Start It Up, Then Ask Permission (2nd of 5).
How Catholic Sisters Established America’s largest private hospital system and largest private school system.
For a hundred years Catholic Sisters moved westward across America, established the first hospitals in towns and cities. By the 1950s one of five hospital beds was in a Catholic hospital.[1] Catholic Sisters established schools as well, educating 11 percent of America’s students by the 1950s. The financial and managerial innovations of Sisters enabled their hospitals and schools to remain competitive even when government and private hospitals or schools were built in towns. The number of Catholic schools and hospitals has declined steadily since 1960. Perhaps Catholic Sisters in our generation are subduing other giants in our day. John Fialka in his book, Sisters, writes,

The fact that hundreds of different orders of sisters could carry out independent missions, working with, working around or working despite the wishes of the bishops gave the church a flexible, innovative structure that coped well with the extreme challenges and opportunities in the new nation . . . It gave the Catholic Church a resilience that allowed it to flow over obstacles and an innovative drive that had it constantly reaching out to new members and collecting arriving immigrants. These are characteristics that many Catholic historians fail to appreciate. They simply baffle most non-Catholics, who continue to view the Church as a monolith.[2]
This is the beauty of the Catholic mission experience: Catholic sisters who joined hundreds of religious orders were authorized to start it up, then ask permission. Catholic sisters provide a textbook example of the value of allowing the people closest to the action, and not boardroom administrators, to take the initiative.
Dr. Roger Finke, who teaches the sociology of religion at Purdue University, has spent years tracking the growth of religions in U.S. Protestant churches. He found they had all had a similar growth cycle: mainline religions would be established, then grow, then go into a decline. Then new Protestant versions would spring up attracting members away from mainline churches. But in three generations membership in newer churches would decline, and the cycle of growth and decline would begin again.[3]
But the Catholic Church just grew and grew. Fialka writes, “I started thinking, how did Catholics avoid this cycle?” Fialka began to study Catholic religious orders.
The Catholic sisters were providing many of the innovations, spreading into every corner of the country. What I found was they provided a tremendous amount of pluralism, a lot of diversity in terms of what’s going on.[4]
The Catholic religious orders were able to adapt to the needs of frontier America. Restless Catholics in religious orders could start new structures to meet the needs that were presenting themselves in a new world. Moreover, Catholic monastic structures allowed women to lead. Consider Katharine Drexel (1858-1955) of Philadelphia. Together with Mary Elizabeth Lange Katharine Drexel founded the Sisters of the Blessed Sacrament for Indians and Colored People. Its aim: “to lead the Indian and Colored Races to the knowledge and love of God, and so make them living temples of Our Lord’s Divinity.”[5] We would not use such terms for people today; the mission society Drexel founded has been renamed “The Sisters of the Blessed Sacrament.” “But at a time in America when it was considered wrong, in some places illegal, to educate black people, they started the schools and colleges that helped create the beginnings of the black middle class.”[6]
Eventually Catholic women began about four hundred religious orders, about eight hundred hospitals, and ten thousand schools, colleges and universities.[7] Catholic sisters dug the first sewer system for the city of Joplin, Missouri.[8] Dr. Bob Smith, a physician recovering from alcoholism, and treating others who had not recovered, began sneaking his patients into St. Thomas hospital in Akron, Ohio. The result of this collaboration was Alcoholic Anonymous.[9] These innovations were made possible because of the autonomous nature of the Catholic religious orders and the discontented members who joined them.
[1] John J. Fialka, Sisters: Catholic Nuns and the Making of America, 1st ed. (New York: St. Martin’s Press, 2003). p. 3
[2] Ibid. p.121
[3] Ibid. p.122
[4] Ibid. p.122
[5] Angelyn Dries, The Missionary Movement in American Catholic History, American Society of Missiology Series; No. 26 (Maryknoll, NY: Orbis Books, 1998); ibid. p.31
[6] Fialka, Sisters: Catholic Nuns and the Making of America. p. 9
[7] Ibid. p. 3
[8] Ibid. p. 11
[9] Ibid. p. 12-13