From left: Panelists Kevin Farley, Monique Cerundolo, Mariya Kalashnikova, Beth Flanzbaum and Neldine Alexandre

Details have been altered in this story to protect patient privacy.

Kevin Farley, RRT, never imagined the first patient he’d care for on his initial day at the Brigham as a respiratory therapist would turn out to be someone who shaped his career.

“Claudia made me a better therapist,” Farley said. “She was the very first patient I had; she was the first patient I charted on. Her room was the first patient room I walked into. I had a lot to learn when it came to Claudia. Everything I do here goes back to her.”

During the Dec. 15 Schwartz Rounds, “When the Team Becomes Family: Caring, Celebrating and Grieving Together,” a panel of five Brigham staff members—representing just a few of the dozens of people on Claudia’s care team—discussed their experiences caring for Claudia and, ultimately, what it was like to lose her. The monthly Schwartz Rounds series is a multidisciplinary forum focused on optimizing compassionate care by exploring the human dimensions of health care.

Born with an incurable lung condition, Claudia left her native country and came to the U.S. in search of a second chance at life. As her health declined, doctors back home told her they couldn’t offer the advanced care she needed and advised that she travel to the States for treatment.

In addition to causing breathing problems, Claudia’s condition triggered other severe health issues. She passed away last year at the Brigham due to complications related to her lung condition.

Claudia had lived in the U.S. for more than a year and frequently came to the Brigham for care. Subsequently, she grew very close to the multidisciplinary experts who worked tirelessly to save her life. It was during this time that her team formed a tight bond with each other, too, as they navigated their patient’s challenging case. Together, they said, they felt like a family as they cared for Claudia, celebrated her life and grieved her loss.

Described as a kind soul whose smile could light up a room, Claudia was a patient the panelists said they’ll never forget. They reflected on the personal and professional struggles they grappled with when caring for her, as well as the emotional toll it took on them all as Claudia’s health failed to improve.

“Nothing helped her. We exhausted all of our resources,” Farley said. “I could only hold her hand and say, ‘I am here with you.’”

Forging Bonds

In the face of these challenges, providers looked for opportunities to lift Claudia’s spirits. One time, they hosted a small celebration for her following a procedure. On another occasion, panelist Neldine Alexandre, BSN, RN, of Thoracic Surgery, painted Claudia’s nails for her. They said these gestures might have been small, but they were significant to Claudia and to each of them.

The panelists spoke about the profound grief each of them experienced last summer when Claudia had died. Her death came as a shock because Claudia had been out of the hospital for some time before her health rapidly declined.

Monique Cerundolo, MA, BCC, of Spiritual Care Services, remembered the day she learned what happened. She was alerted that a family had requested a viewing of their deceased loved one. Not knowing the name of the patient, Cerundolo prepared to assist the family—a process she’s often involved in when patients pass away. When she received the paperwork and saw Claudia’s name listed, Cerundolo was stunned.

“I was heartbroken,” she said. “I had two minutes to gather myself together before I met the family. I had lost someone who was very important to me.”

Mariya Kalashnikova, MD, a fourth-year resident in the Harvard Brigham and Women’s Hospital/Boston Children’s Hospital Combined Internal Medicine-Pediatrics Residency Training Program, was Claudia’s primary care physician. She said losing Claudia was especially difficult because she was the first outpatient of hers who passed away. Kalashnikova reflected on how upsetting it was to hear about Claudia’s passing and the importance of being able to talk with her peers who had also been grieving.

“When I’ve lost patients in residency, they’ve all been inpatients and I had warning. I could be with them and their families,” Kalashnikova said. “It was hard not being able to be there for Claudia during her final moments.”

Healing Together

After grieving individually, the care team banded together again following Claudia’s death to begin the healing process. They comforted each other, wrote poetry and organized a remembrance gathering.

“It’s never easy to lose a patient,” said Alexandre. “But as long as we talk about her and learn from her case, Claudia will always be in our memories in a very special way.”

The panelists encouraged their peers to take the time to process their grief after a patient passes away and set aside even just a few moments to speak with a colleague about how they’re feeling.

“For the rest of my life, with every patient I treat, I will see a piece of Claudia in each of them,” Farley said. “She taught me so much about being a respiratory therapist. I am so glad that Claudia came in to my life—it’s just unfortunate the way that it ended.”

At the end of the discussion, Martha Jurchak, PhD, RN, director of the Ethics Services and coordinator of Schwartz Rounds, commended panelists for their candid reflections.

“It requires a certain kind of bravery to talk about events like this and to acknowledge the grief you experienced,” Jurchak said. “You have shown that we become better providers by sharing our loss and grief so that we can take care of the next patient we encounter. I want to thank you all for being brave in this way.”

Schwartz Rounds are held the second Tuesday of each month, noon–1 p.m., in the Anesthesia Conference Room.