Apology

Yes, I know, if I’m going to post at all, I oughtta post something important, something relating to the somewhat impressive difficulties my small family endured this summer. Unfortunately, return from Omaha was an escape of sorts, and so I didn’t blog; school has since intervened, as have the election (loved the end of McCain’s speech, though were my policy differences with him great enough, it would not have persuaded me to vote for him), and the looking-like-it-might-be-abysmal Notre Dame football season.

Suffice it to say, for now, that Kay is doing well, mostly. A few small issues from the operation remain – a healing thrombosis, scars, a not-quite-normal-feeling abdomen (muscularly and otherwise vaguely, though seemingly improving); and then there is the sadness of it all, and her continual frustration with my position, which never boils over and only occasionally seems to surface.

I will be back. I will provide the answers to the five questions. I will, when I know, answer the question of, will we try again? I will discuss some of the adoption advice I’ve heard (four routes, one bad, one probably best, that one sort of like what happens in Juno, so they say). And you’ll hear a small yippee from me when we (they, I suppose) beat Michigan next week, most probably by something like a point.

Anniversaries, Juxtaposed and Commemorated

I’m disinclined right now to do much with this information, but there have been a number of articles posted in the last month on contraception, IVF, and abortion. I’m going to link them for now, and perhaps someday I’ll have the time, inclination, and courage to go back to them and comment.

Kathryn Jean Lopez posted an article on the 30th anniversary of IVF’s first use, here, and it is one of the few out there that, however briefly, gives attention to the notion of “giving yourself totally to your spouse — not putting up barriers and introducing artificial methods and procedures into your reproductive lives.” As to what the barriers introduced by IVF are, she does not say, and I’m not sure I see IVF as creating barriers, exactly. (Already I’m getting nervous about even posting these, since I feel like I ought to have a treatise-level opinion on each one.) A mostly coherent response came through and is posted here, testifying to, though not proving scientifically or theologically, the wisdom of waiting for God’s hand to work. (It also makes a distinction between giving physically and giving more deeply that I’m not sure I can countenance, since it seems to set adoption up as a higher good than giving life.)

Earlier, observing the fortieth anniversary of Humanae Vitae, Lopez published “Holy Sex@40,” an affirmation of the encyclical’s teachings, turning the words of feminist Jessica Valenti against her, somewhat effectively, I think, to remind her readers of the racist usages to which the pill has sometimes been put, and to remind her of the hardly-lessened burden for the responsibilities of pregnancy that women still face. K-Lo is apparently hitting this issue hard this year, as she has another article out that I’ve not even read, here. If the title and abstract are any indication, it’s a jujitsuistic attack on the pill for what it’s doing to the environment, not so much a first principle attack as a piling-on of all available forces (not that I mind – this is a time-honored political and military tactic, and is consistent with honesty so far as the things said are true).

Also, from July 5, at 1:18AM, see this article for link between contraception and abortion. It’s a bit surprising for me to see it in there, given America’s reputation for opposition to the more conservative sorts of Catholicism, but I’m not an expert on the subject of America and its leanings, so perhaps my expectations are malformed. And there is a First Things article in the current edition, called, rather resoundingly, “The Vindication of Humanae Vitae,” now posted here. I’ve not read it yet, having too many magazines laying about, delivered, bought, and largely unread.

Results

Kay’s follow-up surgery is over, and went reasonably well, though not as well as it might have, in a best case scenario. Kay knew that, if she woke up in the recovery room after the surgery without me already attendant upon her, she would be staying in the hospital. Although it was not the predicted outcome, it did happen. She immediately searched for confirmation of her worst non-death fear – a colostomy – and found that she had not received one. Indeed, no indication had been given that such a measure was even a possibility, much less a likelihood, but it is one of her least dispellable fears. She did find, however, that she had been fitted with another JP drain, and if she looked at the clock, if there was even one available, she found that she had been in the operating room for two hours total, one more than had been planned.

The reason for the extended surgery time was simply the difficulty of the surgery. The abscess wreaked considerable havoc in Kay’s gut, essentially undoing all that had previously been done to un-stick the organs from each other. All was tender, inflamed adhesion, as far as the scope could see, which was not far, as of the reproductive organs only the end of one fallopian tube – whether left or right could not be discerned – was visible. (This tube, for what it’s worth, did have intact fimbria.) Drs. Hilgers and Fitzgibbons also found some remnant of the abscess, though only a teaspoon-sized portion, which they removed, and they “irrigated” – medical-speak for “rinsed” – the area with an antibiotic wash. The JP drain was fitted to allow anything remaining of the abscess to be pulled out, along with blood, irrigating fluids, and whatever other incidental liquids had collected as a result of the surgery.

The primary object of the operation was, I may remind you, the extraction of three pieces of GoreTex bandage. Those bandages had been placed over Kay’s ovaries and uterus to reduce the normal adhesions due to any surgery as much as possible, but had been overwhelmed by the toxicity and ubiquity of the abscess, which left scarring everywhere else. In their efforts to remove these pieces, they had to remove some of the new abscesses, but were hindered in their efforts by the effective blockade created by the jumbled and cohered organs. They hesitated to do much in the way of what they had done last time – separating the organs by removing the scarring – because the inflammation has not yet settled down, and the organs are thus weaker than they would be normally. Of particular concern was the possibility of penetrating the wall of the bowel. Both because this surgery was planned to be less severe, and thus a full bowel prep was not ordered, and because of the weakened nature of the bowel due to the inflammation, which could result in a torn bowel, the surgeons in the end chose to curtail their chase for the third and final piece of GoreTex membrane, leaving it behind.

Kay stayed in the maternity ward, where all of Dr. Hilgers’s patients stay when hospital time is required afterwards (this is either ironic or appropriate, depending on the eventual outcomes of their cases – though the Pope Paul VI Institute and the nurses there were good enough to inquire of us whether we thought the maternity ward was a bad choice for their patients; we told them we were happy to see the babies, if for no other reason than that they were a welcome diversion from the task of healing). The maternity nurses, though a bit shocked to see us – they had hoped Kay would have to endure no more hospital time – were as kind and attentive as ever, apparently giving Dr. Hilgers the news that they felt Kay deserved a gold medal for her behavior, news he promptly passed on to us. Kay was a bit befuddled by this compliment, asking me, “What have I done to deserve a medal? How terrible must the other women be who come through here that I deserve a medal?” I told her it was due to her almost utter lack of complaining, to her patience and mildness when she called the nurses in for help, to her continual sense of humor, to her persistent efforts to comply with their healing instructions (particularly the need to take multiple walks a day). I doubt the other women, mostly delivered mothers recuperating for a day or two, were great termagants, but the nurses’ sense of pity for her rarely precedented stay in their ward, and her perfect behavior throughout, likely elicited the compliment.

On Monday, at one o’clock in the afternoon, Kay and I had our regularly scheduled post-op with Dr. Hilgers, though he had been quite attentive that week already – as is customary he came in to see us every day, skipping only Sunday this time as Kay was clearly in no danger (though he did send his resident in to see her). He had little to say that he had not already said, and his usual joviality was rather suppressed by his discouragement over the results of the June procedure. We had plenty of questions for him, of course, mostly about the future. As the blog format and its readers, however, are polonian in their prejudices, I will attain brevity by saving those – including the questions addressing the mystery of the missing third bit of GoreTex and what happens next – for the next posting.

A Strange Season

This has been an odd summer. As Kay and I walked in the cool of the summer night around ten o’clock, the breeze just ruffling the leaves so that their silver undersides glimmered dimly in the street lights, we marveled at just how little heat there has been this summer. We’ve been blessed, though, for the heat would have added to the discomfort she has felt recovering from her surgery. In the cool, she is progressing apace, and looks to be healing fully. The hole from the JP drain is closed and is almost healed, and her scar looks great. There are still a few issues that seem to be left over, however, from the stress her body has been through. She’s still complaining of an odd taste in the mouth, but I think that will go away once the effect of the antibiotics wears off and her system is allowed to return to normal. Because of her temperature being lower than normal for the past few days, we are not really worried about a resurgent infection, but the doctors have suggested that she may have a bit of anemia, so they have scheduled a blood test for tomorrow. And she has had some problems with digestion. We have introduced new foods to her system gradually, a few fruits here, a couple of seeds or nuts there, but after a particularly rich delayed anniversary dinner (we hit five years in early July), including escargots, Alaskan king crab, and rice pudding accompanied by the ever-perilous raspberry, she awoke at 2:00 AM with stomach pains. Sitting up helped to ease them and allowed her to sleep eventually, and nothing more occurred. Tonight she is a bit uncomfortable, too. I hope that some Tums antacid will help her to sleep.

Meanwhile, I have become beleaguered as well. Yesterday, lying on the bed in the hotel room we ended up scoring for free on the night of our anniversary celebration, I felt the room begin to spin. Only once or twice did it go round, and then it was over, but it was alarming. Rising, I realized that I didn’t feel quite right in the head, and I haven’t since. My head spins seem to be related to the motion of getting up or lying down, and it’s more common when I am lying down. Luckily, my mother is office manager for a neurologist. When I called him after hours yesterday, having mentioned these odd symptoms to my mother late in the day and getting her imprimatur to call her boss, he dashed away my apologies, saying something like, “No, you are not allowed to apologize – you are a member of an honorable family that are good friends of mine. You are welcome to call.” When I explained my symptoms and answered his diagnostic questions, he said I was likely suffering from something in my inner ear, not my brain, but that I should get an MRI anyway, just to be safe. So off I go tomorrow, to relieve my wife’s (and my own) lingering fears that I might have a brain tumor or a stroke, that she will not be left alone at the end of this strange cool summer that we have spent fearing for her, not for me.

The String Has Been Cut

For some reason, I have found myself unable to finish off a review of Neil Gaimon’s American Gods and so have done nothing else in the way of publishing in my concentration on, or wholesale ignoring of, that so far abortive project. I’ve not talked about Lovecraft, whom I’ve also been reading (he’s kind of silly, overall), and I’ve not updated Kay’s condition, despite knowing that there may be some who are interested in the latest. Those who are interested, by the by, are welcome to prod for more information, either through the comments (all three of which I checked before allowing two of them to be published, the first being abusive), or through personal e-mails to jrrhawking@gmail.com.

Kay’s condition is pretty good. A few days ago her spirits received an uplift when we were called by Dr. Hilgers’ office to let us know that the second bacteria in her abscess had been identified, and that the Flagyl she was already taking orally would kill it. Up to this point, knowing only that the E. Coli was being taken care of, we were uncertain that the second, as-yet-unidentified, bacteria was going to be destroyed. They had told us that the Flagyl was likely to do it, but not knowing the identity of the bacteria, they couldn’t be sure until they received a positive identification. As the days stretched on, we were both worried and mollified, worried, because we weren’t sure whether the delay was caused by the slow growth of the bacteria (which we assumed could only be good) or their inability to find something that would kill it (which we assumed could only be bad); mollified, because the output of the drain both lessened and became less yellowish-brown, more clear, with a pink substance we were told was new tissue, white blood cells, and other signs of a return to normality. Clearly we are not really sure how bacteria cultures are accomplished. But however it’s done, it’s been done, and the infection is at bay, if not positively defeated.

So effective has Drs. Hilgers and Fitzgibbons’ effort been, in fact, that the drain’s outflow has dropped beneath the magical number of ten cc’s per day (cc’s are apparently equivalent to milliliters). Once beneath that number, said Dr. Fitzgibbons, the drain could come out. It attained that level on Thursday, at which point Kay called him, and he contacted a local surgeon to remove it. That local surgeon was leaving for vacation, but asked a colleague to do it. This colleague, whose odd name I will not repeat, because I am about to make fun of it, but the oddity of which can be hyperbolically approximated by the pseudonym “Dr. String Barracuda,” was available today, Monday, and, after having been needlessly warned by Kay, as she had been told to warn the person taking it out, to “cut the string,” thus releasing the coil that held it in place, removed the thing out without incident. The extra time with it in did cost Kay another few days of mild discomfort, and some lost sleep as she does not sleep naturally on her back, but it also afforded us the added satisfaction of knowing that the level of drainage did not go up. It has, in fact, not gone above around seven per diem since then, implying that the infection is properly finished. She will, however, watch the leftover wound – small enough to be only bandaged – closely, to make sure there is no excessive drainage, and plans to continue taking her temperature well after this entire project is over, as fever seems to be a good indication that the body is up to something that is causing it exertion, whether or not it is obvious on the outside.

Dr. Barracuda and Kay chatted about how she had gotten to this point, and he did worry her some by his surprise that Dr. Hilgers was using GoreTex to reduce scarring. Just now, in fact, I went into our bedroom, where I found her sitting in front of the TV with worry stitched into her face. I reminded her, as I reminded her earlier, that Barracuda is not a fertility doctor and has no previous experience doing or exact knowledge of what Hilgers has been doing, with some success, for many years. Presumably, had GoreTex not, in the past, precluded adhesions from forming post-surgically, Hilgers would not be wasting his time with the stuff. I also reminded her that Dr. Fitzgibbons, the chief of surgery at Creighton, is aware of and accepting of what Hilgers does, and has said that he uses internal GoreTex bandages all the time. Back when we were in Omaha, Dr. Fitzgibbons said, specifically, that he would have no trouble removing the bandages when we came back. These reassurances had their good effect, but more will undoubtedly be needed, for worry with Kay is like a persistent army that lays siege to her piece of mind, fortified howsoever it may be, and will not be dislodged without a determined assault on his supply train, or an end, altogether, to the war.

We are due to arrive again in Omaha on the 30th of July, with the 31st reserved, we assume, for a pre-op visit, and the surgery scheduled for the 1st of August. Assuming all goes well, and assuming the surgery is able to be conducted laparoscopically (there is some potential that it will become a laparotomy, mini- or otherwise), we will head for home on the 3rd or so, with just under two weeks to prepare for the beginning of the school year. Whether Kay will start on time or not, or as a full-time teacher or not (we are lucky in that, childless and with some help from our families, we can afford to do either), depends on the outcome of the surgery (which will be reported here), as well as on a conversation she will have with her school principal, a woman sympathetic to her because of similar fertility ordeals she underwent herself, some years ago. One way or another, we hope for things to continue looking up, so please place or keep us in your prayers.

We're Home

Kay and I are at home now, having gotten back to our apartment around 7:00 last night. Her parents came over last night with dinner, and my mother will be bringing dinner over tonight. My dear sisters brought over flowers and basic groceries for us, leaving them with a sign that said, “Welcome Home!” By the time we got home, the cold I'd been nursing along the last few days was in full force, so I've been feeling poorly to the point that I could barely rouse myself at 10:00 this morning. I only got out of bed because the nurse was coming over to administer Kay's IV. Having the family care has therefore been a great boon.

The nurse, who came from Coram Specialty Infusion Services, was very friendly and professional. She was entirely unfazed by the abscess – beyond feeling bad for Kay that it had happened – saying that these things happen and are easy to solve. When we said we didn’t know what the second bacteria causing the abscess was (the first is e. coli – very common and nothing to worry about once identified, she said), she speculated that it might be a type of staph infection from the skin. No matter how much they do to clean the surface of the cutting area, she told us, sometimes things survive. Kay lamented that she forgot to wash with Dial antibacterial soap before the surgery, but I figure that if the iodine and things they use in the OR didn’t do it, store-bought bar soap is unlikely to. Still, would have been better to be safe than sorry, I suppose.

We are likely to return to Omaha in about three weeks, when Dr. Hilgers and Dr. Fitzgibbons (the chief of surgery at Creighton) will remove the Gore-Tex bandages. By that point, the course of anti-biotics will be over (the one being given via IV will end on Tuesday), and, we hope, the drain will have been removed. Kay is doing pretty well overall, though she is suffering some minor discomfort from the drain – when the nurses ask her to list her pain on a scale from one to ten, she usually says one or two. Her taste buds are also a bit discombobulated, we think as a result of the antibiotics. All told, we will be glad when the bandages are out and this part of the process is over. We can only hope that the inflammation from the abscess has not undone the progress of the surgery, but we won’t know until we go back in August.

Some Minor Relief

Something I forgot to mention in the last post. Before she went to bed (a good couple hours before I posted “The Waiting Game”), Kay asked me a question: “What if they can’t kill it?” Not quite understanding, I asked for clarification. She then gave me to realize that her conception of the bacteria-identification process was this: the doctors take the culture and then try to kill it with various antibiotics. When they succeed, they know what bacteria they are fighting, and they know how to kill it. Kay’s culture was taken on Sunday evening, and still has not been identified. The longer the wait, the more worried she was getting: they still haven’t been able to kill it!

I responded to this novel concept by reassuring her: no, they identify the bacteria by letting it grow until it identifies itself. But there was a small stab of horror within me as I said this, because I frankly didn’t really know how they do it. I know there’s a disk of sheep’s blood and that the stuff grows on the blood, and that’s about all I knew. I wondered, could Kay be right that this is how they do it? After all, shouldn’t a microscope do the trick? – what needs all these days of growing? Finally, when the nurses came in to hook Kay’s PICC line up to the antibiotic bag, I decided we had to ask. Turns out, I was right. The stress melted out of Kay when we heard this, and I pray that she will sleep better tonight as a result.

The Waiting Game

We know now what we knew the last time I reported anything: Kay has a pelvic abscess. It seems to be under control. She has a little plastic drain coming out of her right abdomen, just a tube and a bubble pump that, when squeezed, wants to expand to its natural rotundity and so suctions out what is inside – a translucent brown liquid that is, if I’ve been listening closely enough, a combination of mucus, germs, and a foreign saline pumped in to liquefy the others. The hand grenade, which is what we call the pump for its resemblance to that weapon, hangs pinned to her clothing, transparent to allow for an easy measuring of the poisons extracted. The plan is that the amount will decrease regularly, implying a decrease in the amount available to be pumped, and that the lab will then figure out what the bugs in the brown fluid are and what antibiotics will destroy them.

Our doctors have been very good to us. Dr. Hilgers comes by every day to keep us up to date, even though there has not been much to tell in the past few days. He is always upbeat and always willing to answer the questions he can. There is none of the condescension in him that one sees so often with doctors, though he is always confident, in an understated way. Kay likes him quite a bit, as do I, and all the nurses speak quite highly of him. (This abscess, incidentally, is apparently the third time he’s seen one in twenty-five years of doing this surgery.) The GI surgeon with whom he has been consulting, and who has been very reassuring that they will fix what ails Kay, comes by every two to three days, and a Hungarian doctor from the radiology department (they put in the pump) has come by on a number of occasions to make sure the hand grenade is working well.

The wait comes from Dr. Hilgers and the GI surgeon needing more information to decide whether they want to take the internal bandages out sooner or later. On their own, Gore-Tex bandages are not a problem – they are used because they are non-allergenic, and their use is fairly common, from what we’ve heard. But as an artificial mesh, they are attractive to germs, and once the germs are in the same region, there is a chance they can colonize the Gore-Tex. Once they do that, they will be protected from antibiotics, which can only reach the abscess through the blood stream. The removal of the Gore-Tex is thus desirable, but the surgery to take them out could stir up the infection dangerously. Therefore we play the waiting game: suction and then reduce or destroy the infection with antibiotics, then go in safely to remove the Gore-Tex at a later date. What that later date will be depends, probably, on what the culture turns up and how long the appropriate antibiotics take to destroy it. It will not be more than three to four weeks, we’ve been told.

The problem now is to wait without getting too down. Kay is has been down for the better part of two days, and doesn’t know whether she wants to leave more or be well more – well, she knows she wants to be well. But she doesn’t want to be here for another week or two while it happens. We are able to go outside, but Kay is confined by doctor’s orders to the hospital grounds. There is some talk of her going home with the grenade – either to the hotel or really back home – then coming back for the Gore-Tex-removal surgery, but until they know what kind of bug or bugs she is fighting, they don’t want to let her go. Ultimately, we just want her to get better, and we’ll do whatever they want us to do to make sure that happens.

Faith and Its Fluctuations

From the beginning of this whole process, Kay and I have been ready to rejoice, only to find our hopes disappointed. The first month we tried to get pregnant, Kay was late with her period. She was never late, she’s rarely been late since, but she was not pregnant. For well over a year we tried, but nothing happened. Finally, they went in to take out her ovarian cysts, not having anything else to try (various fertility drugs, such as Clomid, had failed) only to find that she had endometriosis. At first, that seemed like a good thing: we knew what was wrong and had heard it could be cured with hormone treatment (I think I’m remembering this correctly), not to mention the scraping they had done already. It turned out that it would not be so easy – endometriosis is infinitely more complicated, and as we found out later, the scraping did possibly more bad than good, as it left behind adhesions as effective as endometrial tissue at physically isolating and damaging, through inflammation, the reproductive organs.

We finally began the process with Dr. Hilgers and the Pope Paul VI Institute, well over a year ago (perhaps a year-and-a-half ago), and things seemed to go well in the operation, though we knew it would be a difficult one, and by no means guaranteed success. But these last two weeks have been full of nothing but setbacks, it has seemed: a good first day followed by the somnolence of atalectesis; her revival and subsequent eating followed by vomiting and diarrhea; a bowel revived from ileus followed by fever and renewed coughing; plaintive hopes for pneumonia followed by revelation of the pelvic abscess. Now the less harsh procedure of the catheter and a dose of antibiotics is our hope, against which is juxtaposed the six-month colostomy. (This is not to mention the damage this kind of inflammation can do to ovaries, tubes, and uterus, which, along with the coughing, is for now a secondary worry.) I hope our beleaguered troops hold the line here.

The military metaphor arises because I have been reading the first volume of Shelby Foote’s The Civil War. I am not alone in having Lincoln as my favorite president because of his thoughts, expressed in his profound and serious words. I was too poor a philosophy student to say whether Lincoln’s thoughts were particularly original, but the humility and cadence of their expression is moving in the extreme. There are two writings that Foote quotes, in each of which Lincoln addresses situations of much greater extremity than that in which Kay and I are embroiled. In speaking to a Quaker woman who called on Lincoln to show her support for his having issued the Emancipation Proclamation, he said,

We are indeed going through a great trial – a fiery trial. In
the very responsible position in which I happen to be
placed, being a humble instrument in the hands of our
Heavenly Father, as I am, and as we all are, to work out
his great purposes, I have desired that all my works and
acts may be according to his will; and that it might be so,
I have sought his aid. But if, after endeavoring to do my
best in the light which he affords me, I find my efforts
fail, I must believe that for some purpose unknown to
me, he wills it otherwise. If I had had my way, this war
would never have been commenced. If I had been
allowed my way, this war would have been ended before
this. But we find it still continues, and we must believe
that he permits it for some wise purpose of his own,
mysterious and unknown to us; and though with our
limited understandings we may not be able to
comprehend it, yet we cannot but believe that he who
made the world still governs it.

Kay and I are not so much instruments here, not so much operating as being operated upon (quite literally, in her case), but still her subjection to treatment and my support for her can be said to be our “efforts,” and certainly our “war” would have ended before this had we been allowed our way. And our little case is as worrying to us in its threat to the world for which we are responsible – our parents, our marriage, each other – as the horrendous losses of Antietam were in their threat to the vast arena for which Lincoln was so tragically and movingly responsible.

Lincoln also wrote a private piece, left on his desk but apparently not intended for publication. It was rescued by his secretary John Hay, being published later. In it, Lincoln attempts in effect to reconcile the existence of men such as Bishop-General Pope, and his prayers, with the equally fervent Northern clergymen, and their many prayers:

The will of God prevails. In great contests each party
claims to act in accordance with the will of God. Both may
be, and one must be, wrong. God cannot be for and
against the same thing at the same time. In the present
civil war it is quite possible that God’s purpose is
something different from the purpose of either party;
and yet the human instrumentalities, working just as
they do, are of the best adaptation to effect his purpose.
I am almost ready to say this is probably true; that God
wills this contest, and wills that it shall not end yet. By
his mere quiet power on the minds of the now
contestants, he could have either saved or destroyed
the Union without a human contest. Yet the contest
began. And having begun he could give the final victory
to either side any day. Yet the contest proceeds.

This passage is perhaps less applicable to Kay’s and my situation: there is no one, after all, praying against us. But the enemy that (or who) has entered the field has not been prevented from bringing his soldiers against us. The contest proceeds. We can merely fight by our best lights and pray that, supposing it is His will on earth and in heaven, we receive our daily bread, and that our trespasses will be forgiven us. Father, if Thou wilt, remove this chalice from us: but yet not our will, but Thine be done.
___________________________________________________________________
Thanks, by the way, to The Abraham Lincoln Association, as well as to that perfidious academic institution holding the electronic version of their The Collected Works of Abraham Lincoln. As their version contained some confusing punctuation – perhaps in the manuscript sources? – I have made some changes to match Foote’s version, on pp. 709-10 of Volume I of his work.

The Two Worst Days, Part I

The bad days these past two weeks have been many, but there are two that stand out. The first worst day was Friday, the 27th of June, the third day following surgery, when Kay spent a second day in a stupor more pervasive than the preceding one, in and out of a fever, unable to get past 1500 on her incentive spirometer. She was awake, but not endowed with anything resembling her true personality, just grimly trudging through life and sleeping a sleep that may have been a “prisoners release” but was not “the certaine knot of peace, / The baiting-place of wit, the balme of woe,” for when she awoke she only trudged the more. In the late afternoon and the late evening, she was given a diuretic, the diagnosis being that her somnolence and fever were due to the external compression of her lungs by fluids used during the operation. This diuretic had no impact until late, perhaps twelve midnight, at which point she got up to go to the bathroom. This continued all the night, every half hour exactly, until it tapered off near morning. As she was still somewhat disabled from bending and yanking, I was point man for unplugging the IV – conveniently between her bed and my couch – and we both spent a vergessenworthy but unforgettable night. Miraculously, the next morning, she was better. The fever was down, the lethargy gone despite the long night, and she was allowed to take her first liquid tray since she had gone under, her first food, in fact, since noon of the day before the surgery. All seemed well.

A Quick Note on Dr. Hilgers

My wife has been advised to be as active as possible, sitting up rather than lying down, walking rather than sitting, so we are currently outside on the rather nice patio of Creighton University Medical Center (unfortunately overlooking the highway), where we are engaging in one of our favorite, but recently neglected, joint pastimes – Scrabble. So I don’t have time for a full update, but I wanted to mention something we appreciate about Dr. Hilgers, now more than ever: his kindness and patience. He has enlisted the advice of a gastro-intestinal surgeon and a general practitioner, both to give him advice on my wife’s probable ileus and to prescribe various fluids for her IV. A young and rather jaunty doctor, who seems to be working under the GP, blew into our room yesterday when we were feeling pretty optimistic and announced to my wife, “Well, you look great, but your x-ray doesn’t!” He made a jokey comment about how he was happy to see her distended small intestine, because surgeons love when things are difficult, rather than easy. After reassuring us by saying that he treats the patient, not the x-ray – in other words, that in the absence of corroborating symptoms such as nausea and vomiting there is not enough reason to assume a blockage of the bowel and therefore no reason to operate – he blew out of the room again, residents and fellow doctors following in his wake, leaving us mouth agape and my wife jittery and nerve-wracked.

Dr. Hilgers, who has been in every morning, came in today when I was not here, having left very early to pick up my dad at his hotel for Mass and then a trip to the airport. Dr. Hilgers and my wife had a good conversation. She mentioned this doctor and his extremely poor bedside manner and how it had jarred her, how she’s now imagining all her worst fears. He asked her to tell him what she was afraid of. Other than death, she’s afraid of a permanent nutritional IV – never being able to eat again. I think doctors have to strike a balance between needlessly informing patients of worst-case scenarios, thus stimulating their fears, and limiting their fears by setting the boundaries with a worst-case scenario. In this case, Hilgers rightly chose the latter, telling my wife the worst-case scenario would be a temporary colostomy – six months is the figure he put on it – because the small intestine always wakes up. It just does. He also let her know what the next step will be: tomorrow, if the passage of gas continues and the vomiting doesn’t come back, we’ll try the wet tray again. If she keeps it down, we’ll go to the dry tray. His attention to us, his apparent knowledge, his willingness to explain and answer questions, are all qualities we value highly in him. They’ve made an unexpectedly-difficult recovery that much more endurable for us.

Update: My wife and I have been reading this over before I post it (we’re no longer on the patio playing Scrabble – I’m winning by the way – as these postings always take longer than I think they will to write), and we’ve just realized that we’re not quite sure, now that we think about it, how a colostomy would allow her to go on while waiting for the small intestine to wake up. A colostomy replaces the large intestine, if we understand this correctly, because the large is concerned almost exclusively with disposal, which a colostomy bag can do, while the small is concerned with distribution of nutrients to the body, which a colostomy bag can’t do. Clearly we’ve missed out on some details somewhere along the line, but Dr. Hilgers will no doubt answer them for us when we see him tomorrow.

Surgery Update

I should have posted something by now, but it's been a long, rather eventful week. My wife came out of the surgery ok, but there have been bunches of minor complications keeping her in the hospital, the most significant of which has been something called “ileus,” which has been described to us as a “sleepy bowel.” None of this seems to be life-threatening, and Hilgers has been very attentive to us with daily visits and sometimes multi-daily visits, but it’s been frustrating for my wife and me, and sometimes exhausting, as various issues, such as a diuretic and a nutriment-filled IV have kept her (and therefore me) up half the night with regular urination – as often as every half hour. Anyway, my dad has come into town to spend some time with me, so my wife has released me to go to a steak house for a martini and a t-bone in an hour or so, and I need to take a shower. I will update the blog tomorrow with much more in the way of detail, as my wife and I have recorded many of the events.

Signs?

For many months now I have prayed rosaries for my wife, though not nearly as often as I should, certainly not every day. When I have been strong enough to pray, however, I have most happily prayed the Joyful Mysteries: the Annunciation, the Visitation to Elizabeth, the Nativity, the Presentation, and the finding of the Christ Child in the Temple, for the obvious reason that they are about the miracle birth of Jesus, and we are in need of a bit of a miracle now. We prayed these mysteries in our Rosary on the drive out to Omaha, even though it was on a Sunday and it is suggested that one prays the Glorious Mysteries. When I told my wife we were praying the “wrong” Mysteries, she said, “Can you do that? Is it allowed?” I told her it would be fine.

I was prompted to mention this because, I discovered on the day of my wife’s surgery – yesterday, Tuesday the 24th of June – that three of that day’s scripture passages (the First Reading, the Psalm, and the Gospel) mention the role of God in forming us in the womb. Here are the relevant passages, with their locations:

The First Reading:
1 … The LORD called me from the womb, from the body
of my mother he named my name. 2 He made my mouth
like a sharp sword, in the shadow of his hand he hid me;
he made me a polished arrow, in his quiver he hid me
away…. 5 And now the LORD says, who formed me from
the womb to be his servant, to bring Jacob back to him …
(Isaiah 49: 1-6)

The Psalm:
13 For thou didst form my inward parts, thou didst knit
me together in my mother’s womb. 14 I praise thee, for
thou art fearful and wonderful. Wonderful are thy works!
Thou knowest me right well; 15 my frame was not hidden
from thee, when I was being made in secret, intricately
wrought in the depths of the earth (Psalms 139: 1-3, 13-15).

The Gospel:
57 Now the time came for
Elizabeth to be delivered, and she gave birth to a son. 58
And her neighbors and kinsfolk heard that the Lord had
shown great mercy to her, and they rejoiced with her. 59
And on the eighth day they came to circumcise the child;
and they would have named him Zechari’ah after his
father, 60 but his mother said, “Not so; he shall be called
John.” 61 And they said to her, “None of your kindred is
called by this name.” 62 And they made signs to his
father, inquiring what he would have him called. 63 And
he asked for a writing tablet, and wrote, “His name is
John.” And they all marveled. 64 And immediately his
mouth was opened and his tongue loosed, and he spoke,
blessing God. 65 And fear came on all their neighbors.
And all these things were talked about through all the hill
country of Judea; 66 and all who heard them laid them
up in their hearts, saying, “What then will this child be?”
For the hand of the Lord was with him. 80 And the child
grew and became strong in spirit, and he was in the
wilderness till the day of his manifestation to Israel
(Luke 1: 57-66, 80).

That last reading is of course related to the Visitation – it is the birth of John, later the Baptist, the child who leaps in the womb of Elizabeth when the pregnant Mary visits her older cousin. I don’t believe in omens, and I doubt I am worthy of signs, but finding out that these were the readings for the day of my wife’s surgery, I hoped.

I had another moment, a possible communication through ordinary happenstance, of what might come of this surgery. Just before we pulled out of our parking spot at home to start off to Omaha, my wife asked me whether I had brought our “pod” – which is what we call our i-Audio mp3 player. When I said no, she said, “Go up and get it.” So I did, and as I came out to lock the door, I heard the new baby upstairs crying. It seems like nothing, but he’s been there for a month, and we’ve never heard him crying before. Again, I don’t believe in omens and I consider myself unworthy of signs (or perhaps I am simply weak in my faith), but some things make one wonder.

Operation Day

The psychological ordeal is over, for the time being, and now the physical ordeal has begun for my wife. It really began last night, when she first drank her bottle of magnesium citrate, but this morning she will be put under and have to go through surgery. I’ve thought to write about this, and I’ve thought about this over and over, but I’ve not written much down. I’ve been too stressed out by the thought of thinking this over. My most common thought has been fear, fear of losing my wife, fear for her parents’ loss and loneliness, and fear of being blamed, by myself, by my family, by her parents, perhaps by God. And though I don’t think I am, I’ve also been afraid of finding out I’ve been wrong.

We met with Dr. Thomas Hilgers again yesterday (we last saw him after her exploratory laproscopy last December). He’s a quietly intense man, a slightly disconcerting presence, a bit inscrutable, like most doctors, and with penetrating, appraising eyes. He’s jovial, though, bearded and rotund, a bit like a well-trimmed, tailored, gray-haired Santa Claus. He repeated a few times, “Well, we have our work cut out for us,” in relation to my wife’s severe endometriosis and adhesions. That unnerved her a bit, but she observed that he seems confident; he just seems to be communicating that what he’s doing is labor- and concentration-intensive.

There was a funny exchange between us regarding colleges. I had mentioned a mutual friend to Dr. Hilgers – a local doctor – noting that I knew the man because I had gone to college with his daughter and her husband. He asked, “Where’s college?” When I answered Notre Dame, he remarked, “Well, there you go!” – a remark that wasn’t clarified by the context. He followed that up by asking my wife where she went to school. She was surprised to know that he was familiar with St. Olaf – “oh,” he said, “in Northfield.” It turns out he is from Minnesota, went to St. John’s for college, and did some of his medical training at Mayo, to which my wife responded, “Well, there you go!” to general laughter. Hers seemed pretty clear – it seemed to say, “Wow.” His could have been “Wow,” or “Figures,” knowing how divergent opinions on ND can be.

When I first came into the waiting room, around 6:30 this morning, there were two TV’s on. I was the only one there, and they were both blaring, and so I turned one of them down entirely. I was too slow to turn the other one down, as a group came in while I snooped around the room looking for anyone who might reprimand me for turning off a waiting room television. They left eventually, so I girded my loins and charged over to turn it down. When they came back, they seemed unbothered by the change in sound level (they had previously been sitting right in front of it as it blared, and went back to the same place), so I had peace up until now, about 9:00, when the nice old lady in the waiting room came over to turn on the TV for a young boy who’s waiting on his own. The boy, a son of African immigrants, to judge by his beautifully deep black skin, is sitting without anything to do, other than look across the room at the TV (he seems not to be interested in the magazines), and so she came over to turn up the closer television for him, which is right next to me. I silently groaned, but after she fiddled with it for awhile, she asked the boy if he wanted to watch it. He said no, and she turned to me to find out whether the still low volume was too high. I said no, not wanting to lord it over the whole waiting room, but she then decided to turn it off, since no one would be watching it.

Later:
Just heard from the nurse liaison, a trial position here at Creighton Hospital. She makes a circuit of the operating rooms to find out how the patients are doing. She then comes to the waiting room and updates the family members who are waiting for news. About an hour or two into the surgery, my wife is doing fine. The anesthesiologist says she is stable, and the surgeons are inside, just beginning to take bits of endometriosis out – they are using lasers to cut away the adhesions. I then went out to make a call to update my wife’s parents, who are eager for news, as one might expect.

Later:
The nice old lady came over again. The boy is apparently Sudanese, and they apparently are quite friendly and have the nicest handwriting – or at least he does. She’s a garrulous old gal, but perfectly friendly. When I signed in to the waiting room, she asked who my surgeon was. When I answered Dr. Hilgers, she said, “I knew it. The nicest young couples always come in to him.” Now she wanted to tell me about the Sudanese boy. He’s apparently finished middle school and is on his way to a high school. She advised him not to stay out late, because our culture has changed and there are bad people about. He assured her that he’s always in early. She was quite happy to hear that I am a teacher – I get far more praise for that than I deserve – and commiserated with me like Socrates over the state of today’s youth. She seems to think the Sudanese boy is an exception, and I do too, from the little I saw. He was quite polite with her when she sat down to talk with him, taking her advice without resentment, and when I left to use the phone, I asked him to keep an eye on my laptop, which he did without incident.

Later:
The nice old lady is being nice again, now at 10:34, this time inquiring as to whether a few other people, who aren’t apparently interested enough in their own amusement to bring something to read, would like to watch TV. She asked the woman in question what she would like to watch, CNN? The woman responded, “CNN, Home and Garden, whatever.” “Whatever.” Doesn’t that say it all?

Later:
It is now 12:48. About an hour and a half ago I heard from the nurse liason that things were going well. My wife is still stable, and they have found the fallopian tubes. Way back in December, when they did a laproscopy to check out her interior, they couldn’t get very far. Most importantly, they couldn’t find her fallopian tubes, which might have been damaged or even obliterated by the scarring of the interior by the endometriosis. Dr. Hilgers has found them, however, and they are open and in good shape. I was told at the time that her surgery, instead of finishing between 11 and 12, would now finish closer to 1:00. So, as might be expected, I am starting to get a bit nervous.

Shortly after I received that phone call, I got my in-laws and my parents up-to-date; my father was jokingly unhappy to be called last – in fact, he called me, while I was talking to my mother – but I think he understands. My mother-in-law has been quite nervous, but I think is doing ok. She was moved to tears to hear that my wife and I said some prayers together before she was wheeled out. As a staunch Protestant, she may not have been as moved to tears if she knew the prayers were three Hail Mary’s, but she’s a good woman and easily moved, so she might well have. I also said a Rosary as I sat in the waiting room, a somewhat flawed rosary, however, as I was dozing off in the later decades, due to waking up at 4:30 or so. My final religious effort was a minor sacrifice: last night I ate what my wife ate – broth, jello, and popsicles – and this morning I decided not to eat until I knew she was in the Recovery room. At that point I’ll get up and go out of the hospital to eat something somewhere, but until then I’m devoting this very minor fast to her health and to the Doctor’s success.

Later:
Just heard that Doctor Hilgers might be out to see me in the next fifteen minutes. My wife is apparently doing well, and she will be in the recovery room in about an hour. Ran downstairs to give Sandy a quick call, and then shot right back upstairs.

First Thoughts on IVF, Part V

This next section, a short one, is on something I get into a bit more in my next letter, this notion that sex and all aspects of it are not supposed to be shared with more than one person.

Near the end of your letter, you quote Father Tadeusz Pacholczyk, who says that IVF "undermines the meaning of sex. It violates the exclusivity of the couple's marriage covenant.” You call this ridiculous. There are people out there who make the argument that various forms of infidelity, such as occasional sexual threesomes or open marriages, enhance the love the married people feel for each other. They argue that these situations are the result of consensual decisions, that they are done openly and honestly, that they increase the pleasure and therefore the unifying factor of the sexual act, and that they ensure the unending quality of the marriage by doing away with dissatisfaction based on the undeniable human need, or at least intense desire, for variety. But the Church, and I have no doubt, you, would reject such reasoning because it brings a third person, even one who conceivably could have purely altruistic purposes, into the innermost sanctum of the marriage, that innermost sanctum being the sexual act with its twin purposes of unifying the couple and creating children. To say that bringing another into the 2nd purpose, that of creating children, constitutes a violation isn’t ridiculous, but instead seems to me eminently logical, at least if we accept the first premise.

Where this runs into difficulties I admit, and am not at the moment entirely sure how to resolve, is in matters of degree. Is it permissible for me to tell my buddy, or a therapist, that I don’t know how to satisfy my wife in bed, and to ask for advice on what I should do to increase her happiness in that aspect of our lives? I don’t think that you, I, or the Church would have a problem with that. Is it permissible for my wife to take a drug that helps the ovary expel eggs more readily? It seems clear that no one has a problem with that. Perhaps the difference is this (this is just a guess): in the threesome, and in IVF, the action, either the giving of pleasure, or the joining of the egg and sperm, is actually accomplished by the third party. But when one talks to one’s therapist, or takes a drug that increases egg production, one is not substituting for the sexual act.

I think my notion of substitution takes care of the potential problem of going to see a gynecologist or urologist - one may allow another to touch oneself or one's spouse in an intimate manner, but one would not allow even a medical doctor to engage in the giving of pleasure or the act of procreation in such a situation.

First Thoughts on IVF, Part IV

This next section directly addresses the question of IVF and whether it can ever be appropriate. It addresses some of the indirect objections to IVF, such as the moral quality of the industry and its actors, the question of the Procreative and Unitive natures of sexuality, the relationship of the Church's ban on IVF to its ban on Contraception, a misconception that both my father and wife had that the Church felt that using IVF would somehow deprive my wife's and my sexual union of its Unitive aspect, and the Church's notion that the use of IVF will give us into the "domination" of technology.

I’m finally turning to your discussion of IVF. Much of what I say here will be me thinking out loud, so some of these thoughts may change or be discarded. When you turn to IVF directly, you quote Bishop O’Malley, saying, “Marriage and its indissoluble unity are the only venue worthy of truly responsible procreation,” and mention that you agree. So do I.

Regarding the talk of the domination of technology, I agree that this seems like an overstatement of the case. One possible way of understanding it is a distrust of the people involved in the business, who readily offer disposal as an option for fertilized eggs that will not get used, or who may make on-the-spot decisions about the viability or worth of a particular embryo without your consent, or who may try to persuade you that certain of the embryos are not worth implanting because they are in some way faulty even though they have not ceased to grow (i.e., died). But I realize that this is not a reason for a ban on the action – it’s simply a call for tighter rules and guidelines surrounding the practice, and for Catholics to have nothing to do with those who will not abide by those guidelines. You wouldn’t put your born children into the custody – under the domination – of a babysitter you knew nothing about – but that’s not an argument against babysitters as such.

IVF is an act of procreation alone. Sex with a condom is an act of unification alone, of which pleasure is an important part. But the Church rules that these must be unified in the sexual act in part because they are essential to each other. The unification caused by giving each other pleasure still exists – witness the pain caused by modern breakups in which the participants are sexually active. But the unification is not as complete as it would be because there is no willingness to procreate, there is no willingness to give a physical part of oneself to the other, and not just to the other but to a third who is part the husband, part the wife. You quote the following: “The Church has always taught that there is an ‘inseparable connection established by God between the unitive significance and the procreative significance which are both inherent to the marriage act’ (Humanae Vitae 12). In this sense in Vitro fertilization, by doing away with the unitive meaning, is the mirror image of contraception which suppresses the procreative meaning of the conjugal act.” You then ask, “Why and how does In Vitro fertilization do away with the unitive meaning of the marriage act.” I’m not sure what the source of this text is, so I can’t look at the whole context, but I do not think the text is saying that IVF does away with the unitive meaning of the conjugal act. I think it is simply saying that IVF does not contain the whole of the unitive abilities that the sexual act does. It doesn’t destroy the unity gained by the married couple’s participation in the sexual act, but it doesn’t have that ability either, and so, analogously to the act of sex with birth control, it leaves out one of the essential aspects.

After some more language about domination and dignity, you ask, “Again, what domination? Only you and your wife have the power. You have the power over technology. You are the one using it, it is not using you.” I understand what you are saying here. Here’s a potential explanation of this, which sort of aligns with what I said above about distrust of those companies that are willing to dispose of embryos. As mentioned, sin is about intention; sin is not mortal unless one knows one is doing something wrong. But as you know, there is a concept known as “the near occasion of sin,” and entering into such an occasion is held to be a sin itself. For instance, it is probably not a sin to play poker and risk only $5 in a night. But it may well be a sin if you know the people you are playing with are generally much more serious gamblers, are interested in getting you to play more often and for higher stakes, have shown themselves to be persuasive in other venues to the point that you have trouble resisting them, and if you have relatives, especially a parent or sibling, with a gambling problem. Twenty years down the line, when you blow a third successive rent payment and get yourself and your family evicted, it might be true that you were so in the grip of your addiction or compulsion that you cannot be legitimately blamed for what you did. But you would not be able to argue, based on what you were aware of at the time, that you deserve no blame for putting yourself in the situation.

My point? In Humanae Vitae, section 16, Paul VI wrote, “Let them consider, first of all, how wide and easy a road would thus be opened up towards conjugal infidelity and the general lowering of morality.” Now, I don’t know how many Catholics had pre-marital or extra-marital sex before the Sixties versus how many did after the Sixties. But I do know that since then divorce within the Catholic community has become far more rampant, that most Catholics my age, including most of your parents’ grandchildren, think nothing is wrong with pre-marital sex, that abortion is far more common, that homosexuality is basically approved of and often celebrated by our society, and that our Church has been mired in a sexual scandal that very few bishops were willing to speak out about, in part because of fear for their jobs or the jobs of their friends, but perhaps also in part (as some have theorized) because of more permissive attitudes about sexual acts and experimentation. I know that the pre-Vatican II Church wasn’t heaven on earth, because that will never exist without the Second Coming. But I do think either one of these situations was the case: that fewer people were involved in these situations, that those people who were involved in those situations were involved less often, or that however often these things did happen, people felt far less complacent about them and sought healing for their souls by confessing their wrongs – and if there’s any truth to the Church’s designation of confession as a sacrament, then that’s a very important distinction.

My point here is that at least part of the argument by the Church consists not in the inherent wrong of birth control or IVF (although that is part of it), but in the danger it causes us by setting up temptations in a position that they can far more easily achieve dominance over us. Thomas Aquinas is lauded for rejecting the advances of the beautiful harlot his family thrust into the locked room with him; he would be ridiculed if he had had himself locked into the room with her just to see how strong he was. So we should not, the Church is saying, put ourselves in a situation where, perhaps not today, but someday, the creation of an embryo is viewed not as a child, a living being created by God through the loving act of its parents, but as an object that has many uses, one of which is to satisfy the natural and justifiable urges for parenthood, but another of which is to mine for stem cells or body parts, or to make experiments on, or to effect some ersatz resurrection of a person of whom the embryo is a clone. Obviously this world is already upon us in part, and may be supported and encouraged by Catholic acceptance of even those aspects of it that are viewed as more innocuous.

The rest of the letter, which I'll probably post in two more selections, goes back to side issues raised by my father's letter, including masturbation, the way in which the Church changes or "develops" dogmatically, and a conclusion.

First Thoughts on IVF, Part III

What follows is the weakest part of my letter to my father, the part where I try to refute his claim that Church teaching has changed, as opposed to "developed" (a technical term meaning, off the top of my head, "to change in such a way that the new belief does not contradict but merely refines the earlier belief into a deeper understanding of what God intended than before") through history. I am not nearly educated enough, and Newman's An Essay on the Development of Christian Doctrine did not help me particularly when I read it this past summer (but after I wrote the letter). That may be because I am dense enough to always require a second reading of Newman before I quite get him - he is known as a prose stylist, but I have always found his prose, how to say this, uneventful, which may be the point of those who praise it. Anyway, if you are in the mood to comment, feel free to tell me how I'm wrong.

Regarding the ways in which Church teaching has changed, I am not educated enough to say I am refuting your claims, because I don’t know for sure. I’ll merely tell you the way I understand them, and could be wrong about them. First, I don’t think the morality of the Crusades as such has been disputed. I think that the Church has apologized for any atrocities and wrongs committed by those undertaking the wars, not the wars themselves. Regarding limbo and the necessity of baptism to get to heaven, the latest Catechism makes the following statements:

“Born with a fallen human nature and tainted by original sin, children also have need of the new birth in Baptism to be freed from the power of darkness and brought into the realm of the freedom of the children of God” (§1250).

Original sin: “a deprivation of original holiness and justice, but human nature has not been totally corrupted; it is wounded in the natural powers proper to it” (§405).

“Original sin entails ‘captivity under the power of him who thenceforth had the power of death, that is, the devil’” (§407).

More to the point, it still quotes the teaching from the Council of Trent: “Baptism is necessary for salvation for those who have not yet been reborn” (§980). I was interested in this issue awhile ago, while I was teaching the Inferno, and my research, while not exhaustive, talked about Limbo (which, you are right, does not seem to be mentioned in the Catechism) as essentially a theory, i.e., a potential way of accounting for the fate of unbaptized infants, which is not accounted for in Scripture or tradition. The way Dante has Virgil describe Limbo, which corresponded with what I read in my research, was as a place without punishment, but with the infinitely sad knowledge that one cannot be with God. The research I did also suggested that this teaching was not final, insofar as it has been stated that one needs Baptism to be saved, but no one has ever stated the converse: that a lack of Baptism condemns one to hell. Nor has anyone ever stated that God will not find another, unrevealed, way of solving this problem. In other words, Revelation and tradition require us to confess we don’t know exactly what happens to the unbaptized, but also leaves a space that allows us to consider the theory of Limbo, and to hope and pray that whatever limbo (small “L”) that the unbaptized appear to end up in has already or eventually will be destroyed by the mercy and saving power of God. This knowledge was probably obtained by reading online the Catholic Encyclopedia (at NewAdvent.org), which was written around 100 years ago, so this is not a post Vatican II change, as far as I can tell.

The celibate priesthood is a matter of policy, not truth, and that has been known since it was first mandated in the 1000’s. That has changed, and could change again, but that would not change the teachings of the Church on marriage and virginity, which say that the first is a sacrament while the second is a mandated state for the unmarried, and a special state for those who accept it as part of their vocation.

I don’t know much about the Galileo situation, but the position of the Earth in the cosmos is not an issue of faith and morals, nor does it impact our definition of God. The little I have read defending the Church on this issue claims that the situation was more a battle among scientists who used the political power of the Church to ruin a smarter competitor. I would have to learn more about it, though.

I remember reading a quotation from that Cardinal who talked about the use of condoms. I don’t believe he said it would not be wrong; he said it might be considered less wrong than, for instance, letting one’s marriage fall apart over a lack of sex forced by the husband going and getting himself a case of AIDS from a prostitute. Of course, the sin that may result in the marriage falling apart would be his adultery, plus whatever lack of forgiveness led in the end to divorce, not the choice not to have sex. So I think the Cardinal is wrong, and one Cardinal does not a Magisterium make. There are Church priests and theologians, many, no doubt, men who love God, who have taught what the Church has condemned as wrong, even if they’ve taught many other things in line with the teachings of the Church.

I think you are right to say, “the manner in which the Church has come to decisions about moral teachings has changed over the centuries.” This is one of those areas that would probably be defined as “development,” rather than change. I think the definition of development is that which refines or enlarges the understanding of an earlier judgment by the Church, rather than that which changes an earlier judgment. (Newman wrote a book I own but have not read that is about this subject.) Those who defend the primacy of the Pope obviously use the teaching from the Gospel read in the last few weeks (it was a weekday – I went the next morning after a fairly emotional conversation with my wife the night before) about Jesus founding his Church on Peter his Rock, and how he gave to Peter “the keys of the Kingdom of Heaven,” and told him that “whatever you bind on earth shall be bound in heaven, and whatever you loose on earth shall be loosed in heaven” (Matthew 16:19). Without knowing the specifics, I do know that the argument is made that even in the early, largely unrecorded days, between the Acts of the Apostles and the first councils of the Church, that other bishops would often apply to the bishop of Rome to settle debates. I don’t know if this is settled history or not.

Is it possible that the Church that Jesus instituted is prey to the same problems as the church that had Him killed? Perhaps in some ways, but remember a couple of things: that Jesus established this Church, that he gave to Peter and the apostles the powers described above, that he promised the guidance of the Holy Spirit (who, for instance, helped humans to decide what counted as Scripture, and what did not). Why would Jesus establish a Church prey to the same problems as the one he left behind? Jesus did not change human nature, and so I understand that just as there were sinful Pharisees and Sanhedrin, so have there been sinful Popes, Bishops, and Priests. And just as the institution of the Temple permitted wrongs, so too has the Church of Christ bowed to temporal powers, such as in allowing the practice of granting indulgences in return for sacrifices made to become a business – a repetition of the money-lenders in the Temple, in a way. But Jesus did leave us a new world. The Church teaching on indulgences was not inherently flawed: the sacrifice of money is praised by Jesus when he tells the disciples to observe the little old lady giving her last pence to the poor box. As you no doubt know from your economics classes and your professional life, money is simply a symbol of our labors, a way of transforming them into goods they do not directly produce, so that sacrifice of money is sacrifice of labor. The actions of many individuals within the Church, like bishops who wanted to build a new church to attract tourists, or friars who wanted an easy life instead of the hard, trudging, begging life of poverty and prayer preached by St. Francis, took advantage of this. Irish folk-tales tell of credulous peasants afraid the parish priest will turn them into rabbits if they fail to do what he tells them. Abuses, obviously, but not perpetrated by the Magisterium, by the teaching ability of the Church.

This I don’t understand: you describe what led to your second marriage, what the Church has to say about it, and say: “I understand the reasons for Church rules in this matter; as a matter of fact, I agree with them. However I do not believe I have committed a sin.” I can’t figure that out, Dad. You agree with the Church’s teaching, but you don’t think it applies to you? The teaching does not exist because some people might take advantage of easier rules on divorce (which I know you did not). It exists because the action is held to be inherently wrong. What you say here is probably true (certainly you are a better judge than I): “My marriage to my second wife is more perfect and a more spiritual union that I ever did have with your mother. In sum, I seriously considered the rules and teachings of the church, and then made my own decision to disregard Church rules.” Then you say, “I consider myself to be a good Catholic.” Please do not be angry at me for saying this, but this is what I think will be the case for me: if I change what my mind has been so far and decide it is moral for me to use IVF with my wife, I will not be able to say that. I will be able to say “I consider myself to be a good person,” and maybe even, “I consider myself to be a good Christian,” but I think I will have separated myself somewhat by disagreeing with the teaching of the Church, and my definition of “good Christian” will be thenceforth different from my definition of “good Catholic.” Right now I believe that Catholicism is the most perfect (not totally perfect, because nothing short of heaven ever will be) manifestation of the faith taught to us by Christ, and that “good Catholic” is synonymous with “good Christian.” Perhaps I am wrong about this.

I don’t think the Church has lost its compassion. Jesus himself advocates excommunication, which is today seen as very uncompassionate. In Matthew 18 he says, “If a member of the church [my Bible mentions that this is also translated, “If your brother …”] sins against you, go and point out the fault when the two of you are alone.” Eventually, if the member does not listen, he tells them to bring it to the church [here there is no alternative translation offered for the word], “and if the offender refuses to listen even to the church, let such a one be to you as a Gentile and a tax collector” (18:15-7). If, like Dostoevsky’s Grand Inquisitor, the Church forebears to teach the Word of God, whether that is discerned through Scripture, tradition, or reason, the church is not being compassionate, because it is allowing us to be separated from God. The example of Jesus and the martyrs shows us that ease of practice is not a necessary quality of Christian morality (nor, obviously, is it excluded as a quality of Christian morality).

The next section will finally get into addressing the question of IVF directly, now that I have gotten to the part of my letter to my father where he does so. All of what came previously were my attempts to address the earlier points he was making to prepare the ground for his main argument: opposing my refusal to participate in In Vitro Fertilization with my wife.

Loomings

I just called my wife now and heard the little beep at the end of each ring, which tells me she is on the other line. When she clicked over she told me she had been speaking with her mother. There is no one she talks to more than her mother, who is in many ways her best friend. My wife is an only child, and so the thing that worries me the most about my stance on IVF is the effect it will have on her, not just now, but in the future.

My wife essentially has three people in this world who are hers: her parents and her husband. Her relatives live far away, her friends are simply friends. When her parents die, most especially her mother, she will have lost a great deal that I alone, however good a husband I may be, will not be able to replace. She will have lost a link to her blood family, a link that has not been recreated or echoed in a new member of that family.

Love for one's child is a different kind of love, but a more analagous kind of love to love for one's parent, I would think, than love for one's spouse. A child is someone to whom one can pass on memories of grandparents and culture and tradition. The child can share the same kind of identification with those things that the parent can, and the child can carry those things on beyond the parent's death, beyond even his own death, by handing them down to yet another generation. The spouse can do neither, and so is less of a consolation in such times. And should I die before her, she will be alone indeed.

This vision of coming pain, and, self-centeredly, coming blame, haunts me the most. I hate to think of her in bitter loneliness, and I hate to think that, in the grave, I might be the subject of a deep resentment for leaving her so alone in the world.

First Thoughts on IVF, Part II

Here is the next section of the letter, a series of individual responses to individual points, marked by socio-historico-theological speculation of dubious quality:

At least for now, rather than organizing this on its own terms, I’m going to follow your letter, responding to those things you say that I think require response. Then I may organize this more organically.

I too think the teaching on Mortal Sin makes sense. But I would also argue that one can separate oneself from God without knowing one is doing so. Imagine that the Nazi Joseph Goebbels had not murdered his family when he committed suicide, and that his son grew to adulthood, perhaps in a foreign country. It is conceivable that he would have grown up with an inveterate hatred for Jews and for the principles of those countries that had won the war and thus caused his father to commit suicide. Were he to take the same bus ride as the protagonist of C. S. Lewis’s The Great Divorce, and find himself invited into heaven at the behest of a sister or friend who had died previously, it is possible that he would have treated the offer in the same way as many of Lewis’s characters – perhaps he would have asked whether his father was there, or whether any Jews lived in heaven, or whether Franklin Roosevelt or Churchill or any of the dirty Russians or Poles were there. And if he heard that his father was not, or that any of the others were, perhaps he would have rejected God and chosen to take the bus back to the gray town. A lifetime full of venial sins is hardly a recipe for salvation.

I also believe that the Church can be infallible, and the fact that the declaration of infallibility is rarely used. I don’t think the teaching of the Church on divorce can or will change, however, as the logic of annulment is rooted in the very words of Christ. Citing Genesis, he says, “‘Therefore what God has joined together, let no man separate’” (Matthew 19.6). The fact that more annulments are given out today has no bearing on this revelation or on the teaching of the Church. Perhaps it is a practical response to deeper understandings of how human nature works (i.e., the concept of addiction, which was once thought to be a matter of will, and is now seen to be a matter of genetic predisposition that may make one unfit for undertaking a commitment such as marriage, at least before a serious recognition by the addict of his or her situation and proclivities). Perhaps it is a mistake inspired by the general trend in First World countries towards belief in the inherent goodness of “niceness.” Examples may include the unwillingness of European nations to use war to solve almost any problem, the disbelief in corporal punishment in school or the home, the approval of welfare as a method of solving poverty, the growing intolerance of “judging,” the laissez-faire attitude toward drug use, and the celebration of homosexuality, intentional single motherhood, and meaningless sex. My point is not that any of these is right or wrong, but that the general trend of Western society since the end of the First World War has said that life should be easier, and that people stuck in situations they don’t like should have no moral qualms about extracting themselves by means that were previously disallowed or disapproved of. The actions of the Church obviously depend on people influenced by the society around them. But just because some little Polish ladies get dangerously close to worshipping statues does not mean the Church condones idol worship. And just because the understanding of what constitutes a true marriage has changed, or because the tenor of society in which members of the Church live has affected the way those members think and act, does not change the eternal teaching of the Church that divorce followed by remarriage is wrong. The abortionist may have very pure intentions of helping the pregnant 14-year-old out of a very difficult situation, but that doesn’t automatically transmute his sin into goodness, although it may mitigate the consequences to his soul. (Again, I am not comparing the gravity of any of the sins I use in my analogies to the use of IVF or to divorce and remarriage.)

At one point you say, “I think that ultimately we, as Catholics, must follow our conscience and honestly follow our own moral judgments.” That is fine, but my conscience is not something that was handed to me fully formed. I had to be taught how to be honest and how to treat my sisters, among many other things. And my conscience isn’t something that comes out of my childhood exclusively. You and Mother were and are important models for me in various ways, but I’ve also parted from both of you on certain issues – and in some ways you have both parted from me, in that things you once taught me you have decided you no longer believe are important. My conscience also comes from the teaching of our Church, from my prayer, from Scripture, from my experiences and my conversations. Sometimes it’s confused or undecided (for instance, about the doctrine of Mutual Assured Destruction from the Cold War). Our conscience is something that we are supposed to follow, but if my conscience includes the idea that my Church has the power to “loose and bind” on earth and in heaven, then it may not matter what I think of the actual teaching, especially if my thoughts on it are at neutral – i.e. if I am about where I am, in terms of having a sympathy for but not a fully-formed understanding of the teaching I am trying to uphold.

The next section of the letter discusses change in the Church, and may be the weakest portion yet of the letter, as my education in theology and Church history is poor.

First Thoughts on IVF

I probably have not made this entirely clear in my postings so far, but in order to be sure: the biggest question in my life right now is whether or not to use in-vitro fertilization to get pregnant. My wife and I are at odds over this, as, while we both desperately want to have children, she is willing to use IVF and I am not. Most of the substantive communication we have done on this so far has been through writing, and little of it has happened recently, for two reasons: one, we are incredibly busy with school. Two, I am an avoider by nature. I avoid that which will be troublesome. It is probably my greatest flaw and my greatest sin, for I do not make use of my given talents nearly as often as I should.

I am in the midst at the moment of writing my third missive on this issue, this one in response to part of a book by Fr. Genovesi, S.J. For now, I will contribute to this blog with part of my first letter, one that reached to fifteen pages, and is in many ways flawed. It is a response to my father's first letter, and so you as readers will have to deal with the ambiguities of listening to a monologue when a dialogue would be so much clearer. You will also have to deal with a slightly more impersonal tone than that in which it actually was written, for I will not be disclosing the names of my family members, and so instead of something like "Joe," you'll get, "my brother."

What follows is the first section of my letter, in which I try to mitigate the harm of anything painful I might say in the spirit of honesty, in which I try to show my father that I am trying to act out of love, and in which I address his first point that the consequences of an act should have an effect on how we think of the morality of the act.

Dad,

These are some thoughts regarding your letter. They are not necessarily my final thoughts on the subject. Some of them, responding as they do to illustrations you have made from your own life, will be critical of choices you have made. These views will probably not be entirely a surprise to you, but I don’t know that I have ever stated them outright. Please do not think that I am trying to set myself up in judgment over you, or that what I say means I love or respect you any less than I do. In many ways you were and are a model for me and the way I live my life. I love and respect you immensely, and only write what I do to think through this conundrum and your points as honestly and fully as I can.

Regarding your first point, that I may be endangering my marriage, I agree that is a possibility. My wife has already said somewhat vaguely that she does not know what sort of reaction will come about from her or her parents as a result of this. She has also said that she doesn’t want to emotionally blackmail me, and she realizes that she also fears what reactions may come from me if I decide to do something that I believe to be wrong for the sake of pleasing her and others. I don’t want to downplay the consequences of my decision, because my whole course of thought and feeling on this issue has been full of foreboding about what people will think, how they’ll be hurt, and how they’ll react, people such as my wife, first of all, her parents, who have only one child to give them grandchildren, my parents, who would love to see me have children, my grandparents, who feel the same, my friends, who may be critical of my choice, even if it doesn’t concern them, and any number of relatives who may have any number of things to say about it. That said, I don’t think anyone would bring up this issue if they believed the action to be truly wrong. Perhaps you could have appeased Mother’s angst about not living a more posh lifestyle by becoming a dishonest businessman. But no one, even one who was under the impression that that was the sole cause of the downfall of your marriage, would ever dare accuse you of doing wrong by being honest, because they admire you for your honesty and there is no true dispute about whether you should or should not be honest.

A few paragraphs later you say, “Here's my gut advice to you. A successful, loving marriage for you is much more important than any Catholic teaching on this particular matter.” Again, I don’t think you would say that if you agreed with the Catholic teaching. It’s like a sermon I heard from the head pastor at my wife’s Presbyterian church. He spoke about how Jesus was tolerant, and therefore we should be tolerant in the same way, and erect no barrier to letting active homosexuals become ordained ministers in the Presbyterian Church. I felt that argument was seriously flawed because it totally ignored the morality of the teaching in question – had we been discussing the advisability of putting known, current, and unrepentant wife-beaters in the ministry, tolerance never would have come up as an issue. On a side-note, and addressing a comment you make somewhere else in the letter, wife-beating and use of IVF within marriage are obviously not analogous in their levels of iniquity – I’m not making that argument. But even if the use of IVF within marriage is a venial sin, I think “sin” is the operative word here. I don’t buy the argument that the label “venial” makes something ok.

Finally, the success of my marriage does not rest on my shoulders alone. My wife has vows that she has to respect, vows that require her to avoid as much as possible the paths of thought and ways of acting that cultivate resentment. And my decisions are not made without thought or without love. There is a poem by Richard Lovelace, a British Cavalier during the English Civil War, called, “To Lucasta, Going to the Wars,” that basically encapsulates my thoughts on this issue:

Tell me not, sweet, I am unkind,
That from the nunnery
Of thy chaste breast and quiet mind,
To war and arms I fly.

True, a new mistress now I chase,
The first foe in the field;
And with a stronger faith embrace
A sword, a horse, a shield.

Yet this inconstancy is such
As you too shall adore;
I could not love thee, dear, so much,
Loved I not honor more.

He essentially tells Lucasta, his wife or lover, that he loves something else more than her: war, or more specifically, the reasons for going to war: honor. Now I don’t know whether he means the earthly honor of reputation, or the more spiritual honor of doing right no matter what others think of him, but the point remains: true love consists in doing what is right, even if one’s beloved does not agree with that action. Hence young adults marrying despite the unjust prejudices of parents; hence young men going off to just wars despite the sorrow of their mothers and wives. I don’t think my stance so far is selfishness (I sure don’t feel like I’ve done myself a favor with it, in part because I have looked forward to raising children since I was in college). I think it’s the proper action of putting what is all-important – God and his will – before what is immensely, but not quite, as important – my own and others’ preferences, desires, or possibly even needs. I do love my wife, far more than I can explain, and she loves me too. When we’ve discussed the issue of resentments lingering after these decisions are made, she has said that she has no intention of leaving me and reiterated how much she loves me. And when I asked her whether she was sorry she married “a crazy Catholic,” she said, “No, because that is what makes you the good person you are.”

I don’t think you disagree in essence with what I’m saying. The real disagreement obviously lies in two things: the authority of the Church and the morality of IVF.

The next section of my letter is a series of piecemeal responses to claims my dad makes.