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.”

A new interpreter service to support patients calling outside normal business hours “has been an invaluable resource in providing customer service,” says Aaron McDonald, evening supervisor of Operator Services.

When patients call a clinic at night or on the weekend, they are connected with a phone operator who serves as a bridge between the patient and on-call provider. But most operators are not trained to assist a caller who speaks a language other than English. Reaching a member of the Brigham’s on-staff medical interpreters at night or over the weekend can take longer than during normal business hours, when most interpreters work.

To address this gap, teams from the Department of Quality and Safety and Interpreter Services collaborated with Telecommunications and OB-GYN/Midwifery to better support patients with limited English proficiency (LEP). Led by Yilu Ma, MS, MA, CMI, director of Interpreter Services, the group worked with a third-party vendor to design a program, called DirectResponse, that supports phone operators with non-emergency interpreter needs outside of normal business hours.

Prior to the program’s implementation, Brigham operators who received calls from patients speaking languages other than English during off-business hours often had difficulty obtaining information and relaying it accurately to on-call teams, according to Ma. The operator had to first identify the patient’s language and then put the patient on hold to contact an outside interpreter vendor to assist, which can involve extended wait times.

Now, LEP patients who need after-hours assistance from an on-call OB-GYN provider can more easily access those services. They can connect with an interpreter of their language within seconds. When patients call the program’s designated number from home during off-business hours, they are prompted to select their language by a pre-recorded instruction in that language. Since the patient and provider each contact the interpreter before connecting with each other, the interpreter is already on the line and ready to assist with translation.

“Our partnership with this vendor has decreased miscommunication and allowed patients’ voices to be heard,” said Nicole Sczekan, MSN, CNM, FACNM, director of Midwifery. “Prior to implementing this program, we had reports of patient calls not being appropriately transferred to us. That was distressing for the patient and family, as well as for clinicians. It’s imperative that patients call us with concerns and warning signs in order to provide safe care. Since the start of the program, these complaints have stopped and LEP patients now have peace of mind that they didn’t have beforehand.”

After a successful pilot in the Department of Obstetrics and Gynecology (OB-GYN), DirectResponse will be rolled out to all 28 Brigham clinical services that have on-call services. The program provides interpreter services in nine languages: Arabic, Cantonese, Cape Verdean, Haitian Creole, Mandarin, Portuguese, Russian, Spanish and Vietnamese.

“This is one of our inclusivity initiatives that allows our LEP community to communicate directly with their providers from their homes, independent of assistance from English-speaking family members or friends to translate on their behalf,” said Pamela Brown Linzer, PhD, RN, NEA-BC, associate chief nursing officer of Medicine and the Center for Nursing Excellence, who oversees Interpreter Services and Spiritual Care Services.

Robert Barbieri, MD, FACP, FACOG, interim chief of Obstetrics, agreed. “Interpreter services are so important in health care, so this program is really vital,” he said. “Rapidly accessible interpreter services are critical to providing equitable and high-quality clinical care to patients with limited English proficiency. This project is a testament to the Brigham’s work in continually improving our available interpreter services, and Yilu’s leadership was critical to the success of the program.”

Deborah Darveau, RN, senior patient safety specialist in the Department of Quality and Safety, described the program as an important step in improving the patient experience and advancing health equity.

“All patients deserve to be treated with the utmost respect and to be able to communicate with providers in their native languages,” she said.

“For our operators, particularly the after-hours team, the program has been an invaluable resource in providing customer service,” commented Aaron McDonald, evening supervisor of Operator Services. “The ability to so conveniently connect with another team that is dedicated to providing excellent service has proven itself to be nothing but a boon for accommodating callers in need of patient care.”

Drew Vild and Katie Shields snuggle their newborn daughter, Catalina Brigham.

Shortly into her pregnancy, it became clear to Katie Shields, RN, and her husband, Drew Vild, that one of their first big decisions as expectant parents ― what to name their daughter ― would require a level of diplomacy.

“I wanted something else for the first name, but Drew said, ‘What about Catalina?’” Shields recalled.

She sensed an opening in the negotiations and pounced on the opportunity.

“I’m such a middle name person, so I said, ‘Deal, as long as her middle name can be Brigham,” Shields said with a laugh.

That decision is no coincidence. Shields was a staff nurse in Labor and Delivery at the Brigham from 2016 to 2018, and she has continued to work on the unit regularly in recent years as a travel nurse while the couple has lived in San Diego, where Vild, a petty officer first class in the U.S. Navy, is currently stationed.

“We decided her middle name was going to be Brigham,” Shields says.

To the joy of her parents, their loved ones and Shields’ former co-workers on CWN 5, Baby Catalina Brigham made her debut at the hospital that bears her name on Oct. 31.

“We decided her middle name was going to be Brigham because she was going to be delivered there, and I’m obviously obsessed with the hospital,” said Shields, who describes herself as a Brigham and Women’s superfan due to the close bond she has forged with her colleagues and the immense respect she has for the extraordinary care they deliver.

Delivering her baby at the Brigham was no accident, either. Shields spent much of her pregnancy at home in San Diego but knew that, if possible, she wanted to travel cross-country to welcome Catalina to the world at the hospital that feels most like home.

“I wanted to be surrounded by all my friends, and I consider everyone here my second mom and my second best friend,” Shields said from her hospital room. “It really is a family. Everyone has each other’s backs.”

Originally from Andover, Shields was in town for her baby shower in October and expected to stay with loved ones until her due date in mid-November. But Baby Catalina was, evidently, just as excited as her mom was to see the Brigham and arrived two and a half weeks early. The timing also meant that Shields could share the moment with her family, including her own mother, whom she says has supported her every step of the way.

To celebrate Baby Catalina’s arrival, staff on CWN 5 lined the hallways and cheered “Congratulations!” and “Happy birthday, Catalina!” while Shields, Vild and their little one were transported to their Postpartum room.

Catalina Brigham received a joyous welcome to the world from Shields’ former co-workers on CWN 5.

Labor and Delivery nurse colleague Robyn Serody, RN, said she was overjoyed for Shields — and not at all surprised by her decision to name Baby Catalina after the Brigham or deliver her here.

“Katie loved working here, and everyone loved working with her! She was always positive and could make you smile. Every workplace needs a Katie,” Serody said. “The Labor floor is a family, and Katie will always be a part of our family!”

Speaking from her hospital bed, Shields said she couldn’t imagine starting her family at any other place.

“I’m a strong believer in ‘you get what you give,” Shields said. “It feels so right that we’re here.”

“This one right here — she is what keeps me going,” says Anameidy Roa Martinez (right) of her daughter, Mila (left), held by Donicely Zapata (center), a community health worker with the Brigham’s Bridges to Moms program, which has supported Roa Martinez as she has worked to overcome housing insecurity.

Anameidy Roa Martinez, 29, was seven months into her pregnancy when she developed pelvic pain so severe that it began to interfere with her job as a daycare teacher.

“I couldn’t walk, run or pick up the kids. I couldn’t do anything. It was painful to even take a walk outside,” she remembered. “I loved working with kids, but at the same time it was hurting me.”

She left her job and applied for unemployment benefits.

Roa Martinez was terrified. She lived alone and money was already tight. As she fell further behind on rent, and her due date got closer, she found herself in a situation she never imagined: on the verge of losing her housing.

“It’s the first time I’m dealing with something like this — not knowing how I’m going to pay the next month, what’s going to happen with the amount that I owe now, if I can get a job,” she said. “I have to have a roof over my head not only for myself but also my daughter. That’s the most stressful thing I’ve been going through.”

During one of her prenatal visits at the Brigham, she disclosed her situation to a social worker, who immediately referred her to a program called Bridges to Moms.

Founded in 2016 by Roseanna Means, MD, of the Division of Women’s Health, Bridges to Moms works to address gaps in five social determinants of health — housing, transportation, food security, personal safety and community resources — facing women who are pregnant and experiencing homelessness or at risk of homelessness.

“I volunteered as soon as I heard about this event,” says neonatologist Silvia Patrizi (right), pictured with Roseanna Means (left) at Bridges to Moms’ Career Day event.

The need has only grown as the state grapples with a worsening housing crisis and other economic factors such as inflation place mounting pressure on families, Means said.

“These women come to us at the lowest point in their lives. Meanwhile, they’re going to have a baby. They’re really scared. They don’t have any money. They’re isolated. They don’t have a moms group. They may not have a supportive partner, friends or their own mom in their lives,” Means said. “Yet these women are determined to make a better life for their kids. They are just amazing.”

Across the Continuum

Participants are paired with one of the program’s three bilingual community health workers — William Diaz, Edual Infante and Donicely Zapata — who serve as advocates and navigators to help patients access Mass General Brigham services and community-based resources, including assistance programs for daycare, food, clothing and housing.

More than 90 percent of participants are women of color, who are at disproportionate risk for pregnancy-related complications and death. To date, there have been no maternal deaths among women enrolled in Bridges to Moms.

“Helping people is my passion,” Infante said. “When you get to improve someone’s living condition, it’s a great satisfaction. I am also always learning more and more about the system as I work with our clients, and that knowledge is really important. Many of the cases are similar, so we can use our experience to help more people.”

Patients in the program receive support during the prenatal, peripartum and postpartum periods through the baby’s first birthday to monitor their health needs and address any systemic or institutional barriers that may affect the mother and her child.

For example, the program provides patients with transportation vouchers for all their medical appointments; similarly, mothers whose babies are hospitalized in the Neonatal Intensive Care Unit (NICU) receive free transportation to and from the Brigham each day until their infant is discharged so they can bond with their newborn.

From left: Lydia Marshall and Judah Soray volunteer at the Bridges to Moms Career Day event.

In addition, moms receive vouchers to enjoy a meal at the Garden Café whenever they’re here for an appointment or visit. “I can’t tell you the number of times they tell me this is the only meal they’ve had that day,” Means said.

A core philosophy of the program is to reduce stigma and focus on providing women the resources they and their children need to achieve optimal health. In addition to engaging women during appointments, Bridges to Moms staff visit women in the community to bring them food, diapers, baby clothes, gift cards and other much-needed items.

“We focus on saying here is where you are, here is where you want to go and here are all the ways we can help you,” Means said. “We always tell the women, ‘You are not doing this alone anymore.’”

Set up for Success

The program also places a strong emphasis on helping mothers regain their socioeconomic footing to set them up for future success. Last month, Bridges to Moms hosted a Career Day event in the Hale Building for Transformative Medicine in partnership with Williams James College and Cambridge Trust.

At one station, a Bridges to Moms staff member helped attendees write their resume. Representatives from Williams James College Workforce Development Program spoke with participants about a job training program to become a community health worker. Cambridge Trust volunteers helped mothers create budgets and savings goals.

The event also provided attendees with child care, food, giveaways of baby clothes and free entry into raffles for bigger-ticket baby items, including a pack-and-play portable crib and a bassinet. Translators were available at every station to ensure Spanish-speaking mothers in the program could fully participate.

Additionally, Brigham neonatologists and pediatricians also hosted tables where mothers could ask questions about caring for their baby and common health concerns for infants.

“I volunteered as soon as I heard about this event,” said Silvia Patrizi, MD, a neonatologist in the Department of Pediatric Newborn Medicine and director of the department’s Diversity, Equity and Inclusion Taskforce. “I think the exceptionality of the program is, one, to follow these women and their babies from their pregnancy until the child is a year old and, two, that it is not charity. It’s really helping these women to grow out of poverty, regain dignity and become empowered by making sure they know their rights and have the tools to make a stable life for themselves and their family.”

Roa Martinez — who attended the event with her now 5-month-old daughter, Mila — says she doesn’t know where she would be without Bridges to Moms, which has helped her apply for rent payment assistance and housing lotteries, supplied her with baby clothes and provided access to community resources.

“When I met the Bridges to Moms staff at that first appointment, it was the most wonderful thing ever. Sometimes, you just need somebody to listen to you — and somebody who has had a similar situation as you,” she said. “I’m still so grateful to Bridges to Moms.”

Today, Roa Martinez said she is more determined than ever to give her daughter the best life she can. She is eager to start working again and set up a savings account, with dreams of one day buying a home and becoming a community health worker herself so that she can give back.

“This one right here — she is what keeps me going,” Roa Martinez said while cuddling her baby. “It’s not until you have your own child that you know what it means to keep going, even if you don’t have anything left in you. It’s OK to cry. It’s OK to complain sometimes. But as long as you don’t give up, that’s the only thing that matters. And I haven’t — and I won’t.”

For more information about the Bridges to Moms program or to learn how to support it, contact Roseanna Means, MD.

After sharing an elevator with thoracic surgeons discussing a new, experimental surgery that could treat her autoimmune disorder, Brigham nurse Stephanie Capello decided to inquire about becoming a candidate for the procedure.

After living with a chronic autoimmune disease for the past four years, Stephanie Capello, BSN, RN, CWOCN, a Wound and Ostomy nurse at the Brigham, was eager for relief.

She had developed myasthenia gravis (MG), a neuromuscular disorder that causes the immune system to mistakenly attack the skeletal muscles — leading to muscle weakness that affected her ability to breathe, talk, swallow, chew and more.

Capello recalled her alarm and confusion when her symptoms first emerged in 2018. “I was working Labor Day weekend, and I thought I was having a stroke because I couldn’t talk,” she said. “I couldn’t get my words out.”

She began taking immunosuppressive medicine for her condition and receiving monthly IV immunoglobulin infusions, which provide antibodies for those with antibody deficiencies. While the therapies partially alleviated her symptoms, they also had side effects.

There was another option: surgery to remove her thymus, a gland located under the breastbone and in front of the heart. Her neurologist, Christopher T. Doughty, MD, explained that undergoing a thymectomy would very likely reduce her need for medications. It might even put her disease into remission.

Still, it was major surgery, and Capello was concerned about the risks and recovery. She didn’t feel ready to consider surgery until one day at work when she was standing in a packed elevator, where she overheard Raphael Bueno, MD, chief of the Division of Thoracic and Cardiac Surgery at the Brigham, talking with a colleague about a new, less-invasive approach to performing this procedure.

This new approach, a single-port thymectomy, uses an experimental robot to remove the thymus through only one incision — hence the name “single port.”

“Listening to Dr. Bueno’s excitement and the way he was talking about how it would greatly benefit patients by being less painful, having a faster recovery and shorter stay in the hospital, I began to reconsider and realize it might not be as bad as I thought,” reflected Capello.

The new procedure stands in stark contrast to the traditional way of performing a thymectomy, which has long been an open-heart procedure. Even more modern robotic methods still require four incisions for four different ports to be inserted into the thoracic cavity.

That fateful elevator ride led Capello to recently become the first patient in the U.S. to undergo a single-port thymectomy, an experimental procedure performed by a multidisciplinary team led by Brigham thoracic surgeons Margaret Blair Marshall, MD, and Paula Antonia Ugalde Figueroa, MD. The Brigham is one of six sites in the U.S. enrolling patients in a clinical trial to evaluate the safety and efficacy of this procedure.

On the Cutting Edge

Myasthenia gravis led to dramatic changes in Capello’s once-active life. The condition worsens after periods of activity and improves after periods of rest.

“If I rest, I can get my words out much better,” she explained. “It’s so bizarre because I used to be a marathon runner, and I played college sports. Now, I can just run short distances because I get fatigued with shortness of breath.”

After becoming the unintended audience for a literal elevator pitch, Capello decided to ask Bueno about the single-port procedure. “We were the last three on the elevator, and as he was walking out, I decided to ask him about it,” she recalled. Bueno then immediately arranged a consultation for her with Marshall.

“Dr. Marshall is so professional, enthusiastic and passionate about what she does,” Capello said. “I think her innovation is really impressive, and I felt very comfortable with her.”

Marshall, an expert in robotic surgery, worked together with Ugalde, an expert in single-port operations, along with a multidisciplinary surgical team to perform Capello’s surgery in June. “I am so impressed with Stephanie’s bravery to be the first patient in the United States to undergo this procedure, especially because she knew she needed it but was avoiding it for a long time,” said Marshall. “She is the true pioneer here.”

If the clinical trial proves the procedure’s success, the surgical team hopes to eventually offer it in an outpatient setting, as well as extend this same approach to other surgeries, including lobectomies, which remove a lobe of the lungs.

Following her surgery, Capello was discharged from the hospital in just two days. After two weeks of rest, she was well enough to enjoy a family vacation on Martha’s Vineyard, where she continued to recover from the surgery. “I was amazed at how good I felt and how soon I felt good.”

After she returned to work, Capello saw Bueno in the hallway and let him know how well her surgery and recovery went. Bueno shared that she was the first person in the U.S. to undergo the procedure, which Capello hadn’t fully realized before.

Bueno commented, “The surgery should put her disease into complete remission. Right now, she’s on high-dose steroids with plasmapheresis, so this should be a dramatic improvement in her quality of life.”

It often takes one to three years before patients with myasthenia gravis begin seeing results from thymectomies. As it has only been a few months since her surgery, Capello hasn’t noticed any immediate MG-related improvements from the surgery just yet, but she is excited for her future.

“I always knew Brigham and Women’s was amazing because I’ve worked here my whole career, and I will forever speak highly of this hospital,” Capello said. “It’s also saved my mother’s life in the past, and I’m so grateful I can also say how amazing this hospital is from my own personal experience as a patient.”

Carlos Vazquez (second from right) was among three members of a Brigham neurosurgical team who traveled to Paraguay to care for patients in collaboration with local health care professionals, also pictured above.

Motivated by the desire to expand access to advanced health care, a Brigham neurosurgical team recently traveled to Paraguay to perform a lifesaving surgery for three young patients. Their trip also kickstarted a multi-year collaboration with a team at a hospital in Paraguay’s capital, Asunción, to train local providers on how to perform the same procedure, which treats a life-threatening condition known as arteriovenous malformation (AVM).

AVMs result from deformities in the brain’s blood vessels that occur at birth. The condition causes blood to flow too quickly from the artery to the vein, creating a buildup of pressure that can cause a vein to burst at any moment. Following a rupture, there is a 20 percent chance of death, and the risk of permanent injury to the brain is greater than 40 percent. While surgery can cure AVMs, the condition is rare, and the operation is performed only by a few specialists throughout the world.

This summer, José Kuzli, MD, a neurosurgeon in Asunción, invited Nirav Patel, MD, director of the Brigham’s AVM program in the Department of Neurosurgery, to travel to Asunción to perform AVM surgery for three patients — ages 8, 21 and 37 — and collaborate with Kuzli’s team to establish a training program for neurosurgery providers on the procedure, which is not currently available in Asunción. Patel, joined by Carlos Vazquez, a surgical technician in the Department of Neurosurgery, and Grace Kim, MD, an anesthesiologist in the Department of Anesthesiology, Perioperative and Pain Medicine, arrived in Asunción in late August to meet the three young patients and local neurosurgical team.

Patel, an international expert in repairing AVMs, aims to change the prognosis of patients with this life-threatening condition around the world.

“I feel that helping people with this surgery is what I was put on this Earth to do,” Patel said.

Vazquez and Kim have shared Patel’s mission of making AVM surgery more accessible for years. Vazquez has assisted Patel in surgery for more than a decade, since before they joined the Brigham, and Kim has worked as an anesthesiologist on many complex AVM cases.

“When we work together, the dynamic is streamlined. We know each other so well,” Vazquez said. “I’m really happy we were able to contribute to these patients’ well-being in Paraguay.”

Repairing AVMs is a complex and slow process. Patel’s method is unique and particularly intricate, as he performs the surgery without preoperative embolization — a procedure commonly employed before AVM surgeries to seal arteries. Preoperative embolization uses a vast number of resources, making it especially challenging to incorporate in resource-poor areas of the world. Patel’s approach aims to reduce patient risk and make the procedure more widely accessible.

Patients in Paraguay face other barriers to health care beyond limited access to complex care. While the Brigham team traveled with some supplies that were donated by Boston-area businesses, patients in Paraguay are often required to provide medical supplies for their own procedures, including some medications and heart monitors, Patel explained. Family members of the three patients slept in a tent outside the hospital so they could help with bedside care and provide support as needed. The limited availability of resources in the Asunción hospital remains a long-term obstacle that Kuzli’s team is working to overcome. Patel’s team aims to support efforts to make AVM surgeries sustainably accessible.

Carlos Vazquez (far left), Grace Kim (fourth from left) and Nirav Patel (center left) share a moment with their Paraguayan colleagues, including Jose Kuzli (center right)

While in Paraguay, the Brigham team cared for patients with advanced conditions. One patient was diagnosed with a grade 4 AVM, which is often pronounced inoperable in the United States. Despite these challenges, Patel felt bolstered by his patients’ bravery and the compassionate care the team in Asunción demonstrated.

“There was so much commitment and support all around, including the nurses looking out for every last detail,” he said.

Kim hopes the relationships forged with the care providers and patients in Paraguay will be long-lasting.

“Through this trip, we hoped not only to provide medical care but also to create opportunities for learning and future collaboration,” she said.

Patel believes his collaboration with Kuzli will need outside support while they strive to determine a sustainable method for doctors to provide AVM surgery independently in Paraguay. The August trip was funded in part by Solidarity Bridge, an American nonprofit, and several Boston-area companies. Patel is seeking funds to support another visit within the next six months.

The team in Asunción continues to send Patel updates on their patients’ progress. Each patient is recovering well and has returned home.

Reflecting on his work with the team in Paraguay, Patel expressed gratitude for everyone’s commitment to the project.

“AVMs are something we can cure. It just fits that we should be training people to do this surgery and finding ways to make it sustainably available,” he said. “There aren’t huge numbers of patients affected by AVMs, but these patients are real people in need of medical care, which can cure them for life.”

Robert Higgins addresses staff in Bornstein Amphitheater and via webcast during State of the Brigham on Oct. 27.

Health care organizations around the country continue to grapple with pandemic-induced pressures, including high demand for patient care, staffing shortages and complex financial challenges. The Brigham faces these same headwinds, President Robert S.D. Higgins, MD, MSHA, acknowledged during the fall 2022 State of Brigham on Oct. 27.

But the Brigham community also has a proven track record of overcoming adversity — and that’s no accident, Higgins added. It’s the Brigham’s culture of collaboration, innovation and commitment to excellence that have contributed to our ability to persevere.

These qualities will also guide the Brigham in helping achieve Mass General Brigham’s five strategic priorities — expanding access, improving value, supporting research and innovation, advancing equity and increasing revenue — as the system continues its work to transform into an integrated health care system of the future.

“It’s clear that challenges won’t define us. They’ll just make us better,” Higgins said during the interactive forum, held live in Bornstein Amphitheater and via webcast. “This is not easy work, but it’s nothing the Brigham can’t handle or do. We’ve risen to every other challenge we’ve faced in the past, and we will do so with this one.”

Several factors are contributing to the financial pressures the organization faces, explained Daniel Morash, MBA, chief financial officer and senior vice president of Finance. Continued reliance on temporary labor and inflated supply costs — two trends affecting hospitals around the country — are driving up expenses. However, revenue is not keeping pace as patients come to the hospital sicker and stay longer, an issue exacerbated by a shortage of beds in skilled nursing facilities throughout the region.

Despite these challenges, there are bright spots in the financial forecast, Morash added. Revenue in some areas, including outpatient care and research, is trending positively. Additionally, the Brigham is working with colleagues across Mass General Brigham to identify systemwide efficiencies that could mitigate the impact of the current financial challenges.

“It’s a hard time, but I think we are as well-positioned as we could be,” Morash said.

Maintaining a strong financial foundation is vital to ensuring the Brigham has the resources to make the necessary investments in its people, services and facilities to deliver on the institution’s mission, both leaders said.

“My goal is to make the Brigham recognized as a workplace of choice in academic medicine,” Higgins said. “To do this, we have to invest in and retain our outstanding folks — people who contribute to our mission every day — and treat them as though they are partners and give them opportunities to continue to excel. As we work toward developing new revenue streams, we also have to find a way to continue to support our financial performance in order for us to do all of these things.”

Throughout the forum, Higgins and other leaders emphasized the importance of keeping patients at the center as the Brigham charts its path forward.

“We’ll maintain our focus on patients, be quality-based and driven by our mission, and that will define our direction for the future,” Higgins said.

Reflecting on his time as president since joining the Brigham community nearly a year ago, Higgins said he has witnessed and learned about countless examples of these attributes in action. One touching demonstration of this, he noted, involved a care team on Braunwald Tower 11C who planned a wedding for a patient with end-stage lung disease.

“This is just one example of the incredible compassion and dedication of our teams caring for the entire patient — not just their illness, not just their diagnosis, but their soul — and helping them heal,” Higgins said.

Higgins also expressed his pride in all the Brigham has achieved in research, education and community support, in addition to national recognitions such as the hospital’s position in U.S. News and World Report’s Best Hospitals rankings this year.

“No matter what your role here is at the Brigham, we believe you have an extraordinary opportunity to contribute,” he said.

Additional Updates

The State of the Brigham also featured updates from other hospital leaders about institutional areas of focus:

• Allison Moriarty, MPH, senior vice president of Research Planning & Operations and Innovation, highlighted recent achievements from the Brigham research community, including the development of a highly sensitive test that can detect tiny volumes of COVID-19 in the body — a promising tool in the effort to help patients with long COVID.
• Erik Alexander, MD, vice president of Education, reflected on the diverse talents and experiences this year’s new class of interns has brought to the Brigham, discussed opportunities for systemwide collaboration in training and emphasized that leaders are keenly focused on ensuring trainees have the appropriate balance of providing clinical care and time for learning.
• Shelly Anderson, MPM, executive vice president and chief operating officer, explained how the Brigham is collaborating with colleagues across the system to address capacity challenges through initiatives such as enterprise asset management, which seeks to provide systemwide visibility into availability of beds, operating rooms and procedural rooms for the most effective resource management.
• Maddy Pearson, DNP, RN, NEA-BC, senior vice president, chief nursing officer and the Beth V. Martignetti Distinguished Chair in Nursing, briefed staff on Magnet redesignation, which the Brigham is seeking next year as an affirmation and celebration of the outstanding care that takes place here every day.

View a recording of the event (access restricted to internal network and VPN users).

Brigham and Women’s Hospital mourns the loss of Edwin “Pete” Phoenix Jr., a lead aid on the Waste Management team in Environmental Services, who died Oct. 13 following a sudden illness. He was 66.

A member of the Brigham community for 44 years, Mr. Phoenix worked the day shift and was responsible for waste removal throughout the Brigham’s main campus.

Mr. Phoenix’s memorable smile and warmth brought joy to his colleagues, and several reflected on another one of his unforgettable characteristics: His cheerful whistling throughout the halls of the hospital, which was instantly recognizable.

“Pete always brightened my day with his smile, his jokes and his famous whistling,” said Adam Kayi, a manager in Environmental Services who worked with Mr. Phoenix for 22 years. “He was larger than life, and no challenge was too big for him. He always brought joy and positive energy to work. I miss him a lot.”

Labina Shrestha, MM, T-CHEST, operations manager in Environmental Services and Mr. Phoenix’s direct manager, shared similar remembrances.

“Besides being a great team member, Pete was a wonderful person. Pete always came to work with a positive attitude and a smile on his face,” Shrestha said. “Nothing was ever an impossible task for Pete. He always performed his task to the fullest and kept the area safe for everybody. He loved to whistle when he walked the long hallways and gave that positive vibe to the people around him. We miss him dearly.”

In addition to being the center of so many friendships, the Brigham also became the place where Mr. Phoenix met his wife, Denise, while working a weekend shift three decades ago. They married in 1988.

Jean Saint Paul, a waste handler in Environmental Services, said he was heartbroken to lose one of his closest friends.

“I have known Pete since 2006, and from the very first day, we became best friends. He would always help me with everything and taught me so many things in my life,” he said. “I am feeling like this is my personal loss, like a family member. I am emotional every day and pray that he is happy wherever he is now and still smiling. I miss you, my big brother.”

Henry Tapia, who worked with Mr. Phoenix for 18 years and was his direct supervisor, recalled how Mr. Phoenix always treated others with kindness and made even acquaintances feel like old friends.

“He always called people ‘young fellow.’ I still think about it and smile,” Tapia said. “He was a person of big heart.”

Mr. Phoenix was a friend and mentor to colleagues such as Carson Clark, a lead Environmental Services aid, who remembered how he brought both a lightness and dedication to his work.

“He always made you smile and laugh while performance your job,” Clark said.

Jimmy Caban, a supervisor in Environmental Services, said Mr. Phoenix was in a class all his own.

“Pete never had an unkind word,” Caban said. “He was the nicest person I’ve ever met, but first and foremost, he was always a gentleman.”

Mr. Phoenix is predeceased by his mother, Margaret Phoenix, his son Edwin Phoenix III and his brother, Edward Phoenix. He is survived by his wife, Denise Phoenix, his son Stephen Phoenix, two grandchildren, four sisters and many other loved ones.

Architectural features of the unearthed operating room (left) share considerable similarities to the scene depicted in Joel Babb’s painting (right) of the first successful human organ transplant, which took place at the Peter Bent Brigham Hospital in 1954. (Right image credit: Harvard Medical Library collection, Center for the History of Medicine in the Francis A. Countway Library, Harvard University)

During recent renovations to the Brigham’s Division of Plastic and Reconstructive Surgery clinic and administrative space, construction crews uncovered remnants of a historical operating room (OR) believed to have hosted the world’s first successful human organ transplant.

While removing walls, workers were surprised to find what appeared to be an old operating room with a balcony for watching surgical cases.

Current Brigham faculty members had heard over the years that old ORs from the Peter Bent Brigham Hospital — one of the Brigham’s predecessor institutions — were in the vicinity of this location, but they thought they were one floor below.

However, when compared to historical images in the hospital archives, architectural features of the room suggest it was likely the OR that Joseph Murray, MD, used when he transplanted a kidney from one identical twin to another in 1954. Murray would go on to receive the Nobel Prize in Physiology or Medicine in 1990 for this groundbreaking work and the subsequent development of immunosuppressive drugs.

The painting The First Successful Kidney Transplantation captures what Murray’s OR looked like before undergoing many renovations over the years for other uses. While the artist, Joel Babb, took some artistic liberties in recreating the scene on canvas, there are striking similarities between details in the painting and rediscovered room, such as the arches in the balcony, explained Catherine Pate, hospital archivist.

In this iconic 1954 photo, shot from the balcony above the operating theater, Joseph Murray (center) and his colleagues perform the first successful human organ transplant.

“The most requested picture of all the many thousands in the Brigham and Women’s Hospital Archives is the one we have of the kidney transplant between brothers Ronald and Richard Herrick on Dec. 23, 1954, in a Brigham operating room. From the evidence, it is likely this room,” Pate said. “The achievement of this — the first-ever successful human organ transplant — was comparable in the field of medicine to the first moon landing in the field of aerospace. The bravery of this step into the unknown, especially by the first donor, Ronald Herrick, and the physician/scientists of the Peter Bent Brigham transplantation team, takes your breath away when you stop to think about it. It happened here. What a legacy!”

The room itself was part of the original Peter Bent Brigham building at 15 Francis St., dating back to 1912. Through the ensuing decades, the space underwent numerous renovations. And while features of the room such as the balcony were retained in later reconfigurations, the original fixtures and furnishings were updated over the years and, subsequently, have been lost to history, explained Sonal Gandhi, vice president of Real Estate, Planning and Development.

“Although no original parts of the original operating room were found during this latest renovation, plans are underway to ensure this discovery is acknowledged and commemorated,” Gandhi said.

The historic OR also appears to be the operating room favored by legendary American surgeon Harvey Cushing, MD, known as the father of neurosurgery. From 1912 to 1932, Cushing was the Moseley Professor of Surgery at Harvard Medical School and founding surgeon-in-chief at Peter Bent Brigham Hospital. He was a pioneer in surgical technique, including electrocautery, and developed basic techniques and procedures still used in neurosurgery. He received many honors throughout his career, including the Pulitzer Prize for his biography of Sir William Osler.

The same OR was also used by Dwight E. Harken, MD, the chief of Thoracic Surgery at the Peter Bent Brigham Hospital from 1948 to 1970, to demonstrate early cardiac surgery. Harken is often considered one of the founding fathers of heart surgery and credited as the creator of intensive care units for critically ill patients.

Brigham and Women’s Hospital mourns the loss of Robin Powell, an administrative assistant in the Division of Pulmonary and Critical Care Medicine, who died Sept. 12. She was 62.

Ms. Powell joined the Brigham community in 2009, providing administrative support for Anthony Massaro, MD, director of the Medical ICU (MICU), and the division’s broader operations. With a diverse range of responsibilities, Ms. Powell assisted with scheduling appointments and meetings, organizing conferences and other events, helping submit grant proposals, maintaining MICU coverage schedules, and more.

Widely respected for her ability to solve any problem and beloved for her caring and kind spirit, Ms. Powell is remembered by her colleagues for her devotion to the division.

“Robin’s contributions to the division were vast, and she was a loyal friend to many,” shared Bruce Levy, MD, chief of Pulmonary and Critical Care Medicine, Hilary Goldberg, MD, clinical director, and KC Peoples, senior administrative director, in a joint message to the division. “She will be remembered as a dedicated and highly capable team member, someone who would move mountains to achieve positive results. We will miss Robin profoundly, but her impact on all of us will survive for many years.”

Colleagues spoke of Ms. Powell’s steadfast commitment to helping others and the heartfelt approach that defined her every interaction.

“Robin was a team player and problem solver who was always willing to help anyone,” said Jacqueline Rodriguez-Louis, MPH, M.Ed., program coordinator for the Partners Asthma Center. “She was somebody whom anyone could count on.”

Massaro agreed. “Robin was a remarkable and kind-hearted person. Her dedication and administrative skill provided expert support of MICU physician scheduling and education. She had an enormously positive impact on the MICU, our department and the hospital as a whole,” he said.

“In this life, we all have a choice to affect lives in different ways — Robin’s choice was always positive,” remembered Nancy Beattie, senior credentialing administrator for the division. “She had the ability to bring calm, humor and sensitivity to any situation, and she had an innate ability to know which of these fit and when to share. Robin paid attention and offered advice without being intrusive. If there was a job to be done, she did it, and she did it quietly without the expectation of accolades.”

Ms. Powell was more than a colleague and brought joy to all those around her.

Rodriguez-Louis remembered Ms. Powell as “an amazing co-worker and an even better friend” who had a profound impact on the Brigham community.

“Everyone knew Robin. People adored her. She was still in touch with colleagues who left the division years ago. Robin was a fantastic individual, and we will all miss her so much,” she said. “She was a happy-go-lucky person who took her light everywhere she went.”

Added Beattie: “Hearing of her passing broke my heart, and I will never forget her and the huge impact she’s had on my life, both professionally and personally. Robin was more than my officemate; she was my friend.”

Brigham and Women’s Hospital mourns the loss of Beryl Benacerraf, MD, a world-renowned radiologist, physician, researcher, fetal ultrasound expert, entrepreneur and educator. She died Oct. 1 from advanced cancer. She was 73.

A member of the Brigham community for over 40 years, Dr. Benacerraf had an international reputation as a leader in obstetrical and gynecological (OB-GYN) ultrasound. Her discoveries using ultrasound in prenatal diagnosis of congenital anomalies and gynecological disorders transformed care in these areas of medicine and benefited the lives of countless women.

Dr. Benacerraf had dyslexia, which although impaired her reading ability, also helped her decipher obscure images and view things in entirely unique ways. This helped lead her to groundbreaking insights, most notably that a larger nuchal fold on a second trimester sonogram was a potential indicator of the genetic disorder Trisomy 21, also known as Down syndrome.

Dr. Benacerraf’s research established a standard for pregnant women’s physicians to use nuchal fold measurements to help determine the risk of Down syndrome. Such a discovery launched the field of genetic sonography and dramatically improved prenatal diagnosis and the characterization of fetal syndromes. Among her many other accomplishments were observations on human fetal hearing and using ultrasound to monitor invasive procedures.

Colleagues reflected on her brilliant mind and intellectual generosity.

“Beryl was a true giant in the field of OB-GYN ultrasound who was known internationally as an expert in obstetrical imaging,” said Mary Frates, MD, division chief of Ultrasound. “We at BWH Radiology greatly benefited from her expertise for over 30 years. She taught dozens of staff radiologists, hundreds of Radiology and OB-GYN residents and fellows and trained hundreds of sonographers. Beryl elevated the level of scanning and interpretation whenever she was in the reading room, sharing her knowledge generously with all levels of learners. She was an inspiration to us all and impossible to replace.”

Carol Benson, MD, former chief of Ultrasound and co-director of High-Risk Obstetrical Ultrasound, described Dr. Benacerraf as a “pioneer and champion for obstetrical and gynecologic ultrasound” who reshaped women’s health.

“She spent her career advancing the practice of ultrasound through her clinical work, research and teaching,” Benson said. “She was a terrific mentor, and we all learned from her every day.”

Dr. Benacerraf’s foresight and expertise helped expand the Brigham’s Center for Fetal Medicine and Prenatal Genetics.

“In 1991, when departments of Radiology and OB-GYN at BWH and around the country were in the midst of turf wars over obstetrical ultrasound, Beryl had the wisdom to understand that a collaborative approach was far superior to a winner-take-all approach, as it would take advantage of the complementary areas of expertise of the two departments,” reflected radiologist Peter Doubilet, MD, PhD.

“Beryl approached me, saying that if she and I could agree on a workable arrangement, she was confident that the Brigham Departments of Radiology and OB-GYN would go along with it,” added Doubilet. “We quickly hammered out an agreement that led to the opening of the Brigham’s Antenatal Diagnostic Center, which has flourished for over 30 years as a site for high-quality patient care and research and is now the ultrasound component of the Center for Fetal Medicine and Prenatal Genetics.”

Dr. Benacerraf was a practicing physician who served more than 350,000 women over four decades, caring for patients with extraordinary skill and compassion. She cared for patients at the practice she founded in 1982, Diagnostic Ultrasound Associates, until the day before she could no longer stand unassisted.

Dr. Benacerraf received numerous honors throughout her career, including the Ian Donald Gold Medal from the International Society of Ultrasound in Obstetrics and Gynecology, the Marie Sklodowska-Curie Award from the American Association for Women Radiologists and the Lawrence A. Mack Lifetime Achievement Award from the Society of Radiologists in Ultrasound. Dr. Benacerraf was also recognized as a “Giant in Obstetrics and Gynecology” by the American Journal of Obstetrics and Gynecology.

In addition to her research and practice, Dr. Benacerraf held dual clinical professorships at Harvard Medical School and Brigham and Women’s Hospital in both Obstetrics, Gynecology and Reproductive Biology and in Radiology. She served as president of the American Institute of Ultrasound in Medicine and as editor-in-chief of the Journal of Ultrasound in Medicine.

Dr. Benacerraf was a pioneer not only for women’s health but also for women’s careers in medicine. She was the first married woman to serve as a BWH surgical intern (1976), and she served as a role model and counselor for many younger women striving to achieve clinical and academic prominence while maintaining balance with family life.

Her husband of 47 years, Peter Libby, MD, a cardiovascular specialist and former chief of Cardiovascular Medicine, stated that during their decades of clinical leadership, “Beryl hosted with me so many activities for the Cardiovascular Division with grace and the elegance of her French upbringing, no matter how busy she was with her own career. She somehow found time to do it all, including being a terrific mom and grandmother and my wonderful life partner.”

Beyond her brilliance and tremendous accomplishments, she is remembered for her kindness and warmth.

“She was more than a great colleague,” said Benson. “She was also a terrific friend, and she will be greatly missed.”

Dr. Benacerraf is survived by her husband, Dr. Libby, their two children, Brigitte and Oliver, and three grandchildren, Vivian, Lucie and Brady.

“I’m excited to learn and grow as a team that uses collaborative approaches and draws from everyone’s diverse backgrounds and experiences,” says Caitlin Springer (third from left), chief PA of the new Medical/Surgical Intensive Care Unit, pictured with her PA colleagues. From left to right: Rachel Harris, PA-C; Amy Cotton, PA-C, Caitlin Springer, Chief PA; Olivia Picking, PA-C; Megan O’Connor, PA-C; Meaghan Gagnon, PA-C.

On Sept. 7, the Brigham opened its new Medical/Surgical Intensive Care Unit (Med/Surg ICU) on Braunwald Tower 11C, becoming the hospital’s first unit to provide intensive care for both medical and surgical patients in the same setting. Also known as the Med/Surg ICU, the unit launched with six beds and will expand to a total of 10 beds early next year — an important milestone in the Brigham’s continued efforts to address ongoing capacity challenges.

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) work closely with attending physicians and nurses to care for patients in this setting. Caitlin Springer, PA-C, chief PA of the Med Surg ICU, recently spoke with Brigham Bulletin about how this new team came together.  

What’s your career path been like so far?

CS: I was a physical therapist (PT) first for eight years. I went to PT school at Northeastern, and it wasn’t until I was in one of my last years of school that I learned more about what a PA was and what they could do. It was fascinating to me. Throughout my career as a PT, I never stopped dreaming of becoming a PA. It took me a while to finally make the switch, but I’m so thankful I finally decided to go for it!

I ended up going to PA school at Duke and had a great experience. After graduating two years later, I landed a job in the Emergency Department at Mass General. The environment was fast-paced with a diverse patient population. I learned a lot there by consulting with specialized experts.

Through my time at MGH, I became involved with the ultrasound division. That blossomed into teaching opportunities and training our new hires, as well as teaching at conferences across the country and now world. Teaching ultrasound brings me joy — I find it so rewarding to teach people a new skill where they can gather additional information about a patient, as well as give them tools to enhance success with a variety of procedures. I love seeing when something clicks with a new learner.

Eventually, I got a per-diem position at the Brigham with Metabolic Support Service. It really was my dream per-diem job

Caitlin Springer

(and still is!). I love coming into every shift with that group. I always joked that it felt like Christmas morning on the days I was scheduled because that was how excited I was to come and work a shift with them! The team is amazing, and that experience allowed me the opportunity to expand my procedural skills and, later, per-diem opportunities in ICUs and other areas.

Can you tell us more about your latest role here?

CS: When the opportunity to help launch the new Med/Surg ICU as the chief PA presented itself, it felt like all of my worlds were coming together to create this new, PA-run unit. The goal is to accommodate both medical and surgical ICU patients to help offload the demands of our current units and meet the needs of our patient population, which are steadily increasing in both volume and acuity. We take patients from the Emergency Department, Operating Rooms, transfers from outside hospitals, as well as patients from our floors who have decompensated and require ICU-level care.

To accomplish this, we are led by our medical co-directors, Rachel Putman, MD, and Kristin Sonderman, MD, MPH, and an amazing attending group from whom we can learn directly from while caring for these patients. We’re staffed by critical care attendings from both the Medical ICU (MICU) and Surgical ICU (SICU), which include physicians trained in Pulmonary and Critical Care, Emergency Medicine, Surgery and Anesthesia. It’s so exciting to have such a diverse group of experts leading the PAs.

In preparation for opening the unit in September, our PA team rotated through several areas of the Brigham and Faulkner to ensure they received the training and support they needed to care for this patient population. I feel forever indebted to our colleagues in the many areas that accepted and trained our new PAs, specifically teams from the MICU, SICU, the Faulkner ICU team, the PACE Service, Cardiovascular Medicine, Oncology and the Bedside Procedure Service. Their willingness to help when we did not have a unit to train on was truly incredible.

In addition to everyone who helped train our PAs, the leadership of Jen Beatty, PA-C, Tony Massaro, MD, Ali Salim, MD, and Emily Hinchey, MBA, who helped assemble this whole unit, has been unparalleled.

What do you find most rewarding about being part of this team?

CS: I’m excited to learn and grow as a team that uses collaborative approaches and draws from everyone’s diverse backgrounds and experiences — from PAs who are new grads to others with experience in various specialties, including critical care at other institutions, emergency medicine, neurology, neurosurgery, metabolic support, oncology, pain medicine, thoracic surgery, vascular surgery and the Cath Lab. While we are on rounds, somebody will often be able to use their expertise from a prior role, which can ultimately help best manage a patient.

PAs are easily adaptable — we’re moldable. With this new unit, we get to learn directly from critical care attendings at an academic institution. I feel so lucky to have the opportunity to do this daily while caring for some extremely sick and complex patients. In addition, it’s great to be able to help decompress some of the other areas of the hospital and give them some breathing room and bandwidth.

We also benefit from the experience of many of our amazing nurses, whom I really enjoy working closely with and learning from. Nursing leaders — including Hasna Hakim, DNP, RN, MSN, MPH, CCRN-K, Warren Phillips, BSN, RN, and Kristen Hanlon, MSN, RN, CCRN — have done an outstanding job assembling and training our nurses. I am really excited that we get to build this unit truly as a team and put all of our heads together to constantly make things better. We get to set a whole new culture! It’s such a unique opportunity.

What do you enjoy most about being a PA?

CS: I love that you get to constantly learn from such a wide variety of experts and that you can explore a variety of specialties to gain a diverse experience. I love taking all of those experiences to best help my patients. You really can create your own journey based on your interests and opportunities that arise along the way. And I really love being part of a team. I always say it’s a good day if I learn something new, and with this amazing new team, there will never be a shortage of learning opportunities, so there are lots of good days ahead!

Special thanks to the entire MICU team; Lauren Jeffers, PA-C, and Meaghan Morris, PA-C, and the SICU team; Leanne Wines, PA-C, and Marissa Cauley, PA-C, and the PACE team; Deanna Wall, PA-C, and the Cardiology team; Eric Yenulevich, PA-C, and the oncology team; and Majid Shafiq, MD, MPH, and David Lee, MD, with the Bedside Procedure Service team. And KC Peoples and Alea Moscone for their continued contributions.

Physician Assistant Week is held annually Oct. 6–12 to honor physician assistants’ substantial role in improving health. In celebration of Brigham PAs and their involvement in nearly every facet of the care across the institution, Brigham Bulletin has highlighted one of the many exceptional physician assistants to cap off PA Week this year.

“I call them my family,” says Tony Orlina (center), whose life was saved by friends and colleagues Yaguang Pei (left) and Anand Somasundaram (right).

Tony Orlina, BS, (R)(T), CMD, was exhausted when he returned to his South End apartment on July 24.

He had just arrived home from Logan Airport after spending a week in Virginia with his siblings to care for their 83-year-old mother as she recovered from open-heart surgery. Although the procedure was successful, it was a stressful visit. Physically and emotionally, he was drained.

But it was Sunday afternoon, and tomorrow Orlina was due back to the Brigham, where he works as a treatment planning coordinator and medical dosimetrist in the Department of Radiation Oncology.

Orlina, 52, who lives alone, started to unpack and get ready for the week ahead when he was suddenly overcome by a blinding headache. Then, he vomited. “Hey, Ollie,” he said to his French bulldog, Oliver, “I’m just going to lie down.”

That was the last thing he remembers.

When Orlina opened his eyes again, he wasn’t in his apartment anymore. He looked around and saw someone in scrubs watching him carefully.

“Do you know where you are?” she asked.

“In the hospital,” he guessed.

“Yes,” she responded. “You had an aneurysm.”

By then, a whole day had passed. It was Monday night. Orlina was in the Neurosciences Intensive Care Unit (ICU) at the Brigham, recovering from emergency brain surgery.

He would soon learn the only reason he was there — and alive — was because two fast-thinking colleagues and loyal friends trusted their instincts and decided to check on Orlina at home when he didn’t show up for work that morning.

“If your friends hadn’t found you, you probably wouldn’t be here,” his neurosurgeon, Mohammad Ali Aziz-Sultan, MD, MBA, chief of the Division of Vascular/Endovascular Neurosurgery, later told him.

***

Anand Somasundaram wasn’t supposed to come into work so early on Monday.

He was originally scheduled to arrive closer to lunchtime, but Somasundaram, also a medical dosimetrist in Radiation Oncology, had wanted to finish a few tasks before his upcoming time off.

When he stopped by Orlina’s desk to say hello around 8 a.m., he was surprised to find it empty.

That’s really strange, Somasundaram thought.

Of all people, he would know. In addition to being co-workers, he and Orlina are longtime friends and former roommates. When Somasundaram moved to Boston years ago, he didn’t know many people in the city, but that changed when he started working at the Brigham.

“Tony befriended me quickly, and we clicked really well,” Somasundaram said. “He made me feel at home.”

They became roommates when Orlina learned that Somasundaram was living in a 180-square-foot studio as he saved for an engagement ring.

“One Sunday, Tony called me up and asked, ‘Do you want to live together?’ I said, ‘I can’t afford where you live.’ He said, ‘You can pay me whatever,’” Somasundaram remembered. “I couldn’t believe it. I met this guy five months ago.”

But that’s just the kind of friend Orlina is, he explained.

“He’s the most caring person,” Somasundaram said. “We cooked together. We hung out. We went to fairs, festivals and breweries. We got really close. I think of him as family.”

In the time they lived together, Somasundaram learned that Orlina is a man of routines — meticulously organized, always on time and relentlessly reliable. So, when Orlina didn’t show up for work that morning, Somasundaram sensed something was wrong.

He tried texting Orlina. No response. He called him. No answer. He checked his social media accounts. He tried sending him a message on Facebook. He initiated a FaceTime call. Nothing.

“I decided to check the board. We have this whiteboard that shows who’s on call, and it said that Tony was on pager,” Somasundaram said. “I was like, one, Tony always comes to work, and two, if he’s on pager and can’t make it, he’d get someone to switch with him. At that point, it was a red flag.”

***

He reached out to their other close friend and colleague, Yaguang Pei, medical dosimetrist and treatment planning workflow manager.

From left: Somasundaram and Pei, along with their partners, and Orlina enjoy an outing to a New England orchard last fall.

Pei was on his way to the office when his phone buzzed.

“I got a text from Anand saying, ‘Have you seen Tony? He hasn’t shown up to work,’” Pei recalled. “Tony comes to work religiously every single day, and he always comes to work on time.”

Pei abandoned his commute and headed to Orlina’s apartment building. After entering the lobby, he approached the concierge and started to explain why he was there. The man interrupted him and pointed across the lobby.

“I looked over, and there was Tony sitting on the couch,” Pei remembered.

Right away, Pei realized something was wrong.

“Visibly, he looked fine, but he seemed off. It wasn’t the Tony I knew,” said Pei, who also formed a close friendship with Orlina when he moved to Boston several years ago and has come to think of him like family. “He said he was just tired, but he was confused. He didn’t realize he was in Boston. He thought he was still in Virginia.”

Pei knew he had to act. He took Orlina to the Brigham’s Emergency Department (ED) and let Somasundaram know they were on the way.

“There wasn’t a question in my mind about where we were going to take him,” Pei said. “We’re going to the Brigham.”

***

In the ED, staff performed a CT scan, which revealed a large amount of bleeding in the space surrounding Orlina’s brain, a life-threatening condition known as a subarachnoid hemorrhage.

“When you see this pattern of blood, it’s usually associated with an aneurysm,” explained Sultan.

A cerebral aneurysm occurs when a blood vessel in the brain develops a weak spot, causing it to balloon. When the bulge gets large enough, it can burst.

Half of people who experience a ruptured brain aneurysm die before they receive treatment, and only a third of those who do reach a hospital do well, Sultan explained.

Cerebral aneurysms occur when blood vessels in the brain develop weak spots, causing them to bulge and potentially burst, as seen in this 3D imaging of the blood vessels in Orlina’s brain prior to surgery.

“Tony had a massive rupture, and then the blood prevented the normal fluids around his brain from draining properly, exerting a lot of pressure,” Sultan said. “Either one of those things could have killed him.”

Orlina survived the event for two reasons: His friends ensured he received care quickly — before a more catastrophic second rupture occurred — and the Brigham’s highly experienced, multidisciplinary Endovascular Neurosurgery team worked in collaboration to deliver outstanding, personalized care, Sultan said.

“We’re on the forefront of diagnosis and treatment. We were one of the first in the country to bring together multidisciplinary teams and build hybrid operating rooms, and we’re on the leading edge of innovation, technology and research,” Sultan said. “It’s like having a toolbox with all these different tools, and we select the right ones to tailor treatments for each patient.”

After draining some of the excess fluid in his brain and performing an CT angiogram to confirm the location, shape and size of the aneurysm, Sultan and his team brought Orlina to Interventional Suite, where they conducted an endovascular coiling procedure. Using X-ray imaging to guide their path, the team snaked a small catheter through a blood vessel in Orlina’s leg all the way to his brain. Once there, the angiogram served as a roadmap to the ruptured aneurysm, which the surgical team repaired by depositing platinum coils into the ballooned area to plug it up.

The procedure was completed in about an hour. Orlina was cared for in the Neuro ICU for another two weeks before returning home to continue his recovery. Today, he’s left with very few side effects from the event; his once-boundless energy now has its limits, but he says life is otherwise back to normal.

His recovery has been nothing short of remarkable, Sultan said.

“Tony had one of the worst cases I’ve seen — and one of the best recoveries,” he said. “Even in the toughest moments, he was even-keeled, engaged and positive. He was inspirational.”

***

While Orlina was in the hospital and after his discharge, his colleagues in Radiation Oncology sprang into action to help him — including caring for his canine companion until he was well again.

Pei cared for Orlina’s beloved French bulldog, Oliver, while he was in the hospital.

“Tony is the glue that holds us together. He’s always the one who checks in on us,” said Pei, who took care of Oliver for three weeks. “People in the department really stepped up to support him, visited him multiple times a day in the hospital and contributed to a large UberEats gift card so that he would have food at home. Everyone pitched in to help.”

Daphne Haas-Kogan, MD, chair of Radiation Oncology, said she was not surprised by the team’s response. She sees that same compassion on display every day.

“Our department is like no other. It stands apart in my mind as a place where people just go to the ends of the Earth and back for each other, and that translates into not just to watching out for each other but also going the extra mile for our patients and families,” she said. “How inspiring it is to be part of a group that cares so deeply and is willing to do so much, big and small, for one another.”

That feeling resonates with Orlina, who is deeply grateful for the care teams who saved his life and all that his friends and colleagues have done to support him.

“It’s not just work,” Orlina said. “Yaguang and Anand — I call them my family.”

And true to form, Orlina returned to work as soon as he could. “Classic Tony,” Pei said with a laugh.

In 2015, Roshan Sethi, MD, of the Department of Radiation Oncology, joined film writer Hayley Schore in writing a screenplay inspired by the Jane Collective — a network established in Chicago during the late 1960s to help women access abortions at a time when the procedure was outlawed and stigmatized in much of the United States. At the time, industry insiders told them the film would never be produced by a major studio.

“Hollywood had an unofficial policy of not really mentioning abortion in movies and TV shows,” recalled Sethi, who divides his time between caring for patients at the Brigham and working in film and television.

Sethi and Schore still moved ahead, deciding to co-write the fictionalized story on spec, meaning it had no promise of funding. It was eventually picked up by Roadside Attractions, a popular independent film house.

Much has changed since then — most notably the Supreme Court’s ruling this June on Dobbs v. Jackson, which overturned decades of federally protected abortion rights made possible by the court’s landmark 1973 Roe v. Wade ruling and sparked worldwide discussions about abortion care.

After six years in the making, Call Jane releases in theaters Oct. 28, starring Elizabeth Banks, Sigourney Weaver and Wunmi Mosaku, and directed by Phyllis Nagy, Oscar-nominated writer and director.

“It sometimes feels like art can do nothing, and it sometimes feels like it matters intensely,” he said. “I think that this unspoken Hollywood policy, in some ways, has contributed to the situation we’re in now by cloaking the topic of abortion in secrecy and falsely portraying it as shameful.”

Sethi noted that a larger number of films and television shows openly discussing abortions have been made in Hollywood since 2016, a shift he hopes will yield positive social impacts.

Telling The Story

When he began working on Call Jane, Sethi did not anticipate that the Supreme Court would overturn Roe v. Wade. However, in an interview with Sethi and Schore, Judith Arcana, one of the original “Janes,” warned that the overturn of Roe v. Wade was imminent, having observed efforts to restrict abortion access over the years. People, particularly women of color, have continued to face barriers to abortion access since long before the Dobbs V. Jackson decision. The Janes are part of a storied history of community organizing to provide access to abortion and resist its regulation.

“I really wish the film weren’t so relevant to our time,” said Sethi.

Sethi felt inspired by Arcana and the other Janes. Their story gave him hope and drew him to work with Schore on the Call Jane project.

“It just felt like a really incredible story in that when the Janes were completely disempowered, they armed themselves with the tools of science and medicine and did what they could to save lives,” said Sethi.

A Career of Art & Science

Roshan Sethi (right) with his fraternal twin, Rosh. Both trained at the Brigham together and continue to practice here today.

Sethi’s love of storytelling calls him to write films and TV. He has always loved writing and originally wanted to be a novelist. His previous projects include the romantic comedy film 7 Days, co-written by Karan Soni, and the television drama The Resident, co-written by many writers, including Hayley Schore. The show told the story of doctors navigating a hospital residency program — an experience very familiar to Sethi.

In addition to his writing career, Sethi works as a radiation oncologist at the Brigham, inspired to work in oncology by a family experience with cancer. Sethi’s mother was also a doctor, whose medical work fascinated him and his twin brother from a young age. While Sethi has no experience in reproductive health or medicine, his medical background did help him when he and Schore conducted research for the Call Jane film, and some of the experts who were consulted during the writing are physicians at the Brigham.

Although his lives in medicine and writing are often worlds apart, Sethi says they share a common root.

“I do think they both require the practice of empathy,” he said. “When writing, you try to imagine yourself inside someone’s personality and character, and in medicine, you have to try to understand the people you care for in order to really help them.”

“Just as the river flows forward, you can’t go back,” says Nawal Nour, on living without regrets and accepting the winding journey her career has taken.

Nawal Nour, MD, MPH, sees her life reflected in rivers. Even through unexpected twists and turns, currents perpetually push the water forward. Her career has adopted a similar momentum — pressing ahead, branching out and flowing into new territories with continued purpose.

Nour, chair of the Brigham’s Department of Obstetrics and Gynecology, knows something about rivers.

As a young girl growing up in Sudan, she regularly played along the banks of the Nile River with her three siblings. The southern region of the Nile consists of two branches that meet in Khartoum, the capital of Sudan and Nour’s hometown. And it was in Khartoum where Nour would discover the first branch of her professional interests after reading The Hidden Face of Eve by Nawal El Saadawi, an Egyptian psychiatrist and feminist who wrote about and fiercely challenged the practice of female genital cutting.

“She became one of my role models,” said Nour, who has made it her life’s work to end female genital cutting and to care for women who have experienced it. “I loved her advocacy. I loved that she was outspoken. I loved how she was in the midst of a country where women were not supposed to speak up, and certainly not supposed to speak up about external genitalia — such a taboo subject — and that she had the guts and grit to do so.”

Nour reflected on the immense influence El Saadawi’s 1977 text had on her, among other experiences that shaped her career in women’s health and academic medicine, in the opening of her keynote address, “From the Nile to the Charles River,” during the 2022 Women in Medicine and Science Symposium.

The annual event, now in its 11th year, highlights the achievements of women faculty and trainees at Brigham and Women’s Hospital and Massachusetts General Hospital (MGH). This year, the event was a collaborative effort co-hosted by the Offices for Women’s Careers at the Brigham and MGH.

Throughout her remarks, Nour returned regularly to the metaphor of rivers as she traced the winding path of her career and what she has learned along the way — including the value of taking risks and embracing uncertainty.

“It’s about the journey. Just as the river flows forward, you can’t go back,” she said. “It’s not helpful to be regretful, but it is helpful to learn from your lessons.”

‘So Much More to Learn and Do’

As an undergraduate at Brown University, Nour discovered another passion: public health. She pursued an opportunity to work in a refugee camp, found a mentor in women’s rights, abandoned her pre-med track for a degree in development studies and international relations, and ultimately landed a job with the United Nations’ Division for Women in Development.

While the work was fulfilling, she eventually longed to go back to medicine. She was accepted into Harvard Medical School and made her home near a new river, the Charles.

“Be comfortable with uncertainty. It truly cultivates creativity,” she said. “Some people might say, ‘Oh, gosh, if you’d only stuck with being pre-med, you could have been in med school two years earlier.’ No. Those were really valuable times for me because they made me think, what’s next?”

Like the Nile, Nour said, the two branches in her life would converge in the work she did at the Brigham. In 1999, she founded the African Women’s Health Center, whose mission is to improve the health of refugee and immigrant women who have undergone female genital cutting. It provides access, understanding and community to women who have long-term complications from this tradition and who seek reproductive health care.

That same year, Nour also became the Brigham’s director of Ambulatory Obstetrics and Gynecology, a role she held for nearly two decades until she was named chief diversity and inclusion officer for Faculty, Trainees and Students in 2018.

Nour acknowledged she was initially reluctant to accept the role of chief diversity and inclusion officer, fearing it would take her away from her love of patient care. But she decided to follow her own advice and find an opportunity for growth amid uncharted waters.

“I honestly, transparently and genuinely had a lot to learn. I had spent my world in public health, global health and teaching residents how to do cervical exams, deliver a baby and perform C-sections and hysterectomies,” she said. “Diversity, equity and inclusion were not part of my education. It wasn’t my background, but I learned a lot.”

Her appointment as chair of Obstetrics and Gynecology in October 2020 — becoming the first Black department chair and the first woman to lead OB-GYN at the Brigham — marked another significant change.

“Some rivers have waterfalls. Some are very rapid, slow down in certain areas and then meander. But as you get closer and closer to the bigger body of water, whether it’s the Mediterranean Sea or the Boston Harbor, the water slows down and spreads out,” Nour said. “As our careers progress, our expertise expands. I feel that I’m in that expansive portion of my career, where it can be slower but there’s so much more to learn and do.”

In addition to pursuing passions and taking risks, Nour emphasized the importance for women in medicine and science to remain authentic and curious while forging relationships with mentors, sponsors and peers.

Turning back to the Nile, Nour also said the region holds another lesson — a contemporary one from the nearby Suez Canal. She recalled the 2021 incident involving the large container ship Ever Given, which ground international commerce to a halt when it became stuck in the Egyptian waterway.

After humans failed to extricate ship, nature prevailed. A full moon eventually raised the tides, dislodging Ever Given and enabling it to continue its journey.

“There are times in your career where high winds are going to shift you, and you’re going to get stuck. I’ve had that happen to me so many times, and I felt like I was not moving anywhere. I had to ask, what’s next for me? Is this what I really want to do? What else should I learn?” she said. “Just know for sure that you are going to be unstuck. If you can sit through that uncomfortable situation, know that the moon is going to rise, and the sun will come out again.”

“It was very clear something was going on,” says Peg Movelle (right), describing the events that led to her wife, Sue Morong (left), being diagnosed with early-onset Alzheimer’s disease.

After building a long and successful career in finance, Sue Morong never expected that numbers would one day become a source of confusion. But shortly after starting a new job a few years ago, she made a serious error at work.

“Sue dealt with spreadsheets all day, every day. She was a whiz at numbers. All of a sudden, they were almost foreign to her,” recalled Peg Movelle, Morong’s wife of 25 years. “It was very clear something was going on.”

In 2018, at age 58, Morong was diagnosed with early-onset Alzheimer’s disease, a rare form of the disorder affecting people under age 65.

While her episodes at work ultimately became a wakeup call for the Jamaica Plain couple, they later realized it was only one of many worrying signs that Morong’s memory and cognitive skills had begun to deteriorate. Activities requiring coordination and concentration, such as driving and cooking, had become difficult and even dangerous for her.

“You don’t really think of people in their 50s and early 60s as having significant memory issues,” Movelle said. “But there were all of these minor things that added up to major things over time.”

Advancing the Science

After visiting her primary care physician and a general neurologist, Morong was referred to the Brigham’s Seth Gale, MD, a cognitive-behavioral neurologist who specializes in caring for patients with Alzheimer’s and an investigator with the Center for Alzheimer Research and Treatment (CART), which conducts research related to the disease.

Through CART, many clinical trials enroll patients with mild impairment who have underlying Alzheimer’s disease but haven’t yet developed loss of independence in daily functioning abilities.

“Sue is someone with early Alzheimer’s who was quite high-functioning in day-to-day life,” said Gale, co-director of the Brain Health Program in the Division of Cognitive and Behavioral Neurology. “So, I knew she was a good candidate.”

Although there are FDA-approved treatments for Alzheimer’s disease, these only have the potential to lessen some symptoms to a modest degree. No drug has been proven to stop or reverse the disease’s progression, and the newest drug for Alzheimer’s that was approved in the U.S. in 2021 showed mixed results in its effectiveness. Thus, the decision to participate in clinical trials can be a delicate one for many families, adding to the uncertainties and emotional ups and downs that already accompany living with Alzheimer’s.

Even so, the choice to participate in clinical trials was a welcome one for the couple.

“We were thinking not so much that there would be some miraculous breakthrough, but that we might as well give back and help others through research, since there really wasn’t anything else we could do,” Movelle explained.

In addition to providing opportunities for patients and families to participate in cutting-edge trials, the CART team also engages with Alzheimer’s and dementia investigators around the world to share their findings — hoping to one day discover effective therapies for all patients.

“We try to do no harm, but can we actually help? That’s the big question,” Gale said. “The treatment of progressive brain diseases is an enormous, remaining challenge in medicine. There have been hundreds of medications over several decades studied for the treatment of just Alzheimer disease; six of these have been approved in the U.S., five remain on the market, and none of them definitively slow the disease in any way. While knowledge about Alzheimer’s and related dementias has exploded in recent years, there is still so much work to be done.”

Adapting to Change

Morong was eligible to participate in two trials. The first study tested a medication that hoped to disrupt the signaling pathways that cause the development of amyloid plaques — clumps of protein that form in the brain of someone with Alzheimer’s. She felt there was no benefit from the experimental drug.

She later enrolled in another trial of a monoclonal antibody treatment for early Alzheimer’s, but was unable to complete the study when an unrelated medical issue affected her ability to come in regularly for the IV infusions.

Outcomes like these are not uncommon, Gale explained, but he emphasized that they also aren’t the end.

“Patients and families are often told, ‘There’s nothing we can do,’ but that’s not correct,” Gale said. “I tell newly diagnosed patients that, of course, nothing can sugarcoat the news they’re hearing today, but there are positive and effective things that they and we can do, starting today. There is a lot of evidence that brain-healthy behaviors — like exercise, healthy eating and mental stimulation — can change the trajectory of decline to some extent, perhaps especially for individuals like Sue who have the early stages of mild cognitive impairment.”

Movelle has encouraged Morong to pursue these activities and believes they have helped slow her decline. However, as the years have passed, certain parts of everyday life have inevitably changed for them both.

Morong, who had done most of the cooking throughout their time together, has mostly hung up her apron and now leans on her wife as head chef for their household. Although once an avid bookworm who could devour a novel in an afternoon, she has shifted her daily reading to reciting the headlines for Movelle. And instead of driving or giving directions, Morong now relaxes in the passenger seat while her wife drives and Google Maps leads the way.

As a caregiver, Movelle regularly reminds herself to prioritize her own well-being, too, and to take it one day at a time. For those also caring for a loved one with Alzheimer’s, she shared three pieces of advice: “Enjoy the humor in it, allow your tears and cherish every moment.”

A new COVID-19 booster shot targeting the highly transmissible omicron strain of COVID-19 is now available for people aged 12 and older, following a recent authorization from the U.S. Food and Drug Administration.

Daniel Kuritzkes, MD, chief of the Division of Infectious Diseases, spoke with Brigham Bulletin to address common questions about the new booster and flu shots.

Let’s start with the basics. What is different about this updated booster?

Daniel Kuritzkes

DK: The new COVID boosters are what we call a bivalent booster. Instead of having just one of the COVID variants represented in the vaccine, it includes two variants. So, in addition to having the original strain — often referred to as the Wuhan strain — the booster also includes the BA.5 subvariant of omicron. That’s important because it’s the strain causing the most infections today.

The concept of having multiple strains, or variants, represented in an individual vaccine is not new. The flu vaccine is a great example of this. For years, we used to get a trivalent, inactivated flu vaccine. Now, it’s standard to use a quadrivalent vaccine, which means there are four different strains of flu represented in the vaccine. Similarly, the polio vaccine had been a trivalent vaccine and is now a multivalent vaccine.

What do we know about how effective this booster is against the newer strains of COVID-19?

DK: We know these vaccines are safe and will generate the desired antibody response, which is what we believe is protective. The bivalent vaccine induces better antibody levels against omicron, including BA.5, than the original vaccines — all of which are based on the ancestral strain, which is quite distantly related to omicron. While we don’t have clinical trials data demonstrating just how effective the vaccine is against preventing infection, that is not unusual. We typically rely on so-called surrogate markers, or laboratory markers, of protection to move forward from one type of vaccine to another. Similarly, the flu vaccine is updated annually, and, clearly, we’re not doing clinical trials every year to demonstrate the efficacy of each season’s flu vaccine.

If you recently had COVID, would you still benefit from a booster? If so, when should you get it?

DK: Yes. We know that people who received the original vaccine series, had COVID and then got a booster had very strong protection. Even though the original vaccine — which remains the vaccine approved for primary vaccination — is not as protective against infection or symptoms of the current strains in circulation, it is still extraordinarily protective against severe disease, hospitalization or potentially dying of COVID.

The hope with the bivalent booster is that we gain a bit of an edge and perhaps return to better prevention of symptomatic infection, although that remains unproven. We’ll know in a few months just how successful it is.

In terms of timing, it’s recommended that people wait to get boosted until about three months after recovering from an episode of COVID, and at least two months since receiving their last booster or completing their primary vaccination series.

Does your booster need to be from the same manufacturer as your original vaccine?

DK: No, it doesn’t matter which one you had originally. You can get boosted with the Moderna or the Pfizer vaccine — which are the only ones authorized as boosters — regardless of which vaccine you had initially. My advice would be to find the place most convenient for you to get boosted and whichever booster they’re offering, that’s the one I would take.

With flu season soon upon us, can you get your flu shot and COVID booster together? Are there any concerns with, or benefits to, getting both at the same time?

DK: There are no concerns, other than potentially having a sore arm from each vaccine. I think it’s probably far more convenient for most people to go once to get both vaccinations.

It’s extraordinarily important for people to get their flu vaccine this season. It’s been a couple of years since we’ve seen much flu activity, but we already have clues from Australia about what to expect this flu season because they’re currently coming out of their winter. Now that very few places require masking or emphasize social distancing, they saw a lot more flu activity this season than in recent years.

It’s expected that we, too, will see a significant flu season here in the Northern hemisphere. And because people haven’t seen flu in a few years, immunity may have waned if they weren’t regularly vaccinated, so it’s important for people to do that this season. If you have symptoms, you should also get tested for both, since you can’t really tell flu apart from COVID based on symptoms alone. And if you do have symptoms of either respiratory illness, stay home until you’re symptom-free, so you don’t spread it to your co-workers, friends and other people in public spaces.

From left: Surgery interns John Gaspich and Christian Cullen demonstrate a simple system used on Braunwald Tower 15 to indicate a patient is ready for discharge and should call their ride.

When Caprie Bell, MSN, RN, a charge nurse on Braunwald Tower 15, enters a patient room during her morning rounds, she does two things: First, she greets her patient with a warm and friendly smile. Next, she glances at a whiteboard on the wall to see if there’s a small magnet in the upper corner.

That magnet, which depicts either a green or yellow car, is used on the unit to indicate the patient’s readiness for discharge after recovering from surgery. If there’s a green car, that means the team of surgeons and physician assistants (PAs) who rounded earlier that morning determined the patient can be discharged as soon as their ride arrives. If there’s a yellow car magnet on the whiteboard, it means the team believes the patient is almost ready to go home but first needs to meet certain clinical benchmarks.

“When I see the green car on the board, I know that a conversation has taken place,” Bell said. “I can say to the patient, ‘Good morning. It looks like you’re going home today. Have you called your ride?’”

The intentionally low-tech system has bridged a communication gap that existed between clinical teams in Surgical Intermediate Care ― enabling clinically ready patients to avoid unnecessary delays at discharge while improving teamwork across the unit.

The multidisciplinary project began in response to capacity challenges in the flow of patients from the Operating Rooms (ORs) to the Post-Anesthesia Care Unit (PACU) to the surgical floors. An analysis in May 2019 found that 12 percent of surgical patients on Tower 15 were discharged by noon, even though a greater proportion of them were ready to safely discharge by that time.

“We sometimes know at 6 a.m. which patients are ready to go, yet it was taking six to eight hours for them to leave the hospital,” said Jennifer Beatty, MS, PT, PA-C, director of Clinical Operations and Surgical Physician Assistants. “That’s not a positive experience for anyone. It means that staff on the floor are slammed with both discharges and admissions in the afternoon, patients in the PACU are waiting for a bed, and the patients who are going home will be sitting in city traffic when they could have left much earlier. We knew there had to be a better system.”

As it turned out, there was.

Since the car magnets were introduced in conjunction with a daily morning huddle between Beatty and Tower 15 charge nurses and nursing leaders, the percentage of patients on the unit who are discharged in the morning has more than doubled. As of June 2022, 30 percent of surgical patients on Tower 15 are discharged by noon.

“This project has been an amazing collaboration with shared ownership to improve the discharge process for our patients,” said Karen Reilly, DNP, RN, MBA, NEA-BC, associate chief nursing officer for Critical Care, Cardiovascular and Surgical Services. “The 15th floor has been able to develop a process that allows for timely discharge that not only impacts the patient going home but also improves patient throughput within the hospital.”

Malcolm Robinson, MD, vice chair of Clinical Operations in the Department of Surgery, agreed.

“We often focus on the high-tech ― and high-cost ― solutions when there are times that a low-tech, low-cost solution is actually the most effective,” Robinson said. “The car magnet project is an example of this, and the results speak for themselves.”

Resolving the ‘Information Lag’

So, what had been causing the discharge delay? In early 2019, clinical leaders enlisted the help of Process Improvement experts from Analytics, Planning, Strategy and Improvement (APSI) to find out.

After conducting observations on the unit and staff interviews, the Process Improvement team concluded that nurses weren’t receiving a reliable signal that the patient was ready for discharge in the morning.

Due to the unique needs of the OR schedules, surgeons and surgical PAs complete their rounds earlier than many other units ― usually between 6 a.m. and 7 a.m. ― and before their nurse colleagues’ shift change. In addition, like many rounding clinicians, surgeons and PAs typically entered all their orders later in the day.

That misalignment meant nurses often had to navigate conflicting information about a patient’s discharge readiness based on secondhand information from the patient versus what their electronic medical record indicated.

“There was an information lag of three to four hours,” explained Mark Galluzzo, MHA, lead process improvement consultant for APSI. “The rounding clinician knew that patient A had met all clinical milestones and would plan to put in a discharge order, but that information was just in their brain. Then the patient might tell their nurse, ‘The doctor said I’m going home,’ but when the nurse went into Epic, they didn’t see any record of that. Until the unit staff felt confident discharge was going to happen, they weren’t going to start to move on it.”

While the underlying challenges were complex, those involved in the project said it soon became clear that the solution was simple: “All we needed to do was tell each other what was happening,” said Jan McGrath, MHA, BSN, NE-BC, nursing director for Tower 15.

Beatty agreed: “By 7:30 a.m., we know a lot about what our patient movement will be for the day, but we recognized that didn’t play into how we prioritized our activities and communicated with nurses.”

Creating a Culture Shift

The APSI team came together with four PAs and four staff nurses on the unit to brainstorm ideas to bridge the gap. However, conventional approaches, such as adjusting schedules or having clinicians pause between rounds to enter orders, were not conducive to the way each role group worked.

The teams started thinking more creatively and realized they needed a visual cue ― what became the car magnet ― that nurses on the morning shift could trust to indicate discharge readiness. Additionally, rounding clinicians committed to making it a priority to submit any orders for “green car” and “yellow car” patients right after completing rounds. And finally, the teams implemented a multidisciplinary huddle at 8:45 a.m. to ensure everyone had the same information and to address any unresolved issues in real time.

“The car magnets are low-tech, but I think that’s part of the reason why they work. It’s so simple ― you can’t mess it up,” said Joanna Cassidy, MSN, RN, CNL, assistant nurse director on Tower 15, who was part of the initial workgroup. “The daily huddle we have with Jen has also been a huge help because she’s able to answer a lot of our questions and follow up as needed. It has really improved communication across the unit.”

While the project has been a work in progress, its benefits continue to unfold.

“The metrics are impressive, but I think the bigger part of it has been the culture change on the floor,” Beatty said. “The mindset has changed.”

Kendra King, PA-C, a PA in General Surgery, said that using the magnets is now “second nature” for her and her colleagues during morning rounds.

“You know when you’re in the room that you have to move the car,” King said. “It took a lot of training to get that muscle memory down, but it’s truly saved two to four hours every day in eliminating all the back and forth we used to do. In the end, it’s better for everyone.”

For Bell, the car magnets have also improved her workflow as a charge nurse.

“I have a better understanding of those who are ready to go in the morning, and that knowledge trickles down to the rest of the team. For instance, I can inform the nursing assistants sooner that this patient is going to be discharged in the morning, so they know it’s a good time to help the patient gather their belongings or shower so that they’re ready when their ride arrives,” she said. “It’s all about how we can better care for the patients because they’re the No. 1 reason we’re here.”

Shaun Melendy with his mother, Joyce, during a recent follow-up visit at the Brigham.

When Shaun Melendy, 42, was kayaking down the river behind his West Bridgewater home one winter morning and realized a section of it had frozen over, there was, in his view, an obvious solution to this problem. It did not involve getting out of the water.

Instead, Melendy, a U.S. Coast Guard veteran and diehard outdoorsman, plunged a hunting knife into the ice and used it to pull himself along. As he inched his kayak down the river, he enjoyed the fruits of his labor: a peaceful paddle through a snow-covered forest.

On the surface, the story is a simple anecdote that amuses his loved ones. But it also speaks to something deeper — an adventuresome spirit and relentless optimism in the face of adversity.

Those qualities continue to guide Melendy through what has become the most difficult chapter of his life, which unfolded when he was struck on his motorcycle by a distracted driver who had drifted into oncoming traffic on May 5.

The crash left him with devastating injuries, including the traumatic amputation of his left hand at the scene.

First responders rushed Melendy to the Brigham, where he underwent emergency surgery for severe injuries he sustained throughout the rest of his body. In addition to suffering fractures to his skull, spine, hips, legs, ankles and feet, he needed an 8-inch skin graft to cover a wound on his left leg.

After waking from a medically induced coma, Melendy says one of his first memories was seeing a friendly face at the foot of his bed.

“He had his mask on, but he had a bright smile in his eyes,” Melendy remembered.

It was Matthew Carty, MD, of the Division of Plastic and Reconstructive Surgery, who had stopped by to speak with him about the opportunity to undergo an experimental surgery — part of a clinical trial in collaboration with MIT — that could make it easier for him to use a prosthetic limb. If successful, the procedure would preserve the normal signaling between his brain and muscles, a connection that ordinarily gets severed in an amputation.

“He said, ‘Shaun, I think you’re going to be a good candidate for this surgery. You seem like the type of guy who was active before, and I think I can help you stay active in the future. I don’t think any of the things you’ve done the past are going to end,’” Melendy recalled.

That was all he needed to hear.

“I said, ‘Yes, absolutely,’” Melendy said. “I’m not one to sit still. I love being outdoors. I surf, swim and race kayaks. I cut firewood. I climb trees. I do sprint triathlons. Knowing I do all these things, I thought I would be more upset. But I just knew that I was going to be able to truck forward and figure out what the next step is. I can’t wait to use a prosthetic.”

Another key motivator for him was the ability to help other amputees, particularly fellow veterans, by participating in this clinical trial.

“I want to help people move forward from what they lost,” he said. “Veterans who come home from war should not have prosthetics that don’t work for them.”

‘Mind-Blowing’ Results

That bedside conversation would lead Melendy to become a pioneer — making him the first patient in the world to have lost an upper limb in a traumatic injury and undergo this novel procedure, known as an agonist-antagonist myoneural interface (AMI) amputation.

Traditional amputations, which have seen little innovation since the Civil War, cause amputees to lose the ability to finely control the muscles in their residual limb and, more importantly, the ability to perceive where it is in space without looking at it. This often leads to difficulties when using a prosthesis.

From left: Spine fellow James St. Clair listens as Melendy describes his experiences since his last spinal surgery.

In 2016, a clinical team at the Brigham led by Carty, in collaboration with Hugh Herr, PhD, of the Center for Extreme Bionics in the MIT Media Lab, invented a new method of amputation for lower limbs. It was called the Ewing amputation in honor of its first patient, Jim Ewing. The AMI procedure maintains natural linkages between muscles in an amputated limb, so amputees using a prosthesis feel as if they are controlling a physiological limb.

Importantly, this method can send movement commands from the central nervous system to a robotic prosthesis, so when an amputee intends to flex their ankle, for instance, the robotic limb responds appropriately. It also relays feedback describing movement of the joint back to the central nervous system, allowing an amputee to sense the speed, location and other attributes of the artificial limb.

In 2018, the team adapted the procedure for upper-limb amputations. Since then, four patients at the Brigham had undergone AMI amputations at the arm or wrist, but all were under elective conditions — typically after enduring chronic pain for years due to an old injury. Melendy became the first to have the experimental surgery following a traumatic amputation.

“We’ve always thought these techniques could be applied in the acute setting — something we believe will be especially useful for military personnel with combat injuries,” Carty said. “But in terms of testing that hypothesis, there are clear difficulties: Such events are rare, and obviously we cannot anticipate when the opportunity will arise. Shaun turned out to be a great candidate for surgery and continues to do very well, proving our assumption that upper-extremity AMI amputation can be done safely in the context of acute trauma.”

After receiving a temporary closure at the wound site and recovering from his other surgeries, Melendy prepared to undergo the five-hour AMI procedure.

“The fact that we were working from a traumatic injury made it a little bit harder because we had to use our knowledge of anatomy to reconnect the muscles in the correct manner. You can do that with relative reliability, but it’s much easier when the limb is still in place,” Carty explained. “It made it a little more difficult, but by no means impossible.”

During a post-operative visit six weeks after the surgery, Melendy said it was “mind-blowing” to see even the early results.

“Dr. Carty was checking my residual limb by putting his hands at the end and asked me to move my thumb,” he said. “You could see the muscle constructs moving under the skin, as the surgery was designed to do. Then he asked me to move all my fingers, and all my ‘fingers’ were moving. It’s amazing how those muscles and nerves can still talk to each other.”

Finding Strength

After his discharge from the Brigham, Melendy continued his recovery at Spaulding Rehabilitation Hospital for his other injuries, which amounted to about 20 broken bones and required 10 surgeries over three weeks. Throughout his time at both institutions, Melendy said the care he’s received has been exceptional.

Melendy receives a warm welcome home in July from his beloved dog, Blu, an 8-year-old Cane Corso.

“The coordination between the staff and doctors has been wonderful, and they all made me feel very comfortable,” he said. “They even told me I gave them inspiration. They would tell me, ‘Shaun, I was having a bad day, and since coming in and talking to you makes my day better, I came to see you first.’”

Among those he connected with was Brigham nurse Alex Poliansky, RN, of Braunwald Tower 8.

“He was so optimistic and upbeat. Any other person in his condition probably would have been depressed, but he was not giving up,” Poliansky said. “It was easy to go along with that. We were all hopeful for him.”

Melendy credits his positive outlook to an influential figure in his life: his Grandma Candy.

“My grandmother was paralyzed from polio from the time she was 2 years old until she passed away. She brought me inspiration throughout my whole life,” he said. “So, when I woke up and noticed my hand wasn’t there, I didn’t cry. I wasn’t sad. I just knew I would have her strength behind me to guide me through it.”

The support of his loved ones, including his parents and sister, as well as his local community, has also been incredibly uplifting, he said. And while he has remained relatively stoic throughout his experience, Melendy acknowledged he did have one emotional moment during his recovery: FaceTiming from his hospital bed with his dog, Blu.

“Losing my hand didn’t bother me as much as not being able to spend time with him,” he said. “The first time I FaceTimed with him, I started speaking to him in German, as I had taught him a lot of German commands, and to see him responding when I told him to bark — that made me cry.”

Published: Aug. 16, 2022

On Aug. 4, the Biden administration declared the monkeypox outbreak that started in May 2022 a national emergency. Hospital Epidemiologist Michael Klompas, MD, MPH, recently spoke with Brigham Bulletin about what we’ve learned so far.

More general information about monkeypox is available in this FAQ, compiled by infectious diseases experts across Mass General Brigham.

How significant is this outbreak?

Michael Klompas

MK: We’re now in the midst of the largest outbreak of monkeypox ever. There’s large and growing number of cases both nationally and internationally — over 12,000 U.S. cases and over 30,000 cases worldwide in at least 81 countries. Historically, monkeypox was a disease that was concentrated in Western and Central Africa, but the vast majority of cases we see now are occurring in other parts of the world. The current hotspots are the United States, which has the most cases in the world, and various countries in Europe, particularly Spain, the United Kingdom and France.

This isn’t the first time we’ve seen monkeypox in the U.S. How is this outbreak different from the last one we saw in this country?

MK: In 2003, pet importers brought Gambian pouched rats from Central Africa to a pet distribution warehouse in the Midwest. While there, those rats infected some prairie dogs with monkeypox. Those prairie dogs were then sold as exotic pets to people around the United States and ended up passing on monkeypox to some of their pet owners — classically, through a bite or a scratch, sometimes through close cuddling or cage cleaning. It ended up causing about 70 cases across the country.

What was striking about those cases was that there was no secondary transmission, meaning there was transmission from prairie dog to pet owner, but no transmission on from that human to other people. This mirrors the traditional transmission pattern for monkeypox observed in Africa: The natural reservoir for this virus is rodents, with occasional spillover into human beings through a bite or a scratch, followed by very little onward transmission to other people.

There have been two additional cases in the U.S. since 2003 and before the current outbreak. Both were in travelers from Nigeria and both were diagnosed in 2021: one in Maryland and one in Texas. What is striking about these cases is that these travelers had hundreds of contacts — all the passengers in the airplane, household members, people they interacted with in the medical system — and there were no cases of transmission from those travelers to others. That’s worth keeping in mind because it gives us insight into the very limited risk of monkeypox transmission from casual or passing encounters.

Is monkeypox dangerous?

MK: The good news is that the prognosis is very good. Out of the 30,000-plus cases that have been reported outside of Africa in the current outbreak, there have only been nine deaths reported thus far. I don’t want to minimize those deaths — each one is a tragedy — but from a population-level point of view, the risk is very low.

The hospitalization rate appears to be about 3 percent. Most people who require hospitalization for monkeypox are admitted for pain control or because of bacterial superinfection at the site of the monkeypox lesions. Fortunately, we do have a good treatment — a medication called tecovirimat, also known by the brand name TPOXX. This medication has an interesting history because it was developed as a biodefense strategy against smallpox, which is in the same family as monkeypox. It turns out this treatment is effective against monkeypox as well.

Nonetheless, while the vast majority of people with monkeypox do not get sick enough to require hospitalization, it can still be a very unpleasant experience. Some of the lesions, especially those on the genitalia or rectum, can be very painful, and people can have systemic symptoms that leave them feeling pretty lousy. These can include fever, swollen glands, fatigue, muscle aches, headache and sore throat. These additional symptoms might not all be present, nor all at the same time, and which one appears first varies from person to person.

How is it spread?

MK: Most transmission appears to be through close skin-to-skin contact with infected lesions, such as through rubbing or a scratch. The monkeypox consists of fluid-filled bumps that are packed with virus. They evolve over time and ultimately scab, but throughout their evolution they contain a lot of virus. Direct contact with these lesions is believed to account for most transmissions. Once the virus enters the body of a contact, it can spread to other parts of the body.

Does that mean we should be worried about catching monkeypox by touching surfaces in places like the grocery store, the gym or on public transportation?

MK: The Centers for Disease Control and Prevention (CDC) just published a summary of the first 1,195 cases in the U.S., and there are several insights from this and similar case series from Europe that suggest that, no, the risk of transmission in these kinds of casual contexts is exceedingly low.

First, 99 percent of the people who have been diagnosed with monkeypox are men. To some degree, that might reflect bias in who is getting tested because anyone can get monkeypox, but we’re seeing the same pattern in Europe, which has been dealing with the current monkeypox outbreak for longer than us and where testing has been more broadly available in some jurisdictions. Additionally, the majority of cases have been seen in younger men, and 94 percent of the U.S. cases studied involved men who had sexual or close, intimate contact with another man in the three weeks before their illness began. The other big clue is that half or more of people diagnosed with monkeypox during the current outbreak note that their lesions first appeared on their genitalia or buttocks. Putting those factors together, we can intuit that most transmission is now taking place through sexual or intimate contact.

This fits with the general infectious disease principle that there’s a good correlation between quantity of virus and risk of transmission. We know from studies quantifying the amount of monkeypox virus in different parts of the body that the highest amount of virus is found in skin lesions (more so than in the throat, blood, urine, feces, etc.). Patients with monkeypox can shed virus into the environment, but typically the amount is small — below the level required to be able to infect cells. The rare exception to this is surfaces with heavy exposure to skin lesions, such as patients’ linens.

Finally, public health authorities do think that respiratory transmission is also possible but rare. Monkeypox spreads through the air much less efficiently than SARS-CoV-2. In fact, the CDC estimates that respiratory transmission requires more than three hours of sustained, close contact for transmission to occur.

What this all says to me is that your risk of getting monkeypox from a passing encounter or by touching a random surface in a store or restaurant is close to nothing. If this were a highly contagious disease that you could get by, say, sitting on a bus, going to a restaurant or shopping in a supermarket, we would expect to see many, many more cases in women and children. That said, if you live with someone who has known monkeypox, where there is more opportunity for close contact and for sustained and repeated virus shedding on high-touch surfaces, you should be cautious about washing your hands, cleaning surfaces, avoiding close contact and not sharing food, utensils, bed linens or towels. You should also wear a mask and try to optimize ventilation in shared spaces.

Are there unique risks for health care workers?

MK: Historically, there was only one documented case of a health care worker infected by a patient outside of Africa. It was in someone who changed the linens on a hospital bed occupied by someone with monkeypox. The speculation is that in the course of shaking out the bed linens, some of the virus got into the air and they inhaled it, leading to an infection.

During the current outbreak, two additional health care worker infections have been reported: one due to a needlestick injury and one in whom the mechanism of infection is still being investigated. Relative to the number of patient infections thus far and the number of providers they’ve interacted with, the number of health care worker infections thus far is extremely small.

Given the mechanisms of transmission of monkeypox, MGB is following CDC guidance and recommending that health care workers wear gloves, gown, N95 respirator and eye protection whenever they manage a patient with possible or confirmed monkeypox.

On Aug. 10, Governor Baker signed a bill into law that implements measures to address the mental health crisis in Massachusetts. Leaders at Mass General Brigham (MGB) and other organizations played a key role in championing one of these measures: to expand access to treatment for health professionals with substance use disorders (SUD).

“It is deeply important that we remove the stigma surrounding SUD and work together to foster a supportive environment where nurses and other health care professionals can recover and safely work in their practice settings,” said Maddy Pearson, DNP, RN, NEA-BC, senior vice president of Patient Care Services and chief nursing officer at the Brigham. “Removing barriers to treatment for health care professionals is vital to their ability to seek support and ultimately deliver safe care to patients, which is our top priority.”

Pearson, who co-chairs the MGB Chief Nursing Officer Council, was among leaders of the system’s advocacy for this legislation in partnership with the Massachusetts Nurses Association, the Massachusetts Health and Hospital Association and the Organization of Nurse Leaders.

In addition to Pearson, MGB leaders involved included Chris Philbin and Kevin Sanginario of the Office of Government Affairs; Bernard Jones, vice president of Value-Based Care, Public Policy and Administrative Operations at the Brigham; Vanessa Gilbreth of the Office of General Counsel; and Regina Hagono, of Analytics, Planning, Strategy and Improvement at the Brigham.

“This was a collaborative effort among internal and external stakeholders, and we’re thankful to everyone involved for their efforts to secure the passage of this important bill that supports health care professionals,” said Philbin, vice president of Government Affairs.

Currently, nurses with suspected SUD are referred to the Substance Abuse Rehabilitation Program (SARP) through the Board of Registration in Nursing. The program has been underutilized, with 0.01 percent of the state’s nurses in enrolling in fiscal year 2018.

“The stringent eligibility criteria prevent nurses with a mental health history from applying, and wait times for the program are long,” said Pearson. “Additionally, if a nurse has a relapse, he or she must wait at least a year to request monitored re-entry into practice. We know relapse is a normal part of the recovery process, and it should be treated with the same understanding given to those who have relapses in treatment for other chronic illnesses.”

With the bill’s passage, the Department of Public Health (DPH) will establish a new, voluntary program for all licensed health care professionals who seek support for their mental health or substance use.  An advisory committee of external stakeholders will assist DPH in the development and implementation of the program with the goal of creating a best-in-class experience for participants.

“Our goals were to revamp the state’s program for nursing and to ensure that other health care professionals would also receive improved access to care and treatment,” said Gilbreth, senior legal counsel. “It’s critical that all health care professionals have the resources to receive care, recover and successfully return to their work.”

In addition to nursing, the bill also pertains to pharmacy, dentistry, nursing home administrators, physician assistants, perfusionists, genetic counselors, respiratory therapists, community health workers, naturopathy and emergency medical services. Physicians receive support through the Physician Health Services Program in Massachusetts.

“Other states have non-punitive programs that support nurses and health care professionals and provide the treatment they need to successfully return to practice,” said Pearson. “Massachusetts is renowned for the world-class health care we offer to patients and loved ones. We need to make sure we are also caring for our health care professionals and treating them with the same compassion they show each one of us when we find ourselves in their care.”

Jones noted the dedication of the individuals and organizations leading this effort.

“The passage of the bill is the culmination of nearly four years of work for those involved and is a perfect example of the important role our institutions can play in developing and, in this case, improving public policy,” he said. “This effort has included extensive research, the development of a white paper, and testimony at a public hearing, all to ensure that we have provided information and education around this issue in support of improved access to treatment and ultimately to change how the system works.”

From left: Deland Fellows Judah Soray and Jenny (Torres) Azzam

Each summer, the Brigham welcomes a new class of Deland Fellows in Health Care and Society. This one-year administrative experience prepares early-career professionals to lead health care institutions. Each fellow works closely with a member of the senior leadership team who serves as their mentor.

Jenny (Torres) Azzam, MBA

Hometown: Fontana, California

Executive mentor: Christina A. Lundquist, Senior Vice President of Clinical Services, Real Estate and Facility Operations

Previous roles: Clinical Operations Manager at Intelli-Heart Services and, most recently, Performance Excellence Administrative Intern at UCLA Health

What drew you to Brigham? I was initially drawn in by Brigham’s mission and vision of maintaining and restoring health and am particularly intrigued by our value proposition focused on scalable innovation. Brigham and Women’s Hospital is home to some of the most groundbreaking innovations, and as health care continues to evolve, I aim to be part of an institution with an embedded “change culture.” It is clear that the Brigham and Mass General Brigham continuously strive toward advancement for the well-being of our staff and patients as a system. Thus, the Deland Fellowship was the best opportunity to learn from all the brilliant leaders seeking change to build a healthier world.

What projects are you looking forward to working in during your fellowship? Improving access for patients is a driver for me. I am excited to get involved in performance improvement, operations and strategy work, allowing our patients to obtain timely, efficient and high-quality care while also focusing on improving their experience.

Fun fact about you: I am one of those strange individuals who enjoys running ultramarathons for fun!

Judah Soray, MHA, BPharm, CSSGB

Hometown: I’m originally from Trinidad and Tobago but have lived in Orlando, Florida, and Bristol, England, before moving to Boston for the fellowship.

Executive mentor: Sunny Eappen, MD, MBA, Chief Medical Officer and Senior Vice President of Medical Affairs

Previous role: I’m a trained pharmacist and worked in the retail setting before pursuing graduate school. Most recently, I interned at the Cleveland Clinic in International Operations.

What drew you to the Brigham? Health care is rapidly evolving, and there are many uncertainties about the future. I feel that the academic health care setting is most agile. With such a rich history of pioneering health care, the Brigham is ready to adapt and cater to future needs. Having met with the outstanding leadership team through the application process, I knew I wanted to join the Brigham and support its many dedicated, highly competent and skilled teams. Additionally, the opportunity to collaborate with senior leadership across the entire organization and tackle projects that fit both the organization’s mission and my goals were highly motivating.

What types of projects are you looking forward to working on during your fellowship? The collaborations currently underway across Mass General Brigham appeal to me, so I’m very much looking forward to working on areas that can expand access to more integrated care. My skillset plays well into the international services space, and I hope to help expand those efforts of providing care to patients most in need, both within New England and worldwide. I also hope to join our Patient Experience team in striving to improve the care continuum for every single patient, from admission to discharge and beyond. Another aspect of the Brigham I’m very interested in is our approach to climate and sustainability initiatives— mitigating health care’s impact on our environment, reducing our carbon footprint and helping shape a more environmentally conscious health care industry.

Fun fact about you: I hold nationality in three different countries: Trinidad and Tobago, the United Kingdom and the United States​

To learn more about the Deland Fellowship, visit brighamandwomens.org or attend an upcoming information session on Aug. 15, noon–1 p.m., or Sept. 12, 2–3 p.m.

Brigham and Women’s Hospital mourns the loss of Martin C. Mihm Jr., MD, a physician, researcher and educator in the Department of Dermatology whose groundbreaking discoveries have saved lives and whose lifelong commitment to mentorship influenced generations of clinicians in the fields of dermatology, dermatopathology and pathology. He died on July 19, 2022 of a sudden illness at age 88.

An international expert on malignant melanoma, Dr. Mihm helped shape the way skin cancers are identified and diagnosed, and his discoveries and insights influenced the way these tumors are ultimately treated. Notably, he established the importance of tumor-infiltrating lymphocytes — a type of cell that can recognize and destroy cancer cells — in contributing to the prognosis of patients with primary and metastatic melanoma. He also collaborated with the late melanoma expert Wallace Clark, MD, to create the current clinical categories for melanoma: superficial spreading, nodular, acral lentiginous and lentigo maligna.

“This is a man who has saved countless lives, and I am forever grateful for the degree to which he has enhanced my own life as a mentor and friend,” said Dermatology research colleague Tobias Schatton, PharmD, PhD, who recently partnered with Dr. Mihm on a melanoma study. “Martin set the prime example of how to live with integrity and purpose.”

In addition to his tremendous contributions to science and medicine, Dr. Mihm had an equally profound impact on others with his joyful spirit.

“Beyond his credentials, accomplishments, publications and degrees, Marty was a warm, funny, kind and generous man,” said Thomas Kupper, MD, chair of Dermatology. “His enthusiasm was palpable and infectious. He could make a microscope slide image come alive with subtle insights that, once pointed out, were obvious. He was also considerate, taking time to know the names of all the residents and students in the program and to learn about people around him. He truly was one of a kind — the sort of character who comes along rarely, like a comet leaving light and brilliance in his wake.”

Colleague and friend Jennifer Lin, MD, director of the Melanoma Risk and Prevention Clinic, reflected that Dr. Mihm was always ready to share his experiences and words of encouragement with those around him.

“He had a kind word for everybody,” Lin said. “His enthusiasm and positivity were contagious — and made coming to work so wonderful.”

Dr. Mihm’s passions for life and medicine often intertwined. Lin recalled that Dr. Mihm and Dr. Clark named the “superficial spreading” category of melanoma after sharing the morphological pattern of this lesion with students from the Boston’s Museum of Fine Arts and learning of a painting with similar morphology.

“That he could share his gifts and brilliance with us was a truly wonderful experience, and we are all better for it,” said Kupper.

Dr. Mihm was dedicated to promoting education and mentorship throughout his career. Beginning in 1974, he served as chief of the Massachusetts General Hospital Dermatopathology Unit, where he founded one of the first five dermatopathology training programs in the United States. In 1993, he joined the faculty of Albany Medical Center to establish a new dermatology and dermatopathology training program there.

“Through his mentorship and training for generations of residents, fellows and faculty, Martin’s impact will continue to grow exponentially,” Schatton said.

Beginning in 2010, Dr. Mihm served as director of the Melanoma Program in Dermatology and the Dana-Farber Brigham Cancer Center. He was also the founding director of the Mihm Consultative Service in Dermatopathology.

Over the course of his career, Dr. Mihm’s commitment to patient care inspired his work to make health care, particularly cancer treatment and prevention, more widely accessible. He was a co-founder of the Rare Tumor Institute of the World Health Organization in Milan, Italy, before acting as its external coordinator for five years, and he also helped establish clinics in Albania, India, Italy, Russia and Vietnam. Most recently, he served as co-director of the European Organisation for Research and Treatment of Cancer’s Melanoma Pathology Program.

Adriano Piris, MD, co-director of the Mihm Cutaneous Pathology Consultative Service, met Dr. Mihm after coming to Massachusetts General Hospital for his first dermatopathology rotation. Dr. Mihm soon became an important force in his life, as an inspiring mentor and a dear friend. Piris was honored to eventually work with Dr. Mihm as co-director of the Consultative Service.

“Words cannot express the meaningful impact Dr. Mihm had on my career. Over the years, he became a close friend and a family member. He embodied the concept of true mentorship and friendship for life,” Piris said.

Colleagues and friends noted that Dr. Mihm always remained committed to helping others and acting as a positive influence in people’s lives.

“Up until the final days of his life, he was committed to helping others through his unparalleled kindness, knowledge and compassion,” Schatton said. “Martin’s warmth to everyone around him, without exception, made him a very rare individual, and his absence will be felt by many.”

Dr. Mihm is survived by his cousins, godchildren and loving friends.

Laurie Mott with her husband, Ron, prior to her injury.

Laurie Mott was preparing a big family dinner one day in April when she experienced a terrifying emergency. “I had the table set and everything ready,” she recalled. “I reached over the boiling potatoes to grab the onion powder for the gravy, and that’s when my shirt caught fire.”

Despite the shocking turn of events, Mott — who was one of the first women to volunteer as a Boston firefighter and is also married to a retired firefighter — acted on instinct as she extinguished the flames and called 9-1-1. She was transported to the Brigham’s Burn Center, where she remained for 16 days to recover from the injuries she sustained.

During her time at the Brigham, Mott was eager to understand her condition. She asked her care providers to explain the possible treatments for the burns that extended over her upper body and learned from the nurses on her team how to dress and clean her burns, working hard to participate in her treatment plan.

“She was so sweet and very interested in learning about her condition and her own role in her healing,” said Mary O’Neill, RN, one of the members of Mott’s care team.

Providers informed Mott that a skin graft operation could significantly reduce her chance of infection, decrease her recovery time and improve her overall health care outcomes.

At first, Mott had reservations about the surgery. Not only did she hope to return home as soon as possible, but due to burns under her arms, the operation, which would involve a transplant of healthy skin from other areas of her body to the skin affected by burns, would require one of her arms to remain extended for five days following the operation. Mott worried about discomfort and limitation to her mobility.

Anupama Mehta, MD, medical director of the Burn Center and Mott’s physician, listened, explained all treatment options and then encouraged and empowered Mott to pursue what she felt was the right treatment for her. “Understanding a patient’s lifestyle and where they’re coming from is important when creating individualized, relevant treatment plans,” Mehta said.

Delivering Patient-Centered Care

Being considered an essential member of her own care team made Mott feel more comfortable with the idea of undergoing surgery, she explained. She felt particularly comforted by O’Neill, who supported Mott as she adjusted to caring for her burns and helped answer her questions. When she first saw her burns and worried about what her treatment plan might be, Mott recalls tears coming to her eyes, but she felt reassured by O’Neill, who said, “This is your body. You’re involved in taking care of it.”

After discussing all options with her care team, conducting her own research on the operation and witnessing the collaboration and mutual respect among the members of the Burn Center, Mott elected for the skin graft.

She recalled feeling reassured by the high regard that care providers showed to one another at the Brigham. “Everyone respected each other and played such a wonderful role in my experience,” Mott said. “After I decided to proceed with the procedure, I felt relieved because I was sure it was the right thing to do,” she said.

In thinking back on her time at the Brigham, Mott fondly remembers the kindness her providers showed her. Lauren Pozerski, RN, would bring Mott cups of tea from the nurses’ station after noticing her love for the beverage. When her hands were bandaged, the patient care associates helped her eat. “The little things really made a difference,” said Mott. “They treated me so well. I can’t say enough about them.” Mott was moved to write letters to her physicians and nurses before leaving the hospital, thanking them for their care.

This summer, Mott celebrated her 70th birthday at home, surrounded by her family. While Mott faces obstacles as she continues to recover, she is glad to be home with the support of her loved ones. For now, she is enjoying her husband’s cooking — and looks forward to preparing and sharing a meal with her children when she’s ready to return to the kitchen.

“No doubt, Dr. Higgins will make a far-reaching impact and nurture the Brigham’s strengths into the future,” says former Brigham President Betsy Nabel (right) of her successor, Robert S.D. Higgins (left), who was honored at a July 25 event.

On July 25, more than 100 guests gathered to celebrate The Elizabeth G. and Gary J. Nabel Family Professorship in Surgery at Harvard Medical School (HMS) and its inaugural incumbent, Brigham President Robert S.D. Higgins, MD, MSHA.

This endowed professorship, which is the highest honor HMS can bestow on a faculty member at one of the school’s affiliated institutions, will stand in perpetuity and be held by the president of Brigham and Women’s Hospital. The professorship is named for former Brigham President Betsy Nabel, MD, and her husband, Gary Nabel, MD, PhD, who made a $1 million gift to support its creation and were joined in their generosity by several Brigham Board of Trustees members.

Higgins — who was lauded for his exemplary leadership, pioneering contributions to surgery and research, and tremendous dedication to mentorship and service — described the appointment as “the honor of a lifetime.”

“It’s a privilege to build and expand on the great work of my predecessor, Dr. Betsy Nabel, whose leadership elevated the Brigham to new heights as a premier academic medical center during her impressive tenure,” Higgins said. “Betsy left an indelible mark on the Brigham, and as the steward of this generous gift, I hope to ensure these resources advance our clinical and research enterprise.”

Nabel said she looks forward to seeing Higgins lead the Brigham into its next great chapter.

“By creating this professorship honoring the Brigham president in perpetuity, it’s our collective hope the institution continues to grow better every day,” she said. “No doubt, Dr. Higgins will make a far-reaching impact and nurture the Brigham’s strengths into the future.”

Attendees of the July 25 celebration included hospital leaders, invited speakers, and the Nabel and Higgins families and loved ones. Throughout the evening, guests were treated to warm remarks and stories that highlighted Higgins and the Nabels as leaders, innovators and mentors — and also showcased the collective strength of the Brigham community.

HMS Dean George Q. Daley, MD, PhD, kicked off the celebration, which included remarks by Board of Trustees Chair John Fish, who presented Higgins with a proclamation celebrating and recognizing Higgins’ many achievements.

In addition to the evening’s three guests of honor, other speakers included Gerard M. Doherty, MD, chair of the Brigham’s Department of Surgery and surgeon-in-chief, and Jeffrey Leiden, MD, PhD, executive chairman of Vertex Pharmaceuticals and an alumnus of the Brigham’s residency and fellowship training programs. Daley also read heartfelt remarks from TIMI Study Group Chairman Eugene Braunwald, MD, in his absence, and Brigham primary care physician Thomas H. Lee Jr. MD, and William A. Baumgartner, MD, one of Higgins’ mentors, shared words of praise and congratulations.

Reflecting on his first several months as president, Higgins said the inspiring and welcoming community he found here has exceeded his expectations in every way.

“Throughout my career, I’ve always known the Brigham to be a special place — a place of innovation and inquiry, compassion and caring, and academic rigor and unparalleled mentorship,” Higgins said. “Now that I’ve had the opportunity to experience this community firsthand, I am impressed by the talent, ingenuity, dedication and expertise that exist throughout every corner.”

From left: Unit coordinators Allison Mulhern and Dhanani Gurung with Anne Bane during the Voalte implementation in the Connors Center for Women and Newborns in 2021

When Barbara Lakatos, DNP, PMHCNS-BC, APRN, and Christine Murphy, PMHCNS-BC, CARN-AP, are providing psychiatric nursing consultations on inpatient units, they often need to page a staff member and wait for a return call before they can move to their next patient on another unit.

That’s no longer the case, thanks to the rollout of Voalte, a communication tool that enables HIPAA-compliant texting and voice calls among staff. Launched previously in limited areas of the hospital, Voalte was recently implemented throughout inpatient areas and roles to connect staff in a unified directory. The implementation was made possible thanks to funding from the Caregivers Fund, which provides critical resources to support Brigham employees’ well-being and address emerging needs.

“Voalte has improved our ability to communicate with team members as we move between units,” said Lakatos, who serves as program director of the Psychiatric Nursing Resource Service with Murphy. “We can call, text and page from the app, which streamlines communication and decreases redundancy.”

Christine Wang, MD, a resident in the Department of Medicine, also noted the increased efficiency and positive impact on patient care.

“It’s so easy to check in and close the loop with nurses and other providers on the clinical team, and it decreases any waiting time because Voalte is at our fingertips,” she said. “It also improves quality of care for patients because we’re able to work through issues together as a team in real time.”

A Convenient Way to Connect

Speech language pathologist Stacey McCauley says Voalte has made daily communication more convenient for staff.

Following the most recent rollouts of Voalte in July, 3,800 staff are now experiencing the benefits of the mobile technology.

After signing into Voalte, staff can look up patient names, medical record numbers and bed/room numbers. Staff can see the care team members for each patient, initiate a call or text and confirm when the recipient has received and read a message. Voalte also indicates if a care team member is offline.

Additionally, the app includes quick references — such as paging, drug administration guidelines and Ellucid policy links — to facilitate workflow.

As of July 22, staff have sent an average of 10,077 texts and placed approximately 580 calls per day with Voalte, with about 860 active users per day.

“It’s very convenient to be able to send a message via Voalte without having to log into a computer,” said Stacey McCauley, MS CCC-SLP, speech language pathologist in Rehabilitation Services.

The Speech Language Pathology team began using Voalte earlier this spring and created a daily group message to stay in touch about new consults and other timely information. “We’ve been looking forward to more staff joining so we can easily communicate with other members of the interdisciplinary team,” McCauley said.

“The conversations are happening in real time,” says nurse Jessica Ruxton.

Staff in Pharmacy Services had a similar experience.

“Voalte has been particularly well-received by pharmacists, as it has allowed for easier and more efficient communication with other members of the health care team, as well as with colleagues within the Pharmacy,” said Jeremy Degrado, PharmD, BCCCP, BCPS, clinical pharmacy manager.

Maddy Pearson, DNP, RN, NEA-BC, senior vice president of Patient Care Services and chief nursing officer, noted Voalte’s positive impact on the ways staff communicate and collaborate. “Our goal was to improve the experience of staff and providers and streamline the way we communicate with colleagues and across different teams,” she said. “It’s wonderful to hear from our teams that they are already noticing a difference in workflow. We’re also grateful for constructive feedback that will help us refine our processes as we move forward.”

Recent Rollouts

Over the past two weeks, the implementation team launched the tool in numerous inpatient units and departments in two large waves.

Jessica Ruxton, BSN, RN, and Rachel Colby, BSN, RN, shared that the rollout on Shapiro 9/10 went smoothly and that they are already experiencing the benefits of Voalte.

“The feedback has been nothing but positive,” says nurse Rachel Colby.

“Voalte allows for closed-loop communication with the whole multidisciplinary team,” said Ruxton. “The conversations are happening in real time, allowing non-urgent concerns to be addressed sooner with prompt response time, putting our patients’ minds at ease.”

Colby agreed. “Voalte is fabulous,” she said. “So far, the feedback has been nothing but positive. Everyone is loving the easy use and quick way of communication.”

During the July implementation, staff received support from the Voalte team, Nursing Informatics, nursing leadership and a group of “go-live” volunteers.

“The rollouts have gone very well, thanks to everyone’s efforts,” said Anne Bane, MSN, RN, director of Nursing Informatics and Medication Safety. “We heard overwhelmingly positive feedback from staff.”

Bane and Jenni Theriault, director of Strategic Initiatives for Brigham Digital, co-led the implementation in collaboration with Mallika Mendu, MD, MBA, associate chief medical officer, Charles Morris, MD, MPH, deputy chief medical officer and vice president of Medical Affairs, Mike Clyne, manager of mobile technology for BH Digital, and Catherine Schroeder, deputy chief information officer.

“I want to thank Anne, Cath, Jenni, Chuck, Mike and Mallika for leading this effort, as well as all staff for embracing the technology and sharing their feedback to help us continually improve,” said Adam Landman, MD, chief information officer and senior vice president of Digital for Mass General Brigham. “For a project this size, the rollout has gone very smoothly, and we’re excited to already be hearing from staff about how it is benefiting their workflow, improving communication and, ultimately, enhancing the delivery of care.”

Building on Success in the Connors Center

From left: Labor and Delivery nurses Catrina Pitts and Chanel Daly try out Voalte during the CWN rollout last year.

Some areas previously implemented Voalte, including the Neonatal Intensive Care Unit about five years ago and mother and baby units throughout the Mary Horrigan Connors Center for Women and Newborns (CWN) last fall.

Renee Zaya, BSN, RN, said that the tool has made an immense difference in the day-to-day experience of nurses. “Voalte has been one of the biggest positive changes for communication on postpartum units in years,” she said.

Previously, with the paging system, nurses would spend a lot of time waiting for return calls from physicians and other staff not based on the postpartum units. “It’s almost like texting from your phone,” Zaya said. “These messages can save so much time in your day as a nurse that you can be spending with your patients instead of waiting at the phone for a call back.”

For example, when a patient is experiencing increased pain and requires a new medication order, nurses can message the physician, communicate back and forth, have the orders placed during the process and receive pharmacy approval quickly — all via Voalte.

“In the old system, we would have to page the doctor, wait for the call back, let the doctor know what we need and then wait for the orders,” said Zaya. “The result with Voalte is that the patient receives the medication more quickly, which is the most important thing — providing safe, quality patient care.”

For more information on Voalte, visit this page.

Kris Gagnon, pictured over the years with New Kids On The Block (NKOTB) singer Donnie Wahlberg, chronicles her 300-pound weight loss over 2015, 2017, 2019 and 2022. Gagnon is a huge fan of NKOTB.

After years of living with obesity and feeling uncomfortable in her own skin, Kris Gagnon visited the Brigham’s Center for Weight Management and Wellness in 2016 to learn more about her options. She was screened by the center’s surgeons, psychologist and dietitians, who agreed that bariatric surgery could help improve her health over the long term.

Six months later, Gagnon underwent the surgery and lost more than 300 pounds over the next six years.

“I’ve lost more weight than most people weigh themselves,” Gagnon said. “I’m living my best life because the Brigham gave me a second chance.”

The skills and resources Gagnon received at the Center for Weight Management and Wellness provided the support she needed for her successful weight-loss journey.

By focusing on the physical, mental and emotional aspects tied to successful weight loss, the Center for Weight Management and Wellness takes a comprehensive approach to weight management. Unlike many institutions, the Brigham has a three-pronged program — combining bariatric surgery, endoscopic bariatric approaches and obesity medicine — with each component led by world-class experts.

“The center is the reason for my success,” Gagnon said. “No hospital compares to the care we get here. These doctors truly have a dedication and passion for helping patients live healthy lives. This is one of the few programs that follows us for life, and I can access them and their resources for as long as I want. I see my surgeon twice a year, a psychologist anytime I need to and a dietitian every week.”

Endoscopic dietitian Catherine Page, MEd, RD, CDE, recalled how committed Gagnon was to making lasting changes to meet her weight-loss goals.

“Kris is probably one of the most motivated and driven patients I’ve ever worked with,” Page said. “I was always incredibly impressed with how dedicated she is to her health. Anytime I gave her a suggestion, or when we came up with an idea together, she would take it and run with it.”

Dietitians help patients stay on track before surgery and after their recovery. Page explained their team’s dietitians typically first meet with patients monthly for the six months before their surgery, helping them establish healthy habits and a different approach to food, as well as an understanding of meal planning, balanced meals and food shopping. They continue to meet with patients in the immediate post-operative period and over the long term to establish a sustainable plan for maintaining their progress.

Bariatric surgery aids in weight loss in more ways than one. “Because of the changes to the stomach, bariatric surgery not only makes the stomach smaller, but also affects the hormones that control satiety — your sense of fullness and hunger — and how we process and digest food,” added Page.

“Bariatric surgery is also one of the top treatments for cardiac and orthopaedic issues,” added Scott Shikora, MD, FACS, director of the Center for Weight Management and Wellness. “It can put diabetes or high blood pressure in remission or get rid of them altogether. These are very low-risk procedures with the lowest complication rates of all abdominal surgeries. The benefits of the operation dramatically outweigh the risks.”

Since her surgery, Gagnon appreciates the benefits on a daily basis. “Standing in the elevator used to make me winded,” she said. “Now, I walk up five flights of stairs instead of using the elevator.”

Determination and Dedication

In addition to having a supportive care team, Gagnon has shown what one can accomplish with determination. “Once you’re declared a candidate for bariatric surgery, you have to prove you will change your lifestyle for six months before surgery,” Gagnon explained. “You have to change your life and relationship with food. It’s challenging, but you can do it.”

After Gagnon suffered a serious hemorrhagic stroke in 2011, she gained 300 pounds rapidly. “Rapid weight gain is common after serious illnesses or accidents,” explained Page. “A lot of it has to do with stress on the body, which can cause a lot of inflammation and lead to weight gain. In Kris’ case, she also wasn’t able to exercise to the manner she was before she had the stroke. On top of that, she had dietary changes because the stroke created some chewing and swallowing issues that had to be addressed. Certain medications that decrease infection risk can also cause weight gain, as well.”

Gagnon’s first bariatric surgery was a laparoscopic sleeve gastrectomy, which was later converted to a gastric bypass to help alleviate her chronic case of gastritis and acid reflux, the latter of which she still manages. “It was not an easy road for her, but she fought and accomplished what I would have never predicted,” said Shikora. “Despite her challenges, she would always come into the clinic smiling and happy. She’s a real fighter.”

Gagnon hopes her success inspires others who are interested in bariatric surgery. “If I can do it, anyone can. You will have hard days, but every struggle will be worth it,” she said. “It’s the most rewarding thing you will ever do for yourself.”

From left: Bill Martin-Doyle and Holli Murray co-teach a session on alcohol withdrawal in 2019.

As she began her residency at the Brigham, Marina Zambrotta, MD, MEd, often thought of the advice her mother, a nurse, had given Zambrotta while she was in medical school: Listen to the nurses.

She carried those words with her daily — and nightly, as it turned out.

“I remember being on nights in the ICU as an intern at the Brigham and learning just as much, if not more, from my ICU nurse colleagues as I did from my attendings, fellows and co-residents,” said Zambrotta, now an internist with the Indian Health Service in Shiprock, N.M., and an affiliate physician for the Brigham.

So, when Zambrotta was awarded a medical education fellowship in her second year of residency and tasked with conceptualizing and designing a new medical education program, she didn’t have to think twice about her proposal: Invite nurses to share their expertise with residents in a more structured way.

That kernel of an idea turned into the Nurse-Doctor Co-Teaching Program, which pairs staff nurses with attending physicians to co-lead educational sessions on various clinical topics for residents and other interested staff. First launched as a pilot in the General Medicine Service (GMS) in 2019, the program has since expanded to Medical Oncology and the Emergency Department.

“There’s a historic hierarchy in medicine, and it’s something doctors get exposed to starting in medical school. We need to prioritize breaking down that hierarchy by listening to all of the valuable experience and knowledge that nurses have to share,” Zambrotta said. “It’s really important to emphasize this as early as possible in medical training so that interns who are told and expected to listen to their attendings also listen to and equally value nurses’ input.”

Marly Diallo, BSN, RN, a staff nurse in GMS on Braunwald Tower 14CD who has co-taught several sessions, said participating in the program provided an opportunity to expand her own skills while also strengthening interdisciplinary relationships on the unit.

“I enjoy teaching, and it’s something I do almost every day precepting new nurses, so I thought this was a good opportunity to do more of that and improve the way that we communicate as doctors and nurses,” she said. “As we get new interns and residents throughout the year, that mutual respect is something we always want to reinforce so that we continue to have a culture where we approach each other in the same way.”

Hospitalist Bill Martin-Doyle, MD, who co-teaches sessions on caring for patients exhibiting symptoms of alcohol withdrawal, agreed that the program has been a shining example of enhanced multidisciplinary collaboration.

“It was immediately apparent to me, right from the start, what a great idea this was and the kind of thing that makes you think, how come this hasn’t been happening the whole time?” he said. “There are so many clinical topics where we might have different viewpoints and understandings of the nitty-gritty details, and it’s been fantastic to get everybody in the same room and speaking the same language.” 

In the process of preparing for and conducting the sessions with her physician co-instructors, Diallo said she felt it was an informative experience for both clinicians — and one that can ultimately enhance care in the long run. For instance, in co-teaching a session on arterial blood gas tests, Diallo said she received a greater understanding about the thought process behind a physician ordering the test and interpreting the results.

“For me, it wasn’t just about teaching residents. It’s a learning opportunity for all of us. Let’s say I’m back on the unit and another nurse or nursing student has a question about arterial blood gases, I feel like I can provide a more informed answer,” Diallo said. “It always comes back to the patients, too. The more I know, the better I can communicate with my patients about their care.”

‘We Insisted on Equality’

While the content of the sessions is rigorously evidence-based, the program seeks to cultivate a relaxed atmosphere and create a fun learning environment that bucks convention, explained Helen Shields, MD, a faculty member of the Division of Medical Communications and the Division of Gastroenterology, Hepatology and Endoscopy, as well as the program’s course director.

In place of dry PowerPoint presentations, attendees participate in interactive activities, including Family Feud-style competitions to test their knowledge and contests to redesign catheters. The sessions are also intentionally kept brief — 30 minutes, as opposed to the typical hour-plus format of an academic lecture — to keep everyone engaged.

But behind the breezy exterior is a serious commitment to achieving the program’s original vision of presenting nurses’ and physicians’ unique viewpoints, Shields said.  

“The big value was showing the equality of the knowledge and skillsets, but we had to tease out what were the expert areas of the nurse versus the doctor, then unify them and link them — not just the nurse lectures here and the doctor lectures here. They go back and forth in a complementary manner,” she said. “We insisted on equality from the get-go, and the nurse’s name always comes first in the list of presenters as a sign of that respect.”

Madelyn Pearson, DNP, RN, NEA-BC, senior vice president of Patient Care Services, chief nursing officer and the Beth V. Martignetti Distinguished Chair in Nursing, said this kind of interdisciplinary exchange is invaluable to all members of a care team. 

“Nurse-doctor co-teaching teams are one important way we can bring disciplines together, learn from one another’s perspectives and ultimately enhance the care we deliver,” Pearson said. “This kind of collaboration is more important than ever, given the intense challenges that we continue to face in health care.”

Holli Murray, MSN, RN, PCCN, a staff nurse on 14CD who co-taught the session on alcohol withdrawal with Martin-Doyle, said the program has helped improve collegiality between the two disciplines. While physicians and nurses may work on the same unit, differing shifts and rotations can mean that they don’t have much time to get to know one another. Coming together for these sessions provides an important opportunity to mingle in a more casual setting, Murray said.

“Anytime I can, I try to interact more with the doctors to build those relationships so that later I’m more comfortable speaking up about something,” she said. “I also don’t necessarily feel like I’m instructing the doctors, but I think it’s helpful for them to understand that, as a nurse, I might have different concerns around the patient’s safety and comfort.”

For Zambrotta, it has been exceptionally rewarding to see her original vision come to life. In addition to its expansion to units beyond GMS, the program has also been spun off into a Harvard Medical School course, “Nurse-Doctor Co-Teaching,” to train future medical educators in developing nurse-doctor co-teaching programs. (The next course will be held virtually on Sept. 23.) Zambrotta also hopes to expand the Brigham program to include additional allied health professionals as co-instructors.

“What I was hoping with the initial pilot study on GMS was that interns and residents would feel more comfortable seeking out knowledge and teaching from the nurses on the floor and, vice versa, that the nurses would feel comfortable going up to the interns and saying, ‘Hey, I have a question about this order,’” she said. “Rather than coming from a place of ‘one more page I have to respond to,’ it opens up a more friendly line of communication.”

Once again, Brigham and Women’s Hospital has been recognized as a top hospital in the 2022 U.S. News & World Report’s annual ranking of the best U.S. hospitals. The Brigham was ranked 14th by the publication, while its Obstetrics & Gynecology specialty was named the best in the country — a noteworthy affirmation at a time when access to reproductive health services is being challenged across the U.S. In all, four specialties earned a spot in the top 10 and three specialties made the top five.

The Brigham was also ranked in 12 of the 13 specialties it is eligible to be ranked in, out of a total of 15 specialties rated by U.S. News. In addition to the top ranking for OB-GYN, the Dana-Farber Brigham Cancer Center ranked fourth in cancer, Rheumatology was fifth and Cardiology & Heart Surgery was 10th. Additionally, the Brigham earned the publication’s highest distinction in 18 of the 20 most serious and complicated medical conditions and procedures.

“These rankings are a reflection of the tremendous talent here at the Brigham, as well as our employees’ incredible commitment to our patients and their families,” said Robert S.D. Higgins, MD, MSHA, president of the Brigham and executive vice president at Mass General Brigham. “Through innovative research, comprehensive care and collaboration across our many specialties and disciplines, these rankings are a testament of our dedication to our mission and commitment to provide compassionate and high-quality health care for every patient.”

Nawal Nour, MD, MPH, chair of the Department of Obstetrics and Gynecology, said it was an honor for the department to receive such a prestigious recognition.

“There is a deep commitment and long legacy of support for women’s health care at the Brigham, and we are thrilled to be recognized as the top OB-GYN specialty in the country,” Nour said. “Our specialty is dedicated to ensuring high-quality, comprehensive and equitable patient-focused care to all of our patients, while recognizing each of their individual, and often very personal, needs.”

The annual ratings were developed to help consumers determine which hospitals provide the best care for challenging or complicated health conditions and for common elective procedures. They are based on a point system derived from a comprehensive nationwide evaluation of nearly 5,000 medical centers in 15 adult specialties and 20 procedures and conditions.

Several other Mass General Brigham hospitals were also honored by U.S. News & World Report. Massachusetts General Hospital once again earned a spot on the Honor Roll among the top hospitals in the country. Three Mass General Brigham specialty hospitals — McLean Hospital, Spaulding Rehabilitation, and Mass Eye and Ear — were recognized for national excellence. McLean Hospital was ranked No. 1 in the nation in psychiatry. Spaulding Rehabilitation is No. 1 in rehabilitation in New England and ranked No. 3 in rehabilitation in the nation. Mass Eye and Ear is No. 1 for otolaryngology (ear, nose, and throat care) and ophthalmology in New England and ranked No. 4 for both otolaryngology and ophthalmology in the nation.

Additional details about the U.S. News & World Report ranking system can be found here. The complete listing of America’s Best Hospitals can be found here.

By the Numbers: Rankings by Specialty

*Brigham is not eligible to be ranked in Ophthalmology or Rehabilitation. Mass Eye and Ear, which is tied to MGH for Honor Roll Purposes, ranked No. 4 for Ophthalmology. Spaulding, which is tied to MGH for Honor Roll purposes, ranked No. 3 for Rehabilitation.

** 2021 ranking is based on Gynecology only. 2022 includes both Obstetrics and Gynecology.

Brigham and Women’s Hospital mourns the loss of Robert Osteen, MD, a cancer surgeon and educator whose contributions to the field of surgical oncology influenced generations of surgeons. He died July 14 from complications following a recent injury. He was 81.

With a remarkable tenure spanning almost 50 years at the Brigham, Dr. Osteen established himself as a leading expert in surgery for tumors of the pancreas, liver, stomach, esophagus, colon, breast and other organs. Throughout his career, he served as an influential and beloved surgeon, teacher and mentor. Gifted with a sharp mind, colleagues frequently consulted Dr. Osteen for clinical guidance. Although he retired from clinical practice in 2006, he remained engaged in the instruction and mentorship of students and trainees.

“Bob Osteen had a huge presence at the Brigham and beyond,” shared David Brooks, MD, former director of Minimally Invasive Surgery and program director of the Advanced Minimally Invasive Fellowship. “Despite having long since stopped operating, he was at our Wednesday morning Morbidity and Mortality conference nearly every week, adding sage advice, challenging the residents and staff and generally providing wonderful gravitas to the meetings. His surgical wisdom was always valued. He will be greatly missed by all who knew him.”

Gerard M. Doherty, MD, surgeon-in-chief and Crowley Family Distinguished Chair of Surgery, reflected on the countless lives that Dr. Osteen touched over the course of his illustrious career.

“Few of us can hope to have the impact on those around us — co-workers, trainees, patients and others — that Dr. Robert Osteen had,” Doherty said.

Colleagues remembered Dr. Osteen not only as a great surgeon but also a great teacher — one who inspired others both personally and professionally with his guidance and wisdom. In recognition of his lasting influence on surgical education, the Department of Surgery established a Junior Faculty Fellowship Award in his honor in 2006.

“Dr. Osteen was one of our most respected and active teachers,” added Doherty. “After retiring from clinical practice a decade and a half ago, he patiently devoted himself to the work of teaching Harvard Medical students how to think through challenges in clinical surgery. Dr. Osteen brought his wry smile and gentle guidance to hundreds of students, always grounding them in basic principles and allowing them to work their way through the analyses. At his core, he cared about people and their lives — patients, students, trainees and colleagues — and he made us all better by his friendship and his mentorship.”

Monica Bertagnolli, MD, chief of the Division of Surgical Oncology, remembered Dr. Osteen as a generous mentor, teacher and friend.

“Bob Osteen was an extraordinary role model in every way,” Bertagnolli said. “He had a deep knowledge of the science of oncology. In the operating room, his command of technique was such that no motion was ever wasted. As a junior faculty member, I remember visiting him almost weekly carrying a pile of X-ray films, and he would patiently coach me through the management of my more challenging patients. Every one of his trainees hoped to achieve his level of excellence as a surgeon. It is devastating to hear of his passing. I am so very fortunate to count myself among his many trainees and colleagues.”

Brigham colleague Atul Gawande, MD, MPH, who trained under Dr. Osteen during his residency and is currently serving with the Biden-Harris administration to lead global health at United States Agency for International Development, reflected on the many ways Dr. Osteen touched his own life and career over several decades.

“Losing Bob Osteen is a devastating blow,” Gawande said. “Across almost three decades, I saw him in many roles — as the residency program director who welcomed my internship class, as a teacher in the OR and countless Friday pizza conferences, then as a wise colleague and reliable friend. He was the soul of Brigham surgery for an entire generation of trainees and faculty. He came to occupy a place inside each of us, shaping our ideas about what it means to be a master surgeon, a master teacher and, if you got to know him, a joyful human being.” Gawande also described his time with Dr. Osteen in this 2011 New Yorker article.

Dr. Osteen led a full life that extended far beyond the Brigham’s doors. “He knew how to live well — his keen wit, enthusiasm for life and joy in family and friends were readily apparent,” Bertagnolli remarked.

“He never forgot what is vital and special about the role surgeons have in people’s lives — nor how to leave room for a full and enthusiastic life beyond the hospital,” added Gawande.

In addition to his work with the Brigham, Dr. Osteen published a collection of poems, Zero to Five Knots and a Book (2021), and a history book, Festina Lente: Charting the Mediterranean 1814–1824 (2016). An avid reader, Dr. Osteen researched a range of topics from surgery in the World War II to King Philip’s War. He was also a devoted sailor, navigator and collector of antique maps.

“Outside the hospital, he was charm itself,” Brooks reflected. “A raconteur, singer, actor, poet, historian, sailor of considerable renown — he was a renaissance man who embodied so many things we all admire and aspire to be.”

Dr. Osteen is survived by his wife of 58 years, Carolyn McCue Osteen; two daughters, Carolyn (Morey) Osteen Ward and Sarah Lloyd Osteen; and four grandchildren.

Brigham and Women’s Hospital mourns the loss of Sunni Reis, BSN, RN, a nurse in the Emergency Department (ED), who passed away June 7. She was 37.

Ms. Reis joined the ED team in 2019, working mostly on nights. She is remembered by her colleagues for her kindness and dedication to her patients.

Jenna Collentro, BSN, RN, who served as Ms. Reis’ preceptor, spoke of her ability to remain calm during challenging situations.

“Sunni was a gift to this department, and I knew when I met her that she would do incredible work at the Brigham,” Collentro said. “She caught on fast, always kept her cool, provided excellent care and connected with people.”

Collentro described Ms. Reis as “bright, intellectually and spiritually — a real empath,” adding that “her energy was contagious, her laugh infectious and her light always visible.”

Jeanine Coggswell, BSN, RN, an experienced nurse, recalled the support that Ms. Reis provided to her when she transferred to the ED. “I was feeling overwhelmed and doubted my ability to be successful,” Coggswell said.

But when she began working alongside Ms. Reis, something shifted for Coggswell. “Sunni’s genuine character, her infectious smile, her unpretentious no-nonsense attitude, her humor, her commitment to her patients, her overwhelming pride and fierce love for her children created an energy about her that somehow put me at ease and fueled my flickering confidence,” Coggswell said. “For the first time, I started to actually feel like I was going to be OK and successful in the ED.”

Other colleagues described similar experiences in working with Ms. Reis. “Sunni became one of my first and closest friends when I started in the ED in 2020,” said Stephanie Santos, BSN, RN. “We realized that we lived a few minutes from each other, started carpooling together and quickly connected on a level that made us feel as if we knew each other for a lifetime. We wouldn’t have a second of silence during our hour or more drive to and from work, talking about anything and everything under the sun.”

Santos shared that she counted on Ms. Reis for advice, both inside and outside of work. “She always made the time to ask how you’re doing and did so in a genuine and caring way,” Santos said.

Ms. Reis was a devoted mother to her son and daughter, speaking of them often and with great pride. “She loved her babies and was so proud of her son and devoted to her sweetheart, ‘mini me,’ beautiful daughter,” said Collentro.

Santos agreed. “I often told Sunni that she was a ‘super mom’ after her numerous displays of dedication and love for them,” she said. “She will be sorely missed, and her smile and laugh will always remain with us.”

Ms. Reis earned her bachelor’s in nursing from Bristol Community College in 2010 and worked in emergency departments at several other hospitals before joining the Brigham ED.

Ms. Reis is survived by her son, Sonny D. Pierre; her daughter, Evvie B. Best; her father, Paul J. Reis; her mother, Staci A. Andrews; her stepmother, Jamie B. Brunache; her brothers and sisters, Brianna C. Fernandes, Raynna M. Rezendes, Julian P. Reis, Talia M. Reis and Jhaden P. Reis; her grandmother, Patricia J. Silveira; and many aunts, uncles, nephews, nieces, cousins and friends.

Brigham and Women’s Hospital mourns the loss of Donald Jocelyn, an equipment transporter in Central Transport and Equipment Services, who died of a sudden illness on July 1. He was 60.

A member of the Brigham community for approximately 20 years, Mr. Jocelyn was responsible for maintaining the supply of wheelchairs available in the hospital’s three main lobbies and for discharges on CWN 9 and 10.

Colleagues remembered Mr. Jocelyn for his steadfast commitment to ensuring patients always had access to the equipment they needed to safely and comfortably navigate the hospital.

“Donald was a fixture here at BWH, and although not everyone knew his name, they knew he was the man ‘behind the wheelchairs.’ You often saw him on the Pike pushing about five wheelchairs at once and knew he was on a mission to get them to where they were needed,” said Claire Zaya, nursing director for Postpartum and the OB Float Pool. “I would jokingly tell people that if they saw him on the Pike with wheelchairs to make sure they let him pass, since he was probably on his way to CWN and we needed them for discharge.”

Natasha Jimenez, a patient escort in Central Transport Services, said Mr. Jocelyn took great pride in his work and approached it with a strong sense of purpose.

“He was such a happy person and felt good knowing he was making a difference,” she said. “When a transporter couldn’t find a certain type of wheelchair, all I had to do was call Donald. He was one of a kind and will be truly missed.”

Germaine Dorfeuille, a Central Transport supervisor and longtime friend and colleague of Mr. Jocelyn, remembered the joy he brought to so many people.

“Donald was always making everybody laugh. If you knew Donald, you were never sad,” she said. “He loved the Brigham and being around people here. He used to say he didn’t need a vacation because he liked to come to his job.”

When his help was needed, Mr. Jocelyn was an unstoppable force, colleagues said.

“He was a ball of caffeine. He had a tremendous work ethic,” said Erlande Jean-Louis, senior manager of Central Equipment Services. “You could not miss him — he’d have four wheelchairs lined up in front of him on his way to replenish the lobbies. He was not a tall person, but his energy made him seem bigger than he was.”

Staff on CWN 9 and 10 were grateful to have such an enthusiastic and dedicated colleague supporting them, Zaya added.

“CWN has special discharge carts and they always seem hard to find, especially on the days we have a lot of discharges. Donald was always so responsive with locating them and getting them up to the units,” Zaya said. “Staff knew the days he was not here because we would not have as many available. Donald always had a smile on his face and was humble with accepting our appreciation. His presence will be missed.”

Although his main duties involved equipment, Mr. Jocelyn occasionally assisted with patient transports as needed. In those moments, his characteristic kindness and charm provided comfort to whoever was in his care, Jean-Louis added.

“He treated patients as if they were his own family members,” she said. “He cared. He didn’t forget he worked at a hospital and carried a sense of urgency for what he did.”

Mr. Jocelyn is survived by his niece, Tatiana Roc, and many friends and loved ones.

Kristen (Rousseau) Larochelle hits the ski slopes in her home state of Maine, a favorite hobby she can enjoy again after a lung transplant cured her of cystic fibrosis.

This past winter, Kristen (Rousseau) Larochelle felt the cold air tingle in her lungs as she inhaled deeply on a ski mountain in Maine for the first time in eight years. It felt good.

From birth, Larochelle had lived with cystic fibrosis, a genetic disorder that causes a person’s airways and lungs to become clogged with thick, sticky mucus. This constant buildup makes it difficult to breathe, and the gluey mucus easily traps bacteria, often resulting in regular lung infections. These complications can be life-threatening.

While some people with cystic fibrosis experience milder symptoms, Larochelle developed a severe form of the disease, including a complication that frequently caused her to cough up large amounts of blood.

By the time she reached her mid-20s, her health began to deteriorate. Although once a CrossFit enthusiast, she soon found herself requiring the use of supplemental oxygen for basic activities like grocery shopping. Cold air made it harder to breathe, which also meant giving up her beloved hobby of skiing. Even talking for an extended amount of time would leave her winded. She became reluctant to travel by plane, fearing she might die if her lungs started bleeding uncontrollably mid-flight.

“I was stuck at home pretty much all the time,” Larochelle recalled. “A lot of people I met didn’t even know what I like to do because they knew me as the person who likes to read books and all these things that involve just sitting there, and that’s not really me at all.”

That all changed for Larochelle in late 2018 when a dramatic series of events led to her hospitalization at the Brigham, where she received advanced care in the Thoracic Intensive Care Unit (ICU) to help manage her worsening symptoms until a set of donor lungs became available for transplant.

A Bridge to Transplant

Although Larochelle had been active on the national transplant waiting list since March 2018, it wasn’t until one morning that October that it became clear how urgently she would need a double lung transplant.

Larochelle enjoys a day at the beach with one of her dogs, Khloe.

“I woke up to my lungs bleeding. Within minutes, my bedroom looked like a murder scene,” she remembered.

She called 9-1-1 and was rushed to her local hospital in Maine. There, she learned that cystic fibrosis had severely damaged her lungs — to the point that there were now abnormal and dangerous connections between the blood vessels and airways. Recognizing that she required more advanced care, Larochelle’s providers arranged an ICU-to-ICU transfer to the Brigham.

Shortly after her arrival, Larochelle was placed on a ventilator through a tracheostomy. During one especially intense bleeding episode, her breathing tube became clogged with life-threatening blood clots.

Her body needed oxygen-rich blood. She would benefit from ECMO, a machine used to oxygenate the blood when a patient’s lungs are too sick to perform that function themselves. But there was a serious complicating factor: ECMO can’t be used when there is active bleeding in the lungs. That’s because a large dose of a blood thinner, heparin, is necessary when a patient is connected to an ECMO machine. Heparin increases the risk of bleeding.

After weighing the potential risks and benefits, her care team determined it was Larochelle’s only chance of survival. After injecting her with heparin, they successfully started ECMO, which Larochelle remained on for more than 40 days.

“What was special about Kristen’s case was she was one of the early examples of us using ECMO as a tool to bridge patients to transplant,” said Anthony Coppolino, MD, director of Ex Vivo Lung Perfusion in the Division of Thoracic Surgery. “She was basically on the highest-risk side of transplant that you could really consider.”

‘A Fighting Spirit’

In addition to the physical toll her illness took on her body, being in the hospital for so long became emotionally draining, too, Larochelle said. Most of all, she missed her beloved dogs. To lift her spirits, members of her care team decorated her room with photos of her dogs. One nurse gave her a stuffed animal that resembled one of her pups.

“I would take him for walks around the floor. We’d put him on my walker and say, ‘Let’s take Austin for a walk,’” Larochelle remembered.

During that harrowing time, the warmth and compassion of her Brigham care team made all the difference.

“They became like family,” Larochelle said. “There were so many of them, each so special.”

Taylor Risotti, BSN, RN, one of her Thoracic ICU nurses, said Larochelle’s strength of will at 28 years old was humbling to witness.

“Seeing someone my age go through that — I look up to her,” Risotti said. “She was such a trooper. She did anything and everything to stay strong and get to the point of transplant.”

Finally, in November, Coppolino entered her hospital room with the news that there was a donor. While Larochelle and her family had been anxious to hear those words for more than a month, she also knew the weight they carried.

“It was what I’d been waiting for, but I just kept thinking someone lost their family member,” Larochelle said.

As she was being wheeled to the Operating Room, Larochelle said she was comforted by familiar faces from her Brigham team, including anesthesiologist Alissa Sodickson, MD, who did a FaceTime call with Larochelle from home right she before went under anesthesia.

From her initial admission to her local hospital in Maine, her transport to the Brigham and eventually her transfer to Spaulding Rehabilitation Hospital, Larochelle was hospitalized for a total of 113 days.

In January 2019, after a challenging recovery, Larochelle was finally able to go home. A year later, she sent a letter to her donor’s family to thank them for their lifesaving gift. They now talk regularly, and Larochelle visits when she can.

“They’re my heroes,” she said. “They made sure their son’s wishes were honored to donate life.”

Three years out, Kristen is back to skiing, traveling and walking her dogs — living the life she loves and not taking any moment for granted.

“Kristen had a fighting spirit from the moment I met her,” Coppolino said. “To see her persevere through that difficult course and to have the opportunity to help her get there is very gratifying. It makes what we do worth it.”

Caitie Donohue was able to virtually attend her best friend’s wedding in style with help from her Brigham care team.

On Nov. 7, 2021, Caitie Donohue watched her best friend, Ashley, walk down the aisle, recite her vows and marry the love of her life. Dressed in a light pink bridesmaid gown with a view from the front row, Donohue watched every part of the wedding — from the ceremony to the couple’s first dance — via video on an iPad.

That’s because Donohue participated from a hospital bed at the Brigham, where she was receiving treatment due to complications from her acute myeloid leukemia (AML). Donohue had been suffering from this cancer of the blood and bone marrow since January 2021.

When it became clear Donohue wouldn’t be able to attend Ashley’s wedding in person, her friends and family sprang into action. They transformed her hospital room into a wedding-ready space and helped Donohue dress up for the day. Brigham staff worked closely with Donohue to make sure she could participate — monitoring her health, managing the foot traffic in and out of her room and making sure she didn’t get too overwhelmed.

Prior to her death in June, Donohue expressed her gratitude for the members of her care team who helped make this special moment possible, including one of her nurses on Braunwald Tower 6, Meghan White, MSN, BSN.

“She’s the most amazing nurse, one of the best that I’ve had, and I’ve had a lot of nurses,” Donohue said. “She coordinated everything that day, making sure all my medications lined up so that it wouldn’t interrupt the ceremony. She had signs made for my door to make sure no one came in and interrupted. She just went above and beyond to make sure that I had the best experience that I could have had.”

White, a nurse at the Brigham for 19 years, said she was honored to help lift her young patient’s spirits.

“Caitie kept telling me how much she wanted to be there,” White said. “I said, ‘I’ll make sure no one disrupts you. If anyone tries to come into that room, they’ll have to go through me.’”

Hannah Prange (right) says she was thrilled to work alongside her longtime mentor, Donna Collins (left), during her first shift as a physician assistant at the Urgent Care Center in Foxborough, where Prange began her Brigham career as a medical scribe four years ago.

When Hannah Prange, MS, PA-C, was 2 years old, she carried a toy stethoscope and wore scrubs four sizes too big.

“I was one of those people who always knew what they wanted to do,” Prange said. As a child, one of her biggest role models was Heidi Handman, DO, her mother’s best friend and a neonatologist who, known to Prange as “Dr. Heidi,” inspired her to dream of pursuing a career in the medical field.

Those dreams would eventually lead her to the Brigham, where, after a chance encounter, she seized an opportunity to learn and grow with the support of colleagues and mentors.

Four years after she joined Brigham and Women’s Urgent Care Center in Foxborough as a medical scribe helping providers document information during patient visits, Prange recently began caring for her own patients as a physician assistant (PA) — in the very same clinic.

“There were times before and during PA school that were challenging for me, but I look back on my experiences, and I was really motivated and determined. Now I’m here full circle, and I feel like I have my dream job,” she said. “My colleagues really helped me get there.”

After graduating from PA school in 2019, Prange returned to the Brigham the following year as a PA in the Emergency Department (ED). As she gained experience, she expanded her rotation to other sites. Today, Prange works as a PA in both the Brigham and BWFH EDs, as well as the Foxborough Urgent Care Center where she started her career.

Prange’s colleagues said it has been inspiring to witness her professional growth over the years.

“There is nothing more rewarding than watching our employees grow and supporting them as they strive for the goals they have set for themselves,” said Julia Raymond, regional director of Ambulatory Operations, who previously served as Prange’s supervisor in her prior roles. “Hannah worked so hard to gain the right experience, learn from our providers and establish mentors who would help her along the way.”

Making Connections

As Prange became more focused on a health care career while she attended college, it was after graduation that she discovered her desire to become a PA. She met practicing PAs and was impressed by the care they provided and their ability to explore various fields of medicine. She also shadowed PAs at Dana-Farber Cancer Institute, and she later felt the personal significance of the care that a PA provided her mother following her cancer diagnosis.

Around that time, she happened to meet a Brigham doctor at the Patriot Place’s Dunkin’ Donuts. Prange gathered the courage to introduce herself and ask about medical scribe positions, and the doctor suggested she look at job openings at the Foxborough Urgent Care Center. A few months after becoming a scribe there, she sought more direct experience in patient care as a medical assistant, and her colleagues helped her train for the role.

According to Prange, the community she discovered at the Brigham inspired her to return as a PA.

“Working in health care can be difficult, but my co-workers and colleagues — the people — were supportive of my career path and have been a big part of why I’m happy at the Brigham,” she said.

Prange faced setbacks as she prepared for PA school, including rejection letters during her first round of applications, but she remained resolved. When she ultimately graduated from PA school, Prange was overjoyed at the accomplishment, though also nervous.

Donna Collins, PA-C, assistant medical director of the Foxborough Urgent Care Center, who mentored Prange through the process, says she never doubted that Prange would succeed.

“It has been a pleasure watching Hannah start as a young, eager scribe and then get hands-on experience as a medical assistant,” Collins said. “She is a quick study and hardworking.”

When Prange began her first shift as a PA at Foxborough Urgent Care, she was relieved to see a familiar face: Collins was working alongside her. “The fact that I still work with Donna is so special,” she reflected.

Moments like that helped her gain confidence and feel bolstered by a sense of community.

“Truly, I could not have done it without the other PAs who were training me,” Prange said.

Beginning Work as a PA

Between the lingering pandemic and continued high demand for health care services across the region, Prange acknowledged it has been a challenging time to begin her PA career. Yet, it has also been a learning opportunity and a humbling privilege to help so many patients, she added.

“My job is the most challenging thing in my life, but I love that challenge because I feel like every day I’m learning,” she said. “Even though some days are really hard, you go to work to save lives.”

Looking ahead, Prange hopes to continue expanding her skill set as a PA and to possibly explore other medical specialties — including obstetrics and gynecology, as she has long been interested in that field and recalls her passion for medicine started with Dr. Heidi.

“I’ve always just wanted to help people, and I’ve finally found my calling,” Prange said.

Claire-Cecile Pierre (center) delivers an uplifting keynote address to SSJP’s graduating seniors and other attendees of the program’s virtual graduation ceremony on June 15.

For as long as he can remember, Devin O’Loughlin has been intrigued by his grandmother’s stories about nursing during World War II and the polio epidemic. Now, he looks forward to following in her footsteps as he graduates from Boston Latin Academy and prepares to enter nursing school — a milestone made possible in part by his participation in the Brigham’s Student Success Jobs Program (SSJP).

SSJP matches high school students, primarily from underserved Boston neighborhoods, with year-round paid internships in over 60 departments across the Brigham.

O’Loughlin, one of 26 seniors graduating from the program this year, was awarded a scholarship to study nursing at Wagner College. His experience working alongside and learning from Brigham nurses in the Department of Obstetrics and Gynecology inspired him to pursue his own career in the field.

From left: Robert Higgins celebrates with Devin O’Loughlin at an event for SSJP graduates on June 27.

“Nurses are always in touch with their patients, and they’re caring,” O’Loughlin said. “That’s the kind of medical professional I want to be.”

O’Loughlin described OB-GYN as a welcoming place, one where he felt respected as a team member and empowered to grow.

“Everyone knew me, and I knew everyone,” he said. “The work environment just felt really healthy.”

Supporting Students

SSJP students are paired with supervisors who serve as mentors, and the program further supports students by providing access to academic resources, including tutoring and college scholarships, as well as wellness services, such as mental health support.

By creating job opportunities for students from underserved backgrounds, SSJP seeks to foster and support a diverse workforce in health care. In 2021, 89 percent of SSJP students identified as people of color, 85 percent of SSJP students attended an economically disadvantaged high school, and 74 percent of SSJP students identified as women.

“The program represents a long-term investment in improving patient care, as well as advancing the economic mobility of neighborhoods, families and communities,” said Pamela Audeh, program director of Youth Development and Economic Advancement in the Brigham’s Center for Community Health and Health Equity, which oversees SSJP.

“I had access to resources I didn’t think I would ever have,” said Frenkli Mitrushi, a graduating SSJP senior who interned with the Department of Pathology.

To celebrate students’ achievements, the program hosted a virtual graduation ceremony for seniors on June 15, featuring speeches from student leaders, such as Mitrushi, who, along with O’Loughlin, is a member of the SSJP Student Council. During the ceremony, graduates were reminded that support from their SSJP and BWH communities will continue beyond high school. Through the SSJP, students will have continued access to offer scholarships, internships, academic and mental health resources and support for entering the workforce and obtaining advanced degrees.

Mitrushi joined SSJP as a high school sophomore passionate about the sciences. In addition to the hands-on experience his internship has provided, he has enjoyed the opportunity to interact with SSJP peers and his Pathology colleagues, whether in an informal chat in the Garden Cafe or while learning more technical skills in the lab. His experience at the Brigham has inspired him to pursue the pre-med track at University of Massachusetts Boston, where he plans to study biology, with a goal of addressing health inequities.

Mitrushi’s interest in health care began when he and his family immigrated to the United States from Albania. He realized that despite the vast medical resources in the United States, health care remained inaccessible to many people, particularly in low-income communities. As a leader of the student council, he has facilitated many discussions on health equity, and he plans to be a leader in addressing health inequity throughout his future career.

From left: Robert Higgins congratulates Frenkli Mitrushi.

“I joined the student council to see if leadership was for me, and what I found was that it is,” he said.

‘Crucial Contributions’

The COVID-19 pandemic directly affected SSJP students, their families and their communities in many ways. Even while navigating their own personal challenges and traumas, many students felt inspired to contribute to the Brigham’s pandemic response and chose to work extra hours at testing sites, vaccine clinics and food-distribution sites — often aiding their own communities in the fight against COVID-19.

For Mitrushi and O’Loughlin, the pandemic brought the significance of patient care and equity into sharp focus. Mitrushi helped to facilitate student discussions on equity and the disproportionate effects of the pandemic on Black and brown communities in the United States. When internships returned after a hiatus in 2020, O’Loughlin supported the OB-GYN department, and Mitrushi assisted Pathology as the pandemic continued.

“I really took pride in my work,” Mitrushi said.

All SSJP students make crucial contributions to the hospital. “It’s really amazing to see. Our students are vital members of the Brigham community,” said Audeh.

For Mitrushi and O’Laughlin, what makes the program unique is its support for students and its community of peers.

“It’s great for making friends as well as networking, and it has so many opportunities for truly impacting your life,” said Mitrushi.

Heal Ukraine was one of 50 teams of Brigham staff members, patients, and supporters who participated in the B.A.A. 10K to raise funds for Brigham and Women’s Hospital.

More than 6,100 runners made a long-awaited return to the streets of Boston on Sunday, June 26, for the annual Boston Athletic Association (B.A.A.) 10K, presented by Brigham and Women’s Hospital, the race’s exclusive fundraising partner.

Runners braved hot, humid conditions to compete in the eagerly anticipated race, which marked its return from a three-year hiatus due to the pandemic. The event kicked off with a performance of the national anthem by Charlene C. Hollins, MSN, APRN, FNP-C, a nurse practitioner for Mass General Brigham Urgent Care and former nurse in the Brigham’s Emergency Department, and concluded with post-race stretching led by Brigham physical therapist Karen Lovely, PT, DPT, OCS.

This year, the Brigham welcomed 444 runners and 50 teams — including 266 Brigham employees — who participated either in person or virtually. Together they raised over $200,000 to fuel work at the Brigham that holds special meaning for them, and each had their own story of what brought them over the finish line.

Brigham neurologists Robert Mallery, MD, and Sashank Prasad, MD, co-captains of the newly formed Brainiacs team, ran to raise funds for the Ann Romney Center for Neurologic Diseases. They were inspired to support the work of their colleagues, who are researching treatments for Alzheimer’s, Parkinson’s and other serious neurologic diseases.

“We are excited to have a diverse team of physicians, nurses and trainees, and have been awed by the generosity of those who have made donations on our behalf,” Mallery said.

Charlene Hollins sings the national anthem at the B.A.A. 10K. Check out more race photos here.

“Most of all, we are inspired by our patients and honored to participate in this event for them,” Prasad added.

The ongoing crisis in Ukraine inspired members of the Center for Surgery and Public Health (CSPH) to form the Heal Ukraine team. The team’s goal of supporting cancer and trauma care in Ukraine reflects the mission of the center, which, more broadly, seeks to advance the science of surgery through research that informs policy and program development for safe, high-quality and equitable, patient-centered care in the U.S. and around the world. Among the ways CSPH is supporting Ukraine is by offering consultations to the country’s physicians during this time.

Team co-captains Amanda Reich, PhD, MPH, and Robert Riviello, MD, MPH, participated in past races with colleagues, and both have a longtime love of running.

“Fundraising with the Brigham through the B.A.A. 10K offers the opportunity to combine our personal and professional interests,” Reich said.

“This year, we raised money to support work focused on translating physician- and patient-education resources into Ukrainian and facilitating peer-to-peer consultations for physicians in Ukraine, led by our colleague Dr. Nelya Melnitchouk,” Riviello added. “We were excited to run, work and fundraise together with our friends from CSPH on these shared goals.”

Interested in starting a team, joining an existing one or getting more involved in next year’s race? Sign up for email reminders here.

On Friday, June 24, 2022, the U.S. Supreme Court delivered a decision in Dobbs v. Jackson that overturned decades of federally protected abortion rights made possible by the court’s landmark 1973 Roe v. Wade ruling. As a result of this decision, federal protection of abortion rights is effectively eliminated. This ruling leaves it to the states to decide whether abortion should be permitted, and to what extent.

In Massachusetts, state law secures a patient’s right to an abortion for any reason through 24 weeks of pregnancy. The Supreme Court’s decision does not alter this protection in Massachusetts, nor the Brigham’s longstanding commitment to providing high-quality care to pregnant patients, which dates to 1832 with the opening of the Boston Lying-In Hospital.

One of the nation’s first maternity hospitals designed to care for women unable to afford in-home medical care, the Boston Lying-In Hospital merged with the Free Hospital for Women in 1966, forming the Boston Hospital for Women. In 1980, the Boston Hospital for Women, the Peter Bent Brigham Hospital and the Robert Breck Brigham Hospital merged to become Brigham and Women’s Hospital.

In response to this historic change in women’s health, Brigham Bulletin spoke with four Brigham OB-GYNs and abortion care experts about the various outcomes they foresee as a result of the Supreme Court’s decision.

From left: Nurse Sarah Veader embraces Shannon Wilding during an emotional reunion with the team who cared for Wilding’s father, John Bosse (center), while he was hospitalized for COVID-19. Members of the family, including Bosse’s wife, Nancy (second from right), and son, Brad (far right), returned to express their gratitude for the outstanding care he received.

In celebration of Father’s Day, Brigham Bulletin is highlighting the touching story of a Brigham care team that rallied to support a Maine father and grandfather, along with his family, while saving his life from severe complications of COVID-19.

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Are they brushing his teeth? Even though she had a hundred other things to worry about while her father was hospitalized for COVID-19 at the Brigham last fall, Shannon Wilding couldn’t get the question out of her mind.

Compared to everything else that her father, John Bosse, 65, had endured since getting sick, Wilding knew that her dad’s teeth were probably the least of his care team’s worries.

Shortly after his COVID-19 diagnosis last September, Bosse’s health sharply declined. His wife of 45 years, Nancy, brought him to the emergency room three times at two different hospitals near their home in Lewiston, Maine, when breathing became especially difficult for him. While receiving monoclonal antibody treatment during one visit at a local hospital, Bosse’s blood oxygen levels plummeted. He was admitted to the intensive care unit (ICU).

Bosse was sedated and intubated, and his health continued to deteriorate. His care team in Maine gently suggested the family prepare for the worst and say their goodbyes.

As doctors investigated transferring him to another medical center with greater resources, a family friend urged them to advocate for a hospital in Boston where more advanced care was available. Three days after his ICU admission, Bosse was transported by a Life Flight air ambulance to the Brigham, where he remained intubated under sedation for another 20 days in October and November.

During that time, Bosse’s family visited frequently and stayed in regular contact with his ICU care team on Braunwald Tower 8 — checking in daily, sometimes multiple times a day, to see how he was doing. Wilding, her brother, Brad, and their mother were anxious to learn the latest updates to his condition. How were his blood gases today? When might he be extubated?

But even with so many big concerns, Wilding found that the question about whether someone was brushing her dad’s teeth gnawed at her mind. In the end, it wasn’t only about preserving his dental hygiene — but also his dignity as a person, not just as a patient.

She spoke with one of his nurses, Sarah Veader, BSN, RN. Yes, of course they were brushing his teeth, Veader assured her.

“Dad was still intubated, with so many tubes coming out of his mouth. With no hesitation, Sarah brushed his teeth with confidence and ease,” Wilding remembered. “Rarely, I’m at a loss for words, but I was speechless. At that point, I had only known Sarah for a very short time, but in that moment I knew Dad was in the very best hands.”

Wilding held back tears as she reflected on that memory when she, her father and their family recently returned to the Brigham to thank members of their Tower 8 care team for their lifesaving care and outstanding compassion.

“Everything you guys did — it was like he was your dad, and that was overwhelming,” Wilding told staff during the emotional reunion in the Bretholtz Center for Patients and Families. “You treated us like he was your family.”

Bosse, his loved ones and several representatives from his Tower 8 care team celebrate his recovery.

Bosse was eventually discharged to an inpatient rehabilitation facility in Maine before returning home a few days before Christmas. Although he remembers almost nothing from his time in the hospital, Bosse said he and his family will never forget the extraordinary difference the Brigham made in their lives.

“It was not just the care I received. It was also the way the staff treated my family. They tear up every time they talk about it,” Bosse said. “I know there was a large team, and my family spoke highly about them all. They made this tough time more tolerable for them.”

‘You Do Make a Difference’

The severity of his illness was never lost on Bosse and his family.

“Whenever he sees the news about people in our own town who passed away, he says, ‘That could have been me,’” his wife said.

Bosse reveals a T-shirt his family made for him with the phrase “This Pep Beat COVID.” Pep is short for pépère, a French-Canadian term for grandfather that became Bosse’s nickname years ago. During his illness, “Pep Strong” became his family and community’s rallying cry.

Following his discharge from the Brigham, Bosse embarked on three weeks of inpatient physical, occupational and speech therapy at New England Rehabilitation Hospital in Portland to rebuild his strength. He transitioned to outpatient therapy, and earlier this year was walking with the help of leg braces, a walker or cane.

When he returned to the Brigham in April with his family to thank staff, he walked into the 75 Francis St. entrance with the help of just ankle and foot orthotics. Bosse shared with staff that he’s already back to doing what he loves, including golfing. In August, he plans to participate in a local 10K with his 10-year-old grandson, Conor. By September, he hopes to be back on ice skates to rejoin his hockey league.

“This is such a gift,” said Diane Tsitos, MSN, RN, nursing director for Tower 8, upon hearing all the progress Bosse has made since his discharge. “It really warms our hearts. This is why we do what we do.”

During their visit, the family showed their appreciation by distributing treats to staff and small cards with “The Starfish Story,” a parable about a man who picks up starfish stranded on the beach and returns them to the ocean — a tale to illustrate the influence one person can have on another.

“I am so grateful,” Bosse told the Tower 8 staff gathered in the Bretholtz Center. “Don’t give up on what you do. You do make a difference. It certainly has in our lives. We’re never going to forget.”

Attending intensivist Sarah Rae Easter, MD, emphasized the important role families play in caring for patients and thanked Bosse’s loved ones for their support as well.

“We know him as a patient. We know his labs. We know the physiology. We know the medicine. But that doesn’t mean that we know him,” Easter said. “You know him as a person. You know his passions, his quirks, his pet peeves and his values.  We can’t make decisions about him as a patient without your insights about him as a person. While you were so grateful to us, it was your advocacy for his care that got us to his outcome.”

Galen Henderson and Tina Gelsomino (first and second from left) and Robert Higgins (far right) celebrate with awardees (center, from left) Gezzer Ortega, Shaina A. Lipa, L. Nicolas Gonzalez Castro and Ayobami Akenroye. Not pictured: Ivy Franco

Five rising stars in academic medicine and research were recently named the winners of the 2022 Minority Faculty Career Development Awards (MFCDAs), which seek to support and retain underrepresented in medicine (UIM) trainees and junior faculty at the Brigham.

This year marks the program’s largest-ever number of awardees — a milestone made possible through the support of the Office of the President.

“It is not enough to simply say that we are committed to advancing diversity, equity and inclusion. We must take action to demonstrate that commitment, especially when it comes to creating a culture and environment where the next generation of UIM physicians and scientists can thrive,” said Robert S.D. Higgins, MD, MHSA, president of the Brigham and executive vice president at Mass General Brigham. “It’s our honor to support these emerging leaders in science and medicine through this year’s expansion of our Minority Faculty Career Development Awards program.”

This year’s winners are Ayobami Akenroye, MBChB, MPH, of the Division of Allergy and Clinical Immunology; Idalid (Ivy) Franco, MD, MPH, of the Department of Radiation Oncology; L. Nicolas Gonzalez Castro, MD, PhD, of the Brigham’s Department of Neurology and the Center for Neuro-oncology at Dana-Farber Brigham Cancer

Center; Shaina A. Lipa, MD, MPH, of the Department of Orthopaedic Surgery; and Gezzer Ortega, MD, MPH, of the Center for Surgery and Public Health in the Department of Surgery.

Established in 1996 thanks to the efforts of Marshall Wolf, MD, Howard Hiatt, MD, and Robert Handin, MD, the MFCDA program was created to increase the representation of UIM physicians and scientists in fellowship programs and faculty positions at the Brigham. It provides $100,000 awards to recipients over five years — with a quarter of the funds reserved for clinical/research-related and career development purposes — and is administered by the Brigham’s Center for Diversity and Inclusion.

According to the American Association of Medical Colleges, “underrepresented in medicine means those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” At Brigham, those identities include African American/Black, Alaskan/Hawaiian Native, Hispanic/Latinx and Native American.

“On behalf of the Center for Diversity and Inclusion, we are thrilled to offer five Minority Faculty Career Development Awards to these outstanding faculty members,” said Galen Henderson, MD, chief diversity and inclusion officer for Faculty, Trainees and Students. “This type of award is crucial for faculty early in their careers so they can dedicate time to the advancement of scientific research, clinical care and their own professional development. These awardees are the future leaders of our organization and in academic medicine.”

Learn more about this year’s winners and what the award means to them:

Ayobami Akenroye, MBChB, MPH
Division of Allergy and Clinical Immunology

“My long-term goal is to be an outstanding physician-scientist, conducting translational epidemiologic research in the area of heterogeneity of treatment effect of monoclonal antibodies in the treatment of asthma. Ultimately, I want to improve the care of everyone with asthma — regardless of age, gender, body mass index, or race or ethnicity. I intend to use the period of this award to develop preliminary data, which will inform my first and potentially subsequent R01 applications. My prior training, additional training during the period of this award and excellent mentorship will position me to be one of the rising leaders in my chosen area of research.”

Idalid (Ivy) Franco, MD, MPH
Department of Radiation Oncology

“Through the support of the MFCDA, I will be able to effectively acquire the tools needed to address cancer health disparities, focusing on efforts in health equity, access and inclusion — leading to improved workforce diversity and patient outcomes within Radiation Oncology. I aspire to have my work improve patient outcomes for our most vulnerable communities and inspire younger generations to continue to apply a health equity lens to their work.”

Nicolas Gonzalez Castro, MD, PhD
Department of Neurology, Brigham and Women’s Hospital
Center for Neuro-oncology, Dana-Farber Brigham Cancer Center

“The support of the MFCDA will help advance my current research in glioblastoma genomics and epigenomics, increasing our biological understanding of this aggressive and invariably fatal brain tumor and uncovering new therapeutic targets. Support at this stage of my career will also help me generate preliminary data to apply for additional funding mechanisms as I continue developing as a physician-scientist in neuro-oncology.”

Shaina A. Lipa, MD, MPH
Department of Orthopaedic Surgery

“My main goal over these early years is to build my clinical practice in order to deliver quality and equitable spine care to my patients, which is and has always been my primary motivator. One of the byproducts of this goal is that this will allow me to become a respected faculty member of the spine surgery community and greater orthopaedic community at large. Secondly, this will inform my research, which is focused on the delivery and quality of orthopaedic care in the ever-changing climate of health policy. Receiving the MFCDA would provide the financial support to pursue coursework to gain new skills in the area of quality and safety, which is an area of interest for me, given its relation to primary goal of delivering quality and equitable care to patients.”

Gezzer Ortega, MD, MPH
Center for Surgery and Public Health, Department of Surgery
Patient Reported Outcomes, Value & Experience (PROVE) Center

“The MFCDA will accelerate my overall career goal of becoming an independently funded physician-scientist focused on identifying and addressing inequities in surgical care. I have been highly productive in the early stages of my career, but there are critical knowledge and skills gaps that this MFCDA will resolve so that I can become a nationally regarded expert in improving outcomes for surgical patients with limited English proficiency and advancing language-concordant care.”

Quoc-Dien Trinh explains how the Prostate Cancer Outreach Clinic has adopted a proactive approach to ensure Black men have equitable access to prostate cancer care.

Asking difficult questions, facing hard truths and challenging long-held norms — while at times uncomfortable, these actions are essential to addressing health equity and eliminating racism in health care settings, noted presenters at the Brigham’s Diversity, Equity and Inclusion (DE&I) Town Hall on May 26.

One important conduit for this work is the systemwide United Against Racism (UAR) initiative, explained Brigham President Robert S.D. Higgins, MD, MHSA, during his opening remarks for the event. Composed of three focus areas — health equity, community health and workforce equity — UAR seeks to identify and eliminate racist barriers, systems and actions inside and outside of Mass General Brigham.

Additionally, the Brigham recently established a new multidisciplinary team, the Communication Resource Committee, to advise the Office of the President and Office of Strategic Communication on responding to external events, including those involving issues of racial justice and health equity.

“To really move the needle in dismantling racist systems, we need to address these issues on a number of fronts,” Higgins said. “Real change also requires that we engage the highest levels of our organization while also supporting local efforts and projects.”

A Catalyst for Change in Prostate Cancer Care

The DE&I Town Hall spotlighted two projects at the Brigham — both supported with UAR grants — that are working to address health inequities and structural racism in clinical settings.

Quoc-Dien Trinh, MD, FACS, of the Division of Urological Surgery, discussed the Mass General Brigham Prostate Cancer Outreach Clinic (PCOC), a joint program between the Brigham and Massachusetts General Hospital (MGH) that seeks to make high-quality, affordable prostate cancer care accessible to more men of color.

The clinic, which Trinh co-founded with MGH colleague Adam Feldman, MD, MPH, was created to address the disproportionate burden of prostate cancer among Black men, who are 22 percent less likely to receive treatment for the disease compared to white men.

“Even in Massachusetts, despite the access to insurance, there’s a disparity in access to care,” said Trinh, who also serves as director of Ambulatory Clinical Operations for Urological Surgery, co-director of the Prostate Cancer Program for Dana-Farber Brigham Cancer Center and a core faculty member of the Center for Surgery and Public Health.

In designing the program, Trinh and Feldman met with Black men across Massachusetts to better understand the current barriers to care. Inconvenient services, high costs and mistrust of large health care systems ranked high among the reasons the men interviewed said they avoided care at academic medical centers like the Brigham and MGH.

Rather than relying on a conventional approach of waiting for patients to seek care, PCOC was founded on the principle that providers must be more proactive with outreach and education to connect patients with the care they need, Trinh explained.

A community health worker helps patients navigate appointments, a collaboration with the Department of Quality and Safety proactively identifies at-risk patients who lack referrals, and partnerships with third-party organizations are helping to build trust with local communities.

“The vision is to use PCOC as a catalyst to bring our communities compassionate prostate cancer care,” Trinh said.

Identifying ‘Blind Spots’ in Behavioral Health

Meanwhile, a UAR grant-funded multidisciplinary training program developed in collaboration with faculty from the Brigham, Brigham and Women’s Faulkner Hospital (BWFH) and MGH Emergency Departments (EDs) is addressing how to reduce racial bias and provide trauma-informed care when managing agitated patients.

Dana Im, MD, MPP, MPhil, director of Quality and Safety and director of Behavioral Health for Brigham Emergency Medicine, explained that the project was inspired by a study led by Emergency Medicine resident Jossie Carreras Tartak, MD, MBA, and senior author Wendy Macias Konstantopoulos, MD, MPH, MBA, vice chair for Diversity, Health Equity and Inclusion for MGH Emergency Medicine, in close collaboration with Tom Sequist, MD, MPH, Mass General Brigham chief medical officer, and his team. The multi-institutional research team looked at the use of restraints for patients under an involuntary hold during an emergency psychiatric evaluation. After examining data from 11 EDs across Mass General Brigham, they found that Black and Hispanic patients experienced higher rates of physical restraint in the ED.

Following that 2021 publication, the Brigham’s ED team launched its Emergency Medicine Antiracism and Trauma-informed (ART) Interdisciplinary De-escalation Training Program, which approximately 120 ED staff — including physicians, nurses, support staff, security officers and psychiatrists — have completed to date.

“We felt that, in order to address the disparities in the ED that were highlighted in the study, we couldn’t just present the numbers to our staff and ask them to provide unbiased care,” Im said. “We really had to equip and empower them to provide equitable care.”

Initially launched as a pilot to reduce racial bias during de-escalation, the program, led by Emergency Medicine fellow Farah Dadabhoy, MD, has been expanded to include trauma-informed and antiracism principles. It will be used to train all ED staff at Brigham and BWFH. A similar training program has been implemented in MGH ED as part of the UAR collaboration.

An important component of the training is standardizing the way agitation is assessed and addressed, Im explained. When designing the program, Im and her colleagues learned from their interviews with ED staff that while one clinician might perceive a patient as violent and in need of restraint, another clinician might see the same patient as upset.

In addition to developing a consistent description of agitation, the team developed a team-based algorithmic approach to deescalating ED patients in an agitated state to ensure equitable care.

“We tell our trainees to think of a patient who comes to mind when EMS calls and says there’s a 55-year-old intoxicated male picked up at Forest Hills station. Then juxtapose that image with the patient you picture when EMS calls in with two intoxicated males picked up at a Boston College party,” Im said. “This exercise gives us space, time and opportunity to think through our blind spots and how bias really seeps into our clinical care.”

Taking a Trauma-Informed Lens

Annie Lewis-O’Connor, PhD, NP-BC, MPH, FAAN, co-chair of the Mass General Brigham Trauma-Informed Initiative, explained how understanding the trauma a patient has experienced, including individual and systemic racism, can influence the way they experience health care settings.

“Trauma is intersectional — individual, interpersonal, collective and structural. It’s an event, series of events or set of circumstances that’s experienced by an individual as either physically or emotionally harmful, and the key to it is that it has long-lasting effects,” said Lewis-O’Connor, who also serves as founder and director of the C.A.R.E. (Caring Approach to Resiliency & Empowerment) Clinic.

Trauma-informed care (TIC) is a set of principles that providers can incorporate into their practice to improve the quality of care by building trust, create safe spaces and empowering patients and staff, while also strengthening peer support and interdisciplinary collaboration.

“In fact, TIC does not require you to do more work; rather, it suggests a way to reframe how we work,” Lewis-O’Connor said. “It’s a strength-based framework. It’s about not asking ‘What’s wrong?’ but rather ‘What’s happened?’ and ‘How has that impacted you?’”

View a recording of the event.

Among the many additions to the expanded and renovated ED are two state-of-the-art trauma rooms that make up the Ron M. Walls, MD, Trauma Suite, which is pictured above and was named in recognition of a generous gift from Jane C. and Brian L. Crowley.

After seven years of planning, approvals and a building process that included continued construction during a worldwide pandemic, the Brigham’s Emergency Department (ED) expansion project celebrated the end of its final phase of construction this month.

In addition to doubling the ED’s total square footage and creating another 30 beds, the expanded space boasts a new trauma suite, a dedicated area for behavioral health patients and additional emergency imaging capabilities.

“We’re excited to formally open our new Emergency Department, which will allow us to continue to support our patients who need emergency medical care,” said Robert S.D. Higgins, MD, MSHA, president of the Brigham and executive vice president at Mass General Brigham. “This new, state-of-the-art space is part of our ongoing commitment to meet the needs of our community and improve our patients’ experience.”

The expansion will improve efficiency for ED staff, support a reduction in wait times and provide a more comfortable, healing environment for patients and families, explained Michael J. VanRooyen, MD, MPH, chair of the Brigham’s Department of Emergency Medicine and enterprise chief of Emergency Services at Mass General Brigham.

“We focused on designing a space to both provide the best health care experience possible to our patients and to support our staff,” VanRooyen said. “It’s not just about creating more space but also prioritizing the workflow and the patient journey to make sure we’re leading the way and being an example for other emergency departments in the future.”

The COVID-19 pandemic disrupted numerous facets of hospital operations throughout the year, and the ED was no exception. However, through the work of hospital and ED leadership, Brigham Infection Control experts, construction teams and local regulatory agencies, the construction project continued through this difficult stretch of time.

“We maintained the highest safety standards despite the unique challenges posed by the COVID-19 pandemic,” said Sonal V. Gandhi, vice president of Real Estate, Planning and Construction. “It is a testament to the innovative and dedicated team of professionals who work tirelessly to meet the critical need for increased capacity while providing the best health care experience for our patients, families, surrounding community and staff.”

The three-phase construction project broke ground in 2019 and has resulted in a 26,000-square-foot expansion of the ED’s footprint. The renovation included the creation of an additional 32 exam rooms, an increase from 49 to 81 beds, two state-of-the-art trauma rooms, two advanced X-ray rooms, an additional CT scanner and a second ultrasound room.

The project also included a new entrance, security and check-in desk, waiting room, care initiation and triage rooms, as well as an eight-bed behavioral health observation unit. Care initiation and triage rooms make it possible to quickly advance patient care during longer wait times and for low-acuity patients who can be seen and discharged by medical staff without waiting longer for care elsewhere in the department. A specialized oncology unit catering to the unique needs of patients with cancer emergencies will open at a later date.

These resources could not become available at a more important time, as emergency departments across the city, including the Brigham’s, continue to face high censuses and inpatient boarding challenges, said Christopher Baugh, MD, MBA, vice chair of Clinical Affairs for Emergency Medicine.

“Through this expansion, our team looks forward to better serving patients and families,” Baugh said. “This expansion is also an important part of our mission to ensure that we are supporting our surrounding community — especially as it pertains to serving those patients for whom it could be lifechanging or lifesaving to have access to the highly complex and specialized care that we provide here at the Brigham.”

Specialized Care for Behavioral Health Patients

The behavioral health observation unit has been environmentally tailored to suit the needs of this patient population by providing safe and private space, with softer lighting and reduced noise.

“Improving patient privacy and making sure we provide our behavioral health population with the most respectful space, tailored to their needs, was a top priority for the ED’s nurses, who have been involved in every aspect of the new space,” said Janet Gorman, MM, BSN, RN, associate chief nursing officer of the ED.

“We really wanted to create a space that was internal to the ED but separate from all the other activity so that we can provide dedicated care to our behavioral health patients,” says Dana Im (picture in foreground) about the ED’s new behavioral health unit.

Equipped with its own nursing station, medication room and a dedicated team of providers, the unit was designed to ensure behavioral health patients receive personalized care, explained Dana Im, MD, MPP, MPhil, director of Quality and Safety and director of Behavioral Health for Emergency Medicine.

Patients in the unit also receive a “comfort menu,” which invites them to access a variety of items and services to support a comfortable stay — including earplugs, books and magazines, crossword puzzles, snacks, personal hygiene items and sleep aids. The handout also provides relaxation tips, such as breathing exercises, as well as information about safety and privacy guidelines. Patients are also given an opportunity to contribute to their care plan by sharing their preferred calming strategies and which conditions trigger emotional discomfort.

“Our old ED environment was not conducive to behavioral health care, and we also felt our staff was being pulled in so many directions. It’s really hard to care for an escalating patient while EMS stretchers are passing by every five minutes and trauma teams are activated right next door,” Im said. “We really wanted to create a space that was internal to the ED but separate from all the other activity so that we can provide dedicated care to our behavioral health patients.”

One notable aspect of the Brigham’s behavioral health unit is it is staffed by a multidisciplinary team of ED clinicians, who work closely with social workers, psychiatrists and, most recently, a psychiatric occupational therapist, Im explained. The multidisciplinary team focuses on acute stabilization, treatment and reassessment of both medical and psychiatric illnesses.

Additionally, in anticipation of the unit’s opening, Im and her colleagues implemented interdisciplinary rounds in the ED for behavioral health patients. Rounding in the traditional sense is uncommon in EDs, but the team recognized a need to bring together clinical and nonclinical staff to optimize care for this patient population.

“It’s really a great opportunity for us to come together as a team for patients. Centralizing the care in the new unit will now make it even easier for us to do so,” Im said. “We see a lot of medically complex psychiatric patients, and we’re now uniquely equipped to provide a higher quality of care to our behavioral health patients.”
Sidebar

Featured speakers from the 2022 Women’s Health Luncheon included (from left) Annie Lamont, Hadine Joffe, Robert Higgins and Anita Hill. Not pictured: Bruce Levy

In 2007, a small group of women’s health researchers gathered around a conference room at the Brigham to share insights about their latest discoveries and, distressingly, the tremendous gaps remaining in science’s understanding of how a person’s sex influences disease.

That once-intimate gathering has since grown into a dynamic annual fundraising event supporting and showcasing the groundbreaking work of the Mary Horrigan Connors Center for Women’s Health and Gender Biology before an audience of hundreds of philanthropists, business leaders and women’s health advocates.

This year’s event, held May 6 at the Omni Boston Hotel at the Seaport, marked not only its 15th anniversary but also the luncheon’s first in-person format since 2019. Aptly themed “Finding Our Voice,” the luncheon also coincided with a time when women’s health, specifically reproductive health, is the subject of contentious national debate.

“It is clear that our mission to protect and advance the health and lives of women is more important than ever,” said Hadine Joffe, MD, MSc, executive director of the Connors Center.

Brigham President Robert S.D. Higgins, MD, MSHA, underscored the institution’s unwavering commitment to supporting and advancing all facets of women’s health.

“At the Brigham, we continue to uphold our longstanding mission to provide safe, accessible and high-quality care to all patients who seek it. We deliver care with compassion and without judgment,” said Higgins, who also serves as executive vice president at Mass General Brigham. “We remain patient-centered and focused on achieving the best outcomes. Our commitment to providing high-quality care is importantly inclusive of all women — particularly those from historically disadvantaged backgrounds.”

Uncovering Gaps, Asking Questions

More broadly, speakers noted, women’s health research has made significant strides in recent years — but also still has a long way to go. Throughout that time, the Connors Center has been at the forefront of advocating for meaningful change in the field, Joffe said.

“Fifteen years ago, scientists doing preclinical research were not required to consider sex when they studied animals, tissues or cells. What this means is that research at its most fundamental level and its starting point did not account for the most basic biological differences that exist between females and males,” she explained. “This left us without a clear understanding of how sex influences health and disease, but it left us with medications, medical treatments and guidelines that were not calibrated for women’s specific biology or life experience.”

Several years ago, Connors Center scientists were among those who testified before Congress about this gap. That advocacy contributed to the National Institutes of Health’s 2016 policy requiring scientists to include females and sex-specific information in data they report out, Joffe said.

One compelling and timely example of the need to better understand how sex influences disease can be seen in the condition that has come to be known as “long COVID,” or post-acute sequelae of COVID-19, in which a person who has recovered from the initial COVID-19 infection continues to experience lingering symptoms like fatigue, muscle pain, migraines and cognitive struggles.

Scientists are learning that women are three times more likely to experience long COVID than men, yet the reason for that disparity remains unclear, said Bruce Levy, MD, chief of the Division of Pulmonary and Critical Care Medicine and one of the luncheon’s three featured speakers.

Levy noted that Brigham clinicians and researchers are leading the way nationally in efforts to deliver personalized care to long COVID patients through the COVID Recovery Center and better understand the condition through the Greater Boston COVID Recovery Cohort.

“There are still many long COVID patients we don’t have answers for,” Levy said. “More research is desperately needed, but there are many patients with long COVID who benefit from the care provided at specialized centers like ours.”

The event also featured remarks from Anita Hill, JD, university professor of Social Policy, Law and Women’s, Gender and Sexuality Studies at Brandeis University, and Annie Lamont, first lady of Connecticut and co-founder and managing partner of Oak HC/FT, a venture capitalist firm whose focus includes health care startups.

Reflecting on what it takes to transform women’s health and address inequities, Hill emphasized that research and advocacy must go hand in hand.

“I know we can be, already are and will continue to be the catalyst for the solutions that we are waiting for,” she said. “Find your voice, use it and make change happen.”

The luncheon raised more than $700,000 to fund women’s health research — $150,000 of which was pledged during the event to fund new IGNITE Awards, which provide direct support to Connors Center scientists who are conducting groundbreaking research in women’s health.

“They are the most important thing in my life,” Nicole Haight (second from right) says about her four children.

In celebration of Mother’s Day, Brigham Bulletin is highlighting how one mother’s unwavering devotion to her family set her on an extraordinary path to healing with the support of her Brigham care team.

The pulsing sound in Nicole Haight’s ears just kept getting louder. Whoosh. Whoosh. Whoosh. It was disorienting as she worked as a building painter, trying to maintain her balance on lifts and ladders. At home, the pulsing was eventually so loud that it nearly drowned out the sound of her youngest son’s cries.

Then came the crippling migraines. Haight, 29, had never experienced anything like them in her life. She saw a doctor near her home in Stockton, Ill. They thought it was a severe ear infection. It turned out to be something much worse.

After undergoing an MRI last June, Haight learned she had an arteriovenous malformation (AVM) in her brain. It’s a condition that causes capillaries — tiny blood vessels that connect veins and arteries — in the brain to form incorrectly.

Haight at work prior to her diagnosis

“One of the best descriptions somebody gave me was that it’s like a bunch of Christmas lights tangled up,” Haight said.

In a healthy person, brain capillaries are like speed bumps on a busy road, preventing blood from flowing too quickly across these connections. In someone with an AVM, blood rushes from the artery into the vein — the source of that loud pulsing sound Haight was experiencing — and causes the vein to blow up like a balloon. At any time, the pressure buildup can cause the vein to burst without warning. If that happens, there is a 20 percent chance of death. Among those who survive, the risk of permanent injury to the brain is greater than 40 percent.

AVMs are rare, affecting one in 100,000 people, and congenital, meaning they are present from birth. They are the leading cause of hemorrhagic stroke in young people.

Haight, a single mother of four, says she wrestled with what this diagnosis meant for her and her family.

“I was so scared,” she said. “I even started a notebook and wrote notes to all my kids, just in case I wasn’t here.”

Determined to Find a Solution

Shortly after her diagnosis, Haight drove two and a half hours for consult with a neurosurgeon in Wisconsin. They told her that her AVM was inoperable and offered to treat it with radiation therapy — an approach that would offer a low likelihood of success and take six years to complete, a period during which her AVM could rupture at any time.

So, she saw another neurosurgeon. And another. And another. In all, she met with seven surgeons across the Midwest. They each told her the same thing: Surgery was just too risky due to the size and location of the AVM, which was in the area of her brain that controls speech. One hospital in Chicago agreed to perform an embolization, a treatment that stops blood flow in a targeted area. The procedure was unable to completely resolve her condition.

An image of Haight’s AVM, captured on a diagnostic angiogram, shows an artery going directly to a vein without intervening capillary.

It started to feel like her life was being taken over by researching doctors, scheduling appointments and traveling across states for consults — all while managing her worsening symptoms. But Haight says none of that compared to the heartbreak she experienced as she watched her children process what was happening.

“It was hard on my kids because I don’t think they fully understood why I was always so sick. That was the worst part,” she said. “My dad had passed a few years prior, and they asked if I was going to end up with their grandpa.”

Haight was determined not to let that happen — and thanks to a chance encounter, she became connected with the Brigham Neurosurgery team who refused to give up on her, too.

Defusing a ‘Ticking Time Bomb’

While at a house-painting job outside Chicago last year, Haight, her mother and her uncle — who all work together as part of a family business — got to chatting with their client and learned that his son was a Neurosurgery resident at the Brigham. After they shared her story, he offered to make an introduction.

That was how Haight met Nirav Patel, MD, director of the Brigham’s AVM Program and a global expert in treating complex AVMs. They scheduled a virtual visit, and Patel reviewed the scans from Haight’s latest MRIs.

Removing an AVM is a painstakingly slow, careful process. The entire surgery is performed under a microscope as Patel and his multidisciplinary team work to untangle and remove the malformed blood vessels, millimeter by millimeter — a process that takes up to 12 hours.

“We often see patients with high-grade AVMs who have been bounced around and told it is a ticking time bomb — that nothing can be done. But that isn’t always true. If we catch it and surgically remove it, it’s gone forever,” Patel explained. “For so much in neurosurgery, we don’t get a cure, no matter how good of a job we do. But this is one of those diseases where, with a great team and a lot of effort, we can cure these patients for life.”

Among hospitals in Boston, the Brigham stands out for performing the highest volume of AVM removals and taking on the most complex cases, Patel said. Over the course of his career, he has completed more than 100 of these surgeries and is passionate about ensuring patients worldwide have access to this lifesaving procedure.

For Patel, there was no question in his mind that he and his team could help Haight.

That was all Haight needed to hear. This February, she and her mother got into their pickup truck and made the 16-hour drive to Boston. She couldn’t fly, as the cabin pressure in a plane might have caused her AVM to rupture.

But before they could see Patel in his clinic, Haight was struck with severe migraines and went to the Brigham’s Emergency Department. Her care team there paged Patel, who met with Haight and her mother. The team prepped her for surgery.

“‘I’m glad you’re here. We’re going to take care of you,’” Patel remembered telling them.

‘I Feel So Free’

After half a day in surgery, Haight was placed in a medically induced coma for seven days to help her body rest and heal. When she woke up, she only remembered one fact about her life: her four children.

“I’m grateful for every little thing,” Haight says of life after her surgery.

“They are the most important thing in my life,” Haight said.

While it took some time to recover her speech and other fine-motor skills, Haight said all the symptoms of her AVM had vanished. Within a few days, she was eager to return home to her family and received the go-ahead from her care team to rejoin her mother in their pickup truck and head back home. Today, almost fully recovered, Haight is back at work and enjoying every moment with her loved ones. Her AVM is gone — permanently.

“I feel so free now,” she said. “I’m grateful for every little thing.”

Among the recipients of her gratitude are her Brigham care team, she added.

“I’ve never met staff who are so caring,” she said. “Dr. Patel is so different from any other doctor I’ve met. He smiles whenever he sees me. He genuinely cares. At one point, he said to me, ‘I will treat you as a whole person. I know you’re a mother. I know you have kids.’ I felt like to all the other doctors, I was just a case.”

Patel said he was not surprised to see Haight recover so quickly.

“She’s an unstoppable force,” he said. “Mothers always bounce back the best because they have that motivation. They are willing to do whatever it takes to be there for their kids.”

Left photo: Ira Santos, shortly after his surgery in April 2020; Right photo: Santos, now fully healed and in remission, enjoys a moment recently with his husband, Barry Macero.

When Ira Santos started to find it difficult to breathe through his nose, he assumed allergies were to blame. But when his symptoms worsened and his face became swollen and painful, he knew something else was wrong.

Even so, nothing prepared Santos and his husband, Barry Macero, for the shocking revelation they received after Santos underwent a CT scan: It was cancer.

They learned Santos had developed squamous cell carcinoma — an aggressive form of skin cancer — in an uncommon location, including his sinuses, palate and the bottom of his eye socket. After consulting with a surgeon near their home in Peabody, Santos and Macero received another bombshell.

“They immediately told him he needed surgery, and they were going to remove his eye,” Macero recalled. “When we asked about alternative therapies and chemotherapy, they said it wouldn’t work.”

The prospect of losing an eye would be difficult for almost anyone to accept. But as a hairdresser, it would have been especially devastating for Santos, who relies so heavily on his vision to do his job well.

“I said to Ira, ‘How are you going to cut hair with one eye?’” Macero said.

They sought a second opinion at Dana-Farber Brigham Cancer Center. That decision saved Santos’ life — and his eye.

“We called and got an appointment right away, and when we came in, we were assigned a team of doctors,” Macero said. “The first thing they said was, ‘Before we do surgery, let’s see if we can reduce the size of the tumor with chemotherapy.’”

Several rounds of chemotherapy were somewhat effective in reducing the tumor size, but ultimately not enough to avoid surgery. However, the care team’s willingness to try a less-invasive treatment strategy — and their understanding of how important it was to preserve Santos’ eye, if possible — made the couple feel like they were in the best hands, they said.

“I can’t tell you how wonderful they were,” Macero said. “They made us feel included in all the decisions.”

‘It Was a Miracle’

Eleni Rettig, MD, of the Division of Otolaryngology-Head and Neck Surgery, who led the team that performed Santos’ surgery two years ago, said a multidisciplinary, patient- and family-centered approach is essential to achieving the best outcome for patients like Santos.

To develop a treatment plan for Santos, Rettig worked closely with colleagues Glenn Hanna, MD, of Medical Oncology, and Danielle Margalit, MD, of Radiation Oncology.

“Head and neck cancer in general is not very common, and because the treatment can have such an impact on your function, it’s ideal to be treated in a high-volume center that has experience with these tumors and the reconstruction,” Rettig said. “We treat patients as a team. We’re able to see them together in our clinic, which is unique and provides patients some comfort in knowing we collaborate so closely.”

In Santos’ case, because imaging showed the tumor had invaded the bottom of his eye socket, the team was uncertain whether the cancer had spread to the area directly around his eye, Rettig explained. They wouldn’t know for sure until he was in the Operating Room (OR) and Rettig had an opportunity to take a tissue sample from his periorbita — a fibrous capsule surrounding the eyeball — to see if cancer cells were present.

In addition, the surgery itself would be challenging, Rettig said. After removing the tumor, Rettig would need to reconstruct his cheekbone and eye socket using segments of bone from Santos’ leg, as well as skin from his leg to recreate his palate. The team used computer modeling in advance of the surgery to plan the reconstruction. Once in the OR, they transferred the bone and tissue and, finally, sewed the blood vessels together under a microscope.

“It’s one of the most complex surgeries we do,” Rettig said.

When a Pathology team reported back that the periorbita was cancer-free, Rettig said she breathed a sigh of relief. There was no need to remove Santos’ eye. After more than 12 hours in the OR, she called Macero to share the good news.

“She said, ‘I saved his eye and got 100 percent of the cancer,’” Macero remembered. “I started crying. I said, ‘Oh, my God. Thank you so much.’ It was a miracle that she saved his eye.”

Santos’ surgery took place in April 2020, just as the pandemic prompted the Brigham to implement restrictions on visitors. Despite all the uncertainty of that time, Santos and Macero said that staff who cared for him postoperatively made them feel cared for and connected to his loved ones.

“Ira used to rave about the nurses when he was there,” Macero said. “They encouraged him to call me as much as he wanted.”

After being discharged home, Santos underwent six weeks of radiation therapy with more chemotherapy to ensure all the cancer was eliminated. Today, Santos maintains a clean bill of health, and says he feels great and that his eyesight is just as good as it was before surgery.

“The recovery was very nice,” Santos said. “The doctor said that maybe I could go back to work in 10 months or one year, and I got back in three months.”

Macero said they are both incredibly grateful for the care they received.

“I can’t tell you how thankful I am for Dana-Farber and Brigham and Women’s,” Macero said. “They are amazing.”

From left: Claire-Cecile Pierre, Sunil Eappen and Allison Moriarty listen as Robert Higgins delivers his opening remarks during State of the Brigham.

In his first five months leading the hospital, Brigham President Robert S.D. Higgins, MD, MSHA, has found one thing abundantly clear: Even in the face of so many challenges, members of the Brigham community demonstrate a level of dedication and compassion that is unmatched, Higgins told staff during his opening remarks at the first State of the Brigham forum on April 14.

Speaking to a live audience in Bornstein Amphitheater and viewers watching the webcast virtually, Higgins acknowledged the past year has been physically, mentally and emotionally taxing. From the ongoing pandemic to capacity issues affecting hospitals nationwide earlier this year, the hardships that health care workers have faced often felt relentless, he remarked.

Even so, Brigham staff have remained unwavering in their support of patients, families and each other, Higgins said.

“I’m proud to say we’ve seen the Brigham community remain rooted in our commitment to high-quality patient care and driven by our mission,” he said.

To illustrate this, Higgins highlighted several examples of how staff bring the Brigham’s values to life. Among these was the recent launch of a groundbreaking clinical trial to test nasal vaccines for Alzheimer’s disease. Reflecting how the Brigham creates breakthroughs, the trial will study how well the vaccine prevents the onset of Alzheimer’s in younger, high-risk patients as well as if it halts the progression of symptoms in patients with active forms of the disease.

“This trial represents the culmination of nearly 20 years of research at the Brigham led by Dr. Howard Weiner,” Higgins said. “For two decades, his team has accumulated preclinical evidence supporting the potential of this nasal vaccine for Alzheimer’s — an amazing testament to the value of investing in this type of research.”

Higgins also underscored the importance of continuing to collaborate across Mass General Brigham and fulfill the promise of truly integrated system of patient care.

Additionally, he cautioned that there are still headwinds on the horizon, particularly as the financial impact of the pandemic continues to reverberate.

“As we have in the past several years, we have to see that our expenses are controlled as we consider how to balance our current budget,” Higgins said. “I’m proud to say that, like everything else, the Brigham will lead the way. As my mom said, pressure makes diamonds, and we want to continue to be the jewel in the crown of the American health care system.”

Additional Updates

The State of the Brigham also featured updates from other hospital leaders about priority areas, including research, quality and safety, and community outreach.

Allison Moriarty, MPH, senior vice president of Research Planning & Operations and Innovation, highlighted the many ways the Brigham research community is pursuing scientific breakthroughs and translating lab discoveries into clinical innovations. Among these are efforts around cell and gene therapy. In alignment with research colleagues across the system, Brigham researchers are expanding their studies of these cutting-edge therapies from cancer to other disease areas.

“All of us have been touched by human diseases and conditions,” Moriarty said. “You can be assured that whatever is ailing you or others across the country, we have somebody who’s working on it.”

Sunil Eappen, MD, MBA, senior vice president of Medical Affairs and chief medical officer, reviewed the results of the Brigham’s recent Joint Commission reaccreditation survey — describing the experience as “the most positive I’ve ever seen” because staff and surveyors genuinely sought to learn from one another, he explained.

Eappen noted that the survey resulted in 58 findings, many of which relate to issues that all staff can, and should, remain vigilant and proactive about addressing.

“If you’re a clinician, don’t use abbreviations. If you see oxygen tanks that are sitting without a container, do something about it — tell somebody. If you see ceiling tiles that are damaged, call to have them repaired,” Eappen said. “These are things that we expect someone else to take care of, but it’s really our responsibility to do that together. And this is not something you should be doing just in the last week before The Joint Commission comes. We should be doing this all year long.”

Another important area surveyors review is an organization’s safety culture, and reporting safety concerns is a vital part of that, said Eappen. He urged staff to report systems, processes and behaviors that could, or do, compromise care quality and safety.

“We want you to feel confident about reporting because we are working to move towards being a high-reliability organization,” he said. “The goal is to get to a point where we are incredibly proactive in thinking about ‘this could be a risk’ and fixing it, so we never have that safety event occur. This is the way the nuclear power and aviation industries work.”

Claire-Cecile Pierre, MD, associate chief medical officer and vice president of Community Health, provided an update on the Brigham’s latest community health needs assessment, a process the hospital is required to complete every three years.

Pierre explained that during the last assessment in 2019, several Boston-area hospitals recognized the opportunity to coordinate in a way that better served local communities and collaborated in conducting surveys, analyzing data and deciding how to allocate resources. The Brigham will build on the success of this strategy for 2022 by continuing to collaborate with other city hospitals and colleagues across Mass General Brigham, she added.

Lastly, the forum provided an opportunity for staff to ask questions, leading to discussions around issues such as staffing, compensation and diversity and inclusion.

From left: Cheryl Lang, Alexandra Chéry Dorrelus, Lawrence Stevenson, Rahsaan Peters and RonAsia Rouse demonstrate the use of a sand therapy toolkit, which the Louis D. Brown Peace Institute uses as part of its Peace Play in Urban Settings program. Funds raised by the Brigham and other hospitals for this year’s Mother’s Day Walk for Peace will support the distribution of these toolkits to community members.

While patients have their most acute care needs met in the hospital, long-term healing often happens closer to home — underscoring the importance of partnerships with community-based organizations. One example of this is the partnership between the Louis D. Brown Peace Institute (LDBPI) and the Brigham’s Violence Intervention and Prevention Programs, whose staff collaboratively deliver compassionate, comprehensive care to patients and families admitted to the Brigham after experiencing community violence.

“In one’s darkest moments — in the midst of the pain of loss and trauma — light often comes from those who rally around us,” said Claire-Cecile Pierre, MD, associate chief medical officer and vice president of Community Health at the Brigham. “It is when partnerships transform into a community of support that we — the Brigham, LDBPI and others — can together provide critical guidance through the complex aftermath of community violence. We are incredibly fortunate to have LDBPI’s leadership and partnership in this work.”

In collaboration with the multidisciplinary teams who care for survivors of violence, Brigham staff in the hospital’s Center for Community Health and Health Equity work with patients and their loved ones through the center’s Violence Recovery Program (VRP) and the Jamaica Plain Neighborhood Trauma Team (JPNTT) to begin the process of physical, emotional and spiritual healing in the aftermath of violence.

Aiming to assist with long-term recovery and prevent readmission, VRP and JPNTT advocates Dana Jackson, Rahsaan Peters, Sade Smith and Lily Stern support patients through crisis intervention and trauma response; communication with family and connection to resources; safety planning and after-care plans; advocacy within the legal, employment and education system; and warm referrals to organizations such as LDBPI.

Determined to honor and carry on their son’s legacy, Joseph and Clementina Chéry established LDBPI in 1994 after their 15-year-old son, Louis, was killed in a crossfire shootout in Dorchester on his way to a Teens Against Gang Violence meeting. Leaving the hospital with no resources or roadmap, his parents sought to transform support for survivors of homicide victims in Boston.

“People need to know what comes next,” said Alexandra Chéry Dorrelus, LDBPI’s co-executive director and Louis’ sister. “They need to have somebody guiding them all the way through, and they need to know that something happened that was totally outside of their control and that the control is in their hands now moving forward — and that there is a path forward.”

Building Trust

LDBPI worked with the City of Boston to develop best practices for supporting those who have lost a loved one to homicide. In addition to implementing this model locally with partners such as the Brigham, LDBPI staff have trained other community organizations across the country on these practices.

Within 24 to 72 hours after a family experiences homicide, VRP introduces the family to LDBPI staff and support starts immediately. From helping families bury their loved one and ensuring they know essential, acute information such as their detective, police liaison and court advocate, to engaging them in various longer-term supports, LDBPI guides families with care, expertise, respect and transparency.

Critical to their work is building trust, explained Lawrence Stevenson, LDBPI’s survivor support coordinator.

“A family’s ability to trust is broken at the same time they are being asked to trust all these systems, so we have to go above and beyond to develop that trust, keep our commitments and be transparent,” Stevenson said. “Knowing that this is because families have been victimized and have such a loss of control, it’s important that we’re always putting the control back in our family’s hands. In this field, we have adopted this idea of making sure we’re trauma-informed — and that’s important — but you also have to be survivor-centered as well.”

‘A Guardian Angel’

Describing LDBPI as “a guardian angel,” Rahsaan Peters, the Brigham’s VRP coordinator, works closely with the organization to support patients and its work.

“They’re No. 1 when it comes to homicide support,” said Peters, explaining it is critical to “support LDBPI, whether that’s following its lead, bringing a referral, volunteering there or whatever it may be to make sure I show support to them and to the family.”

Similarly, LDBPI staff emphasized the value of their partnership with VRP and the Brigham.

“We are absolutely shifting culture together,” Chéry Dorrelus said. “Rahsaan has been a part of our providers network from the very beginning and is one of the few people who can walk around and tell the full history of homicide response in Boston.”

VRP’s partnership with LDBPI has extended beyond supporting patients and has benefitted the larger Brigham community as well. For example, by connecting Brigham’s Stepping Strong Injury Prevention Program with LDBPI, Peters helped facilitate a recent “Lunch and Learn” event, where Brigham staff heard from LDBPI and other local leaders about their work and ways in which the hospital can support those who have experienced community violence.

LDBPI’s advocacy at the state level has also resulted more equitable victims’ compensation and the establishment of a Survivors of Homicide Victims Awareness Month, observed Nov. 20–Dec. 20, in Massachusetts.

“After the Lunch and Learn, multiple Brigham employees expressed how much they learned and valued the event,” said Molly Jarman, PhD, MPH, program director of the Stepping Strong Injury Prevention Program. “The Lunch and Learn has served as a jumping-off point for further collaboration with LDBPI, including supporting the Mother’s Day Walk for Peace and Homicide Awareness Month. We look forward to continuing to build on this work.”

VRP, JPNTT, Stepping Strong and LDBPI see this type of education, advocacy work and collaboration as key to bringing more people into the conversation to achieve long-term change.

“The Mother’s Day Walk for Peace is a fantastic way for the Brigham community to support the Louis D. Brown Peace Institute and visibly affirm our commitment to community safety,” said Bernard Jones, EdM, vice president of Value-Based Care, Public Policy and Administrative Operations at the Brigham. “All of us hope for a day when violence prevention and response is no longer necessary. Until that day comes, though, our patients and our neighbors need these important partnerships.”

To join the Brigham’s Mother’s Day Walk for Peace Team, click here.

From left: Emilie Schlitt; Paul Kent (center) with Audrey Epstein Reny and Steve Reny; and Vanessa Welten

In celebration of the 126th Boston Marathon, Brigham Bulletin is highlighting the stories of three members of the Brigham’s Stepping Strong Marathon Team. Comprising 138 runners, the Stepping Strong team will follow the historic Boston Marathon route on April 18 — all in support of The Gillian Reny Stepping Strong Center for Trauma Innovation at the Brigham.

About Stepping Strong

Established in the aftermath of the Boston Marathon bombings, The Gillian Reny Stepping Strong Center for Trauma Innovation has evolved from one family’s bold response to a personal tragedy to a thriving, multi-institutional, multidisciplinary hub tackling the continuum of trauma care — from prevention to treatment to rehabilitation. Its mission is to catalyze multidisciplinary collaborations that inspire groundbreaking innovation, effective prevention and compassionate intervention to transform care for civilians and military heroes who endure traumatic injuries and events.

You can advance this critical work by supporting the Stepping Strong Marathon Team. Click here to meet members of the team or make a gift.

Emilie Schlitt, BSN, RN, PCCN, CWOCN

It was a spring day in 2013 when Brigham nurse Emilie Schlitt, BSN, RN, PCCN, CWOCN, wheeled her patient, Gillian Reny, then 18 years old, out of the 45 Francis St. entrance. It was Reny’s first time outside since she had been rushed to the Brigham after suffering devastating injuries in the Boston Marathon bombings.

Sunshine warmed their faces, and Reny relaxed into a smile.

“I couldn’t think of a better team to run for or support,” says Schlitt.

Schlitt still gets choked up thinking about that moment, even after all these years.

“I remember that day like it was yesterday. Just to see that smile on her face was everything. It makes your day as a nurse,” said Schlitt, who was among the team that cared for Reny and other marathon bombing survivors on the Plastic Surgery Stepdown Unit in 2013. “She hadn’t been outside since the bombing, and that was her biggest challenge for the day at that point. Seeing her smile was amazing. It was almost like being a parent — you’re so proud.”

That strength and resilience continue to inspire Schlitt, who will run this year’s Boston Marathon to support trauma survivors like Reny on behalf of the Stepping Strong Marathon Team.

“A lot of what I teach my patients is what the Stepping Strong Center also values: getting patients back to doing what they love,” said Schlitt, who is now a Wound and Ostomy nurse. “Stepping Strong and the Renys have turned something so tragic into something positive, and it’s been incredible to see Gillian flourish into the lovely young woman she is today after going through everything she did. I couldn’t think of a better team to run for or support.”

Although Schlitt is a longtime runner, this will be her first marathon. Even after a few setbacks in her training, she says her momentum and motivation grow stronger each day.

“Marathon training is not easy, but when I think of what Gillian and so many of my patients have gone through, it helps push you through everything,” she said. “Gillian woke up every single day, ready to conquer a new day and a new challenge. There is no reason that I cannot get one foot in front of the other and continue training, no matter what.”

It’s a dedication she also brings to her nursing practice.

“When you are with a patient, they are the only one in that moment,” Schlitt said. “You take a deep breath, push aside whatever else is going on and ensure your patient feels like they are the only person you are caring for that entire day.”

Paul “PK” Kent

Paul Kent, 58, had both of his legs amputated below the knee, but don’t ever tell him he’s suffered limb loss. Quite the contrary, he insists. Becoming a bilateral Ewing amputee gave him everything — most importantly, his life.

Kent stands on a surfboard with his new prosthetics for the first time at York Beach in Maine.

Kent, who goes by PK, developed a genetic peripheral neuropathy in his 30s that, by his late 40s, led to near-constant wounds on his feet. Although he felt no pain, the condition led to life-threatening infections that required frequent hospitalization.

Once an endurance athlete and avid swimmer, Kent found himself struggling to do basic tasks. His health concerns became so grave that the single father of two stopped planning family vacations, unable to even think a few months ahead.

“Every day, I lived with a fear of death because a wound could turn into sepsis. The day of my surgery, Dec. 1, 2020, my life changed for the better — immediately,” Kent said. “I probably wouldn’t be alive today without the Ewing amputation.”

In 2016, a clinical team led by the Brigham’s Matthew J. Carty, MD, a surgeon in the Division of Plastic and Reconstructive Surgery and director of Strategy and Innovation at the Stepping Strong Center, in collaboration with Hugh Herr, PhD, of the Center for Extreme Bionics in the MIT Media Lab, invented a new type of lower-limb amputation procedure, known as the Ewing amputation.

Named after the experimental procedure’s first patient, Jim Ewing, the Ewing amputation preserves normal signaling between the muscles and the brain. Compared to a standard amputation, the Ewing procedure maintains natural linkages between muscles in an amputated leg, so amputees feel as if they are controlling their physiological limb, even though it’s been replaced by a prosthesis.

Once he healed from surgery, Kent was eager to put his new prosthetic limbs to good use.

“When I stood up on a surfboard for the first time this past summer, it told me there are no limits on what I can do,” he said.

Next on his list: running the Boston Marathon, which he will do this year for the first time as a member of both the Brigham’s Stepping Strong team and Spaulding Rehabilitation Hospital’s Race for Rehab team.

The Stepping Strong Center’s bold vision for trauma innovation makes it a powerful incubator for ideas that can transform the lives of amputees, Kent said. In particular, he is impressed with the center’s support of early-career investigators and novel projects that may not necessarily garner traditional research funding.

“I like what’s going on at Stepping Strong and the progressiveness of the program,” Kent said. “It incentivizes out-of-the box thinking.”

Kent is also on his own mission to improve the lives of fellow members of the disabled community, having recently launched (dis)ABLED Life Alliance, a public benefit corporation whose first initiative is focused on increasing access to prosthetic devices.

Although he knows the marathon is an ambitious challenge, Kent says nothing can stop his momentum.

“I’ve been held back for so long,” he said. “As Dr. Chris Carter over at Spaulding said to me, ‘Your victory is showing up at the starting line.’”

Vanessa Welten, MD, MPH

From left: Vanessa Welten is joined by her father, Harry, during a road race; Harry Welten achieves his career best at the 1994 Boston Marathon; a young Harry Welten with baby Vanessa.

Vanessa Welten, MD, MPH, was navigating the usual stressors and challenges of her first year of surgical residency in February 2019 when tragedy struck: Her father, Hendrikus “Harry” Welten, was killed when he was struck by a vehicle while out on a run after work near their family’s home in Ottawa, Canada.

Welten felt like her world came crumbling down.

“It was devastating,” she said. “I needed to find a way to channel my grief.”

Her path to recovery started with taking up the sport her father loved: running. An elite marathoner, Harry Welten had been competing in marathons since his late 20s. On April 18, 1994, he achieved his personal career record of 2 hours, 21 minutes and 45 seconds in the Boston Marathon, finishing as the first Canadian and 52nd overall.

Exactly 28 years later, Welten will follow in his footsteps — literally — and honor his memory by running this year’s Boston Marathon with the Stepping Strong team.

“I learned about Stepping Strong through my work experience, and their mission really resonated with me — the idea of turning tragedy into hope,” said Welten, now a fourth-year resident in General Surgery at the Brigham. “I decided I’m going to do this for my dad, for me and for this bigger cause.”

Training for the race has helped Welten process some of her grief. While running, she listens to music that reminds her of her father: Bruce Springsteen, The Who and Bryan Adams.

“I feel closer to him, but it’s a mix of emotions,” she said.

While Harry Welten had plenty of his own boast-worthy accomplishments, his greatest pride and joy — and what he bragged about the most — were his daughters.

“He would tell everyone every single detail of our lives, regardless of whether they wanted to hear about it. He was so proud of us,” Welten said. “But our accomplishments are in large part a reflection of what he did for us. He wanted us to excel and pushed us because he saw our potential. He encouraged and supported us, and never put a limit on anything we wanted to accomplish. He was our family’s cheerleader and the type of person who made you feel like you mattered.”

Her own family’s experiences have also underscored why a patient- and family-centered approach is essential to surgery.

“I wasn’t the trauma victim, but I very much feel tied to the trauma that happened to my dad,” she said. “When I see patients who have experienced devastating trauma or injuries, I’m also always trying to clue in on those support people in their lives who might be struggling. Taking care of a patient is so much more than taking care of the ailments that you see. It’s a much bigger picture and requires a much bigger team, and that goes back to Stepping Strong. They emphasize a holistic approach to healing because they consider all the different ways trauma can impact someone.”

From left: Fraternal twins Rosh and Roshan Sethi trained at the Brigham together and continue to practice here today.

In celebration of National Siblings Day on April 10, Brigham Bulletin is highlighting an unlikely pair: twin brothers Rosh Sethi, MD, MPH, of the Division of Otolaryngology–Head and Neck Surgery, and Roshan Sethi, MD, of the Department of Radiation Oncology.

When patients entered the primary care clinic of Asha Sethi, MD, in Calgary, Alberta, they could expect two precocious and enthusiastic individuals to assist them at the front desk: her 10-year-old twin boys, Rosh and Roshan, who often shared a single chair as they checked in patients and retrieved their paper charts.

Quite literally underfoot in their mother’s clinic as children, the Sethi twins say this early exposure to patient care put them on the path — nearly the same one, in fact — to their own medical careers. Both trained at the Brigham and continue to practice here today.

“We just lived in that clinic. We had our entire childhood there,” recalled Roshan, who splits his time between caring for cancer patients as a radiation oncologist and writing and directing film and TV in Hollywood.

“Being of service was something we were taught from a very young age, mainly by our mother,” he added. “Medicine can be a noble, selfless profession, and that was very much the way our mom did it. She would arrive early and stay late. She took care of thousands of patients in the northeast of Calgary, which was an area heavily populated by immigrants where primary care options were limited.”

With encouragement from their mother, the brothers began volunteering as young teens at Tom Baker Cancer Centre, serving high tea to patients. The experience further inspired them, as both gravitated toward areas of medicine involving cancer in their adulthood.

Rosh, a surgeon specializing in complex head and neck tumors and microvascular reconstruction, also studies innovations in treating such cancers as a researcher with the Center for Surgery and Public Health. His areas of focus include oncologic care health outcomes and cost-reduction measures for patients undergoing treatment for head and neck cancer.

“We had an early exposure to medicine, but for some reason I was hooked on surgery at a very young age,” Rosh said. “I would read Grey’s Anatomy at the school library, and later I would watch YouTube videos of surgeries. I loved anatomy and that focus on patient care.”

“I think it comes down to our parents, especially our mom, who always felt strongly that we should be together,” says Rosh Sethi.

Rosh and Roshan, who are fraternal twins, went on to attend Yale University together as undergraduates, lived together as roommates and enrolled in most of the same classes. They both attended Harvard Medical School as well before embarking on residency together at the Brigham. And when it came time to decide where to continue their careers, the Sethi brothers say there was no question about where they wanted to be.

“We always felt a natural inclination toward the Brigham because of the people we worked with and the environment here,” Roshan said.

And while so much of their lives have overlapped, the brothers are the first to acknowledge the differences in — or rather, complementary nature of — their personalities. They are each other’s biggest fan.

It was no surprise to his brother that Rosh — patient, precise and a gifted visual artist — went into surgery. Meanwhile, Roshan is the more animated, free-thinking twin, with a creative mind, photographic memory and talent for storytelling that has allowed him to flourish in two careers, his brother said.

Even for twins, who are often close-knit by nature, the pair share an exceptionally tight bond.

“I think it comes down to our parents, especially our mom, who always felt strongly that we should be together,” Rosh said. “She wanted us to stay together, learn from each other and remember that we’re always the best of friends.”

“We’ve been side by side since the womb,” Roshan added. “Family is really important in Indian culture, and there’s an expectation of staying close. Although that filtered down to us in the way that we were raised, I also just feel like it was meant to be.”

Making a pot of coffee, getting dressed, changing a baby’s diaper — these are everyday tasks that many people don’t give a second thought. But seemingly ordinary activities can quickly become difficult and demoralizing for patients with a neurological condition that impairs their fine motor skills, such as Parkinson’s disease, or those who are recovering from a stroke or brain injury.

Helping these patients regain function and independence is occupational therapist Nicole Mannion, MA, OTR/L, whose newly established role is bringing more complex, specialized care to the Greater Boston area.

Part of a multidisciplinary team delivering outpatient neurological rehabilitation in Foxborough, Mannion said patients with neurological conditions often have multiple concerns that become closely intertwined with their rehabilitation work.

“It’s atypical that you’re only treating motor issues from a stroke,” she explained. “As you start to care for a patient, you realize they have problems with their vision, executive functioning or ability to problem-solve, or they may have post-stroke depression. Then you add challenges with transportation and navigating the health care system, which can be especially difficult for someone with a cognitive impairment. Those are some of the things that make treatment more complex.”

Part of Rehabilitation Services, the Brigham’s Occupational Therapy team consists of 15 inpatient occupational therapists (OTs) and eight outpatient OTs who support clinics at the main campus, 850 Boylston St. and Foxborough. Mannion is the first and only neuro-focused outpatient OT.

Helping patients find alternative ways to comfortably perform everyday activities and tasks, OTs assist patients in adapting to challenges with their movement and coordination due to an illness, injury or disability. For the patient population Mannion cares for, this can include helping someone recovering from a stroke to use the bathroom by themselves. Recently, she cared for a young mother who was struggling to change her baby’s diaper after a brain injury caused uncontrollable movements in her hands.

A large part of her job is helping patients feel comfortable discussing their goals and limitations, Mannion explained.

“You get down to talking about things that are very personal, and that can sometimes be hard for patients,” she said. “In addition to building rapport with patients, I try to validate their experiences. These patients are living with major issues, and well-meaning family members often say things like, ‘You’re going to be fine,’ but sometimes that’s not what people need to hear. They want validation that this is extremely hard and life-changing.”

Celebrating the progress that her patients make is the best part of her day, Mannion said.

“When they say, ‘Oh, my gosh! I can do this now,’ it’s a really good feeling,” she said. “Being part of these bigger, life-changing events has always been of interest to me. I feel better when I can do things to help.”

Multidisciplinary Care in a Community Setting

In addition to Mannion, the specialized Neuro Rehab team at the Brigham and Women’s/Mass General Health Care Center in Foxborough includes physical therapists (PTs) and speech language pathologist. Adding an OT to the team has enhanced the quality of care across the spectrum of rehabilitation services, explained Beth Regan, MS, CCC-SLP, the team’s senior speech language pathologist.

“We tend to share patients within our caseloads and frequently engage in discussion about goals we are working on, as well as the patient’s strengths and areas for improvement,” Regan said. “This can really be helpful in treatment planning, especially with more challenging neurological diagnoses.”

Mannion noted that making this kind of specialized OT care available in an outpatient, community-based setting is not only about convenience. For patients with neurological conditions, it can make a difference in whether they access care at all.

“For patients who live outside of the city, it’s easier to get here. While that’s important for everyone, it’s especially important for these patients because they often rely on someone else for transportation,” she explained. “And because this site has a comprehensive program, patients can come here and see Speech Therapy, PT and me all in the same place. It makes the care so much more fluid, and for neurologic issues it’s pretty rare to find a clinic that has all three specialties.”

Nancy Kelly, MS, OTR/L, clinical supervisor of Occupational Therapy, described Mannion as “the perfect person to lead the way” in elevating care, especially where the need is so great.

“Expanding our outpatient expertise to include intervention for people who have neurological conditions has been a long-term goal of mine,” Kelly said. “Nicole brings excellence and enthusiasm to her role, and her patients receive outstanding care.”

Occupational Therapy Month is held every April to honor occupational therapists’ substantial role in improving patients’ health and quality of life. In celebration of Brigham OTs, Brigham Bulletin is highlighting one of the many exceptional OTs who play a critical role in our delivery of high-quality, patient-centered care.