‘This Too Shall Pass’ : Sister Marie Madeleine Shonka, Chief of St. John’s, Looks at the Center’s Future and at Life After the Quake--When She Lost Her Job, Hospital, Home

Sister Marie Madeleine Shonka, president and chief executive officer of St. John’s Hospital and Health Center in Santa Monica, is taking stock these days after the Northridge quake closed St. John’s. Gone are her hospital and its 1,750 employees, gone are her home and her roommates.

The 67-year-old Sister of Charity, a dead ringer for the woman on the See’s candy box, now lives in a 2BD, 2BA apartment with her closest friend and senior assistant, Sister Alice Marie Schwieder. Sitting in their new environs with Frank Sinatra crooning “Fly Me to the Moon” over the radio, Shonka talked about the tasks ahead.

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Question: What will happen to St. John’s Hospital?

Answer: St. John’s will never be the same. It will be different. It will be better. The most dramatic thing will be razing the North Wing. This is an opportunity to prepare ourselves for the health care of the next century. We’ve known all along that there is an excess of hospital beds in Southern California and that we did not need 501 beds.

When we reopen the South Wing in August, we’ll have about 150 inpatient beds. The volume of inpatients has decreased significantly and the volume of outpatients has increased. We are going to work with Santa Monica Hospital so that both of us are meeting unmet community needs. Maybe we’ll develop a medical-mall type of approach, where you have multiple, walk-in clinics with dentistry, inpatient beds, emergency activities and free-standing surgery centers.

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Q: Do you think most health-care facilities are moving in that general direction?

A: Outpatient is less costly and a more effective way of meeting public needs. When I first came here in 1968, about 10% of our surgery was outpatient. A patient would come in the morning, have surgery and go home at night. The rest of the surgeries, patients would stay five or 10 days. With the changes in health-care delivery, we are now finding that about 60% of our surgery is done in an outpatient capacity. We need to accommodate much fewer inpatients.

Other hospitals will be in the same situation in the future, where they will have to look at programs and services directed at the health-care revolution.

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Q: What is motivating the movement toward outpatient care?

A: Doctors prefer it because it gives them a broader turnover of patients. It’s more cost-effective. Many patients prefer it. Maybe the future patient is a working man who can’t give up a weekday to come in for surgery. Maybe there are options for him to come in on Friday, recuperate over the weekend and get back out on the job on Monday.

I think, with the Clinton health plan, or whatever version comes out of it, that people will stay healthier as we move into preventive medicine and we won’t be looking at long-term stays. We’re a much healthier country now. Most people that came here in 1968 would come for maybe two or three days to get annual physicals.

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Q: What is your view on Clinton’s health-care plan as it stands now?

A: The goals, access and universal coverage are really very important. The challenges will be in looking at how we can accommodate access and still have reimbursement that is projected to be much less.

I am concerned about these alliances (a concept of managed competition where regional alliances representing consumers would shop among competing insurance plans for the best deals and deliver report cards to health plans, hospitals and doctors) they are talking about. I am concerned that it could become a bureaucratic maze.

Price-fixing would be a very serious problem. It has not ever worked in any of our major industries. If everything were price-fixed that would be fine, but if a hospital is price-fixed in what it can charge, but the people outside and vendors are not, then it could inundate a hospital with red ink in a short period of time.

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Q: How are you dealing with all these losses since the earthquake, including the severance of all these employees who considered St. John’s a family?

A: I get emotional when I talk to my employees and say goodby after all those years. I have cried. And it really kind of tears you apart after awhile. But in all fairness to them, you really have to sever relationships so they can find jobs because it is just never going to be the same.

But the loss of the sisters is one of the most poignant things for me. It’s lonesome. I always enjoyed seeing them at meals, and I miss that. It’s like disrupting a family -- it kind of gets convulsed and it’s going to get more convulsed in the next few months. But this too shall pass.

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Q: Some former St. John’s employees have said that they feel betrayed because they say they were told that they would not get priority over other applicants for jobs when the facility reopens and because, initially, they were told that they would not retain seniority if rehired.

A: We made a mistake with the seniority. But we heard the employees’ complaints and we made the adjustments. Now if an employee had 15 years’ seniority and they were gone for (up to five years) they could still come back in at the 15-year level.

Some of this is a misunderstanding or confusion or anger at things in general and at life in particular. We have spent a lot of time, effort and energy to develop a cadre of employees that really represent St. John’s. Why would I, at this point in time, go out and bring in total strangers to go about our mission, our ministry and our work efforts?

We felt so compelled to give good severance packages because we know that nobody could be down from February to August, particularly when there are going to be 1,000 less jobs now.

It doesn’t take a rocket scientist to see what the devil has happened here with the hospital down. I really feel badly that so many were laid off. But I didn’t create the earthquake. I just didn’t do it.

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Q: What has it been like living in an apartment after having spent 45 years in a convent with a community of religious sisters? You have a Betty Crocker cookbook on the coffee table. What kind of cuisine is served up at night?

A: The food was brought up from the cafeteria every day (when the convent was on the hospital’s sixth floor) , so cooking, baking and shopping are things we have to deal with. I am abhorrent of shopping, for clothes or anything. And I just don’t cook. I cooked our first meal here and Sister Alice Marie was sick the next day. We decided to let her cook the meals. All I did was scramble eggs and bacon. I am hoping she got an illness from something else.

But it has been different, challenging and lonesome. I lost my job, my hospital and my home all in one day. This is where we live now. It’s a nice, cute lovely apartment, but for me, the loss of the sisters was the most traumatic thing.

I used to always have a Super Bowl party. I watched it in my new apartment, and there were only two of us to have my usual party with the chips, dips, popcorn and beer. My heart was with Buffalo, but my money was on Dallas.

I am a great, great sports fan. I’ve always been like that. I was the only girl on the block in a little town of Chapel in western Nebraska and whatever the boys were playing, either football or basketball, they let me play because they knew it was OK for the guys to push me around and tackle me. And women, at that time, weren’t the highest priority in Chapel and still aren’t. But I have had a happy career as a sportsperson.

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Q: Where do you think nuns are today in terms of the public perception, from the 1966 movie “The Singing Nun” to today’s “Sister Act 2,” and in the patriarchal power structure of the church?

A: I enjoyed “Sister Act,” just the fun of it. I haven’t seen the second one, but nuns are real live human beings and we like to laugh, work and pray. We are products of our age. We are no longer isolated in a convent. Some dress in habit, some don’t. We have far more exposure to all the issues that people face. Although we don’t face the same issues, simpatico and compassionately, we can really identify with their problems.

The power structure of the church is still predominantly male, but I think that the future of the church is recognized in the contribution of the many marvelous women who are committed as deeply as cardinals, bishops and priests to our faith and service.

And I’ve met people who simply don’t like nuns. They can be very rude. I always laugh and say, “I’ll bet somebody rapped their knuckles with a ruler when they were in grade school.” You just have to try and develop an individual relationship with them.

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Q: Do you think sisters will ever say Mass, become priests or bishops?

A: Heard a joke about that one: The Pope was very ill. One night, he went to sleep and woke up thinking he saw the heavenly Father there and he said, “Oh, heavenly Father, do you think there will ever be married priests in the church?” And the heavenly Father said, “No, not in your lifetime.”

The next night he had another vision, and he said, “Oh, heavenly Father, do you think nuns will ever say Mass in the church?” And He said, “No, not in your lifetime.”

And the next night, he had another vision and he said to the heavenly Father, “Do you think that there will ever be another Polish pope in the church?” And He said, “No, not in my lifetime.”

I love that joke.

BACKGROUND

The biggest task of Sister Marie Madeleine Shonka’s 26-year career at St. John’s Hospital and Medical Center will be planning a St. John’s for the 21st Century. Although the 52-year-old hospital now has outpatient services, inpatient won’t be available until August and the immediate future calls for demolition of the North Wing, home to the nursery, obstetric beds, a chemical-dependency unit, surgical-medical beds, a neonatal-intensive-care unit and a transitional-care unit. Shonka--unbending as leader of the prominent hospital where she has collected 18 humanitarian awards and earned such endearments as “the angel of St. John’s” and health-care visionary--is dealing with the loss of 10 of her fellow Sisters of Charity. After the quake, they were called home to Leavenworth, Kan., and reassigned. Her new apartment in Santa Monica, a far cry from the convent at the hospital, marks the first time in 45 years that she has lived outside an institution.