Brigham emergency physician Morgan Broccoli captures this scene in İskenderun, Turkey, where she deployed with Team Rubicon to assist with disaster response after a devastating 7.8-magnitude earthquake struck the region.

On the morning of Feb. 6, Brigham emergency medicine physician Morgan Broccoli, MD, MSc, woke to the news that a 7.8-magnitude earthquake had hit Turkey and northwestern Syria. By noon, she was exchanging texts with other members of Team Rubicon, the humanitarian organization she has been involved with since 2021. A team was mobilizing, and they wanted to know if she could join.

Broccoli immediately replied: Yes. She had experience volunteering in Haiti after the 2021 earthquake and in Poland last year during Russia’s invasion of Ukraine. She also happened to be off for two days and had supportive colleagues in the Brigham’s Emergency Department who helped cover her six upcoming shifts. “Everyone in my department was amazing,” she said. “I was on a plane by 6 p.m. that same night.”

Remote Support Activated

As Broccoli headed to Turkey, several of her Brigham colleagues heeded the call to help in other ways.

“Coordination of humanitarian response efforts is complex,” explained Sean Kivlehan, MD, MPH, emergency medicine physician and director of the Emergency Health Systems Program at the Harvard Humanitarian Initiative (HHI). “On-the-ground personnel are needed to offer immediate aid, forge relationships and provide direct situational awareness while collecting key data. Remote support is important because it connects the various on-the-ground actors to ensure coordination and planning, and allows for the rapid aggregation and dissemination of data.”

As HHI’s representative to the World Health Organization’s (WHO) Global Health Cluster based in Geneva, Kivlehan works to strengthen all aspects of humanitarian response, particularly within the health sector. After the Turkey-Syria earthquake, the Health Cluster focused on sharing and analyzing data, as well as connecting health experts and partners in their networks to address urgent needs.

One of those experts was Brigham endocrinologist M. Furkan Burak, MD, who had both personal and professional ties to the country. In addition to being a native of Turkey, he served as ambassador to the U.S. for Turkey’s Ministry of Health (MoH). When the earthquake hit, Burak was devastated. “First, this is a humanitarian crisis. And second, I’m Turkish, so there I was, thousands of miles away from my country and my people. I felt helpless.”

“There I was, thousands of miles away from my country and my people. I felt helpless,” said endocrinologist M. Furkan Burak, recalling his initial reaction to the crisis in Turkey.

Advised by his friends and colleagues in Turkey not to come, Burak made the difficult decision to stay in Boston, where he leveraged his connections to serve as a local coordinator between Turkey’s MoH and the Turkish Consulate General in Boston. Providing support remotely, Burak connected with HHI and other contacts to distribute Turkey’s list of urgent health needs and ensure the right supplies were delivered to the right place as efficiently as possible.

Assessing the Needs

Broccoli and colleagues were some of the first to arrive in Turkey, where they found the country’s government requesting type 2 and 3 emergency medical teams (EMTs), which have surgical capacity as classified by the WHO, as part of their focus on the search-and-rescue effort. Team Rubicon is considered a type 1-mobile EMT, approved only to provide outpatient emergency and primary care.

“I found it remarkable that the entire world seemed to be in Turkey, wanting to help,” she said. “There were urban search-and-rescue teams from all over the world. There were also many non-governmental organizations waiting just outside the affected area to assist with medical, logistics and water, as well as sanitation and hygiene needs.”

Broccoli spent two weeks in the southern Turkish city of Adana, about 140 miles from the quake’s epicenter, where she provided the WHO with critical medical needs assessments. She attempted to travel to Syria to assist efforts there, but it was ultimately determined too unsafe. “I would have liked to do more, but the system was created for a reason,” she said.

That perspective resonated with Erica Nelson, MD, MPhil, MS, Brigham emergency medicine nocturnist and Team Rubicon’s deputy medical director, who supported Broccoli from the U.S.

“This is largely about rejecting a colonialist model of humanitarian aid,” she said. “We are not going to come in and tell you what you need, and we are not going to traverse your space without an invitation. The most effective response is when you support local infrastructure and local expertise.”

The day the earthquake struck, Nelson was putting in 60-hour weeks of clinical work in Navajo Nation through a partnership with the Indian Health Service. Even so, she managed to make time for all the backend work that is critical to any disaster response — advising on a variety of needs, including ethics, security, logistics and mobilization, and monitoring and evaluation.

Reflections in the Aftermath of Disaster

Now back at the Brigham, Broccoli, Nelson, Burak and Kivlehan have been reflecting on their recent experiences.

“Humanitarian crises, even with all of their tragedy, are remarkable for the good they bring out in society and are a reminder that while there is much work to be done, the desire to improve humanity is there,” Kivlehan said. “All of us humans are in this world together, and we need to work collectively to reduce suffering wherever it is found.”

Broccoli is currently involved in a large-scale trauma education project in Ukraine, and will continue seeking humanitarian response opportunities outside of the U.S. “While I enjoy helping offload the system in acute response, the more important work is to prepare countries to respond internally to their own disasters,” she said.

For Nelson’s part, she is now helping support a response to Cyclone Freddy in Malawi, working to support local health and WASH (water, sanitation and hygiene) infrastructure in Guatemala, and continuing to foster opportunities to build local capacity for disaster response.

Burak has a trip to Turkey planned in May, where he will visit the earthquake site and assess the mental and physical health needs of the area’s young people. He is also hoping the trip will help him further process his feelings. Since February, Burak has had flashbacks of carrying bodies after the 1999 İzmit earthquake, one of the country’s deadliest natural disasters.

“Witnessing that horrible scene as a child was what made me decide to be a doctor, because I didn’t want to feel helpless,” he said. “I know there are many things we will have to do in the days, weeks, months, years and decades ahead. We will be helpful.”

“This place is essential,” says longtime Performing Arts Clinic patient and violinist Judith Eissenberg, who brought her instrument to a recent appointment.

In 2008, violinist Judith Eissenberg received an invitation to perform Quartet for the End of Time, a piece whose haunting title evokes the conditions in which it was composed and premiered — in a Nazi prison camp during World War II, by French composer Olivier Messiaen while he was imprisoned there.

“It is the most fabulous piece, almost an hour long,” said Eissenberg, a chamber musician for more than 40 years and a professor of music at Boston Conservatory at Berklee.

Soon after rehearsals began, Eissenberg started to experience pain, numbness and tingling in her left arm. She pushed through the discomfort for the first concert, but during the next performance realized the issue was more serious than she had thought.

“I remember during the second concert seeing my bow do this really weird thing and my finger was sticking up in the air and shaking,” she said.

Eissenberg saw a sports medicine doctor and tried conventional physical therapy but did not see much improvement. A fellow musician referred her to neurologist Michael Charness, MD, founding director of the Brigham’s Performing Arts Clinic.

Established nearly 35 years ago, the clinic provides highly specialized care for musicians with performance-related injuries and disorders. The multidisciplinary team sees injuries including overuse injuries, musculoskeletal problems, such as tendinitis, hand, neck and other body pain, and neurological problems, including ulnar nerve entrapment, carpal tunnel syndrome, as well as movement disorders including tremors and focal dystonia (involuntary muscle spasms).

Surgery isn’t always required, but it can be beneficial for some patients. The clinic collaborates with the Hand and Upper Extremity Service in the Department of Orthopaedic Surgery for surgical treatments.

“Studies have suggested the overwhelming majority of symphony players will have an injury at some point in their careers,” Charness said. “The mechanics of their instrument may be contributing to their injury, so we can make modifications. We can sometimes help them by simply changing their time management and encouraging a break from practice every 20 to 25 minutes.”

Personalized Care That Strikes a Chord

Upon seeing Eissenberg for the first time in late 2008, Charness immediately recognized the source of her discomfort — in more ways than one. She had an ulnar nerve entrapment, a condition that occurs when a nerve that runs along the forearm becomes pinched, often due to repetitive movement. It is sometimes corrected with surgery to release the nerve, a procedure Eissenberg ultimately underwent at the Brigham in December 2008.

Part of the reason his patient’s symptoms were so familiar to Charness is that he is a musician himself, a pianist, who had suffered from ulnar nerve entrapment when he was a postdoctoral fellow at the University of California, San Francisco (UCSF) and played in a musical trio.

“I was fortunate the violinist in my trio at the time was a neurosurgeon who said, ‘I think you have an ulnar nerve entrapment. Let me fix it,’” Charness recalled.

Neurologist Michael Charness, the clinic’s founding director, is also a pianist.

That encounter shaped the course of his career.

After he healed from surgery, Charness started seeing musicians in the back of his UCSF lab who had their own hand and arm problems. The program became known as the Health Program for Performing Artists at UCSF. When he came to Boston in 1989, he started the clinic at Brigham and Women’s. Since then, the clinical team has grown to include Performing Arts rehabilitation specialists, including occupational therapist Kelly Belinsky, MS, OTR/L and physical therapist Joanne Bosch, MSPT, CHT, as well as neurologist Christopher Stephen, MD, FRCP, SM, physiatrist and hand specialist Scott Homer, MD and psychiatrist Samata Sharma, MD. The team’s three physicians are musicians, as well.

“It helps a lot to understand the precise nature of musicians’ movements, the postures they have to be in and the stresses they deal with,” said Stephen, also a pianist. “But with the incredibly complicated and dexterous things musicians can play come a lot of potential problems.”

The team’s vast personal and professional experience in performance-related injuries has given them a keen understanding of how best to care for this patient population and what matters most, Homer added.

“The act of jumping from provider to provider, looking for a reliable assessment, can be stressful and delay recovery — adding to the musician’s woes at a potentially high-pressure time in their careers,” he said.

‘Absolutely Essential’

For Eissenberg, getting back to performing after surgery wasn’t an easy feat, but it was one she was prepared to take on. She started practicing again for just one minute at a time, three times per day, and gradually built up her endurance for her next performance in March 2009. Charness assured her that while she wouldn’t be able play the whole concert during practice, she would make it through entire pieces.

“It was a prestigious concert, all Beethoven,” she said. “I got up there in March and we played it.”

Since then, Eissenberg has regularly returned to the Performing Arts Clinic to maintain her function and proactively address potential issues. It’s a message she passes onto her students at the Boston Conservatory, even referring some who report hand and arm pain.

“I just sent one of them to the clinic. He also started out with a sports doctor, but this is a different kind of sport,” Eissenberg said.

Just like athletes need specialized care, Eissenberg said musicians need the Performing Arts Clinic.

“This place is essential — absolutely essential,” she said. “I have my life back.”

Currently, the Performing Arts Clinic sees patients on Saturdays. The team hopes to add more providers to increase access and further research surrounding musician injuries.

“People are coming to us and saying, ‘How can I not lose my livelihood, my love of music, my love of playing?’” Charness said. “That really resonates with us.”

From left: Noelle Castilla-Ojo, Adam Beckman and Rebeca Vergara Greeno are among the 248 medical students who matched with a Brigham residency program this year.

Across the 18 Brigham residency programs participating in Match Day — when thousands of medical school students across the country discover where they will continue their medical training — 248 aspiring physicians matched at the hospital this year.

“We are so excited by our Match Day results and to welcome this amazing group of interns,” said Maria Yialamas, MD, director of the Brigham’s Internal Medicine Residency Program, which will welcome 77 interns this summer. “We are thrilled by the diverse backgrounds and interests of these talented physicians who will become health care leaders. The future is very bright.”

Yialamas added that 56 percent of this year’s class of Internal Medicine interns are women and 27 percent represent racial or ethnic identities that are underrepresented in medicine (URiM). Across all Brigham residency programs, 54 percent of matched interns are women and 21 percent are URiM trainees.

Current Brigham intern Sachit Singal, MD, said he looks forward to being there for his newest colleagues as they embark on the next stage in their training.

“As cliché as it may sound, the people that comprise ‘the Brigham family’ are its strongest asset, and it has been wonderful to become a part of that family over the past year,” he said. “As I transition into second year and begin leading medical teams, I aspire to cultivate an environment in which my interns feel safe, supported and confident to pursue their learning and growth as physicians, much like the environment I was given this past year.”

In celebration of Match Day 2023 on March 17, Brigham Bulletin spoke with three newly matched interns to hear what inspired their paths to medicine.

From Nursing Assistant to Doctor, Advocating for Patients All the Way

Noelle Castilla-Ojo’s path to becoming a doctor was inspired by her immigrant parents. “My mom was one of 12 kids growing up in the Philippines and didn’t go to college — not because she didn’t want to, but because she didn’t have the opportunity,” Castilla-Ojo said. “My parents always encouraged me to get an education and do something that would make me happy.”

It turned out that taking care of others is what makes her the happiest. When Castilla-Ojo was 3 years old, her mother, Conchita, who didn’t have access to health care, became a nursing assistant. “My mom took such great care of others, but she had no one to take care of her,” Castilla-Ojo said.

From left: Noelle Castilla-Ojo celebrates her match with her mother, Conchita.

Following in her mother’s footsteps, Castilla-Ojo worked as a nursing assistant in a memory care unit while in college at Northeastern University.

“I really enjoyed caring for people and giving them pieces of their life that they used to enjoy, like their favorite food or music or clothing,” she said. “That felt like a really important part of the care process.”

Seeking more leadership opportunities and the ability to have greater impact, Castilla-Ojo decided to pursue a medical degree and was accepted to Harvard Medical School (HMS), where she went on to co-found a geriatric outreach club that pairs students with residents at senior living facilities. Though originally conceived as a program focused on having students accompany the residents to their medical appointments, the club shifted its focus during the pandemic to remote outreach to help patients combat loneliness and social isolation.

On Match Day, with her mother and her partner, Justin, by her side, Castilla-Ojo opened her envelope and was overjoyed to find that she had matched into the Brigham’s Internal Medicine Residency Program.

“It felt surreal,” she said. “You think about matching the entire time you’re in medical school, and then it finally happens. All my cousins and aunts and uncles in Nigeria and the Philippines were all sharing pictures and celebrating along with me. I’m the first to attend college in the U.S., so this means so much to me, as well as to the many people who have bolstered me up to this point.”

Castilla-Ojo is excited to join the Brigham, a place she knows and loves.

“I wanted to become a doctor who does more than just prescribe,” she said. “When I did my primary rotations at the Brigham, I saw residents being praised for taking care of their patients in many ways other than just with medication. That’s the type of position I want to be in.”

She looks forward to learning best how to advocate for her patients.

“In this primary care program, there’s an emphasis on social justice. I’m excited to be mentored and do more work with health disparities within geriatrics,” she said. “I’m just really grateful for the opportunity, and I’m sorry in advance for all the questions I’m going to ask!”

Answering an Unexpected Call to Serve — from the U.S. Surgeon General

Adam Beckman describes his grandmother as one person who inspired him to pursue medicine. Trained as a social worker, she continues — in her 90s — to provide mental health care for her patients. She taught Beckman from an early age about injustices in the health care system and the responsibility to promote social justice.

“She taught me about healing relationships — about the power of using one’s voice to advocate for people left unheard,” Beckman said. “At the Brigham, I was pulled in by the way trainees talk about clinical care and the range of work they are doing to address the challenges of accessing needed medical care in America. Learning from them makes me honored and delighted to join the Brigham internal medicine and primary care community.”

Adam Beckman (right) walks with U.S. Surgeon General Vivek Murthy (left) in December 2021.

As an undergraduate, Adam got a taste of interdisciplinary work related to medicine and the role physicians can play. With the Global Health Justice Partnership at Yale University, he was part of a team working to improve access to hepatitis C medications among incarcerated populations.

“I was struck by the power of doctors, epidemiologists, lawyers and government officials working together to tackle a medical and public health crisis,” he said.

During medical school at HMS, Beckman had the unusual opportunity to again be part of such interdisciplinary work. He was asked by Brigham alum and U.S. Surgeon General Vivek Murthy, MD, MBA, to serve as a special advisor to the surgeon general during the thick of the COVID-19 pandemic. Beckman described taking a one-year leave of absence to work in the Biden-Harris Administration as both terrifying and a remarkable chance to serve.

Looking back, Beckman said working in government helped give him perspective on the role of clinicians.

“Federal government is — at its best — simply a lot of people working hard to make our country, our medical system and our public health infrastructure better,” he said. “I have met many medical students, residents and health care workers we would be lucky to have contributing to that work.”

As he prepares to begin his residency at the Brigham, Beckman is focused on learning to be part of a clinical team and become a highly skilled doctor, a journey he knows takes a long time. He sees the Brigham as a very special place to train for those roles.

“In many ways, what I am most looking forward to is meeting my co-residents and being part of this community,” he said.

Though unsure precisely where his path will go, Beckman hopes to follow in his grandmother’s footsteps.

“She has shown me that serving patients until the final years of one’s life can be deeply impactful and bring continuous joy,” he said. “I hope to experience that too.”

Driven to Care for the Vulnerable

Rebeca Vergara Greeno’s interest in medicine came from an unlikely place: a lack of exposure to medicine and doctors growing up. “My family didn’t have any health insurance for a period of time during my childhood,” she said. “I think I went to maybe one doctor, which is kind of a rarity. Luckily, I was a healthy kid.”

Unfortunately, not all her family members were so fortunate. Her close-knit family moved from Guatemala to Las Vegas when she was a child, and they all lived in the same apartment complex.

“I had the experience of seeing one of my uncles pass away from liver cirrhosis in his own home because he didn’t have health insurance and didn’t go to the hospital,” Vergara Greeno recalled.

She also watched her Norwegian-American mother struggle to access care for a curable type of skin cancer.

“It was cheaper for her to go back to Guatemala than to pay out-of-pocket costs here in the U.S.,” she said. “It wasn’t until my mom finally qualified for health insurance through the Affordable Care Act that she was able to get proper treatment. Although I didn’t know it at the time, watching my family struggle with the many social factors that deter people from seeking medical care helped shape my earliest interest in medicine.”

Vergara Greeno’s desire to go into medicine was kickstarted in college when she started working as an interpreter in a free clinic.

“I saw a whole population of uninsured people who were dealing with many more issues than my family had, including not being documented,” she said. “That’s when I really connected with that patient population and felt like medicine was a place where I could be the most useful.”

She continued on that path in medical school at Yale School of Medicine, where she became one of the directors of a student-run clinic that served a large population of uninsured patients during the peak of COVID-19.

As an aspiring doctor, Vergara Greeno believes her experiences help her empathize with patients.

“I think I can connect and build trust with patients, but I also understand I can’t assume I know everything about a patient based on a shared culture or experience,” she said. “I try to ask open-ended questions and stay open to all possibilities.”

Vergara Greeno was ecstatic to learn she had been matched with the Brigham.

“There are a lot of things at the Brigham that really overlap with my interests, including their global health work in Guatemala,” she said. “There’s also a very strong primary care track where I can build on the knowledge that I have. My focus is on becoming a well-rounded primary care physician so I can give my patients the best care possible. And I think the Brigham is the best place to do that.”

From left: Liz Yates and Louis Nguyen

When Liz Yates, MD, MPH, began her surgical residency at the Brigham, she brought along her deep interest in climate change and desire to make a difference.

“I think climate change is going to have a big impact on resources and disparities in the future,” she said. “I wanted to help reduce our contribution to climate change as a systemic issue and a global problem.”

In 2020, Yates was paired with mentor Louis Nguyen, MD, MBA, MPH, vascular surgeon and vice chair for Digital Health Systems in the Department of Surgery, to investigate potential projects. Together, they developed and championed Watching Our Waste, an initiative to reduce the incorrect use of red medical waste bags in surgical and procedural areas.

Red bags are used in Operating Rooms (ORs) and other clinical areas of the hospital to safely dispose of materials that are saturated with blood or other biohazardous waste. However, they are often used incorrectly to dispose of lightly soiled gowns, gloves and similar items. This improper use carries a financial and environmental cost: Not only is red bag waste five times more expensive to process than regular trash, but it also releases more greenhouse gas emissions during processing. The higher costs occur because red bag waste is transported to a special facility in Rhode Island to be autoclaved — a process that uses high-pressure steam to sterilize materials — for decontamination before it can be transported to a separate waste-to-energy facility.

“The project developed as a kind of nexus of our two interests, and it’s been a really incredible collaboration,” Yates said. “We combined my background and education in climate change and climate science with Dr. Nguyen’s unique experience and expertise in behavioral economics, which is the approach we’ve leveraged to get people to change their behavior.”

Getting Buy-In

Although Nguyen understood that reducing red bag waste was a worthy goal, he knew that for the project to be successful they would need buy-in from incredibly busy staff who were focused on patient care. That’s where his background in behavioral economics came in.

“My contribution to the project was to turn Liz’s interest in the environment into something that was implementable and respectful of everyone’s primary jobs, which is taking care of patients,” he said. “We wanted to come up with a solution that made it easy for staff to make the right choice, but still preserved their autonomy. So, we came up with a set of systems that would benefit the environment and implemented them into the regular workflow.”

In designing the program, Nguyen and Yates involved all stakeholders, including clinical staff and leaders in Environmental Services and Infection Control, to incorporate their feedback and ensure any proposed changes would not compromise patient and staff safety.

Loay Kitmitto, director of Environmental Services, was an enthusiastic supporter. “Red bag waste is so much more expensive to process, and we knew that it was being used incorrectly,” said Kitmitto. “We had wanted to make these changes for a while, but it helped to have the backing of the physicians who are actually working on the floor.”

From the start, they also had the support of Gerard Doherty, MD, surgeon-in-chief. “Having senior leadership recognize that this is an important project was a great boost to our efforts, because it takes a team effort to make a difference,” said Nguyen.

Implementation Brings Positive Change

Behavioral economics is a research field that uses psychology and economics to understand why people and societies behave the way they do — particularly when it acts against their interests — and applies these insights to encourage the desired actions.

Using these concepts, the team devised a simple plan to reduce red bag waste in the ORs: Make access to red waste bins slightly less convenient than the regular trash bins.

“In most of these surgical areas, the red waste bins had been the most available and easiest to reach, making it easy to use them incorrectly,” Yates said. “Instead, we made the openings for those bins a little smaller and put them a little further away. So now, as a clinician, you have to consciously choose to use that red bin, rather than it being the default. This enables clinicians to make the ‘right’ choice more easily, without impeding their workflow.”

After its initial pilot in the ORs, the project has since been adopted in Cath Lab and other procedural areas in the hospital. Overall, red bag waste at the Brigham has dropped by 29 percent in the ORs post-implementation, with even larger reductions expected in other procedural areas.

“We’ve really reduced our red bag use in the Operating Rooms and have almost eliminated them in the Cath Lab, so that’s been really rewarding,” said Yates.

The team has also developed and implemented a tool to track how much waste each area of the hospital is producing, which had never been done before.

“Each month, I collect data from the hospital’s waste managers and vendors to track recycling, trash and compostables, and one of our team members builds it into a monthly dashboard,” Yates said. “Now we can actually see improvements, and we’re starting to break it down by each area of the hospital, so we can tell where the waste is coming from and how different areas of the hospital are changing over time.”

Expanding the Reach

The Watching Our Waste team is now rolling out other initiatives to reduce waste across the Brigham and other Mass General Brigham hospitals, such as BWFH and Salem Hospital.

When working on new projects, Yates said the team seeks to act as consultants.

“We never impose our perspectives or viewpoints on a clinical working space, but we do leverage our connections as clinicians with boots on the ground,” said Yates. “We go into a space, see the day-to-day activities and ask everyone who works there what they want improved. Then we come up with a few recommendations and get them approved by all leadership before we implement any processes. It’s really effective to get buy-in on the front end so that we don’t face much resistance with actual implementation.”

Both Yates and Nguyen said that one of the biggest wins for the project has been the positive feedback they’ve received.

“I think our greatest impact has been to help change the culture,” Nguyen said. “We let people know it’s good to think about environmental issues as a part of all the other things we do in the hospital, and we want to continue this approach of collaboration among different groups as a platform for further change.”

Allegra Campagna, pictured at Flathead Lake in Montana just a few months before experiencing a life-threatening cardiac event, is one of the first Brigham patients to undergo an innovative method of aortic bypass surgery for people with Marfan syndrome, which Campagna recently learned she has.

After getting up for work one morning in October 2021, 27-year-old Allegra Campagna experienced an excruciating chest pain unlike anything she had ever felt before.

“I had this ripping, bursting feeling I described as like a flower blooming in my chest,” she recalled.

Then a clinical psychology graduate student living in Washington state, Campagna enjoyed an active lifestyle filled with hiking, ballet and other exercise. She never imagined she might have a serious health condition at such a young age.

When her symptoms did not resolve, she went to a local hospital, where doctors discovered a ruptured aneurysm in her aorta, the body’s largest artery. She was quickly transported by air ambulance to a hospital in Spokane for emergency surgery and was later diagnosed with Marfan syndrome.

That turbulent and frightening day changed the course of Campagna’s life. Now, nearly a year and a half later, she is grateful to the multidisciplinary team of experts at the Brigham who performed a lifesaving, complex and innovative cardiac procedure that has set her on the path to healing and getting back to what she loves most.

Sudden Changes

Marfan syndrome is a genetic disorder that occurs in about one in 5,000 people and affects the body’s connective tissue, which are the fibers that provide support for and anchor the organs, as well as other structures in the body. The condition can cause complications in the heart, blood vessels, skin, lungs and bones, among other organs. If the aorta is affected, as in Campagna’s case, Marfan syndrome can become life-threatening.

“That was a whirlwind,” she recalled. “I went from pretty normal and healthy to, ‘You have this genetic condition that affects multiple areas of your body.’”

Although Campagna’s emergency surgery in 2021 succeeded in saving her life, her diagnosis required a complete lifestyle change and monitoring to prevent another episode. According to the Marfan Foundation, patients with Marfan syndrome are strongly recommended to avoid strenuous physical activity in order to avoid injuring their heart.

Shortly after moving to Boston in June 2022 to begin her final year of training for her clinical psychology program, Campagna had another health scare when she experienced severe abdominal pain one day. She went to the Brigham’s Emergency Department (ED), and a CT scan showed that she had a second aneurysm in her aorta.

After being cared for by the ED’s multidisciplinary Code Aorta team, Campagna was referred to cardiologist Rajat M. Gupta, MD, of the Heart and Vascular Center, and Kim de la Cruz, MD, FACS, FACC, FCCP, section chief of Aortic Surgery in the Division of Thoracic Surgery, co-director of the Aortic Disease Center, to determine the most appropriate treatment.

“In someone with her condition, we recommend surgery to address an aortic aneurysm before there’s a rupture,” Gupta said.

Detailed imaging shows the difference between Campagna’s enlarged aorta before surgery (left) and after the aneurysm was repaired (right).

De la Cruz evaluated Campagna for an open thoracoabdominal aortic aneurysm (TAAA) repair. The surgery involves replacing large portion of the aorta with a graft and reconnecting the smaller arterial vessels to the respective organs. In Campagna’s case, her aorta needed to be replaced almost completely from the chest to the abdomen, a section known as the thoracoabdominal aorta. Then, the blood vessels branching off it — which supply blood to organs like the liver, kidneys, stomach, intestines and lower extremities — needed to be reattached.

“The normal size of the aorta is about an inch wide. An aneurysm is any abnormal enlargement of the aorta. An aortic aneurysm needs surgery when it grows to over two inches,” de la Cruz explained. “In Allegra’s case, her thoracoabdominal aorta grew rapidly to about the size of a soda can, meeting criteria for repair. Otherwise, without repair, her aorta is in danger of bursting or leaking out blood, and that causes pain, organ damage and death.”

A Safer Approach

Because patients with Marfan syndrome have soft aortic walls, this extensive surgery is the best approach, de la Cruz explained. Patients without this complication are usually better candidates for endovascular repair, which is a minimally invasive procedure that involves inserting a graft through blood vessels in the groin.

Still, open TAAA repair is not without risks. Because of the complex nature of the surgery, the risk of paralysis, renal failure and death after surgery is high.

De la Cruz is an international expert in a version of the procedure known as TAAA repair with left heart bypass, which has significantly lower rates of complications. De la Cruz was recruited to the Brigham for his expertise in performing this procedure, which he learned in Houston from one of the world’s most experienced and leading experts in it, Joseph Coselli, MD, FACS.

What makes this form of TAAA repair safer for Marfan patients, yet also far more complex to perform, is that it uses a left bypass, rather than the standard full bypass, de la Cruz explained. This allows the operating team to transfer blood to other parts of the aorta not being worked on during the surgery. It results in far less bleeding, a reduced dose of blood thinners and a significantly lower rate of complications compared to the full bypass procedure.

The Brigham is the only hospital in New England to offer this approach.

“We’ve done four of these procedures in the hospital so far,” de la Cruz said, “and all of the patients have walked out of the hospital with good outcomes.”

Allegra Campagna (center) and her boyfriend, Kyle Schofield (left), share a moment with cardiac surgeon Kim de la Cruz (right) during a post-op visit.

Stronger Each Day

Although the prospect of heart surgery was daunting, Campagna said her team’s honest communication and patient-centered approach alleviated many of her worries. She underwent the procedure in November 2022.

“Dr. de la Cruz was really good at explaining what was going on,” Campagna said. “He had goals for every day — stabilize blood pressure, increase hemoglobin level — written on the whiteboard in my room, and it felt very collaborative. I really appreciated that.”

The surgery left Campagna with a scar across her stomach, left ribcage and back, and a painful healing process immediately after. Despite the initial challenges, Campagna said her strength continues to improve, and she remains grateful for the support of her loved ones.

“I know it sounds like cliche, but you definitely have your ups and downs,” Campagna said. “I have to remember that, on average, I’m doing a lot better than I was last week, and I’m doing better today than I was yesterday.”

Now four months out from surgery, Campagna must return for yearly follow-ups to ensure her heart and aorta remain in good condition. While she remains cautious about placing undue strain on her body as it continues to heal, she has been cleared to resume all the activities she enjoyed before, including hiking, walking and ballet.

Gupta expressed his admiration for Campagna’s optimism throughout her diagnosis and treatment.

“She’s just really a remarkable person who has been a pleasure to take care of,” Gupta said. “I think she’s been through a lot, yet she’s always had really good attitude and has been eager to get better and help others with Marfan Syndrome.”

Phelicia Cadet snuggles with her son, Kashden.

As a mother-to-be, Phelicia Cadet had one wish: a healthy pregnancy and birth.

Yet as an African American woman, Cadet and her baby were at disproportionately higher risk for complications during both of those events. When she gave birth to a healthy baby boy, Kashden, at the Brigham last spring, Cadet was relieved and overjoyed to experience exactly what she wished for — something she says she could not imagine achieving without the support of her doula.

“She was the other person who had my voice,” Cadet, 28, said of her doula, a person trained to provide physical and emotional support to pregnant patients and their loved ones before, during and after childbirth.

Although not medical professionals, doulas offer education, companionship, advocacy and guidance around prenatal care, labor and delivery, breastfeeding, infant care and more. Doulas also often serve as liaisons between a patient and their medical team, helping families communicate their goals and understand information about birth interventions, pain management and other aspects of their care.

“She was like a second family member for me,” Cadet said. “I could trust her, and I knew everything would be OK because I was in the hands of somebody who understood me, could guide me through this and would make sure I had a safe pregnancy and birth.”

Studies have shown that doula support is linked to improved outcomes for mothers and babies, including lower rates of unplanned cesarean sections (C-sections), but access to doula services is not equitable. Doulas are usually not covered by health insurance, and paying out of pocket can be expensive. A birth doula, for instance, can cost several thousand dollars — putting it out of reach for many of the patients who might benefit most.

Early in her pregnancy, Cadet was excited to learn from her Brigham obstetrician, Nicole Smith, MD, MPH, of the Division of Maternal-Fetal Medicine, that she was eligible to participate in a program that would pair her with a doula for free.

One of 19 pilots supported by Mass General Brigham’s (MGB) United Against Racism strategy, the program, called Birth Partners, seeks to address racial inequities in birth outcomes by improving access to doula care. Across MGB, Black patients are twice as likely to have an unplanned C-section compared to white patients. Additionally, Black, Latinx and Indigenous patients leave the hospital exclusively breastfeeding after giving birth less than half as frequently as white patients.

Currently in its second year, the Birth Partners pilot has funding to provide doulas to Black and Indigenous patients — populations deemed to be at the highest risk for complications — who are planning for a vaginal birth at the Brigham, Massachusetts General Hospital (MGH), Newton-Wellesley Hospital or Salem Hospital.

The program uses a monthly lottery system to match a select number of interested patients with doulas, and the team monitors participants’ C-section and breastfeeding rates, as well as patient experience metrics.

Although research has yet to pinpoint precisely how or why doulas affect birth outcomes, the benefits of their involvement in pregnancy, birth and postpartum periods are clear and measurable, Smith explained.

“There’s a lot of data that supports the utility of doula support and their efficacy in decreasing the risk of cesarean birth,” Smith said. “Doulas provide emotional and physical support, and they can become a communication bridge to help everyone understand the goals of the family.”

‘Like I Was Her Sister’

After learning she was eligible, Cadet eagerly enrolled in Birth Partners and was connected with longtime doula Ieshia Lee of Birthing Gently, one of two Boston-based doula agencies that partners with the program.

Lee served as Cadet’s doula for most of her pregnancy, as well as during her delivery and following the birth of her son. They continue to remain in touch, with Lee checking in to see how she and Kashden, now 9 months, are doing.

“Sometimes your role gets to be bigger than a doula,” says Ieshia Lee (left), who recently visited Cadet and her son at their home in Randolph.

“Sometimes your role gets to be bigger than a doula,” Lee said. “I wanted Phelicia to feel like I was her sister. I supported her with everything she was going through as a mother, pregnant woman and a human being.”

Without participating in the Birth Partners program, Cadet says she would not have been able to afford doula care. As a result of her experience, though, she feels strongly now that doulas should be covered for any patient who wants to work with one.

“Giving birth is not easy,” Cadet said. “Every woman in this world deserves to get this type of treatment and support.”

Ultimately, Birth Partners’ leaders hope that the program serves as a model for increasing access to doulas more broadly for all pregnant patients — something that may soon come to fruition.

MassHealth, the state’s public health plan, is exploring an expansion of benefits to potentially cover doula services for its members. If approved, the hope is that private insurers will follow suit, explained Allison Bryant, MD, MPH, senior medical director for Health Equity at MGB and an OB-GYN at MGH.

“It would be great for everyone to have access to a doula at no cost,” Bryant said. “The nature of our grant funding shaped the scope of our pilot so that we’re starting with groups who are at highest risk, but this is a fantastic intervention from which many patients could benefit.”

Smith agreed, adding that she hopes doulas become a routine presence in labor and delivery units everywhere.

“In many hospitals, there can be tension among providers when a doula is there, but I think our nursing staff and physicians are really quick to welcome innovation and consider novel approaches to advance birth equity,” she said. “Their embrace of this program has been a classic demonstration of why we provide great care at Brigham. It’s wonderful to work as part of a team who prioritizes patient- and family-centric care.”

The Division of General Obstetrics and Gynecology Specialists Team — represented (center, from left) by Julianna Schantz-Dunn, Amaka Onwuzurike and Khady Diouf — were one of 27 teams honored during the 2023 Pillars of Excellence Awards by Brigham President Robert S.D. Higgins and Rosemary Sheehan, chief human resources officer for Mass General Brigham.

As a unit coordinator in the Medical Intensive Care Unit (MICU), Cedric Depestre is always at the ready, especially when an emergency occurs — a point not lost on his nurse colleagues, who regard him as a “phenomenal” team member known for his proactive support of unit staff and heartfelt commitment to patients and families.

“Cedric has been a phenomenal unit coordinator for the Medical ICU and excels at anticipating the nurses’ needs,” wrote a colleague who nominated him for a Pillars of Excellence Award for his outstanding contributions. “He demonstrates great organizational skills, helping ensure we are ready for each patient. Cedric is often the first face a family will meet when entering the MICU. Families are often dealing with the worst days of their lives, and he greets them with compassion and poise.”

Depestre was among the 61 individuals and 27 teams honored during the 27th annual Pillars of Excellence Awards ceremony, which returned to an in-person format for the first time since the COVID-19 pandemic began three years ago. This year’s awards were presented to honorees throughout the Brigham family, including those who represent our Dana-Farber Brigham Cancer Center.

“I’m thrilled to be with you here in person — a milestone after several years of entirely virtual events due to the pandemic,” said Robert S.D. Higgins, MD, MSHA, president of Brigham and Women’s Hospital and executive vice president at Mass General Brigham, during the event. “It’s truly inspirational to see the collaboration between different groups to achieve a common goal. As we say at the Brigham, we’re stronger together. Thank you for your dedication to our patients, to our community and to each other.”

Supporting Patients, Families and Each Other

Another nominee this year was Tramaine Sanders-Palmer, an administrative assistant in Engineering, who assumed additional responsibilities for her team during a period of transition in the department.

“Tramaine is the perfect example of a great team player. She is a reminder that our duties sometimes go beyond our role,” her nominator wrote. “She showed up on time, with a smile, never said no and got the job done. She was a tremendous support to our department, and we are truly thankful to have her on our team.”

Theresa Oduol, a research assistant in the Division of Pharmacoepidemiology and Pharmacoeconomics, was commended for her work to strengthen her division’s contributions to advancing diversity, equity and inclusion (DE&I). Through her role as a co-chair on the Department of Medicine Diversity Council’s DE&I Committee for her division, she increased the volume of applicants to the team’s summer diversity internship program by 444 percent, volunteered to serve as a mentor and internship coordinator, and hosts recruitment strategies for diverse talent in faculty positions, among a host of other DE&I work.

Theresa Oduol

When a new colleague who recently moved to Boston expressed her anxiety about being new to the city, Oduol reached out to other research assistants to create a welcome guide to Boston, covering everything from the housing market to dinner locales.

“It is an honor to know and to work with Theresa, and I aspire to be everything that she emulates and embodies,” her nominator wrote. “She is not only a co-worker but also a mentor.”

Nurse practitioner Callie Siegert, MSN, AGNP-C, team lead of the oncology-focused branch of the Palliative Care Consult Service, earned the most individual nominations this year of any honoree, with 10 colleagues writing to share their reflections on her selfless and unwavering dedication to patients, families and colleagues.

“She brings unique and special characteristics to her role and is the most flexible, dedicated person I work with on our clinical team on a regular basis,” one nominator wrote. “Every time I come to clinical service, she asks — despite having her own complex and busy workload — how she can help me, how my day is going and what she could be doing better.”

Outstanding Teamwork

Among the team honorees this year was the Employee COVID-19 Antigen Testing Kit Distribution Team, who were tasked with distributing test kits to staff when the first Omicron variant peaked in January 2022.

“From the beginning, all team members knew the goal and the impact this would have on ensuring our workforce felt safe during the height of another COVID wave,” their nominator wrote.

Faced with the immense task of distributing over 10,000 testing kits to employees as fast as possible, the team successfully leveraged an MGB QR-code scanning system that streamlined the process and allowed them to rapidly deliver the kits in less than two weeks.

“Like many efforts during COVID, all members who were involved in the employee antigen test kit distribution team took on the responsibility in addition to their normal ones during an already busy time,” the nominator wrote.

The Operating Room (OR) Central Processing Department (CPD) Biomedical Engineering Team was recognized for their remarkable collaboration to overcome challenges during a period of expansion and transition.

“They leveraged experience, energy, resolve, understanding and good cheer to provide stellar service during a markedly straining time,” their nominator wrote. “From resolving critical video integration errors to locating just the right screw size for repairing a surgeon’s reading glasses, OR-CPD Biomedical Engineering is always there to help — as a team.”

“He’s the love of my life,” says Rosemary Hale of her husband, David, who received a lifesaving heart transplant at the Brigham last year.

One year ago, David Hale, 63, could not imagine making plans for the future.

Born with a heart defect, David has been sick for most of his life. The combination of a ventricular septal defect — a hole between the bottom two chambers of his heart, which caused a heart murmur — and a weak heart muscle took a toll on his body once he reached his 20s and 30s.

“I was doing construction, and it got to the point that I just couldn’t function,” he recalled. “I couldn’t walk very far, and I was so tired all the time.”

After decades of medications, surgeries and other interventions as his health worsened, David was approved by his Brigham care team as a candidate for a heart transplant on Feb. 8, 2012. But the call that a donor organ was available seemed like it would never come, even as his condition continued to decline.

“I got to the point where I thought it wasn’t going to happen,” he said. “It was like I had no plans for tomorrow. I was living just a moment at a time.”

Exactly 10 years to the day after he was listed for a heart transplant, David received the call he had been waiting for — a donor heart was available — and received the gift of life through a heart transplantation at the Brigham on Feb. 8, 2022.

“It’s like life just started all over,” David said, reflecting on the first anniversary of his transplant. “It’s a blessing, but it’s not an easy blessing. You see so many people go through so much trouble, and knowing the donor had to die for you to live — you’ve got to work hard, but it’s worth it. I got a chance to see my granddaughter walk.”

‘It Makes My Heart Smile’

Their family’s experience gave his wife of 33 years, Rosemary, a whole new appreciation for her work as a platelet pheresis technician in the Kraft Family Blood Donor Center, which collects blood and platelet donations to support patients at the Brigham and Dana-Farber Cancer Institute.

Throughout his life, David required multiple blood transfusions as he underwent various procedures and treatments related to his illness. During one surgery, he received over 10 pints of blood.

“I’ve been working in blood services for 35 years, and even when you take blood from someone every day, you don’t see where it goes,” Rosemary said. “When he would receive a transfusion, I would always look at it and wonder, did I take it?”

She tears up when reflecting on the profound difference blood donors have made for their family.

“It just made me love my job more,” she said. “When someone comes in to donate blood or platelets, it makes my heart smile. I don’t know if they realize how important they are. Sometimes, I would love to get out in my community and shout, ‘Please donate blood!’ It makes me emotional because if it wasn’t for donors, he wouldn’t be sitting here today.”

Road to Recovery

When David’s health began worsening in his 30s, he underwent surgery in Connecticut to repair the hole in his heart — a condition that places stress on the heart and can cause heart failure.

While that first procedure brought some improvement, it also meant he had a number of medications to keep track of, and eventually his symptoms returned. After moving to Boston with his family, he began receiving care at the Brigham, where experts continued to monitor his health and, ultimately, recommended he undergo evaluation for a heart transplant.

“It was a total shock,” David said of that revelation.

In addition to the new uncertainty about his health, becoming a transplant candidate reshaped their lives in other ways. Because donor organs must be transplanted quickly to remain viable, David needed to be within a short driving distance to the hospital and notify the team in advance if he needed to travel.

Eventually, his care team recommended he receive a left ventricular assist device (LVAD), an implanted mechanical pump that supports heart function and blood flow in patients with heart failure. For some patients, including David, LVADs are considered a “bridge to transplant,” keeping the heart functional until a donor organ becomes available. A multidisciplinary team led by Hari Mallidi, MD, FRCSC, clinical director of the Cardiac Surgery Service in the Heart and Vascular Center, performed the procedure in 2018.

Again, the procedure improved his quality of life in many ways and brought new challenges as well.

“Our lives changed. He had to plug in at night, unplug during the day and walk around with a battery pack all day,” Rosemary explained, referring to the external power components that LVAD patients must keep charged at all times for the device to function. They lived in fear of a power outage striking their home.

After experiencing an infection at the LVAD site, David’s health declined again — to the point that he was moved to a higher-priority position on the transplant waiting list. A multidisciplinary team led by Akinobu Itoh, MD, PhD, surgical director of Heart Transplantation and Mechanical and Circulatory Support, performed the transplant last year.

Today, David continues to build his strength. Everyday activities, such as cooking a meal or taking a walk through the neighborhood, give him great satisfaction. And after years of staying tethered to Boston as they awaited that fateful call, David and Rosemary have booked their first vacation together in a decade, with plans to visit family in New Orleans this summer.

“It’s nice to just get out of the house, drive and not have people worried about me being by myself,” said David, who is also planning a solo trip to Oregon to visit his brother. “One day, it dawned on me that there are no tubes, no bells, no alarms going off. There was always something around the corner I had to worry about. It’s been a relief to leave all of that behind.”

His cardiologist, Garrick Stewart, MD, of the Division of Cardiovascular Medicine, said it has been rewarding to see David and Rosemary enjoy their happily ever after, particularly after so many ups and downs.

“He’s resilient and has tremendous support at home with his wife,” Stewart said. “Despite being sick enough to be on the heart transplant waiting list for a decade, he persevered.”

And as Valentine’s Day approached this month, Rosemary said she could not imagine a more beautiful gift than what David’s lifesaving transplant has given their family.

“He’s the love of my life,” she said.

To schedule an appointment at the Kraft Family Blood Donor Center, email BloodDonor@partners.org, call 617-632-3206 or visit kraftfamilyblooddonorcenter.org. View a calendar of upcoming community-based blood drives.

“I am incredibly proud of this team,” says Kari Irwin (seated at center), nursing director of the L2 PRU, of the staff who make up the unit’s new overnight team, which includes (standing from left) Guirlande Sanon, Laurie Dervil, Giselle Chalk and George Fantoni.

Located in the lower levels of the Shapiro Cardiovascular Center, the L2 Procedural Recovery Unit (PRU) cares for patients immediately after they have undergone Cardiac Catheterization Lab (Cath Lab), Electrophysiology (EP) and Interventional Radiology procedures. Although many patients can be safely discharged from the 29-bay patient preparation and recovery area shortly after their procedure, others require additional monitoring and care.

Historically, any patient who needed post-procedure care past 10 p.m. was transported to an inpatient bed in the Shapiro Center. Why? Because until six months ago, the L2 PRU was a daytime unit. But upon seeing an opportunity to help alleviate some of the hospital’s ongoing capacity challenges while ensuring patients receive excellent care, a multidisciplinary team worked together last year to open six beds overnight on L2 PRU for post-procedure recovery patients with less than a 23-hour stay.

Since launching in late August, the L2 PRU has cared for nearly 350 patients overnight who otherwise would have been placed in an inpatient bed in Shapiro.

Kari Irwin, MSN, RN, the unit’s nursing director, spoke with Brigham Bulletin about what these changes have meant for patients, families and staff.

What prompted the decision to open L2 PRU overnight?

Kari Irwin: Some of our cardiology outpatients need to stay for an extended recovery phase, or they just need an extra set of eyes on them overnight. We care for them immediately post-procedure, and before going live with our overnight care, they would typically go up a Shapiro bed.

The capacity challenges have been very difficult, so over the past year and a half, the Brigham leadership team reached out to explore options for providing the same level of care that we would on an inpatient floor in another location.

We want to keep those beds available upstairs for patients who need more extensive inpatient care while ensuring our shorter-stay patients continue to receive great care. As we thought more about it, we realized, who best to care for these patients than the staff who are very familiar with these procedure types? It’s their bread and butter. They know the cases in and out.

How did you put the overnight team together?

Irwin: It was really important that we found a designated team to care for these patients, and that started with a search for two new charge nurses overnight. They cover Monday through Friday, overlapping one day of the week, which is great because we can share ideas and learn from each other. From there, we hired the rest of the team — four nurses and two patient care associates (PCAs). We also have relationship with the Periop Float Pool, which helps support us through sick calls or time off.

Everyone on the team has experience in cardiology or critical care, which was also very important because there’s a spectrum of acuity that we see after patients come out of procedures. Before we opened, I worked very closely with the charge nurses to make sure they had the resources they needed.

It’s been about six months since the overnight service launched. How is it going so far?

Irwin: I am incredibly proud of this team, and they continue to impress me with their care and knowledge. They really just have all the answers. The level and quality of care they provide is no different than any other location in the hospital. We see these patients from when they walk in the door in the morning before their procedure to when they go home, and our team knows them well.

We have capacity for up to six patients right now. That may not seem like a lot, but these patients come out of very complicated procedures and the nurses are working closely with them overnight to facilitate their recovery — getting them to walk and eat earlier, making sure their labs and testing are completed, and ensuring anything else is addressed before discharge.

Have there been notable changes from the patients’ perspective?

Irwin: We changed the culture of the patient care experience. We’ve been able to put a conditional discharge program in place, which is a nurse-driven discharge that allows patients to leave as early as 6 or 7 a.m. if they meet certain clinical criteria.

We found that patients really enjoy knowing they can leave early. They don’t want to wait for their providers to round on them upstairs if that is the only thing keeping them here. We provide them with a to-go breakfast, and most patients and families are happy to get ahead of the morning traffic if they can.

Was there any other memorable aspect of this project for you?

Irwin: When you are part of such a big change like this, there are so many details to consider before going live. One of the great experiences I had was working with all of the different departments to identify and cover all of those needs. It wound up being really fun getting to work with wonderful colleagues in departments like Food Services, Biomedical Engineering and Linen Services — people I never would have had an opportunity to meet if it wasn’t for this project. Everyone came together to make this work.

What do you think that says about the culture of the Brigham?

Irwin: I think that we truly are one big family trying to do the best and right things for our patients. You can tell that the underlying theme is that patients really do come first.

Despite implementing several proactive measures to protect facilities from the bitter cold that descended on Boston Feb. 4–5, the extreme weather conditions pushed the hospital’s infrastructure past its limit in many areas, as seen above in the A Building, where teams worked tirelessly over the weekend to mitigate flooding from burst pipes.

Karen Fiumara, PharmD, was rounding through the hospital on Saturday night, Feb. 4, to check on areas affected by the record-breaking cold in Boston that weekend. When she opened the door to an office in the A Building she had visited earlier in the day, she couldn’t believe her eyes.

Just hours prior, the same space was filled with several inches of standing water and littered with debris after ceiling tiles had collapsed under the weight of a water leak. It was one of more than 75 areas across the Brigham where extreme weather conditions caused burst pipes, overhead sprinkler malfunctions, outdoor equipment failures and other damage to facilities.

Fiumara, who served as the first of two incident commanders after the Hospital Incident Command System (HICS) was activated in response to the campus-wide event, encountered a dramatically different scene when she returned that evening.

“It was like a fairy had been there and waved a magic wand,” said Fiumara, vice president of Patient Safety. “What our Engineering, Environmental Services, Environmental Affairs, Police and Security, VPNE, Infection Control and many other teams accomplished that night — I don’t even understand how they did it. The work they did in such a short time to identify and minimize the damage that had occurred was simply unbelievable.”

Sarah Tsay, MPH, director of Emergency Preparedness, was left with a similar impression after witnessing how staff responded to the challenging series of weather-related events.

From left: Claudia Molina, Digna Candelario and Maria Gonzalez Baez (foreground) and Jean Honorat (background) of Environmental Services, pictured above in OR 16, were among the staff who responded to more than 75 areas affected by last weekend’s record-breaking cold.

“It was nothing short of Herculean,” she said. “Looking back at this event, I’m just overwhelmed by how extraordinarily professional, thoughtful and dedicated all of these groups were to maintaining patient safety.”

A deep freeze and strong winds descended on New England starting late on Friday and into Saturday, with Boston temperatures reaching a low of minus 10 degrees and frigid winds making it feel like minus 37 degrees at one point on Saturday.

In anticipation of the strain the weather would place on facilities, the Brigham’s Engineering team proactively took several measures to minimize the impact. Even so, the extreme conditions of that weekend pushed infrastructure past its limit in many areas, and multiple teams worked nonstop on Saturday and Sunday to mitigate multiple, simultaneous issues as they arose.

“One of the most challenging types of events to manage in an emergency response is one like this that’s dynamic and rapidly unfolding,” said Scott Goldberg, MD, MPH, medical director of Emergency Preparedness and director of Emergency Medical Services for the Department of Emergency Medicine. “The team was trying to keep track of all that was happening and respond to new events at the same time.”

Despite the challenges, the hospital remained fully operational throughout the weekend with minimal impact to patient care on the main campus — a reflection of the teamwork and dedication of everyone involved, said Loay Kitmitto, director of Environmental Services.

“It is in our DNA to rise up and respond in these situations,” said Kitmitto, whose team worked tirelessly to remove water and debris, as well as clean and sanitize affected areas. “It makes me smile knowing how committed we all are to providing the very best care to our patients, no matter the circumstances.”

As a result of the many teams’ collaborative, swift and skillful response, the hospital did not need to cancel or reschedule any surgeries or procedures, nor were any patients discharged due to the event.

Sean Gouvin, who recently joined the Brigham as director of Engineering, said it was humbling and affirming to be part of such an extraordinary effort.

“As a new person to the organization, it was pretty remarkable to see how all the teams came together,” he said. “Minimizing disruptions to patient care was our No. 1 priority. Considering what we were facing, to have the successful outcome we did — I was really taken aback. Everyone here cares about this place.”

Rapid Response

The first sign of problems became apparent around 5 a.m. on Saturday, when a nurse administrator reported that several areas of the hospital were experiencing significant temperature fluctuations. A few hours later, staff in the Infusion Center in the Hale building reported a foul odor, later discovered to be caused by a malfunctioning air handler on the building’s roof that had failed due to the cold. Staff quickly mobilized to transport patients to Braunwald Tower 3D so they could continue receiving infusion treatments.

While that response was underway, reports started rolling in of sprinklers releasing water in the Emergency Department and first floor of Shapiro Cardiovascular Center due to burst pipes. From there, the pace and volume of incidents increased rapidly, and teams in Incident Command and throughout the hospital worked tirelessly to triage the events.

“We didn’t know where the next thing was going to happen,” Fiumara recalled. “We were responding and planning in parallel, and that was difficult, but I had the good fortune to be working with so many smart and capable colleagues, including Rob Munroe of Emergency Preparedness. He is the most articulate, unflappable, organized, clear thinker you would want by your side as incident commander.”

As new leaks and failures were discovered, Engineering teams contained and repaired the damage with exceptional speed, skill and precision, Gouvin said.

“Our mechanical, electrical and plumbing infrastructure is one of the heartbeats of this organization. To know that our Engineering crews were able to keep our critical, life safety infrastructure running when these systems were severely compromised is a testament to the experience these folks have in understanding the complexity of these systems,” he said.

Kevin Slattery, director of Police, Security and Commuter Services, reflected on the teamwork and dedication his staff demonstrated, with the weekend’s response co-led by Larry Nialetz, deputy chief of Field Services and Exterior Operations, and Peter Kelly Jr., deputy chief of Distributed Campuses, Communication and Training.

“So many members of our department stepped up and went above and beyond to support each other and the hospital in these emergency situations. Many officers, supervisors and managers came in from home to help. They worked extra shifts to ensure we had sufficient staffing to get through this crisis,” Slattery said. “We received assistance from our colleagues in Valet, who also went above and beyond — taking on additional responsibilities to help us manage the situation.”

Before Police and Security supervisors arrived on scene on Saturday night, Lead Officer Sal Pontes managed the team’s response. Amid unpredictable and potentially disastrous circumstances, Pontes demonstrated exemplary professionalism and composure, Nialetz said.

“Upon our arrival, Officer Pontes was able to accurately brief us on the current status of the floods, and he was able to position other officers in strategic locations where pipe bursts were continuing to happen, as well as respond to the various scenes throughout the hospital, guiding our Engineering Department to the locations,” Nialetz said.

The sub-zero cold snap also created challenges across the distributed campus. Brigham and Women’s Harbor Medical Associates clinics in South Weymouth had to close on Monday, Feb. 6, so that Environmental Affairs and operations teams could assess and address the resulting water damage and other potential safety issues.

“The Harbor operations leadership team, led by Regional Director of Operations Kris McCue, jumped in on Sunday to contact and reschedule nearly 600 patients for Monday to a different Harbor location,” said Cindy Peterson, MBA, vice president of Regional Ambulatory Operations and Business Development.

‘This Is What We Train For’

In her seven years at the Brigham, Labina Shrestha, MM, T-CHEST, operations manager of Environmental Services, has never seen this severity of flooding at the hospital but always knew her team would be ready to respond to an event like this.

Douglas Lafata-Hernandez, lead environmental service aide, removes water from the 75 Francis St. lobby.

“This is what we train for,” said Shrestha. “We came together to support one another, with the goal of making sure the spaces were safe and clean for our patients and staff. Our team members were self-motivated, and they empowered one another to do their very best. It was wonderful to see how much pride they all took in their work, no matter the task.”

Robert Seeley, MS, CSP, Environmental Health and Safety manager, and Jon Boyer, ScD, CIH, director of Environmental Affairs, assessed affected areas to identify potential hazards in the environment and advised on the steps needed to make areas safe again.

“The scale of this event was larger than almost any facilities event I’ve seen here at the Brigham, but in a way, our role was not so different from what we do every day,” Boyer said. “We come when people call us to provide collaborative, competent services around risk management, health and safety. Rob was the first on the scene for our team and did a great job providing detailed, measured information at points when our critical knowledge and skills were necessary.”

The timing of the weather event — a weekend — also created challenges. Although facilities teams brought on additional staff in anticipation of possible issues, it quickly became clear that more operational support was needed as the situation became more complex. Colleagues from across the Mass General Brigham system heeded the call for help, along with staff from CBRE, a commercial real estate vendor.

“We were able to call on our colleagues at the system level, including project managers to help keep track of incidents and additional engineers to relieve staff who had been working nonstop and needed to rest,” Goldberg said.

And while repairs are still ongoing, the extraordinary weekend response made all the difference as more employees, patients and visitors returned to the main campus on Monday.

“For me, one of the most rewarding parts of this entire event was showing up on Monday morning,” Goldberg said. “Besides a whole bunch of dryers, it felt like business as usual.”

Top left photo: Members of the OR team, from left: Jack Sharpe, Scottie Fosberg, Deborah Colwell, Barbara McDermott (seated), Barbara Clark, Gloria Charles, Carol Richard (seated) Ian Grey, Mark Johnson and Rosemarie Maddi (seated). Top right photo, from left: Gloria Charles assists Lawrence Cohn in preparing the patient while John Collins and Richard Shemin inspect the donor heart. Bottom photo: Lawrence Cohn, John Collins, Richard Shemin and Gilbert Mudge received engraved Playmate coolers in celebration of the 1984 event.

History was made on Feb. 2, 1984, when Boston’s first heart transplant took place at the Brigham. The patient was Gerald Boucher, 43, a pharmacist from South Hadley. 

“The first heart transplant helped bring divergent specialists together,” said Gilbert Mudge, MD, who started the Brigham heart transplant program. “For the first time, people began to say that the hospital was truly bigger than the sum of its parts.”  

In honor of American Heart Month, the Brigham community is reflecting on what this historic milestone meant to the Brigham and the field of medicine. 

“I remember that day and the following weeks,” said one respondent in a post on the Brigham’s Facebook page about the first heart transplant. “Regardless of where you worked at BWH, there was excitement.” 

In a 2006 Brigham Bulletin story, the late Lawrence Cohn, MD, former senior cardiac surgeon, who participated in the first heart transplant, reflected on the historic event. 

“There weren’t many heart transplant teams in the country,” Cohn said. “We had the right team, the right enthusiasm, the right support from the hospital and the right patient.”  

The Brigham’s Heart Transplant and Mechanical Circulatory Support Program is the oldest and largest in New England. Since performing the first and second successful heart transplants in New England in 1984, the program has completed more than 600 transplants. Instrumental to that success is the passionate and experienced multidisciplinary team. 

“I was one of the nurses in the ‘cardiothoracic’ surgery ICU that cared for him. Exciting times!” said another respondent in a Brigham Instagram post about the first heart transplant.  

Another commenter recalled when the helicopter transporting the donor heart landed at nearby Wentworth Institute. Former Brigham cardiothoracic surgeon Richard Shemin, MD, was there to collect the heart in a Playmate cooler. Later, Shemin, Cohn, Mudge and John Collins, MD, received engraved Playmate coolers in celebration of the milestone. 

“A step forward for mankind,” said another respondent.  

Peter Pushor, 73, says he is overjoyed to be in good health and resume his active lifestyle, including going ice fishing this January (pictured above), thanks to the lifesaving care he received at Dana-Farber Brigham Cancer Center.

One night in November 2016, Peter Pushor woke up to use the bathroom. But when the 73-year-old retiree living in northern Maine tried to go back to bed upstairs, he found himself struggling to walk.

“I realized I was awfully weak, and I couldn’t take more than four or five steps,” said Pushor, who was widowed and living alone at the time. “I knew something was really, really wrong.”

He dialed 9-1-1 for the first time in his life and was taken to a hospital in Bangor. After several exams, Pushor learned he had advanced esophageal cancer.

That discovery was the first time Pushor would confront cancer, but it would not be his last. He ultimately overcame two bouts of complex, life-threatening cancers, thanks to the expert care he received at Dana-Farber Brigham Cancer Center (DFBCC).

“There are no signs of any problems today,” said Pushor, whose care team continues to monitor him but has otherwise declared him cancer-free. “It’s just a miracle to be where I am today.”

Choosing Hope

Shortly after Pushor began radiation therapy and chemotherapy in Maine for esophageal cancer, it became clear a surgical intervention was necessary. He was referred to Scott J. Swanson, MD, a Brigham thoracic surgeon and director of the Minimally Invasive Thoracic Surgery Program.

“I was so positive that I was going to beat this,” recalls Pushor, pictured above in 2019 after overcoming his first bout with cancer.

“I was so thankful and grateful to be with Dr. Scott Swanson,” Pushor said. “At the time, I was aware that he was probably the best surgeon in the country.”

To remove Pushor’s cancer, Swanson and his team performed an esophagectomy — surgical removal of the esophagus — an extensive and complex procedure with a difficult recovery process.

Due to the nature of his surgery, Pushor could not eat solid foods while he healed in the Surgical Intensive Care Unit, requiring a surgical feeding tube to meet his nutritional needs during his post-operative recovery. He credits the care and treatment he received at the Brigham with helping him regain his strength.

“This is where I started to realize that if I want to get out of here and get well, I need to do exactly what they’re telling me to do: Get up on my feet,” Pushor said.

Next, he participated in a yearlong clinical trial for an immunotherapy drug beginning May 2018 under the supervision of Swanson and Dana-Farber Cancer Institute’s Jeffrey Wisch, MD. Pushor remembered his medical team being cautious about optimism, given the severity of his disease prior to surgery, though his hope never wavered.

“I was so positive that I was going to beat this, and I felt so good,” he said. “Every day, I was feeling stronger and stronger, and every day there’s more and more appreciation for where I am and where I’m headed.”

Swanson added: “I think people underestimate how helpful that is to somebody’s outcome, when they can come in positive, strong and in good shape.”

Five years after the initial 9-1-1 call, Pushor’s care team declared him cancer-free. But little did he know that cancer would soon become part of his life again.

A Surprising Discovery

In June 2021, Pushor noticed one of his lymph nodes in his throat was swollen to the size of a pencil eraser. He was referred to Danielle Margalit, MD, MPH, of the Department of Radiation Oncology, and Rosh Sethi, MD, MPH, of the Division of Otolaryngology, who confirmed Pushor had cancer again. Although the tumor was in a similar location to his first bout with the disease — this time at the base of his tongue — it was a different cancer entirely.

Following a biopsy and laryngoscopy, Sethi determined that the neck mass contained squamous cell carcinoma — the most common type of head and neck cancer. It was caused by human papilloma virus, better known by its acronym HPV. Although more commonly associated with cervical cancer in women, HPV can also lead to oral and oropharyngeal cancer in both sexes.

Pushor’s care team partnered with him to determine the best treatment plan, which ultimately consisted of 33 radiation treatments from June through July 2021, a process that essentially meant Pushor lived in Boston during that period.

“He was very knowledgeable in terms of thinking through what for him personally would make the most sense,” Sethi noted. “He really trusted us, which is a difficult thing to do when you have cancer in your life and a prognosis in someone else’s hands.”

His previous experience with cancer in the same area of the body was something Margalit said she had to account for in planning his treatment.

“I had to make sure that when I treated his lymph nodes in his neck that I didn’t overlap from where he’d had radiation before,” she said. “Because if there’s too much radiation where it overlaps, it can cause dangerous side effects.”

Despite the rigor of his treatment, Pushor maintained hope throughout the ups and downs of the process.

“It’s almost like a roller coaster,” he said. “You’d have a few days where you’d be worn down and fatigued, and then you’d kind of come out of it to almost normal feelings, and then it was up and down for several months. But here I am today.”

Pushor and his wife, Debbie, whose unwavering support he says played a direct role in his recovery, enjoy a Red Sox game at Fenway Park in June 2021 while in Boston for his medical care.

Cared for ‘as a Patient and a Person’

Pushor was considered cured after recent scans and blood tests showed no cancer in his throat. He is now in the monitoring phase, which entails a visit with his medical team every few months.

In addition to his constant optimism, Pushor credits the support of his family and friends as well as his faith for getting him through his ordeal.

“My wife was there beside me, helping me with every step all the way,” he said. “I attribute my positive attitude to my routine that she kept me on — made sure I was up to date with all my pills, supplements, fluids and food — to keep me strong. She was a big factor.”

Pushor emphasized how grateful he is to DFBCC for the care he received.

“They are truly, deeply concerned about you as a patient and as a person, and they want you to be comfortable and are there for you,” Pushor said, “I just can’t say enough good about them.”

Nowadays, Pushor is back home in northern Maine, where he spends time outdoors and enjoys his retirement.

“It’s so enjoyable to get out, be around people and go snowmobiling, ice fishing and to the festivals that they do here,” he said. “It’s so much to look forward to, and I’m so thankful to be where I am health-wise. I love it.”

Brigham nurse Luciana Henderson (bottom row, far left), who was treated for leukemia at Dana-Farber Brigham Cancer Center, is one of several patients featured in a new marketing campaign highlighting the center’s personalized care.

While her peers were enjoying a relaxing Thanksgiving break during their senior year of college, Luciana Henderson, BSN, RN, spent hers wracked with anxiety in a Connecticut emergency department.

“I remember having to check in, and they ask you why you’re there. I had to say, ‘I think I have leukemia,’” recalled Henderson, who had been advised by her doctor to seek emergency care after some concerning blood test results. “I was 20 years old. It was really numbing to say.”

Two days later, she had a bone marrow biopsy to confirm the cancer diagnosis and genetic testing to identify what might be causing the disease. As Henderson and her family awaited the results, their local oncologist recommended that Henderson’s sister get tested to see if she could be a potential donor for a bone marrow transplant, in the event Henderson needed one. As it turned out, her sister was a perfect match.

Once the genetic testing results revealed a mutation linked to leukemia, Henderson’s local oncologist referred her to Dana-Farber Brigham Cancer Center (DFBCC), where experts reviewed the findings and recommended that she undergo a bone marrow transplant as soon as possible.

Those decisions not only saved Henderson’s life, but also reshaped the course of it. Now a Brigham nurse in Medical Oncology on CWN 7, Henderson chose the nursing profession based on her own experiences as at DFBCC patient. The personalized, expert and compassionate care she received years ago continues to inspire her nursing practice today.

“As a patient, I just felt like my team was so on top of it. They listened to me and my family, and everyone was so nice and caring. It really made such a difference for us,” said Henderson, who has been in remission since undergoing chemotherapy and a bone marrow transplant with her sister’s donated stem cells.

Now, she is also one of several patients featured in a new DFBCC marketing campaign highlighting the center’s highly specialized, personalized and patient-centered model of care. Launched on Jan. 23, the campaign seeks to bring patients’ faces and voices to the forefront through advertisements on local television, streaming media, radio, digital channels, outdoor structures and social media, as well as content on Dana-FarberBrigham.org.

“As we were developing the campaign, we heard time and time again about the incredible compassion and deep expertise of our clinical teams and the many ways in which they tailored care plans to meet the needs of their patients — not only their clinical needs but their social and emotional needs as well,” said Lori Schroth, vice president for the Office of Strategic Communication. “We’ve worked hard to capture that sentiment and hope it reflects the pride we have for the incredible work of our teams who care for patients and families affected by cancer.”

Not one to seek the spotlight, Henderson acknowledged it has been surreal to hear from friends, family and colleagues when they see her in one of the campaign spots. But she added that she was more than willing to overcome that discomfort if it gives hope to even one person.

“I actually hate attention, and now people are texting me every time they see me on TV,” she laughed. “My whole thing is we need to bring awareness, and when you see a success story, it can be really helpful — including for nurses, as we often see people when they are very sick.”

Henderson also hopes sharing her story will shine light on the importance of the National Marrow Donor Program and encourage more people to consider providing a lifesaving marrow or blood stem cell donation.

Despite her newfound status as a local celebrity, Henderson said she feels the utmost humility and gratitude for the opportunity to deliver the same level of compassionate care she once received.

“I’m truly honored to do this work — having patients share their life with you when in their most vulnerable moments and being able to listen to them, care for them and help their families,” she said.

Matthew Medina and Anissa Dickerson share a moment after the screening of Call Jane, a film about abortion access in the 1960s that was co-written by Brigham physician Roshan Sethi.

It was no coincidence that Matthew Medina, MSN, CNM, RNC-OB/EFM, attended the opening night of Call Jane last October.

The independent film, which stars Elizabeth Banks and Sigourney Weaver, chronicles the story of the Jane Collective — an underground network established in Chicago in the late 1960s to help women access abortions at a time when the procedure was outlawed and stigmatized in much of the United States.

A nurse midwife at the Brigham, Medina cares for pregnant patients, making the subject of the film especially close to his heart — particularly in the wake of the U.S. Supreme Court’s decision to eliminate the constitutional right to abortion in its Dobbs. v. Jackson ruling in June 2022.

Yet there was another factor that inspired him to buy tickets for Call Jane: the film’s special connection to the Brigham. Its screenplay was co-written by Roshan Sethi, MD, a Brigham radiation oncologist who splits his time between patient care and a career in Hollywood as a writer and director.

After the lights came back on in the Hingham theater where Medina and his husband watched the film, they were approached by another moviegoer. “Thanks for being here,” she told them. “We’ve gotten though it once, and we’ll get through this again.”

For Medina, the next steps were clear.

“I knew this film had to be shared with our community and knowing it was created in part by our BWH family made it that much more important,” he said.

He reached out to a colleague, Deborah Bartz, MD, MPH, associate director of Family Planning and director of Education for the Mary Horrigan Connors Center in Women’s Health and Gender Biology, to think about how they could celebrate the film and its message with the Brigham community.

Bartz suggested they align the effort with the 50th anniversary of Roe v. Wade, the Supreme Court ruling that had established abortion as a constitutional right on Jan. 22, 1973, until the court’s reversal of it last summer.

In collaboration with Sethi, both Bartz and Medina organized a screening of Call Jane at the Brigham on Jan. 23 as a celebration of Roe and an opportunity for the Boston abortion care community to come together in support of patients, families and each other.   

“The Dobbs decision was a blow — a personal blow for those of us who are pregnancy-capable and a professional blow for those of us who work daily to protect access to safe, legal abortion,” Bartz said. “This event was truly meant to be a therapeutic moment to bring us all together to celebrate, voice, vent, rage and reflect in a safe, shared space. The 50th anniversary of Roe v. Wade is a momentous occasion that we could not let slip by unnoticed.”

‘Called to Serve’

Sethi, who co-wrote Call Jane in 2016 with screenwriter Hayley Schore, was touched to see his Brigham colleagues mobilize this effort in support of patients and providers.

“It took many, many years for the movie to get made and the investment and hard work of so many people. It was an incredible gift seeing it hit theaters in October 2022 but an even greater privilege to screen at Brigham and Women’s with my colleagues and the people who are doing the work celebrated by the film,” Sethi said. “I’m really grateful to Dr. Bartz and Matthew Medina for spearheading the event.”

The screening was followed by a multidisciplinary panel discussion with Bartz and several other clinical and research experts in abortion care: Anissa Dickerson, MSN, MPH, CNM, director of Boston Medical Center’s Refugee Women’s Health Clinic; Deb Campbell, BSN, RN, a Labor Delivery and Family Planning nurse; Alisa Goldberg, MD, MPH, director of Family Planning; and Liz Janiak, ScD, MSc, MA, a social and behavioral scientist at Harvard Medical School and the Harvard T.H. Chan School of Public Health.

Medina, who also serves as chair of the Massachusetts section of the Association of Women’s Health, Obstetric, and Neonatal Nurses, a co-sponsor of the event, encouraged health care professionals to use their platforms to tell lawmakers that abortion is an essential component of reproductive health care that can save a person’s life or protect their health.

“Having this event, watching this movie — it is a reminder that we have been called to serve a population that has often had to suffer silently. We will continue to fight for healthy, safe and comprehensive OB-GYN care,” he said.

Celebrating patient-focused, quality-based and mission-driven highlights across our Brigham community

Download the PDF

Table of contents:

• • Patient and Family Care
  • Supporting Our Community
  • Research and Innovation
  • Education
  • Supporting Our Mission
  • President’s Message

Patient and Family Care

Emergency Department Expansion Goes Live

After seven years of planning, approvals and a building process that included continued construction during the pandemic, the Brigham’s expanded Emergency Department opened 30 beds, a new trauma suite, a dedicated area for behavioral health patients and additional emergency imaging capabilities in May.

Brigham OB-GYN Ranks #1 in U.S.

In recognition of the exemplary patient- and family-centered care that our Department of Obstetrics and Gynecology delivers, U.S. News & World Report named the Brigham the nation’s #1 hospital for Obstetrics and Gynecology. This recognition accompanied the news that the Brigham once again earned a spot on U.S. News’ Best Hospitals Honor Roll for 2022–23.

Supporting Our Community

Collaborating to Better Serve Boston Residents

As part of our 2022 Community Health Assets and Needs Assessment, the Brigham participated in a citywide collaborative to jointly identify and address the most pressing health issues facing Boston residents. Guided by input from residents and local organizations in the Brigham’s five priority neighborhoods — Dorchester, Jamaica Plain, Mattapan, Mission Hill and Roxbury — we are partnering with community stakeholders to eliminate health inequities.

Meeting with Community Leaders

Understanding the communities we serve — including what matters most to residents — is essential to improving community health and well-being. To that end, in 2022 we organized five community meetings and tours throughout the Brigham’s priority neighborhoods, connecting with over 60 community-based organizations and partners. A community meeting held in June at the Immigrant Family Services Institute in Mattapan is pictured above.

Research and Innovation

Brigham Researchers Work to Solve the Mystery of Long COVID

Brigham investigators are leading efforts to better understand the long-term effects and prolonged symptoms of COVID-19, the condition known as long COVID. In March, the Brigham led the launch of the Boston COVID Recovery Cohort, a consortium of six sites in Greater Boston participating in a nationwide study of people with long COVID. Brigham researchers also developed an ultrasensitive test to detect miniscule amounts of protein from the virus that causes COVID-19 and found evidence these proteins linger in patients with long COVID.

Landmark Clinical Trial Delivers on the Promise of Heart Failure Drugs

Last summer, physician-scientists from the Brigham presented new evidence that drugs originally developed to treat type 2 diabetes may benefit a wide range of patients experiencing heart failure. Brigham investigators helped lead the largest clinical trial to date on a broad range of patients with heart failure, finding that a class of drugs known as SGLT2 inhibitors provided protection from cardiovascular events.

Education

Elevating the Next Generation of URiM Physicians

The Brigham was proud to welcome another diverse incoming class of residents in 2022. Across all medical and surgical residency programs, nearly one in four (24%) of this year’s incoming interns are underrepresented in medicine (URiM) trainees. One of the many ways we recruit diverse talent for our training programs is through participation in events like the 2022 Annual Medical Education Conference (pictured above), where Brigham residents spoke with medical students about our programs.

Nurse Residency Program Achieves Accreditation

Our Nora McDonough Nurse Residency Program — which provides a yearlong, comprehensive orientation to help nurses develop their skills and grow in their practice with a supportive cohort — achieved accreditation as a Practice Transition Program from the American Nurses Credentialing Center for demonstrating excellence in transitioning nurses to new practice settings. With this milestone, the Brigham is one of 220 nurse residency programs worldwide with this accreditation.

Supporting Our Mission

The generosity of our donor community fuels many aspects of our work. Here are a few highlights from our Development Office:

• Raised $188 million in FY22 to support clinical care, research, education, capital improvements, the Brigham Fund and more.
• Hosted 35 donor engagement and recognition events, including 17 Distinguished Chair celebrations.
• Held 38 donor fundraising events, including 25 community fundraising events and the inaugural Brigham Caregivers Classic, benefiting the Caregivers Fund, which provides resources to celebrate, support and unite our health care workers.

To learn more, visit bwhgiving.org.

President’s Message

I am extraordinarily proud of all that we accomplished in 2022 to deliver expert and compassionate care, drive research and innovation, train tomorrow’s health care professionals and care for our communities.

Of course, last year was not without its challenges. Like nearly every health care organization, we carried out our mission in the face of capacity constraints, staffing shortages and significant uncertainty in the world around us. Even as we continue to endure these challenges, I am filled with optimism because I know we are weathering the storm together — as one Mass General Brigham community. And we are accomplishing that by doing what we always do: keeping our patients and their families at the center, so they receive a consistently exceptional experience.

With so much change in health care, we cannot stand still. Mass General Brigham must become the integrated academic health care system of the future, and here at the Brigham we have made critical contributions to achieving this vision. By helping launch enterprise
services in Emergency Medicine, Radiology, Anesthesiology, Pathology and Cardiovascular Medicine/Surgery, we are ensuring more patients and their families have greater access to world-class, equitable care. This past year we also celebrated another enterprise milestone: the launch of the Mass General Brigham Gene and Therapy Institute, our first systemwide research center.

We are so fortunate to have the most dedicated, creative and compassionate teams shaping the future of health care. Even with such an incredible legacy behind us, I am confident that our best is yet to come.

Robert S.D. Higgins, MD, MSHA
President, Brigham and Women’s Hospital
Executive Vice President, Mass General Brigham

From left: Charlene Hollins and Nadia Raymond present at the Jan. 10 Diversity, Equity and Inclusion Town Hall.

Work to dismantle racism and advance health equity often occurs without addressing an important gap — an institutional culture in health care that has caused employees to feel pressured to accept discriminatory, disrespectful or abusive behavior from patients and visitors.

That must change because maintaining a safe, inclusive and caring environment for all means valuing the employee and patient experiences as equally important, Brigham leaders emphasized during the Diversity, Equity and Inclusion Town Hall on Jan. 10.

“We want to ensure every member of our team — our workforce — and every patient and family member who walks through the doors of the Brigham and Mass General Brigham is treated equitably, with compassion and respect,” said Robert S.D. Higgins, MD, MSHA, president of the Brigham and executive vice president at Mass General Brigham.

Last October, Mass General Brigham announced a systemwide Patient/Family/Visitor/Research Participant Code of Conduct policy, which defines appropriate conduct for patients, families, visitors and research participants and provides a model for workforce members to respond to disrespectful, discriminatory, hostile or harassing behaviors.

The policy, developed as a systemwide effort through Mass General Brigham’s United Against Racism strategy, represents “a new paradigm” in health care that affirms the intersection of employee and patient experiences, explained Normella Walker, MA, CDP, executive director of Employee Experience in Diversity, Equity and Inclusion and the Office of Mediation, Coaching, Ombuds and Support Services.

The policy does not circumvent our institutional commitment or our legal obligation to provide high-quality care to patients, but rather provide an avenue to ensure our workforce is supported.

“There’s this idea that you just have to ‘put up with disrespect for the sake of the patient, but what we’ve been doing is tacitly condoning bad behavior,” Walker said. “If we’re going to create a culture that feels good for everybody, that culture also has to include a positive experience for our employees.”

Kevin Slattery, director of Police, Security and Commuter Services, shared how staff can use the S.A.F.E. Response framework to address inappropriate or abusive behavior. S.A.F.E. is an acronym, with each letter representing a step in the process: Spot a threat, assess the risk, formulate a response and evaluate the outcome.

The Brigham’s S.A.F.E. Response framework provides a consistent approach for responding to challenging interactions with patients or families in inpatient and ambulatory settings. When a S.A.F.E. Response is initiated, a multidisciplinary team comes together within 15 minutes, including representatives from the care team, Police and Security, Quality and Safety, Patient and Family Relations and others as needed.

“The employee should not feel like they are left alone to address this by themselves. We want to make sure they have all the support they need,” Slattery said.

The S.A.F.E. Response framework is not intended for a rapidly escalating situation where there is an imminent threat of violence, Slattery emphasized. In those situations, staff should call Police and Security at 617-732-6565.

‘Equity Is the Only Acceptable Goal’

Additionally, several clinical leaders shared updates during the forum on how the Brigham is advancing health equity in patient care. Speakers highlighted examples of how the Brigham is committed to ensuring every one of our patients and their families have the best experience — one defined by high-quality care and compassion.

Regan Marsh, MD, MPH, medical director of Quality, Safety and Equity, discussed how domain teams of health equity leaders work in collaboration with unit-based teams to systematically advance racial justice and equitable care delivery.

Charlene Hollins, DNP(c), MSN, APRN, FNP-C, nurse administrator at the Brigham and a nurse practitioner for Mass General Brigham Urgent Care, highlighted several initiatives the Emergency Department has undertaken to deliver equitable care, including the department’s Anti-Racism and Trauma-Informed De-escalation Training Program.

Nadia Raymond, PhD, MSN/MHA, RN, regional nursing director for Southern Jamaica Plain Health Center, reflected on the joy and fulfillment that comes from working together to reshape health care systems so that they are equitable for all.

“Although we are keenly aware that much work is ahead of us, as a community we choose to see that as opportunities,” Raymond said. “Ultimately, this is creating a greater depth, meaning and humanity to our work in health care. Collectively, we are stating what my dear friend, the late Dr. Paul Farmer, once said: Equity is the only acceptable goal.”

Staff Resources

The Patient Code of Conduct seeks to maintain a safe, inclusive and caring environment for all. The following resources are available for staff who experience or witness inappropriate, discriminatory or abusive behaviors by patients, families or visitors.

• Tip sheet for responding to discriminatory remarks
• SAFER model algorithm
• Ordering and printing Code of Conduct posters and handouts
• Policy: Patient/Family/Visitor/Research Participant Code of Conduct: Responding to Disrespectful, Discriminatory, Hostile, or Harassing Behaviors
• Mass General Brigham Patient Code of Conduct
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Yuet Ming Lau Chan

Brigham and Women’s Hospital mourns the loss of Yuet Ming Lau Chan, an inventory coordinator in Materials Management, who died on Dec. 10. She was 55. 

Ms. Lau Chan joined the Brigham in 2008 and quickly established herself as an invaluable member of the Materials Management team. Colleagues remembered the immense care and attention she afforded her work — demonstrating an unwavering commitment to patients and colleagues.  

“She cared deeply, put everything she had into her work and took care of her floors like a protective mother,” said her manager, Damon Wallace.  

Wallace recalled how Ms. Lau Chan inspired others in the department to follow the standard of excellence she exemplified, a lesson he learned firsthand upon meeting her in 2009. 

“I soon came to know Ming as a force to be reckoned with, and she was very much a stickler for details and getting things right. I listened to Ming and learned her process, which was good training because she handled things the right way,” he said. “You knew you couldn’t let certain standards slide because Ming wouldn’t do that, so not wanting to let Ming down became synonymous with not letting the patients and staff down. I always appreciated that, as it helped me know the job better and Ming better as a person. She had a big heart.” 

As an inventory coordinator, Ms. Lau Chan oversaw supply needs for multiple inpatient floors and the Emergency Department for most of her career. In 2020, she shifted her responsibilities to support Materials Management’s STAT Room, an on-campus storeroom for backup supplies. As the hospital experienced a series of supply shortages during the pandemic, the importance of Ms. Lau Chan’s contributions grew tremendously, said Kenneth Shelton, area manager for Central Supply and Linen Services. 

“Basically, she created a job we didn’t know we needed,” Shelton said.

In addition to her strong work ethic, Ms. Lau Chan was a beloved friend and colleague whose kindness touched the hearts of many. 

“Ming is and always will be a great person — willing to help anyone, at any time,” said Roy Boone, materials handler. “She was the best of our department. No one will ever measure up to her.” 

Ms. Lau Chan is survived by her husband, Sair; her daughter and son-in-law, Eva and Deivid Mauricio; her sons, Stanley Chan and Kevin Chan; her daughter-in-law, Madelyn Ma; three grandchildren; five sisters and many other loved ones.

While challenging at times, 2022 was a year marked by world-class patient care, innovative research, community events and educational milestones. Through it all, the Brigham community exhibited the utmost compassion towards one another, our patients and their families. 

Relive the moments in our “The Year in Photos” gallery. 

Doing whatever it takes to deliver patient-centered care. A lifesaving decision by two friends. A final act of exemplary compassion and kindness. These actions and qualities inspired a multidisciplinary committee to select two individuals and two teams — all of whom were previously nominated for the Brigham Way — for one-time spot bonuses in recognition of their extraordinary efforts.

The Brigham Way is an employee-appreciation campaign established to recognize staff who foster a culture of excellence, respect and professionalism by going above and beyond their duties to create an exceptional Brigham Experience for patients, families and colleagues.

All Brigham Way nominees are celebrated at quarterly luncheons with Brigham President Robert S.D. Higgins, MD, MSHA. Each calendar year, a Brigham Way Bonus Selection Committee recommends one individual and one team of five or fewer whose outstanding contributions are deserving of a one-time spot bonus. In recognition of an especially impressive collection of nominees this year, two individuals and two teams were selected to receive bonuses.

“Day in and day out, our fantastic staff make the Brigham a special place for patients, families and colleagues alike. We, the entire leadership team, are delighted to recognize these individuals and teams for their outstanding commitment to our mission. They exemplify what it truly means to live our values.”

Kristen Sullivan, a practice manager in the Department of Pediatric Newborn Medicine, said it was an honor to have her contributions recognized through the Brigham Way campaign and be named a recipient of the spot bonus.

“I have the privilege of working alongside exemplary physicians, allied health professionals, nurses and administrative leaders. It is their commitment to serving our youngest, most fragile patients and their families that truly inspires me,” she said. “I witness excellence in these folks every day, and it inspires me to go above and beyond for our patients. One of my favorite quotes is from Desmond Tutu, who says, ‘Do your little bit of good where you are; it’s those little bits of good put together that overwhelm the world.’”

Learn more about the 2022 winners in the words of their nominators:

Cardiac Sonographers, Echo Team

From left: Robert S.D. Higgins and Faranak Farrohi, chief cardiac sonographer, with honorees Amanda Murphy, Sylwia Marciniak, Brenda Docktor and Justin Cheng (not pictured: Samantha Hayes)

“This team of hardworking, compassionate and kind sonographers has been front and center since the pandemic. They stay late to finish the job, come in early and work voluntarily on weekends to support our Dana-Farber outpatient requests. Despite facing staffing challenges for two years, the team has gone above and beyond with a smile to support BWH and our patients.”

Yaguang Pei and Anand Somasundaram, Medical Dosimetrists, Department of Radiation Oncology 

From left: Anand Somasundaram, Tony Orlina, Yaguang Pei and Robert S.D. Higgins

“Yaguang and Anand saved the life of their friend and colleague, Tony Orlina, when they decided to check on him at home after he didn’t show up for work one day. As it turned out, Tony experienced a ruptured aneurysm and collapsed at his apartment, where he lives alone. They brought him to the Brigham Emergency Department, where he was rushed into emergency neurosurgery and received lifesaving care. Their friendship and story are so touching and truly exemplify what it means to care for one another!”

Helen Smith, Senior Access Facilitator, Patient Access

“Helen, who has worked here for over 40 years, worked diligently to make sure a man who spent over five weeks in the morgue had a place to be laid to rest. She went the extra mile to find the man’s next of kin and contacted a local funeral home to make arrangements. She truly embodies the standards of BWH. She was determined to make sure this patient’s loved ones were found and he could be laid to rest with dignity.”

Kristen Sullivan, Practice Manager, Department of Pediatric Newborn Medicine

“Kristen helps coordinate the Transition to Home program. Recently, Kristen faced administrative staffing challenges, and during this time she did it all. Kristen never lost her smile or her sense of humor, and was always willing to go above and beyond — assisting with cleaning patient rooms, setting up clinic staff for their day’s schedule changes, covering the NICU discharge rounds and going the extra step to make sure the families had all the resources they needed while at home, including going out of her way to pick up a special baby formula from a pharmacy outside of the area so a family could feed their baby until Supply Chain could send it to the BWH Pharmacy.”

If you know a colleague or team of five or fewer who go above and beyond to significantly enhance the Brigham Experience, consider nominating them for the Brigham Way. Nominations for the upcoming March luncheon are due Friday, Feb. 10. Those nominated by this deadline may be eligible for the 2023 one-time spot bonus.* For questions, contact BrighamWay@bwh.harvard.edu.

*Nurses in the collective bargaining unit are not eligible for the one-time spot bonus.

Over the past year, I have quickly become aware of how special our health care providers — including nurses, doctors and other care team members — are in taking care of our patients and their families. And now through personal experiences for me and my family, I further recognize the high-quality and compassionate care our organization provides. Recognizing what all of our patients and their families already know, our Brigham family delivers world-class care with outstanding compassion and dedication to our community and its well-being. Thank you for all that you do.

Robert S.D. Higgins, MD, MSHA
President, Brigham and Women’s Hospital
Executive Vice President, Mass General Brigham

I will always remember the purple flag day we had at 15 Francis St. to honor overdose victims in 2022 for Recovery Month. As a person in long-term recovery, for me it is about saving lives. I have lost not only family members to the disease of addiction but also a lot of good friends and participants.

Pablo Gonzalez, CARC
Senior Recovery Coach, Bridge Clinic

Jaye Hall, our beloved administrative manager in the Department of Emergency Medicine, is always looking for opportunities for her staff. She has been diligently sourcing areas for opportunity and improvement for the administrative staff within the department.

During 2022, she developed the Administrator Academy. The academy is a hybrid-modeled platform that focuses on bridging the gap for employees who may not be exposed to professional development opportunities that are offered to other role groups. With over 10 courses focusing on technical skills, leadership and community-building, the Administrator Academy has become a fun and very needed resource for the department! Open to all, the classes have ranged in size and number. With leaders from our department hosting courses on public speaking, CME and finding your leadership style, everyone walks out with more knowledge than they had before and maybe even with a new friend! Thank you, Jaye, for being a wealth of information and advancement for our staff!

Cassandra ‘Cass’ Georges
Program Manager, Office of IDEaS
Department of Emergency Medicine

Victims of violence are part of our patient population on Braunwald Tower 8. To better care and support our patients, we partner with the Brigham’s Violence Recovery Program (VRP). One of the key members of the VRP is Rahsaan Peters. Rahsaan introduced us to the Louis D. Brown Peace Institute (LDBPI), which was spearheaded by Clementina Chéry, who lost her teenage son to senseless gun violence. The Peace Institute supports members of the community who have been affected by gun violence and continue their work in spreading peace across the city. Part of that work is the annual Mother’s Day Walk for Peace.

In honor of Survivors of Homicide Victims Awareness Month, Nov. 20–Dec. 20, our Tower 8 Practice Councils recently partnered with the LDBPI to create seven wreaths with the seven principles of the Peace Institute: faith, hope, unity, forgiveness, love, courage and justice.

Diane Tsitos, DNP, RN
Nursing Director
Braunwald Tower 8 Burn/Trauma/Surgical

I will never forget bringing the American flag on the field at the BC Healthcare Heroes game in September.

Jason Salzsieder
Provider Enrollment, Brigham and Women’s Physicians Organization

I will always remember the feelings of joy and anticipation I felt upon learning that a new president had joined our BWH family. At the first town hall meeting, we had the opportunity to meet Dr. Higgins and ask him questions. I welcomed him, of course, and then told him, “Roll up your sleeves and let’s get to work.” His response felt genuine and comforting because I saw in him a leader of color, which makes me so very proud, and someone who is exceedingly qualified to lead this great institution!

Jacqueline Rodriguez-Louis, MPH, MEd, CTTS
Programs Leader, PAC Community Outreach, Division of Pulmonary and Critical Care Medicine

Everything we do at the Brigham is centered around our patients. In inpatient areas, staff typically support patients for a brief window of time — sometimes the most difficult moments, days or weeks of their lives. These teams don’t always know how deep of an impression they have made on the lives of our patients and their loved ones after discharge.

That’s why this story out of Braunwald Tower 8 touched my heart.

This spring, John Bosse and his family returned to the unit to thank them for the care they provided when he was ill with COVID and intubated for 20 days. John and his family thanked the team for treating him “like family.”

During their visit, the family shared the “Starfish Story,” a parable about the difference one person can make in another’s life.

The family’s emotional reunion with staff is a powerful reminder of the impact of relationship-based care and the difference our teams make. This is one beautiful example among so many throughout the hospital — in inpatient, outpatient, emergency and procedural areas — that demonstrates how much the compassion of our staff means to patients and loved ones, long after they’ve left the hospital.

Maddy Pearson, DNP, RN, NEA-BC
Chief Nursing Officer and Senior Vice President, Patient Care Services

I loved serving as a mentor and internship coordinator for our first in-person Diversity in Pharmacoepidemiology undergraduate summer program. Mentorship is one of the most rewarding roles I’ve experienced.

Theresa Odoul
Research Assistant, Division of Pharmacoepidemiology and Pharmacoeconomics

Our beloved Radiation Oncology colleague Maureen Farrell retired this year after 41 straight years as a nurse at BWH. Maureen was a dedicated and steady presence in Radiation Oncology, always ready to assist wherever needed. She was known for her consistency and reliability, her caring nature and her willingness to go above and beyond on behalf of her patients and her co-workers.

A recent comment on a Press Ganey survey described Maureen to a tee: “Maureen Farrell was extremely caring, helpful, responsive, calm, and thorough. She’s a gem.” To give her a warm sendoff on her final day in the department, Rad Onc staff surprised Maureen by lining the hallway as she exited the clinic. The emotional walk brought tears to Maureen’s eyes and also to those of us who had worked with her over the years — many of us having gone through our medical training in the department and, in a sense, having “grown up” with Maureen as a wise and compassionate guide. Maureen’s walk down that hallway was a touching goodbye for all of us, honoring someone who had a profound impact on her patients and colleagues alike. We will miss her greatly!

Paul Nguyen, MD, MBA
Vice Chair, Clinical Research
Department of Radiation Oncology

A few weeks ago, I was covering our Radiation Oncology urgent patient service in our Boston clinic, and the number of simulation, or “sim,” appointments crept up to nearly 100 for the week. These are the radiation mapping appointments that precede every patient’s course of radiation treatment. Just a few years ago, seeing 100 sims in a week would have been unthinkable and unmanageable for us.

During the week I was covering, there was, appropriately, no big celebration for reaching this number. For me, however, it represented the culmination of lots of small steps that our department has taken over the years to live up to our commitment of being there for our patients. These include things like changing the sim scheduling model, increasing efficiency to allow shorter sim appointment slots, hiring staff to match demand and implementing a “doc-of-the-day” system to provide physician coverage. No heroics — just the result of purposeful, team-oriented projects that unlocked our potential.

I’ll remember that week for what it was (a celebration of sorts) and what it wasn’t (a disaster of scrambling and rescheduling). It made me proud of what we accomplished working together, and optimistic for the accomplishments we will see in the future.

Neil Martin, MD, MPH
Clinical Director, Department of Radiation Oncology

I’d like to give a shout-out to my colleagues and co-workers — including Dr. Robert Barbieri, Deborah Darveau, Aaron McDonald, Pamela Linzer, Lisa Maccioli and Sigfredo Salguero — for their unwavering support and incredible collaboration in Interpreter Services’ DirectResponse pilot and for their continual drive to roll it out to all Brigham on-call services outside business hours.

This program allows our limited-English proficiency patients and their families to receive equitable care and service without language barriers. The meetings, emails and tons of behind-the-scenes work paid off due to each one’s dedication, hard work and brilliant ideas. This is my brightest shining moment of 2022.

Yilu Ma, MS, MA, CMI
Director, Interpreter Services

The medicine nursing leadership team (12A, 14ABCD, 16AB) got a rare moment in November to participate in a team-building event at the Isabella Stewart Gardner Museum, led by the Center for Visual Arts in Healthcare team, which was co-created and led by Dr. Joel Katz and Brooke DiGiovanni Evans at BWH.

The group’s goals were aimed at training health care teams in visual arts methods to build essential skills in humanistic health care, including empathy, teamwork, respect, and curiosity; enhance critical thinking, diagnostic analysis, communication skills and cultural understanding; and improve the lives of health care workers through opportunities for self-care, reflection, social connections and creativity.

For example, one activity asked the team to observe the museum’s beautiful courtyard and create poems based on their five senses. It was a memorable activity for team bonding and a break from patient care activities.

Here are our team poems about the courtyard describing our visions and insights in a collaboratively constructed poem.

Protected Beauty
Virgin Beauty
Cold Vibes
In Vibrant Color
with Peaceful Vitality

—Pam Linzer, Kate Callahan and Linda Delaporta

***

Autumnal Peace
Sounds of waterfall renews your soul.
The brightly muted autumnal scene brings you calm and peace;
The watchful eyes of the statutes appear in awe of the surroundings like the guests;
The soothing tranquil light allows you to reflect, if just for one moment;

—Marie Swain Price, Jennifer Cartright and Maria Daveiga Etheart

***

Meditative Whispers
Meditative whispers, the calming sounds of the waterfall;
Bring peace together;
Falling into the wonderous tranquility of the golden hour.

—Ruth Jones, Daphnee Souvenir and Jill Osborne

Pamela Linzer, PhD, NEA-BC, RN
Associate Chief Nursing Officer, Medicine and the Center for Nursing Excellence

We are coming up on year TWO as the Office of Inclusion, Diversity, Equity & Social Justice (IDEaS) within the Department of Emergency Medicine! For the past two years, IDEaS has been creating spaces for growth, collaboration and healing — with a mission centered around creating a safe and respectful home for all employees — to advance racial, ethnic, gender and religious diversity, with a focus on those underrepresented in medicine (URiM).

To revamp our in-person activities, IDEaS hosted our first in-person moonlight dinner to welcome new URiM faculty and staff! A night full of great food, big laughs and shared experiences, it provided a much-needed space to continue fostering spaces of community and belonging!

Office of Inclusion, Diversity, Equity and Social Justice (Office of IDEaS)
Department of Emergency Medicine

I supported our Brigham Block Party event by giving out cookies to thank our employees. It was so wonderful to see so many people and to hear such appreciation for Brigham. I enjoyed hearing about everyone’s roles and the impact they make for our patients. Several patients had asked what we were doing, and they were thrilled that we were doing something to appreciate our people. Our teams are very hardworking, and it was great to be able to give something little back to thank them.

Patricia Hollinger, MBA
HR Specialist, Human Resources

We started off 2022 as just 14AB and our tight-knit community of nurses, PCAs and UCs, and we’re ending 2022 now as 12A/14AB/15A, with many new nurses joining our family. It was not always easy growing this much — between the staff orienting new grads and travelers, being short-staffed at times and the stress that comes with opening two units — but we all stuck together and lifted each other up during this difficult time. We’re looking forward to making new memories in 2023!

Leslie Hirshberg, BSN, RN
Staff Nurse, Braunwald Tower 12A/14AB/15A

I will always remember the Brigham Way lunch where Renata Morales, RN, was honored. She is our iCMP nurse and very deserving of the award.

Charlene Victorino-Griffiths
Practice Manager, Primary Care
Brigham Circle Medical Associates

The 2022 Connors Center Annual Research Symposium was held at Brigham and Women’s Hospital on Nov. 29 in conjunction with the Brigham/Harvard Reproductive Outcomes of Stress & Aging (ROSA) Center, a National Institutes of Health Specialized Center of Research Excellence on Sex Differences. Over 100 attendees from the Connors Center, BWH, MGB and external community gathered for the first in-person event hosted by the Connors Center since 2019. Speakers included investigators and trainees from the ROSA Center and recipients of Connors Center awards and fellowships.

Daniel Grossman, MD, delivered the keynote address, “All Hands on Deck: Strategies to Maintain Access to Reproductive Healthcare Post-Roe.” Dr. Grossman is currently the director of Advancing New Standards in Reproductive Health (ANSIRH), a research program in the Bixby Center for Global Reproductive Health and the Department of Obstetrics, Gynecology and Reproductive Sciences at University of California, San Francisco, where he is also professor. During the symposium, he shared insight into the current status of reproductive health care access after the repeal of Roe v. Wade, including its disproportionate effects on people of color and individuals in rural, anti-choice areas. Dr. Grossman discussed the consequences of reduced abortion access leading to an increased rate of self-managed abortions and criminalization of patients. He shared strategies to meet increased demand for reproductive care in states with protective policies in response to these changes. Alisa Goldberg, MD, MPH, program director, Family Planning Fellowship, and Lydia Pace, MD, MPH, director of Women’s Health Policy and Advocacy and director of the Global Women’s Health Fellowship, provided introductory remarks and facilitated the Q&A session with Dr. Grossman.

Connors Center members then presented their research in a series of presentations and Q&As.

Session 1:

• “Sex differences in characteristics, outcomes and treatment response with dapagliflozin across the range of ejection fraction in patients with heart failure: Insights from DAPA-HF and DELIVER,” presented by Wendy Wang, MD, First.In.Women fellow
• “Physiologic and social stressors and health during the menopausal transition,” presented by Emily Oken, MD, MPH, ROSA Center project 2 co-investigator
• “The action of melanocortins on Kiss1 neurons in the control of fertility in the female mouse,” presented by Rajae Talbi, PhD, ROSA Center pilot awardee

The proceeding Q&A session was moderated by JoAnn Manson, MD, DrPH, MACP.

Session 2:

• “Brain-based outcomes in postmenopausal women with MDD,” presented by Katherine Burdick, PhD, IGNITE awardee
• “Novel approaches using machine learning to investigate and predict hypertensive disorders of pregnancy,” presented by Vesela Kovacheva, MD, PhD, IGNITE awardee
• “Codifying the right to abortion: Impact of the Massachusetts ROE Act on out-of-state referrals,” presented by Steffanie Wright, MD, Family Planning fellow

The proceeding Q&A session was moderated by Cindy Liu, PhD, director of Psychosocial Stress, Diversity and Health.

The symposium concluded with brief remarks from Annie Lewis-O’Connor, PhD, NP-BC, MPH, FAAN, introducing a project funded by the Lisa L. Leiden Fund for Research in Women’s Health Excellence. The collaborative, multidisciplinary project will analyze the effects of trauma-informed care on providers and patients alike. The collaborative aims to integrate nursing leadership in research and transformative programing.

Thank you to all speakers, moderators and attendees for supporting and engaging with the important research funded by the Connors Center and making this event a success!

Patricia Gallegos, MPH
Project Manager, Mary Horrigan Connors Center for Women’s Health and Gender Biology

The fourth annual Emergency Medicine for Rural and Indigenous Communities Conference 2022 (EMRIC) took place in Flagstaff, Arizona, from Sept. 15 to Sept. 17. This year’s theme was “Innovation and Adaption.” It was the first time both planning committees from Boston and Arizona met, as the entirety of the conference planning was done virtually! It was a great weekend of many firsts, formal introductions and feel-good moments after a year of planning. It was an incredible time to see everyone come together and discuss emergency medicine within the context of rural and indigenous communities. From the procedural skills day to the two days of content, panels and discussions, it was truly a needed experience and one that none of us will ever forget!

Front-Line Indigenous Partnership staff
Department of Emergency Medicine

The Front-Line Indigenous Partnership program (FLIP), an initiative of the Department of Emergency Medicine, has successfully completed our first year in partnership with Tséhootsooí Medical Center (TMC). Our clinical exchange program is a concerted effort aimed at advancing medical, nursing and technical educational partnerships between Brigham and Women’s Hospital and tribal health care systems in the southwest. To date, over 12 providers from our Emergency Department have completed clinical rotations.

Capturing the heart of the clinical exchange program, TMC physician Dr. Jessica Salamon submitted this touching testimonial: “BWH has joined us at a time when physician staffing in the Emergency Department at TMC has been a challenge, and on multiple occasions, the BWH physicians have altered their schedules and agreed to extra hours to support our team. It has been a pleasure to share the unique challenges and rewards of working in rural medicine with the BWH group, and we have been glad to incorporate new perspectives into our day-to-day in the Emergency Department. It has been a true exchange of ideas and practices in the spirit of providing consistent, quality care to the Navajo population that our hospital serves, and we look forward to working together in the winter months ahead.”

Office of IDEaS and Front-Line Indigenous Partnership Program
Department of Emergency Medicine

One of the nice, yet bittersweet, moments in 2022 I will always remember is when my wonderful colleagues in OB-GYN surprised me and showed their appreciation and love for me and my work by getting me flowers, cards, cakes, desserts and gifts in February before I transferred to the International Patient Center. I really appreciated it, and I’m so grateful to the team. I worked with them for three years, which was the greatest work experience I ever had.

Mira Eissa, MBA, HCM
Senior Administrative Assistant, International Patient Center

There are many moments that I look back on this year, but my favorite was my very first day at Brigham and Women’s Hospital. I began my journey here this past January as a radiology tech aide — my very first job in a hospital. To say I had little experience under my belt would be an understatement. But soon enough, and with the help with my fellow CT techs, I caught on. My co-workers not only modeled how to do the job, but they also, most importantly, demonstrated empathy and compassion. I knew then that I was exactly where I was meant to be — here at BWH.

Brigham and Women’s Hospital has always been a huge part of my life. I am both a Brigham baby and the daughter of a former sonographer at Brigham: Karen Carten. My mother worked as an imaging technologist for 33 years. She started her career at 850 Boylston and then moved to the Foxborough campus as their lead sonographer. My mother loved her career and the role she played in patients’ lives, but what she didn’t know is how big of a role she would play in my own career. In May 2018, I lost my mother to a sudden illness. She had just turned 61 and was full of love and light. She was such a bright light not only for the Foxborough family but also for Brigham and Women’s Hospital as a whole. I feel so lucky and loved.

I’ll never forget my first time bringing a patient to their room. I do not drive in general, so driving stretchers was a whole new ballgame. I remember talking with a patient while bringing her through the Emergency Department, and she asked me what made me want to get into radiology. The answer was really so simple, yet it felt so hard to articulate. But in the moment with that patient — explaining my past and present — it felt so safe to tell my story. I felt a sense of comfort, happiness and love come over me. Most importantly, I felt my mother, and, in fact, I continue to feel her every time I walk into the entrance to 75 Francis St.

Each moment I am given with a patient is one that is easily time well spent. From my own experience, we never know when our last moment is our last, so be sure to make each one count. That patient interaction in the ED opened a new door in helping me become who I am meant to be here at BWH. It’s true what they say: If you love what you do, you’ll never work a day in your life.

Ellie Carten
Radiology Tech Aide, Department of Radiology

One of the highlights of this past year for me was being able to resume some of the in-person events and connections that we took for granted prior to the COVID pandemic. I had the privilege of celebrating with our physicians at the Physician Recognition Reception, honoring the Distinguished Clinician and Professionalism Awards recipients at the Annual Meeting of the Medical Staff, and getting to meet informally with many physician colleagues at our monthly BWPO President’s lunches. These opportunities underscored how honored and humbled I am to be part of this amazing Brigham family and I look forward to making more in-person connections in the new year.

Giles Boland, MD
President, Brigham and Women’s Physicians Organization
Executive Vice President, Mass General Brigham

One of the highlights from this past year was organizing a series of events with Diana Reusch, MD, a pediatric dermatology fellow at Boston Children’s Hospital, to expose 45 middle and high school students to medicine. These students were able to concentrate on perfecting their running stitch, identifying organs using an ultrasound, honing their laparoscopic surgical skills and learning the importance of personal protective equipment. This collaboration was with a summer youth program of the Phillips Brooks House Association (PBHA), a student-led community service organization at Harvard University with yearlong programming for local underserved youth in the Boston and Cambridge area. Over the summer, there are 11 neighborhood-based camps that offer quality programming and professional development to provide valuable work experiences and positive social connections in a safe, inclusive environment. We were able to work with teenage students involved in PBHA’s Junior Leaders in Communities (JLinc) and LEADERS Program. It was exciting to meet them, show them around the Longwood Medical Area and teach them about careers in medicine.

While I was completing my master’s thesis through the Divito Laboratory in the Department of Dermatology, I joined the Do Right, Stay Well (DRSW) Committee. Moving to Boston during the pandemic, I yearned to connect with the local community. Joining DRSW gave me that chance while also promoting skin health and awareness. Through Margaret Cavanaugh-Hussey, MD, MPH, a member of DRSW, I was so lucky to become connected with Dr. Reusch to plan these events with the PBHA.

This effort came together thanks to generous funding provided by the Department of Dermatology’s DRSW Committee, resources from the STRATUS Center for Medical Simulation and the kind efforts of so many people to help plan Longwood-area excursions for the teens. Other planners and volunteers included Harvard dermatology residents Dr. Balaji Jothishankar, Dr. Thet Su Win, Dr. Danna Moustafa, and Dr. Madeline Dewane; Harvard dermatology attendings Dr. Jennifer Huang and Dr. Arash Mostaghimi; medical students Lara Emerson (Tufts MS4), Nicole Trepanowski (BU MS4), Gustavo Velasquez (Harvard MS4), Maria Asdourian (Harvard MS4), Natalie Braun (Harvard MS2) and Julio Servin Flores (Harvard MS2); PBHA staff member Shaquanda Brown; medical scribe Morgan Schaefer; Department of Dermatology staff Mary Sbuttoni and Lily Vu; and STRATUS operations manager Persephone Giannarikas.

Being part of a group of people invested in inspiring youth has been empowering. Uniting with other members of the BWH community to host these events is something I will continue to cherish. It allowed me to spend time with these students and learn about their stories and passions. I hope to continue to give back and guide them towards their dreams in the same way my mentors have done for me.

Natalie Asemi
Laboratory technician, Department of Dermatology

There are many moments from 2022 that brought me joy, but these five hold a special place in my heart. From supporting colleagues, to working hard for our patients, to developing new and improved processes, to celebrating the accomplishments of our community, I am in awe of the incredible teamwork and talent represented in the above photos.

• The Human Resources team supporting our employees at a Giving Gratitude event
• Maddy Pearson, DNP, RN, NEA-BC, chief nursing officer and senior vice president, receiving her Distinguished Chair in Nursing (pictured with colleague Cori Loescher, BSN, MM, RN, NEA-BC)
• Central Sterile team mapping out performance improvement
• The International Patient Center team, who work together to bring patients to the Brigham who need our specialized services
• The tireless efforts of team who staffs the Kraft Family Blood Donor Center’s blood mobile to receive lifesaving blood and platelet donations in support of our Blood Bank

Shelly Anderson, MPM
Executive Vice President and Chief Operating Officer

Did reading this year’s collection of Moments from Our Hearts inspire you to share your own? There’s still time to contribute! Simply use the comment box below to share a Brigham moment from the past year that you found touching, meaningful or made you feel proud to be part of the Brigham community.

Please note that comments on this page are moderated and will not immediately appear after clicking “Post Comment.” If you would like to submit a photo to accompany your submission, send it to bulletin@bwh.harvard.edu and a member of the Brigham Bulletin team will add it to your post.

Driven by a shared commitment to build equitable systems of care across the U.S., several Brigham leaders are working with the American Medical Association to guide a national network of health systems in embedding equity into their quality and safety operations — a program directly inspired by work the Brigham has done in this area to better serve our patients and families. Pictured above: Jarquis Jones cuddles with her baby, Cayson, in the NICU.

It started with a pitch.

Karthik Sivashanker, MD, MPH, was a fellow in the Department of Quality and Safety four years ago when he became convinced that health equity needed to be incorporated into the Brigham’s quality and safety work — a kernel of an idea sparked by his participation in the Institute for Healthcare Improvement’s (IHI) Pursuing Equity initiative.

He approached his colleague Karen Fiumara, PharmD, BCPS, CPPS, then the hospital’s executive director of Patient Safety, with a question.

“I basically walked into Karen’s office one day and said, ‘Don’t you think we should be looking at some of these factors — whether a person’s self-identified race, language or insurance type is having any impact on safety events?’” recalled Sivashanker, now vice president of Equitable Health Systems at the American Medical Association (AMA). “She said, ‘Yeah, I don’t know why we’re not doing that.’ She was an immediate ally.”

That informal conversation ignited a transformation, launched in partnership with the IHI in 2019, in how health inequities are identified and addressed at the Brigham. Since then, it has grown, expanded and, most recently, inspired a national collaboration to support other health systems on the same journey to improve health outcomes for historically marginalized populations.

A Systemic Solution

At hospitals around the country, equity was historically treated as a separate domain of health care, with assorted projects or initiatives often executed in isolation from one another and lacking broader, lasting engagement.

But systemic problems — including racism, sexism, ageism, ableism and other forms of prejudice — need systemic solutions. One way to do that, Fiumara and Sivashanker concluded, was to integrate equity into existing quality and safety structures. As a starting point, they led work to update the Brigham’s safety reporting tool so that staff filing a report could indicate if they believed bias or discrimination played a role in an event.

“This isn’t a problem we solve by devoting more resources to new initiatives or programs. These are foundational principles that must be embedded into our infrastructure,” said Fiumara, now vice president of Patient Safety. “Just as we design systems to provide safe care, we need to also make sure they are designed to deliver equitable care.”

From that first initiative, several more have blossomed in the areas of quality, safety, access and patient experience, with the goal of building systems that prevent harm by anticipating and correcting inequities in care.

Exchanging Knowledge and Ideas

To spread the impact even further, Brigham leaders have shared what they’ve learned with peers around the country over the past year as part of a nationwide collaboration.

Leaders from the Brigham partnered with colleagues at the AMA and The Joint Commission to establish the Advancing Equity through Quality and Safety Peer Network, a yearlong mentorship and networking program that has brought together participants from eight health systems who are learning how to apply an equity lens to all aspects of quality and safety practices.

“Quality is not the sole job of the chief quality officer. Similarly, managing and working on health care inequities is not the sole job of the chief diversity or equity officer,” Fiumara said. “It has to be seen as the responsibility of every person in the organization.”

The AMA-led program, which will soon conclude its first cohort, was co-designed with the Brigham. The quality, safety and equity framework that participants learn was designed and tested at the Brigham in collaboration with the IHI. Additionally, several Brigham leaders serve as faculty members for the Peer Network.

Peer Network faculty members, from left: Karen Fiumara, Esteban Gershanik, Nadia Huancahuari, Regan Marsh, Karthik Sivashanker and Normella Walker

“It has simply been a joy to join with others who are also dedicated to cultivating greater equity in health care,” said Normella Walker, MA, CDP, a faculty member for the Peer Network and the Brigham’s executive director of Employee Experience in Diversity, Equity and Inclusion and the Office of Mediation, Coaching, Ombuds and Support Services. “The platform provides a forum for sharing knowledge and deepening understanding and is advantageous on multiple fronts. It broadens our ability to influence change in this area, learn from others’ experiences and cultivate additional allies.”

Through monthly learning labs, peer-to-peer sessions, case reviews, individual coaching and other virtual activities, participants in the Peer Network learn practices and implementation strategies for systematically identifying and addressing root causes of inequities through an integrated approach to quality, safety, equity and operations.

“Our approach to collaborative case review and the ability to explore sensitive issues related to racism in a way that feels communal both facilitate learning and, most importantly, avoid blame,” Walker said. “We have shared our framework for discussing cases in a manner that provides safety and support as we engage in collective problem-solving using the equity-informed, high-reliability model.”

Collaborative Learning Along the Journey

Faculty member Regan Marsh, MD, MPH, an emergency physician and one of the Brigham’s three medical directors of Quality, Safety and Equity, recalled a recent presentation by a Peer Network participant who had identified an inequity in the personal care items patients in their hospital received. The hair and grooming products the hospital provided were not suitable for people with curly, coiled or kinky hair — a purchasing decision that disproportionately affected patients of color. As a result, they felt unseen and needed to buy and bring their own products.

The Peer Network participant shared that after learning about this concern, the hospital changed its purchasing practices to obtain personal care products suitable for more hair types — sourced from vendors led by people of color — and trained nurses and staff on providing patients these products if they wish to use them.

“As a faculty member, it’s been so interesting to see the different approaches people are taking, and it’s provoked ideas on our side, too. It’s very much about collaborative learning,” Marsh said. “This really is a space where the more people are at the table, the better.”

Hospitalist Esteban Gershanik, MD, MPH, MMSc, a Peer Network faculty member and Brigham medical director of Quality, Safety and Equity, agreed that it has been gratifying to support colleagues around the country as they design and implement more equitable systems of care.

“These traditionally aren’t easy conversations or easy spaces for people to be in, and it’s been great to see people support each other, be thoughtful and open, and normalize such conversations in these discussions about advancing their work toward racial justice and health equity,” he said. “We all face similar and different challenges depending on the communities we’re in, but we’re all trying to better understand our treatment of everyone who comes through and who does not come through our doors.”

Emergency physician Nadia Huancahuari, MD, FACEP, also a faculty member and Brigham medical director of Quality, Safety and Equity, said it has been energizing to see so many peers from across the country share an enthusiasm for engaging in this important work.

“While this work may be new for many of us — and that may make us uncomfortable at times — we are all fully committed to it for the sake of our patients,” Huancahuari said. “It’s a journey, not a destination. We have quickly realized that the more curious we become, the more we learn and uncover. For instance, one of our areas of focus is patient experience, where we continue to discover opportunities to address inequities to ensure all patients and families feel seen, cared for, safe and welcome. It’s inspiring to be part of a team that is leading the way in how we define, design and validate more equitable patient care and experiences.”

Brigham NICU graduate Cali Durant (pictured above) is one of more than 100 babies who have benefited from a new program that supports families of medically complex infants for several weeks following their discharge from the hospital.

About a month into her son’s stay in the Brigham’s Neonatal Intensive Care Unit (NICU), Yanai Dandridge was both excited and nervous when staff approached her with the opportunity to bring her baby, Cali, home sooner than expected. Since delivering him at 33 weeks for safety reasons — due to a rare, life-threatening pregnancy complication known as hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome — Dandridge eagerly watched her son grow bigger and stronger in the NICU’s expert care.

Once Cali was medically stable, NICU staff said he was eligible for discharge through a new program for babies like him called Transition to Home (TTH). Launched in October 2021 in collaboration with several Mass General Brigham hospitals, the virtual care program delivers continued support to families with medically complex NICU graduates during their first weeks home.

“When you’re at home without the support of hospital staff, it feels a little different, so having this resource was so nice,” Dandridge shared. “It was very helpful, especially as a first-time parent. We were able to ask any questions we had. They alleviate my worries with real-life facts, tangible solutions and comfort. It’s immensely helpful.”

Many infants followed with the TTH program and discharged home with on-going medical needs and medical equipment, such as feeding tubes or oxygen. Before leaving the hospital, NICU nurses teach caregivers how to safely replace their baby’s nasogastric (NG) tube at home and how to enter their baby’s daily metrics — such as weight, milk or formula intake, output (number of diapers) and oxygen saturation — into their Mass General Brigham Patient Gateway portal. Metrics are monitored daily by pediatrician Mollie Warren, MD, director of the program, and her team.

Equipping families with the resources, information and confidence to safely care for their babies at home often saves them days, sometimes even weeks, of additional hospital stay, according to the TTH team.

“Leaving the NICU and the comprehensive support it provides can be stressful, especially during the first few weeks transitioning to the home environment,” said Warren. “Our goal is to provide assistance during this time, ensuring babies continue to do well while also championing for their caregivers in a family-centered way.”

Warren was inspired to begin this program in part from her own personal experience. “My daughter spent five months in the NICU after she was born,” she shared. “When my husband and I were finally able to bring her home, we were both nervous, even though we’re both doctors, so I can only imagine how families without medical knowledge feel.”

Since the program began, the team has cared for 100-plus infants and continues to grow.

“This program helps transition families from high-tech monitoring in the NICU to a seamless family unit at home,” said Debbie Giambanco, DNP, NNP-BC, PMHNP-BC. “Helping them manage feeding issues, poor sleep and very high anxiety is invaluable.”

Comprehensive Care

All patients in the Growth and Development Unit of the NICU are eligible for the program while other NICU babies are evaluated for eligibility, including those who go home with oxygen or require an NG tube for feeding to supplement nutrition while learning how to eat.

“We work closely with the family to help them understand their baby’s unique health needs and feel confident in going home,” said Mara Sceery, RNCC, care coordinator. “It’s customized to each baby based on their and their family’s needs.”

Families are followed virtually over the course of two to four weeks. During that time, Warren is available by pager and conducts weekly virtual visits to answer any questions and make sure the babies are growing appropriately. She also communicates with local pediatricians to provide information about the baby’s NICU stay and smooth the transition.

“We try to help parents feel empowered and advocate for themselves and their baby’s needs,” she said.

Given the amount of time NICU graduates typically need to learn to eat independently, the ability for families to replace NG tubes at home can provide a reduced length of stay.

“Oftentimes, babies spend the last few weeks in the hospital just trying to learn how to eat, whether by bottle-feeding or breastfeeding, before they can be discharged from the hospital,” explained Warren. “This is completely on the baby’s own timeline. You can’t just give them a bottle and expect them to be able to figure it out.”

Families in eligible zip codes who don’t have access to technology at home are supported through the Mass General Brigham United Against Racism Patient/Family Tablet Loan Program. “If a family doesn’t have a computer or access to Wi-Fi, we loan them the tools they need,” said Warren.

Additionally, the Transition to Home team makes referrals to Bridges to Moms, supported by Roseanna H. Means, MD, for families with housing insecurities. “If a family whose child is in the NICU doesn’t have housing or if they have any transportation challenges, they are automatically enrolled in our program, even if the baby does not have medically complex needs,” said Warren.

Collaboration Is Key

The Brigham NICU team collaborates with the outpatient feeding and nutrition teams at Mass Ear and Ear (MEEI), Massachusetts General Hospital (MGH) and Newton-Wellesley Hospital to provide ongoing, specialized care close to home.

“We help babies transition from the NG tubes, and we have a pulmonary and GI specialist and speech pathologist and dietitians to help us safely remove feeding tubes,” said Christopher Hartnick, MD, MS, director of the Division of Pediatric Otolaryngology and of the Pediatric Airway, Voice, and Swallowing Center at MEEI. “For those who don’t have an NG tube but have difficulties feeding and/or breathing, we help ensure they do so safely.”

Collaboration is vital in providing patients with a coordinated and seamless experience, he added. “We are all patient-focused, and we develop a team approach so that we can care for the children and their families together,” Hartnick said.

After babies graduate from the TTH program, they are referred to other Mass General Brigham programs to support their continued growth and development. These include the MGH Feeding and/or Aerodigestive Clinics for continued feeding support and the NICU Follow-Up Program in the Center for Child Development at the Brigham.

Additionally, if families enrolled in the program need hands-on support replacing their baby’s NG tube, they can receive direct access to care through the emergency department at MEEI, or the Special Care Nursery at Newton-Wellesley without the typical ED wait times.

Dandridge spoke highly of her experience with the program. “Everyone was so kind and genuine,” she commented. “I could feel that they genuinely cared about what I went through and what was to come for both my baby and me. I’m forever grateful.”

Providers with diverse clinical backgrounds, combining their respective expertise in critical care medicine and surgery, care for patients in the new Medical/Surgical ICU on Braunwald Tower 11C. From left: Amy Cotton, Reza Afrasiabi, Rachel Putman and Meaghan Gagnon review a case together on the unit.

A new intensive care unit (ICU) on Braunwald Tower 11C that cares for both medical and surgical patients is helping to address some of the Brigham’s ongoing capacity challenges by adding much-needed ICU beds and greater flexibility to how the hospital uses available resources.

Known as the Medical/Surgical ICU, or Med/Surg ICU for short, the unit opened in September with six ICU beds, and another four beds will open on the unit in winter 2023. It is the Brigham’s first unit to provide intensive care for both medical and surgical patients in the same setting.

“It makes the capacity of our ICUs a little more dynamic,” said Jennifer Beatty, MS, PT, PA-C, director of Clinical Operations and Surgical Physician Assistants. “We will have 10 flexible beds to safely care for critical care patients from either discipline, allowing us to adapt better to the needs of our patients any given day.”

The launch of the new ICU is one of several initiatives the Brigham has undertaken to address unprecedented demand for patient care. It also marks the culmination of a complex, multidisciplinary effort that was a year in the making — including work by several teams to reallocate the space on 11C, prepare the area for a new use, train the clinical teams staffing the unit and safely transport critical care patients between units.

“The high census that we continue to see has been challenging for our entire organization. This effort has been a great collaboration by many different teams that will give us more flexibility in our ICUs,” said Tom Walsh, vice president for Inpatient Operations and Analytics, Planning, Strategy and Improvement.

The unit is novel in its leadership structure, having both a medical director and surgical director in recognition of the value of interdisciplinary expertise.

“There is a huge benefit to having close-knit communication between medicine and surgery,” said Kristin Sonderman, MD, MPH, surgical director of the Med/Surg ICU. “As surgeons, if we call for a medicine consult, it’s because we want to hear from someone who has a different brain. When we’re working side by side, those discussions happen much more frequently. We can easily call over a medicine attending and say, ‘What am I missing?’ or ‘What are your thoughts?’ It’s a true multidisciplinary unit.”

The unit is unique in more ways, too. While other ICUs at the Brigham are staffed by teams that include residents and fellows, these trainees do not make up the Med/Surg ICU team. Instead, physician assistants (PAs), led by Chief PA Caitlin Springer, PA-C, work closely with attending physicians and nurses, led by Nursing Director Hasna Hakim, DNP, MSN, RN, CCRN, to care for patients in this setting.

Rachel Putman, MD, the unit’s medical director, added that combining medicine and surgery has also provided patients and families with greater continuity of care for patients who ultimately require both branches of intensive care.

“We’ve had some very sick medical ICU patients who needed to go to the operating room, and we were able to keep those patients on the same service with the same team,” she explained. “It’s really advancing the collaboration we started building during COVID, when we were all working across different teams and disciplines to care for the same patients.”

In designing the Med/Surg ICU, the planning team gave considerable thought to which patient populations would be most appropriate for the unit, Beatty said.

“There is a wide breadth of patients, including those from general surgery, surgical oncology, ENT, plastics and some emergency surgery,” she said. “We also recognized that there are certain populations, such as neuro or trauma patients, who should continue to go to specialized units for critical care.”

Making Moves

Opening a new unit is far more complex than moving people and equipment to a different floor. Because the hospital has a fixed amount of space for inpatient care, any changes to one area affects another.

In preparation for the Med/Surg ICU opening, the unit that previously occupied 11C, the Thoracic Surgery ICU, was relocated to Shapiro 6E in August. It now shares a floor with the Cardiac Surgery ICU, which occupies Shapiro 6W. Meanwhile, that move triggered another: The previous occupant of Shapiro 6E, the Cardiac Surgery Stepdown Unit, was moved to Shapiro 7W.

For six weeks, nursing leaders for the affected units met regularly to prepare for the safe transport of patients and to ensure staff were welcomed to a space that contained the equipment and supplies they needed.

“Moving any ICU patient is difficult, especially when they are on ECMO and multiple pressors. You need nursing, respiratory, transport and security just to move one patient,” explained Maureen Tapper, MSN, RN, PCCN, nursing director of the Thoracic Surgery ICU. “We met numerous times before the actual move to ensure it went as smoothly and professionally as possible. Everyone did a great job, and I think it’s improved the relationship between nurses on 6 East/West. We both care for some of the sickest patients at the Brigham, so it’s united us.”

Maria Bentain-Melanson, MSN, RN, nursing director of the Cardiac Surgery ICU, emphasized that it was essential to involve unit staff in the planning process, not only to keep them informed but also to solicit their feedback and ideas about how to make the moves successful. For example, nurses shared that they needed a dedicated workroom on the floor for completing nursing reports, which the planning team was able to accommodate.

“With any change, there’s always a fear of the unknown, but including staff in the planning and decision-making from the get-go makes it a more transparent process for everyone,” Bentain-Melanson said. “All of our planning was about how we could keep patients at the center.”

Magnet champions prepare to visit units to speak with staff about Magnet and go over questions appraisers may ask.

In May 2018, Brigham and Women’s Hospital received Magnet designation for the first time in recognition of nursing excellence and outstanding care provided by interprofessional teams. Now, the hospital is preparing for redesignation in advance of a virtual site visit Jan. 30–Feb. 2.

“Achieving Magnet reflects the work of an entire organization in support of the highest-quality patient care,” said Pamela Linzer, PhD, RN, NEA-BC, associate chief nursing officer for Medicine and the Center for Nursing Excellence. “Our site visit is an opportunity to show appraisers our processes and practices that support care teams in delivering patient care.”

During the site visit, appraisers will be validating the examples that were shared in the Department of Nursing’s 4,000-plus page application, which was submitted in July. Upon reviewing the application, the Magnet Program Office determined that the Brigham was ready to proceed with a site visit.

“This is a testament to the exceptional care we provide and the outstanding group of writers and leaders who left no stone unturned in demonstrating how we meet each Magnet standard in our application,” said Maddy Pearson, DNP, RN, NEA-BC, chief nursing officer and senior vice president of Patient Care Services.

More About Magnet

Magnet is a four-year designation awarded by the American Nurses Credentialing Center — a subsidiary of the American Nurses Association — in recognition of excellent care delivered by nurses and interprofessional teams.

To achieve Magnet, organizations must provide examples and evidence of how they meet Magnet standards of Transformational Leadership, Exemplary Professional Practice, Structural Empowerment and New Knowledge, Innovations and Improvements.

“Our documentation comprises a wide range of examples of nursing excellence in collaboration with other departments and roles for each source of evidence,” said Elaine Joyal, DNP, RN, NEA-BC, Magnet Program director.

Examples include nurses participating in voluntary community and global outreach efforts with organizational support; reducing hospital-acquired infections with nurse-led interventions; developing new innovations to support the patient experience; disseminating research findings; and collaborating with multidisciplinary teams to provide compassionate, culturally sensitive care, among many others.

Jennifer Riley, MSN, RN, IBCLC, of Lactation Services, said developing the application as part of the Magnet Writers group was an inspiring experience.

The Department of Nursing’s Professional Practice Model

“Through our writing, I either met or learned about the work of so many Brigham nurses,” she said. “I have tremendous gratitude for what everyone gives of themselves each day to improve patient care in their specialties.”

Pearson noted that the application illustrates the work that Brigham nurses and their colleagues do each day.

“Our commitment to excellence, knowledge, collaboration and compassion in support of relationship-based care is the foundation of nursing practice at the Brigham, and this is what makes us a Magnet organization,” she said.

Preparing for a Site Visit

During the four-day site visit, a team of Magnet appraisers will visit the Brigham virtually. A Brigham team will support the visit by placing computers with video technology on rolling carts that enable appraisers to see numerous areas and speak with staff about their practice and processes.

Sessions will also be held in conference rooms for both nursing staff and interprofessional colleagues, with appraisers participating via video. In preparation, Magnet champions — a group of staff nurses and nursing leaders — are holding Magnet rounds on units to review the types of questions that appraisers will ask.

“Our staff and leaders will know the answers to these questions because it really is about what they do each day, but it’s helpful to have a sense of what to expect as we approach the visit,” said Monica Tucker-Schwartz, DNP, RN, NE-BC, senior nurse director for Procedural Services and Magnet co-program director. “We want everyone to feel comfortable.”

Pearson says the site visit and the months leading up to it are a time to celebrate the contributions every role makes to the experience of patients and loved ones at the Brigham.

“Magnet is truly a celebration of what we do each day, and I hope that everyone feels a sense of pride in the outcomes that we continue to deliver, even amid so many challenges with the pandemic and capacity constraints,” she said.

Magnet Resources:

• Review examples of how we meet Magnet standards in Heart & Science.
• Test your knowledge of Magnet with trivia.
• Visit PikeNotes to watch a video and brush up on the basics of Magnet designation.

Chris Nelson enjoys engaging with colleagues as he navigates every corner of the hospital with his equipment cart.

Chris Nelson, an inventory clerk in Biomedical Engineering, is quick to greet anyone he encounters as he travels about the Brigham’s main campus and Brigham and Women’s Faulkner Hospital to deliver packages and equipment and maintain his department’s stock of engineering parts and other materials.

“I love talking to people,” said Nelson, a member of the Brigham community for 20 years and a Pike celebrity, given the nature of his work. “I’m a very friendly person, so it just comes naturally to me to see someone and say, ‘Hey, how are you?’”

In addition to taking inventory and inspecting machinery, Nelson leads many special projects, including work to ensure that warm water runs through eyewash stations and that automated external defibrillator (AED) units are functioning each week.

“I especially take pride in making sure the AEDs are working correctly because that’s a lifesaving machine, so I know that machine is working and can hopefully save a person,” Nelson said.

That level of dedication is emblematic of the Biomedical Engineering team — known informally as Biomed — whose technicians, engineers and administrators work to maintain and implement clinical technology across the Brigham.

“I am fortunate to work with a very well-rounded team that is both technically sound and human,” said Michael Fraai, MS, CCE, executive director of Biomedical Engineering. “We take care of each other. Nobody lets each other fall.”

From scales to IV pumps and everything in between, the team is responsible for inspecting, testing, installing, maintaining, repairing and replacing approximately 32,000 devices used in patient care throughout the Brigham and its regional ambulatory locations.

Dylan Wright, who was recently promoted from technician to clinical engineer, also finds his work rewarding because he knows it is helping patients receive high-quality care. As an engineer, he now manages projects for updating technology used in patient care.

“I think the most rewarding part of the job is being able to walk around on the floor and see the new technology in use, knowing that a lot of effort and work went into getting the equipment on site and in the hands of the nursing and clinical staff,” Wright said.

Powered by Collaboration

The Biomed team also collaborates with colleagues in other departments to lend their expertise to larger-scale projects at the Brigham. In December 2019, for example, the team oversaw efforts to replace more than 800 mattresses in less than one week. While mattress conversion was seemingly outside the usual scope of Biomed’s work, the team’s vast experience and expertise in transporting, implementing and managing large volumes of equipment guided the project to success as they collaborated with more than 21 departments.

Kerrie-Ann Jack, senior business director of Biomedical Engineering, led the project and recalled navigating the logistical challenges of managing the timely shipment of mattresses from California while also ensuring they could be installed quickly upon arrival to minimize any disruptions to patient care.

Among the many collaborations that emerged during that project, Jack said, it was rewarding to work with colleagues in Interpreter Services to translate patient communications about the mattress conversion and with Shipping and Receiving to manage the delivery of the shipping containers.

“I think it’s fascinating for people to know the interaction we have with so many different departments,” said Jack. “They might not recognize how long our tentacles run. We manage a huge clinical technology footprint, but we also always end up working with a multidisciplinary group to roll out a project.”

Valuing Diversity, Elevating Opportunities

According to Fraai, the work of the Biomedical team is informed by its members’ varied expertise and diverse life experiences. Many cultures and identities are represented on the team, and even in the largely male-dominated discipline of engineering, women make up the majority of Brigham Biomed.

Women, including Kerrie-Ann Jack, pictured here, make up the majority of Brigham Biomed — a notable feat in a historically male-dominated field.

Within the department, staff are encouraged to become certified in their fields as technicians, engineers or administrators. In 2021, Jack passed an exam to become a certified Healthcare Technology Manager. The title certifies that she has studied the use of technology in clinical settings, and Jack participates in many engineering projects as an administrator.

The department also seeks to inspire future generations. Jack leads efforts to partner closely with the Brigham’s Student Success Jobs Program (SSJP), which matches high school students from under-resourced areas of Boston with paid internships at the Brigham. Some SSJP interns have returned to the Biomedical Engineering team as full-time staff.

In line with its goal to elevate opportunities for women in the field, the team has also partnered with Dana School for Girls through the school’s science, technology, engineering and math program to share the experiences of women engineers at the Brigham.

In addition to this work to engage with their local community, Biomedical Engineering staff lead international efforts to share retired Brigham equipment with medical facilities in other countries that have less access to medical funds and resources.

At the Brigham and beyond, the Biomedical team remains committed to improving and enhancing health care through technology, all while continuing to create pathways for professional growth.

“I get to learn a lot at the Brigham. There are always a lot of projects going on,” Wright said.

“Behind the Scenes at the Brigham” is a recurring series in Brigham Bulletin that provides a glimpse of the people whose everyday contributions help make the Brigham a world-class institution. Is there an individual or team you’d like to see featured? Send your ideas to bulletin@bwh.harvard.edu

One week after welcoming their twins to the world, Sean LaPorta and Tejal Patel tested positive for COVID-19. The couple says their Brigham NICU team went to extraordinary lengths to help them bond with their boys, Rahm and Yogi LaPorta, pictured above at home in November, while they isolated at home.

Sean LaPorta and Tejal Patel couldn’t believe what they were hearing during what was supposed to be a routine prenatal visit: Their twins needed to be delivered — and soon.

Patel was 32 weeks pregnant.

Their boys were being monitored for a rare condition called twin anemia polycythemia syndrome, also known by the acronym TAPS. It occurs when blood flows unequally in the womb between twins, causing one baby to receive too much and one to receive too little. After scans that day in May revealed some concerning developments, doctors recommended Patel undergo a cesarean section as soon as possible to ensure the twins’ safe arrival.

Later that day, Rahm and Yogi were born — each weighing about 3 pounds. Given their fragile state, they were quickly transported to the Brigham’s Neonatal Intensive Care Unit (NICU) to receive lifesaving care.

But just when LaPorta and Patel were starting to get their bearings, life threw them another curveball: One week after welcoming their babies to the world, the couple tested positive for COVID-19.

In the face of such an uncertain time for their family, the couple said their NICU team cared for their whole family with such extraordinary dedication and compassion — especially while LaPorta and Patel isolated at home, away from their boys, for two heart-wrenching weeks.

As Thanksgiving nears, the family says words cannot express the depth of gratitude they feel toward the Brigham staff who supported them during that time and through the rest of the boys’ stay in the NICU.

“I don’t usually get emotional, but when I talk about how much the team means to me, I get choked up,” LaPorta said. “It’s amazing anyone can have that much empathy. It’s not just that they take pride in their jobs, but they also have an ability to connect with people and understand exactly what they need.”

While LaPorta and Patel remained at home, NICU staff ensured the family could bond by setting up regular FaceTime sessions with the twins so their parents could read books and sing to them over a video call.

Although Rahm and Yogi avoided catching COVID-19, their possible exposure to their parents’ infection meant NICU staff needed to take additional precautions while caring for them. That included putting on and removing a full array of personal protective equipment each time they entered and exited the boys’ room during the isolation period.

“That extra mile was an extra marathon,” LaPorta said. “They would have to gown up and find coverage for their other patients every time they helped us set up a FaceTime call, then listened to us read a thousand books and moved the devices around so we could see both of our kids.”

“When I talk about how much the team means to me, I get choked up,” LaPorta says of the NICU staff who cared for their family.

Yelena Platsman, BSN, RN, one of the boys’ primary nurses in the NICU, said she never once considered those moments a burden. Just on the contrary, she added. She delighted in quietly listening to LaPorta and Patel lovingly read, and reread, stories such as Chicka Chicka Boom Boom and Steam Train, Dream Train to the babies.

“I imagined myself in their shoes and how difficult it must be to not only have my children in the NICU, but to also be separated from them,” she said. “I knew how much those FaceTime visits meant to Tejal and Sean. It was their only way of connecting with their boys.”

Family-centered care is an essential component to helping infants recover, grow and develop during their time in the NICU and beyond, Platsman added.

“The health of babies doesn’t just depend on the medical care they receive in the NICU. Their long-term health is dependent on the bond they form with their parents,” she explained. “Having parents involved as much as possible in taking care of their children promotes bonding, as well as parental confidence.”

Now 6 months old, the twins are thriving at home. Rahm, the more active of the two, seems to be close to crawling — an exciting milestone for any baby and even more thrilling for his parents after seeing him overcome the challenges of a premature birth. Yogi, who had been using a feeding tube to help meet his nutritional needs, is starting to explore the delights of solid foods and learning how to eat on his own.

“I’m most grateful right now for my kids,” LaPorta said. “It’s amazing to see them move forward and know that they’re happy and healthy.”

The couple says they couldn’t imagine where they would be without the support of their Brigham NICU team, said LaPorta, who is a twin and NICU graduate himself.

“They’re going to be part of our lives forever,” LaPorta said. “My parents still talk about their NICU staff and how amazing they were, and their stories don’t even come close to what our nurses did for us. They really need to know that we’re going to be forever grateful, and they’re always going to be part of the story for our kids.”