“I will be sitting in a chair and she will be walking and talking. Nuala is a lecturer. She’s a person who speaks to an audience of one or an audience of 500, it doesn’t matter,” said Mancini. “She brings insights to the conversation. … She doesn’t have a lot of time for chit-chatting. You know, she never talks about the weather. I don’t think she even notices it.”

Mancini and Kenny worked together for years hashing out revised guidelines for Canada’s bishops on handling sexual abuse by priests. In fact they worked on Protecting Minors from Sexual Abuse: A Call to the Catholic Faithful in Canada for Healing, Reconciliation, and Transformation for far longer than Kenny would have liked.

“She said, ‘What the hell? Why is it taking so long?’ ” he recalled.

The committee’s work was done in the spring of 2017 and the document was in bishops’ hands in time for their fall plenary meetings. But the new Canadian guidelines didn’t resemble abuse policies in the United States or anywhere else in the world — which made some bishops nervous. They decided not to vote on them. By 2018, after the Pennsylvania grand jury report and Pope Francis’ Aug. 20 “Letter to the People of God,” Canada’s bishops had to act.

Kenny knows not all bishops want to hear what she has to say on sexual abuse. Not because they don’t care and not because they think she doesn’t know what she’s talking about. It’s because they’ve faced calls for radical, root-and-branch solutions from all quarters for 30 years. Root and branch is hard to do.

“They’re tired. We’re all tired,” Kenny told a small, largely academic audience that turned up for the Toronto launch of her new book on the abuse crisis, Still Unhealed: Treating the Pathology in the Clergy Sexual Abuse Crisis.

For 30 years — longer than anyone else — Kenny has been in the business of figuring out how and why a Church that claims to be founded on the radical compassion of Jesus could tolerate and even foster abuse. She started in 1989 as a member of the Winter Commission looking into the explosion of allegations that followed from the Mount Cashel scandal in Newfoundland. It was a strange, new moment in the history of the Church, when suddenly it seemed every parish on The Rock had a story to tell about an entitled, privileged and protected abusive priest. This was the first full-blown, media-age abuse scandal to hit the Church anywhere in the world — a dozen years before the Boston Globe’s Spotlight team caught the attention of Americans.

She’s had parallel careers as a medical doctor, a pediatrician, a professor, a bioethicist, deputy minister of health for the government of Nova Scotia, an author and an advocate for better, deeper, community-based palliative care. These parallel tracks in Kenny’s life have allowed her to bring scientific training and an instinct for diagnosis to the theological problems of power, clericalism and abuse in the Church.

Her theology rests on what she calls “my medical metaphors.”

“The last chapter is called ‘The Jesus Prescription,’ ” she told The Catholic Register a month before she had to turn in the manuscript for Still Unhealed. “What I call, ‘reconstructive surgery.’ It’s reconstructive surgery. This is not cosmetic surgery. Reconstructive surgery is necessary.”

She has suffered a wealth of contumely and scorn in theological circles for this kind of talk.

“I don’t write like a theologian. I’m too direct,” she concedes. 

To protect herself she brought in Irish-Canadian theologian David Deane of the Atlantic School of Theology to help smooth the theological kinks in the new book. But she knew all along she wasn’t really writing for theologians.

“There are so many Catholics who are saying, ‘What the hell is going on here?’ ” she said.

“There are so many Catholics who are saying, ‘What the hell is going on here?’”

If that sort of talk seems a little salty for a 75-year-old nun who has survived cancer twice, she acknowledges her hard edges.

“I’m swearing. I shouldn’t be swearing. Sister shouldn’t be swearing. Don’t ever tell anyone,” she once said with a wink to this reporter.

Kenny is the New York City-born daughter of an Irish immigrant welder. She found herself — her vocation and her sense of purpose — as a smart, New Yorker Catholic school girl in the 1950s. She was taught by east coast Irish-immigrant nuns who happened to be Sisters of Charity of Halifax.

In 1962, the very month that Pope John XXIII opened the Second Vatican Council and glorying in the Catholic Camelot presidency of John Fitzgerald Kennedy, Kenny entered the Halifax novitiate, hoping to pick up the mantle of her teachers. 

“I grew up in the ’50s in New York — Irish, Catholic, immigrant parents. The Church was everything,” she recalled. “I mean first communion, baptisms of new babies, going to weddings, confirmations, seeing the bishop, the Catholic school, graduation from Catholic school. Then I enter religious life in 1962, the year the Second Vatican Council starts. Wa-hoo! To be Catholic is big stuff.”

In joining this order, this particular 18-year-old was making an enormous sacrifice. She had the book-smarts, drive, work ethic and instinct for human suffering to be a doctor — and she knew it. But the Sisters of Charity were teachers. However she might want to be a doctor, she believed God had called her to be a Sister of Charity. 

For a life jammed in between a blackboard and row upon row of kids, she was prepared to give up her dream.

By the end of Vatican II Kenny, then known as Sr. Agnes Shaun, had an arts degree and sufficient education to take up her post at the blackboard. But by then, Mother Superior was rethinking her order’s narrow channel of roles available to sisters. She started asking sisters what they wanted to do.

Kenny didn’t understand the question.

“I said ‘Mother, you tell me what you need. I like everything. I like to learn,’ ” she recalled. “She said ‘I’m giving you a choice.’ This is 1966. This was very early on for choice.”

Though Kenny was incapable of actually saying she wanted to be a doctor, Mother Superior figured it out. She gave Kenny (“Me, this little 22-year-old twerp”) a year to complete all the science courses and write the MCAT.

“For me, it was a specification of my calling as a baptized Christian and then as a religious woman and then the calling to the healing and reconciling mission of Jesus Christ — which is what health care is all about,” she said.

She became a pediatrician. The sisters bought her a little station wagon and she went town to town through rural Nova Scotia, when Nova Scotia was so rural Anne of Green Gables would have been bored, checking up on babies and their mothers, sitting kids on kitchen tables to listen for irregular heart beats, watching for signs of developmental delay, diagnosing the dark monsters of cancer hiding in their tiny bodies.

“She’s still a kid’s doctor. When you see her with little kids, you know.”

“She’s still a kid’s doctor. When you see her with little kids, you know,” said Sr. Joan O’Keefe who has inherited the burdens of long-past Mothers’ Superior, now known as the Congregational Leader. 

“What I see is that other part of her that still just has great joy in children, and has such fun with them. I think, sometimes she could use a little more of that.”

O’Keefe took vows the same year as Kenny. She marvels at the intellect, energy and will of the good doctor.

“She’s just so focused. Probably, I would do better if I was more like that. But we’re all different. That’s who we are,” O’Keefe said. “She’s achieved a great deal. I don’t think she is someone who rests on that. There’s something about her that’s driven.”

Driven enough that she went from her station wagon to a professorship at the University of Toronto and a post in Toronto’s internationally renowned Hospital for Sick Children. As she began forming the next generation of doctors, she noticed how as technology raced ahead and medical research deepened, medical ethics was becoming a separate specialty — separate from the doctors who actually make day-to-day health care decisions.

She went to the United States and studied with the founding fathers of medical bioethics. In 1993 there was a fellowship at Georgetown University’s Kennedy Institute of Ethics under Dr. Edmund Pellegrino. She debated principle-based decision-making with Tom Beauchamp and Jim Childress — philosophers who laid out the four pillars of autonomy, justice, beneficence and non-maleficence that underlie all modern bioethics. In 1996 she walked into the Dalhousie School of Medicine and made a deal with the dean, Jock Murray. She would give half her earnings to set up a department of bioethics inside the School of Medicine, and she would chair it.

The genius of the way Kenny went about teaching bioethics was that it never strayed from the actual practice of medicine, said Christine Simpson, who today heads up the department Kenny founded.

“From her physician perspective, she really saw the types of issues — the ethics issues — that come up in providing health care,” Simpson said. “The pediatrician wondering how you make difficult decisions about a child’s treatment, how do you work well with parents to make those decisions? I think Nuala always saw there was a need to be able to wrestle with those types of issues.”

Whether it be with her Church or with her profession, she’s still wrestling. She retired from the Dalhousie University job in 2004 with an Order of Canada medal pinned to her chest, then threw herself into the debate over assisted dying as bioethics advisor to the Catholic Health Alliance of Canada. 

She wrote Healing the Church in 2012 in the hope that ordinary Catholics would take up the challenge of reform in the wake of the sexual abuse scandals. 

In the spring of 2013 she was transfixed by the election of Pope Francis. 

“When we saw him first come out on that balcony, something just happened that brought joy to my heart,” she said. “He showed the simplicity and the centrality of Jesus.”

Then, early in his papacy, Francis started talking about clericalism. Finally the Pope saw what Kenny saw in the abuse crisis. Power is the problem — how we exercise it and how we idolize it.

But like any good doctor, Kenny doesn’t just diagnose the problem and walk out of the room. She has a course of treatment ready.

“She’s a lot closer to what Pope Francis is calling for when he writes about accompaniment,” said Mancini. “You gotta be there. Otherwise, you don’t actually have an influence on anybody.”

For those she loves — her Church and the practice of medicine — the struggle is never over.

“She feels really, really like it’s her job to get to the end and the end isn’t in sight yet. It’s that driven personality,” said O’Keefe.