Posts from the ‘We Care’ category

Family of four

Alex and Tim Lieto with their children, Luca and Faith, outside their New Hampshire home

It’s hard to imagine a mom who cherishes Mother’s Day more than Alex Lieto, 34, of Portsmouth, N.H.

She still gets choked up remembering what it was like to hold her firstborn, Faith, now 2 and a half. After more than two years of fertility treatments, six pregnancy losses and unfathomable heartbreak, arriving at that moment with her husband, Tim, 34, felt like a dream — one they almost couldn’t believe had come true.

“There are no words,” Alex said through tears, recalling their experience in Labor & Delivery at the Brigham. “The second she came out, I was like, ‘She did it. We did it. I can’t believe we did it. Is this really happening? Thank God.’”

This Mother’s Day is even sweeter for the Lieto family, who recently celebrated the birth of their second baby — a boy, Luca, now 5 months old.

“There’s a heck of a lot more laughter in this house with them here. Even when things are really crazy with the kids, we never complain. Just being with them — and being a family — is something we never take for granted,” Tim said. “Al is a fantastic mom, and seeing her have the chance to be one is all we could ask for.”

Reflecting on the profound losses they have experienced over the years, Alex acknowledged that Mother’s Day also remains a somewhat bittersweet holiday.

“Before I had my kids, there was a handful of really hard days — Christmas, New Year’s, birthdays. Mother’s Day was the hardest of all,” she said. “The fact that they’re here is frankly surreal, and while I feel so blessed to be able to celebrate this day with them, my heart breaks for the women who are struggling because I know their pain.”

Two smiling children

“There’s a heck of a lot more laughter in this house,” says Tim Lieto of his children, Luca and Faith

Guiding and supporting the Lietos on their path to parenthood over the past six years was Antonio Gargiulo, MD, a reproductive endocrinologist and surgeon at the Brigham’s Center for Infertility and Reproductive Surgery.

Gargiulo, whose team performed several rounds of in vitro fertilization (IVF) for the couple at a Mass General Brigham-affiliated satellite in Exeter, N.H., said this was one of the most challenging, and ultimately heartwarming, cases he has worked on his 25 years in the field.

“This was a particularly hard-fought battle,” he said. “The humbling and inspiring part of this for me, as a provider, is seeing how these two people never lost hope. We’ve had many very difficult discussions and a lot of tears through the years, but the reality is our team knew they were going to be successful because of their attitude, dedication and the fact that they made this their No. 1 goal.”

More than just providers, Gargiulo and his multidisciplinary colleagues truly became part of their team, the Lietos said. “He’s part of our family, and he treated us like family,” Alex said.

‘A Whole Other Level of Loss’

Originally high school sweethearts, Alex and Tim married at 25 and knew that they would soon want to start a family. After struggling to conceive naturally due to male-factor infertility, they began pursuing IVF.

Initially, the procedure seemed promising. Egg retrieval and fertilization went smoothly, and Alex got pregnant right away. Within a few short weeks, however, she suffered a miscarriage. They waited and tried again — and saw the same outcome, over and over.

“When you have a miscarriage, it’s a pain you can’t even describe. Within a second, your world comes crashing down,” Alex said. “I remember very vividly talking to friends and family after my first miscarriage, and they would say, ‘So many women have a miscarriage, but the odds are you won’t go through that again.’ So, we tried again but had another miscarriage — and another and another and another.”

On their fifth round of IVF, they pursued additional screening to ensure a genetically healthy embryo was implanted. After they passed the first trimester, the couple allowed themselves to exhale. They excitedly began picking out names for a boy or girl.

But at 19 weeks gestation, they experienced their most tragic loss of all — a baby boy they named George. The grief was incomparable to anything they had gone through previously.

We care. Period. logo“It was a whole other level of loss,” Alex said. “We assumed we were just the unluckiest people ever.”

Alex and Tim delivered George at the Brigham in 2016, and the extraordinary compassion their Maternal Fetal Medicine care team demonstrated touched them deeply.

“The care we received during that delivery was amazing,” Alex said. “The nurse who delivered George impacted our life forever. After we went through that process, I realized there was no other place I’d rather deliver a baby and no other hands I wanted to be in. We always knew we had the best care in the world.”

Staff prepared a memory box for the family, including photos and other keepsakes, to honor baby George.

“It’s the worst day of your life. And then, all of sudden, you have this staff who are treating it not as the worst day but rather as an important day,” Tim said. “They said how beautiful he was and made us feel like it was going to be OK.”

Hope and Faith

Over the years, Alex and Tim said they explored countless explanations for their fertility challenges. They underwent medical and genetic tests and tried dietary changes, exercise regimens and more. They leaned on family, friends and their religious faith for strength. After experiencing yet another loss after George, they started considering options such as adoption and surrogacy.

Mom and child on the beach

Alex shares a special moment with her daughter, Faith, on the beach.

Gargiulo told them he had one more idea. He reached out to a colleague in New York — and former Brigham resident — who specialized in recurrent pregnancy loss. After extensive testing, they discussed two peculiarities in Alex’s biology that otherwise weren’t affecting her health but might explain their hardships: She had a form of insulin resistance that caused blood sugar spikes, although not severe enough to make her diabetic, and an inability in her body to break down blood clots.

Alex began taking medications to address both issues, and they tried another round of IVF. From the beginning, the odds did not seem to be in their favor. Of the 12 eggs retrieved, only two fertilized. Just one tested as genetically healthy.

The Lietos braced themselves for another heartbreak. But as the weeks went by, Alex’s pregnancy was closely monitored by her Maternal Fetal Medicine care team and continued to progress without major complications. Nine months later, they welcomed baby Faith into their arms.

Despite all they had to overcome, the couple say they never lost faith in their dream — the very sentiment that inspired their daughter’s name.

“We always kept hope,” Tim said. “We knew, one way or another, we were going to have a family.”

It’s a message the Lietos hope will resonate with other families experiencing similar challenges.

“I always had to dig a little bit deeper and find the strength I never knew I had. You can too. Don’t give up,” Alex said. “We always say to each other the only way out is through. All the losses we had were so that we could get to Faith and Luca. Do I want to do it again? No. But would I to get them? Every day for the rest of my life.”

Collage of infants in formalwear

From left: Baby Maddie, Baby Alex and Baby Della, with her parents, get all dolled up for “prom night” in the NICU.

Before the pomp and circumstance of graduation come the festivities of prom night — and with it an opportunity to celebrate an important milestone in style. On the eve of their graduation from the Brigham’s Neonatal Intensive Care Unit (NICU), three infants and their families did just that in the most adorable fashion.

Babies Alex, Della and Maddie — whose families met and bonded while the three infants were receiving care in the NICU’s Growth and Development Unit — got glammed up for their own version of prom night on March 9, thanks to a team of creative and compassionate NICU staff.

The idea was the brainchild of NICU nurses Kerri Duggan, RN, SarahKatherine Mascoli, BSN, RN, and Mary Sawyer, RN, who were part of Baby Maddie’s care team.

When Maddie had enjoyed a successful feeding session after some previous difficulties, Duggan joked that Baby Alex could take her to prom as a show of support for her upcoming graduation from the NICU. As the families had also formed close ties with Baby Della’s family in the Growth and Development Unit — where each baby is assigned a bed space in different areas of a shared room — it was only fitting that Della also join the festivities.

We care. Period. logo“The moms found the concept comical, but also it ignited an idea — why couldn’t they have a NICU prom?” said Sawyer. “Our parents and their babies don’t often have ‘typical’ birth stories. We in the NICU celebrate every moment and milestone, as we recognize it’s important for parents to know that their infants are making progress. ‘NICU prom’ just seemed like an ideal way to celebrate all of the infants’ and parents’ hard work before they ultimately graduate from the NICU.”

Mascoli purchased supplies and props to set up a makeshift photo booth, which she decorated with the help of NICU physical therapist Tricia Flynn, PT. The families brought formalwear for their little ones, and Sawyer’s sister, a student in floral design school and former Brigham nurse, fashioned miniature corsages and a boutonniere.

Maddie’s mother, Eliza, expressed her gratitude to the care teams for devising such a special and heartwarming way to celebrate the families’ next chapter.

“Our NICU team brought in decorations and accessories, had customized corsages and a boutonniere made, and were able to celebrate our incredible infants with us,” Eliza said. “Of course, all three babies fell asleep almost instantly, but they were still completely adorable in their dresses and tux! We will never forget the NICU prom as a very bright spot during an emotional journey. To say that our care team is amazing is an understatement. They are now friends for life.”

Sawyer said that staff were grateful to help create a magical moment for the families.

“For these parents, it was a night of laughter that followed many days of a stressful hospital admission and an experience they can carry with them throughout the days ahead,” she said. “Since COVID-19, we have had to change so much, including how families interact with each other. They no longer have a dedicated parent lounge where they can meet other parents and reflect on what each other is going through. These three sets of parents have forged a unique bond from behind curtains and masks where they cheer on each other’s infant and the milestones they accomplish.”


Staff in clinical and non-clinical roles have volunteered their time or taken on new assignments to keep the employee COVID-19 vaccination clinic in the Hale building running smoothly and safely. Top row, from left: Megan O’Connor; Gyorgy Frendl vaccinating Zara Cooper; Brieanna Gacek. Bottom row, from left: Brendan Cormier, Rachel Fearing and Sarah Micucci

Editor’s note: This is the first in a two-part series recognizing the extraordinary efforts of staff who made the Brigham’s employee and patient COVID-19 vaccination programs possible. Click here to read part two, which features the patient vaccination teams.

In December, the second-floor atrium of the Hale Building for Transformative Medicine transformed from a quiet lunch spot to the bustling hub of activity for employee COVID-19 vaccination at the Brigham. In the weeks and months since, Brigham staff have continued to work tirelessly behind the scenes to administer the vaccine to their colleagues and provide a seamless experience for all who entered the clinic — all while becoming a part of history in the making.

To ensure the clinic was operational as soon as vaccines were available, the Brigham drew from its existing workforce to staff clinical and non-clinical roles. That included dozens of employees — medical assistants, nurses, physicians, physician assistants, practice managers, research assistants and more — who volunteered or were temporarily reassigned to support the clinic’s day-to-day operations and collectively administer thousands of vaccinations every week.

Stronger Together Brigham Values Logo“I have been so impressed by our Brigham staff who have stepped up to administer vaccines and support the clinic in Hale,” said Karl Laskowski, MD, MBA, associate chief medical officer for Ambulatory Services, who co-lead the employee vaccination program with Paula Kackley, MBA, executive director of Clinical Services, and Sarah Kirchofer, MSN, RN, NP-C, NE-BC, interim director of Occupational Health Services.

“Their enthusiasm and dedication have provided hope during what would otherwise be a very hard winter,” Laskowski added. “They have worked extra hours, sometimes in addition to their regular roles. They have braved snowstorms. They have come in early and left late. And they have administered tens of thousands of vaccines. None of this would be possible without their hard work.”

‘The Best Job I’ve Ever Had’

Among the vaccinators is physician assistant Megan O’Connor, PA-C, who volunteered to work 12-hour shifts at the Hale clinic once a week and said she gives about 70 to 80 doses of the vaccine per shift.

“It’s been such a rough year that it’s so nice to have a little bit of a bright side,” O’Connor said. “It’s exciting. I haven’t been involved in anything like this before.”

Every shift, O’Connor converses with colleagues she hasn’t seen in months, as well as many new faces, as she gives them a dose of the groundbreaking vaccine. Despite the long hours, O’Connor said the work is extremely rewarding.

“It seems like a simple task to give shots in arms all day, but the reaction from people is really overwhelming. Everyone’s so excited, emotional and a little bit anxious,” O’Connor said.

Image of quote from articleNurse Brieanna Gacek, RN, BSN, PCCN, helped open the first Special Pathogens Unit and Special Pathogens-Intensive Care Unit (ICU) during the first surge in spring 2020. Nearly one year later, she received a new assignment — to administer some of the first doses of the vaccine in the Hale clinic.

“We were all really grateful for the opportunity. I felt like it was a glimpse of hope after what we all had gone through in the last year,” Gacek said. “To be able to give the vaccine to my colleagues has been an honor and I am so grateful to help keep them safe from the virus.”

Gacek said it has been inspiring to see so many people come together, including colleagues from many different departments and retired staff who returned to support the clinic, all with the shared goal of overcoming the pandemic.

“The vaccine clinic is very busy. There are a lot of questions that come up and it can be hectic at times, but it’s been so rewarding to be there making a difference and seeing people who are so gracious and genuinely happy to be there,” Gacek said. “A lot of the vaccinators have said, ‘This is the best job I’ve ever had.’ Everyone feels they’re getting this sense of fulfillment from being able to help protect people from the virus and return to a sense of normalcy.”

Anesthesiologist Gyorgy Frendl, MD, PhD, who also serves as director of Anesthesia Critical Care Research, spent his vacation days volunteering as a vaccinator at the employee clinic in Hale.

“At some point, there were a lot of doctors, surgeons and anesthesiologists coming in to get vaccinated, and they were all surprised that I was sitting there. But I think it was very reassuring for them to hear that I already got the vaccine,” Frendl said. “So, I not only vaccinated them, but I also told them that when I got it, I was OK.”

‘Even Better Than I Could Have Hoped’

Non-clinical staff have also played an essential role in employee vaccination efforts — including checking in colleagues for their appointments, scheduling their next dose and countless unseen contributions that keep the clinic running smoothly.

Sarah Micucci, a medical assistant in the Division of Rheumatology, works as an operations lead at the Hale clinic, where she helps with check in and check out, greeting new arrivals, distributing the vaccine to vaccinators and assisting with Epic troubleshooting. She said the vaccine clinic’s greatest strength is that it draws on the diverse experience and expertise of employees from across the Brigham, resulting in a team with an expansive skill set.

Image of quote from article

“I’m extremely grateful to be working and learning alongside people who genuinely want to help in any way that they can,” Micucci said. “This has made the clinic run even better than I could have hoped.”

Brendan Cormier, a Safe Care Commitment assistant and nursing student, said being an operations lead at the clinic has been his favorite job to date. Playing a crucial part in helping colleagues receive the vaccine, and working in the clinic’s inviting atmosphere, keeps him motivated during long shifts.

“Arriving to work and seeing the schedule full of people to be vaccinated can be a bit daunting at times, but then I remember that every person who comes into the clinic is one more person who is on their way to being protected,” Cormier said.

Patient care associate and graduate student Rachel Fearing said she checks in about 700 to 800 people during her shifts as an operations lead. When the employee vaccine clinic began transitioning to appointments for patients 75 and older, Fearing remembered one woman tearing up when she arrived for her first dose.

“No matter how hectic the day is, or how long the hours are, experiences like that one — with someone who was just so overwhelmed and so overjoyed with our little clinic in the Hale building — make it all worth it,” Fearing said.

Laskowski reflected on the tremendous difference that clinic staff have had on the Brigham community.

“With very little lead time and a seemingly non-stop schedule since then, staff in Hale clinic have done an outstanding job in helping our employees get vaccinated these past three months,” he said. “Leaders from some of the mass vaccination sites visited Hale prior to their launch to learn how they might model a successful high-throughput clinic. We could not have achieved nearly a fraction of what we did without the remarkable contributions of our vaccinators and clinic staff.”

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Collage of two photos. Left photo, Carmen Blandin Tarleton seven months after her second face transplant. Right photo: Bohdan Pomahac examines Tarleton during a recent follow-up appointment.

Left photo: Carmen Blandin Tarleton, seven months after her second face transplant; Right photo: Bohdan Pomahac examines Tarleton during a recent follow-up appointment.

An unusual pain on her face caught Carmen Blandin Tarleton by surprise one day in August 2019.

It had been six years since Tarleton underwent a face transplant at the Brigham following a brutal attack by her estranged husband, who doused her with chemicals that caused severe burns on over 80 percent of her body and rendering her legally blind.

A former nurse, Tarleton knew the symptoms might be her body signaling that her transplant was failing. Her doctors had warned her of the possibility over the years. Fiercely optimistic by nature, however, she tried to push the thought out of her mind. The pain could be anything, she told herself.

Within two days, it became clear something was wrong. Her discomfort worsened, and now it was accompanied by swelling. Tarleton contacted her Brigham care team and scheduled an appointment for the following week. But by the time the weekend arrived, the swelling turned into intensely painful blisters. She came to the Brigham, where her care team confirmed her worst fear: Her body was rejecting the transplant.

“I was in shock,” Tarleton recalled.

Nearly one year later, life would surprise her again — this time for the better.

Last July, at age 52, Tarleton became the first person in the U.S. and second in the world to receive a second face transplant. The 20-hour surgery, involving a multidisciplinary team of over 45 clinicians, was the 10th face transplant performed at the Brigham since 2011 and the 16th nationwide.

Photo of Tarleton being transported to the Operating Room

Tarleton is transported to the Operating Room for the first of two procedures for her second face transplant in July 2020.

“I said, ‘I want one more shot, and if it doesn’t work, then so be it,’” Tarleton said, recounting a conversation with her care team about pursuing a second face transplant. “If I was a candidate, I wanted the best possibility. But I just let it go after that. I didn’t worry about it, and that’s sort of how I roll because you can’t get caught up in the drama, worry and concern of that and still feel good.”

Now, seven months after her second face transplant, Tarleton says she feels better than she has in years and is deeply grateful for not only her donor’s gift but also the compassionate, dedicated Brigham team who has stood behind her every step of the way.

“When life brings you negative experiences, it’s only to allow you to evolve as a human being, and I feel like that’s what happened to me,” she said. “Do things get easier, and then I get happier? No. I get happier, and things get easier. And that’s what I’m realizing.”

Tarleton had the opportunity to speak with the family of the donor recently and came away inspired after the emotional meeting.

“I have such great appreciation for my donor and donor family for this life-changing gift,” she said. “Their ability to make such a decision in the most difficult of times is a true offering of love to their family member and me, a stranger they did not know. I was so happy for the opportunity to let them know how much they impacted my life for the better.”

Writing Her Next Chapter

Compared to her first face transplant, the donor tissue used in Tarleton’s recent surgery is far more compatible — greatly reducing the risk of another rejection — and it more closely resembles how Tarleton looked before her injury, in terms of skin tone, hair color and face size. Her recovery has also been smoother this time, thanks to several changes her surgeons made to the transplant procedure (see related sidebar for more details).

Bohdan Pomahac, MD, director of Plastic Surgery Transplantation, who led the surgical team for both of Tarleton’s transplants, said he has been delighted with how well Tarleton is progressing and recovering.

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“One can hope for a transplant to last a patient’s lifetime, but realistically speaking, every type of transplant has a finite lifespan. Carmen’s second transplant was a carefully planned and executed operation that provides hope to all patients whose transplant is failing,” Pomahac said. “Carmen is one of the most resilient patients that I have had the opportunity to care for. We call this procedure life-giving, and we are thrilled to offer her the opportunity to return to the type of life that she so richly deserves.”

Since her injury, Tarleton’s life has been full of rewarding experiences. She became a published author and inspirational speaker, sharing her story of courage and forgiveness with audiences worldwide. She also celebrated more personal milestones, including learning to play piano and becoming a grandmother.

“My first face transplant served me very well. I accomplished many things that I really needed to stay in this life, and one of them was comfort,” Tarleton said.

With her next chapter waiting to be written, Tarleton sees only greater possibilities on the horizon.

“I am looking for a new life, new adventures,” she said. “I can’t put it into words yet, but it’s going to be a lot of fun. I’m just going to have a really good time, and I know it.”

A Different Transplant Experience

Photo of surgeons in Operating Room

Members of the Otolaryngology-Head and Neck Surgery team work in collaboration with members of the Plastic Surgery team to prepare Tarleton’s face for transplant.

Carmen Blandin Tarleton’s first transplant experience was challenging because the lifesaving blood products and tissue grafts she needed as a result of her original injury placed her at a higher risk to reject the transplant, a complication known as sensitization. Over the years, she experienced repeated episodes of rejection, which injured the blood vessels supporting her first transplant.

“Once a patient is highly sensitized, they remain at higher risk of rejection,” said Anil K. Chandraker, MD, director of Renal Transplant Medicine and a member of the transplant team. “Going into her second face transplant, Carmen was not highly sensitized, not at high risk of rejection, as she had lost nearly all of the HLA antibodies in her blood that had made her previously highly sensitized — likely due to the immunosuppression she had received during the first transplant.”

In addition to the rarity of a second face transplant, the surgery was unique on several other fronts. First, it was marked by an unusually close tissue match from Tarleton’s donor, which lowers her future risk of rejection. Additionally, the surgery progressed differently than the previous ones the Brigham team had performed.

“This will likely serve as a prototype going forward,” said Bohdan Pomahac, MD, director of Plastic Surgery Transplantation. “The surgical team paused the transplant approximately 15 hours into the surgery, allowing us to better manage the blood loss, which can interfere with blood clotting during the operation. We completed the surgery the following day, which decreased the time Carmen had to spend in the operating room overall.”

Tarleton said the acceleration of her recovery was remarkable. “I stayed in the hospital for half as long than I did the first time, and I did not need as many medications. I almost lost my first face transplant post-operatively, and this time it wasn’t like that at all,” she said. “I did so much better. My recovery has gone extremely well.”

Amanda, Patrick and Noah Beauregard

Amanda and Patrick Beauregard bond with their newborn son, Noah

Amanda Beauregard, 31, did her best to ignore the mounting discomfort in her belly while resting in her husband Patrick’s room in Medical Oncology on Connors Center 7.

Amanda, then 38 weeks pregnant, tried to reassure herself the pain was probably just pent up stress after the crazy day they’d had. The Lowell couple originally planned to come into the Brigham that morning for an MRI scan to determine if some worrying symptoms Patrick, 32, was experiencing meant the colon cancer he’s lived with for three years had spread to his brain.

But that morning, Patrick’s symptoms were so severe that they instead took an ambulance to a nearby community hospital, and he was soon transferred to the Brigham. After an MRI confirmed a cluster of tumors were pressing on Patrick’s brain, the couple met with his care team to discuss their options, ultimately opting for surgery and radiation therapy.

After they were settled on Connors Center 7, Amanda sent a message to her obstetrician’s office about potentially transferring her care from Massachusetts General Hospital, where she had planned to deliver, to the Brigham. Just in case.

Baby Noah unexpectedly arrived a few hours later. Patrick went into the Operating Room the following day.

Behind the scenes of the family’s emotional whirlwind of events, their Brigham care teams — comprising countless staff across multiple areas — rallied together in extraordinary ways to support them at every turn.

We care. Period. logoThroughout the family’s stay, staff from several areas coordinated visits between floors so that Patrick and Amanda could be by each other’s side and bond with Baby Noah together. Anesthesiology, Neurosurgery and Operating Room (OR) staff seamlessly accommodated a last-minute schedule change to move Patrick’s surgery from Saturday to Sunday to give the couple extra time to celebrate the joyous addition to their family.

And while navigating the compounding challenges of a high census and the COVID-19 pandemic, several teams collaborated to ensure Amanda and Baby Noah could stay a few extra days so that all three could go home together when Patrick was ready for discharge.

“We were treated with such care, compassion and thoughtfulness,” Amanda said. “It took a lot of people working together to make sure we got the best care — not just physically but also emotionally — and could stay together as a family, understanding how important that was to us.”

Katherine Gregory, PhD, RN, associate chief nursing officer for Women and Newborns, described the event as a shining example of the compassionate, patient- and family-centered care that staff deliver every day.

“The pandemic has changed many things about how we care for patients and families, but it has not changed our commitment to meeting our patient’s complex health needs with expertise and empathy,” Gregory said. “Caring for Patrick, Amanda and Noah as a family required the expertise of many teams from across the Brigham.”

‘Let’s Do This for This Family’

When Amanda went into labor in Patrick’s room, Medical Oncology nurses accompanied her to Obstetrical Admitting. Baby Noah arrived about two hours later — before Patrick could even make it to Labor and Delivery, where staff ensured Amanda received additional support amid such a rapidly evolving event.

“It is not often in adult Oncology that we have a crossover to Labor and Delivery, but I think this event truly exemplifies the level of compassion and dedication that exists among our staff,” said Emily Hagens, MSN, RN, nurse director for Connors Center 7. “Everyone on the unit recognized what a unique and incredibly stressful situation it was for Patrick and Amanda.”

Obstetrics and Gynecology resident Samantha Truong, MD, who was among the many members of Amanda’s multidisciplinary care team, agreed: “In so many ways, our care expands beyond just making sure a patient is meeting their postpartum milestones. We wanted to make sure their family could be together during such an important time, from the birth of their son to Pat’s surgery. As a care team, this family’s story sat in our hearts.”

Neurosurgeon Nirav Patel, MD, who was part of the multidisciplinary team that performed Patrick’s surgery, recalled how the family’s touching story inspired the whole team.

“After we decided to postpone the surgery, I explained the situation to the OR team. To be honest, I wasn’t sure how people would react. It was already a busy weekend, and the OR was stretched a little thin due to COVID,” he said. “But, of course, everyone jumped in to help. The day of the surgery, Evan Blaney, the anesthesiologist, turned to me and said, ‘Let’s do this for this family.’ Our patients’ bravery makes any challenges we face look like nothing.”

Supporting Patients and Families

During such an unpredictable time in their lives, it was reassuring to have so many people in their corner, Amanda said.

Beauregard family

Amanda and Patrick Beauregard, with Baby Noah, during their stay at the Brigham

“I cannot imagine having to go home without Pat. It just meant so much to be able to stay there and know that we were in such good hands. If I was trying to speak with one of Pat’s providers on the phone and Noah started to have a fit, my nurses would say, ‘It’s OK. I’ve got him. I’ll take him to the nursery for you,’” Amanda said. “Then they’d be on the phone with Pat’s nurses coordinating so that Pat could come down or, if Noah was in the nursery, that I could go up and see Pat.”

The dedication demonstrated by staff in the Neurosciences Intensive Care and intermediate units, where Patrick recovered after surgery, came as no surprise to Karen Reilly, DNP, RN, MBA, NEA-BC, associate chief nursing officer for Critical Care, Cardiovascular and Surgical Services.

“We have extraordinary staff who not only provide outstanding clinical care but also go above and beyond to meet the physical and emotional needs of both the patient and family,” Reilly said. “This is vital to the healing process.”

After experiencing so many ups and down with Patrick’s illness over the years, Amanda said they take each day together as a gift — one that has now become even more precious.

“Any time we get bad news, it’s obviously very shocking and so upsetting. But I think we’ve always tried to stay positive, stay hopeful and keep moving forward,” she said. “We don’t want to fill any day with negativity. We just don’t see a point in it, and that’s especially true now with Noah. We try to soak up every day together as much as we can.”

Victoria Addonizio and Krista Atherton prepare a COVID-19 testing booth

From left: Victoria Addonizio and Krista Atherton prepare a COVID-19 testing booth at a community site in Dorchester.

One of the pandemic’s greatest tragedies was COVID-19’s disproportionate impact on underserved communities, particularly among people of color — a grim trend caused by structural inequities throughout the nation, local communities and the health care system at large.

During the pandemic, state data revealed several “hotspots” — areas with disproportionately high rates of infection – in predominantly Black and Latinx communities, including Dorchester, East Boston, Hyde Park and Roxbury.

By late April, Black residents of Boston accounted for 41 percent of known COVID-19 cases and 34 percent of deaths, yet Black people comprise only 22 percent of Boston’s population. Similar disparities were reflected in the Brigham’s own patient census during the pandemic.

“Prior to COVID-19, many of us were painfully aware of the inequities faced by patients in our surrounding communities as a result of racism and poverty,” said Christin Price, MD, program director for Medicaid ACO/E-Care Optimization in Brigham Care Strategies & Innovation. “When COVID-19 disproportionately hit such neighborhoods, these inequities were brought to light for all to witness.”

In mid-March, a large team at the Brigham came together in anticipation of this crisis and to plan a comprehensive response. Meeting daily, the multidisciplinary team worked to identify, escalate and address equity concerns within the Brigham and the communities it serves.

“One of my biggest lessons from the COVID-19 equity response is how necessary it is to have teams that are multidisciplinary, diverse and community-engaged if we hope to be effective at addressing inequities,” said Cheryl Clark, MD, ScD, a hospitalist and health equity researcher, who led Incident Command’s Equity, Diversity and Community Health Response team.

Offering a Helping Hand

One notable aspect of the Brigham’s equity response was the establishment of several temporary sites in Dorchester, Hyde Park, Jamaica Plain and Roxbury where staff provided COVID-19 testing, educational resources and care kits containing cloth masks and hand sanitizer. In addition, eligible residents received boxes of fresh fruits and vegetables. At Brookside Community Health Center, staff also distributed diapers and assisted residents with voter registration.

“Social determinants of health (SDOH) — such as food, housing and financial stability — greatly impact one’s health and access to quality treatment,” Price said. “The Brigham Health response, therefore, involved an approach that served the needs of the whole person.”

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Tracy Sylven, CHHC, MCHES, director of Community Health & Wellness at BWFH, worked closely with a team from across Brigham Health, which included Price and Kelly Fanning, MBA, executive director for Ambulatory Services, to stand up the sites, facilitate testing and manage the logistics to support the teams performing SDOH screenings.

“Just as a blood sample can tell us so much about your health, the same rings true about your address,” Sylven said. “We’re committed to reaching those who have been underserved. Our calling is to allow every voice to be heard and to make a positive impact in each community we serve, but the stark reality is that not only do people need our help today more than ever but they’re also going to need our help going forward, too.”

Patricia Gonzalez, a community health worker at the Phyllis Jen Center for Primary Care who supported the community testing sites, said it was “a true blessing” to help local families.

“Through working at these community sites, I have seen firsthand the struggles that families are facing right in our neighborhood,” Gonzalez said. “This experience has given me an even greater sense of responsibility to make sure I am taking care of each of my patients to the best of my ability every time.”

Read more reflections from staff who supported community testing sites.

Wanda McClain, MPH, vice president of Community Health and Health Equity, praised the team’s response and noted that it creates a strong foundation for future equity work.

Group photo

Staff supporting the Hyde Park-based mobile testing site gather for a team photo.

“This multi-departmental and Brigham Health-wide team broke down silos, came together quickly and got to work,” McClain said. “I could not be prouder of this group and look forward to carrying the lessons learned during the pandemic into our reimagined future.”

Brigham clinicians and staff also helped support Boston Hope, a 1,000-bed medical center built at the Boston Convention and Exhibition Center for COVID-19 patients who could safely recover outside of an acute care facility. Giles Boland, MD, chair of the Department of Radiology, served as its co-medical and operations director.

Bernie Jones, EdM, vice president of Public Policy, expressed his admiration for the many ways the Brigham community supported its neighbors in their hour of need. He applauded the teams led by Fanning, Price and Sylven for stepping up to assist with the sites during the pandemic.

“Their collective work clearly represented our value ‘We’re stronger together’ and embodied teamwork, partnership and community, in every sense of those words,” Jones said. “People came together from across the institution in a way that was nothing short of inspirational, propelled by a common desire to serve communities disproportionately impacted by the virus.”

Supporting the Brigham’s Workforce

In addition to community-based efforts, staff from several areas — including the Center for Diversity & Inclusion, the Center for Community Health and Health Equity, the Office of Diversity, Equity and Inclusion, Patient Safety, Quality and Safety and the COVID-19 Equity, Diversity and Community Health Response team — collaborated to support the Brigham’s workforce on issues related to equity.

They organized several virtual forums on a range of topics, including raising awareness about health equity issues, prejudice against Asian-American communities during the pandemic and the combined trauma of racism and COVID-19.

Recognizing that many members of the Brigham’s workforce live in communities that were disproportionately affected by COVID-19, they also organized a series of educational forums for groups of employees.

“We will continue to be persistent with our anti-racism work, our commitment to health equity, diversity and inclusion as our institutional priorities,” said Tina Gelsomino, MSW, LCSW, RCC, director of the Center for Diversity & Inclusion. “Compassion for ourselves and each other is also an essential tool as we continue to work through this.”

Meeting Multilingual Needs

Interpreter Services staff worked tirelessly throughout the pandemic to ensure multilingual access to resources and information. The team not only provided medical interpreter services in clinical settings, but also completed more than 140 urgent translation projects for materials distributed to staff, patients and families.

Interpreter Services staff

Interpreter Services staff, from left: Veronica Larouche, Yilu Ma and James Wiggins

“Timely translations are essential to reach underserved populations,” said Yilu Ma, MA, MS, CMI, director of Interpreter Services.

During the pandemic, Interpreter Services and others also helped launch a new program, Bilingual Clinician Volunteers for Interpreter Services Emergency Response Planning, to ensure that patients and families with language barriers wouldn’t experience challenges accessing interpreting services, even during a worst-case pandemic scenario.

Led by Marta Solis, Spanish-language interpreter and training coordinator, the program assessed more than 20 medical professionals at the Brigham who could potentially be called upon to interpret if all other interpreter resources were exhausted.

“Being able to experience firsthand the candidates’ outpouring of love and willingness to help was my silver lining during this pandemic,” Solis said.

George Araneo walking in woods

George Araneo enjoys a hike in Maudslay State Park in Newburyport about a month after his procedure.

George Araneo’s life changed forever last October. Walking home from dinner on Halloween night, Araneo, 66, suddenly became unconscious and fell to the ground. Having no idea what just happened or why, his next memory is waking up on the sidewalk. Today, the avid cyclist, runner and hiker is on the road to recovery, thanks to the lifesaving care he received at the Brigham. He’s back to exploring his favorite walking trails and working out at the gym. He’s even entertaining a future cross-country bike trip — an activity he worried might not be possible when he got sick.

Two years ago, Araneo, who lives in Newburyport, was at a general check-up when his physician heard a strong heart murmur — an unusual sound heard between heartbeats. He was sent for an echocardiogram and was diagnosed with aortic stenosis, a common but serious disorder in which blood is unable to flow freely from one of the heart’s valves to the body’s main artery, the aorta.

Experiencing no symptoms prior to this diagnosis, Araneo was shocked when he received this news. He continued to live as much of a normal life as possible following that appointment, but in 2019 he noticed cardio exercise was becoming more difficult and subsequently scaled back his workout routine.

It was not until that evening last fall when Araneo knew his heart problems were more serious than he realized.

An Alternative to Surgery

After seeing his cardiologist in Brookline, Araneo was referred to the Brigham, where his care team began preparing to replace his heart valve. Upon being evaluated at the Brigham’s Structural Heart Clinic, Araneo learned that he was a candidate for transcatheter aortic valve replacement (TAVR), a minimally invasive alternative to open-heart surgery performed in the Cardiac Catheterization Lab.

Traditionally reserved for sicker, older patients in their late 70s and 80s who have other health complications — and for whom surgery carries higher risks — TAVR uses advanced imaging to help specialists guide a catheter into the heart through a small incision in the groin and insert a replacement aortic valve. Last year, the U.S. Food and Drug Administration approved the clinical use of TAVR for low-risk patients like Araneo.

Interventional cardiologist Pinak Shah, MD, medical director of the Brigham’s TAVR program, said Araneo was a good candidate for TAVR because he was in great physical shape and had the ideal valve anatomy for obtaining a positive result from the procedure.

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“He is definitely one of the more active and fit patients whom we have treated with TAVR,” Shah said. “He is in excellent physical condition, and our team wanted to avoid surgery in order to help him get back to his activities sooner.”

When Araneo heard the news that he would not need open-heart surgery, he relaxed instantly.

“As soon as I walked into the Brigham, I felt safe and secure,” he said. “I always knew I was in good hands and that my comfort was top priority for my care team.”

An ‘Incredible’ Experience

Araneo underwent a TAVR in January, and the procedure was a resounding success. Immediately afterward, he was transported to the Cardiovascular Recovery Room and was speaking with friends 30 minutes later, said cardiac surgeon Tsuyoshi Kaneko, MD.

“TAVR is a game-changer in the management of aortic stenosis,” Kaneko said. “Traditional open-heart surgery would have required George to stay in the hospital for four to five days, and he would have had at least six weeks of recovery time. Instead, he was discharged the next day and almost fully recovered within a week.”

Araneo is grateful for the care he received at the Brigham and was elated to return to his normal routine just days after the procedure.

“I had the surgery on Thursday, and I was walking out of the hospital at 2 p.m. that Friday,” Araneo said. “The procedure was just unbelievable. I got in a cab from the Brigham to North Station and was on the train heading home before I knew it.”

Now, he’s back at the gym, getting outside as much as possible and researching upcoming cycling events.

“My entire experience at the Brigham was incredible,” Araneo said. “I met great people who took such great care of me.”

Kaneko said the Brigham Heart Team hopes more people will be able to benefit from this minimally invasive procedure now that it’s been approved for a larger patient population.

“It is a great joy for us to see our patients recovering so quickly following the TAVR procedure,” Kaneko said. “Our dream is to treat more patients like George.”

To learn more about TAVR at the Brigham, contact the Structural Heart Program at 617-732-7678.

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Seven panelists sitting in chairs

Panelists, from left: Nomi Levy-Carrick, Gail Levine, Cheryl Clark, Lindsey Wu, Kerry Quealy Son, Bill Theisen and Joji Suzuki

The first time Dawn Shreve reached out for help, she was a scared and confused teenager struggling to cope with a series of disorienting changes at home, including her parents’ divorce and the death of her grandmother.

At age 12, she smoked marijuana for the first time. Soon, she was using it every day to dull her distress. It wasn’t long before Shreve, previously an honor roll student, began struggling academically and acting out at home. Her parents urged her to see a counselor, but it took time for her to warm up to the idea.

Eventually, she made an appointment. Despite feeling overwhelmed and vulnerable, she hoped it would start a healing process. Instead, Shreve said, she was shuffled between various therapists and psychiatrists who made her feel judged and powerless.

“They never listened, so I stopped talking,” she said.

That experience stayed with Shreve throughout her teens and 20s — discouraging her from trusting the health care system again even as her need for support only grew. She started misusing other substances, including prescription painkillers and alcohol, and experienced addiction, relapse, intimate partner violence, the death of two children and several other traumas.

Dawn Shreve

Dawn Shreve shares her story.

Today, she is nearly 11 months sober, backed by a robust support network and filled with hope. Shreve — who shared her powerful story of recovery and resilience as the keynote speaker of the Brigham’s fifth annual V-Day event on Feb. 6 — said she would not be where she was today without the compassionate, expert care she received at the Brigham’s Bridge Clinic, which provides rapid access to multidisciplinary care for patients with substance use disorders.

“Seeking their help was one of the best decisions of my life. They believed in me when I did not believe in myself,” she said. “My providers don’t judge me for who I was but rather look towards the future. They focus on what and who I can be, not who I used to be.”

The event, “Caring for Survivors of Interpersonal Violence with Complex Medical Needs: Fostering Resilience,” was among the hundreds held worldwide this month to honor V-Day, a movement aimed at raising awareness about violence against women and girls.

A New Approach

Following Shreve’s remarks, a panel of multidisciplinary experts reflected on what providers can learn from her story and how they can best deliver trauma-informed care more broadly.

Joji Suzuki, MD, director of the Division of Addiction Medicine in the Department of Psychiatry, said Shreve’s early experiences underscored the need for providers to become well-versed in motivational interviewing, a clinical technique for accomplishing behavior change in patients by evoking their own desire to and reasons for change that align closely with principles of trauma-informed care.

“Earlier on, clinicians did care but they didn’t know how to express that care other than being punitive and coercive because that was the definition of ‘helping,’” Suzuki said. “We’ve evolved to a place where we acknowledge that coercive strategies can be useful in certain situations, such as emergent and acute situations. But for the most part, it has to be about empowering patients to make the choices they would like to make and giving the choice back to them.”

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Lindsey Wu, MD, a hospitalist and director of the Integrated Teaching Unit, agreed that all patients, and especially those with a trauma history, need to have “a voice and a choice” in their care plan.

Bill Theisen, RN, nurse case manager for the Integrated Care Management Program in Care Continuum Management, also emphasized that providers need to exercise patience and flexibility when caring for patients with complex needs and backgrounds. “It takes a long time sometimes for people to feel safe enough to tell you some of the things that are really underlying all the challenges,” he said.

Jeffrey Katz, MD, MSc, a member of the V-Day Planning Committee and director of the Orthopaedic and Arthritis Center for Outcomes Research in the Department of Orthopaedic Surgery, offered the event’s closing remarks and invited attendees to reflect on the discussion’s themes of patient empowerment.

“As employees in a health care institution, it’s our privilege to nurture and bear witness to the resilience of survivors of interpersonal violence, and it’s also our responsibility to take care of these survivors with compassion,” he said.

View a webcast recording of the event.

Suzanne Erwin standing with book cart

Suzanne Erwin delivers books and magazines to patients with warmth and compassion.

Even in the era of Kindles, iPads and countless other digital distractions, technology is no replacement for the simple joy of curling up with a book or thumbing through a magazine for some people. One person who is keenly aware of this is Brigham volunteer Suzanne Erwin, the shepherd of the hospital’s traveling book cart.

For more than 20 years, the Brigham’s book cart program has invited hospitalized patients to enjoy donated reading materials delivered by friendly volunteers, including Erwin. The cart, which visits most inpatient units once per week, is filled with books and magazines spanning a variety of genres — mystery novels, historical nonfiction, celebrity gossip magazines and crossword-puzzle books, just to name a few.

It would be inaccurate to call the program a lending library; it offers the books and magazines with no expectation of return. For that reason, the need for a steady donation of reading materials is ongoing.

“There’s just something special about reading an actual book that brings comfort to a lot of people,” said Kelsey Craig, volunteer program and training coordinator in the Office for Sponsored Staff and Volunteer Services, which oversees the program. “It’s not just about the books, either. It’s also the conversation and human connection. Some people don’t want to take anything but appreciate having someone to talk to.”

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Erwin, who began volunteering at the Brigham last September, agreed that the books and magazines are only part of what the program contributes to the patient experience. Patients who have been in their hospital room for several days may want to chat about the weather. Others swap book recommendations with Erwin. On Mondays during football season, Erwin noticed that many patients were eager to chat about the previous night’s game, so she often brushes up on sports news before making her rounds.

Some simply thank her for coming in.

“Even if they don’t take a book or magazine, people are really happy to have that face-to-face interaction and have a conversation about something other than their illness,” Erwin added. “Some patients may not be up for a visit when I come by with the cart, and that’s OK, too. They’ve got a lot on their plate. But if they’re receptive to a visit, I’m delighted to help make their stay here a little more comfortable.”

The Write Stuff

To protect the health and safety of all patients and families, the book cart is unable to visit certain units — such as those caring for patients with a compromised immune system — or rooms where precautions for infection control are in effect.

For those patients who are able to participate, many will opt for a standard novel or nonfiction book. But most gravitate toward shorter paperbacks and, most popular of all, magazines. Perhaps unsurprisingly, thick tomes like War and Peace aren’t in high demand.

“Especially for someone who isn’t feeling well, or who may be in the hospital for only a day or two, flipping through something like People magazine or National Geographic can be a relaxing and welcome distraction from their illness,” Craig explained.

Erwin, who previously worked in health care, said it has been immensely gratifying to combine her love of reading with the opportunity to give back.

“At this moment in my life, I have time to give, and seeing the impact of that contribution is super rewarding,” she said.

If you would like to donate books or magazines to the book cart, contact Kelsey Craig at or 617-732-6584. Materials should be new or gently used. For magazines, recent editions are preferred, but all donations are welcome.

Two staff members prepare a stretcher for transport

From left: Tigist Asseged and Germaine Dorfeuille prepare a stretcher for patient transport.

For 40 years, Germaine Dorfeuille, a supervisor in Central Transport and Equipment Services, has called the Brigham her second home. With a passion for helping others, she takes immense pride ensuring she and her team provide safe, courteous and timely transport of patients and equipment.

“I come in to work every day and feel like a little kid on their birthday,” said Dorfeuille, who started her career in Central Transport as a patient transporter. “I cannot put into words what the Brigham, our patients and the Central Transport team mean to me. I hope I can work here for another 40 years.”

A department within Inpatient Clinical Services, Central Transport is responsible for transporting patients, medical equipment and other patient care-related items throughout the hospital. The 125-person team operates 24/7, 365 days a year, transporting patients to and from testing and clinical appointments throughout the main campus, Dana-Farber Cancer Institute and Boston Children’s Hospital, as well as to the Brigham’s main lobby areas at discharge. They also provide transport from the Brigham’s helipad.

In addition to the transport of patients, Central Transport moves specimens to laboratories, disinfects transport and patient equipment, delivers oxygen tanks and responds to emergency codes.
The department also plays an important role in hospital-wide projects to improve patient care. Last January, Central Transport joined a multidisciplinary team to assist with a mattress conversion project, which involved replacing nearly 800 mattresses in patient care areas throughout the Brigham. In May, Central Transport staff were among the 12 teams that replaced about 3,800 large-volume infusion pumps with a new model, the Baxter Spectrum IQ pump.

Raul Rodriguez, the department’s senior manager, has worked in Central Transport for 30 years. Like Dorfeuille, he started at the Brigham as a transporter. He is proud of his team and everything they do to support patients, families and employees.

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“We function as part of the patient care team, and every request we receive is treated with the high level of respect it deserves,” Rodriguez said. “We are proactive, and each one of us is always willing to help.”

One part of the job that Rodriguez enjoys most is witnessing members of his team train one another and coach each other on different safety protocols and hospital systems, initiatives and procedures. Staff also mentor student interns and volunteers on the team.

Erlande Jean-Louis, a manager in Central Transport, said she and the team enjoy having the opportunity to mentor young students.

“We provide them with the tools they need to succeed and, through our work and interactions with patients and colleagues, inspire them to pursue a career in health care in the future,” Jean-Louis said.

For members of the Central Transport team, their interactions with new patients and those who come to the Brigham regularly for care make each day rewarding.

“Many patients request our transporters by name,” Rodriguez said. “We have the privilege to hear patients’ stories and learn from them. They appreciate that we are always here to help them, no matter the time of day.”

“Behind the Scenes” is a monthly series that provides a glimpse of the people whose everyday contributions help make the Brigham a world-class institution. Is there a team you’d like to see featured? Send your ideas to


From left: Michael Mirabile meets with Cheyanne Perryman, an SSJP alumna and recent college graduate.

As Ekram Sakhta pursues her dream of becoming a Brigham nurse, she has been eager to soak up any career guidance she can find. So, when invited to an event that offered the chance to meet with a member of the Brigham’s Human Resources (HR) team, receive feedback on her resume and discuss career goals, she jumped on the opportunity.

This was not the first time that Sakhta, who is pursuing a nursing degree at Simmons University and working per diem as a unit coordinator in the Shapiro Cardiovascular Center, has found a helping hand at the Brigham. She is an alumna of the Student Success Jobs Program (SSJP), which partners with select Boston-area public high schools to foster the next generation of talented, diverse health care workers.

A program of the Brigham’s Center for Community Health and Health Equity (CCHHE), SSJP matches high school students with mentors and paid internships across the institution. Alumni of the program continue to receive support as they enter college and the professional world through individual mentorship and events such as the recent career workshop.

The Jan. 9 event Sakhta attended in Carrie Hall brought together nearly 25 SSJP alumni with members of HR’s Talent Acquisition team who volunteered their time. In one-on-one and group meetings, HR staff offered career guidance and shared tips for resume writing, searching for and applying to jobs, preparing for interviews and more. Following the event, staff and SSJP alumni mingled in the Fish Rotunda at 15 Francis St. for networking with senior leaders from the Brigham and Mass General Brigham.

“The Brigham has been my rock ever since I joined SSJP during sophomore year of high school,” Sakhta said. “Every step of the way, I have received so much support from SSJP and my mentors here. Having the chance to sit down with HR staff and review my resume was very helpful, and I am looking forward to keeping in touch with them as I begin to look for job opportunities.”

Feels Like Home

Pamela Audeh, CCHHE’s program director of Youth Development and Economic Advancement, has known some SSJP alumni since they were in elementary school due to their participation in CCHHE youth programs. To witness these graduates come back to the Brigham with their resume in hand was a special moment, she said. 

We care. Period. logo“Our students are very dedicated, and to see their ambition and drive is inspiring,” Audeh said. “For many of them, they grew up at the Brigham, so events like these offer them an opportunity to come back to a place that feels like home. It’s heartwarming to see them translate the experience they had at the hospital onto a resume.”

Michael Mirabile, Talent Acquisition manager in HR, was among the staff who volunteered at the SSJP event. He met with SSJP alumni to discuss their career paths and offer feedback on their resumes and cover letters.

“It was really exciting to meet the students and learn from each of them about their career goals and aspirations,” Mirabile said. “The job search process can be overwhelming, so we are here to help coach these students, listen to them and provide advice.”

Many SSJP participants are interested in pursuing a career at the Brigham once they finish school, and Mirabile said it’s a goal for his team to help the students identify how they might be able to grow within the system.

HR is also working to raise awareness about SSJP and its students so that hiring managers throughout the Mass General Brigham system are aware of this unique talent pool that brings Brigham experience to entry-level positions.

“This collaborative approach links our skilled, diverse SSJP alumni to roles that enable them to contribute to exceptional patient care at Brigham Health,” said Michelle Keenan, CCHHE’s senior director of Health Equity and Social Innovation. “I can think of no better way to live out our organizational values and realize our goal to contribute to a healthier community and world.”

Hiring managers and employees interested in becoming a mentor or volunteer for CCHHE youth programs can contact Pamela Audeh at



Murray Daniels practices on the piano using prostheses on his three injured fingers.

For as long as Murray Daniels can remember, he has felt most at home on a piano bench.

Around age 5, he began experimenting on the piano, trying to recreate songs he had heard elsewhere. That early start led to a lifetime of musicianship, mostly self-taught. For the past decade, Daniels, now 65, has played the keyboard in a cover band, performing songs from the Beatles, Billy Joel and Elton John, among other artists, at local charity events. Over the years, he has also served as a substitute organist at his local church.

“Music is a significant part of my life,” said Daniels, a former Air Force pilot and recently retired information systems engineer. “It engenders an emotional response both in the person creating the music and the person listening to it. It’s a form of emotional communication when done well, and I don’t mean when it’s performed without mistakes — rather, when you put your heart and soul into it.”

This deep connection to song made it especially devastating when he experienced a traumatic hand injury 15 months ago due to a snowblower accident, resulting in the partial loss of the three middle fingers on his right hand.

But thanks to the advanced, expert care he received at the Brigham, Daniels is back to doing what he loves most — making music.

Life-changing Events

On the morning of Nov. 16, 2018, Daniels looked out the window of his Bedford home to survey the unpleasant job ahead of him: removing several inches of wet, heavy snow that had piled up overnight.

“I try to be conscientious about clearing it quickly,” he explained.

He brought his snowblower out and got started, but it wasn’t long before the discharge chute clogged due to the snow’s slushy composition. Daniels released the controls and examined the obstruction.

“I was impatient. Being an engineer, I thought I understood how the snowblower worked and where the moving mechanisms were. I was wrong on both accounts,” he said. “There was some residual tension in the mechanism. Even though I had taken my hands off the controls and it appeared motionless, I put my hand where I shouldn’t.”

Once the clog began to dislodge, the blades abruptly rotated once more before Daniels could pull his hand away. He and his wife rushed to a nearby hospital for emergency care.

Knowing the Brigham had a renowned hand and upper-extremity trauma service, Daniels and his family advocated for his transfer to the Brigham for his surgery.

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Lydia Helliwell, MD, of the Division of Plastic and Reconstructive Surgery, was part of the multidisciplinary team who performed the surgery. In the operating room, the team focused on closing the wounds in a controlled manner and repairing the nerves to minimize the chance of hypersensitivity, she explained.

“We’re accustomed to managing complex injuries. The surgical team, colleagues in the Emergency Department and occupational therapists are all able to work together and deliver great outcomes for our patients,” Helliwell said. “That said, surgery is only half of the patient’s recovery. The other half is the therapy to get their motion back, and motivated patients such as Murray are the ones who do the best. I can’t take credit for all of his hard work.”

Daniels described his experience at the Brigham as nothing short of exceptional.

“I can’t say enough good things about Dr. Helliwell and all of the staff, especially the nurses, who were considerate, thoughtful and attentive to all of the things you take for granted,” he said. “I would not hesitate to recommend the Brigham to anybody.”

Back on the Bench

As Daniels embarked on recovery, he was eager to return to the piano.

“Music is terribly important to me,” he said. “I had to get back to it right away.”

Within two weeks of discharge from the Brigham, he was performing again with his band, although only with his uninjured left hand. Daniels quickly became aware of his new constraints as a musician. His three injured fingers were not long enough to reach between the black keys on a piano, which significantly limited what he could play. The reconstructive surgery had also thickened his fingers, affecting his dexterity at the keys.

During a follow-up appointment at the Brigham last year, he mentioned the concern to Helliwell, who suggested he consider prostheses and provided a referral to the Hanger Clinic.

By April, Daniels found a set of prostheses that enabled him to play the piano comfortably. About six weeks later, he was back to practicing on his home keyboard. Soon after, he returned to doing live performances with his bandmates and playing again at his church.

Reflecting on his experience, Daniels hopes others can take two lessons from his story. First: Never, ever put your hand in a snowblower. Second: It is possible to find fulfillment after a traumatic injury.

“I feel very lucky that I only lost what I lost and that I was able to get back a lot of my life,” Daniels said. “I understand that people who have the same kind of injury may lose more or less than what I did. Either way, I would encourage them to continue to try to get what they can out of life and don’t give up.”


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Ann Taylor shares a moment with Deepak Bhatt.

Two years ago, on the eve of Thanksgiving, Ann Taylor and her family feared the worst.

After going to a community hospital near her home in Merrimac, Mass., to seek care for shortness of breath, Taylor learned she had experienced a heart attack, brought on by advanced cardiovascular disease. She was rushed to the Brigham, where her care team made a distressing discovery: Three of the four major arteries serving Taylor’s heart were 99 percent blocked. The fourth had a 90 percent blockage.

Her fragile condition and complex medical history meant Taylor was far too sick to survive coronary bypass surgery — one of the most common ways to restore blood flow to the heart when multiple arteries are blocked. Deepak L. Bhatt, MD, MPH, executive director of Interventional Cardiovascular Programs, presented another option to her and her family: a less-invasive procedure performed in the Cardiac Catheterization Lab to reopen her arteries using five thin tubes called stents.

While the procedure wouldn’t require open-heart surgery, Taylor and her family learned it was still extremely risky — offering only a 20 percent chance of survival — due to her frail state. A nurse gently suggested to David, her husband, that he contact their loved ones so that they could say their goodbyes. A priest was called to deliver Taylor’s last rites.

But seemingly against all odds, Taylor survived the procedure and rapidly recovered. On the recommendation of her care team, she returned to the Cath Lab the following week to have three more stents inserted in her coronary arteries. After about three months, she was home and regaining independence — learning how to walk, talk and feed herself again.

Today, as another Thanksgiving approaches, Taylor says her heart is not only strong but also overflowing with gratitude for the multidisciplinary care team at the Brigham who saved her life and restored her health. Over the past two years, her cardiac function has returned to near-normal levels, allowing the 57-year-old grandmother of four to get back to doing what she loves most — spending time with her family.

“I don’t know how to express it except that ‘thank you’ isn’t enough,” Taylor said. “I have so much to be thankful for. Brigham and Women’s gave me the chance to continue enjoying life with my husband, kids and grandchildren. You have no idea how much that means to me.”

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David echoed his wife’s appreciation for their care team’s determination, dedication and expertise.

“Anywhere else would have turned her away and sent her home, and we probably would just be waiting for a massive heart attack to occur,” he said. “Dr. Bhatt stepped up to the plate for Ann. If it wasn’t for Brigham and Women’s, she wouldn’t be with us today.”

‘Something Else Is Going On’

Part of what made Taylor’s care plan and prognosis so uncertain was her complex medical history. She lived with diabetes from age 11 to 36, eventually requiring her to undergo a kidney and pancreas transplant in 1999. She received a second kidney transplant in 2010 after the first donor organ failed.

While the transplants cured her diabetes, she continued to experience long-term complications from the disease. So, upon feeling fatigue and shortness of breath one day, Taylor said a heart attack was the furthest possibility from her mind. Having also been previously been diagnosed with cold-induced asthma, she thought the chilly November weather might be to blame for her breathing problems.

“I wasn’t sure what was happening. I was trying my inhalers, and nothing was working. I called my doctor’s office, thinking maybe it had something to do with my kidneys,” she recalled. “The nurse called me back and said, ‘This is not asthma. Get to a hospital. Something else is going on.’”

Beating the Odds

Among the potential complications that Taylor, her family and Brigham providers had to consider was how the Cath Lab procedure might affect her transplanted organs. Coronary stents are guided into the arteries with the help of contrast dye, which can be taxing on the kidneys. Fortunately, Taylor experienced no complications as a result — another unexpected outcome.

Bhatt said he’s been thrilled to see Taylor beat the odds and continue to thrive.

“Here was a woman who came to us in cardiogenic shock, which means the heart was not able to pump blood and therefore all of her vital organs weren’t getting the blood and oxygen they need to function. On top of that, she’d had at least one heart attack and multiple organ transplants,” Bhatt said. “If you put this into a predictive model, the statistics would not be in her favor. This is a wonderful example of our willingness to look beyond the numbers.”


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Mikhala Heil with a memory book used in the service.

Mikhala Heil with a memory book used in the service.

Sixteen years ago, the multidisciplinary Mary Horrigan Connors Center for Women and Newborns Bereavement Committee began hosting a small remembrance service in Carrie Hall to help families coping with the loss of a baby. Since then, the service has grown tremendously, with many families returning year after year to remember their babies and support each other.

“Grief does not end,” said Elisa Abdulhayoglu, MD, MS, FAAP, of the Department of Pediatric Newborn Medicine and a member of the Bereavement Committee. “It changes form over time. Families that have recently lost a baby and families that lost a baby years prior meet each other, and many times, this helps in the grieving process.”

This year’s service, held on Oct. 27 in Cabot Atrium, brought together more than 100 family members, some of whom experienced this tender loss as recently as September and others whose loss occurred over a decade ago.

“Families welcomed the opportunity to honor their baby and spend the day reflecting and remembering their child with others who understand their pain,” said Leslie Morette, BSN, RN, nurse-in-charge for the Center for Labor and Birth. “The friendships and relationships among these families have grown over time.”

We care. Period. logoThe ceremony included reflections, poetry, music and an opportunity for families to write their babies’ names on paper stars and place them on a board depicting the night sky.

Families also took time to write words of love they can share with others in memory books and on stones that are kept in the hospital chapel, said Mikhala Heil, MDiv, of Spiritual Care Services, who serves as chaplain resident for the Neonatal Intensive Care Unit.

“New bonds were made and old bonds were renewed,” Heil said. “Beautiful poems and words were shared, and, most importantly, these babies’ lives were honored and remembered by this community.”



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Sejal Shah meets with a patient in the ED.

The following is an excerpt from “Entitled to Hope: Odysseys in Mental Health” in the fall issue of Brigham Health magazine. Read the full story here. *All patient names have been changed to protect privacy.

At 8 a.m. on a Tuesday, Sejal Shah, MD, chief of the Division of Medical Psychiatry, headed to the Emergency Department (ED) for her morning rounds. She leads the hospital’s psychiatric consultation liaison service, the most consulted specialty throughout Brigham Health. In addition to the ED, units such as general medicine, oncology, cardiology, and obstetrics and gynecology call on consulting psychiatrists to assess patients and provide recommendations for care.

Shah checked in on her two psychiatric patients, including Ellen*, who was lying on a gurney in a treatment bay — one of two in the ED with a retractable metal door installed in the back. Any medical equipment Ellen could use to harm herself was secured behind the door. The overhead lights were dimmed. A patient care assistant sat nearby to monitor her safety and address any immediate needs.

This was Ellen’s second time in the Brigham’s ED in a week. She hoped an inpatient facility could help her recover from addiction and depression so she could get back home to her young son, who was being cared for by her mother. Asked what it’s like for her in this environment, Ellen shook her head: “It’s too much.”

Shah told Ellen they were looking for a bed for her. After 34 hours in the tiny room, Ellen transferred to an inpatient facility.

“The system is so broken,” Shah later said. “We’re grossly under-bedded. Patients can board for days in the ED waiting for an inpatient bed, and Massachusetts is one of the better states. In other states, patients can wait for weeks or months. More often, nothing is available, so they get discharged without their needs being met.”

Feeling the Crunch

On any given day in the U.S., thousands of people come to EDs in search of relief from symptoms of mental illness, only to find themselves at the mercy of an overburdened mental health care system.

During the past six years, the number of patients seeking emergency mental health care in the EDs at the Brigham and BWFH increased from 3,500 to 4,600 per year. However, these numbers do not reflect the total number of people who come to the EDs for other issues but ultimately also need mental health care.

We care. Period. logo“A lot of people arrive with substance use disorder, alcoholism, drug overdose and pain issues as their main concern, who also have overlying psychiatric complaints,” said Michael VanRooyen, MD, MPH, chair of the Department of Emergency Medicine. “The Brigham ED is adept at managing patients’ acute psychiatric complaints, particularly if they’re agitated or potentially violent. When patients require extended care, we try to move them to our inpatient psychiatric facility at the Faulkner campus, which has 24 beds, or to other facilities, but there is a severe shortage of inpatient capacity.”

To better accommodate patients experiencing mental health crises, the Brigham ED is adding a Behavioral Health Care Unit as part of its expansion, expected to be completed by late 2021. The unit will provide a safe, quiet place for vulnerable patients to receive the treatment they urgently need. The staff’s goal is to resolve patients’ symptoms and discharge them or to manage their conditions before transferring them to an inpatient psychiatric facility.

Not Giving Up

David Silbersweig, MD, chair of the Department of Psychiatry, is one of many people determined to improve care and the ways people access it — and to destigmatize mental illnesses.

“Psychiatric disorders are real medical disorders, and they are ubiquitous,” Silbersweig said. “Every year, one in four people is affected. When you add addictions, it goes way beyond that. And when you add co-morbid medical illness, which most people have by the time they’re older, the rate goes way up again. Every family is affected.”

Silbersweig acknowledged the difficulties of changing the way mental illnesses are understood, diagnosed and treated.

“It’s taken longer than cardiology or other fields because we’re dealing with the most complex functions of the most complex organ that make us who we are as human beings,” he said. “That’s also why these are among the most poignant of disorders: because they affect our individuality, relationships, identity, control of our own mind and behavior, and our subjective experience and emotions.”



Brian Mushlin (center), with his family

After being diagnosed with an aggressive form of bladder cancer at age 40, Brian Mushlin spent the next five years trying to beat the disease through a multitude of medical treatments. But with each new chemotherapy drug, success was fleeting. While an initial follow-up test would appear promising, the cancer would soon creep its way back into his body.

“I kept thinking, ‘Onto the next treatment,’ but after a certain point, there really were no more treatments,” he said. “My doctor told me, ‘We need to start thinking about removing your bladder.’”

It was an option Mushlin, now 46, had hoped to avoid. For most patients, bladder removal requires a patient to undergo a urostomy — a surgical procedure that creates an opening, or stoma, in the abdominal wall that allows urine to pass through and empty into a pouch worn on the patient’s body. For the rest of their lives, patients must drain the bag several times each day as it accumulates urine.

In addition to being a young, active father of three, Mushlin is also a Cambridge Police patrol officer, SWAT team member, marksman and firearms instructor. Although very eager to have his cancer removed, he was concerned about the challenges a urostomy pouch could pose while, for example, serving a warrant or apprehending a suspect.

“Sometimes my job is a bit physical. What would happen if the bag was damaged or punctured, or how would I drain it at work, in uniform?” Mushlin said. “I’ve been a police officer for 21 years, and I want to continue my career in law enforcement, but it would be difficult if I had to manage a urostomy bag in my line of work.”

Seeking a second opinion, Mushlin and his family met with the Brigham’s Matthew Mossanen, MD, of the Division of Urology, to explore other options. Mossanen told Mushlin he was a good candidate for a novel procedure called neobladder reconstruction, which creates a substitute bladder from a portion of the patient’s intestines after bladder-removal surgery. During the procedure, surgeons connect the neobladder to the patient’s ureters — two tubes linking the bladder and kidneys — and urethra.

The substitute organ is placed in the original bladder’s location. Eventually, patients can urinate normally and maintain continence.

While a neobladder functions similarly to a regular bladder, it does lead to differences in sensation. Intestinal tissue doesn’t have the same nerves that tell the brain when you need to urinate; instead, patients with a neobladder must learn to recognize different bodily cues, sometimes described as feeling similar to abdominal fullness.

“Brian is unusually young for this type of bladder cancer, which on average is diagnosed at age 74,” said Mossanen, who performed the surgery with a large multidisciplinary team that included Steven Chang, MD, MS, of Dana-Farber/Brigham and Women’s Cancer Center. “Older patients typically are not as active, and therefore many are comfortable with a stoma. It’s a very personal decision. For Brian, a neobladder offered a much better quality of life compared to a stoma.”

Unparalleled Care and Compassion

Mushlin — who underwent the nine-hour, robot-assisted surgery in July — said he feels stronger and more confident each day. Within six weeks of discharge, he was back to walking his dog around his Walpole neighborhood, doing errands and beginning to try light exercise at the gym. His cancer is now in remission, and his care team continues to closely monitor his health and progress.

We care. Period. logoThe Brigham is one of the few hospitals in New England to perform robot-assisted neobladder reconstruction, an approach that enables surgeons to perform the complex procedure less invasively and with greater precision.

“We have a highly skilled multidisciplinary team with an amazing breadth of talent and experience,” Mossanen said. “While smaller hospitals will maybe do one of these procedures a year, we perform several each week. And a big reason why they go so smoothly is because there’s a large, specialized group of people — from the clinic to pre-op to the OR to the floors — ensuring that our patients receive the very best care.”

Mushlin agreed, noting that he was continually impressed by not only the quality of care he received, but also the warmth and compassion he and his family experienced every step of the way.

“From the minute I met with Dr. Mossanen, I knew I was in good hands, and he came to see me every day when I was in the hospital. The nurses and patient care assistants on the floor were also unbelievably awesome. Even after I went home, the staff continued to make themselves available and invited me to call the floor directly if I had any questions,” Mushlin said. “All of that means a lot to me. I mean, that’s what you’re looking for as a patient — they really care.”



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From left: Ryan Davidson, Zachary Pierre, John Nyonnoh, Samantha Campione, Caitlin Murphy and Daniel Fernandez display their pink patches.

By the time Capt. Kevin Slattery joined the Police and Security team two years ago, he was already well-acquainted with Brigham, although in an entirely different context compared to his role today. More than a decade prior, both his mother, Alice, and his sister, Katherine, were diagnosed with breast cancer and treated at Dana-Farber/Brigham and Women’s Cancer Center.

The experience gave Slattery — who regularly accompanied his loved ones to appointments and exams — a deep appreciation for the Brigham’s world-class care and the exceptional warmth and kindness of those who work here. So, when his Police and Security colleagues recently organized a campaign to raise awareness about and funds for the Brigham’s breast cancer programs and research, Slattery didn’t hesitate to participate.

In doing so, he is among many uniformed personnel in the department who are showing their solidarity for breast cancer patients, families, clinicians and researchers by swapping their standard blue shoulder patches for a pink patch in October, which is recognized as National Breast Cancer Awareness month.

The Brigham effort — spearheaded by Sgt. Samantha Campione, Sabrina Mason and Zachary Pierre — is inspired by the Pink Patch Project, a national campaign that invites public safety agencies across the U.S. to wear a pink uniform patch this month and support breast cancer research. As part of their homegrown initiative, the hospital’s Police and Security organizers worked closely with the Development Office to have their fundraising benefit the Brigham’s Comprehensive Breast Health Center.

By wearing the pink patches, Police and Security staff hope to spark conversations about the Comprehensive Breast Health Center’s services while also inspiring people to contribute to the team’s $4,000 fundraising goal, which will directly support the center’s work. Donors receive a collectible pink patch as a thank-you gift, but donations are not required to obtain a patch; they are freely available to anyone who’s interested, Campione said.

We care. Period. logo

“I thought this would be a great way to show our colleagues that we stand with you,” Campione said. “We’re all working toward the goal of helping people get better. This project shines a bright light on an important issue while demonstrating that we care in more ways than one.”

Serving the Brigham Community

Dave Corbin, director of Police, Security and Parking, said he is proud to see his team rally around such an inspiring cause.

“Breast cancer has touched almost everyone here, directly or indirectly,” Corbin said. “Our staff have been so passionate about this project since it launched, and their tenaciousness in engaging the community has been amazing to witness.”

Slattery said his family’s experience with breast cancer underscored for him the enormous importance of regular screening. His sister is now in remission — something he credits to her care team’s early detection of the disease and expert treatment. Their mother, who had been diagnosed with an aggressive form of breast cancer, survived for 10 years before passing away last year at age 88; he also attributes her extended prognosis to early detection.

“As someone with a wife, two daughters and four sisters, this issue is so important to me,” said Slattery. “Had it not been for the excellent care my sister received here at the Brigham and Dana-Farber, I don’t think she would be alive today.”

Department staff also highlighted how the initiative has been a rewarding opportunity to connect with colleagues and patients in a different way. “We’re here to serve the Brigham — this is our community,” Campione said. “This is just another way of serving.”

To learn more about obtaining a pink patch, speak with any uniformed Brigham Police and Security officer or concierge on the main or distributed campus, or call 617-732-6565.


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Lois Ence and her husband, Bill

Lois Ence and her husband, Bill

Lois Ence, mother of eight, grandmother of 37 and great-grandmother of nine, faced a difficult decision after her left eye began to tear uncontrollably and the lid began to droop.

An MRI test at the Brigham confirmed what Ence, 76, suspected: For a third time, a tumor was growing in the front of her skull, just behind the forehead, and pressing on the top of her eye.

In 2001 and 2016, doctors removed a noncancerous brain tumor known as a meningioma. Even with successful surgery, some meningiomas may recur. The tumor itself is not deadly, but when it grows in crowded, crucial regions of the skull, it can cause serious health problems.

This time, tests showed a new, grape-sized tumor that likely was pushing on the muscle that holds up the eyelid and on the gland that produces tears, causing her symptoms.

Omar Arnaout, MD, of the Department of Neurosurgery, explained that if the condition was left unchecked, she could lose use of her left eye as the muscle eventually failed to hold up the lid. Alternatively, she could consider surgery to remove the tumor.

After two previous and lengthy brain surgeries, followed by challenging recoveries, Ence was willing to risk her left eye to avoid a third invasive surgery.

Upon carefully studying her case, Arnaout proposed using a new, minimally invasive “keyhole” technique. Working through a small incision in her eyelid, known as a transpalpebral approach, he would be able to remove the tumor — forgoing the need for surgeons to go through the bone in her skull to reach the mass.

Although initially still skeptical about any additional brain surgery, Ence changed her mind after meeting with members of her multidisciplinary care team, which included providers from the Division of Plastic and Reconstructive Surgery, who would partner on the procedure.

She liked how her providers spoke directly and clearly with her about her condition and the benefits of the keyhole approach. Their teamwork and trust in each other were apparent.

“They had my complete confidence after that,” she said.

‘This Looks Perfect’

Each keyhole surgery is unique and custom-designed for the individual patient. Neurosurgery and plastic surgery teams prepare extensively to plan the safest route to the tumor, with minimal scarring and tissue disruption.

Ence’s surgery was performed in early June. The team approached the tumor from below instead of from above, making a small incision in her upper eyelid. Inserted through this “keyhole” opening were instruments used to remove the tumor and affected bone. “We were able to sneak in behind the eyeball to the roof of the skull where our target was,” Arnaout said.

Once Ence’s eyelid healed, the incision was no longer visible within the folds of her eyelid.

“The surgery took half the time than the doctors expected,” Ence said. Afterward, she was alert and well enough to safely avoid a stay in the Neuroscience Intensive Care Unit. After just one night in the hospital post-surgery, Ence returned to her Worcester home.

“The recovery was so easy. I was on my feet the next day,” she said. “I immediately started to do word puzzles to stretch my brain and to go for walks.”

As her eye cleared of excess fluid, she returned to reading. Within weeks, she was back to driving, volunteering and preparing for a late summer trip to California to attend her granddaughter’s wedding, visit Yosemite and spend additional time with her family.

“I’m kind of a miracle,” Ence said. “The stitches blend into my eyelid. I’ve earned my wrinkles. To me, this looks perfect.”


From left: Daniel Solomon and Christin Price participate in a panel discussion about recovery in Bornstein Amphitheater.

From left: Daniel A. Solomon and Christin Price participate in a panel discussion in Bornstein Amphitheater.

Not only has the Brigham Health Bridge Clinic been providing timely care for patients with opioid addiction and other substance use disorders since opening last year, but it’s also inspiring innovation to combat the region’s opioid crisis.

During a Quality and Safety Grand Rounds, “Opioid Epidemic Solutions Panel,” on Sept. 12, speakers discussed what they and their colleagues are doing to help patients, particularly those with concerns related to injection drug use. This event, which was led by Scott Weiner, MD, MPH, of the Department of Emergency Medicine and director of the Brigham Comprehensive Opioid Response and Education (B-CORE) Program, was one of several events hosted this month at the Brigham and BWFH to celebrate National Recovery Month and educate our community about the Brigham Health services available to those in need.

Daniel A. Solomon, MD, a physician in the Infectious Disease Clinic who also cares for patients in the Bridge Clinic, spoke about a pilot at the Brigham that is examining whether it’s safe and effective for patients who inject drugs to receive IV antibiotic treatment at home for infections caused by injection drug use.

Even though patients who inject drugs are prone to recurring infections and often need prolonged antibiotic therapy, they historically have not been considered good candidates for a peripherally inserted central catheter (PICC) line — a tube that is inserted into a vein and remains accessible for patients who need ongoing IV treatments. Providers are often reluctant to discharge patients who inject drugs with PICC line out of concern for them using the catheter to inject illicit drugs.

As a result, these patients often undergo long-term inpatient stays to receive IV antibiotics. Patients who inject drugs are referred to the Bridge Clinic — where they receive individualized care plans that may include addiction treatment medications and psychosocial services — and those who meet certain criteria can now successfully complete their course of antibiotics at home.

Since April 2018, 20 patients with a history of injection drug use have been discharged from the Brigham to home with a PICC line to complete a course of IV antibiotics with close follow-up care in the Bridge Clinic. During the Quality and Safety Grand Rounds, Solomon reported that all the patients have completed their antibiotic course and experienced no PICC line complications. Three patients relapsed while on IV antibiotics, but none used the PICC line for illicit drug use. Collectively, 570 inpatient/rehab days were spared for these patients.

“Here is an example of one program that was made possible because of the existence of the Bridge Clinic,” Solomon said.

Continued Progress

In addition to the discussion about the home pilot, panelist Christin Price, MD, administrative director of the Bridge Clinic and clinical director of the Brigham and Women’s Medicaid ACO, provided an update on the Bridge Clinic.

We care. Period. logoMore than 400 patients have been referred to the Bridge Clinic since April 2018, and 75 percent of them came to at least one appointment. The average duration of care in the clinic is two and a half months. There is a cohort of patients that has remained with the Bridge Clinic for a longer period of up to 10 months, given their ongoing high acuity. Price said she’s thrilled with the progress that has been made in the clinic to help patients in need. In particular, the Bridge Clinic’s 83 percent retention rate — representing patients who continue to receive treatment at the clinic or in longitudinal care after six months — outshines national averages for similar programs, which rarely reach 50 percent.

“We’re here not only to treat our patients’ addiction, but to also care for them as people,” Price said. “Our goals are to get our patients into treatment, aid them on a path to recovery and help them with other things going on in their lives, such as homelessness or food insecurity, which can often impede recovery. We’re here to support each of them in many ways.”

For more information about recovery month, and to view a calendar of events, visit


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From left: Stephen Conway, Sharon Conway, Sarah Conway, Baby Sophia, Nomi Conway, Adam Kaye and Jake Conway. NICU alum

From left: Stephen Conway, Sharon Conway, Sarah Conway, Baby Sophia, Nomi Conway, Adam Kaye and Jake Conway

Sharon Conway, LICSW, was 26 weeks pregnant in 1987 when she and her husband, Stephen Conway, MD, saw the meticulously laid-out plans for the next chapter of their lives take an unexpected turn. It also marked the beginning of a heartwarming, multigenerational story in which the Brigham would play a central and recurring role.

At the time, Stephen was completing a neuromuscular fellowship at Lahey Clinic. He had accepted a job in Connecticut, and the young couple began preparing to move to Hartford.

Sharon, then a social worker at Beth Israel Deaconess Medical Center, was approached by a concerned nurse colleague who observed that she looked a bit swollen and offered to take Sharon’s blood pressure. It was dangerously high, and Sharon was quickly admitted at Beth Israel with preeclampsia before being transferred to the Brigham for the advanced care available in its Neonatal Intensive Care Unit (NICU).

Their daughter, Sarah, was delivered two days later, weighing just 1 pound, 14 ounces.

Stephen and Sharon Conway celebrate their granddaughter’s birth at the Brigham.

Stephen and Sharon Conway celebrate their granddaughter’s birth at the Brigham.

Despite her uncertain start, Sarah grew and thrived without complications, thanks to the lifesaving care she received in the NICU. Nearly three decades later, she would return to the Brigham — not as a patient but following in her father’s footsteps as a neurologist-in-training in the Harvard BWH-MGH Neurology Residency Program, in which she now serves as a chief resident.

“Who would have ever imagined as we sat anxiously around her isolette in the NICU that she would be back so many years later?” Sharon said. “We had so many worries and fears back then. We couldn’t even dare to dream an outcome like this, but the care that we received at the Brigham was phenomenal. I can’t say enough about how grateful and privileged we feel.”

And just this May, the Conway family added another cherished chapter to their Brigham story when Sarah (now Sarah Conway, MD) and her husband, Adam Kaye, MD, celebrated the birth of their daughter, Sophia, at the hospital.

“How could I not have her here?” said Sarah, who is currently on rotation at Massachusetts General Hospital. “Over the years, my parents imparted on me how thankful they were for the care that I received at the Brigham when I was little, and we’re all so appreciative for the care Sophia and I received more recently. I’m happy to work in medicine and have an opportunity to give back in some way.”

‘Held Our Hands and Our Hearts’

As an infant, Sarah stayed in the Brigham’s NICU for seven weeks, at which point she was healthy enough to be safely transferred to a Connecticut hospital closer to the family’s new home. During their first experience at the Brigham, Sharon and Stephen said the care team’s extraordinary kindness was an immense comfort.

Sharon and Stephen Conway hold their daughter, Sarah, for the first time.

Sharon and Stephen Conway hold their daughter, Sarah, in the NICU for the first time.

“We were particularly attached to Sarah’s primary nurses, who held our hands and our hearts through the whole thing,” Sharon said. “They really gave us the confidence that Sarah was getting what she needed, and they were honest about things that were complicated and potentially scary. I felt like I always had somebody with me.”

Stephen — an alumnus of the Brigham, Beth Israel and Boston Children’s Hospital’s neurology residency program — said his familiarity with the Brigham as a trainee assured him that Sarah would receive world-class medical care. Even so, as an anxious new father, he gained a deeper appreciation for the exceptional compassion and seamless communication their Brigham care team practiced daily.

“Even though I had been to the NICU as a resident, it’s just another world as a patient,” Stephen said. “Everyone made us feel very comfortable, and knowing the hospital as I did, I felt we were in very competent hands.”

A Special Connection

Years later, when it came time for Sarah and her husband to apply to residency programs, Sarah said the Brigham-Mass General program was a natural choice for her — not only for its academic excellence but also its connection to the hospital that was so meaningful for her and her family.

We care. Period. logo“Match Day was one of the most exciting days of my life,” said Sarah, who will continue her training at the Brigham next July as a neurology fellow. “When I opened the envelope and saw the Brigham-MGH program inside, I burst into tears.”

For her loved ones, it’s heartening to know that Sarah is still being cared for at the Brigham, albeit in a different way.

“She’s had the opportunity to get the most incredible and sophisticated medical training from the best of the best, and we felt that she and Sophia got the highest-quality care possible when our granddaughter was born,” Sharon said. “We are indebted to those who provided her with a miraculous start.”


Home | About the NICU

Jessica Lambert and Mayra Pinilla Vera collaborate in the lab.

From left: Jessica Lambert and research fellow Mayra Pinilla Vera collaborate in the lab.

At Princeton University, rising sophomore Jessica Lambert found no shortage of opportunities to advance her studies and gain experience as she pursues a career in public health and indigenous studies. But as she considered her options for internships earlier this summer, one stood out above the rest: the Four Directions Summer Research Program.

Part of the Brigham’s Center for Diversity and Inclusion, Four Directions aspires to train the next generation of Native American health care leaders through an eight-week research internship with mentoring, networking and hands-on experience at the Brigham and Harvard Medical School. The program connects students with a faculty mentor, whom they work with on a basic science or translational research project, culminating in a final project presentation.

Celebrating its 25th anniversary this year, Four Directions has trained more than 200 students to date.

Lambert, an enrolled citizen of Choctaw Nation and a first-generation descendent in the Eastern Band of Cherokee Indians, said Four Directions surpassed all her expectations — offering not only a phenomenal learning opportunity but also a rare and meaningful chance to connect with other American Indian students.

“At Princeton, I’m only one of a handful of Native students, so the sense of community this program offered made it really special,” she said. “You’re able to talk about your experiences, and everyone will know what you’re going through. There was also an incredible support system beyond the students. Everyone was so welcoming and wanted to see us succeed.”

Four Directions is open to undergraduate rising sophomores, juniors and seniors from around the U.S. In addition to research, students participate in clinical shadowing, professional development workshops, weekly discussion groups, social activities and more.

Lambert, one of eight students in this summer’s cohort, interned with Rebecca Baron, MD, of the Division of Pulmonary and Critical Care Medicine, and contributed to research about respiratory disorders. On the clinical side, she shadowed Stanley Ashley, MD, of the Division of General and Gastrointestinal Surgery, and observed a hernia repair in the Operating Room.

Through activities like these, participants gain skills, experience and knowledge they can draw from to empower themselves, their communities and future generations of all Native Americans, said Thomas Sequist, MD, MPH, director of Four Directions.

We care. Period. logo“By advancing the representation of Native Americans in medicine, biomedical science and public health, this program is an essential part of addressing both diversity and equity in these fields,” said Sequist, who is also a physician at the Phyllis Jen Center for Primary Care and chief quality and safety officer at Partners HealthCare. “In addition, our faculty and staff are exposed to cultures and viewpoints different from our own while being challenged in new and thoughtful ways. Together, it makes us all better at what we do.”

Baron, who has served as a Four Directions mentor for 20 years, said it’s a joy to welcome the students into her lab each summer.

“I have always loved participating in this program, as I feel we benefit as much, if not more, than the students do. We have the unique opportunity to learn about their background and culture, and it is inspiring to see them grow and develop in our environment,” she said. “I have longstanding relationships with many of the students whom I’ve mentored over the years, and it is a true privilege to see them thrive and to see their careers develop.”


Home | Brigham Values | Four Directions Summer Research Program

Marianne Weiler displays a radiation therapy mask for pediatric patients painted to resemble Spider-Man.

Marianne Weiler displays a radiation therapy mask for pediatric patients painted to resemble Spider-Man.

Every superhero undergoes a transformation. Clark Kent turns into Superman. Peter Parker becomes Spider-Man. Diana Prince changes into Wonder Woman. And with a little help from Lead Radiation Therapist Marianne Weiler, MBA, RT(T), pediatric cancer patients who are undergoing radiation therapy at the Brigham have the option to transform into superheroes, too. 

Any patient receiving radiation therapy targeted to the brain must wear a special mask to keep their head in place during treatment. The material looks a bit like a fencing mask, covering the face with mesh or lattice-like holes that allow the patient to see, hear and breathe while being kept in place for their radiation treatment. To help make pediatric patients more comfortable wearing these masks, Weiler has started painting them with some familiar, friendly faces — depicting comic-book characters, for instance — so they look more like something you would find in a costume store than a hospital. She was inspired after seeing similar projects at other hospitals on social media. 

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“It hit a chord with me,” Weiler said. “Even if it offers these kids a little bit of comfort, it’s worth it because they go through so much already.”

After talking to her supervisors and co-workers about the idea, Weiler and her colleagues worked together to offer these decorated masks to their pediatric patients. 

“When Marianne asked if we could paint the masks, I thought it was an exceptional idea,” said Todd Vivenzio, MBA, RT(T), director of Radiation Therapy Services at Dana-Farber/Brigham and Women’s Cancer Center. 

The department has created a book of templates patients can choose from, and they welcome requests for custom designs. While superheroes have been the most popular choice, others have included one modeled after Boston Bruins goalie Tuukka Rask’s hockey mask.

“I just love what the kids come up with. They are so creative,” Weiler said. “One girl was talking about her love of chocolate, and that’s how we ended up with a mask depicting the M&M’s characters.”

Marianne Weiler paints a radiation therapy mask.

Marianne Weiler paints a radiation therapy mask.

‘Truly Uplifting’

Weiler usually receives requests via care team colleagues, including Pete Meagher, OCN, RN, a radiation oncology nurse, and Courtney Audet, a child-life specialist. Once she knows what the patient wants, Weiler makes a sketch, outlines it on the mask and then uses a combination of paint and markers to fill in the design with vivid colors. The process can take about an hour, but some requests, such as the Bruins mask, require more detail and can take almost twice as long. 

The art supplies are safe to use on the masks and don’t interfere with treatment. Patients who would like to keep the mask can safely do so.

In the few months since Weiler started the project, she has painted fewer than a dozen masks, but she believes even this seemingly small-scale effort has made a profound difference for patients and their families. When patients are comfortable wearing their masks, it can make them feel more at ease during treatment, which means they might be able to avoid the need for sedation — something often used with pediatric patients undergoing radiation therapy, as it can be difficult for small children to lie still for an entire treatment session. 

According to Weiler’s colleagues, the tangible difference the masks make for their young radiation patients is undeniable. 

“Seeing a child smile and run to their nurse or therapist with excitement as they show their custom design is truly uplifting,” Vivenzio said. “Moments like this, when the patient and their family have forgotten, even for a second, about why they are at the hospital, make what we do well worth it.”


Home | Radiation Oncology Care for Children

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Sumaira Ahmed

Five years ago, Sumaira Ahmed noticed a small black circle partially obstructing vision in her right eye. It expanded over the next two days, and soon she was unable to see out of that eye at all.

The development caught her off guard; Ahmed was in her mid-20s and otherwise healthy. But her loss of vision quickly escalated. One day at work at a previous job, she walked into a wall she hadn’t seen and collapsed.

“I got rushed to the hospital. I couldn’t really feel my hands, and I was experiencing burning and tingling sensations in my feet,” recalled Ahmed, who now serves as director of Strategic Marketing and Business Development at the Neil and Elise Wallace STRATUS Center for Medical Simulation.

After a battery of tests, Ahmed was diagnosed with neuromyelitis optica (NMO), a rare autoimmune disease that creates inflammation throughout the central nervous system — causing the immune system to misidentify healthy cells in the optic nerve and spinal cord as foreign invaders. NMO patients can experience vision loss, eye pain, paralysis of the arms and legs, and bladder or bowel incontinence, among other symptoms. Its cause is unknown, and it has no cure. For patients with severe forms of the disease, it can be fatal.

Despite the challenges of living with a chronic illness — which include receiving over 200 chemotherapy infusions since her diagnosis and undergoing surgery every six months to assist with the disease’s peripheral symptoms and side effects of treatment — Ahmed has kept a positive outlook. Since the beginning, she has believed there was a greater purpose behind her diagnosis.

It didn’t take long for her to find that direction. Two months after being diagnosed, she established The Sumaira Foundation for NMO.

Growing from a two-person operation to a 28-person, volunteer-based nonprofit, The Sumaira Foundation for NMO aspires to raise awareness of NMO and build a global community for patients and caregivers. The organization also fundraises to advance NMO-related research through two grant programs: the Spark Grant and Joannie’s Unicorn Grant, a pediatric-specific award named in memory of Joannie Rios, a 6-year-old NMO patient who died earlier this year. In June, Tanuja Chitnis, MD, of the Department of Neurology, was named the inaugural recipient of the Joannie’s Unicorn Grant, which will support her study evaluating the effects of NMO treatments in pediatric patients.

Bright Lights, Big Smiles

On a personal level, Ahmed hopes to inspire positivity among patients and their loved ones. The foundation’s social media presence and website are purposefully adorned with bright colors and cheery graphics, which frame its mission statement of “illuminating the darkness” around NMO.

“I want everything we put out there and everything we do to pick these people up and make their lights brighter and their smiles bigger,” Ahmed said. “There is a lot of heart in our organization. We genuinely just want to help.”

To keep the conversation going, Ahmed developed a multimedia platform called “Voices of NMO,” which enables people affected by the disease — including patients, caregivers and clinicians — to chronicle their experiences. In addition to raising visibility and providing an outlet for those who feel isolated, Ahmed hopes the project will help scientists and clinicians recognize new patterns related to the disease and possible therapeutic targets.

To date, the platform has shared more than 60 stories. Some include patients who were misdiagnosed with multiple sclerosis (MS), which manifests in similar ways to NMO but is a much different condition. Common treatments for MS can be detrimental to NMO patients, something Ahmed believes is crucial to increase awareness of within the medical community.

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“I want the foundation to be a pillar of hope and support for patients, showing that there is a light at the end of this tunnel,” Ahmed said. “I hope that our work eventually leads to a cure so that people don’t have to live in darkness.”

‘A Place Where You Belong’

In her work at the STRATUS Center, Ahmed says she is inspired every day by people who share her personal vision: to save lives.

“I have been able to apply a lot of what I learned at the Brigham to the foundation, and things are just flourishing because I’m fortunate to have both of them in my life,” she said.

Meanwhile, Ahmed’s colleagues at STRATUS are equally moved by her commitment.

“Sumaira is creative, bright, savvy and warm. She is one of the major reasons for STRATUS’ success,” said Charles Pozner, MD, executive director of the STRATUS Center.

Looking to the future, Ahmed hopes to one day open a physical center in Boston targeted to the medical and community needs of NMO patients.

“As a patient, you have no idea why this happened to you, and it’s hard to connect with other people,” she said. “I think building a brick and mortar that signifies a safe place of belonging, togetherness, understanding and hope would be a dream come true, especially at a place like the Brigham.”



From left: Terri Gorman, Karen Cashman, Corinne Cyr-Pryor and Katherine Gregory

From left: Terri Gorman, Karen Cashman, Corinne Cyr-Pryor and Katherine Gregory

In the four decades since Karen Cashman was a patient in the Neonatal Intensive Care Unit (NICU) at the Boston Lying-In Hospital, one of the Brigham’s predecessor institutions, much has changed. Most visibly, the environment of care for premature and sick infants is now the Mary Horrigan Connors Center for Women and Newborns (CWN). Yet, as Cashman was heartened to see during a recent visit to the Brigham, the exceptional warmth and compassion of those caring for the babies has remained the same.

To celebrate her upcoming 40th birthday and honor her beginnings, Cashman returned to the Brigham last month to mark a lifetime of gratitude for the excellent care she received for three months following her premature birth. She said coming back was an unforgettable experience and one made especially memorable when she reconnected with a Brigham nurse, Corinne Cyr-Pryor, RNC, MSN, IBCLC, who had cared for her at the Lying-In so long ago.

“This visit provided me with the gift to not only celebrate how far I’ve come but also to recognize and thank the providers who invest so much of themselves in the care of the Brigham’s tiniest patients,” said Cashman, who lives in Maine with her husband and two daughters.

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Cashman said it was an honor to meet with Cyr-Pryor, who continues to work in the NICU as a staff nurse and lactation consultant, and express her appreciation for her commitment to patients and their families. For Cyr-Pryor, seeing former patients like Cashman thrive and live happy, healthy lives is what has kept her working in the NICU for so many years.

“Babies are awesome, and the proof was in the wonderful woman, Karen, standing before us that day,” Cyr-Pryor said. “Helping these tiny patients and their families is a passion and a privilege.”

An Enduring Influence

During Cashman’s trip to the Brigham, she toured the NICU with Katherine Gregory, PhD, RN, associate chief nursing officer for CWN; Terri Gorman, MD, NICU medical director; and Lynne Blech, administrator for Patient/Family Relations.

Cashman learned about the evolution of the NICU and advancements in care that have taken place there throughout the years, including the installation of the first NICU-dedicated MRI in the country in 2018 and the recent NICU renovation and expansion.

Reflecting on her visit, Cashman said everyone she met welcomed her and made her feel she has always been a part of the Brigham family.

“Forty years ago, the Brigham made my family feel reassured, like we were in good hands, and that we had the best care on our side,” she said. “I believe no matter if you had a healthy start, have met great adversity or are somewhere in between, it’s beneficial to pause and reflect on your life, celebrate who you have become and acknowledge those who’ve helped to get you where you are today.”

As an infant and throughout childhood, Cashman and her mother participated in Harvard Medical School studies. Cashman was surprised to find out much later in life from her mother that her baby teeth did not go to the “tooth fairy” but to research. Today, her family still believes in the importance of improving care through discoveries.

“While I know I am just one of many babies who contributed to the advancement of care, it’s amazing that somehow my contribution helped with the progress of medicine, in particular premature births,” Cashman said. “I like to think what I was a part of at the time helped to create a more promising world. I believe my care, possibly my life, could have been much different if I did not end up at the Brigham.”

Her experiences as a patient also inspired her to pursue a career in the health care industry, most recently as public relations director for Northern Light Health, an integrated health care system in Maine. Through her job, she enjoys paying her gratitude forward.

“I use my love of words and communication to uplift others and help them find hope and reassurance when they may need it most,” she said. “Having a career in health care is an important piece of who I have become.”



Angel Ayala displays one of the new media carts.

Angel Ayala displays one of the new media carts.

When a Brigham patient realized being hospitalized meant she wouldn’t be able to watch the Game of Thrones series finale in May, she was disappointed. But thanks to the compassion and creativity of the Brigham’s Audiovisual Services team, she was able to see who ended up ruling the fictional world of Westeros, after all.

Angel Ayala, a senior Office Services technician, provided the patient with a custom-made media cart — equipped with a 32-inch smart TV, Wi-Fi capability, a Blu-ray player, USB ports and a retro Super Nintendo game console — that he had recently designed and assembled. Patients can borrow one of the four carts upon request during their stay.

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Ayala created the carts to provide an entertainment option that offers some of the digital comforts of home, such as streaming video services. The inspiration to create the media carts came from Ayala’s observations as a member of the Audiovisual Services team and from his personal experience as a patient at the Brigham. While there are TVs installed in patient rooms at the hospital, they have limited capabilities.

“The carts help to bring a little joy to patients while they are staying at the Brigham and makes their time here a little easier,” Ayala said. “Whether they’re having a bad day, recently received some difficult news or just need some time to unwind, patients can use the cart to watch a favorite show or view something on YouTube, for example.”

Collaborative Spirit

Following the initial idea, Ayala began researching parts and devices for the carts that could work within the space limitations of patient rooms and be easily maneuvered so as not to block medical equipment. He contacted other departments, including Patient and Family Relations, to share his idea and see how they could help deliver the carts to patient rooms.

The first media cart was ready for patient use just a few weeks after Ayala started working on the project in April.

Peter Linck, manager of Office Services, praised Ayala for turning the idea into reality.

“Angel shows great collaborative spirit, always wanting to work together to make things better and to approach challenges and drive creative solutions,” Linck said. “He truly leads by example.”

Requesting to use one of the media carts is easy. Patients and their families, as well as faculty and staff, can contact Patient and Family Relations or the Audiovisual team directly. Ayala or one of his team members will deliver the cart and walk the patient or family member through its components.

Ayala also worked with the Department of Biomedical Engineering and Central Transport to equip the carts with tracking devices so that Ayala and his team can monitor their real-time location and coordinate pickup and return. The team also collaborates with Infection Control to ensure the carts are sanitized before and after each use.

“Most departments under Materials Management don’t usually have direct interactions with patients, so the AV team taking this opportunity to build the media carts is such a great gesture — helping our patients and their family members feel more comfortable during their stay here at the Brigham,” said Jonathan Santiago, director of Materials Management.

A fifth media cart is in the works thanks to a donation from Red Thread, a vendor that works with the Brigham to design and equip workspaces.

Lisa Lauritzen, RN, noticed firsthand how the media carts made a difference for one of her patients.

“It was an opportunity for my patient to keep his mind active and enjoy a fun activity,” said Lauritzen, a nurse in the Orthopaedic Surgery unit on CWN 7. “It made me feel like, for that one brief moment in time, I made a difference in this patient’s day.”

While Ayala had originally envisioned his project as a tool to help patients pass the time in a hospital bed, he quickly realized that the carts had other uses, too. One of the first requests for the media carts came from a patient approaching end of life who wanted to use the screen to display family photos and videos. Using USB ports installed on the cart, family members were able to connect their phones and enjoy the heartwarming images during an otherwise difficult time.

“It felt nice knowing that the media cart was helping them share memories with each other,” he said.

Ayala is also considering adding some other updates to the carts, such as a mini-computer and a streaming media device — all aimed at continuing to improve the patient experience.

“This is exactly the kind of work that Angel is best at: developing ideas, inspiring others to join in the work and building on the interest and feedback generated from such exciting projects, all of which, in turn, lead to future ideas,” Linck said.

For more information about the media carts and how to reserve them, contact Patient and Family Relations at 617-732-6636 or Audiovisual Services at or 617-732-8627.