It is a long journey from nineteenth-century nativism to twenty-first-century secularism, but that is precisely the journey that St. Vincent’s Hospital has traveled during more than 150 years of service to Catholic New York. Now that the journey appears to be coming to an end, as the exhausted institution edges closer to closure, Catholics of a certain vintage can’t help but look back with nostalgia and gratitude on the Church of their childhood—a Church that embodied Archbishop John Hughes’ vision of a separate-but-equal Catholic world of hospitals, schools, orphanages, and other brick-and-mortar institutions.

It’s hard for a Catholic who grew up in New York in the 1950s and 1960s to imagine Greenwich Village without St. Vincent’s—indeed, to imagine New York without any Catholic hospitals. If St. Vincent’s does, indeed, close, an era that began before the Civil War will end, for St. Vincent’s is the last Catholic hospital left in New York’s five boroughs.

The Catholic hospital system, like the parochial school system, owed its existence to the culture wars in New York during the 1840s and ’50s, when nativist enmity and violence led then-bishop John Hughes to build separate facilities for his mostly immigrant flock. A recent exhibit at the Museum of the City of New York, entitled “Catholics in New York,” charted the progress of Hughes’ vision. Within a century New York was home to hundreds of Catholic grammar schools, dozens of high schools, several colleges and, of course, a vast and well-regarded health-care system.

The Sisters of Charity ran St. Vincent’s, reminding us of the opportunities the Church allowed women religious—opportunities denied women in the secular world. Nuns not only provided care and education; they ran the institutions that John Hughes and his successors built. Indeed, in the early twentieth century, a remarkable Italian immigrant named Mother Frances Xavier Cabrini used her considerable willpower and devotion to build Columbus Hospital on Manhattan’s East Side. In the early 1970s Columbus was renamed in honor of its most prominent founder. A few years ago, however, Cabrini Medical Center closed, foreshadowing the fate that seems to await St. Vincent’s.

These institutions—and the city’s hundreds of vibrant parishes—made up a parallel universe for New York Catholics for more than a hundred years. Urban Catholics, in New York and elsewhere, identified their place of residence as a parish, not a neighborhood. They were born in Catholic hospitals, educated in Catholic schools, married in their home parishes, and buried in a Catholic cemetery.

That world is slowly—actually, not so slowly—disappearing. That’s not to say there are no vibrant parishes left in New York. Nor is it to say that Catholic schools are doomed. But New York Catholics who grew up in the 1950s and 1960s can’t help but feel a tug as they read, not only of St. Vincent’s plight, but also of the state of Catholic education and other services. The world has changed, and, many would argue, not for the better.

The New York Times summed up the undoing of St. Vincent’s—and, perhaps, of many other Catholic institutions—in a sub-headline on the front page on February 3: “Hospital Was Loyal to a Mission that Limited Profits.”

There is something noble about that sentiment—something that, surely, Archbishop John Hughes would have approved.

The hospital’s mission—indeed, the Church’s mission—has not changed, nor should it. There will be casualties, and there will be change. But would any Catholic, no matter how nostalgic, prefer a Church that would betray its mission for the sake of unlimited profits?

Terry Golway is the director of the Kean Center for American History at Kean University in Union, New Jersey.