Mother Marianne and the Sisters of St. Francis

By Patrick Downes

Was it coincidence or providence?
   The same week the date of Mother Marianne of Molokai’s beatification was announced came the revelation that her sisters were exploring ways to leave the operation of her most prominent island legacy — Oahu’s two St. Francis Hospitals.

However one views these two seemingly conflicting developments, they are not entirely out of character with the bold history of Sisters of St. Francis in Hawaii.

It was 122 years ago that Mother Marianne said goodbye to running two major hospitals in New York to staff a ramshackle government facility in the remote island kingdom of Hawaii. Hardly a great career move.

The Franciscan superior walked away from the benefits of U.S. citizenship, hard won by her father, for residency in a sugarcane nation and whaling port with a Protestant powerbase.

This woman of immense talent and grace then agreed to spend the rest of her days in this isolated archipelago’s most isolated spot to serve a few hundred unwanted people she could not cure.

And she did it all graciously, gladly and eagerly.

She was, like Jesus, a sign of contradiction. Now consider for a moment the fruits of her paradoxical life. In Hawaii alone, because there was a Mother Marianne, there are hospitals, schools, extensive healthcare programs and the islands’ largest religious order.

And after 87 years, her bones have been sifted from the Molokai soil and carried back home to New York in a step toward the universal acclaim that will come when the Vicar of Christ beatifies her in Rome on May 15.

The news that Mother Marianne’s sisters will relinquish St. Francis Medical Center and St. Francis Medical Center-West sounds like another contradiction. Though Mother Marianne did not herself establish the hospitals, her spirit did. As her beatification will celebrate her life, the situation with the medical centers would seem to diminish it.

It’s hard to imagine a Hawaii without a St. Francis Hospital. For more than 75 years it has been nestled there on the slope overlooking Honolulu. For generations it has been Hawaii’s quintessential Catholic institution, run by religious sisters in the spirit of Assisi, serving the poor, stepping forward to treat Hawaii’s most difficult and chronic patients and embracing compassionate care of the dying.

The recent addition, Medical Center-West, a vision of a prescient Sister Maureen Keleher for the Ewa plain when it was still covered with cane, is now one of expanding leeward Oahu’s most valuable assets.

Make no mistake, St. Francis Hospitals’ preference for the poor does not mean they are poorly equipped. These thoroughly modern medical centers have been pioneers in transplant surgery, oncology, renal care and medical technology. Their services are top notch; their care is first rate.

However, the bottom line for the sisters was never a financial one but a scriptural one: “The charity of Christ impels us.”

Unfortunately, “the charity of Christ” has not always effectively served as a strategy for gaining a competitive edge in the modern health care market in Hawaii.

Poor patients are costly. Chronic patients can be an economic drain. Government mandates are expensive. Labor strikes can be crippling. But the Sisters of St. Francis — first vowed to poverty, chastity and obedience — were always clear about their mission. It’s not market share; it is the healing ministry of Jesus.

So after prayerful reflection and a somber reality check, the Sisters of St. Francis came to the painful conclusion that their healing ministry was in danger of being set spiritually adrift by the struggle to stay financially afloat.

Their solution is to change course, away from acute care toward long-term care and care of the dying.

It is not a new direction for the sisters. In fact, as St. Francis Healthcare’s chief executive Sister Beatrice Tom is quick to point out, Mother Marianne’s original mission — the care of patients with incurable Hansen’s disease — was “long-term care” coupled at the end with “hospice.”

It is a mission they have never left. Their commitment to Kalaupapa is unbroken. Their call to nursing has expanded and embraced education — certainly itself a “long term” enterprise. Their foresight brought home care, elderly care and, of course, hospice care to Hawaii. They recently broke ground for a revolutionary elder residential support community in leeward Oahu.

While these accomplishments are enough to make the Franciscan Sisters among the most imaginative religious orders to bless the islands, they have been bolder still.

Some saints become the model for statues, paintings and movies. Mother Marianne became the model for flesh and blood lives of service.

As missionaries to a modern society, her sisters went where no religious congregation in Hawaii had gone before. They opened a nursing school and maternity wards, established a program for the mentally retarded children and another for alcoholic women, put high-tech dental clinics on wheels to serve the dispersed needy on the neighbor islands, established a medical ethics program that serves the Pacific, and placed nurses in parishes to expand health ministry into the faith community.

They also took a chance in opening Hawaii’s first Catholic high school in 30 years — the first on the island of Kauai.

Not all these endeavors survived, but their virtue was in their vision, which closure did not diminish. Often the decision to end an effort is more difficult than the decision that initiated it. Perhaps it is a wisdom learned from such work as hospice — how to recognize conclusion, how to say goodbye.

The sisters are nearing the point of another difficult goodbye.

What the future will bring for the St. Francis Medical Centers is, as yet, undecided. It may be a merger or sale or lease or some other kind of agreement. Whatever the prospects are, Sister Beatrice desires three outcomes — “that the sisters are justly compensated, that the Catholic mission is preserved and that the poor be taken care of.” These are serious and justified conditions.

So let the buyer (or lessee or management partner) beware. In addition to gaining valuable medical assets, whoever acquires the medical centers will inherit an extraordinary Catholic culture of care, nurtured in the spirit of Mother Marianne, now renewed by her universal acclaim.

It is not a legacy to be taken lightly. Rather, it requires an accountability the sisters have the right and duty to demand.