I have cancer,” the elderly woman announced from her hospital bed high above York Avenue in Manhattan. “But cancer is not the sickness. Cancer is the cure. Because cancer brings you close to God.”
A Catholic priest is ordained to give God. The priest exists to mediate in the name and power of the one Mediator—to be an instrument who gives glory to God in sacrifice and the grace of God to souls. At every ordination, each new priest, just moments after being ordained and clothed in priestly vestments, kneels before the bishop, who slathers the priest’s palms with perfumed chrism and exhorts: “May the Lord Jesus Christ, whom the Father anointed with the Holy Spirit and power, guard and preserve you, that you may sanctify the Christian people and offer sacrifice to God.” Such became the ambit of my activity henceforth. Such became the concerns of my heart.
For every newly ordained priest, hands still fragrant, the first months of ministry are precious. There is the awe of the first confession and the fanfare of the first Mass, and perhaps other Masses of Thanksgiving and celebrations, too. But it is always the deeper mystery at hand that is so striking. For the new priest begins to perform acts he previously could not have performed in any respect. I had prepared for these acts for some seven years but had never actually done them. One cannot simulate instrumentality. So I, the new priest, must act. I must do the priestly things, at once confident in the God who has ordained me and humble before the God who is yet saving me. “Understand what you will do, imitate what you will celebrate, and conform your life to the mystery of the Lord’s Cross,” the bishop also told each of us, passing into our anointed hands a paten and chalice filled with bread and wine, the principal tools of our new trade.
In my Dominican province, the Province of St. Joseph in the Eastern United States, it is common for newly ordained friars to be tasked with two months of intense pastoral ministry before returning to Washington, D.C., for a final year of studies in theology. Usually, one priest is sent to the Dominican Healthcare Ministry, an apostolate and bioethics center based on the Upper East Side of Manhattan that provides spiritual care to patients at several hospitals throughout the city. Such was my lot in the summer of 2024.
For the new priest, hospital ministry is a plunge into the deep. First, compared to the priest’s ordinary orbit, the hospital is strange. The smells and bells of the patient floor are not those of the sanctuary. A white thirteenth-century habit with a fifteen-decade rosary swinging from the side announces itself among scrubs and white coats. It signifies a different kind of physician-ship, ordered to a different though complementary end. The body, after all, exists for the sake of the soul, and the soul for the sake of God. Order and priority: The good of grace in just one soul, St. Thomas Aquinas explains, exceeds the good of nature in the entire universe.
Second, there is no warm-up at the hospital. My orientation meeting at Memorial Sloan Kettering Cancer Center was interrupted by an emergency call for a patient who was actively dying. I was not the priest on duty, but I was the priest most immediately available. So I was instructed to go up—orientation could wait. Later that day, a Spanish-speaking patient returned to the sacraments for the first time in some sixty years. These sorts of things, I would soon learn, occur frequently. God is serious about his desire to go the distance, to save all and bring all to full knowledge of the truth, especially in the final moments. Which actually happened on one emergency call at 2:30 a.m., when a woman expired just as the last drops of baptismal water graced her head, poured from a pill cup no less, in the presence of fourteen members of her family. Heaven enveloping earth—now, at the hour of death, right before our bleary eyes.
Memorial Sloan Kettering, which the Dominican Healthcare Ministry serves day and night all year round, excels in its area of expertise. Everyone who has been to Sloan, whether as patient, family, employee, or visitor, knows this. Go to any floor of the main hospital at 1275 York Ave., and competence abounds. The environment is energetic, hopeful. Doctors conduct research and perform trial treatments that are available nowhere else, and adept and cheerful nurses wear T-shirts that read, “imagine a world without cancer.”
Yet the obvious, uncomfortable truth remains that the human mortality rate is absolute. Modern medicine, with all its marvels, can heal and enhance human life but, in the end, only delays the inevitable. “If we ever do achieve freedom from most of today’s diseases, or even complete freedom from disease,” wrote Lewis Thomas, onetime president of Memorial Sloan Kettering, “we will perhaps terminate by drying out and blowing away on a light breeze, but we will still die.”
Cancer is peculiar among diseases that kill. Viruses, bacterial infections, parasites—these cause death from without. Heart disease, organ failure, and genetically transmitted illnesses are closer to cancer, for in these cases, the body gives way of itself. And then there are the autoimmune diseases, which, like cancer, attack the body from within, but, unlike cancer, do so through an immune system tricked into assailing what is itself healthy.
For all the harm these afflictions wreak, the physical evil at work in cancer is more profound. For cancer is life turning against itself at its core. The DNA of a healthy cell—that most basic material principle of life—mutates, and then the cell divides and divides and divides, multiplying with chronic vigor. These new mutant cells, which can begin in almost any tissue or organ, do not buttress the life of the organism of which they are part, as cells are designed to do. No, they mock it. Like parasites produced by one’s own body, cancer cells can evade immuno-detection and shirk the natural death cycle that healthy cells obey. In turn, cancer cells can replicate infinitely, inundating one’s body with what is inimical to one’s body. It is sick irony: By their immortality, cancer cells reap our mortality—from manic mitosis to malignant mass to metastasis to the morgue. Only then does cancer finally die.
Considered in the light of divine revelation, cancer may well be the most primordial lethal curse consequent on Adam’s sin. Though cancer does not figure much in the Scriptures (the Philistines suffer an outbreak of tumors after capturing the Ark of the Covenant in 1 Samuel 5), death figures from the outset: “You shall not eat of the fruit . . . neither shall you touch it, lest you die” (Gen. 3:3). But they touched and ate, and so we who are dust must return to dust. If a man is not killed by another organism, a natural disaster, or a freak accident, or by the failure of his own organism, the very principle of his life will revolt against him. His own cells will destroy him.
When a priest leads an OCIA class or a marriage preparation meeting, death is mostly an abstraction. It is something we need saving from, yes, but something still far off. In the hospital, however, and especially the cancer ward, the Catholic priest must deal with death directly. Usually, there is time to broach the subject with patients and family: the diagnosis, the prognosis, the ultimate implications, both physical and spiritual. And naturally, patients vary in their willingness to face what lies before them. Some are aware and preparing: “I trust in God, Father, and am coming to terms with this.” Others exhibit a stoic indifference: “We all have to die.” Yes, but what of dying well? Still others stand in denial: “I’m fine. I’ll beat this and get back out there. I have more things to do.” And then? Or if not?
No one can avoid ultimate questions. But in our age, so underinformed on spiritual matters, these questions have become all the more intimidating. When the crucible comes, many fumble about, despairing of real answers and trying to “meaning-make” their way to a noble death. Yet the truth is that we are not left to our own devices in our search for answers. God himself has already made the meaning. Moreover, God has commissioned the priest to manifest that meaning—not because the priest of himself has particularly keen insights into the nature of disease or the meaning of life and death, but because the priest bears God’s insights, which impart God’s peace. Because there are, in fact, real answers: God’s providence is infallibly good. No diagnosis, and no response to treatment, is an accident in his loving plan. And God really has appointed death as our ultimate and universal punishment since Adam, though only to unveil a greater glory: that he should redeem us from eternal death in and through the death and resurrection of his Beloved Son, and in and through our own death and resurrection in him. These soaring, saving truths converge in chiaroscuro mystery: Earthly life ends in darkness, even as the light of eternal life dawns. And here we stand together—patient, family, medical staff, priest—at the threshold.
The austerity of this mystery struck me at the beginning of the summer, at that very first orientation-interrupting call. But the impression only intensified over the next two weeks, when, almost daily, I would visit Jack, a gregarious and athletic twenty-three-year-old man from Long Island suffering from neuroblastoma, a rare, typically childhood cancer. I met him on my second day at Sloan, three weeks exactly from the ordination and only about an hour before celebrating a Saturday evening Mass of Thanksgiving across the street at the Dominican Church of St. Catherine of Siena. Jack’s referral sheet read “declining condition,” and when I walked in, he was very weak, and his mother, his older sister, and her fiancé were seated around his bed. The room was heavy. I didn’t know it, but the night before, one of his doctors had reported that Jack’s liver was failing, and all options were exhausted.
Jack had been battling for more than two and a half years, since his senior year of college, but in recent months, his cancer had pulled ahead decisively, though only physically. For after his initial diagnosis, Jack had come completely alive in the Catholic faith of his upbringing. He began, whenever he was able, to join his father at daily Mass. He studied the Scriptures, watched apologetics videos, and read theology and the lives of the saints. And then he discussed these things over long walks with his father, and while hanging out with his sister and brother and friends, and at a men’s prayer group at a nearby parish, and in so many priceless moments with his mother, who, herself a nurse, cared for him indefatigably at home and in the hospital. The result was that Jack began to see and embrace God’s purposes at work in and through his sufferings. And with his humor and charm, Jack spurred others to join him—from his extended family and large circle of friends, to fellow patients in Sloan’s pediatric unit, to his own doctors and nurses, whom he spared neither the daggers of his wit nor the double-edged sword of the gospel. He once dared ask his mother, who was grappling with his worsening state: “Mom, whom do you love more, God or Jack? You know the right answer.” And when there was hesitation, he doubled down and asked again.
Eleven days after I met Jack, God forced our hands on this central question. He had prepared Jack with all the rites of the Church and a speck of Holy Communion for a final meal. And then, early in the fourth watch of the night, as Jack’s family and nurses kept bedside vigil, God consumed Jack in a blazing fire of divine love and human suffering (Heb. 12:29, Song of Sol. 8:6). It was a pleasing offering, a holy death: one beloved son by divine grace, conformed to another Beloved Son by divine nature. Had Jack recovered—an outcome for which so many had prayed and from which much goodness and spiritual fruit surely would have come—Jack’s life would have been too human, too this-worldly, too predictably heroic. God’s ways are more mysterious, more cruciform, more sublime.
The night Jack died, he appeared in near-perfect health in the dreams of two of his closest friends. “Jack, you look great. You beat the cancer!” one friend exclaimed in his dream. “Yeah, I pulled through,” Jack affirmed, but with his eyes down, as if he knew something his friend did not yet know. In the morning, both friends awoke to a group text from Jack’s younger brother delivering the news. Mysterious, cruciform, sublime. Which spoke for itself at his wake and funeral, packed with hundreds of family, friends, peers, even nurses from Sloan, each pondering what Martha and Mary pondered at their loss: “Lord, if you had been here, my brother would not have died” (John 11:21, 32). But the Lord had in fact been there all along, right in the thick of it, and our task was to ponder how—to make sense of what God had just done through Jack, and of what Jack had just done with God.
“Did I not tell you that if you believe, you will see the glory of God?” Jesus said to those gathered outside Lazarus’s tomb before he raised the man from the dead (John 11:40). The responsibility of the Catholic priest is to point to the glory of God—to help others see what God is really doing beneath the surface, at the deepest level of things—and to make this glory really present through the sacraments.
The preeminent virtue that the priest must bring to the hospital, then, is living faith. “We walk by faith and not by sight” (2 Cor. 5:7), and never more intensely than at the hour of our death, the hour of glory (John 17:1–3). Because at death, whether one’s own or that of a loved one, the sheer invisibility of the gospel addresses us in its purest form. The naked eye sees only a living body, racked, about to reach its end. And as death closes in, an entire life’s worth of misdeeds and regrets can return in a frontal assault. The horror. What comes next—for me, or for my loved one?
But the mind illumined by faith beholds an eternal horizon opened up by the mercy of God at work in the cross of Christ. By this faith, the hospital priest understands that he spends his days at the foot of Calvary, “the place of the skull.” He looks death in the face again and again, though never alone. Rather, the priest stares down death together with the Living One, the Conqueror, who died but now holds the keys of death and Hades in victory (Rev. 1:18).
So poised, the priest testifies to what he sees when he looks at death with Christ. With a conviction and compassion that render him credible, he encourages the patient lying before him that death is not the end, that the deathbed is, in truth, an altar, a living crucifix, and that Christ looks back in love from highest heaven, beckoning us to offer ourselves with him and so come to him. And then the priest, as only he can, makes present the full power of Calvary by performing the saving signs thereof: I Absolve You . . . Through This Holy Anointing . . . The Body of Christ. Through these sacred acts, the priest outdoes his own humanity: He forgives what no man can forgive, heals what no doctor can heal, and feeds as no food can feed. “If anyone eats of this bread, he will live forever” (John 6:51).
Inevitably, a priest is affected by his ministry, as also the Incarnate Word, our great high priest, was affected by his ministry. He marveled; he wept; he sweated blood; he died in ministry. And above all, he was perfected in love through his ministry—not that he ever loved imperfectly, but rather that he performed greater and greater acts of love, until he performed the greatest act of love a man ever has performed or ever will.
Every priest is privileged to experience something of Christ’s priestly affections. The holier the priest, it would seem, the more profound his experience, but for the new priest at least, for whom everything is so novel, this deeper love he has begun to share with Christ is to be especially savored. He sees, through the new lens of his instrumentality, that the same redemption God is working in his own soul, God is also working, through his unworthy hands, in the souls of others. He likewise sees how the truths of faith that he has contemplated and studied with great fervor for many years are both real and useful for souls. Because only the truth sets free, only the truth has grace, only the truth perfects in love.
In the hospital, everything is intensified because the finish line is approaching. We cannot flee from the finish line but must run toward it in faith. There, ministering on the homestretch, I found that for the believer who is prepared to exit this life, death is often easier to accept than it is for the loved ones who are looking on. Patients pronounce striking utterances. One man in his late seventies—a retired contractor and heavy-machine operator fondly described by his son as a “hot dog connoisseur”—looked forward blankly after receiving Holy Communion and declared before a full room, “God is present.” A formulation, his son assured, that was not in his father’s register. The man died a few days later. Another time, a rapidly declining forty-two-year-old woman, who had desired to convalidate her seven-year civil union into a sacramental marriage, came to clarity of mind just long enough to exchange vows with her husband during a ceremony in her hospital room. (The nurse even brought up a cart of celebratory treats from the café.) When it was her turn, the bride answered “Yes!” five times over, then added the only two words prescribed: “I do.” Already anointed and no longer able to eat, she died the next morning—a seventeen-hour marriage, the last sacrament she received. And then there was the forty-seven-year-old wife and mother of two who signed her last will and testament, confidently professed the creed, and received full last rites with the apostolic pardon and viaticum, all about an hour before she died.
For the loved ones who look on, seeing God accomplish such works up close has its own impact. Many family members open up to the light of faith through their exposure to suffering. The dying point them to life beyond the veil. And by grace, those who remain can come to see that notwithstanding death’s sting, what has happened is ultimately good, because St. Paul’s assertion to the Philippians is true: “to die is gain” (Phil. 1:21). So much so that when one helps others attain that gain enough times, one mysteriously begins to wish it for oneself. “To depart and be with Christ—it is much better” (Phil. 1:23). But we do need priests, and so “it is more necessary that I remain in the flesh” (Phil. 1:24).
God knows what he is about. In ways that exceed human understanding, he unites us to himself precisely through the scourge of death. “I have cancer,” the elderly woman announced—freshly absolved, anointed, and communicated—from her hospital bed high above York Avenue. “But cancer is not the sickness. Cancer is the cure. Because cancer brings you close to God.”
Such is the logic of the cross, the true logic of our life on this earth. “When I am lifted up,” Jesus promised, “I will draw all men to myself” (John 12:32). For some, God uses cancer unto death to draw them once and for all, as in the case of a daughter of Hungarian gypsies, who was born into Nazi captivity and reared in communist atheism but baptized, confirmed, and anointed on her deathbed in the ICU. For others, God uses cancer unto discharge, sending them back into his vineyard, at least for a time—like the faithful captain of an FDNY ladder company forced into early retirement by cancer from 9/11, his second day on the job, or the tech executive, also with 9/11 cancer (he was working in the towers), who returned to a beautiful practice of the faith after decades away. And down the line, whether they reach remission or return for readmission—as did the captain, who died with such grace last June—God still knows what he is about. For the lifting up only began on Calvary. It was perfected on the third day, and especially forty days after that.
Fourteen months after Jack’s passion and death, God granted a taste of resurrection. Jack’s older sister married her fiancé, and there, for the first time since Jack’s services, we all were together again—Jack’s family and friends, including the two who saw him in their dreams, and even one of his nurses from Sloan. Jack, too, made his presence known. During the homily, which made reference to him, the lights suddenly flickered. They flickered again when the newlyweds recessed: a double sign, we dared to hope, of the family forerunner at the nuptial banquet on high, descending to grace another with his approval. Because God knows what he is about.
This magnificent mystery of salvation through suffering goes widely unknown in our day. Assisted suicide proliferates, and so many slide into serious error about the true meaning of life and death, either unaware or in denial of the divine glory at hand. “Did I not tell you that if you believe, you will see the glory of God?” (John 11:40).
We know there is much work, indeed much praying and preaching and policymaking, to be done. But we also take confidence from the fact that God yet accomplishes his greatest wonders where few, if any, are there to witness—as in the hospital room, through the ministrations of the priest, especially at the end of life. “Having loved his own who were in the world, he loved them to the end” (John 13:1). Salvation, after all, is clinched only at the end, in the final moment before death. The priest wants to be there. The priest exists to be there, to give God’s presence there: “I am with you always, even to the end of the age” (Matt. 28:20).
