Vatican 
Correspondent
jallen@natcath.org
 

"Everybody talks about democracy in the Middle East these days. But the truth is that we are caught between two theocracies."

- Boutros Mouallem,
the retired Melkite archbishop of Galilee

By JOHN L. ALLEN JR.

Bismarck once said that laws are like sausages - it's not good to know too much about where they come from. Much the same thing, in my experience, could be said of news. Thank God the end product of modern journalism is usually more impressive than the path we sometimes take to get there.

This week offered a classic example, in the form of rampant speculation about the pope's health.

On Monday, March 21, at roughly 8 p.m. Rome time, rumors began to fly across town that John Paul II was dead. In my years on the Vatican beat, I've seen a half-dozen or so of these scares; in this case, it seems the rumor first cropped up with an Italian TV channel. However such talk originates, once a journalist gets hold of it, he or she begins calling sources to try to find out what's going on. This being the Vatican, when those sources are unavailable or unresponsive, the journalist will then turn to colleagues to find out what they're hearing. Those journalists, in turn, start calling their own sources and colleagues, and so on. Pretty soon everyone in Rome is calling everyone else, recycling the same non-information, hoping against hope to find that one person who actually knows something. It doesn't take long for something like mass panic to set in.

The only "official" channel of information in such a situation is the Vatican spokesperson, Joaquin Navarro-Valls, who at least initially was not taking calls Monday night. Beyond Navarro-Valls, the only sources who could authoritatively confirm or deny the story, at least in the critical early moments, would be the pope's doctor, Renato Buzzonetti, and his private secretary, Archbishop Stanislaw Dzwisz, and neither were quickly reachable. Hence for a half-hour or so, there was no natural brake on people's imaginations.

The backdrop to this speculation is the visible fact that the pope's recovery is neither as speedy nor as full as his doctors had hoped when he returned from the Gemelli Hospital for the second time on Sunday March 13. In his fleeting public appearances since, he has appeared gaunt, weak, and in discomfort, providing a context in which health speculation is certain to flourish.

I was in New York on business as all this unfolded, but since my Italian cell phone is a tri-band, I was able to participate in the madness as if I were still home. From 2 p.m. to 3:30 p.m. or so on Monday in New York, the phone rang constantly with people reacting to the buzz. In defense of my profession, it wasn't just journalists. Diplomats and even some church officials, including some outside Rome, also wanted to know what was going on. Like everybody else, I spent about 45 minutes of cold sweat and panic, before it became clear that this was a false alarm.

Let's be clear that this is not just morbid curiosity: the pope is a global figure of singular stature, and his death will trigger a critically important transition in the Catholic Church. Hence journalists would be irresponsible not to take signals of declining health seriously. At the same time, obviously, in a hot-house atmosphere it's easy to get carried away.

(Just as Monday's mini-crisis drew to a close, I had a 4 p.m. appointment with Archbishop Celestino Migliore, the Holy See's permanent observer to the United Nations, at his midtown Manhattan office. Migliore was "blessedly ignorant" of the latest round of rumors, and I was actually grateful to have an excuse to turn the cell phone off for an hour and a half. For that block of time, we spoke about the United Nations, Vatican diplomacy, and recent events in American Catholicism -- a fascinating exercise, though I confess that in light of everything else that was happening, it felt slightly surreal.)

In the end, nobody jumped the gun and prematurely reported the pope's demise, and thus we can chalk one up for the self-discipline of journalists working under extremely stressful conditions -- after all, nobody wants to be remembered as the guy stuck on hold while the competition breaks the biggest story your beat will ever see.

Yet even if we didn't get the story wrong, there's still a risk that this kind of scare can exercise a disproportionate influence on our sense of the story. In an atmosphere in which hard data is difficult to find, journalists have to make quick judgments about how to shape what little information we do have, and most of us will be tempted to color the latest developments in darker hues because we know all the alarming rumors making the rounds, even if we don't print or broadcast them.

In the end, however, the reality has probably not changed much from where it was more than a month ago, on Feb. 1, when John Paul II went into the Gemelli Hospital for the first time in this round of health struggles. His condition is cause for alarm, and anything could happen. At the same time, it's also possible that the pope will survive these episodes and continue on for some time. Elderly Parkinson's sufferers often go through several crises before the end comes, and obviously John Paul II has the best medical care at his disposal. As frustrating as this is, there's no "scoop" to unearth on this one -- only time will tell.

In the meantime, my cell phone will be on. Now if I can just get the right people to answer calls when it counts.

* * *

So what do you do when you're stuck in New York as a papal health crisis unfolds?

In my case, the answer seemed clear: Manhattan has perhaps the greatest concentration of medical talent per square mile anywhere on earth, so I decided to seek out experts on Parkinson's Disease to talk through some scenarios.

Dr. Cheryl Waters, the Albert B. and Judith L. Glickman Professor at Columbia University's School of Medicine and a Parkinson's expert, stressed that John Paul's current difficulties are not all directly related to his Parkinson's. The tracheotomy the pope underwent on Feb. 24, for example, is "very unusual" for Parkinson's patients, Waters said.

"We don't have patients who have their upper airways infected," she said. "I've never had a patient who needed that."

That procedure, she said, was likely a response to an independent infection, through she said that the Parkinson's "complicates" recovery.

Waters said that many Parkinson's patients, like John Paul II, suffer from other sorts of respiratory difficulties. Many, for example, develop "aspiration pneumonia," related to an inability to swallow that causes food and secretions to settle in the lungs. To cope with that tendency, she said, many Parkinson's patients undergo forms of respiratory therapy that generally include "antibiotics, having a therapist pound on the lungs, spitting up secretions, and using a mask to inhale moisture and oxygen."

Dr. Enrico Fazzini is an associate professor of medicine at New York University and director of the Manhattan clinic for the American Parkinson's Disease Association. Fazzini said that the pope's deterioration has been more rapid than with most patients whose Parkinson's emerges only in old age.

"Every time I see him, he looks like a statue," Fazzini said. "He's progressed from the initial symptoms very rapidly. It doesn't make sense."

Fazzini believes one of three things explains the pope's deterioration: 1) he's not getting enough medicine; 2) he's intentionally under-medicated because it's producing too many side effects; 3) he actually doesn't have Parkinson's Disease in its classic form, but a related disorder called "striatonigral degeneration," in which it's not just the areas of the brain that produce a neurotransmitter called dopamine that don't work, but the areas that receive it as well. For that reason, medical treatment generally has little impact; "it's like throwing seed on concrete," Fazzini said.

Striatonigral degeneration typically shows up when a patient is in his or her 50s or 60s, Fazzini said, and has a rapid downward spiral, including physical rigidity and breathing problems. If that's the case, Fazzini said, there's really no "treatment" other than helping the patient cope with the gathering deterioration as much as possible.

Fazzini said that whether the pope has classic Parkinson's or this more debilitating variant, the greatest dangers are generally choking, pulmonary infections, bedsores, urinary tract infections, and falls due to disorientation and loss of balance.

"Falls tend to be really devastating for these patients," Fazzini said. "They break their hips or dislocate their shoulders, then they go to the hospital and get infections, and sometimes eventually die."

Other end-of-life scenarios for Parkinson's patients, Waters and Fazzini said, include strokes, heart attacks, choking, and pneumonia, in addition to urinary infections and bowel infections caused by too much time in a seated position.

I asked both physicians about the mental state of Parkinson's sufferers. Is it realistic, I wanted to know, to believe that John Paul II could still be completely lucid, as Vatican officials have repeatedly said?

Waters said that many Parkinson's patients eventually experience some difficulty with cognitive functions, including confusion, hallucinations, paranoia, disorientation, and vivid dreams. On the other hand, Waters said, a certain percentage of Parkinson's patients, perhaps 25 to 30 percent, never exhibit these symptoms. Patients whose initial symptoms are tremors, rather than falls or loss of balance, are much less likely to experience dementia, she said. John Paul II falls into that category of "tremor pre-dominant" Parkinson's patients.

In addition, Waters said, the standard medication for Parkinson's, levodopa, can sometimes produce cognitive abnormalities such as hallucinations or seeing and hearing things. For older patients, she said, it also often causes drowsiness, so that dosages are often reduced for the elderly. In the right dosage, however, she said, the levodopa should be perfectly safe.

The bottom line, she said, is that elderly Parkinson's patients with John Paul's physical symptoms "can be entirely lucid, especially with the right type of support."

"I have some extremely sharp 85-year-old patients," Waters said.

Waters said, however, that the pope's "time on task" is obviously much more limited as he ages.

"He's not capable of working eight-hour days," she said. "He has to be paced, and needs naps and rest."

Fazzini said that all Parkinson's patients experience some "cognitive impairment," in the form of a loss of attention and concentration, a tendency to become distracted, and a loss of ability to focus on details.

At the same time, Fazzini said, "it is entirely realistic" to believe that John Paul is still capable of processing complex information and making decisions.

"I see no evidence that the pope is experiencing dementia," Fazzini said. "There's every reason to believe that he's still fully in command of his faculties."

Finally, I asked both Waters and Fazzini about the argument often given by church officials that John Paul II is providing valuable testimony about bearing suffering with dignity. Do they notice that kind of impact among the Parkinson's patients they treat?

"Actually, he frightens them a little," Waters said. "He looks so fragile and unwell, and they don't like to imagine themselves in that condition." Waters said that unlike Parkinson's sufferers such as former American Attorney General Janet Reno, who seems "active and energetic," the pope is not in that sense "an example of hope" for her patients.

At the same time, she said, it's "amazing" that John Paul II continues to battle against the disease as he does, and he shows patients that even in the most pronounced stages of Parkinson's, one can "continue to function and play an important role."

Fazzini said John Paul is indeed a "positive role model" for his patients.

"He has a very strong will, and his mind is still working," he said. "He's testimony to the human being's capacity to fight against things which ultimately we cannot control. A different kind of person would have given up a long time ago."

* * *

On March 19, I spoke at a Voice of the Faithful conference on Long Island, N.Y. Some 500 people showed up -- mostly, I'm sure, drawn by Dominican Fr. Thomas Doyle, the prophet who anticipated the American sexual abuse crisis back in the 1980s, and by the opportunity to network with one another.

I missed Doyle's presentation, because I had to come out to Long Island by the morning train. According to a Newsday report, however, he told the group that, "The issue is basically power," urging laity to "move from infancy to adulthood" in their attitudes toward church leaders.

The nation's bishops, he reportedly said, "are still putting a Band-Aid over a cancer."

Doyle today works as an addiction counselor in Maryland.

The on-going fallout of the crisis was clear at the gathering. The corridors outside the hotel ballroom, for example, were dominated by posters containing information on 39 priests accused of abuse who had either worked for, or in, the Rockville Centre diocese, the main ecclesiastical jurisdiction on Long Island. The posters were produced by BishopAccountability.org, a reform organization that has also posted data on the group's web site.

I had been asked to speak on the election of the next pope, a subject of perennial Catholic interest, and this group seemed typically eager to think through what's at stake for the church and the various scenarios one might anticipate.

Afterwards, I met Juan Vaca, one of a handful of ex-members of the Legionaries of Christ who have brought sexual abuse allegations against Fr. Marcial Maciel Degollado, the order's founder. Vaca, once the head of the Legionaries in the United States, today lives on Long Island.

I had a brief chat with Vaca before I had to catch a train back to Manhattan. He told me that he's active in a local Long Island parish, and sees his efforts to bring to light what he regards as the truth about Maciel and the Legionaries as a "mission."

Those charges have been repeatedly denied both by the Legionaries and by Maciel himself. Recently, the Congregation for the Doctrine of the Faith took steps to re-activate a complaint against Maciel filed by Vaca and the other accusers. At the same time, however, several senior Vatican officials, as well as the pope, have made recent public statements praising both Maciel and the Legionaries.

* * *

I suppose Voice of the Faithful is one of those groups conventionally labeled "controversial," in the sense that people hold widely differing opinions about it. For some, it's the best thing to come out of the crisis, a grass-roots movement among laity to make the Catholic church more accountable, transparent and participatory. For others, VOTF is an object lesson in the dangers of smuggling interest groups and secular politics into the church. For one thing, these critics say, VOTF sets up a "laity vs. the hierarchy" dynamic that's not consistent with good ecclesiology; for another, they say, in at least some places VOTF is just the same old liberal activists under another flag.

VOTF members are obviously aware that the organization is not uniformly beloved. Indeed, the March 19 event took place at a hotel rather than on church property precisely because their relationship with Bishop William Murphy of Rockville Center has been troubled.

A couple of the organizers of the Long Island event asked me if I had been "hassled" for agreeing to speak to them.

In fact, I didn't experience any blowback. If I had, I would have responded that dialogue in the church means keeping everyone in the conversation. I simply don't believe that speaking to a group necessarily implies endorsing its agenda, whatever that might be; I think it can also mean a desire to build relationships based on sympathy and mutual respect. (I said the same thing, by the way, when some Catholic liberals raised questions about my accepting an invitation to speak at Archbishop Charles Chaput's seminary in Denver last year.)

Many of the people I met in Long Island went out of their way to say that they were not activists by temperament, and neither were they liberal radicals -- a few, in fact, made a point of telling me they had voted for George Bush. (One guy said to me that if Bush can bring democracy to the Middle East, maybe there's hope for the church!) Yet, they said, the sex abuse crisis convinced them that the church they love needs help.

Moreover, these people are backing up their talk with their time and treasure. I learned Saturday that the woman who processed all the tickets for the conference at which I spoke, Ileen Weidig, did so from home while recovering from an appendectomy. Meanwhile the woman who organized the speakers, Pat Paone, also worked from home while suffering from a case of the shingles so severe it left her blind much of the time. Yet both soldiered on, unpaid, because both believe something important is at stake.

It's a matter of fair debate whether VOTF's platform of "keep the faith, change the church" is ultimately adequate, given that some elements of ecclesiastical structure are based on faith convictions about Christ's will for the church. It's fair, too, to ask whether there's enough spiritual depth, enough sense of being part of a worldwide family of faith, in the VOTF project in at least some instances. At the same time, it's equally fair to observe that VOTF members across the country have repeatedly reached out to bishops in a spirit of collaboration and dialogue, and sometimes they've been spurned. Pope John Paul II said on Sept. 12, 2004, in an address to the bishops of New Jersey and Pennsylvania, that "participation, consultation and shared responsibility" are an "intrinsic requirement of the exercise of episcopal authority." The experience of VOTF to date suggests the American church still has some ground to cover to implement that vision.

All that, however, can be talked out in dialogue with church authorities and other voices in the Catholic conversation. The important thing to note, it seems to me, is that the VOTF folk I met in Long Island came across as decent, faithful people trying to do something positive for the church.

Surely that's something upon which one can build.

* * *

Last week I had the pleasure of meeting Archbishop (Pierre) Boutros Mouallem, the Melkite archbishop emeritus of Galilee, who was in Rome for an inter-religious event. Mouallem was born in Galilee, and moved to Lebanon in 1941, where he lived through World War II, the Arab-Israeli conflicts, and Lebanon's own civil war. In 1990, he was appointed head of the Melkite church in Brazil, where he remained until returning to Galilee in 1998.

There are approximately one million to two million Melkites in the world, mostly Arabic-speaking Christians in the Middle East, with diasporas in various parts of the world (Brazil hosts the largest Melkite community outside the Middle East). The term "Melkite" refers to the Emperor Marcian and the council he sponsored at Chalcedon, and distinguished this group of Middle Eastern Christians from those who followed the monophysite heresy.

Mouallem told me that his community "is in decline," with lots of young Melkites abandoning the Middle East for North America, Australia and Europe. He said that two factors are primarily responsible: 1) economic stagnation and a sense of hopelessness for the future, and 2) political and civic discrimination against Arabs, including Arab Christians, within Israel.

On this second point, Mouallem said that Arabs "are not treated as full Israeli citizens," citing as examples difficulties in having Arabs serve as public officials, at least in his region of the country, and the "expropriation of land" which he claimed falls disproportionately on Arab shoulders.

In addition to those two points, I asked, is the rise of Islamic fundamentalism also a factor in driving some Melkites away?

Mouallem said that on a one-to-one basis, relations with Muslims in Galilee are generally good, and many people are optimistic about the direction of the new leadership of the Palestinian Authority.

Yet when I pressed about the impact of groups such as Hamas and the general trend towards Islamic fundamentalism, Mouallem acknowledged that their ascendancy is also worrying his flock.

"Everybody talks about democracy in the Middle East these days," he sighed. "But the truth is that we are caught between two theocracies."

Mouallem said that today, as an emeritus archbishop, he sees his role as a sort of roving ambassador for Christianity in the Middle East.

I'm retired, but I'm still strong," he said. "I have to be strong for my people, who are suffering."

* * *

So much has been written and said about the Terry Schiavo case in the United States that I hesitate to add anything here. It's already well-known that the Holy See has been outspoken; three senior Vatican officials have appealed directly on Schiavo's behalf, including Cardinal Renato Martino, president of the Pontifical Council for Justice and Peace; Cardinal Javier Lozano Barrigan, president of the Pontifical Council for the Health Care Pastoral; and Bishop Elio Sgreccia, president of the Pontifical Academy for Life.

The American press, already accustomed to the engagement of religious conservatives on Schiavo's behalf, has not given a great deal of attention to these Vatican interventions, treating them as largely pro forma.

In fact, however, if one sees these statements through the lens of normal Vatican operating procedure rather than the particular contours of American debate, they're really rather extraordinary. As a general rule, Vatican officials restrict themselves to enunciating general principles, treating particular cases, pieces of legislation or elections as something for local bishops to address. Readers will remember, for example, during the American debate over communion for pro-choice Catholic politicians, that Vatican officials outlined the general rules in church law but never even cited the name "John Kerry" in doing so.

The willingness to enter into the particulars on Schiavo, therefore, suggests that officials in the Holy See regard this case as of singular importance, analogous in the camp of "Culture of Life" issues to the Rocco Buttiglione case in Europe in the area of "secular fundamentalism." In both instances, several Vatican officials (including, both times, Martino) believed that something so unjust, so potentially important in terms of precedent value, was taking place that it had to be denounced by name.

From the point of view of the Schiavo drama, the Vatican is no doubt a bit player. Its role is, nevertheless, unusual, and may signal a growing willingness on the part of at least some Vatican officials to get down to brass tacks when key moral and cultural questions are at stake.

* * *

The idea that the National Catholic Reporter's Rome bureau is a one-person operation has always been a myth. Without my wife Shannon's contributions in keeping the books, handling logistics, and providing a thousand-and-one forms of support, this show would have closed a long time ago.

This week, however, I'm pleased to announce the temporary addition of another member to our cast. Beginning immediately, and for the next few months, Rome-based journalist Stacy Meichtry will be assisting me with coverage of the pope, the Vatican, and all manner of things Catholic.

Meichtry has already written for NCR, including a terrific piece of reporting on the Catholic church's response to the HIV/AIDS crisis some weeks ago. His work will now be appearing more regularly in the print edition of NCR, on the Web site, and from time to time in this space.

Over his time in Rome, Meichtry has worked with The Associated Press and The Washington Post. With both he was responsible for general-assignment reporting, not just the Vatican, so he brings broad experience to his new duties.

If that were all I knew about Meichtry, it would have been enough to catch my eye. In fact, however, our association goes back a bit more. I was his journalism teacher at Notre Dame High School in Sherman Oaks, Calif., in 1996-97, where he first cut his teeth as a reporter and editor. I'm glad to see that something from that experience stuck.

Look for Meichtry's byline, which I'm sure will be a boon to our coverage.

The e-mail address for John L. Allen Jr. is jallen@natcath.org