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How do we know what they know?


Growing up, we always set an extra place at the dinner table, and when I was old enough to do the dishes, I asked why. Practical Aunt Mary said it was to make anyone who dropped in feel welcome. My grandmother, a romantic, said the extra plate was for Jesus present among us.

Later that year, when the parish priest came over to school to lecture about the Holy Eucharist, both of my family's explanations meshed easily into his formal description of the Last Supper. Transubstantiation didn't faze me: Of course Christ turned his body into bread and wine to feed us all, just as my widowed mother fed me with her body's milk, energy and sacrifice.

My child self recognized the same love in both kinds of meals -- and that message survived all subsequent theological overlays. Which is why I did a double take when my friend Jenny told me her dad, a lifelong devout Catholic now in the final stages of Alzheimer's, is no longer allowed to receive communion.

When the volunteer eucharistic minister at the nursing home first withheld the sacrament, Jenny called her parish priest. "The volunteer said he could no longer receive communion because he didn't know what it was," she complained to the priest.

"That's right."

"How does she know what he knows?"

"Oh, come on," the priest said wearily. Why, he'd had a parishioner with Alzheimer's just recently, and he'd had to stop giving that man communion, too.

Jenny was furious. She wanted to know why the Catholic church spent so much of its energy building a foundation for the dignity of the unborn, then pulled it out like a rug when an older mind failed.

Trying to be fair, I asked just how bad Joe -- a warm, gregarious Italian we all loved to joke with -- had gotten. "He doesn't always know my name," she answered. "But one day when I came off the elevator, he looked up and said, 'You belong to me!' and held out his arms."

Joe was baptized as an infant. The woman he married became a Catholic at the time of their wedding. They sent all four children to Catholic schools -- kindergarten through, in one case, the doctorate. Listening to Jenny talk, I felt her anger pulsing in my veins, too.

So without saying much to Jenny, I began casting about for an explanation that made sense.

Eventually, someone mentioned an article The Washington Post printed years ago about a priest with Alzheimer's. I called the reporter, Laura Stepp, and she remembered immediately. "I watched him celebrate Mass, and it was slow and painstaking but it was also very moving and felt very meaningful," she told me. "When he served communion, he had someone helping him, but he held the ciborium. The idea that someone with Alzheimer's couldn't receive communion is absurd."

Warmed by our mutual indignation, I was tempted to agree and hang up, but I felt obliged to point out that Joe wasn't as cognitively aware as the priest must have been. "Doesn't matter," she replied. "Who are we to say that they don't know? Before my grandmother died, I went to visit her on a Sunday morning. She couldn't talk, but as soon as I put my arms around her, she leaned toward me with this big smile on her face. I sang 'Amazing Grace' and rocked her, and I know she knew what I was doing. On some level, they know until they are dead."

A friend who is a hospice chaplain recently told me about staying a few extra hours with a woman who was supposedly comatose, far beyond cognition. Looking around the woman's room for clues, Susan took her hand and started talking: "You've been a mother and you've taken care of other people all your life, and you probably never thought you'd be here, where it's loud and there are indignities and you have to wait, and --" She felt the woman's hand move and glanced at her face. Tears were rolling down her cheeks.

In Eucharist we make "a single exception to a law of science," Msgr. Ronald A. Knox wrote in 1956. "We admit there is something we come across in our experience which can communicate energy without losing energy in itself." In other words, we are willing to shatter our rational assumptions and posit Christ's presence without proof.

But we are not willing to grant the possibility that, after 82 years of devout faith, a core of recognition might outlast the socially appropriate responses.

For the record, Knox does note that Eucharist is more than cognitive: "When a man lies on his deathbed, it is through his body that sacramental grace comes to heal him." I tried to imagine Jesus hosting a dinner at the nursing home and waving Joe away.

Unfortunately, Jesus didn't set the historical precedents for pastoral decisions about Eucharist, which were nuanced even in the Rev. James O'Kane's Notes on the Rubrics of the Roman Ritual, published in 1872.

"Communion is not to be given, in any circumstances, to those who are insane and who have never had the use of reason," he wrote. "If, however, before they became insane, they evinced pious and religious sentiments, they, according to the decree of the Council of Carthage, may be admitted to its participation at the close of life, provided there be no danger to be apprehended of discharging the stomach or of other indignity and inconvenience."

The indignity and inconvenience of stomach discharge would hardly be my criteria, but I appreciated his generosity of spirit. Jenny's priest made no similar offer; no promise of Eucharist at the deathbed; no suggestion of a regular blessing in lieu of the host.

Hoping the current doctrines said more about disability, I called Catholic University. Fr. Gerard Austin, OP, was out of town; the PR woman called him with the question. "You're to check the U.S. Bishops Guidelines in Origins, June 29, 1995, paragraph 20," she said.

Dogged by now, I hunted down the reference, "Guidelines for Celebration of the Sacraments with Persons with Disabilities." But I started with paragraph 19, which defines the Eucharist as "the summit and the source of all Christian worship and life."

Paragraph 20 said the person must "be able to distinguish the body of Christ from ordinary food, even if this recognition is evidenced through manner, gesture or reverential silence rather than verbally." Pastors are encouraged to consult with family members, psychologists and experts on disability. "Cases of doubt should be resolved in favor of the right of the baptized person to receive the sacrament."

I suppressed my "Eureka!" and tried to be logical. The bishops' main question seemed to be whether someone can distinguish the Eucharist's significance. If Joe couldn't do so, why fuss about the theology and ideology of bringing him the sacrament?

Why? Because for 82 years he's been told it's the center of his faith, the bringing-to-life of his relationship with God.

Because his wife and family know it's what he'd want.

Because no other human being can be sure what's happening within the mysteries of his consciousness right now.

St. John Chrysostom wrote that "the time for communion is ... when you have a pure conscience and your life is purified from sin." I'm willing to bet there's more purity -- some accumulated over a faithful life, the rest forged by illness' theft of control -- in Joe's soul than in that of most communicants.

We do still believe he has a soul, don't we?

Jeanette Batz is a senior editor at The Riverfront Times, an alternative newspaper in St. Louis.

National Catholic Reporter, January 31, 1997