Who Shall Take Care of Our Sick? Roman Catholic Sisters and the Development of Catholic Hospitals in New York City (review)

While this book's title suggests a primary relevance to one city, the history that Bernadette McCauley depicts could be replicated in dozens of cities across the United States. Roman Catholic sisters, concerned with the well-being of the largely immigrant Catholic communities they served and moved with compassion for the poor and sick of all faiths, founded some of the earliest hospitals in cities, mining camps, farm communities, and railroad towns from coast to coast. Most of these hospitals still endure today, albeit merged into larger health-care systems. The story of the development of Catholic hospitals in New York City affords a convenient window into this complex and inspiring history.

The author's focus is the period between the founding of St. Vincent's Hospital in 1849 (the city's third hospital, and the first to be organized by a religious group) and the hospital-reform movements of the 1920s. The overall treatment is thematic rather than chronological. Readers will gain insight into the motivations—rooted in immigrant history, nativist struggles, and religious zeal—for founding more than twenty Catholic hospitals; the lives of the sisters themselves, and their distinctive approach to the mission; the type of care and treatment offered, and its evolution from the palliation of chronic illnesses to more-aggressive treatment of acute illnesses; the intricacies of hospital financing, mingling philanthropy, public financing, and fees for service; and the impact of early twentieth-century reform movements on hospital organization, professional preparation, and treatment options. An epilogue summarizes developments up to the present, including organizational mergers and the decreasing identification of the hospitals with specific congregations of sisters.

The six religious congregations featured in the narrative were founded in the early decades of the nineteenth century for a variety of services such as teaching, catechizing, and tending to the needs of the poor and sick. None was organized specifically for nursing—but the need called to them, and, especially after their service in the Civil War battlefields and tending to victims of epidemics in the city, public admiration for them grew and treatment at a "sisters' hospital" came to be considered a guarantee of compassionate and competent care. The sisters lived and worked in the hospital, receiving no salaries and organizing their spiritual and communal lives around this ministry. In addition to nursing, they served as cooks, laundresses, pharmacists, clerks, administrators, and trustees. While originally lacking professional preparation, they soon saw the need for education and founded hospital nursing schools for sisters and laywomen. As a result of their influence, nursing came to be seen as a quasi-religious calling, requiring uncommon discipline and dedication. Further, the identification of sisters with the development of hospitals contributed to the public's perception of the hospitals as places of safety, compassion, and healing.

McCauley demonstrates familiarity with all of the principal studies of American nursing and hospital development, and with Catholic institutional history. She draws on the archives of the Archdiocese of New York, of the religious congregations involved, and of the public hospitals. Contemporary media resources and governmental studies help fill out the picture. The themes woven throughout her book include the impact of the changing status of Catholics in society, the sensitivity to religious diversity in the provision of health care, the changing role of women, and the tension between public and private responsibility for health care. Readers interested in any or all of these themes will find in this account an engaging case study.