first day of a new Church year.  Advent begins without fanfare on the first of the four Sundays before December 24th.  Advent ends with the joyous commemoration of Jesus’ birth.  Advent ends with the commemoration of Jesus’ flesh and blood arrival in this world.  Advent ends with the commemoration that Jesus, fully Divine and fully human, was born into and lived on this planet, this same place where we now live and breathe, study and work, celebrate and mourn.  The name advent comes from the Latin roots ad and venire which mean “to come to.”  But that simple translation does not convey what Advent means. 

Pope Benedict XVI explained that advent is the translation of the Greek word parousia which means presence, but even more specifically means arrival.  Arrival is the beginning of another’s presence, it is not the fullness of that presence. Think about it.  Arrival is the beginning of another’s presence, it is not the fullness of that presence. The birth of a baby is only the beginning of a presence that will permanently change and shape a family.

Presence is never complete, it is always a becoming.  Presence is never complete, it is always changing and evolving.  And  presence never ends even when the other has died or is absent.  Even now we are being influenced by the presence of others who are distant or dead.  Parents.  Teachers.  Mentors.  Friends.  And others.  Their presence influences how we live our lives.  The memory of their presence may determine what we decide and how we act.  Their presence in our lives may soothe and comfort us during times of stress.  And sometimes that presence may be the source of continuing anxiety and pain.  There is one thing we must never forget.  It is impossible not to respond to another’s presence.  Even “ignoring” another’s presence is a specific way of responding to it.

Jesus’ presence is an advent presence.  Jesus' presence is always a “coming to,” it is always a "coming toward." It is always dynamic.  During advent we recall that Jesus is both present in this world and is always becoming newly present to this world and in our lives. During advent we become more aware that Jesus is present in this place.  But, it is only the beginning of that presence. It is not the fullness of His presence. The fullness of Jesus' presence will only be known when each of us passes from life into eternal life. 

Jesus’ presence in our lives is a triple presence.  We only have to look around this space, we only have to listen, we only have to taste, to experience that triple presence. Jesus is present in the community of believers when the Church prays as one, most particularly in the Holy Sacrifice of the Mass.  Jesus is present in the words of the Gospel when it is proclaimed in the assembly of believers.  And, Jesus is present most tangibly, Jesus is truly and substantially present, in the Eucharist, the bread and wine, which will soon be consecrated, broken, and shared.  

Advent is not the time to prepare for a holiday.  Advent  is the time of preparation for a Holy Day. We are preparing to commemorate the birth of the Messiah.  We are awaiting the anointed one.  We are scanning the horizon for the star that announces the approach of the Son of God, Son of David, and Son of Mary. We are awaiting the King of Kings and the Prince of Peace, the One who is like us in all things but sin.

As we begin Advent we recall that Jesus came toward and into this world to save it and to ransom us from sin and death. 

Veni, Veni Emmanuel!
Captivum solve Israel!


Sometimes it is a luxury to address the feast or celebration rather than amplifying the readings.  The first Sunday is one of those days.  Having some fairly nice weather.  The rain finally stopped. Went into the center to take photos of the lights. Will post next week as I've yet to download on the computer.  

Spent much too much time yesterday watching college football.  And yes, I watched the Penn State game.  Until 1 AM.  And, pray tell, who could fall asleep after that.  Yes I am dragging.  Going to call it a night very soon (is approaching 10 PM here).  

Posted some photos of Penn State in honor of the superb season.  The alumni association allotment of tickets for the game in Indianapolis next week sold out in 15 minutes!  Didn't try.  Too far from Ljubljana.   So these are some of them

Studying in the stacks at Pattee Library on a Saturday night.  


The stacks at Pattee on a Saturday night.

The tchotchke shop at the HUB Bookstore decorated for Christmas. 

Part of the mall in the autumn.

Looking from the bridge between two life sciences buildings toward downtown.

The HUB, Hetzel Union Building, on a Saturday night.  It didn't look anything like this back in 1968-1971.

Art student carrying her painting of the new Creamery toward the new Creamery so as to finish it.

Eisenhower Chapel.  How I yearn to officiate at wedding in here some day.


 +Fr. Jack, SJ, MD

Friday, November 25, 2016

Thanksgiving Dinner

Thanksgiving in Slovenia 
Sometimes one kind act condenses the meaning of months. The Jesuit community here in Ljubljana did that today. I can't thank them enough. We had a Thanksgiving dinner. 
Ljubljana is six hours ahead of the east coast. It is still a little early for turkey at 9:00 AM EST but I'm sitting here in an I-can't-believe-how-much-I-ate stupor. I ate a lot though it did not approach the usual 3500 I would have consumed back home in part because my 'family' up in Marblehead begins with a lobster bisque that is astonishing both in taste and, were one interested (I'm not), caloric burden (SHOUT OUT to Christine). 
We had the usual community prayer together in the small chapel at 12:45 PM followed by lunch at 1:00. The retreat house cook (our food is sent up from the retreat house kitchen) made turkey fillets explaining that when she tried to buy a whole turkey she was told that they are sold only at Christmas. There was gravy (not one lump!), stir-fried Brussels sprouts and the kind of sweet sour kapusta (same in Slovenian) that mom made at least weekly. Anything in the cabbage family is my favorite vegetable. Potatoes and salad rounded out the meal. It began with an excellent soup. Desert was cake with something I haven't seen at table in two months: ice cream. Wine of course and espresso afterwards finished the meal. I was moved to take an extra glass of wine to sip in my room. 
Of course there was toasting. I was asked to pray both before and after. And there was singing. These men and the congregation at our church put most American Catholics to shame. They sing beautifully with the typical Slavic harmonies at the drop of a hat, especially Fr. Jože, the oldest man in the community (I am the third oldest!). 
What am I thankful for? This year the love of this community who have accepted me fully into it, who have helped me in the first months, encouraged language learning (pronunciation is much better than free conversation) and have taught me a great deal. It is the community custom to go for a short walk and beer, hot chocolate, or coffee after the 7 PM Mass on Thursdays. We will do that tonight. Am looking forward to an 'after dinner beer.' Now, if I could only get them to understand the rules of American football for a bit of a flag game on the lawn in front of the house life would be perfect. However, I don't think I am going to push it too far. This year.
Have a Blessed and Happy Thanksgiving. Ideally I will be in a coma-like sleep by the time most of you start digging in.

The photo below is one with which I am fascinated.  It is a complete abstract of the lights of Koper.  I was walking along the water in Piran.  Koper was across a significant amount of water.  The lights along the shore in Koper were visible but they weren't going to show up as anything more than white dots unless the photo was cropped.  That severe of a crop would have raised other complicated problems.  I set the camera for eight seconds, made a few other adjustments and then panned across the horizon keeping the camera as straight as possible.  Then spent some time in post-processing on the computer.  I think it would look great as a very large canvas on a large blank wall in a big room.   This is a technique I will explore when the conditions are conducive.


Had hoped to go to the Christmas Light lighting this evening.  This being Ljubljana, however, it was raining.  The rain was a bit too hard to go out with a lens (the one I used for the photo) that is not weatherproof.  Expect to get out over the weekend.  

+Fr. Jack, SJ, MD

Tuesday, November 22, 2016

The Oath and Killing

My dad received his M.D. from Temple University School of Medicine in 1931.  He died suddenly, though I now realize from the perspective of time, not unexpectedly, in July 1974.  I was in the last two weeks of my junior year at the same medical school.  (Though irrelevant to everything that will follow, I can never express my gratitude to two late deans at Temple Medical, M. Prince Brigham and Hugo Smith, for the kindness and compassion they extended in allowing me to take the surgery final, scheduled the week of dad's funeral, when I felt ready to take it, and for considering my six-week internal medicine rotation complete after the four weeks I'd already finished.). 

Dad's death and the timing of that death was a wound that took several years to heal.  Eventually, like other wounds, it scarred over.  Were you to look at my soul today you could still see the scar. It occasionally gets a bit inflamed.  That inflammation is not something to fight against but rather to be gently rubbed, acknowledged, and soothed.  It was a hard-won scar on both dad's and my parts.

As we were planning the funeral I wanted, indeed, had to have, a copy of the Hippocratic Oath next to the crucifix in his coffin.  Dr. Steve Wartella, a radiologist and tremendously kind man, was very helpful getting a copy in those days before computers made it easy to find and print a copy suitable for framing.  It was held in a brown fake wood frame from Woolworths. That copy of the oath, in the same $7.57 (plus tax) frame, has hung in my apartment, office, or room ever since.  At the moment it is packed in a box at Campion Center along with the rest of my stuff.  Should I return to Slovenia I will ship it over.  It meant a lot then. It means even more today. 

All of this was triggered by an item from the Catholic News Service that popped up on facebook.  The headline is:  Cardinal Dolan urges stronger effort to stop physician assisted suicide. 

http://www.usccb.org/issues-and-action/human-life-and-dignity/assisted-suicide/to-live-each-day/upload/to-live-each-day-with-dignity-hyperlinked.pdf

Dolan makes an important point that I hadn't considered.  "The legalization of doctor-assisted suicide creates two classes of people: those whose suicides are to be prevented at any cost, and those whose suicides are deemed a positive good."  In an American society that has become extremely hypersensitive to 'isms', 'ists', a panoply of 'phobias' and in general insists on pounding any round peg possible into a square hole of discrimination, this seems to be a widely ignored thought.  The cardinal described the situation well, “We remove weapons and drugs that can cause harm to one group, while handing deadly drugs to the other, setting up yet another kind of life-threatening discrimination . . . ”

The Oath Attributed to Hippocrates has a long history.  It was never universally accepted by physicians, even in ancient times.  While reading some history of medicine a few years ago I learned that not all physicians took or abided by the oath.  The ones who did were deemed "Hippocratic Physicians."  By now, however, the "Hippocratic Oath" has become traditional at medical schools, generally upon entering and at graduation.  The question is whether the bowdlerized oath means anything at all today.  Should it even be called The Hippocratic Oath or perhaps changed to something like, "The Doctor's Promise" or "The Medical Code Based on Hippa and Medicaid?" I was stunned when the "oath" we pronounced less than a year after dad's death bore no resemblance whatsoever to the copy in dad's coffin.  I cannot recall the exact words in the graduation program which, like the framed oath, is in a box at Campion.  I do recall searing disappointment that we pronounced what seemed at best a pseudo-oath.

There are now many versions, none of which seem to include a proscription against killing a patient, none of which include forbidding abortion, and most of which no longer caution against having sex with a patient or member of the patient's household as did the original oath quoted as follows,   "Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art. . . . I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free." 

Cardinal Dolan notes that, rather than being abandoned to the ease of being killed by a lethal combination of drugs or poisons, the dying require care.  They require intense symptomatic management.  They must be assured that they are not a burden or a bother.  What Dolan and many others call for is not easy.  Almost forty years practicing first internal medicine (fourteen years) and then geriatric psychiatry (twenty-six years) allow me to say that it is not easy by a long shot.  It requires compassion (from the root words for 'to suffer with'), it requires physical and emotional stamina on the part of the physician who is confronting his own mortality every time he enters the patient's room or, ideally sometimes the patient's home.  It requires a very certain and detailed knowledge of physiology, pathology, and pharmacology, not just good intentions and a few prescribing trees that instruct "if this then this."  Care for the dying demands knowing the patient as a living being.  Perhaps it is this last part, knowing the patient, that is being destroyed in American medicine. 

Six months after dad's death I began a cardiology rotation.  The name of the hospital is irrelevant.  I was assigned to a group of six or seven cardiologists.  They were excellent at what they did.  And they were very nice guys who treated me well.  My qualm was how they practiced and made rounds.  Every morning I walked into a patient's room with a different doc.  The dialogue went something like this, "I'm Dr. Harrison.  You don't know me but I work with Dr. Miller who admitted you.  He told me all about you."  The following day Dr. Wilson repeated the same things mentioning both Harrison and Miller.  Eventually during the recitation of four or five names who handed off the patient, I realized I was the only consistent presence in the patient's room all week.  I swore I would never do that to my patients.   

Caring for the dying is physically, emotionally, and spiritually demanding. It is exhausting work.  Sitting at the bedside of a twenty-something year-old patient as he approached an unpreventable death from devastating and terminal heart-lung disease, I screamed "WHY?" at God, a prayer that was greeted with silence at the moment.  Despite his physical struggle to breathe and the wracking coughs that brought up dark red blood clots, I never had the thought to kill him in the name of compassion and relieving his suffering.  God knows it would have been easy enough with a slight adjustment of medication.  He got through that awful crisis.  When he did die a few weeks later he was home.  Watching a football game.  That angry WHYYYYY? hurled at God was answered. 

The question behind Cardinal Dolan's talk is whether physicians are willing to do the hard work needed.  Are they willing to be compassionate, to "suffer with" in down and dirty fashion?   Are they willing to stay when they desperately want to flee the room or punch a wall?  Are they willing to be what they think to be an ineffective presence (presence is never ineffective) seeming unable to do anything to relieve the suffering?  Would they rather be in a bioethics seminar room making pronouncements about short-circuiting suffering rather than fighting sleep at 3:00 AM while sitting in a chair next to the bed, perhaps scared out of their minds?

In 1977 I had the immense privilege, a life-changing privilege, of working as a house officer for six weeks under Dr. Cicely Saunders at St. Christopher's Hospice in London.  One day, in my uncomprehending youthful state, I asked what she thought about what was then called "euthanasia" assuming agreement. Dr. Saunders was a tall woman.  She crossed her arms under her ample bosom, made herself even taller, her halo of white hair like a cloud above me, and almost thundered her response.  It was not pretty.  Her philosophy was that pain could always be controlled.  It wasn't always easy or without risk but it could always be controlled.  Killing a patient was never the answer.  That is quite a difference from the Dutch who are considering physician assisted suicide for those who are simply tired of living.

Another of Cardinal Dolan's remarks is a fitting end to these thoughts, “Patients need our assurance that they are not a burden — that it is a privilege to care for them as we ourselves hope to be cared for one day. A compassionate society devotes more attention, not less, to members facing the most vulnerable times in their lives.”

The above thoughts were triggered by something that popped up on facebook (yes, I had to bite the bullet).  Scary, especially the Dutch and/or Beligans who are thinking of allowing those who are simply tired of living rather than terminally ill, be administered "physician assisted suicide."  Ditto for Alzheimer's patients who didn't request it.  Obviously given at the behest of the family or the physician ('the inheritance is going to run out' or 'I need a bed on Monday').  

Attached are a few more photos from Piran.  Sunday morning Robert took me up to St. George's Church, bell tower, and baptistry, each of which is a separate structure.  There was sun.  

Robert checking out the catch with two fishermen.


Morning fog is rare in Piran.  This was one of those rare days.

Forty minutes earlier we sat under the white canopy at the upper left corner of the square with coffee and croissant.

The pink house in the corner of Tartinijev trg is 'the Venetian House.'  

Heading to the boats with coffee

+Fr. Jack, SJ, MD