Illustrations by Gina & Matt
I started to pray silently in the empty elevator as the doors slid shut and I ascended to the fourth floor.
“God, I am not feeling this today,” I began. I was tired, distracted by issues with my work as a writer. “Please help me be present to the people I meet. Help me offer them some small comfort.” I made the sign of the cross as the doors opened to familiar smells of chemical disinfectant, bodily odors and institutional food.
I was at St. David’s Medical Center, as I’ve been one Sunday a month for most months over the last nine years. St. David’s is a 500-bed hospital and rehabilitation facility in Austin, a few blocks from the University of Texas’ main campus. The school’s cavernous football stadium is visible from many windows on the fourth floor.
That day was the first Sunday in December, and it was again my turn to distribute Holy Communion to the Catholic patients who had requested it. I had attended the 8:45 a.m. Mass at St. Austin across the street from the university, where I have been a parishioner for three decades — ever since I moved to the city as a graduate student.
One of my patients was a lovely young woman with a head injury. I assumed as much from the bandage wrapped around her skull and her room assignment on the floor that houses the neuroscience unit. The list I received at the front desk told me only her name; privacy laws prevent the sharing of additional information. “Hi Christine,” I said after I knocked and, with her permission, entered through the open door. I introduced myself, explaining that I was from St. Austin. “Did you request Holy Communion today?”
She told me she was a kindergarten teacher, and I imagined that with her easy smile and sparkling eyes she was a favorite among her students. She said she had been in a car accident about a week earlier and was scheduled for surgery in the next day or two. She asked me to pray for her husband and her son, whom she called “my Wyatt.” For the most part, Christine seemed fine, but in the middle of our conversation she suddenly said, “I have six bathrobes.”
The confusion on her face made clear that she’d expected to say something else. She didn’t become frustrated as much as she tried repeatedly to say what she meant. Finally Christine sighed and said, “I don’t know.”
Not wanting to exhaust her, I segued into the Communion ritual and began to recite a list of intentions from an order of worship pamphlet I carry in an expandable folder. The folder also holds prayer cards in English and Spanish, the church’s business cards and a few inexpensive rosaries. I personalized the final intention for Christine, praying for her upcoming surgery, her recovery and her family members by name. I reached into the small, black, leather pouch I wear around my neck during my ministry rounds and removed a gold-colored pyx. It looks like a compact and is about the size of an Oreo. I popped the lid and removed a host, which I had received at Mass. “Christine, the body of Christ,” I said, pressing the wafer into her open palm.
In the moments of silence that followed, I was overwhelmed by the enormity of Christine’s situation, and I began to tear up. Then I broke into a sweat from embarrassment. The last thing I wanted was to draw attention to myself or upset the person I was there to comfort.
Christine gazed up at me from her bed. “Are you crying?” she asked. Her voice was caring and kind, even childlike in its curiosity and openness. I nodded. She reached across the bed and squeezed my hand before I made a hasty exit.
I returned to the elevator and descended to see more patients. I am often alone in the elevator at this time of day, and I have come to think of it as my office, a private space where I can glance over my patient list, gather my thoughts, or — as with Christine — compose myself between patients. The elevator is a liminal space removed from the hospital hubbub, though it often carries the scents of people who have ridden in it before me. Sometimes I detect floral perfume, cigarettes, coffee or even breakfast tacos. I am in Texas after all.
I never learned what happened to Christine: if her surgery was successful, if she was able to return to teaching or if she is now living with lingering injuries. I rarely see the same patients twice. I read the obituaries regularly, but only once in the years I’ve been volunteering have I read a death notice for a patient I had visited at St. David’s.
That interaction with Christine happened a few years into my outreach. While today I might still tear up during a visit, I like to think I am better at sharing my feelings with patients, better able to verbalize my sadness or concern for their situation in a way that expresses care.
In The Art of Ministering to the Sick, perhaps the first manual of its kind, Dr. Richard Cabot and Reverend Russell Dicks discuss what a volunteer like me might expect from these visits. “We do not assume that the minister can get adequate information about the patient’s soul in a few minutes, or that he can even know the whole of it,” they wrote in 1936. I could not have known “the whole of it” in Christine’s case, but I could have been more fully with her in the moment we shared. In time, this became my goal.
The prayer I offered sounded inadequate. My own faith felt shallow in comparison to her calm certainty about God’s role in her life. I lifted the wafer to her lips as she opened her mouth.
I first learned about St. Austin’s Communion outreach ministry in 2011, through an email sent to those of us who already volunteered at the church. I had been a lector for about 10 years. The parish liturgical director had reached out because patient requests for Communion at the hospital were increasing, putting a strain on the program’s existing pool of volunteers.
Around the same time, I flew home to New Jersey to spend a week with my parents. My father, George Macor ’61, was undergoing treatment for colorectal cancer, and I was there to help him with his radiation and chemotherapy appointments. The debilitating treatments were especially hard on my father, who had been stricken some 30 years earlier with a rare neurological disease that had left him handicapped and depleted his body’s myelin sheath, a layer of protein and fatty tissue that insulates the nerves and is an essential protective barrier during harsh treatments like radiation therapy.
Near the end of my trip, I drove my father to the emergency room after he nearly collapsed from dehydration. We spent eight long hours together in a small room off the ER. Aside from giving him fluids through an IV, his medical team couldn’t do much for him or for his painful, abraded skin.
I was surprised to discover that being there made me anxious. I felt cowed by the brusque attendants. The beeping machines and intermittent alarms kept me on edge. I did not feel I could be a competent advocate. My parents were in their 70s then, and it occurred to me on the plane back to Texas that I might be spending more time in hospitals in the near future. Maybe, I thought later, I should answer the liturgical director’s email.
The practice of setting aside the Eucharist for those unable to attend Mass dates to the earliest days of Christianity. “The church has always sensed its obligation to those who cannot be with us,” says Father Rich Andre, the Paulist priest who oversees St. Austin’s Communion outreach and calls it a vital part of the parish’s mission.
Founded in 1908, St. Austin is home to more than 2,000 parishioners and attracts a large student population. It’s known as a diverse, urban parish focused on social justice and the needs of those whom Pope Francis describes as living on “the peripheries of existence.” Andre says that if the Eucharist is the ultimate sacrament for Catholics, then bringing it to those in need is an essential way to express care. But, he adds, “the whole is greater than the sum of the parts. For those who are alone, for those who are scared, the human connection is just as important. Somebody who’s willing to listen, somebody who’s willing to sit with the hard questions and show some care, all those pieces are important.”
Over the course of a few weeks in the fall of 2011, I shadowed outreach veterans as part of my training. I learned the most from Sara, a longtime parishioner and registered dietitian who teaches at the university. Sara’s research interests in childhood obesity had brought her into contact with doctors and nurses in hospitals and outpatient clinics, and she understood how those spaces functioned. From her I learned the signage that indicated when to “gown up,” which meant donning a hospital gown, a face mask and gloves before entering the rooms of especially vulnerable patients. She also explained that the designation “NPO” on a patient’s door is the Latin abbreviation for “nothing by mouth,” which means a patient cannot ingest the Eucharist but may still receive a blessing. I was able to observe less tangible aspects of the ministry, too, such as how to read the room and when to talk less or shorten prayers.
Still, I felt unprepared when it was time to go solo. “Has he suffered? Has he seen anyone suffer?” Cabot and Dicks asked in their pastoral manual. “Has he seen the fear of dying?” Answering these questions may determine whether a volunteer is ready to handle the demands of the ministry. My father’s situation aside, I wondered if I had seen enough suffering to be an effective minister.
At St. David’s, volunteers often team up to work through the patient lists, which can run into the double digits. We split off with our half or third of the list and rarely run into one another. From the start I was paired with Joe, a tall, trim gentleman maybe 10 years older than me. We know very little about one another, but we have developed a warm shorthand for our brief encounters. These include waiting in the back of the church to receive the excess hosts we’ll take to the hospital and those Sundays when we arrive simultaneously at the reception desk to divide up the patient list. Joe, who recovered from heart surgery at St. David’s rehabilitation facility, likes to visit those patients so he can buoy their spirits by sharing his story.
One Sunday when Joe was out of town, I ended up visiting a few patients in rehab. The facility’s corridors are wider than the hospital hallways to accommodate wheelchairs and walkers. Its halls tend to be quieter, with patients either working hard in the physical therapy areas or resting in their rooms. I had finished my visits and was waiting for the elevator to take me back to the lobby when an older man approached me. “Do you have any extra?” he asked, indicating the pouch around my neck. The stethoscope around his neck told me he was a doctor.
I hesitated. I did have two extra hosts that day. I would much rather give them to someone else than consume them in my car, which is the protocol for leftover hosts. I was also comfortable with giving Communion to hospital staff, if doing so didn’t deprive the patients on my list. During St. Austin’s semiannual ministry meeting, one or two volunteers had expressed concern over these requests. They felt the ministry was about bringing Communion to the sick and was not to be used as a convenience for healthy doctors and nurses. I disagreed and was relieved when the priest leading the meeting suggested we do what we felt most comfortable doing.
But the doctor who stopped me in the rehab facility was gruff and awkward. Most doctors typically ignore me, and I knew from talking to other ministers that this was common. I wondered if some resented our presence in the busy hallways, particularly if they were nonbelievers. Yet this doctor clearly understood the meaning of the cross on my pouch.
I said I would be happy to give him Communion. I fumbled in my handbag for my printed prayer card and read a short blessing. I opened the pyx, pulled out the wafer and held it between my fingers.
“Doctor, the body of Christ,” I said.
“I don’t know if it’ll do any good,” he muttered, half to himself, before he said, “Amen.”
He took the host from me and put it in his mouth. I looked away, shocked by his candor. After a moment of silence, he cleared his throat. He looked me in the eye and said, “Thank you.” I smiled, and we went our separate ways.
“That is what it looks like,” says Reverend Brian Fitzgerald, a United Methodist pastor and St. David’s chaplain. “You can be a part of something in real life that changes them and transforms them because God is using you to make that happen.”
Fitzgerald works with multidisciplinary teams of doctors, nurses, social workers and others who see as many as 24 patients at a time. His colleagues might not always appreciate the benefits of pastoral care, but he believes the consistency of showing up — as a chaplain or an outreach minister — month after month, year after year, is key. “After a while, they get used to you. When they see you, they know what they’re going to get. And they see that’s what God looks like.”
I’ve met that doctor only a handful of times in the years since our first interaction. He always asks if I have extra hosts, and I always make sure that I do. His gruffness has never disappeared, but I’ve grown more comfortable with it. I ask him how his day is going and compose a prayer based on what he seems to need in that moment: more compassion, greater patience, skill for an upcoming surgery.
One day he reached into his shirt pocket before we parted ways. “Here,” he said as he handed me his business card. “You can call me if you need help with parking in the garage or anything else.” I’m not sure what motivated him, but it felt like a gift, his way of expressing deep gratitude.
The third floor of St. David’s is devoted to maternal care and includes labor and delivery (L&D), the neonatal intensive care unit, the nursery and patient rooms. Ministers rarely visit this floor unless we receive a request, as I did several years ago when an L&D nurse named Ashley first appeared on our patient list. Ashley’s weekend shifts made getting to Mass difficult.
Entering the maternity unit means passing through a series of security checkpoints. I sign in at the reception desk on the first floor and receive a sticker that identifies me as a visitor and is visible on my shirt to the nurses who admit people to the floor.
Once through the main door, I walk down a long hallway and turn left. My steps slow as I pass the nursery. Tightly swaddled newborns sleep in clear containers that look like acrylic shoeboxes. I may see a nurse preparing to bathe an infant, its tiny face red and angry as its swaddle-warmed skin is momentarily exposed. I ring a doorbell at the end of the hall, and, sizing me up by security camera, another unseen nurse buzzes me through the double doors and into the unit.
One day I asked for Ashley at the nurse’s station, then tried to stay out of the way as I waited. Labor and delivery is generally a calm unit. Conversations among the nurses are quiet, and it’s rare to see another visitor loitering in the hallway.
That Sunday, Ashley walked quickly around the corner, offered a warm hello and led me into an unoccupied room. Her shiny auburn hair was pulled back from her face, and a healthy fringe of dark lashes framed her warm, green eyes. She took the host from me and bowed her head in prayer. When finished, she asked me if I would do her a favor. She had a patient in her last trimester at risk of losing her baby. The expectant mother was young — a teenager — and Catholic. Ashley had asked her if she wanted to receive Communion, and she had said yes.
I followed Ashley to a corner room. She knocked lightly, and we entered. Veronica was sitting up in bed, her rounded belly visible beneath her hospital gown. She had long, dark hair and brown eyes. “I know it’s God’s will whether or not my baby will die,” she said. “I just want God to give me the strength to deal with whatever happens next.” She looked at me with a sad but steady gaze.
I was more than 30 years older than Veronica, but I felt like a child in her presence. The prayer I offered sounded inadequate. My own faith felt shallow in comparison to her calm certainty about God’s role in her life. I lifted the wafer to her lips as she opened her mouth.
As I walked the hallways leading out of the unit, I once again passed the nursery. I wished I had asked Veronica if she knew her baby’s gender, or if she had chosen a name. A month or so later, I asked Ashley about her, and she told me Veronica had lost her baby that same day.
I was not surprised that the baby died, but I was surprised by how it affected me. I cried on the drive home, and Veronica and her baby were in my prayers often during the weeks that followed. I wonder even now how she is doing in the wake of her loss. I have no idea if she planned to raise the baby or place it for adoption, but I suspect she would have kept her child. Not for the first time, I ask myself what I would have done at her age.
Like most hospitals at the start of the coronavirus pandemic, St. David’s was closed to volunteers by the end of March 2020. Reverend Fitzgerald and a colleague took over the pastoral care for patients of every denomination.
“Even though COVID is horrible, there have been these very deep moments,” Fitzgerald says. During the summer he met a young man whose parents were being treated simultaneously for the virus. The mother passed away first. Forced to keep his distance, Fitzgerald instructed her son on how to administer the sacrament of healing, the anointing of the sick, to his father. Donning protective gear, the man received the oil from Fitzgerald, who then stood in the hall and watched through the window as a nurse led the man to his father’s bedside. The pastor began to recite the prayers. When it was time for the anointing, he knocked on the glass to signal the man, who recited a prayer he had written on the bag that had contained his face shield. Then he anointed his father’s forehead and palms with the blessed oil as Fitzgerald completed the litany.
When Fitzgerald told me this story, I realized how much I missed these opportunities for real connection. Around the same time, I was asked to join St. Austin’s pastoral council. It was their second invitation. I had turned them down two years earlier when I was traveling back and forth to New Jersey to help my ailing parents. Then my father passed away in 2018, and my mother died 18 months later. With Communion outreach on hiatus due to the pandemic, it seemed like a good time to say yes to the new request.
One of my first tasks involved helping to plan a phone campaign to check on the well-being of parishioners. St. Austin’s priests and staff spread the word about the calls, encouraging people to answer their phones. Still, we anticipated leaving many voicemails or sending texts in lieu of actual conversations.
On my third night of calling, I reached Cynthia, a parishioner in her late 60s. After a few minutes I recognized her as the woman who often sat in front of my family at Mass. Although Cynthia was unaffected by the virus, she had sprained both of her ankles and was hobbling around with one leg in a cast. Even if she wanted to attend Mass in person, she couldn’t have gotten herself to church.
Cynthia and I stayed on the phone for a half-hour, talking about her life and what she missed most about St. Austin. She belonged to at least one volunteer ministry, which still met over Zoom. Some of these friends dropped by with groceries and whatever else she needed, and Cynthia emphasized that while she was alone, she wasn’t necessarily lonely. But when it came time to end the call, she choked up. I waited on the line as she wept quietly, then composed herself.
To my surprise, I was able to sit with the moment. I didn’t rush to fill the space between us. I waited, and I was even able to take in Cynthia’s emotional thank-you when we said goodbye.
Perhaps, to paraphrase The Art of Ministering to the Sick, I have experienced enough during these nine years — in my life, in my ministry — to become more comfortable with my faith, or with what the authors call “devotion.” Witnessing others’ suffering and having suffered myself has given me the “right” to be with Cynthia in her sadness. “Your need, my understanding, and my desire to help are my authority for coming to you,” Cabot and Dicks wrote.
Devotion through service, the authors believed, “answers the challenge” of seeing someone in the “intimacies of their pain.” It “opens people’s minds through their hearts.” Looking back over the years of my ministry, I see my own heart growing by steps. With each encounter and every experience, I imagine my faith — my devotion — blossoming like a new rose.
Alison Macor is the author of a forthcoming book about the making of The Best Years of Our Lives, winner of the 1947 Academy Award for best motion picture. The names of patients and some identifying details in the essay have been changed.