Every Spring, parishes across the country hold first communion celebrations. The event is for many a treasured memory. For some, however, it is a painful experience. This is the story of a Catholic with Celiac Disease, a condition that makes bread a deadly poison - even the smallest piece of Eucharistic Bread. A rare condition, most of us are not aware of the terrible suffering it brings. For Mary McMenamin, the pain is doubled. Both she and her daughter have the disease. Mary is a parish director of religious education.

Six weeks after receiving my diagnosis, I was sitting in my newly designated seat in the front pew facing the Eucharist tabernacle, nervously struggling with prayer. I looked up at the ornate receptacle and read the familiar passage from John's Gospel inscribed above it:

"Your Fathers ate manna in the wilderness and died, Whoever eats this bread will live forever."

I felt hit in the stomach. What an extraordinary oxymoron I had become: a Catholic with a Eucharistic-based spirituality, and a person with celiac disease, medically forbidden to partake of even a trace of the wheat-based host. The bread of life had become poison to my body.

Celiac disease is a genetic auto-immune disorder that manifests itself in the gastrointestinal tract. Microscopic villi, finger-like projections lining the small intestine that absorb necessary nutrients from food, are damaged whenever gluten, the protein found in the grains wheat, rye, oats and barley, are consumed. The results range from malnutrition, gastrointestinal distress and weight loss, to fatigue, depression and osteoporosis. One also risks eventually developing malignancies such as non-Hodgkin's Lymphoma.

Cheating on this diet is not an option. No breads, cookies, crackers, pizza, cakes, pies, pasta, pretzels or bagels. However, a restricted diet brings good health, Rice, Corn, and potatoes are the main staples, easily transformed into acceptable pizza, bread, pasta and cookies.

Regrettably, frequent insensitive reactions from acquaintances, family or friends exacerbate the dietary restrictions. Easily forgotten, denied, or overlooked is the symbolic and symbiotic relationship in our culture between celebrating and eating. Picture attending a wedding, baptism, or a Christmas party and not eating, or a night out with friends but with no bites of nachos or slice of pizza. Celebrating by "brownbagging" your own meal looses a lot in the translation.

Now imagine going to Sunday Liturgy without dining on the Eucharistic Bread. According to the Congregation for the Doctrine of the Faith (June, 1995) the only option of celiacs is to receive hosts that "contain the amount of gluten sufficient to obtain the confection of bread," that is, low-gluten hosts.

Unfortunately, even this can cause intestinal wall damage and promote cancer. Any special hosts "quibus glutinum ablatum est" are declared invalid. Although one priest told a celiac friend of mine that "receiving rice hosts would be detrimental to her faith," most celiacs probably do not agree. Rice bread is our bread of life, except in the Catholic Church.

People with celiac disease are entitled by right of their baptism to receive the Eucharist; fortunately, the Eucharist wine is medically acceptable. One can definitely celebrate without eating, but the price paid
for this partial participation is a profound sense of loss. This is most painfully evident with celiac children.

A Child's Response:

Eight years ago, at age two, my daughter, Annie, was diagnosed with celiac disease. During her preparation for first Eucharist, she often asked, "Do you think they will ever let me us rice bread?" When she realized the answer, she often wept with the pain of a child who has been left out. My attempts to explain were met with disbelief and incredulity. I concur.

As director of religious education, I know how desperately second graders want to feel included. Children with celiac disease live a lonely lifestyle every day of their lives. Most snacks brought to school are different from their classmate's; every birthday party invitation means bringing your own cupcake and ice cream. Sometimes invitations to play do not come, as some parents are reluctant to deal with the special diet. Similar incidents occur with adults. To be unable to eat and drink in your spiritual home, the Church, is truly the nadir of such examples.

Fortunately, working with a thoughtful pastor and staff, Annie's first celebration of the Eucharist was, and continues to be joyful. Eucharistic ministers, as well as the rest of the celebrating community, have been made aware of our disease, and welcome us to be first in line to receive the Blood of Christ. Some days, however, are bittersweet. When Annie or I have a mild sore throat or chapped lips, we choose not to drink from the cup. The ensuing spiritual pain is inevitable.

Unfortunately, many adult celiacs are uncomfortable receiving special attention, as is the case when parishes do not regularly offer the cup. Moreover, even when the cup is offered, no particle of the bread can be broken into the chalice, so a separate cup must be made available for the celiac. Occasionally celiacs are reluctant to initiate and unfamiliar liturgical practice, and regrettably, stop going to church. Even more difficult is the situation of the person with celiac disease who is also a recovering alcoholic. Such persons have to participate in the Eucharist "by desire." For the pastorally sensitive, this is unacceptable.

This ecclesiastical problem is destined to grow; recent medical evidence puts the incidence of celiac disease in the United States perhaps as high as one in every 175 people. Celiac disease in the United States is often written off as "spastic colon" or "irritable bowl syndrome." The problem magnitude of this disorder cries out for a national pastoral response.

Consider the loss of experiences. Sing the lyrics to "I Am the Bread of Life.: Carefully listen to a homily. Look at any stained glass window. The symbolism of bread quickly turns into a sign of affliction and alienation. This spiritual loss has given rise to the obvious need for a discussion of the theology of the cup, a Eucharistic symbol with an untapped wealth of meaning for people with celiac disease.

The Sign of Wine

Dinner guests frequently bring a bottle of wine. Meals enjoyed with wine are celebratory in nature; and like a loaf of bread, wine is often shared with friends and loved ones. It seems no coincidence that the first miracle Jesus performs in the gospel of John is the changing of mere water into wine in the midst of a community wedding. Yet, at the Last Supper, wine becomes much more than the celebratory complement to a meal. It is proclaimed and held up as the blood of the new covenant. At his crucifixion, Jesus'
last action before giving up his spirit is the acceptance of the bitter wine from a centurion's sponge. Jesus uses wine as a sign of celebration and community, but also as a powerful symbol pointing to the inevitable way of the cross.

The followers of Jesus are offered his wine in the cup. Often as a symbol of God's will, the cup of Jesus definitely engenders that meaning. Jesus prays that this cup will pass from him. He challenges John and James and their desires for power by asking if they can drink from his cup. Jesus lifts up the cup during the last supper that holds the blood of the new covenant. Sharing the one cup at his meal can be seen as a sign of community, but soon develops into a challenge: can you too, follow Jesus?

The Church and the Blood of Christ

Even the nature of blood is a silent symbol that could perhaps be awakened. The sight of blood usually stirs fear in most people. Some, however, immediately react by helping stem the flow, Blood represents suffering and pain, but is also the stuff of life.

Blood is dynamic, vigorously pumped by the heart, giving life as it rapidly, vibrantly pulses through the body. Red blood cells bring oxygen and life to every minute part of the person. White blood cells battle and engulf dreaded intruders and protects every ounce of our flesh. Tiny blood platelets bind themselves together to heal wounds.

It has been helpful to me to dwell on the Church not as the Body of Christ, but as the Blood of Christ, a community bound together in the celebration and ultimate challenge of the cup; a community intent on enlivening, protecting and healing the world and each other; a community that knows that it is painful to bleed, but can only be renewed by its pouring out of itself, and receiving the ultimate transfusion of the new Blood of Christ.

Symbolism is at the heart of every Catholic. Theologically, I know that the Eucharistic bread is the body and blood of Christ, and that the Euchaistic wine is the blood and body of Christ. But to have a community to join in the total memorial meal of the Eucharist, we need to participate fully: to eat and to drink. After seven years of not eating at Jesus' table, I still miss his nourishing community ritual. Surprisingly, since in my eyes the norm for Eucharistic bread should be a freshly baked loaf, I even miss the wheaty-papery taste of those old, thin communion wafers and the nascent holiness they commanded in the mind of my seven year old self.

I am grateful to celebrate the Eucharist with my very welcoming community. I encourage other parishes to open their hearts to those of us who are unable to break bread.