A Good Hospital

Let’s imagine the best Catholic hospital–the best possible Catholic hospital, the Platonic ideal of the Catholic hospital.

The first thing to be said about this hospital is that it would not be like other hospitals, even other hospitals of comparable size, standing, geography, etc. It would be different, and not just because it would have a name like “Sacred Heart” or “Our Lady of Something”. And it would be orthodox, not in the sense that everyone checks the right doctrinal boxes, but in the sense of any organization that has a mission and where everyone is on board with that mission and sees themselves as serving that mission.

The second, and most important, thing to be said about this hospital is that it would view itself as being primarily in the business of being in the care of souls. Everyone working at the hospital, from the CEO down to the janitor, and with everybody in-between, would view themselves as in the business not of providing medical care, but of providing care for souls. It wouldn’t just be that no patient in the hospital would be just a number–although that alone would be exceptional for a hospital. It would be that every doctor, every nurse, would have a holistic view of every patient, and think first of caring for people’s souls, then caring for their minds, then caring for their bodies.

As an aside, my wife and I chose the private clinic where our daughter was born because it was the only one we found where they offered a spiritual preparation to birth course, not just physical/psychological. We only later found out that it was widely ranked as one of the very best maternity clinics in the country. Sainte Fé is run by nuns (of course) who were all ridiculously adorable–and competent. Some of the nuns were nurses, some were ob-gyns, some were administrators. Our daughter was born a few days before Christmas. On Christmas Eve, the nuns went around every (non-IC I guess) room in the clinic playing guitar and singing Christmas songs and handing gifts they hand-made for the babies and parents. The first time my daughter left the medical environment was in my arms to go to Midnight Mass in the clinic’s chapel, which I’m sure you can imagine was a moving moment for her parents (she slept through the whole thing, of course).

Thinking of a hospital as being in the business of caring for souls sounds nice but not really difference-making if you’re thinking about someone who broke their arm, but in those medical procedures surrounding the beginning and the end of life we can see how important care of souls is. Often it can make all the difference.

Now, once this is said, here’s the point I am getting to. Remember, we are imagining the best Catholic hospital possible. All of what I have just said is of utmost importance. But if we think of the best possible Catholic hospital, we have to think that it would also be a really good hospital.

By which I mean the best Catholic hospital would have some of the most skilled and talented medical personnel in the world, and it would be at the cutting edge of technology. Doctors in the best Catholic hospitals would think of themselves as caring for souls first, absolutely, but they would also be excellent at medicine. Administrators in the best Catholic hospitals would be evaluated first, absolutely, on their faith and charity, but then, and equally rigorously, on their skill as administrators. If we are thinking about the best Catholic hospital, we are necessarily thinking about one of the, if not the best hospital in the world for medical outcomes and so on. It would be one of the world’s most outstanding research institutions. We are thinking about a hospital which would be on the cover of magazines like the MIT Technology Review and Harvard Business Review and the McKinsey Quarterly for its relentless innovation. We are thinking of a place where cutting-edge new medical procedures and new organizational templates would be tried out all the time. What’s more, we are thinking of a place where, if you were to suggest a medical innovation and someone replied “We’re here to take care of souls first, not medicine”, everyone else in the room would look at them as if they sprouted a second head, because everyone would understand instinctually that to take care of souls necessarily entails being extremely competent at medicine, if only because our options regarding caring for someone’s soul narrow down considerably once their body’s dead.

Where am I going with this? As I’m sure you figured out, I am, after Pope Francis, using the metaphor of the Church as hospital.

And the metaphor I’ve outlined I think helps make two interrelated points that I don’t see made enough:

Competence matters. A priest who was like a spiritual father to me and who ran a relatively large ecclesial movement was in the habit of saying “Finding eager and dedicated volunteers is easy. Finding competent volunteers–that’s hard.” The Church is “in the business” of doing many many many things. Running hospitals. Running schools. Feeding the poor. Sheltering the homeless. Providing psychological guidance. Continuing faith education. Catechesis. Saying the liturgy. Doing public advocacy. The list is endless, and it is a true blessing that it is endless. It is easy enough to see that to be a truly Catholic hospital, a Catholic hospital has to be many things other hospitals don’t, but it first has to be a good hospital. Well, this is true about most everything else. We Catholics spend a lot of time (myself very much included) on abstract discussion about how we should do this or that or the other thing, and comparatively little on just doing it very well. The liturgy is a great example. The problem of the liturgy in the daily life of the Church is not the topics we endlessly obsess about–vernacular vs. Latin, ad orientem vs. versus populum, organ vs. guitar…–the main problem of the liturgy in the Church is mediocrity. The problem is not guitar music, it’s bad guitar music. Now, I realize that competence is not wished out of a hat. I realize that the Church is always strapped for resources, and it doesn’t exactly recruit out of Harvard Business School (insert your own joke here). As my mentor pointed out, this is really hard. But it seems to me that actually talking about it, actually being aware that this is Step #1, is something we don’t do enough. It won’t fix anything by itself, but I do think it’s a place to start.

Empiricism matters. The Catholic Church is heir to the most stupendously rich intellectual patrimony in the history of humanity. The reason why I like the metaphor of the hospital is because a good hospital is at the cutting edge of science. Do we think the Church should be at the cutting edge of science? By which I don’t mean that Catholic institutions should be the world’s premier research centers for, say, physics, although they should (and maybe are). By which I mean that one exceedingly Catholic idea is that one of the reasons God gave us senses and a rational mind is that through rational inquiry applied to the world we can discern His will. Let me be more concrete: if you were to draw up a list of the world’s 100 most innovative global development charities, how many Catholic ones would be on the list? How many among the Top 20? I am sure there would be some in here that I don’t know about, but I do think we’re not doing as well as we can. The two most innovative Christian development charities that I know of are Evangelical: World Vision and the International Justice Mission. Which organizations are renowned as leaders in the microfinance movement? Off the top of my head, I can cite the Grameen Bank and SKS Microfinance and PlaNet Finance, none of which are Catholic. And speaking of actual hospitals, what about the Mayo Clinic (founded with the help of nuns!) or Narayana Health? And, forgive me for getting on my hobbyhorse, but what about education? KIPP, Teach for America, OLPC, Harlem Children’s Zone, Khan Academy, AltSchool–those aren’t Catholic organizations. Again, I am sure plenty of Catholics are working on amazing stuff in the shadows, and these organizations don’t have all the virtues, but do you see the point I am making? In higher ed, where’s the Catholic Udacity or Minerva Project? Speaking of education, of course, I would be remiss not to note that the greatest education scientist of the 20th century, Maria Montessori, was a devout Catholic, and that her findings, enormously in accord with both science and Catholic theological anthropology, have been utterly ignored by the Church which continues to mostly establish schools which are merely carbon copies of secular schools. The Gates Foundation wants to eliminate malaria and deploy every means to do so–where is this kind of vision for the Church? (And yes, it is about vision, not money–God provides.) Meanwhile, we have the Pope telling us the reason people go hungry is because we first-worlders throw away food. One of the most exciting current trends in development science is the use of randomized field trials, which are the golden standard of evidence in social science, to determine the effectiveness of poverty interventions. Given her scale, her presence everywhere in the globe, her myriad social services agencies and bodies and her higher ed and research institutions, the Catholic Church is uniquely placed to take the lead in this movement and in the process not only advance science, but immeasurably improve millions upon millions of lives for the very great glory of God. I could go on and on and on. But the point should be clear: if you want to be the best Catholic hospital, it is self-evident that in order to do so you need not only the right theology and holiness, you need to be at the cutting edge of science and innovation. This doesn’t seem to me to be in the picture in the Church at all. In using empiricism to be better at being “the Church” we have another great ally, which is Catholic theology. When it comes to human beings, “science” is much less conclusive than when it comes to particles and lumps of matter, because the causal density is so deep. Empirical investigation, as extremely important as it is, can only give us leads and insights and suggestions. Everyone can do that. But thankfully, we have the other piece of the puzzle, which is Catholic anthropology. In designing some social program, we the Church should be able to design the best social program because we would have both the best scientific work and also the best theology to answer the questions that the empirical work can’t answer. But I don’t see us being conscious of the opportunity.

The Nave of St Peter’s Basilica by Manfred HeydeOwn work. Licensed under CC BY-SA 3.0 via Wikimedia Commons.


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  • Dan13

    I’m a bit curious on your thoughts about the liturgy. When it comes to hospitals, or schools, or research then people who have gifts and talents suited towards those roles can excel while those who are unsuited will participate in other things. However, we’re all called to worship, so it seems a bit different to me.

    • That’s a huge topic and one I will come back to, but I would offer up the following analogy: it’s like an orchestra. Which means (1) everyone has a different role; (2) the composer’s piece might be amazing, and the conductor might be a great conductor with all these wonderful ideas about how to express the music’s beauty, if the violinists are bad violinists, you’re still going to end up with bad music.

  • JohnMcG

    I don’t think there is a shortage of raw talent in the ranks of Catholics — a look at the prominence of Catholics in various professions would demonstrate that.

    The problem seems to be that Catholics are choosing not to apply those talents in service of building up the Church and its various institutions.

    For example, I don’t think many Catholic physicians would consider the establishment of the type of hospital you describe as the pinnacle of their profession.

    So why not? Well professions in the Church do not pay as well as the secular world. Does this point to a lack of virtue on the part of people who chase after higher compensation elsewhere? Or does it point to the fact that all of us are not willing to pay for quality in these things and instead settle for mediocrity in return for not being hounded for money as often. I suspect it’s a but of both.

    There’s also a bit of a vicious cycle where a person with recognizable talent who presents him or herself and her gifts can quickly become overwhelmed by the variety of things to be done. This shouldn’t stop us, but it can be difficult to avoid burn out.

    • “I don’t think there is a shortage of raw talent in the ranks of Catholics — a look at the prominence of Catholics in various professions would demonstrate that.

      The problem seems to be that Catholics are choosing not to apply those talents in service of building up the Church and its various institutions.”

      I think that’s absolutely right. The first point was one I wanted to make and forgot.

      That’s a very big topic, but one thing I would say here is: talent begets talent just like success begets success. You see this in the foundation of the great religious orders. The charism of the founders attracted other exceptional people and that’s what, to use a French expression, made the mayonnaise take. Which brings us back to my original point, which is that we would do a lot of good if the institutional Church put a big premium on just doing what it currently does *really well*.

    • JohnMcG

      One more thought is thinking about how Catholic services should play with a welfare state.

      Perhaps the Church’s service should be more empirical and science-based. But it occurs to me that this is a possible strength of large-scale government programs. They are well-positioned to conduct research and apply the results to well-crafted programs.

      What they are not well-suited to, and what the Church may be better positioned to do, is to know the needs of the person standing in front of them. Empiricism may tell us how to craft education policy; it may not tell us how to educate *this child.*

      I guess my point is I’m not sure whether we should aim to compete with or complement the services provided by the state. Probably some mix of both.

  • Sounds like a great place. Where is that, in France? Paris? I wish we had something like that where i live. As an aside you should break up your paragraphs into smaller chunks. Just my opinion. Take it for what it’s worth.

    • What place?

      Re: paragraphs, you’re right. It’s something I’m aware of. If you see big unbroken chunks of texts, it’s that I was banging on the keyboard stream-of-consciousness at that point. I try to go back and break them up but don’t always do that. Thanks.

  • captcrisis

    This badly needs saying. In too many Catholic facilities the medicine has been “faith based”. You know who I’m talking about.

  • BTP

    It’s all about budgets, isn’t it? You simply can’t have excellent music without a serious budget commitment. Singers and musicians want to get paid, if they are good enough to do so.

    When it comes to schools, government provision of education has greatly reduced the size of the market — you have to be a household that can afford ten- or fifteen thousand dollars per child per year. There aren’t that many of those households so, in just the same way that small towns have a small variety of restaurants, there isn’t a lot of variety in schooling.

  • jlhyacintha

    There is a “Catholic version” of Teach for America, it’s called the UCCE University Consortium for Catholic Education. There are about 15 affiliated programs across the US where new primary and secondary teachers live in Catholic community with each other for 2 years while teaching in Catholic schools and studying for their Master’s degrees.
    The vision is there, and the teachers who come from this program are some of the most skilled, dedicated and passionate educators I have worked with. Their website is pasted below: