Summer 2020 | Volume 101, Number 3
SR. MARY HADDAD, RSM, MSW, MBA
After he learned of the birth of Jesus, King Herod ordered the execution of all males under the age of two in the areas around Bethlehem. Herod was filled with fear that one day this "new born king" would become powerful and overtake him as King of Judea. The cries of those children calling to their mothers ring out every year as the church remembers them on December 28, the Feast of the Holy Innocents.
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From the Upcoming Fall Issue
D.W. DONOVAN, D.Bioethics, and REX HOFFMAN, MD, MBA
Providence Holy Cross Medical Center is a Level II trauma center located in the northern tip of Los Angeles. The hospital has a reputation for serving the community in the most difficult of situations, playing a major role in responding to disasters, from earthquakes and train crashes to school shootings and rampant fires.
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From the Upcoming Fall Issue
JULIE TROCCHIO, BSN, MS
This is a story of a personal journey. It wasn’t until I started my job at CHA that I found out the organization was and is more than health care. During my first week at CHA I attended the board meeting where the primary issue was "formation," a term I did not know in relation to health care. Formation, I learned, meant continuing the mission, values and spirit of the sisters that founded — another word I did not know in this context — our ministries — yet another expression I had to learn, meaning our buildings and services — to continue the healing ministry of Jesus. The discussion centered on the courageous women who left their European convents to deliver nursing care in this country.
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ARCHBISHOP WILTON D. GREGORY, SLD
The impact of the coronavirus has furnished even more irrefutable proof of what was already widely known or at least commonly suspected — that there exist vast inequities within our society and social structures when it comes to health, finances and other shared opportunities. The medical statistics associated with this pandemic describe the disproportionate consequential effect of those inequities upon people of color, the poor and the elderly. While I suppose that some people will continue to endeavor to explain away or refute the hard evidence, few can deny that the coronavirus has disproportionately sickened and killed more people in those three categories than among the general population, not only in our nation, but worldwide.
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LAURA McKINNIS, MSN, NP-C
I've worked in emergency medicine for 20 years and have come to believe the foundation of emergency medicine is problem solving: We see weird stuff and we figure out how to handle it. We first started seeing cases of COVID-19 in late February. That seems like a lifetime ago. The department was drowning in its normal, heavy volume, and then we lost use of COVID isolation rooms that needed extensive cleaning. As the fears of the coming pandemic grew, so did patient volume. It felt like we were always managing the problem a week too late. As soon as we adjusted, made space and found solutions, the testing protocol would change or the patient volume would shift or new concerns over availability of personal protective equipment (PPE) caused us to proceed in ways that never before would have been tolerated. But we keep adjusting.
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REV. ADAM RUSSELL TAYLOR
Abundant life. Human dignity. A seamless garment of life. All of these sacred promises and commitments are at the very heart of the Christian faith and form an ethical standard to guide and measure public policy and leadership around the elements of the common good, including health care. Yet these faith imperatives are being undermined and betrayed by pervasive and persistent racial disparities in health care, many of which are tied to the legacy and continued impacts of institutionalized racism. The COVID-19 pandemic has further laid bare the dire consequences of entrenched systemic racism and injustice within our society and health system with African Americans being disproportionately infected and killed by the virus at alarming rates.
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SAM F. HALABI, JD, MPhil
The national consciousness and conversation are now focused on racial disparities across all aspects of society: employment, law enforcement, education and certainly health. Over the course of the pandemic, COVID-19 has imposed disproportionate burdens of severe illness and death on Black and Latino Americans. These disparities are in fact part of a long-standing feature of the U.S. health system.
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JUSTIN HINKER
It will come as no shock to professionals in long-term care, but among the most important lessons our team learned in recent weeks is the uniquely fluid nature of time. At Avera Prince of Peace Retirement Community in Sioux Falls, South Dakota, we have 114 skilled nursing facility beds, 60 assisted living beds and 74 independent living beds. Our residents are why we do the work we do.
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KATE JACKSON-MEYER, PhD
As the coronavirus pandemic rages on, it is becoming increasingly evident that many on the frontlines are, understandably, distressed. Distressed by the high volumes of patients and the lack of personal protective equipment (PPE). Anxious about not having enough ventilators as they face unprecedented resource allocation decisions. Grieving from watching patients die alone. Health care workers, first responders and chaplains may experience moral distress due to the COVID-19 crisis, and this can affect them psychologically, morally and spiritually. It is incumbent on Catholic hospitals and long-term care facilities to care for their personnel, with particular focus on the frontliners who are experiencing more of this kind of harm.
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NATHAN ZIEGLER, PhD, ODESA STAPLETON, JD, and MUZIET SHATA
On a rainy Thursday afternoon, a middle-aged man came to the hospital for his visit with a specialist. He had many routine procedures to treat his condition, but so far little progress had been made. He was growing tired, frustrated and worn down. That day, the patient became somewhat agitated as the specialist made his rounds through the room. The patient's attitude switched instantly from one of being tired but compliant to being hostile, angry and challenging. The shift in tone was noticeable to his care team, and they started inquiring about his behavior. Moments after his specialist left the room, the chaplain came to provide spiritual care. The chaplain noticed the man's shift in behavior and mood, so she asked him what he needed to feel more comfortable. The patient looked up at her and said, "I want you to get that Arab doctor off my care team!"
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DAVID LEWELLEN
In the first week of the coronavirus epidemic in the Bay Area, Sr. Donna Moses, OP, a chaplain, was asked to visit a dying patient who was symptomatic for COVID-19. At the nurses' recommendation, she put on an N95 mask, a gown, a face shield and two sets of gloves.
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MARY ANN STEINER
Samuel L. Ross, MD, is the current chief community health officer for Bon Secours Mercy Health, one of the largest health care systems in the nation, with facilities that serve communities in Florida, Kentucky, Maryland, New York, Ohio, South Carolina and Virginia. He is responsible for a large network of community outreach initiatives that focus on housing, education, job skills, behavioral health, substance abuse and rehabilitation, all focused on reducing health disparities and improving access to care for the communities that Bon Secours Mercy serves.
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LAURA HORWITZ, MA, and KAREN LINNEMAN
What becomes possible when hundreds of families find new ways to talk about, learn about and work to eradicate racism? This question fuels the work of We Stories, an organization in St. Louis that asks white families in particular to change the conversation about and build momentum toward achieving racial equity. We Stories encourages participants to intervene in the cycles that keep us segregated, suffering and stuck by asking how the status quo gets perpetuated in white communities and by inviting families who
have been on the sidelines to learn more about systemic racism and take an active role to confront it.
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DANIEL J. DALY, PhD
Medical facilities in the United States must ration health care in response to the COVID-19 crisis.
There is an acute scarcity of medical resources. Facilities lack both the materials (ICU beds, ventilators, testing kits, personal protective equipment) and the personnel (doctors, nurses, respiratory therapists) required to treat patients suffering from COVID-19. In response to the impending scarcity of resources, some fear that rationing could disadvantage patients with physical and mental disabilities for mechanical ventilation.
Some ethicists have suggested that age be a factor in determining which patients are disadvantaged for scarce resources.
The scarcity of resources during this pandemic requires ethicists to determine just principles for the rationing of life-sustaining treatment. Should age, life-years expected, or the quality of a patient's life be considered when deciding who receives a ventilator and who does not?
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EDEN TAKHSH, MD; JAMES SIFUENTES and GENESSA SCHULTZ, EdD
At Saint Anthony Hospital in Chicago, our Catholic mission and values focus our work on meeting the needs of the underserved. Our vision aligns with what Jesus told his followers: "whatever you did for one of the least of these brothers and sisters of mine, you did it for me." (Matthew 25:40) Due to historically racist systems and policies in the United States, "the least of these" often end up coming from oppressed communities of color. Racist and oppressive policies manifest in the form of implicit bias, poor quality of health care, high cost of services and stereotypes that directly affect how people of color utilize health care systems, often waiting until symptoms, illnesses and diseases become detrimental to their health before seeking medical care.
The need for trusted and quality care provided by safety net hospitals in marginalized communities is vital in improving health outcomes. Saint Anthony is a safety net hospital.
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REV. CHELSEA LEITCHER, MDiv, BCC
Today, a patient was discharged after an extended stay in the hospital. As we do for many patients who have survived COVID-19, we celebrated the patient's discharge. Staff who had cared for the patient lined the halls — smiling, clapping and some even had tears in their eyes. There were balloons, and a celebratory song was played over the loudspeaker as the nurse wheeled the patient to their spouse, who was eager and ready to take their loved one home at last. As a hospital chaplain, I know the value of having a case like this patient, to the family, certainly, but also to the medical community. When illness feels overwhelming, having someone who was so sick recover so beautifully changes the mood of all those who worked with them. For many staff in our hospital, this patient was our miracle — that ray of hope that reminded us even the sickest person can get better.
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MARCOS L. PESQUERA, RPh, MPH
I began my career as a community pharmacist, with all the optimism and idealism that belong to the young. In the flurry of filling prescriptions in a busy pharmacy, occasionally I would notice a patient who only wanted to purchase two- or three-days' worth of medication for their chronic condition. Obviously, I was concerned. A chronic condition such as hypertension (high blood pressure) requires that medication be taken regularly as prescribed to avoid serious consequences. Certainly, the patient had been educated about that. I found my attitude more critical than compassionate in those circumstances.
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BRIAN SMITH, MS, MA, MDiv
During the past few months we have heard the word "unprecedented" used to describe the coronavirus pandemic. Others have referred to this time as "disruptive" and "chaotic" as the health care world we have known has been turned upside down. No one believes that we will ever go back to the way things were. Everyone seems to be asking, "What will our new reality be?"
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GEORGE B. AVILA, MURP, MAHCM
Writing on the topics of health disparities and racism is not an easy task, as I feel no amount of words can really speak to the depth of these issues in our society, especially at this moment. Over the past few months our nation has been confronted with two pandemics that have shaken us to our core. COVID-19 infections have significantly impacted communities of color throughout our country, highlighting the fact that the most vulnerable among us are the "essential" backbone that hold together our economy and have the least access to care. The cries of racial injustice from our African American brothers and sisters have made it clear that we can no longer be silent or complacent. Our world is yearning for justice, and we are each called to examine our own conscience, stand in solidarity and, most importantly, act.
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FEATURES
Draws from Legacy of the 'Angel of Alcoholics Anonymous'
BETSY TAYLOR
At Rosary Hall in Cleveland, they don't like to talk about waiting lists. When someone struggling with addiction seeks help, they try to provide it — right then, right there. During daytime hours, Rosary Hall accepts walk-in patients, people seeking immediate treatment for alcoholism and drug dependency. "When someone's ready, they don't want a bed tomorrow. They don't want an answering machine," explained Orlando S. Howard, director of outpatient treatment services and quality improvement for Rosary Hall.
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MARY ANN STEINER
One of our most knowledgeable and prolific writers was lost to Health Progress when Fr. Francis G. Morrisey, OMI, JCD, PhD died on May 23 in Ottawa this year. Fr. Morrisey wrote his first article for Health Progress in 1982, his last in 2016 and logged almost 40 more arti-cles in the magazine within that span of decades. His long bibliography shows that Health Progress was just one of many of the publications that offered his scholarship and clarity to its readers.
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100th ANNIVERSARY
BRIAN SMITH, MS, MA, MDiv
"Whether it be the sweeping eagle in his flight, or the open apple-blossom, the toiling work-horse, the blithe swan, the branching oak, the winding stream at its base, the drifting clouds, over all the coursing sun, form ever follows function, and this is the law. Where function does not change, form does not change. The granite rocks, the ever-brooding hills, remain for ages; the lightning lives, comes into shape, and dies, in a twinkling. It is the pervading law of all things organic and inorganic, of all things physical and metaphysical, of all things human and all things superhuman, of all true manifestations of the head, of the heart, of the soul, that the life is recognizable in its expression, that form ever follows function. This is the law."
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