According to the author, a Catholic and a reporter for the Wall Street Journal, nuns were the entrepreneurs of American Catholicism, creatively and energetically working to extend the territory and deepen the ministry of the True Church. In the early 1800s especially, Catholics experienced fierce prejudice and active persecution in the United States. By the end of the 1800s they had become largely accepted in American society. What made the difference? The entering wedge, the right arm of the gospel-health work. During the Civil War, 20 percent of the nurses on both sides were Catholic nuns. In many communities in the burgeoning West, nuns opened the first hospitals. By 1950, 20 percent of the hospital beds in the United States were in Catholic hospitals created and operated by the 'sisters.

The other major institutional contribution of the sisters was the Catholic parochial school system, which by 1950 was educating 11 percent of American students in over 10,000 Catholic schools. Catholic elementary and secondary schools (and even colleges) depended heavily on the faithful, underpaid work of nuns.

In a sentence that reminded me of Ellen White's role in the history of Loma Linda University and Medical Center, the author wrote, "Sisters were, far and away, the biggest risk-takers of the Church, often taking out big mortgages to build schools and hospitals". I was also reminded of White by the sisters' attempt to work around the deeply embedded racism in the church by opening two orders specifically for black women.

Those familiar with early Adventist history will hear echoes in the extreme frugality practiced by the sisters who were teachers. In February 1920, the order sent three volunteers to open a new elementary school in Westwego, a working-class suburb in New Orleans. ?Sister Bonaventure Monhollan, the youngest of the group, later recalled that on Mondays they rose at dawn and walked two and a half hours to reach the school. They had a cold lunch of jelly and cheese sandwiches. At night they went to a small cabin, rented with borrowed money, which had no cooking utensils. One night they looked in the larder to find only a small glass of jelly, one teaspoon and two slices of bread. "Well, I looked at the other two, then at the two slices of bread and said to myself, 'I am the youngster', so I got up from the table, went to bed and cried myself to sleep".

There is much to celebrate in the work of these heroic, stoic Amazons of the Kingdom of God. And there are some sober lessons. In 1968, there were 180,000 sisters. Convents were full. The following year the flow of young women into the sisterhood abruptly stopped and the population of nuns began aging. Now there are about 80,000, with a median age of 69.

What happened? Fialka cites several possible factors. One is the change in society. Through the 1800s and the early 1900s, the orders offered women a real alternative to ordinary domesticity. Nuns were adventurers. They got an education. They could become leaders of significant institutions in an era when women were expected to stay home and tend to the children. In the decades after the 60s, opportunities for women dramatically expanded.

Another sobering explanation lies in changes that followed Vatican II. At that church council, 8,000 men and 15 women (who were given the same observer status as Protestant representatives) spent three years thinking about the future of the church. Vatican II altered the historic honor and spiritual status of nuns. Some sociologists believe that in the process, the church reduced the attraction of the 'separated' life of a nun.

Following Vatican II, many orders underwent a radical revisioning process. Some orders rapidly and dramatically altered the center of their identity and practice from spiritual and religious to political and psychological. Their new guiding saints became Ralph Nader, Cesar Chavez and Carl Rogers. They practiced solidarity with the Sandinistas and ecofeminists. They identified with the struggle against the Vietnam War and the military-industrial complex. They became obsessed with global issues and blind to local ministry.

This secularized, amorphous mission to the world did not draw young people who were looking for a way to radically engage in the religious life. But it is precisely that kind of radicalism that would move a young person to embrace the disciplines of the religious life. On the other hand, many nuns who left said that one of the factors pushing them out of the religious life was their growing awareness that as women they would always be second-class citizens in a male-dominated church.

A critical concern facing the orders of sisters now is retirement. Very few of the orders funded retirement for their members. Older members were financially supported and physically cared for by younger members entering the orders. That had worked well for over a thousand years around the world. But in the United States after 1968, younger people no longer joined the orders. In 1985, a survey by the Arthur Anderson auditing firm estimated the gap between available retirement funds and actuarial predictions of need was $2 billion. A current estimate pegs the funding gap at $6 billion.

The book finds one bright spot in a rather gloomy picture. In Nashville there is a convent that is receiving new, young recruits. St. Cecilia's class of 2001 was composed of 18 women whose average age was 24. ?According to the director of vocations, these young women are looking for a traditional religious life. The top questions applicants ask are "Do you wear a habit?", "Do you have daily devotions?", "Do you pray the rosary?". Eighteen new nuns is wonderful. Eighteen per year, however, represents at best a slight slowing but not a reversal of the inexorable decline.

This history of Catholic sisters in America offers several cautions for Adventists. Liberal friends and society at large may applaud the removal of distinctive practices or disciplines by a religious group, but that generally does not increase the group's attractiveness for people who might actually join, and it will not keep people from leaving. Counting on an eternal supply of new converts to support the aging members of an organization can be very embarrassing if that supply dries up. Quality schools and quality medical institutions are no guarantee of converts.

The story of these sisters dramatically highlights the danger of change. There appears to be a strong correlation between some of the changes introduced by the orders following Vatican II and the accelerated decline in vocations. But a careful reading also illustrates a corresponding truth: Change is inevitable. In the same period, vocations to the priesthood also declined by half. In 1965 about 1,000 men joined the priesthood. In 2000, 450 joined. There are about 2,000 Catholic parishes without a resident priest.

Could the sisters have managed change better and avoided their precipitous decline? Maybe. But stasis was not an option. Society was changing and so was the church. The Bishops Conference decided to compel all the orders to join an umbrella organization. Some believed this crippled the entrepreneurial spirit that had helped to build the orders.

The Adventist church in the United States is also in numerical decline, especially if you do not count first- generation immigrant converts. We face a serious challenge with providing for the retirement of church employees. There is not a large stream of young people embracing the stern disciplines that have characterized our church in the past.

It is glaringly obvious that our present administrative systems, evangelistic methods and congregational patterns cannot be expected to reverse our own pattern of shrinking, aging membership. We can't just do the same things harder and expect better results. We are facing inevitable change. The question is, will we change deliberately or reactively?

Adventism was built with an aggressive, entrepreneurial spirit. It is now characterized by a highly integrated top-down control structure. It is highly unlikely that someone sitting in an administrative office is going to spark significant renewal in the church or launch a creative initiative that will actually reverse current trends. The future lies in the hands of young adults and their God. Perhaps, if we will give them enough support and permission, they will create a new church that saves the best of the old. But if we make preserving the institution our primary mission, I am afraid that my grandchildren will know the Adventist church only as the heroic, barely remembered work of their ancestors.

God forbid. May it never be.