The Question of Reopening – A Sermon on Psalm 23 and John 10:1-10

I love this. Jesus is the gate. We need to keep relating to the gate, to the life within Jesus, “you in me, I in the Father” so that we may be one…” Being together in wanting abundant life, being in solidarity, is an important way to hold this “open gate” of the heart…

Interrupting the Silence

The Fourth Sunday in Easter – Psalm 23 and John 10:1-10

My first sermon in this Season of COVID-19 was on Psalm 23. That was six weeks ago. We began this season of life by reminding ourselves that the Lord is our shepherd and we shall not be in want. I’m sure you know how the rest of it goes – the still waters and green pastures, fearing no evil, the table in the wilderness, the overflowing cup, daily goodness and mercy.  

I commented back then how fortunate we were that Psalm 23 was one of our assigned readings and that it was exactly what we needed to hear. And I say that again today.

Psalm 23 and today’s gospel (John 10:1-10), with it’s images of shepherd, gatekeeper, gate, sheep, thieves and…

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Someone telling you your own story

The book “The Spirituality of Imperfection” by Ernest Kurtz and Katherine Ketcham, has been a favorite source of reflections for me for about 15 years.  One of the stories I love best is from Jewish lore.  I call this the story of The Baal Shem Tov and the Bishop.   The Baal Shem Tov before he died, asked a disciple to carry on his work, going far and wide to tell stories about the master.  In a far country, a wealthy nobleman was very happy to receive the disciple, and eagerly waited to hear the stories.  But his mind went blank.  Finally, after a few days, he started to leave, and then he remembered one story.  He was with the Master when they came to a Christian town, just before Easter.  The usual thing there was to kill a Jew, in the fervor around the crucifixion of Jesus.  So the disciple was very afraid.  But the Baal Shem Tov went to a big house, along the square, and threw open the upper window to look at the procession of people coming into the square.  The bishop in his robes was very imposing.  The Baal Shem Tov told his disciple to go down and tell the bishop that the Baal Shem Tov wanted to see him.  The disciple was trembling with fear, but went to the bishop, and was amazed that the bishop listened, and after his sermon, went with the disciple, to see the Master.  They went to an inner room, spoke for a long while.  Then the Baal Shem Tov came out, and said now they could go away.  The disciple was very sorry this was such a fragment of a story, but he did tell the nobleman about it.  The effect in the nobleman was immense.  He recognized the disciple, and he said, that the bishop in the story was he himself.  He was descended from a line of distinguished rabbis.  He had converted to Christianity in a time of persecution, out of fear, and had been praised, and raised to being a bishop.  He had had a dream, in which he recognized that his soul was in peril.  The Baal Shem Tov had told him that he should return to a simple life of holiness and prayer,  and give up his money and titles.   He should have hope, and  “When a man comes and tells you your own story, you will know that your sins are forgiven.”   When a man comes to tell you your own story, you know that your sins are forgiven.  And (what is always true), is that when you are forgiven, you are healed.

I love this story, because although I am a Christian, I understand that there are people who are and must be, true to their own faith, their own understanding of God.  I do not think we should try to convert or change people’s faith.  What I do think we should work to change, is our own behavior, and especially that part of us which is conscious, which has that “still small voice” of conscience.   Expanding our ability to love, to forgive, and to have patience and forbearance, is what we are being invited to DO.  God calls to each of us, and God forgives us, and we need to hear that voice of forgiveness.  We never hear the voice of God when we are self-satisfied, but only when we are trying to live with peace, with serenity and courage, and to do the will of God.  Putting aside our own egos, trying to help meet the needs of others around us, is what most heals.  When we reach out in love, in solidarity, and forgive each other, we are most like the God we want to be close to, and with whom we want to be in relationship.

Pandemic update, end of March

Not only do we still not have enough test kits so that we can really find out the denominator of the number of people who can make it through with just mild to moderate symptoms, vs. needing oxygen or ventilators, we still don’t have the Personal Protective Equipment (PPE) in every hospital.  For the past 10 days I have been reading stories from good doctors on the front lines who have been told by administrators that they cannot wear masks, because it will scare patients.  It may be they couldn’t get enough of this equipment, as the administration pitted states against each other and hospitals against each other, to try to get the needed masks , gloves, ventilators, and gowns and booties.  This is against the backdrop of the administration under Mr. Trump sending 17.8 tons of PPE to China to try to help in February, as the Wuhan epicenter escalated into full-blown terror.  This was a good instinct to help our neighbors in distress, but left us without the back up for a pandemic here, and no new materials were ordered or authorized, in spite of the dire predictions of likely spread to the US.

Many friends have been trying to find masks, or make them from cloth, but the cloth is not good for stopping viral particles, compared to the surgical masks (56% effective) or the n95 masks, (95% effective).  In New York which is now in the exponential growth and death rates are skyrocketing, there are big trucks parked outside the hospitals to take out the dead bodies, and doctors and nurses barely able to control the constantly escalating demands for ventilatory assistance.  There are plane-loads of docs and nurses going to help NY, and I feel so grateful for these brave people, and worried for them, also.

San Francisco has been able to stay in Shelter-at-Home mode, and to avoid the escalation so far.  The data show that it is working, and we have only had 380 deaths, not the almost 2,000 of NY, NJ and CT.  Our whole Bay area has been asked to stay in for another month, and the peak is supposed to be April 15.

I spent the past several days trying to help docs with finding support to say they can wear PPE, and we got it 2 days ago from AAFP.  I wrote Governor Newsom yesterday asking for him to please issue an edict that all medical personnel must wear PPE, and preferably the n95 masks.  Today the NY Times published an article about the doctors fighting the administrators of hospitals to get appropriate equipment and be allowed to wear it, instead of being fired.  This is good, the media is now going to help us be heard, and force the hospitals to get the masks and have everyone wear them.  It also is now apparent that many people in the public arena are willing to wear masks to try to limit contagion, which is also great.

I feel guilty in being safe here in isolation at home, when so many are dying.  The deaths of 51 doctors in Italy, along with 10,000 people, is heartrending.  I saw a photo of coffins lined up, and it made me able to finally write a poem, called “50 Coffins in Italy”.   I sent it today to Rattle, hoping they will accept it, as something dealing with what we are seeing in the news.  I am trying to comply with the plan to “flatten the curve.”   I am still registered in the Medical Reserve Corps in our town, if they need retired docs to come in.  I don’t want to go to another place, I need to be able to be at home, at least.  I have been walking down the driveway and back up again, to get exercise every day.  I want to go to walk on the beach, but am saving it for when I really need it.

I ate an artichoke for dinner, cooked in the pressure cooker.  I have been trying to learn to eat better, stay healthier in my patterns, boost my immune system. I have some lemons and some ginger, and I have been making tea.  I have made chicken soup with a lot of garlic.  Little by little, I am trying to get a sort of rhythm at home, along with getting to be part of the zoom meetings for the Lectio Divina, and for Al-Anon.  This is helping me to stay connected.  Also I am checking with Sebastian almost every day, and I got to speak on the phone tonight with Andy, who is in MN.  He still thinks the president has helped do the right thing for the pandemic, so it shows how the media has twisted the minds of the people.  We are going to see if this finally makes people understand his absolute failure of leadership;  Trump’s failure to care for the common good, and “to form a more perfect union”.   I am grateful for the work of so many independent journalists, and this week, especially for Heather Cox Richardson.  I am going to sleep so much better, now that I know our docs and nurses have the n95 masks.

Health care and the Pandemic covid-19

It is so hard to be in the sidelines, now.  Watching what is happening, since the administration refuses to take the scientists seriously, and has gutted both the NIH and the CDC of the people who would normally be best at responding to the new virus which is both very infectious, and due to cause a lot of deaths from pneumonia, is painful.

We don’t have the testing capability, as there are not enough testing tools set up, and the factory which makes the test has to be ramped up to produce millions of kits for the test.

Doctors are worried, because if sick people come to the office, which is not set up for quarantine and for helping protect others from exposure, the staff and other patients may be exposed.  It seems that South Korea did the right thing by setting up 73 independent testing sites, with full protective gear, and allowing people to get tested without putting others at risk.

The self-quarantine or “distancing” being recommended is the only tool we have to blunt the disease onslaught, which has an exponential growth curve.  In one town there were 3 cases 1 week, 300 the next, and a thousand the following week.  This will rapidly overcome our hospitals’ ability to respond and take care of patients.   The need for oxygen will be easier to meet than the need for a respirator.  These machines are big and expensive and most hospitals don’t have many just sitting around not being used already.  The hospitals are mostly working at full capacity or above 95%, which means there are no extra beds or extra respirators, or the staff to take care of the patients.  In Wuhan, they built 2 hospitals in 2 weeks, but they did not have staff sufficient to man the hospitals.  In Washington state, the head of Public Health asked for 230,000 respirators.  Apparently finally yesterday they got about half of them.  I am amazed they got them!  We heard from doctors in Italy that they are trying to apply the ethic of “prioritization” which is to try to give the best treatment to the ones who are most likely to make it, which means they are not treating anyone over 60 or with an underlying condition with full resources.  They are on the edge of collapse of their medical system, and a beloved family doctor in Lombardy already died of the disease, as he came out of retirement to help with the disaster.

Many friends in many places say that the big stores are out of toilet paper, and zinc lozenges, alcohol and hand sanitizers.  Most of my friends over 60 are prudently canceling all the events they were intending to do for the next 2 months.  I feel sorry for all the loss to the air travel industry, the restaurants, and local small businesses,  who depend on people shopping.  I looked up the travel insurance, and they don’t accept a pandemic or epidemic as a reason for cancelling a trip and getting a refund.

I am also upset when doctors much more brilliant than I, who are on the front lines, say that they cannot get the tests they need.  The best thing that happened as the data began accruing this week, is that Katie Porter, a great Congresswoman, was able to question and make the head of the CDC agree to allow the testing for free.  Since the testing usually involves testing for influenza A and B, as well as a complete blood count (CBC) and metabolic panel (to be sure liver and kidneys are ok, and that the blood sugar and electrolytes are ok) adds up to over $1000 dollars.  Most people can not afford that test.  And we need people to be able to access the testing.  Most labs are apparently still ramping up the access to large numbers of tests coming in.

If someone is over 70, their risk is 8%, and if over 80 the risk is 16-20%.  If they are hospitalized, the risk is 20-30%.    We all need to stay home.  We all need to hunker down, but also talk to each other, trying to speak on the phone to elderly people who are feeling lonely and isolated.  IF you have teens who are healthy, ask them to offer to babysit for doctors or nurses with small children, who need to be at the hospital.  This is a hard time for the whole world.  All humans are at risk.

A trip to Guatemala

I was not thinking that I needed to reconnect with my Latina roots, but the minute I felt myself to be in a place where people are naturally both respectful and kind, it was like unsquishing the marshmallow of myself, back into who I really am! I was so glad to hear Spanish spoken, and be able to carry on conversations, and also hear the natural politeness, and feel the unhurried pace of the people around us. By being in the Peace Corps in Paraguay after college, and then in Mexico for Medical School, I have a big chunk of my own life experience and myself as a young person in the milieu of latin culture. Remembering words delighted me, remembering whole sentences, and how to say something more gracefully delighted me even more. I was truly nourished in the soul by this trip!

Waking up to breakfast in a place where women are making hand-made fresh tortillas is like being in heaven. Throw in bougainvillea in full bloom, a beautiful volcano with a halo of a lenticular cloud just below the peak, and old heavy wooden carved doors and ceilings, tile roofs, and 20 inch-thick stone walls, put me in my happiest frame of mind. I loved the city of Antigua, but also the area around Lake Atitlan, the small villages with women weaving on backstrap looms, in a time-honored tradition. I love the bright colors, the happy feeling of the textiles they are weaving!

When we got to Chichicastenango, I wanted only to try on some old huipiles (the serape-type blouses, made of hand-woven and sometimes over-embroidered with more bright colors). I was not intending to buy anything the first day we were there. But when I saw these gorgeous cloths, I could not help buying several; both two old ones, and two new ones. I also bought a beautiful shawl, of navy embroidery on royal blue woven cloth. By the end of the market day, I owed everyone on our small tour money, as I had not brought enough cash for all this gorgeous stuff! I was a tiny bit concerned that the rest of the week I would rue the purchases, and wish I had waited, but as the exposure to more weaving and huipiles in various markets went on, I was very happy with what I got the first day.

I continued to see wonderful bargains, with new and interesting designs, in each market we went to. In Antigua, just up from the arch over the main street, there is a wonderful indoor market which gave lots of access to viewing and considering the different designs of cloths and huipiles, and good prices, although fixed. The last day, we went to the market in Guatemala City, and I found a wonderful cloth purse-bag, with hummingbirds embroidered on it. I had not seen this design before.

We went to the wonderful museum Ixel, in Guatemala City, and saw more about the weaving, and the videos for education were wonderful. We watched a procession from one of the Holy Week processions, in a small town, with all the musicians, and all the people wearing “traje”– the traditional clothing. We learned about pre-Columbian culture of the different Maya people. We saw one of the latest ruin sites of the Ki ché people. The ones we were most exposed to were the Ki ché people, who are in the region around Lake Atitlan.

We loved the weavings at the town of San Juan de la Laguna, on the other side of the lake from Panajachel. This town has a women’s weaving cooperative. They take turns doing the whole task of picking the cotton, taking out the seeds, then beating the cotton to make the fibers line up more linearly, and then spinning them on a spindle. Once they have a good amount of yarn, they dye batches, in colors from different plants. Some cotton is naturally white, and a different kind is naturally a beige-brown color. In some of the weavers’ towns, new thread is now being imported and used, both silk and mercerized, and polyester, from different places, in order to give the brilliant colors play. In San Juan, they are trying to stick to the traditional cloth process. The backstrap looms are held in front, and strapped around the back, and many women are seated with their knees bent and their lower legs folded under them. I can not maintain that position, and cannot imagine doing it for hours, to be able to weave! My thighs would be screaming in pain! In these towns, the women weave their own bridal wear, and they also need to weave a fabulous piece for the mother-in-law, which takes about a year. They can’t get married until all this weaving is done!

The roads through the mountains are a feat of engineering, very similar to the Hwy 17 road we have here, to Santa Cruz, in Ca. There are trucks full of rebar and bricks, busily moving to new construction places. The small farms all the way up the mountainsides are terraced, and look very healthy. The vegetables in the markets look very healthy and tempting! We got a fabulous meal in Guatemala City, at the “Cocina de Señora Pu”— a Mayan woman who cooks with the old dishes and very fresh ingredients, wonderful and interesting spices, and she has an advanced degree in both cooking, nutrition and Mayan anthropology around cooking. The food was so good that we came back for another meal the next day! She is tiny, lovely, and humble; and lets you watch how she makes miracles of meals from a 4 burner stove and an old pressure cooker. Most of her food was steamed or roasted-cooked on a thick iron “plancha”.

We got to watch how cocoa is harvested and readied for market, and learned to drink cocoa tea made with water instead of milk. We learned also about coffee, which is another product of Guatemala. And we went to see how they carve the Guatemalan jade, which is different than the Chinese jade, and there is a lavender variety which is quite lovely.

We had a van in which we travelled, driven by a very attentive and kindly man. We had a wonderful tour guide who grew up in Guatemala, then came to America, and is now trying to introduce people to her beautiful homeland. And we had great talks by a tour guide who explained a lot of things about the culture and the language, and answered endless questions we had about plants and customs of the people.

I cannot recommend highly enough that you take a trip to see this amazing country. There are Swiss-German influences in the mountains, where pine and cypress are also around tropical plants and orchids. Some immigrants from 100 years ago have left their mark on the area in the way wood is carved, and how cheese is made. They also have some wonderful beer!

I got a book about the Maya and weavings, from a woman who lived there, named Carmen Petersen. She did some great paintings of the women wearing their traditional clothes. Her work was the baseline for the Museum of Ixchel. I fear that the traditional weaving will not go on forever, as more women get other opportunities, but for now, it is great to see them sharing in the cooperatives of weavers, to help make ends meet for their families.

I liked the bed in the hotel we stayed in in Guatemala City, the Barcelø. Soft pillows and help for arthritic hip. Also, there is a pool.

All in all– a great learning experience, beautiful, healthy and fun!

Entering Advent In Hope – Fr. Daniel Berrigan

this is so perfect, it does not need me to add anything.

Interrupting the Silence

By Thomas Good – Thomas Good / Next Left Notes, CC BY-SA 4.0, Wikimedia Commons

“It is not true that creation and the human family are doomed to destruction and loss—
This is true: For God so loved the world that He gave his only begotten Son, that whoever believes in Him shall not perish but have everlasting life.

It is not true that we must accept inhumanity and discrimination, hunger and poverty, death and destruction—
This is true: I have come that they may have life, and that abundantly.

It is not true that violence and hatred should have the last word, and that war and destruction rule forever—
This is true: Unto us a child is born, unto us a Son is given, and the government shall be upon his shoulder, his name shall be called wonderful councilor, mighty God, the Everlasting, the Prince of peace.

It is…

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Gazing into the Face of a New Beginning – A Christmas Sermon on Luke 2:1-20

YES! This is what I meant to say… but Michael said it so much better. God’s desire for us and for the world!

Interrupting the Silence

Baby-oneminuteoldShe gave birth, wrapped him in bands of cloth, and laid him in a manger. It’s all rather matter of fact as St. Luke tells it (Luke 2:1-20; Christmas Eve). It sounds like it could be any birth. It was probably like a lot of births throughout the world today. A newborn, a blanket of sorts, and a makeshift crib. “Good news of great joy,” the angel called this birth. So what does this child bring us? He can’t walk or talk. He can’t feed or care for himself. He can’t really do much at all. Despite all this, however, the angel declares this child to be our Savior, our Messiah, our Lord. So what does he offer us? Why would God choose to come among us and enter our world as a newborn baby? What do we see in this child? What draws us to this night?


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Autumn is always the time of great hope and coherence for me. Several things happened this month to make it more special. My niece, Elizabeth Rose got married to her love, Calland, in a beautiful outdoor site in Cambria California. I had a week of time at the beach house before that, enjoying monastic silence and beautiful weather, walks on the beach, and fabulous sunsets.

I had decided to rejoin the group Writer’s Relief, to try to help get some of the poems I have been writing published. This year, I got my sixth book, “Melody, Memory and Silence’ published. And when I was driving home from the gym about 3 weeks ago, the editor of the California Quarterly called to say she wants my poem about the Backpack for the Pilgrimage for her upcoming edition of the journal! This made me ecstatically happy, as I had begun to feel that maybe my poems are too old-fashioned, and that no one who is post-modern will like them.

I got to go to the event we have shared every other autumn since 2000, called “Through Our Own Eyes” — a retreat at Esalen on the Big Sur, for women physicians. This year was a joyful one for me, as we emphasized the necessity of telling good stories within our work, the way the story is told by the patient or the physician can influence how we SEE the diagnosis and the treatment. Storytelling is dear to my heart, as is poetry. One of the things we do is make necklaces of the beads we all bring to share, and each of us gets to take home a metaphor of the circle of women who hold us and help us be strong in the way we feel about our work, and how we bring resilience to it. I now have 5 of these necklaces, and when I wear them all, I feel like a tribal chieftain, in a fortifying costume which emphasizes what we hold sacred.

I also have been so blessed to see my sons stretching their wings and moving more deeply into their adult lives. This is a great joy for me. Seeing many of my nieces and nephews at the family wedding this month was also a joy. They are getting stronger and becoming more deeply themselves. I was glad to be given that time with family members who I don’t see that often, and really was so blessed to see them having fun together, also.

The weather is still good, although we have definitely entered our fall weather, the mornings have been clear and crisp. I am very grateful for the good friends and good health I still have been blessed with!

Finding Balance Between the Law and the ethical concerns about Abortion

Finding a balance in the abortion debates

by Martina Nicholson, MD

I am a retired Ob-Gyn, and a Catholic.  I majored in philosophy in college, and I have always had an intense interest in ethics.  I was trained to believe life is sacred, but I also watched my male college friends grapple with being sent to Viet Nam, for a war we did not believe was either reasonable or just; and at that time we grappled with “The Just War” arguments given to us, for consideration in trying to get an exemption for conscientious objection.  At the time, women were safe from the draft, so I did not personally have to consider being sent to fight in a war.   I also joined the Peace Corps right after college, and that also informed my sense of social justice.  The real limits of choices and moral distinctions for people,  due to poverty and unjust governments were very obvious to me, in my travels and life learning.

Since those early years, in which I was much more grounded in theory than in the problems of real life, I have come over and over to the problems in a crisis pregnancy, and what to do about it; what would be of best help to the particular woman, in this particular time.   I was often assisted in dealing with crisis in a particular woman’s  pregnancy by a supportive family; but sometimes, no community of advocacy and support was available.  This is the greatest heartache, and for the woman who is pregnant, the greatest need.   Love should be the context for a new life.

We were taught in my philosophy classes,  to dislike the idea of modifying an ethical opinion for a particular situation.  “Situational ethics” seemed somehow wobbly and undependable.  I now think this is all that matters, to find the most ethical action in a particular person’s situation, and to try to help that person carry it out.  I think sometimes it is helpful to use the popular question “What would Jesus do?”   We know that the only people Jesus condemned were the high priests and religious lawyers.  He said “You whited sepulchers, you impose a heavy burden you yourselves will not carry.”  Everything Jesus did was based on love.  What he told us about the Father was all about love.  He did not bully anyone.  He said  “Abide in me, in my love, and the Father who loves me will come and abide with you, so that our love may be complete.”  Every human action he did was stretching out to do something for someone, with love.

It seems incredible to me that theology treatises did not start with questions about who you are, what family and gender you belong to, and who you love.  And most of all, do you have a higher power, loving and gentle, giving you spiritual strength and support to help you?   To be told that you are not allowed to love the person you love, or that God doesn’t want you to love that person, seems to me to be completely twisting the character of God out of all recognition from the one Jesus describes for us.  It destroys the internal radar of people who need to feel their Higher Power’s guidance and support.   Motherhood is one of the ways we are called to grow much bigger than the self we are now… and we need help.  

And then there is history.  In Roman times, there were many virgin-martyrs.  This was not about sex, it was about the duty to the state, to have sons who would grow up to be Roman soldiers, to fight Rome’s wars.  Women who refused to marry and be pregnant were considered traitors to the state, and went to their martyrdom.  The woman for whom I was named,  St. Martina, was one of these brave virgin-martyrs of the early church, around 300 AD.  They tried to burn her at the stake, but it rained.  They tried to get lions to tear her apart, but the lions sat down quietly.  So finally, they chopped off her head.  This gives poignance to the title of virgin-martyr.

So what I now think about the right of the state to protect the unborn is complicated with the question of the right of the state to send that child after it is reared, to be a soldier for the state.   Since Dorothy Day, I think there have been legitimate questions about whether ANY modern war can be considered a just war.  More and more, the wars we have fought are to get oil or natural resources away from a different country.  Many of our wars are to topple governments which actually were “the will of the people.”  The story of Viet Nam, and the role of Ho Chi Minh after WWII is instructive.  And this foreign policy twisting goes down to what we are now doing in Venezuela.  And possibly the instigation of a war with Iran, which could quickly escalate to nuclear holocaust, if not the end of life on Earth.  All for reasons which have nothing to do with self-determination as a people.  

My belief is that the life in the womb is important, and that the woman who is becoming a  mother is also important.  She is not just a carrier, but a human being,  and her natural dignity and worth do not depend on motherhood.   Her talents, her desires for her own life, and the partner who helped to conceive this child also matter.  God has given her life, and her life also should not be devalued.   The life in the womb is organic, and grows to become a child.  Any limit, in any attempt to find a place that one’s ethical rule can become categorically clear, is not possible, in this continuum, I believe.  It is not that it is a pre-child one minute, and a child the next minute.  God brings new human life into the world through women and pregnancy, but it is a continuum of growth and development.  So, trying to nurture and protect it seems reasonable and important, and part of our duty to God, as much as stewardship of the earth through being good gardeners and good farmers.  We have a saying in our field of obstetrics, based on data, that $1.00 in prenatal care saves $3.00 in pediatric care for premature or unhealthy babies.  

Medically, you cannot have an abortion after 24 weeks, because 24 weeks is the beginning of possibility of life outside the womb.  Before that, the lungs are not developed enough to hold air and pass oxygen to the blood.  Even if you try to put a tube into the infant’s airway to help it breathe, the lungs cannot fill yet.  This may be the source of some people’s concern that a very premature baby is “gasping for air” and the doctors are not trying to help save it.  The instinct to gasp for air is there, but the lungs are incompletely formed; they are more like liver tissue, than the honeycombs of lungs, with pockets for air.  It is like a butterfly being torn too soon from the chrysalis, and unable to fly.  There are stories of babies born below 24 weeks who make it through the months in the NICU to become capable of leaving the hospital.  Most of them probably have been wrongly dated in the length of their gestation.  Yes, miracles do happen, but they are very rare.   Another situation is when the fetus has no kidneys, so that it will not be able to live without dialysis all its life.  These fetuses often also do not have full lung capacity, and also may “gasp for air” as a reflex, even at later gestational ages,  but attempting to resuscitate them is usually unsuccessful.  Neonatologists are educated in fetal anomalies, and are aware, when a lethal anomaly is present, that it is not “life-enhancing” to try to give full resuscitative care.   Neonatologists are also now required to give parents a realistic assessment of the chance for the premature infant at this gestational age to be able to grow up, and become a child with full capacity.  The earlier the premature fetus is born, the higher the risk for lifelong disabilities, especially cognitive delays and impairments. 

Because of this, most hospitals which do not have a Tertiary level NICU will send the pregnant mother  with very premature impending deliveries, to the nearest center, before the delivery, if possible;  in order to give her the appropriate counseling, and to help the baby be born in the best center to treat extreme prematurity if it is viable. 

Recently there was a poll taken that 76% of Americans would like to see abortions limited to under 12 weeks.  The problem with this, medically, is that lethal anomalies may not be detected with ultrasound scanning,  until 18-20 weeks.  Such problems as anencephaly, or severe cardiac malformations, or absence of kidneys, may make the ongoing life of this fetus seem an unbearable burden to some mothers.   

Medically, also, a mother may develop a serious medical condition which threatens her own life.  Cardiac problems, severe kidney disease, or cancers are among the conditions which may make it necessary for a mother to consider termination of pregnancy.  In these cases, there are Ethics Committees in hospitals, where doctors and a team of people help to discern what is the best possible answer in keeping with the beliefs and concerns of the mother.  If a mother with a medical illness needs to terminate a pregnancy, her very life is at stake, and she must have the best possible medical care during and before and after this procedure.  The abortion must be done by one of the most skilled surgeons.  Problems with cardiac output and blood clotting disorders make the procedure even more dangerous, and if the mother does NOT have the procedure she also might die.  These women need to be given the best care we can give them, and often the heartbreak of losing a desired child is an added trauma. 

If a fetus is born before the 24th week, in most places with a sophisticated NICU, the parents are given the choice of comfort care.   When the preemie baby is born, the pediatric neonatologist determines clinically, whether there is potential for life-outside the womb, whether there is a chance for resuscitation to be successful.  If the mother has asked to “do all possible” and there is potential for viability, in a tertiary care NICU, this help will be given.  But if the fetus is insufficiently mature for the resuscitative efforts to be of any use, the parents will be counseled that comfort care is “the best thing to do.”

The baby is wrapped in warm blankets and given to the parents to hold.  Most physicians believe this is the least traumatic and best way to serve families with the difficult and painful loss of a very premature infant. 

We have 60 years of data that millions and millions of women and couples have been able to successfully plan families and carry these families healthily, with smaller human families being the norm.  Being able to feed and clothe and house the family is a normal part of the duty and desire of parents.  Choosing how many children to have, and trying to choose what an optimal time is, for when to have children, is also a reasonable and wise part of stewardship of the gift of fertility.  We would not want farmers to ignore the weather and the needs of their land in planting crops.  We want our societies to be stable and our families to be sources of love and mutual support and care.  Using scientific technology and birth control methods which have been shown to be safe, effective and helpful for couples in planning families is sensible.  I have been waiting a long, long time for the reversal of the ban on contraception, by the Catholic Church, which has cruelly treated women and couples who have been prudent and modest in their desire to raise healthy families, by saying that the Church thinks it is sinful and implying that God doesn’t love you if you are using birth control.   For some people it is impossible to see that this is a bullying position, not one which actually allows the freedom to the couple to choose what is best for them.  At least in theory, the Catholic ethical position is that God has given us freedom of choice.  We are to be allowed, (even encouraged!), to exercise our consciences, in living.   Jesus said “I came that you might have life, and have it more abundantly.”  He did not say women had to have as many children as the body can bear.  He did not say that men have the right to rape women, or force women to carry more children.  It is interesting that Mary his mother, only had one child.  This is a model which is even more helpful now, as human population burgeons all over the planet.  

So, over time we have to keep asking ourselves, what the right answer is, about abortion, and why.  We are a political society and a land of multicultural diversity.  We have laws which enshrine the belief that all people are equal and that we are a country based on the rule of law.  I think we have to understand that ethically,  in medicine, the primary priority is autonomy.  In political society, I believe the proper ethical role of the church in our country is in moral suasion, rather than forcing or bullying women to carry children.  And that leaves us with what should be legal.  I believe abortion should be legal.  I believe we need to protect the physician’s right, to not do abortions, and to do them, without legal sanctions, or criminalizing either the doctor or the patient.   There is no middle ground ethically, to reconcile people who think pregnancy is sacred,  with people who think the right of the woman over her own body is sacrosanct.   I believe we have to let women choose whether to continue a pregnancy.  We can try to persuade a woman that it would be better to carry this child, and we can try to make it more bearable for her by helping her with the other corporal needs;  housing, food, safety, healthcare,  the means to exist as a parent, and also in dealing with possibly violent or cruel people who surround her. 

Our proper role is to help women grow into mothers, by supporting them emotionally and spiritually, as they take on this task.  No woman feels completely ready or capable of becoming a good parent, her self-doubt can be excruciating.  And helping the women with their needs in pregnancy is the proper role of the family and community.  The community becomes even more important when the family cannot meet the woman’s real needs. 

If you ask “Who is the advocate for the unborn child?” it is the family, the community, the people surrounding the pregnant mother.  The natural best advocate would be the father.  But some men do not take the role of fathering as a sacred trust.  Others are incapable.  So the community becomes the support for the woman in a crisis pregnancy.  This is NOT the state.  It is more variable, more fragile.  But it is REAL, and it understands that a child will need more support and advocacy as he or she grows.  For someone to insist that the state take on that role is unrealistic, I think. 

The highest amount of domestic violence is aimed at vulnerable pregnant women.   Many women seek abortions because of rape, or incest, or partners who are violent or addicted to substances which make their behavior cruel, life-threatening, and unpredictable.  Women want to be able, when bringing a child into the world, if possible, to give the child a stable home.  We should applaud this instinct in women, instead of condemning it.  For some women, their own parents and family can provide that safety and home, allowing her to get on with her life as a single mother.  Some women are dynamic and courageous enough to work through all the vulnerabilities of being a single mother with almost no social support.  But not all women have that ability and strength.  If the society and the church community wish to be of service for women in crisis pregnancy, they will be more creative, finding ways to support pregnant women with housing and safety and medical care.  The mandate for the Christian community is TO LOVE.  We love each other by providing for the needs of each other.   The society at large also DOES have a stake in the healthy raising of children.  We now have 20-25% of children being raised below the poverty line, often in unsafe housing and unsafe situations.  This is compounded for mothers who themselves are afflicted with mental illness or addiction.  And it is severely complicated with fathers who are violent, drug-addicted, locked up in prison and so unable to be helpful in real time to the mothers and children, and also in social situations of unsafe housing and communities without adequate safety for children and families.  The USA is now considered one of the top 10 places in the world for violence against women to occur.  Women and children refugees and homeless people needing shelter are even more vulnerable to violence; abuse, rape,  torture, human trafficking, and death.  

In the long run, I believe we will do the best we can with the difficulties of crisis pregnancies if we confine the actions of the Christian community to trying to LOVE instead of bullying women.  And in our national laws, we will do best by protecting the women’s right to pregnancy terminations.  As medicine evolves, new methods and more effective methods of family planning have come and will keep coming, and we should do our utmost as a society to make these methods available for all women to use and to choose.  By giving women and couples the right to decide what is best for their own families, we put family life on the surest footing.  

In the rest of the world, and before the advent of modern contraception, the only real means to solve overpopulation were war, famine and plague.  But now we have medically safe and prudent ways to help families, to help make childbearing and child-rearing the best it can be, in spite of all the difficulties, risks,  and uncertainties of modern life.    For those who think this is not pro-life, I say that we also allow capital punishment and killing in war, in spite of the 5th commandment, which has no sub-clauses.   God knows the amount of slaughter going on in the world, and how many millions of children die of hunger, malnutrition and curable diseases due to lack of access to medical care.  What we should be striving for is TO LOVE.  Jesus’ mandate, and his message was pretty clear– “this is how people will know you are mine, that you LOVE ONE ANOTHER.”

Theology and Relationships

I am not sure what exactly the focus of the big meeting planned for February 2019 at the Vatican will be, but I hope that there is actually a forum and quorum for the issues of relationships as evolving and dynamic, and not static.   We need to have language which articulates respect for each person, and that people are never to be treated as an object. 
Most of the theology of sex and sin when we were young centered on single acts, not on relationships.  For more than 40 years, we have had theologians who are Teilhardians in the assessment of progress of human culture and well-being.  We have been able to discuss the theology of marriage, and of good theology in general, as a deepening conscious integration of the love of God, and the knowledge that goes with that love of God.  Thus, the issues of honesty, vulnerability, respect, compassion, tenderness, humor, caring, generous listening, accountability, forgiveness, boundaries, self-esteem, etc, which were never covered in discussions about moral theology in the past, are now at the forefront of  how we should be able to form good healthy relationships in safety with other people— not just sexual intimacy but emotionally satisfying friendships, spousal relationships which mature over time, parent-child relationships which also mature over time,  and other kinds of interactions which may contain emotional, spiritual and physical components of intimacy. 
I think it is a good time for us as a church to retire the wrong thinking which got embodied in the encyclical “Humanae Vitae” as a proscription against birth control.  Sensible family planning decisions need to be left to the conscience of the couple, as they plan their lives and take on the burdens of parenthood.  I think we need to address how to include gay people in a respectful way, which recognizes that sex is part of intimacy and love relationships of many kinds.  We need to have informed theology which leans on modern psychology and the best spiritual guidance about being a healthy human being.  We need to aim at protecting people from STDs and traumatic side-effects of having a sexual event which is disrespectful and not loving, such as incest, rape, abuse of a minor, sexual assault, etc.  We need strong proscriptions against sex trafficking, and concerted efforts all over the world to provide shelter for people who are at risk for this modern slavery.  I believe this is actually something our Church should be doing.   I certainly hope that international agreement will happen in making sure there are always 2 adults when children are present, to lessen the risk of a child being injured or taken advantage of in any way.  We need to have strict protocols in place, to protect children from sexual predators.  We also need to do ongoing surveillance and rigorous assessment to keep pedophiles from having access to children;  and to protecting our schools and parishes, with reasonable oversight of committees which include laypeople and parents.  Since sexual assault is a crime, we also need to be sure that predators go to jail, and are not promoted or hidden within the church. We need to have  full cooperation with the law and the police. 
We also need to have  credible pastors, who are attempting to live their own vows in a healthy and humble way.  For this reason, I am even more hopeful that we will now move to have the clergy have the option of marriage, and also that women will be given a wider role in pastoral care.  
Maybe this time, in which my friend Tim’s daughter Katie has embarked on the vocation of becoming a Poor Clare, can be a time of great growth in the Church, equivalent to when Galileo said that the movement in the heavens is such  that the earth rotates around the sun.