Deathbed fk-8 Page 23

  Dr. Anderson nodded.

  “Then I suppose the same can be said for this worn-out uterus. It can no longer serve any positive purpose. It’s just a trauma waiting to happen. So I’d say that it would be morally acceptable the next time you see that womb to remove it.” Koesler fingered some fries. He felt somewhat self-satisfied.

  “That’s pretty much the way I figured it, Father,” Anderson said.

  Koesler lost some of his smugness. “If that’s the way you had it figured, what in the world was the purpose of asking my opinion?”

  “Well, you see, Father, I just got done talking over that part of the decision with Mr. Haroldson here, just to make sure it would be okay to do the hysterectomy. But that was preliminary to the other more pertinent question I had just posed to Mr. Haroldson right before you came to the table.”

  “And that was . . .?”

  “If it was okay to do the hysterectomy, then wouldn’t it be preferable just to tie the woman’s tubes? That way we would isolate the uterus. She would never get pregnant again and we would avoid major surgery in favor of very minor surgery.”

  Koesler glanced at Haroldson, who was sitting back wearing a large smile as if waiting to see if the priest could guess the correct answer. Koesler hated to be put in this position. It was as if he’d been tricked. He’d settled a problem that had already been settled. For no accountable reason, he felt as if he had passed some juvenile test and now was being put through a similar, but higher-level exam.

  “Apparently,” said Koesler, “you came down here to ask Mr. Haroldson’s opinion. Why don’t you do that?”

  “Oh, no, Father,” said the still-smiling Haroldson, “you’re the designated expert on theological matters. Why, young Dr. Anderson is in luck that you chanced to join us.”

  I didn’t “chance” to join you, Koesler thought. You invited me to join you, you curmudgeon.

  Anderson seemed to be playing the role of monkey in the middle. By this time, he didn’t much care which of them fielded the question.

  Koesler inserted a single strand of fried potato in his mouth and thought. “Tie the tubes, eh?” he said. “It makes sense to me. And it might make glorious sense to the poor woman.”

  “Then you think it would be morally acceptable to perform a tubal ligation!” Haroldson more challenged than questioned.

  Koesler felt a moment of embarrassment as if he had given an incorrect answer in class. But he recovered quickly. “Well, yes. However you wish to figure it; a part for the whole, if you will. If it’s acceptable to perform a hysterectomy, it seems equally, if not more, acceptable to perform a lesser operation for the same purpose. The idea is this woman shouldn’t chance being pregnant again. Or, rather, that she can no longer depend on her womb to sustain a fetal life.”

  “You’d allow that even though there is nothing whatsoever wrong with the Fallopian tubes!” Once again, Haroldson put an audible exclamation mark at the end of what might have been an honest question.

  “Yes, I think so. It serves the same purpose and certainly makes more sense than a hysterectomy. As the Doctor here has said, it’s a trade of minor surgery for major. I think it’s the obvious conclusion.”

  “And how would you justify that theologically, Father?” As time passed, Haroldson’s questions became more clearly a series of challenges. The plaster-of-paris smile began to fade as well.

  “Justify it? What are you driving at?”

  “What principle in moral theology would justify your conclusion, is what I’m driving at. Sounds like situation ethics to me!” It was evident from Haroldson’s inflection that he considered situation ethics a pejorative term.

  Anderson glanced at his watch. Two things were certain: He had to get back to his hospital duties and his procedural dilemma had become a bone of contention between Haroldson and Koesler. “If you don’t mind, I’ll just get back to my rounds. I’ll get back in touch with you both later and find out what you decided.”

  Anderson left the table. As far as Haroldson and Koesler were concerned it was as if the Doctor had never been there.

  “Well, I’ll admit that, while I gave the uterus business some ‘theological’ consideration, the opinion on the tubes was sort of off the top of my head. But it certainly did not spring from situation ethics. I’m afraid I can’t subscribe to a school where all morality is weighed by an intention to do the ‘loving’ thing.”

  “Well,” Haroldson said, “that’s refreshing. But then, may I ask what theological consideration you used to justify the original hysterectomy?”

  For some reason, Haroldson seemed determined to keep Koesler in a pupil-teacher position.

  “I suppose,” Koesler replied, “that would be the principle of the double effect.”

  “You mean,” Haroldson corrected, “the principle of the indirect voluntary, of course.”

  Damn, thought Koesler; he’s right. But he’s also nit-picking. Indirect voluntary was but the generic term under which fell the principle of the double effect. In either case, one dealt with a consequence that was not directly willed. Specifically, in the double effect, one posited an action from which flowed two distinct effects, one of which was “evil.” To be justified in traditional Catholic theology, the action must be good, or at least indifferent. The immediate consequence of the action must be good and the good must outweigh the evil of the secondary consequence, which, in turn, is not directly desired or willed but only permitted.

  That, in a nutshell, was the principle of the indirect voluntary and its firstborn child, the principle of the double effect. And the insistence on a reference to the generic term was an indication to Koesler that Haroldson could be a difficult person with whom to do business.

  “Yes,” Koesler admitted with little grace, “you’re right. It’s the principle of the indirect voluntary.”

  “Exactly. The operation is not only warranted and good, it will happen of necessity because of the Caesarean delivery. The first and immediate effect of the surgery will be the removal of a worn-out, tired, and ineffective organ. And that is good, and it outweighs the contraceptive effect, which is not directly willed, but only tolerated.”

  “Uh-huh.” No doubt about it, Koesler was becoming testy.

  “And you feel the same reasoning applies to a tubal ligation in this case?” Haroldson made it seem a rhetorical question to which Koesler was about to wrongly respond.

  “Yes, I do,” Koesler replied, giving, by Haroldson’s standards, the wrong answer.

  “Would you mind explaining that, Father?”

  “Look, I’ll admit we aren’t dealing directly with the defective organ. But in performing the hysterectomy the surgeon’s going to have to cut the Fallopian tubes anyway. So what’s the difference? What’s the difference if he cuts the tubes and then removes the defective uterus, or if he simply cuts the tubes, isolating the uterus, and leaves the organ there—to the great benefit of the patient?”

  “The difference is, Father, that the surgeon is operating on a healthy organ and on a healthy organ alone. Thus making the action in se mala.”

  It had been a long time since Koesler had heard the term evil in itself, or totally evil.

  “And besides that, “ Haroldson continued, “the Pope had something to say about this!”

  “The Pope?”

  “Yes, the Pope!”

  “Which one?”

  “PiusXII.”

  “That was a long time ago.”

  “Words for the ages.”

  “Well, what did he say?”

  “That when someone halts ovulation to save a damaged uterus, that is direct sterilization and therefore illicit.”

  “He was talking about the prevention of ovulation. At most that would refer to the antovulent pill.”

  “Or to the Fallopian tubes that carry the ova.”

  “I don’t think so. Besides, that opinion must go back to the forties or fifties.”

  “Father! That is—”

  “I know, I
know: the ordinary magisterium.”

  “Yes! The ordinary magisterium!”

  “I don’t suppose it would help to point out that the usual teaching function of the Church has developed and changed over the years . . . make that over the centuries.”

  “Father, since you are a part of this hospital, at least for the time being, maybe it would be good to know just what you believe. Just what theological school do you belong to? Vatican II? Vatican III? Vatican IV?”

  Koesler laughed. “I believe about what you do, John, except not quite so rigidly.”

  “Not so rigidly! Then you are a situationalist.”

  “No. No, just someone who cannot help seeing some grays in moral theology.”

  “Grays?”

  “John, the theology we grew up with . . . well . . . it was the theology of The One, Holy, Catholic and Apostolic Church. There was development going on, but ever so slowly. And John, I don’t think it will ever be that way again.” Haroldson was about to interpose an objection, but Koesler quickly continued. “Not that I am about to adopt every new thought just because it’s new. But the theology we grew up with is based on a natural law ethic. It’s an absolute and objective sort of morality. And, on the one hand, I think there’s been considerable development in our understanding of the natural law. And, on the other, I think we can stand some mix of proportionalism where we weigh the proportion between good and evil, where the human person is the norm and each person is unique.

  “Besides”—Koesler winked—“I’ll bet I could dig up a probable opinion to support doing a tubal ligation to isolate that woman’s uterus.”

  Haroldson shook his head. “I don’t care. I’m just glad I’ve lived my life at a time when Church teaching was clear and objective and dependable. Today’s young priests are creating their own Church. And they can have it.”

  “As hard as it probably is for you to believe this, I don’t disagree with you all that much. But I’ve got to hand it to you, John; you have an excellent understanding of moral theology. Usually, when I get into a discussion with a layperson, the main problem is that we’re not talking about the same thing. Usually, our disagreement rests with the layperson’s misunderstanding of traditional theology. That certainly is not the case with you. You have an excellent grasp of systematic theology. I can’t help wondering where you got it.”

  “It’s nothing.”

  “I beg to differ. And you couldn’t have picked it up in just any parochial school. Where?”

  Haroldson sipped his coffee as if trying to decide whether to get into this. “The seminary.”

  “The seminary! I didn’t know. Tell me about it. How far did you go?”

  Haroldson smiled grimly. “From the very beginning to the very end.”

  “The very end! I don’t understand: You weren’t ordained a priest?”

  “No.”

  “Then . . .”

  Haroldson hesitated. “The thing is, you see, Father, I’m an ecclesiastical bastard.”

  Koesler was neither shocked nor surprised. There were lots of ecclesiastical bastards around. This was not caused by an unmarried mother. It was a case of one’s parents not having their marriage witnessed by a priest. And this was the result of one or both parents opting out of a Catholic wedding; or one or both parents had been previously married and not in possession of the required declaration of nullity for the previous marriage.

  “And that,” Haroldson continued, “is an impediment to Holy Orders.”

  “Well, yes. But a dispensation is possible. Now it’s routine. “

  “Not then. Not when I was a seminarian. Oh, the dispensation from the impediment of illegitimacy was possible. But the petition for the dispensation was by no means routinely made. And in my case, the bishop simply decided not to petition. And that was that.”

  “But the bishop must have known the problem of illegitimacy was there. Why would he let you go all the way through the seminary if he wasn’t going to ask for a dispensation?”

  Haroldson shrugged. “I don’t know. I’ve always thought that he let me complete my seminary education because it certainly couldn’t hurt me even if I lived the rest of my life as a lay Catholic. In retrospect, I’d have to agree with that. And I suppose he spent some of his time during all those years praying for guidance. The answer to his prayers must have been not to process my case to Rome.”

  “My God!” Koesler was appalled. “All those years! You were no better than a puppet. And the bishop was playing puppeteer!”

  “Oh, it wasn’t that bad.”

  “Wasn’t that bad! You spent nearly twelve years preparing for the priesthood. Early on, the bishop could have told you he wasn’t going to do anything about an impediment that was no more than a Church law that could have been suspended. If nothing else, you could have been freed to find a bishop who would have gone to bat for you.”

  “You’re building this up larger than life, Father. I wasn’t blindfolded during all those years. I knew about the impediment and I knew the decision was entirely in the hands of the bishop. You see, for me, the bishop’s decision in the matter was the will of God. I entered the seminary intent only on knowing whether the priesthood was, for me, God’s will. As it turned out, it wasn’t.”

  Koesler looked at Haroldson as if for the first time. “I admire your faith, I really do. But I think I would have to look well beyond the whim of a bishop for an expression of God’s will.”

  “For me, that was it. Besides, all those years of a fine liberal arts education paved the way for my premed.”

  “You were premed!”

  “Yes.”

  “But you didn’t complete it. You didn’t become a doctor.”

  “No, one more incomplete endeavor.”

  “But why?”

  “No money. Or, rather, I ran out of money. There were no government loans. Nor any other, for that matter, for someone of most modest means. But,” Haroldson began arranging his tray, “neither experience was a failure as far as I’m concerned. Since both of them led to this hospital. This,” he said it fondly, “this Catholic hospital. The seminary trained me in things Catholic. And medical school gave me a special preparation for the hospital. And this has been my life . . . my very life.”

  Koesler noticed the slightest quiver at the corners of Haroldson’s mouth. The priest was touched at this sign of emotion.

  “And now,” Haroldson continued, “they expect me to leave it. Just, one day soon, stay home instead of coming to where my life is. Just because a man reaches an arbitrary age, he is expected to die.”

  Strange, thought Koesler, the similarity of reaction to retirement on the part of Haroldson and Sister Rosamunda. “Oh, come now, John,”Koesler said, “that’s painting it rather more bleakly than necessary, don’t you think? Especially with your background, there must be any number of fulfilling things you could do. Teach, for instance.”

  “That’s what she said.”

  “Who?”

  “Sister Eileen.” Haroldson almost spat the name. “She doesn’t understand. You don’t understand. Nobody understands. A man can die when he’s forced out of his life’s purpose. Father, I’m fighting for my life!”

  “John, I’ve known people who dreaded retirement every bit as much as you do. And they managed to live through it. Even thrive on it.”

  “You don’t understand. You just don’t understand . . .” Haroldson picked up his tray with its now-empty dishes and left.

  Easily half of Koesler’s lunch remained. It was cold and now unappetizing. That was all right, he thought. Selecting that much food had been an imprudent whim. It was just as well to leave half of it uneaten.

  He sat for a few minutes pondering his conversation with Haroldson. Koesler had learned much. Perhaps it was true that every organization needed at least one hatchet man. And perhaps John Haroldson was that man on behalf of St. Vincent’s Hospital.

  On the other hand, it might be true that to understand was to forgive all.
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br />   * * *

  “Aren’t you finished with this story yet?”

  The peevish tone took Pat Lennon back to her youth when, as she liked to joke now, nuns were nuns and religious sisters were prone to admonish young Catholic students to “cast down your bold eyes!” But she was utterly unprepared for any harsh statement from Sister Eileen Monahan. So, Lennon was startled by the question.

  “Why . . . yes, as a matter of fact,” she replied, “I am almost finished. Another interview or two and I’ll have all the information I need. Then there’s writing it up for the magazine. But that’s a rather flexible deadline. Was there some hurry, Sister? I wasn’t aware of any.”

  “It just seems that it’s taking an awful lot of time.”

  Lennon hesitated. “Is there something wrong, Sister?”

  “Wrong?”

  “You don’t seem yourself.”

  Eileen pinched her brow just over the bridge of her nose. “I have been abrupt, haven’t I? Sorry.”

  “No need to apologize. On the contrary, you’ve been most patient and cooperative. Everybody at St. Vincent’s has been. Especially you. That’s why I was surprised just now. It is perfectly reasonable for you to want me out of your way. But it seemed sort of . . . out of character for you.”

  Eileen smiled, it seemed in spite of herself. “Well, I’m glad we’ve managed to give you a good impression of St. Vlncent’s. All the more reason I feel ashamed I was short with you just then.”

  “Is there something . . .”

  “No. No, I’ve been having some headaches and a little dizziness lately, that’s all.”

  “Are you taking anything for it?”

  “Some aspirin. A little Terpin Hydrate, but that’s for a kind of constant congestion. It’s probably just the onset of a cold. We’ve got the kind of weather for an annual Michigan cold or flu. It’s nothing to be concerned about. I’ll be all right.”