The whole aim of marriage is to fight through and survive
the instant when incompatibility becomes unquestionable.
— G.K. Chesterton

Medication errors in healthcare are serious business. They can be dangerous – even deadly – for patients, first of all, as well as devastating to the healthcare workers responsible and very costly to healthcare institutions. Yet they still happen – despite all the safeguards, bar code and scanning technology, and other system checks in place these days.

It’s understandable, then, that when we talk to our first-year nursing students about passing meds, we emphasize that prevention of error is key. We teach them the Five Rights of med administration – right patient, right drug, right route, right time, right dose – and we drill them about checking those rights three times. Every patient. Every time. “Treat every med pass as if it were your first med pass,” I tell them. “And if you don’t think you have time to double-check things, then slow down enough to triple-check.”

These are principles that apply to many dimensions of healthcare – like in surgery for example. Have you heard the horror stories about people having procedures performed on the wrong limb or side of the body? That is much less likely to happen if surgical teams introduce strict procedures for verification before the first cut, and there’s a movement to make it a universal practice. It’s called a Surgical Safety Checklist, and it includes a Time Out to literally stop and verbalize for everyone involved who the patient is, what procedure will be performed, and on what part of the patient’s body.

I got to thinking about these preventive efforts in healthcare after Pope Francis promulgated his relaxed annulment protocols recently – streamlining the process and making it either cheap or free. The publicity generated seemed to fall into two camps: Some critics denounced the changes as being disastrous for the institution of marriage, introducing a de facto Catholic divorce in the opinion of some; others tentatively lauded the new streamlined process as a baby step in the right direction, expressing great hope that further liberalization of Catholic marriage (and re-marriage) protocols will follow.

Either way, it’s important to remember that the real problem that the Holy Father was getting at is the rampant divorce rate among Catholics, especially here in the West. In general terms, an annulment (or, more formally, declaration of nullity) is the Church’s official determination, after a thorough review of available evidence, that a valid marriage never existed in the first place. Annulments are only an issue once a marriage has ended, and even then they’re usually sought only when a divorced Catholic is seeking to marry again in the Church. Regardless of how we parse the Pope’s adjustments to that review process, the fact remains that the Church will still be stuck with sorting through messy, painful marriage situations that might’ve been avoided if everyone involved had taken a moment to clearly and unapologetically articulate prior to the exchange of vows what was about to happen.

And what exactly is about to happen before the vows?

For one thing, what is about to happen at a Catholic wedding has very little to do with what has been going on throughout the courtship period. “The trouble with being engaged is that it bears very little relation to being married,” writes Hubert van Zeller. “Only in the widest sense is it a test: it is a prelude rather than a preparation to matrimony.” Van Zeller contrasts traditional engagement, wherein couples can only imagine what their married life together will be like, to a religious community’s novitiate that compels potential members to literally experience the life they’re committing to – with all its bumps and foibles and imperfections.

By comparison, then, the future bride and groom are taking a huge risk when they finally appear at the altar, rings in hand. And though it would be “against the Catholic spirit to view marriage as a gamble,” in the words of Van Zeller, “it must nevertheless be, from its very nature, an act of faith.”

What’s more, it’s an act of faith that ushers in tremendous challenges – that is, marriage is really hard, even for Catholics – and we get a special sacrament and expressly tailored sanctifying grace to help us persevere. Nevertheless, even with that, we still struggle, as the latest Pew Research survey of American Catholics attests.

Given all that, I’m wondering if our pre-marital preparation is too heavily oriented to what comes after the wedding – like the three essential “words” of healthy marriage as identified by Pope Francis: Please, Thanks, and Sorry. “There is always arguing in marriage, sometimes the plates even fly,” he later counseled married couples, as if to illustrate the point. “The secret is that love is stronger than the moment when there is arguing.”

He’s right, of course, and it’s patently true that courtesy, gratitude, forgiveness are crucial dimensions of nuptial longevity. However, those habits will not save a marriage that is inherently topsy-turvy, particularly if one or both parties to the marriage had a fundamentally skewed vision of what was expected of them from the get-go.

Insert “Time Out” here.

As with medical error, the way to address Catholic divorce is not by adjusting how we handle mistakes after the fact, but rather the prevention of mistakes in the first place. I think we can take a cue from the healthcare industry here and introduce some kind of a matrimonial Time Out – right in the sacristy, immediately prior to every Catholic wedding. Kick out the bridesmaids and groomsmen, the parents and wedding planners. Then, soberly, deliberately, away from all the decorations and festivity, the priest can lay out for the bride and groom, in no uncertain terms, what it is they are about to agree to: “unity, indissolubility, and openness to fertility,” in the words of the Catechism – the true essentials of marriage.

It wouldn’t hurt to add some specifics as well – to wit:

1. Openness to fertility: “It is part and parcel of Christian marriage that you absolutely reject any and all forms of artificial contraception,” the priest can say. “Remember that part of our pre-marital counseling? That means from the very beginning – tonight, your wedding night, included. If that’s a problem, say so now.”
2. Indissolubility: “Start your life together with a rock solid assumption that divorce is not an option,” he could continue. “If you’re thinking that this is just a trial run, and you can always get an annulment, then you shouldn’t go through with this.”
3. Fidelity/unity: “Be faithful to each other – no ifs, ands, or buts,” the priest might stress. “No wiggle room here, and no cutting corners.” Then, turning slightly toward the groom, he could add, “This means no pornography, of any kind, whatsoever. Period.”

Finally, just before heading out to the altar, the priest might conclude with words along these lines from Van Zeller: “Unless you make of your marriage a wedding of what God wants wedded, and in the way God want them wedded,” he writes, “you minister to yourself alone – and to the ultimate undoing of your married life.” It’s a reminder that Christian marriage is for heroes – as Christianity itself is.

Oddly enough, that’s in direct conflict with a proposition put forward by Cardinal Kasper with reference to Catholics and divorce: “Heroism is not for the average Christian.” I’m reluctant to publically differ with a prince of the Church, but he’s simply wrong. Of course all Christians are called to be heroic – married or otherwise. After all, all Christians are called to be saints, and marriage, when lived heroically, is designed to produce just that.