Doing What Needs to be Done

Doing What Needs to be Done

Butler Hall Steps

They have often been called to serve in ways outside of their usual duties. But whether it has been helping during a diphtheria outbreak, starting a hospital, or founding a nursing school, the Presentation Sisters have always responded when it comes to caring for others.

The Bible tells a story of ancient Jews being oppressed by foreign occupiers in which a mother’s seven sons get executed for not abandoning their faith.* Christian legends have a similar story about seven young men and their mother being martyred by Roman oppressors. A more recent echo of the story has a better result.

In 1900, a diphtheria epidemic struck Aberdeen, and when a mother and her seven children contracted the disease, no one would go to their house to care for them, except the Presentation Sisters. We don’t know what happened to that family, and the story may be apocryphal, but that epidemic is what launched the Sisters’ health ministry. When local doctors asked the Presentation Sisters for help, they turned some classrooms in the school they’d built 12 years earlier into hospital wards. And the rest, as they say, is mustard. 

“The Sisters like the Gospel parable of the mustard seed,” said Todd Forkel, CEO of Avera St. Luke’s, “the idea that if you have faith, great things will come from small things. That’s what’s happened in Aberdeen from the Sisters’ work.” And beyond Aberdeen. As Avera Health CEO Bob Sutton observed, Avera Health is the largest female-founded organization in the Upper Midwest. 

The local city fathers 120 years ago might have approached the Sisters because they had been helpful during an earlier epidemic. It might also be because they knew the Sisters would get things done. But why did the Sisters say yes? After all, 20 years earlier, they had been recruited from Ireland, where the Sisters of the Presentation of the Blessed Virgin Mary had been founded in 1775 by the indefatigable Nano Nagle, to be teachers. They didn’t have medical experience. So why take this on? 

“There was a need,” is the simple explanation offered by Sister Janice Klein, President of the Aberdeen Presentation Sisters (the congregation established here in 1886). Sister Janice added that “Nano Nagle responded to needs in her time. She cared for the sick and provided for the poor. When Aberdeen’s business people and doctors approached the Sisters about needing a hospital, I think those early Sisters said we have to respond to this need.” She continued, “That’s what our community does—responds to needs of people in a compassionate, Gospel-justice way.” It comes from the charism—the spiritual gift—the Presentation Sisters believe Nano Nagle had, which Sister Janice defined as “alleviating oppression and promoting human dignity by incarnating the compassion and justice of Jesus.”

Sister Kathleen Bierne sees it the same way: “Nano always said, ‘Do what needs to be done.’ That’s what we do.” She also credits “the pioneer spirit that brought us here in the first place. It led us to be a nursing community when we had no intention of doing that or running a hospital, which we had no intention of doing either. It had to be God’s will.”

Mother Joseph Butler was the superior of the Aberdeen Sisters when they decided to accept the city’s request. In a much more hierarchical time, she probably made the decision herself, but said Sister Janice, “She had the vision to see this as a beginning.” Today, out of dozens of Presentation congregations on three continents, Aberdeen’s is the only one in the world that has a health system.

Starting a hospital hadn’t been in the long-term plans of the Sisters, but as Sister Kathleen noted, “It tells you about the need to adapt.” The Sisters soon bought land for a hospital, selling craft work to raise the money, and the 15-bed St. Luke’s Hospital opened in 1901 in what is now the parking lot south of the main building. Within a decade, they were running two more hospitals in South Dakota and one in Montana, including the new McKennan in Sioux Falls. Building a hospital was certainly a leap of faith. In 1900, according to the ledger, the Sisters had $1.90 in their year-end account; in 1901, it was $1,465—a 77,000% increase. The Lord provideth indeed. That’s a lot of mustard. 

It didn’t take long for things to get crowded, however. In 1924, the Sisters set aside their plans to build a new convent and instead constructed a six-story, 159-bed hospital where the current St. Luke’s stands. Around the same time, they also built new hospitals in Sioux Falls and Mitchell. In Aberdeen, the Sisters moved into the old hospital to live, renaming it Butler Hall after the pioneering mother superior. A decade later, they added a chapel to the southwest corner of Butler Hall.

1958 Scaled

Buildings are one way to look at a story because they are ways of responding to current needs and hoping to meet those of the future. Anticipating the stewardship that would be a future Presentation value, the Sisters repurposed buildings. The original school had become a hospital. The old hospital became a convent. The former Lincoln Hospital building downtown became a wing of St. Luke’s when the Sisters rolled it on logs from 5th and Lincoln to 3rd and State. The process rebooted in 1974, when, after 50 years, the six-story hospital was demolished and replaced with the current St. Luke’s on State Street. Construction has never really stopped. CEO Todd Forkel, who started at St. Luke’s as a radiation technician in the early 1990s, observed, “The hospital campus has about tripled in size since I started working here.”

In the midst of this, the Sisters bought 100 acres north of town. Three decades after they had prioritized a new hospital over a new home for themselves, they finally built a new convent on the highest point in Aberdeen, naming it Presentation Heights and moving there in 1954. In another repurposing, Butler Hall became a residence for nursing students.

Education remained a primary and evolving focus of the Sisters, both in the formal education of young people in the many schools they led in the state, and in training nurses. They had established an initial nursing school in 1908, and in 1942, they created the Presentation School of Nursing. In 1951, they took over sponsorship of Notre Dame Junior College in Mitchell and moved the programs to Aberdeen. The college then became Presentation College and added a nursing degree. Again, in the world of Presentation Sisters, the Aberdeen congregation is the only one with a college.

Health care evolved too. The polio epidemic that struck the nation in the 1940s and 1950s marked a milestone in the history of the hospital. St. Luke’s was one of the first hospitals in the area to get iron lungs, which helped polio patients breathe, and the hospital became a center for the treatment of polio. Over the decades, St. Luke’s also added more and more subspecialists among its physician corps, a response to what CEO Forkel described as the Sisters’ insistence that the hospital adhere to its founding rural focus and commitment to providing care as close to the patient’s home as possible. In addition, beginning in the late 1950s, the Sisters began purchasing land for nursing homes in Aberdeen and other communities.

By this time, it was also becoming clear that changes in health care as a whole would require changes in both how the Sisters would administer their hospitals and who would do it. Fortunately, the congregation treasurer Sister Stephen Davis had the savvy to recognize that “things were changing and we needed to respond,” said Sister Kathleen. “As the intricacies of health care became more and more complex, we knew we didn’t have people familiar enough to manage it. Sister Stephen knew that bringing in lay support was the right thing to do, and it became a great grace.” The Sisters began to welcome and mentor lay people into leadership roles at the hospital, including the first lay CEO of St. Luke’s, Harold Brady, in 1964.

This laid the groundwork for additional major changes in administration. The Sisters and their lay advisors saw benefits in bringing their four major hospitals together under one leadership, and in 1979, the Presentation Health System was formed. Within two decades, discussions began between the Presentation Sisters of Aberdeen and the Benedictine Sisters of Yankton about merging their hospital systems. Sister Kathleen said, “It was two years of intense conversations, but again it was the right thing to do.” Avera Health was created in 1998.

The Sisters also began to face the facts that vocations to religious life were declining. “If you look at vocations over time, they ebb and flow,” Sister Kathleen noted. “Today, women who would be active in society have so many more options in America than they did when many of us joined the order.” With smaller numbers and aging members, the Sisters were unable to perform the same roles as they once had. CEO Todd Forkel recalled, “When I was doing X-rays here, there were many Sisters in the everyday staff jobs at the hospital. Now their roles are entirely in governance.”

And they remain active in governing the health care system they created. The leadership of each order—Presentation and Benedictine—oversees the entire organization. In addition, each hospital in the Avera system, which now includes more than 30 hospitals across five states, has both a Presentation and Benedictine Sister on its board. Sister Janice is on the overall leadership group, and Sister Kathleen is in her fourth term on the Avera St. Luke’s board—one of four Sisters on the 18-member board. 

But this governance doesn’t guarantee the Presentation charism remains. “We want the legacy to continue so we want to do whatever we can do to insure that,” Sister Kathleen explained. Now, hospitals have lay people who keep mission at the forefront. That’s a responsibility Todd Forkel takes very seriously. “I tell my staff we should hold it in the highest regard that the Sisters handed this to us and have entrusted it to us. I see it as a privilege,” he said. From the Sisters’ perspective, it seems to be working. Sister Janice said, “Mission is very deep in the Avera system. Its values of hospitality, compassion, and stewardship are witnessed every day, and they lead back to Presentation values as well.”

A story that began with a large family continues with hundreds of births at St. Luke’s every year, none perhaps more famous than the five who arrived in 1963. The Fisher quintuplets drew worldwide attention to Aberdeen and the hospital. It may seem ironic that a group of women who committed their lives to God and ministry rather than child rearing are so connected to miracles of birth. But the Presentation Sisters have been about nothing if not about life, and making it better for all they meet.

Today, the mustard tree has grown. One of the most impactful institutions in Aberdeen, Avera St. Luke’s has 1,200 employees and a $100 million payroll—four times the city government budget. About half of its patients come from outside Aberdeen—people who spend money with other businesses too. Besides health care, its economic impact is huge.

While they’re not stepping back from their ministries, the Presentation Sisters are looking to the future. They’ve announced plans to build two new residences, Presentation Place in Aberdeen and Presentation Center in Sioux Falls, and to vacate Presentation Heights. Responding to their own needs for once, the Sisters have designed the buildings with health care in mind to tend to the needs of aging Sisters. But a practical—and typical—selflessness infuses this project too: the buildings will transition to become Avera long-term care facilities as the Sisters no longer need them. Yet another legacy.

Responding to needs, adapting, being flexible—whether it was adding nursing to their teaching ministry, modifying and adding buildings, adapting as the industry and their congregation changed—like the ancient families of seven, the Sisters stuck to their principles, but they also adjusted to respond to the needs at the time—even as that often meant adding to what they were doing, not replacing. And always with a palpable grace. As a now unknown Presentation Sister wrote decades ago: “We are called to be Women of the Lord…Women who laugh and dance and sing…Women who weep not because we have lost something but because we have been given so much.” 

These women of the Lord have made an indelible mark on Aberdeen. // –Patrick Gallagher

*Note: The Books of Maccabees typically only appear in Catholic and Orthodox Bibles.

Thanks to Sister Lois Ann Sargent and Kathleen Daly of the Presentation Sisters Archives for their assistance in telling this history.

Screen Shot

This early 1940s photo of the St. Luke’s campus was taken from the air looking east.

Many Buildings Served Many Patients And Nursing Students

A. Medical Annex This building was built as Lincoln Hospital on Lincoln
Street, across the street from the YMCA. The Sisters bought it and moved
it to this location in 1941. It later became Lourdes Hall after the original
hall was demolished.

B. Overpass bridge The bridge that connects Lourdes Hall with St. Luke’s
was built in 1944 and still arches over Third Avenue.

C. St. Luke’s Hospital of 1928 In 1927, the Sisters’ Presentation Academy
was torn down from this spot and replaced with a modern hospital in 1928.

D. Lourdes Hall This building served as housing for nursing students

E. St. Luke’s Hospital of 1900 Originally constructed in 1900 as a single
building, this complex of structures evolved quickly. By 1913 several wings
and additions were added accommodating 100 beds. This set of buildings
became known as Presentation Academy after the 1928 Hospital building
was finished then renamed again to Butler Hall. It was demolished in 1970
to make room for the southern enlargement of St. Luke’s.

F. Chapel This chapel was built in 1937 and demolished in 1970 to make
room for parking for the hospital. Several of the stained-glass windows
were salvaged and reused at the “new” Presentation Heights Convent
(PC) built north of town.