“This co-location is a super-charger in terms of exchanging ideas and information,” says pain medicine specialist Christopher Gilligan (right), shown discussing a recent case with orthopaedic spine surgeon Melvin Makhni (left).

After completing a long-distance run last year, Wendy started to feel pain radiating from her lower back into her legs. Within days, she couldn’t walk, let alone run. Even sitting — something she did for 10 hours a day at work — became excruciating.

Oh, no, she thought. Not again.

Wendy (who requested her last name not be used) had experienced a debilitating back injury several years prior. Although the location of the pain was different this time, its severity was all too familiar. And as someone who thrived in an active lifestyle, her heart sank at the possibility of having her mobility compromised again.

Fortunately, she knew exactly whom to call: James Kang, MD, chair of the Department of Orthopaedic Surgery, who led the team that performed her last back surgery about four years ago.

After Wendy underwent an X-ray and MRI for her more recent issue, she expected Kang to start discussing options for another surgery, but the direction of their conversation surprised her. He suggested she meet with Christopher Gilligan, MD, MBA, chief of the Division of Pain Medicine, to see if epidural injections would sufficiently manage her back pain.

At first, Wendy acknowledged, she was skeptical. With her first back injury, specialists at other institutions had recommended injections, which were ultimately unsuccessful. On the other hand, she wasn’t eager to undergo another surgery. Wendy said she put her trust in her Brigham care team, and, sure enough, the injections resolved her pain and restored her function.

“It’s a thousand times better,” she said. “I’m back to running three miles a day, going to yoga and Pilates, and doing Crossfit. I’m also training for the Pan Mass Challenge and actually just did a 50-mile bike ride a couple of weeks ago, too.”

It wasn’t just the quality of care and speed of her recovery that amazed her, Wendy says. The seamless collaboration her providers demonstrated, and the ease with which staff swiftly managed her referrals and insurance approvals, left a lasting impression as well.

“As the patient, you’re already exhausted and in pain. The last thing you want to do is run around and find out who to see next,” Wendy said. “My doctors and their staff bend over backwards to coordinate with each other, and they try to find every possible solution and see what someone else may have missed.”

“It’s a thousand times better,” says Wendy, who is back to doing what she loves most — staying active — after undergoing epidural injections in her lower back.

That’s exactly the experience that Gilligan says every patient can expect to receive at the Brigham and Women’s Spine Center, a new service line that seeks to enhance spine care through improved multidisciplinary collaboration, expanded and more timely access to care, and a more seamless experience for patients and referring providers.

“When a patient has neck or back pain, there are a lot of different types of specialists they could see. How would they know who’s the right one for their concern? That complexity is a real and understandable source of frustration for patients,” said Gilligan, who serves as director of the new Spine Center. “We’re taking the burden of navigation off patients and referring providers. All they need to do is call or email the Spine Center, and we’ll take care of the rest. We’ll get them to the right provider at the right place at the right time.”

A Collaboration ‘Super-Charger’

With a combined team of neurosurgeons, orthopaedic surgeons, pain medicine specialists, physical medicine and rehabilitation specialists, advanced practitioners and other clinical staff, the Spine Center delivers integrated care and innovative treatments for spine patients.

“We may all see the same type of patient, but we each have different tools in our toolbox,” said Spine Center neurosurgeon Hasan Zaidi, MD, who also serves as co-director of the Adult Spinal Deformity and Scoliosis Program. “The best way to support our patients is to put all these great minds together, which we’ve been doing for years. Now we are strengthening our collaboration even more with the launch of this Spine Center.”

It’s far more common for these specialists to have clinics independent from one another, Gilligan said, but the Spine Center is based on the notion that multidisciplinary collaboration between these providers is essential to providing the best care. That’s why one of the center’s founding objectives is to have surgical and non-surgical providers “co-located” in, or share, the same physical workspace.

“We write our notes sitting next to each other in the same physician workroom. We’re looking at the patient’s MRI together. We’re talking about their case together,” Gilligan said. “This co-location is a super-charger in terms of exchanging ideas and information.”

To improve access to care, the Spine Center provides services at 10 locations, including the main campus in the Hale Building for Transformative Medicine as well as sites in Chestnut Hill, Foxborough, Framingham, Jamaica Plain, Milford, Mansfield, Pembroke, South Weymouth and Westwood. The team also includes several physician assistants who specialize in spinal care to expand access and reduce wait times.

“This is such an extraordinarily talented team with an outstanding depth of quality in different fields. To my mind, the level of spine expertise we have at the Brigham is unmatched,” Gilligan said. “I’m incredibly enthusiastic about the many ways in which we’ll provide patients with enhanced care while just making it that much simpler for patients to get the care they need.”

To contact the Spine Center, call 877-777-2134. For an e-referral, Brigham providers can use the Epic referral name “BWH Spine Center.”

Top row, from left: Laurie Quimby, Bernie Jones and Salmaan Keshavjee; Bottom row, from left: Carmen Santos and Monik Jiménez

As an epidemiologist who studies the health of people in prisons and jails, Monik Jiménez, ScD, SM, FAHA, has become accustomed to hearing people react with cynicism or scorn when she talks about her work.

“I’ve actually had people say to me, ‘You know what? They deserve to be there,’” she said.

But rather than wear her down, such responses only re-energize Jiménez to remind others about why everyone should care about protecting the health of marginalized communities, including incarcerated people.

“I share my lived experience. My father was incarcerated for a large portion of my life — a big piece of my childhood and adolescence — and so I tell them, ‘You’re talking about my father. You’re talking about somebody’s brother, sister, mother or our elders.’ I try to humanize it for people,” said Jiménez, sharing her perspective during a recent Lead the Change virtual panel discussion, “Prisons and Jails: Reform, Re-entry and Decarceration.”

“The experience of incarceration on an individual or a community is an important public health issue, and it is a confluence of the structural racism and inequity within our country — manifesting in the ultimate type of marginalization,” Jiménez continued. “This is our lane. It impacts the lives of our patients and their communities.”

Moderated by Bernie Jones, EdM, vice president of Public Policy, the July 8 event also featured reflections from Salmaan Keshavjee, MD, PhD, a member of the Brigham’s Division of Global Health Equity and director of Harvard Medical School’s Centre for Global Health Delivery, Laurie Quimby, MD, former medical director of Essex County Correctional Facility, and Carmen Santos, a specialist in Workforce Development at Mass General Brigham and coordinator of the Brigham’s SUCCESS Program.

Breaking the Cycle

The panel’s wide-ranging discussion explored how incarceration affects the health of individuals and communities, contributing factors such as systemic racism and classism, and the continued stigma and inequities that current and former inmates face.

“We suspend our moral frame for how humans should be treated when we think of prisoners,” Keshavjee said. “They’re punished, but the punishment never ends. The punishment means they can’t get jobs. They’re stigmatized in society. When you start to look at this from the medical perspective, this is deleterious to people’s health.”

Speakers also discussed ways to address these inequities and support people re-entering society. One example of this is the Brigham’s SUCCESS Program, which provides job opportunities at the Brigham to people who have been disconnected from the workforce due to nonviolent offenses.

Participants in the program who successfully complete a 90-day pre-employment period can transition to a full-time position. Candidates also receive additional support for both professional and personal needs — including skills training and assistance with childcare, food and transportation — to set them up for success, Santos explained.

“The great part about this program is that we’re offering an opportunity — giving people a second chance and that feeling of belonging, connecting and employment, which is greatly needed,” Santos said. “It really makes me proud to say that we offer this at the Brigham because it’s an opportunity for someone to really have a chance to grow in the Brigham community and add to our fabulous organization.”

Addressing COVID-19

From a public health perspective, prisons and jails can become “epidemiologic pumps,” explained Keshavjee, who has long studied and developed interventions for the transmission of another contagious disease, tuberculosis, in Russia’s prison system.

“People go in and out of prisons and jails, so if someone gets infected, it actually puts the disease back in the community,” Keshavjee said.

During the COVID-19 pandemic, this reality became especially apparent as prisoners, detainees and guards were moved between different environments, he said.

“There’s 55 percent turnover in the U.S. jail population each week, so this provides a constant supply of people who may have been previously exposed to a virus — in this case, SARS-CoV-2,” Keshavjee said. “Because of this constant movement, it’s not a surprise that there have been 620,000 COVID-19 cases in prisons.”

Throughout the pandemic, it has also been important to look beyond the statistics and understand how COVID-19 has affected incarcerated individuals’ physical health, mental health and basic living conditions, Jiménez said. Getting these types of insights has been challenging for researchers, who have been able to accomplish it largely through partnerships with community organizations that work closely with incarcerated populations, Jiménez said.

In conducting their surveys, one discovery for Jiménez and her colleagues was how physical distancing — a cornerstone of preventing the transmission of COVID-19 — translated in a carceral (prison or jail) setting. Inmates were confined to their cells or housing units for 23 and half hours per day, with such lockdowns lasting for more than a year in some parts of the country.

“We learned was that a large proportion of people did not have access to basic needs — toilet paper, access to regular showers, water. They also had reduced access to mental health care and medical care,” Jiménez said. “COVID-mitigation strategies employed within a carceral setting have led to incredibly punitive conditions of confinement and, I would even argue, violations of human rights.”

One possible solution panelists explored was decarceration, or the early release of people from prisons and jails, with the goal of reducing density in such settings.

“Decarceration is a public health tool,” Jiménez said. “Carceral settings are very porous ecosystems; people are moving in and out. What happens behind the wall happens into the free world, so it’s imperative for us to broaden how we think about public health measures.”

To receive information and updates about upcoming events, email leadthechange@bwh.harvard.edu and request to be added to Lead the Change’s mailing list.

Even after undergoing brain surgery and radiation therapy to treat brain cancer, 14-year-old Shadiamond Perez emanates an unrelenting sense of optimism — dancing and laughing everywhere she goes.

Her enthusiasm for life is so infectious that her Brigham care team in the Department of Radiation Oncology was inspired to organize several impromptu musical performances for Shadiamond and her family to comfort them during Shadiamond’s treatment sessions.

Sydney Sanford, head of the Child Life Program in Radiation Oncology, was one of the first individuals Shadiamond encountered upon beginning treatment. An expert at easing nerves and bringing lightheartedness to high-stress situations, particularly for younger patients, Sanford quickly became a friendly, familiar face to Shadiamond and her family.

“Every day, for six weeks, at 7 a.m., my mornings were brightened by Shadiamond and her incredible grandparents,” said Sanford. “She is a true ray of light who spread happiness to anyone that she encountered.”

Recognizing Shadiamond’s passion for music and dance, Sanford urged a colleague, Denis Surette, a radiation therapist in the department, to play his guitar for Shadiamond and her family, as he periodically had for other patients and Brigham staff.

In the quiet lull of the children’s waiting room, as Shadiamond prepared for radiation therapy, Surette strummed his guitar and softly sang songs that he found meaningful. Shadiamond hummed and swayed along to the music, greeting whatever fears she had with a smile.

For Surette, these moments were poignant. An avid believer in the healing powers of music, Surette had brought his father’s old guitar to the pediatric playroom in the Department of Radiation Oncology at the Brigham, where staff, patients and families could enjoy plucking its weathered strings.

“It was special,” said Surette, who recently left his role at the Brigham, reflecting on his performances for Shadiamond and her family. “Music can resonate with everybody. It meant a lot to me to be able to make Shadiamond happy.”

Although music can’t undo the hardships Shadiamond has endured, her family says it reminds them of the goodness that remains in the world.

“Shadiamond was always asking, ‘Where’s the guitar guy? I want him to play me a song,’” said Jacqueline Perez, Shadiamond’s grandmother. “They all loved her, and they treated us so kindly.”

“She is a true ray of light,” says Sydney Sanford (right) of her young patient, Shadiamond Perez (left).

‘She’s a Miracle’

While Perez shares her granddaughter’s strong spirit, she said that the past year was incredibly challenging for her and her family. As the world around her was consumed by politics and the ongoing COVID-19 pandemic, Perez says her primary focus this past year has been ensuring the precious granddaughter she raised from birth became healthy again.

Although Shadiamond struggled throughout her young life with frequent seizures, electric shock sensations and chronic asthma, Perez never anticipated her granddaughter’s cancer diagnosis. On March 4, Perez tucked Shadiamond into bed at 8 p.m., as she always did. A mere fifteen minutes later, she heard Shadiamond cry out for help, claiming that her head was in excruciating pain. Knowing that Shadiamond was prone to severe migraines, Perez laid her down on the couch and watched her anxiously. When Shadiamond became disoriented and began vomiting, Perez knew that something was wrong and called 911.

Shadiamond was rushed by ambulance to a hospital near their home in Springfield, Mass. where the doctors quickly determined that she was experiencing internal bleeding of the brain due to a five-centimeter blood clot. Later that night, Shadiamond and her family were transported by helicopter to Boston Children’s Hospital. After consulting Perez, doctors in the Intensive Care Unit performed an operation to reduce Shadiamond’s internal bleeding, both removing a bone and temporarily placing tubes in Shadiamond’s head.

“I went ballistic,” said Perez. “I just cried and prayed.”

Shortly later, they performed a biopsy, determining that Shadiamond had a cancerous tumor on her brain and would need surgery to remove it, followed by five weeks of radiation therapy at the Brigham.

Despite experiencing some newfound challenges with her vision, and some minor difficulty with the mobility of one hand, Shadiamond woke up from this third surgery as her same happy self — her resilient spirit unscathed, her desire to dance stronger than ever. Still, Perez said that there are challenges on the horizon.

During a recent follow-up appointment, Shadiamond received an MRI, leading to the discovery of another brain tumor. Shadiamond’s sunny outlook continues to shine, however, and her family continues to remain hopeful that a bright future lies ahead.

“She’s a miracle,” said Perez. “They thought she wasn’t going to remember us and other family members. She did. Thank God. All the prayers make miracles.”

Daniela Lamas on the set of The Resident during the show’s second season, which was filmed in 2019. Lamas continues to serve as a writer on the show, which enters its fifth season this fall.

Daniela Lamas, MD, a pulmonary and critical care physician at the Brigham, has always enjoyed the heart-pounding experience of watching medical dramas on TV. Lamas has been passionate about medicine all her life, whether practicing it herself or enjoying its depiction in fiction.

Although Lamas had long dreamed of writing for a TV medical drama — and attempted for years to reach out to TV producers — it wasn’t until 2018 that opportunity struck.

Roshan Sethi, MD, an attending physician in the Department of Radiation Oncology, happened to be the co-creator for The Resident, a Fox medical TV drama that follows the lives of doctors and nurses at the fictional Chastain Memorial Hospital in Atlanta and enters its fifth season this fall. Recognizing the Brigham connection, Lamas applied for a position on The Resident’s writing team. Sethi and his fellow producers were quickly intrigued.

Not only did Lamas have an array of unique writing experiences— which include publishing her own book, You Can Stop Humming Now: A Doctor’s Stories of Life, Death, and In Between, and contributing to the New York Times — but she also had a reservoir of firsthand knowledge on the medical field. Although Sethi left the show to complete his residency and work in movies shortly before Lamas joined the writing team, Lamas was nonetheless grateful for the Brigham connection.

“She brings real insight to the show but also understands the demands of network entertainment,” Sethi said.

Upon beginning her new role, Lamas’ creative faculties quickly got to work. The stories, bred out of years of experience working in a hospital, came pouring out of her.

Lamas quickly noticed several similarities between her roles as a doctor and TV writer. In both contexts, she said, collaboration and teamwork are key. However, Lamas noted that there are also some striking differences between how the medical field is represented on TV and what she witnesses at work.

“In TV, I think we often come down on the side of drama,” said Lamas. “They tell me often ‘this is not a documentary.’ The way we tell stories about the characters can create a patient outcome that is not completely realistic.”

Introducing Authenticity

Lamas noted that TV rarely shows the complexity of medicine, especially when it doesn’t follow a straightforward path or lead to a satisfying conclusion. The sometimes painstakingly slow procedures or the ever-puzzling feeling that nothing more can be done to save someone don’t necessarily align with high-stakes, fast-moving, against-all-odds plotlines on network TV.

Daniela Lamas on the set of The Resident with Malcolm-Jamal Warner, who plays surgeon A.J. Austin (“The Raptor”) on the show, in 2019

Lamas is committed to making The Resident more reflective of reality through creating narratives that will grip, move and resonate with her audience, while still maintaining as much authenticity as possible.

“I used to watch television and think, ‘Why can’t it be more realistic?’” she said. “But there are these mandates to make things dramatic, have happy endings and have the moment before the commercial be built up to this escalation.”

While sometimes unrealistic, these fictional plotlines can also be viewed as a platform for spreading awareness around lesser-known illnesses.

Several years ago, Lamas had a patient who was diagnosed with sickle cell anemia and was hospitalized on a ventilator for several months before she passed away. The patient’s enthusiasm for people, poetry and life itself made her presence linger in Lamas’ mind. With permission from the patient’s family, her story eventually inspired a character, Rose, who appeared in the most recent season of The Resident.

While Lamas’ patient — only 30 years old — was not able to overcome sickle cell anemia, the character in the show is introduced to an innovative form of gene therapy, which ultimately saves her life.

“My patient’s family members who were able to watch the episodes said they found it meaningful to have sickle cell disease in a network TV show because it helped increase understanding, at least among those they had talked with who had seen the show,” said Lamas.

Portraying the Pandemic

Perhaps the greatest challenge Lamas and her fellow writers faced this year, however, was deciding how to represent the COVID-19 pandemic in a single 45-minute episode. Not only did they have to figure out which stories to tell, but they also had to predict what a post-pandemic world would look like in the episodes that followed.

Creating a script that generates realistic characters and plausible scenes is no easy task. Since becoming a TV writer, Lamas said she pays closer attention to her surroundings and to the nuances of human behavior.

“When you’re thinking about a script, you have to think about where people are in a room and what they are going to do or say,” she said. “Thinking in three dimensions while writing is something I have never done before, but it is useful for all types of writing.”

This perceptiveness also serves Lamas well in the hospital. As a physician, she continually bears witness to suffering and healing — experiences that add meaning to her life.

“Working in the medical field, you have this amazing passport into these extraordinarily important, scary, sad, hopeful moments in people’s lives,” she said. “Sometimes, I think about letting the writing take all my time, but I love being a doctor so much. I’m extraordinarily lucky to be able to do both.”

Clockwise from upper left: Frances Grimstad, Kathryn Rexrode, Rodrigo Aguayo-Romero and Sari Reisner

Ensuring that research is inclusive and respectful of transgender and gender-diverse identities often begins with asking the right questions for the right reasons.

How are transgender individuals being represented in a study? From a research perspective, is it more informative to know a person’s biological sex or their gender? Which practices are being used to gather data and are they inclusive?

On June 30, a group of experts from the Brigham and beyond explored these questions and more during the virtual panel discussion, “What Does Transgender and Gender Diverse Inclusivity Look Like in Research?”

The panel — which featured Rodrigo A. Aguayo-Romero, PhD, a research fellow in the Department of Medicine at the Brigham, Frances Grimstad, MD, MS, director of Trans Reproductive Health Services at Boston Children’s Hospital, and Sari L. Reisner, ScD, director of Transgender Research in the Division of Endocrinology, Diabetes and Hypertension at the Brigham — cast light on practical ways to cultivate a greater sense of equality and representation for transgender and gender-diverse individuals in research.

Moderated by Kathryn M. Rexrode, MD, MPH, chief of the Division of Women’s Health, the

hour-long event was hosted by the Brigham Research Institute (BRI) and the Center for Diversity and Inclusion in celebration of Pride Month and drew a wide audience of researchers, professors, health care workers and students.

‘We Have Different Dimensions of Gender to Consider’

In order to be as accurate as possible in the representation of data in research projects, all three panelists emphasized that researchers must recognize gender is not binary — meaning that it is more than simply male or female. Rather, they noted, gender is a nuanced spectrum that is sometimes more relevant to a study than biological sex.

Grimstad said a study that focuses on adolescents’ transportation preferences is an example of a situation in which defining the participants’ internal sense of identity would be far more informative than knowing their biological sex characteristics.

Discerning when to ask about sex and when to inquire about gender may seem like a complex task, but Reisner affirmed it is a crucial step in making respondents feel seen and heard.

“When we are talking about gender, we are talking about the sociocultural dimensions that become mapped onto biology,” said Reisner. “Oftentimes, we have different dimensions of gender to consider, such as gender identity, meaning a person’s internal felt sense of themselves, or gender expression. These different dimensions have been shown to matter, and I’d encourage everyone to think about which are important and when in your own research.”

Dismantling Power Imbalances

Ensuring gender equity for transgender individuals in research requires more than simply reflecting on the various dimensions of gender, however.

“Inclusivity refers to the continuous work to dismantle power imbalances and create equity in positions of power and decision-making roles — not only behind the scenes in research but also in the research itself — in order to ensure that those who come from historically marginalized identities are given a voice to be heard,” said Aguayo-Romero.

For transgender and gender-diverse individuals’ voices to be heard, they must first be given the freedom to define themselves on their own terms, experts explained. In discussing data collection strategies and surveys, panelists said that researchers must be wary not to unintentionally project a limited view of gender identity onto research participants. This means diversifying both the questions they ask during studies and the potential ways participants can respond.

For example, rather than forcing participants to select a single, static gender identity when collecting demographics, Grimstad suggested asking, “What is the closest and most comfortable descriptor of your gender right now?” Not only is this word choice more inclusive, but it also ensures that the data collected is as accurate and thorough as can be.

“We as researchers cannot deny we get to choose the questions we engage in, which means that there is bias in the research we are doing,” said Grimstad. “This means that if we are working with a community that has been historically marginalized and underserved and excluded, then it is our duty to think intentionally about how the questions we can ask can work toward their liberation.”

The panelists agreed that it is only when researchers begin to ask these questions that their respondents will be able to answer freely and authentically — allowing their voices to fully resound in the data.

Paula Smith

Brigham and Women’s Hospital mourns the loss of Paula Smith, a unit coordinator on Braunwald Tower 15, who died April 25 of brain cancer. She was 32.

Remembered for her gentle nature, artistic spirit and quiet brilliance, Ms. Smith made a lasting impression on the many patients, families and staff whom she encountered in her eight years at the Brigham, according to colleagues.

“Paula was an amazing soul. She saw the good in everyone and the goodness in any situation,” said her mother, Lelias Blake, BSN, RN, a Float Pool nurse. “Throughout her illness, she was steadfastly positive in the face of such an unrelenting and ravaging disease. Her ability to remain so composed and endure so much with such dignity will always be an inspiration to me.”

A trained writer, artist and illustrator, Ms. Smith routinely found ways to use her natural gifts to lift the spirits of her patients and colleagues. To help patients from other countries feel more at home, Ms. Smith would often draw a picture of their native country’s flag and bring it to their room. During the winter holidays, she illustrated colorful decorations for her unit. And when she learned that one of her patients loved cats, Ms. Smith sketched an image of a charming kitty and delivered it to the patient’s bedside, much to their delight.

Ms. Smith used her artistic talents outside of work as well. Before her death, she wrote, illustrated and self-published a children’s book, How to Hurry up Slowly, about a snail named Jasmine. She had an opportunity to hold the book in her hands a few days before she died, her mother recalled.

“She had the biggest smile on her face when she held it close to her chest,” Blake remembered.

As a unit coordinator, Ms. Smith was devoted to her work and ensuring the unit ran smoothly, said Aimee Davis, BSN, RN, a nurse on Braunwald Tower 15.

“She was always responsive, supportive and cheerful in working with the nurses. She had many capabilities and did this job to her fullest to support the rest of the team,” Davis said.

Underneath Ms. Smith’s quiet demeanor was a thoughtful heart, curious mind and clever wit that made her a cherished friend and colleague, Davis added.

“She was a very bright woman with so much creativity and rich life experiences,” Davis said. “If you took the time to chat with her, you’d quickly realize what a treasure she was.”

Jennefer Trowers-Smith, RN, a nurse on Braunwald Tower 15, agreed.

“The way Paula would listen and respond to you — she just had this soothing expression that put you at ease,” Trowers-Smith said. “I will miss her smile and that calm presence she had. She was a real sweetheart and truly like a daughter to me.”

Outside of work, Ms. Smith is also remembered for her adventurous nature and love of travel, having visited 14 countries in her lifetime. A Boston native and proud daughter of Jamaican immigrants, she graduated from the Noble and Greenough School and Wesleyan University.

In addition to her mother, Ms. Smith is survived by her father, Paul Smith; her brother, Randy Smith; her sister, Taylor Smith; and many aunts, uncles and cousins.

This article is adapted from content originally published on DFCI Online.

Larissa Lee

Brigham and Women’s Hospital mourns the loss of Larissa Lee, MD, a pioneer in the treatment of gynecologic cancers and director of the Gynecologic Radiation Oncology Service at the Brigham and Dana-Farber Cancer Institute, who died June 23 of advanced gastrointestinal cancer. She was 44.

Respected as a researcher, clinician, teacher, mentor and colleague, Dr. Lee was a member of the Department of Radiation Oncology since 2010. Her scientific contributions over the past decade include advances in radiation treatment techniques, trials of novel immunotherapies and studies to overcome the problem of treatment resistance. Her influence on the field of gynecologic cancers and the example she set of compassion, scientific rigor and collaborative spirit left an indelible impression, according to her colleagues.

“Colleagues from around the world sought out her mentorship, expertise and technical skills,” said Neil Martin, MD, MPH, clinical director for Radiation Oncology, who knew Lee from their days as residents at the Brigham and Dana-Farber. “Larissa served some of our most vulnerable patients with complex medical and social situations. She was absolutely beloved by her patients as they recognized her genuine care for them as individuals.”

Her compassion took many forms, colleagues said, but was always evident in a desire to be of assistance.

“When I think of Larissa, I think of a quote from Albert Pike: ‘What we do for ourselves dies with us. What we do for others and for the world remains immortal,’” said Daphne Haas-Kogan, MD, chair of Radiation Oncology.

Haas-Kogan experienced that thoughtfulness when she joined the Brigham and Dana-Farber in 2015.

“There’s always a lot to learn when starting a new position,” Haas-Kogan said. “Larissa was one of those on whom I relied. She not only taught me some aspects of radiation oncology that were outside my area of expertise but also was a model of the collaborative approach that forms the foundation of our department’s mission.”

As a clinician, Dr. Lee was known for her expertise in brachytherapy, in which radioactive material sealed in small pellets is implanted in cancerous tissue to kill tumor cells. Her reputation in this field helped make the Gynecologic Radiation Oncology Service the treatment center of choice for patients across New England and drew trainees from around the world.

Her research centered on improving the efficacy of radiation therapy and reducing its side effects. She led efforts to improve the use of biomarkers — bodily substances that can indicate a tumor’s aggressiveness or response to treatment — in addition to developing devices used in treatment and directing multiple clinical trials of potential therapies and techniques.

As an inventor, Dr. Lee helped design and test new tools for the treatment of gynecologic cancers. She developed a device that measures oxygen content within tumors during brachytherapy procedures. This information helps doctors identify portions of the tumor where oxygen levels are low, which tend to be less susceptible to radiation therapy. These areas can then be earmarked for additional doses.

“Larissa devoted her career to the study of gynecologic cancers and developing better and less toxic radiation treatments for women with gynecologic cancers,” said Ursula Matulonis, MD, chief of the Division of Gynecologic Oncology. “She was a superb and compassionate clinician who cared deeply about her patients and was a wonderful collaborator and colleague. She was a treasure to all of us who had the honor of knowing her and interacting with her. She was an incredibly special person, and she will never be forgotten.”

Associates and colleagues have moved to honor Dr. Lee with the creation of two awards in her name: the Larissa Lee Outstanding Clinician Award, for Radiation Oncology physicians who embody her qualities in patient care, and the Harvard Radiation Oncology Program Larissa Lee Mentorship Award, whose recipients will be selected by residents in Radiation Oncology at Harvard-affiliated hospitals.

Colleagues are also raising funds to establish the Larissa Lee, MD, Endowed Lecture at the Brigham and Dana-Farber to focus on the issues Dr. Lee was most passionate about.

Dr. Lee is survived by her husband, Jai Eswara, MD; their sons, Ethan and Erik; her sister, Brittany Bychkovsky, MD; her brother, Chris Mellee; and her parents, Susan and John Lee.

Donations for the lectureship can be made via its Giving Page, the Pan-Mass Challenge page of Dr. Lee’s sister, Brittany Bychkovsky, MD, of the Breast Oncology Center, or Neil Martin’s Marathon Team page.

Pat’s Place Catering Business Will Continue, Remain Located at the Brigham

From left: Pat Bruno Sr. and Pat Bruno Jr. stand behind the counter in Pat’s Place at 15 Francis St.

In the early 1970s, a hospital administrator at the former Boston Hospital for Women approached a friend and local restaurant owner, Pat Bruno Sr., to ask if he was interested in taking over the hospital’s coffee shop. The café had kept erratic hours and was in dire need of an experienced, steady hand to make it successful.

He signed on, and the first iteration of Pat’s Place opened for business in 1975. The hospital café soon became a bustling destination for staff, patients and visitors — attracting patrons from all walks of life, including the Kennedys and famed former House Speaker Tip O’Neill, recalled Pat Bruno Jr., who started working at his father’s business after school as a teenager.

Just six years after Pat’s Place launched, a significant shift in the health care landscape threatened to close the café. In 1980, several Longwood Medical Area hospitals merged — the Boston Hospital for Women among them — to form Brigham and Women’s Hospital. Approximately 500 staff members and loyal customers signed a petition urging the newly established Brigham and Women’s Hospital to find a new home for Pat’s Place.

An August 1981 edition of Inside Brigham and Women’s Hospital announced the welcome news: “Pat Bruno, the popular proprietor of ‘Pat’s Place’ at the former Boston Hospital for Women, is back in business.” Pat Sr., “known for his friendly smile and his uncanny ability to remember names and faces,” the hospital newsletter added, would serve breakfast and lunch in the 70-seat café at 15 Francis St., where it remains today.

Having cemented itself as a beloved part of the Brigham community for more than four decades, Pat’s Place will close its doors for good on July 31. The younger Pat, who took over the business about 25 years ago, said it’s time for a new chapter.

“This pandemic put things into focus for me, and I got to realize life is not all about working,” he said. “I’m approaching retirement age, my father is 86, I’m expecting my first grandchild soon. It’s a good time for me to slow down.”

Still, the moment is bittersweet, the younger Pat acknowledged.

“There are people here I’ve known for 40 years. You get to know their lives and become like their psychiatrist. You wouldn’t see that in a regular restaurant,” he said. “It can be the most esteemed doctor in the world, and they just walk into Pat’s Place for a laugh and a bite to eat. Everyone’s treated the same here.”

While the Pat’s Place café is closing, its popular catering business will remain operational and be located in the Brigham. Brigham departments and staff can continue to place Pat’s Place catering orders after July 31 by contacting Pat Bruno at p.bruno26@yahoo.com or pbruno2@partners.org.

“Pat’s Place has been a staple of our community for nearly half a century, and we’re thrilled that Pat will continue to offer his hearty and well-loved meals to our employees through his new catering-only business,” said Douglas Carney, AIA, MBA, senior vice president of Real Estate, Facilities and Operations.

The Brigham has committed to Pat Jr. and his staff to help find each employee who both want and qualify to find replacement jobs in the Brigham family if they want to stay, Carney said. The hospital is also planning for future alternative uses for the space, both long- and short-term options, to ensure there is a food service available at that end of the campus.

‘Where Everyone Knows Your Name’

A big part of what made Pat’s Place so inviting and comfortable was the friendliness, warmth and familiarity between its employees and customers. Known fondly by regulars as “the crew,” the café’s cooks, cashiers and other staff — many of whom come from the local community — are just as big an attraction at Pat’s Place as the food, said several longtime patrons.

Known fondly by regulars as “the crew,” the café’s cooks, cashiers and other staff are just as big an attraction at Pat’s Place as the food.

“Pat’s Place is very special to me. It reminded me of the TV show Cheers, where everyone knows your name,” said Florence Connolly, an operation manager in the Division of Cardiac Surgery. “When I would go in there, they all would say, ‘Flo!’ I would feel like Norman from Cheers.”

Connolly — a customer for 25 years whose favorite orders include the café’s tuna sandwich with extra pickles — was saddened to hear the news about Pat’s Place closing.

“Pat is a dear friend who always took care of me, no matter how busy he was and how many last-minute crazy requests I had. He is kind, generous and a true gentleman,” Connolly said. “He hired a hard-working crew that was dedicated to him and to all of us. Also, a special thank you to his wife, who worked behind the scenes.”

John Chi, MD, MPH, director of Neurosurgical Spinal Cancer in the Department of Neurosurgery, said stopping into Pat’s Place for coffee or a sandwich never failed to brighten his day.

“It’s not fancy. It’s not glitzy. But that’s what makes it great,” said Chi, a regular for 13 years who, as a Philadelphia native, stands by the café’s steak-and-cheese sandwich as its winning menu item. “The guys who work there are terrific. We’ll talk about football on Monday mornings during football season. I show them pictures of my kids. I’m going to miss that camaraderie.”

And when Brigham staff haven’t able to come to Pat’s Place, it hasn’t been uncommon for Pat’s Place to come to them, the younger Pat said. It’s all part of the café’s commitment to supporting the Brigham community, he added.

“A lot of the doctors get so busy in their clinics and can’t go out for lunch, so I still bring food down to them every day,” Pat Jr. said. “The people are what make this place so special. The guy who comes in and takes my trash is just as important as the president of the hospital. You see how hard people here work. They are so dedicated.”

Even after preparing countless meals for patients, visitors, staff, donors and members of the local community for more than 40 years, Pat Jr. said food is often the last thing he thinks about while on the job. In fact, his favorite meal is decidedly off-menu — his wife’s home cooking, which he looks forward to enjoying more often.

On June 17, Brigham and Women’s Hospital unveiled a new brand and logo, representing a vision for enhanced collaboration with colleagues throughout the Mass General Brigham system for the benefit of patients and their loved ones.

Here are five things to know about the new brand and logo and how they will be implemented at the Brigham. Learn more on PikeNotes.

1. It’s a Marathon, Not a Sprint

It is going to take time to switch over to the new identity. Branded items — including websites, internal communication channels, ID badges, printed materials, vehicles, signage, work wear and more — will be updated in phases over the next year. To implement the transition as economically as possible, the Brigham is taking a “deplete and replace” strategy, in which all existing supplies, stationery, etc., with our former brand will be used up before new materials are ordered. There will be a period of time when the new and old logos are used simultaneously, and that is OK.

2. Do Not Alter the Logo

The new icon and logo should not be copied or altered for any purpose. A rebrand team is supporting the rollout of the new logo and will be reaching out to areas across the hospital to inventory items that need rebranding. Any item that needs rebranding will be managed centrally through this team. There is a suite of brand resources, including branded Word documents and PowerPoint templates, available on The Pulse, as well as more information about how to properly use the logo. Learn more about the brand support and approval process on The Pulse.

3. Aligning With our Broader System

Brigham Health will no longer be used as part of the Brigham’s external brand identity, and there will no longer be a Brigham Health logo. In cases where there is a need to formally refer to a program or activities that span across Brigham and Women’s Hospital, Brigham and Women’s Faulkner Hospital and the Brigham Physicians Organization (BWPO), please write out each institution by name. For internal purposes only, it is acceptable to use the phrase “Brigham family,” when referencing collective work across these entities.

4. A New Email Signature Format Is Available Now

Updating your email signature is an effective way to share who you are, where you work and the work you do. Please take a moment to update your signature in Microsoft Outlook. Directions and guidelines are available on The Pulse to ensure your signature is consistent with the new brand. Work is underway to determine how email signature templates can feature the Harvard brand for employees who are also faculty, staff or students of Harvard Medical School, as well as how the Magnet logo should be added for those employees for whom it is relevant.

5. ID Badges Will Be Updated Soon

In the coming months, employees will receive an overlay, which is a plastic adhesive that will go on top of the existing badge. It will incorporate a new design and contain enhanced security features. For now, staff should continue wearing their ID badge with the current branding. At the appropriate time, employees will be invited to bring their ID badge to a designated area for updating. More information about the badges will be shared when this process is ready to begin.

A handful of representatives from the many teams that contributed to the long-term bed plan celebrate the project’s completion.

When the COVID-19 pandemic struck last year, teams across the Brigham rapidly mobilized to convert most of the Shapiro Cardiovascular Center and parts of the Braunwald Tower into specialized units dedicated to the care of COVID-19 patients — a transformation that required scores of patients and staff to temporarily relocate from their home units.

As the Brigham’s COVID-19 census began to subside earlier this year, a multidisciplinary team started implementing a long-term inpatient bed plan to unravel those temporary changes and return patients and staff to their original locations or newly designated home units.

After three months and more than 340 bed moves, the Brigham’s long-term bed plan was completed on June 3. The seamless execution was a testament to the collaboration of a large multidisciplinary planning team and their partners on inpatient units, hospital leaders said.

The transition also represents one of the biggest moves of patients and staff in the Brigham’s history.

“It’s difficult to describe the massive amount of coordination and collaboration that needed to happen behind the scenes to make these moves possible. From the residency leadership to staff on the units, so many people went above and beyond to ensure patient safety remained at the heart of every step we took,” said Sheila Harris, vice president of Patient Access Services. “I am so proud of how everyone came together to overcome the many challenges and achieve a safe, seamless move.”

Charles A. Morris, MD, MPH, deputy chief medical officer, agreed.

“In all my years at the Brigham, I can’t recall a project of this scope that was executed so smoothly. The team moved hundreds of patients across dozens of care areas, and did so in seamless fashion, all while the hospital was seeing an extraordinarily high volume of patients,” Morris said. “Their masterful execution allowed us to continue the critical work of meeting the needs of those in our beds as we moved beyond the COVID surge.”

‘It Was Like the Game Tetris’

The bed plan was created with input from key stakeholders to maximize quality and efficiency of care delivery, match bed allocation to service volume, facilitate regionalization, improve geographic clinical integration and maximize flexibility, among other objectives.

One especially complex challenge the team navigated was conducting the moves as the hospital’s medical and surgical census returned to pre-pandemic levels.

“It wasn’t like the move at the beginning of the pandemic, when essentially you had all these empty pods because volume in other areas was low,” said S.E. Chang, manager of Inpatient and Clinical Services Projects. “As COVID was ramping down, everything else just went straight up, so it was much harder to move people.”

To maximize safety and minimize disruption, the project team used a phased approach, moving 10 to 20 patients per day during a unit move. They worked closely with affected units to ensure areas were sufficiently staffed during the transition, as well as with the Admitting team to safely manage census and admissions.

“Ultimately, it was like the game Tetris,” Chang said. “We’d move one area, which then allowed us to move another and another. We did a lot of careful planning to really sequence that out in a safe, efficient manner.”

In addition to coordinating closely with nursing and physician leadership on the units, the teams worked with staff from Biomedical Engineering, Central Transport and Equipment Services, eCare, Engineering, Environmental Services, Food Services, IS, Materials Management, Patient Care Services, Pharmacy, Police and Security, and Respiratory Therapy, among others.

Karen Reilly, DNP, MBA, RN, associate chief nurse for Critical Care, Cardiovascular and Surgical Services, commended those involved for their extraordinary work.

“It was an incredible amount of teamwork. No one department could have done this on their own,” she said. “It just goes to show how committed people were to making this happen, and the thoughtfulness that went into planning every detail to ensure we had the right staffing, supplies, equipment, technology, layout, monitoring and so forth to care for the patient population and support the staff when we moved them.”

Reilly also applauded staff on the units for their dedication and adaptability amid so much transition.

“They were amazing. When it was their day to move, they would rise to the occasion,” she said. “They knew it was going to be challenging, but they’d say, ‘Let’s figure it out’ because they understood why we needed to do this.”

Personal finance expert Suze Orman chats with Jason Walrond, a dispatcher for Central Transport and Equipment Services, during the special event.

Personal finance expert and grateful patient Suze Orman chats with Jason Walrond, a dispatcher for Central Transport and Equipment Services, during a special event.Two days after learning she had a rare, non-cancerous tumor on her spinal cord last summer, renowned personal finance expert Suze Orman underwent a 10-hour surgery with a 20-person surgical team at the Brigham to remove it.

The complex, emergency neurosurgery saved Orman from life-altering health concerns, including the possibility of paralysis. Grateful for the exceptional care she received at the Brigham, Orman sought to show her appreciation and give back the best way she knew how: by sharing her financial expertise with members of the Brigham community, including some staff from her own care team, through personalized counseling sessions.

“The care that I got when I arrived, all the way through my stay, was over the top,” Orman said. “I want to thank all of you — every single one of you — because I do believe to this day that if I didn’t come there, I don’t know if I’d be sitting here.”

In recorded conversations with seven members of her care team, Orman answered common questions about personal finance, including student debt, real estate investments, emergency funds, cryptocurrency and planning for college and retirement. The conversation, which was introduced by Sunil Eappen, MD, MBA, interim president and chief medical officer, and Madelyn Pearson, DNP, RN, NEA-BC, senior vice president of Patient Care Services and chief nursing officer, was broadcast to the Brigham community on June 16.

Jason Walrond, a dispatcher for Central Transport and Equipment Services, spoke with Orman about how to maximize his retirement savings between a traditional 403(b) plan and Roth IRA plan.

“Talking to Suze was so helpful because I was already considering readjusting my retirement contributions, and just hearing her say it confirmed that I’m making the right decision,” Walrond said. “It was a great experience because I’m learning more about my finances as I get older, so getting to talk to her about it was an honor. I mean, it’s Suze Orman — when do you get an opportunity to speak with someone that well-versed in finance? She has been there, done that and lived the life.”

Jerry Villa, MD, PhD, a Neurosurgery resident who was part of Orman’s care team, asked Orman for her perspective on how to best navigate the unusual situation physicians face as they transition to a higher income bracket after completing their training.

“Suze has a long track record of being an authority of financial matters. It was a pleasure helping with her care, which I think made me comfortable speaking to her about financial matters,” Villa said. “She helped me better understand how to live within my means, despite my level of training, to remain financially sound.”

Emma Pennock, PA-C, a physician assistant in Neurosurgery, asked Orman for her guidance on whether she should consider investing in the stock market while paying off her student loans.

“Her advice to not get involved with stocks or other financial ventures that I am uncomfortable or unfamiliar with was very sound,” Pennock said. “She helped resolved some internal conflict I had regarding how best to manage my expendable income. I am grateful she took the time to share her expertise.”

While money can often feel like a taboo topic to discuss openly, staff who participated in the program said Orman’s sincere, no-nonsense style made them feel comfortable speaking candidly about their questions and concerns.

“I think having proficiency in understanding your own financial situation is super important. As someone in the medical field with significant student debt burden, my circumstances are not unique,” Pennock said. “I felt discussing these topics openly would be helpful not only for myself but potentially for my peers and colleagues as well. Money is a tool, and we should all understand how to utilize it effectively to reap the most success and benefit throughout our lifetime.”

Sunny Eappen welcomes Brigham staff to the virtual forum.

Collaborating more closely across the Mass General Brigham (MGB) system presents an opportunity to significantly enhance the patient experience, explained Sunil Eappen, MD, MBA, the Brigham’s interim president and chief medical officer, during a virtual forum for all staff on June 17.

“Across MGB, we need to integrate our health care delivery so that we can provide the best experience for our patients with the easiest access,” Eappen said. “For the first time in nearly 25 years — from when Partners was first formed to now as Mass General Brigham — we are really making strides to accomplish this.”

The topic was one of many covered during the virtual forum, which also featured presentations on the Brigham’s new brand and logo, COVID-19 situation updates and policy changes, and the latest developments in diversity, equity and inclusion work at the Brigham and across the system. Staff also had an opportunity to ask questions on these and other topics.

Eappen emphasized that while working as a fully integrated system will reshape some aspects of how work gets done, the Brigham will retain its unique culture and values, as well as its international leadership in patient care, research, education and community outreach.

“As we do this work to integrate better and work better together, it will not change the Brigham in the sense that we’ll remain a phenomenal place to work — where we are kind and compassionate both to each other and to our patients,” Eappen said. “The quality of care that we deliver and the research and innovation we do won’t change.”

To underscore this work, Lori Schroth, interim vice president of Strategic Communication, introduced the new Brigham brand and logo, which were announced earlier in the day in a message to all staff. As one of the founding hospitals of Mass General Brigham, the new logo is embedded within the system’s brand identity. (Visit PikeNotes for additional information and resources.)

“This represents our vision for enhanced collaboration with our colleagues throughout the system, and it indicates to patients that we’ll be one system working together,” Schroth said.

COVID-19 Updates

The forum also featured a series of updates about the pandemic. Declining case counts at hospitals across the system and in the local community, along with high vaccination rates among staff and patients, recently prompted Mass General Brigham to announce several changes to the Visitor Policy, Facility Density and In-Person Gatherings Policy and Universal Mask Policy.

Julia Sinclair, MBA, senior vice president of Clinical Services and Critical Response Operations, reviewed the policy updates and shared some details about how these are being implemented locally— including the removal of capacity restrictions in elevators, the implementation of distanced and non-distanced dining areas, and the option for clinics to eliminate plexiglass distancing dividers in their waiting rooms.

Sinclair also took a moment to acknowledge that 505 days had passed since the Hospital Incident Command System was first activated in response to the pandemic and paused to reflect on the extraordinary teamwork that has taken place over that period.

“Together is where we are,” Sinclair said. “You’ve all contributed, and we all did it together. I’m so proud of what we have done and know that whatever we have to face in the future, we will all succeed.”

Nationally and locally, COVID-19 cases are dropping dramatically, with Massachusetts now averaging about 100 new cases per day — a far cry from the peak of 6,000 new cases daily, said Michael Klompas, MD, MPH, hospital epidemiologist. The Brigham now has approximately two to four patients hospitalized with COVID-19 each day.

While these gains can largely be attributed to vaccines, Klompas noted that the U.S. still has a considerable population of unvaccinated people. And with more contagious variants of the virus spreading throughout the world, including in the U.S., Klompas cautioned that it’s possible U.S. cases may rebound particularly in areas of the country with low vaccination rates.

Recent studies have shown, however, that mRNA vaccines, including Pfizer’s and Moderna’s, are highly effective against the new variants, Klompas added.

United Against Racism

Hospital leaders also provided an update on the United Against Racism campaign and local efforts at the Brigham to advance diversity, equity and inclusion.

Zara Cooper, MD, MsC, chair of the Executive Advisory Committee for Diversity, Inclusion, Health Equity and Community Health, emphasized that it is vital to integrate the principles of diversity, equity and inclusion into the Brigham’s broader goals and strategy.

“We recognize that this really is fundamental to everything that we do as an organization, a health system and a national and international leader. We can’t go forward until we start to deal with these things,” Cooper said. “It’s been an exciting journey thus far. We have a lot of work to do, but I think we’re started some important conversations. I’ve had the pleasure to be a member of the Board of Trustees, and I can tell you this is a conversation that’s happening at the highest levels.”

Paula Squires, MBA, SHRM-SCP, SPHR, senior vice president of Human Resources, highlighted the development of Know the Line, a systemwide program to prevent discrimination, sexual and other forms of harassment abusive conduct in the workplace. This program includes mandatory training called Common Ground for senior leaders, managers and staff and a new incident reporting platform that will be introduced this fall.

Squires also discussed the systemwide priority to increase diversity at the highest levels of leadership, including the Brigham board, as well as in administrative and faculty leadership roles across the Brigham. All new leadership positions at the Brigham have diverse search committees and new processes to improve recruitment, including a new “de-biasing” tool that is used to remove unconscious bias from job descriptions for these roles, Squires added.

“Diversity and inclusion really matter,” she said. “The key is diversity of thought. When we all bring our perspectives to the table — when we bring that thought together — it leads to better decision-making and better outcomes for our patients and each other.”

Another forum, focused entirely on the Brigham’s work in support of our United Against Racism initiative, is being planned for later this year and additional information will be forthcoming.

Jennifer Rodriguez, a nurse on Braunwald Tower 14AB, says the support she received through SSJP made all the difference in her career.

Growing up, Jennifer Rodriguez, RN, often felt as if she were her family’s liaison to the health care system. Her parents, both born in the Dominican Republic, primarily spoke Spanish at the time. For this reason, Rodriguez frequently had to translate medical terms for her loved ones, explaining to them what various medications were used for and accompanying them to doctors’ appointments.

Now a nurse at the Brigham on Braunwald Tower 14AB, Rodriguez has channeled her childhood aptitude for caring for those in need into a fulfilling career. However, she said she would not be where she is today without the Student Success Jobs Program (SSJP), a year-round internship program at the Brigham that creates educational, employment, and mentoring opportunities for Boston high school students at partnering schools and helps build a diverse health care and science workforce.

Over the program’s 20-year history, it has touched the lives of more than 700 students, the very large majority of whom are people of color. Like Rodriguez, students have gone on to achieve success in their chosen field, thanks in part to the support they received early on through SSJP. Evaluation results from the student cohort that graduated high school between 2012 and 2020 show approximately 46 percent of alumni are currently working in the health care field.

“What makes SSJP such a unique and special program is that it leads so many Boston youth to select an academic path to meaningful health care careers that impact their own lives and the lives of others,” said Paula Squires, MBA, SHRM-SCP, SPHR, senior vice president of Human Resources at the Brigham.

Rodriguez was a sophomore in high school when she was first accepted into SSJP. Although she knew she wanted to go into health care, she had never contemplated what steps she would need to take to get there. Rodriguez said SSJP was an unforeseen gift in her life, helping to close that knowledge gap while affording her the opportunity to gain practical work experience and a plethora of new friends and mentors who challenged her to grow.

The staff at SSJP not only connect students to paid internships at the Brigham, but they also offer guidance on the college application process, educational monthly seminars, free tutoring services in science and math and the opportunity to apply for financial scholarships for college. In the class of 2021, 88 percent of all SSJP seniors applied for and received a financial scholarship for college. Among SSJP’s total population of current college students, 84 percent are first-generation college students, illustrating the profound impact of SSJP’s support system.

Upon being accepted into SSJP, each student is matched with a health care professional at the Brigham who serves as both a supervisor and mentor. Above all, Rodriguez said she was most influenced by her SSJP mentor.

“I needed her when I was 15,” said Rodriguez. “She took me under her wing, and we just had this bond.”

Meaningful Mentorships That Last

The connections forged at SSJP stand strong against the passage of time. SSJP mentors keep in touch with students long after they have finished their internships, offering ongoing support and guidance on the next step in their careers.

Edmund Mbugua, a project coordinator in the Health Administrative Office, joined the SSJP community when he was 14. His supervisors, mentors, and fellow interns quickly transformed into close confidantes and best friends.

During Mbugua’s first internship at the Brigham, he worked in the Center for Community Health and Health Equity, shadowing and observing the workflow of various departments. The following years, he gained experience in a variety of areas, moving from the Operating Rooms to Phlebotomy Services to Physical Therapy.

Now, four years later, Mbugua aspires to one day become the president of a hospital. SSJP not only catalyzed Mbugua’s career development, but, perhaps more importantly, it also affirmed for him that he is capable of whatever he sets his mind to.

“Without SSJP, I would not be where I am today,” he said. “They gave me an opportunity and a chance that a lot of people didn’t.”

Supporting Students as They Grow

Pamela Audeh, program director of Youth Development and Economic Advancement at the Brigham’s Center for Community Health and Health Equity (CCHHE), said her heart is warmed by the SSJP graduates returning years later as adults, eager to continue their careers at the Brigham.

“Having the privilege to meet people so young and see them on their path and see them achieve and contribute so much and learn and grow at the Brigham — that is one of the most amazing things to witness,” said Audeh.

Although the staff at SSJP encourage their students’ homecoming, Audeh said they also encourage students to look at the range of learning and professional opportunities available to support their successful careers.

SSJP graduate Augustina Nguyen most recently served as a public health intern at the Brigham. After completing the position in May, she joined the Future Public Health Leaders Program at the University of Michigan through the Center for Disease Control and Prevention’s Undergraduate Public Health Scholars Program, where she will research health inequities.

“My experience through SSJP has prepared me well for the internship I am currently working at,” said Nguyen. “It’s been a week in the program, and I am already transferring the skills I learned from my previous department towards the work I am doing now. It’s been really exciting to be able to do so.”

In a year, Nguyen will embark on a yearlong Thomas J. Watson fellowship in Ecuador, Norway, Australia and Vietnam, where she will study the impact that Western medicine has on traditional medicine in indigenous and local underserved communities.

Nguyen’s passion for public health knows no borders; it will guide her around the world and back. However, Nguyen said her roots remain at the Brigham.

“I think SSJP played a really important role, if not the most important role, in where I am today,” said Nguyen. “Not only career-wise but all around.”

For more information about SSJP or becoming a mentor, contact Pamela Audeh at paudeh@bwh.harvard.edu.

Congratulations to the SSJP Class of 2021!

Graduating seniors celebrate their next chapter during a virtual ceremony hosted by SSJP.

On June 17, the Student Success Jobs Program (SSJP) hosted a virtual celebration to honor this year’s class of graduating seniors. Here are a few fun facts about the SSJP Class of 2021:

• 31 graduates
• 29 scholarships awarded
• Most attended colleges and universities (listed in order of popularity):

• • UMass Boston
  • Bunker Hill Community College
  • UMass Amherst
  • UMass Dartmouth
  • Boston University
  • Northeastern University
  • Tufts University

• Top three majors (listed in order of popularity):

• • Nursing
  • Public Health
  • Political Science

David Fogelman enjoys a recent hike with his daughter.

When David and Jackie Fogelman welcomed their daughter into the world two years ago at the Brigham, the overwhelming joy of that moment immediately outshined any remnants of uncertainty leading up to it.

“I couldn’t believe she was there with us,” David remembered. “We didn’t know whether it would be a boy or a girl, so I got to announce that we had a daughter. Finding that out for us was beautiful, and the first thing I wanted to do was get our baby into her mother’s arms. Seeing her hold our daughter for the first time was probably the most intense thing I’ve ever experienced. It was just the three of us — together.”

After trying to conceive on their own for about a year without success, the Fogelmans reached out to the Brigham’s Center for Infertility and Reproductive Surgery to meet with fertility expert Raymond Anchan, MD, PhD. There, they also discussed their concerns about possibly passing along certain genetic disorders. Jackie knew that members of her family had a rare, serious cardiac condition, and after doing prenatal screening, the couple found out they both carried the same recessive gene for another genetic disorder.

“We wanted to make sure we were not only able to move forward with the pregnancy but also that we would have the best shot of having a healthy start for our baby,” David said.

Their care team at the Center for Infertility and Reproductive Surgery worked with the couple to develop a plan for additional genetic counseling, fertility treatments and in vitro fertilization to ensure that only embryos that did not carry the unwanted genes were selected for implantation.

Jackie and David Fogelman, with their daughter

“As parents, even the smallest thing with your kids totally distresses you, and here was a couple who were known genetic carriers for a condition that could be very detrimental to the baby,” Anchan said. “The expertise, technology and care we have at the Brigham allowed this family to realize their dream and feel assured their baby was going to have a healthy start.”

In late 2018, the Fogelmans got the news they were waiting for: a healthy baby was on the way.

“We felt like that was a major milestone at the time, and very soon after that it became clear that it was like the admission to get into the arena,” David said. “Now, every next thing was going to be bigger than all the things before it combined.”

The compassionate care the family experienced at the Brigham made an incredible difference every step of the way.

“From when we walked into Dr. Anchan’s office for the first consultation to when we walked out the main entrance with our baby, everyone supported us, whether they knew why we were there or not,” David said. “What stood out to me the most about the Brigham is everyone you interact with just knows what they’re talking about. I appreciate that as someone who works in health care myself. When we had questions, they had answers. It was comforting.”

As Father’s Day approaches, David reflected on the extraordinary experience of becoming a parent and the joys of fatherhood — a journey that will become even more exciting as he and Jackie prepare to welcome their second child this summer.

“Ultimately, my favorite thing about being a father is getting to know my kid,” David said. “Getting to know her has been the privilege of a lifetime.”

For Anchan and his colleagues, seeing the happiness this family experienced as a result of their pregnancy — and having a role in that outcome — was especially touching.

“Certain dads stick out in your mind, and this was one of them. For David, this child is clearly the center of his world,” Anchan said. “These are people whose lives were visibly changed by having a baby.”

Nubian Square (Photo courtesy of the City of Boston)

More than 150 years have passed since the Union Army informed enslaved people in Texas on June 19, 1865, that they were free — an event that would come to be celebrated annually on that day as Juneteenth.

The history behind the anniversary, now observed as an official holiday in Massachusetts, is bittersweet. President Lincoln’s Emancipation Proclamation had outlawed slavery almost three years prior. But Texas’ remote location and relatively low presence of Union soldiers, who were tasked with enforcing the ban on slavery, meant the news did not reach enslaved people as soon as it should have.

RonAsia Rouse, MPH, program manager for Health Equity in the Brigham’s Center for Community Health and Health Equity (CCHHE), can’t help but see a connection to how outreach and education around COVID-19 pandemic and subsequent vaccination efforts have played out in communities of color.

“In light of the disproportionate effects COVID has had on Black and brown people, I think it’s important to recognize the history and legacy of how information and resources are shared with communities of color,” Rouse said. “Over a century after the events that inspired Juneteenth, this inequity still occurs, and it’s one that we know has devastating consequences.”

In that spirit, Rouse and several colleagues across Mass General Brigham (MGB) are collaborating to organize “Don’t Be the Last to Know: Information, Education and Vaccinations,” an outreach event at the city’s Juneteenth celebration in Roxbury’s Nubian Square on Saturday, June 19, noon–4 p.m.

The event will offer attendees access to COVID-19 testing, vaccine information, other educational materials, care kits with masks and hand sanitizers, and other giveaways. Attendees will also be able to receive vaccinations if they wish (no appointment, ID or insurance necessary). The Brigham’s Talent Acquisition team in Human Resources will also be on-site to discuss potential employment opportunities at the Brigham.

The first 100 people to stop by the tent will receive a free meal, sponsored by Black-owned businesses in Nubian Square. The tent will also feature a trivia game, focusing on facts about COVID-19 and Black history, in addition to raffles for gift cards to local businesses.

The event’s leadership team includes Rouse, Cindy Diggs and Damien Leach of MGH, Geneva Gordon of MGB.

The team is partnering with several community organizations — including Harvard Street Neighborhood Health Center, Roxbury Main Streets and We Got Us — to ensure the offerings are aligned with what would be most useful to residents and local businesses, Rouse said.

“It’s important that we use our resources to highlight, amplify and collaborate with the organizations that have been in the community doing this work, rather than trying to overshadow them,” she said. “These organizations know the community members and understand what they need.”

In addition to the Juneteenth event, the Brigham’s community vaccination team will continue to expand community-based vaccine availability by hosting mobile clinics at Brookside Community Health Center (Tuesdays, 8:30 a.m.–noon), the Egleston Square YMCA (Tuesdays, 4–7 p.m.) and Church of the Holy Tabernacle in Dorchester (Thursdays, 8:30 a.m.–noon), with additional sites in Dorchester, Roxbury and Mattapan being planned.

“While we are currently focused on providing COVID vaccines, we are eager to identify other ways that our mobile van could meet the needs of our community,” said Mimi Jolliffe, executive director of Brookside Community Health Center.

From left: Noreen Valentine and Katie Lewis demonstrate the convenience of Tap-N-Go at Brigham and Women’s/Mass General Health Care Center in Foxborough.

When asked how often she logs in and out of Epic each day, McKenzie Walker says one word comes to mind: nonstop.

As a medical practice assistant in the Orthopaedic and Arthritis Center in the Hale Building for Transformative Medicine, Walker uses the electronic medical record system to document a patient’s vital signs, height, weight, medications and more. Manually typing in her username and password dozens of times each day was burdensome and occasionally stressful, especially when the clinic was busy.

Last year, the center was selected to pilot a new system called Tap-N-Go, which offers the ability for Epic users to “tap” their hospital badge on a reader located at the workstation to log in and out of Epic on Epic Express devices.

The speed, ease and convenience of the system was life-changing, Walker said. Now, she can’t imagine going back.

“Tap-N-Go has allowed us to be a lot more effective by being able to deliver care more quickly and efficiently. It’s been a huge benefit for us,” she said. “We have it in all of our exam rooms and on the workstations on wheels, which has been super helpful on busy days. If a doctor is asking us a question about the patient outside the exam room, it’s easy for us to just tap and log on to get an answer right away.”

Developed by the Information Systems (IS) team, Tap-N-Go is now available across all Brigham sites and supported on more than 4,000 Epic Express devices. The system is expected to be deployed across all Mass General Brigham sites by the end of August — ultimately supporting about 40,000 Epic users and 13,000 Epic Express devices.

To ensure privacy and security, staff using Tap-N-Go need to manually enter their password when they first log in during a shift. After that, they can access Epic with just their badge for about 12 hours. Staff can log out of each session by tapping their badge again or clicking the yellow lock icon on their workstation.

The project was directly inspired by the results of a clinician well-being survey, which found that the frequency of logging in and out of clinical systems was contributing to frustration and burnout, said Jenni Theriault, director of Strategic Initiatives for Brigham Health IS.

“It’s been a really great project to work on. Everyone is excited when this solution shows up on their floors,” Theriault said.

Joe Hartigan, DPM, a podiatrist in the Department of Orthopaedic Surgery, has used Tap-N-Go for the past five months and has significantly improved his workflow as a provider.

“When you’re seeing a lot of patients, all those little tasks are onerous, even if it’s just 20 seconds during a visit,” said Hartigan, who practices at the main campus, Foxborough and BWFH. “There’s a repetitive monotony of having to retype your username and password so many times. Tap-N-Go is a game-changer in that regard and definitely helps with burnout. It makes our day infinitely better.”

Rolling out the system at the Brigham depended on a high degree of collaboration among multiple IS teams, including staff in Application Delivery, Device Engineering and the Brigham Health IS site team. The Brigham’s Nursing Informatics team was also an important partner in the project, Theriault said.

“This was one of those projects that, from an end user perspective, is very simple and straightforward. On the backend, though, it sits right in the middle of our infrastructure — interacting with operating systems, Citrix, Epic and more — so it required a lot of collaboration,” Theriault said. “We also worked closely with IS colleagues across the enterprise, so it was also a great demonstration of systemness.”

To learn more, view a Tap-n-Go tip sheet or email jatheriault@partners.org with questions.

While babies are born every day at the Brigham, a family of Canada geese took that to a whole new level — the outdoor terrace of the Hale Building for Transformative Medicine, to be precise.

The family of two adult geese and their six goslings made a temporary home on the terrace in early May before being safely relocated to a nearby location by Boston Animal Control on May 25. To ensure the geese were safe and comfortable during their time here, the terrace was closed to staff and visitors. That closure will be briefly extended while Environmental Services cleans and disinfects the area.

A goose on the Hale terrace tends to her goslings moments after they hatch.

In their short time here, the feathered family attracted many faithful fans.

Jay Crowley, senior audiovisual technician in Office Services, checked on the family each morning to ensure they were accounted for and to provide fresh water.

Christina Corey, research program coordinator in the Center for Clinical Investigation, located on the third floor of the Hale building, and her colleagues enjoyed watching the geese since they first built their nest. They were delighted to witness the moment the eggs hatched as the six goslings came into the world.

“My colleagues and I have had the pleasure of watching the mom and dad geese make themselves at home on the ‘garden’ rooftop right outside our windows,” Corey said. “From pecking at the window and honking to laying six giant eggs, these geese brought a little light into our workday.”

“It always feels like coming back home here,” says Sunny Eappen on his relationship to the Brigham.

When he joined the Brigham as an anesthesiology resident, Sunil “Sunny” Eappen, MD, MBA, felt he had found his community — one full of people who led with compassion, empathy and heart.

He continued to nurture that connection throughout his career, even as his work took him in new directions. After residency, he stayed on as an attending anesthesiologist at the Brigham, working in a basic science lab in the Medical Research Building for his first three years and eventually went on to serve as vice chair of Clinical Affairs for the Department of Anesthesiology, Perioperative and Pain Medicine. Years later, while in leadership roles at Mass Eye and Ear, he continued to work regularly at the Connors Center for Women and Newborns to practice as an obstetric anesthesiologist. When he received the call in 2018 to serve as the Brigham’s chief medical officer — a position he maintains today — the path forward was clear for him.

Now, reflecting on his appointment as interim president in March and his first three months in the role, Eappen says he can’t imagine being anywhere else.

“It always feels like coming back home here,” he said. “Intellectually and academically, the Brigham is one of the top places in the world to practice. But what really sets us apart is that the people here are incredibly kind, caring and compassionate. That’s what brought me here as a resident. It’s what brought me back as CMO. And it’s what makes this role I’m in now feel like such a privilege.”

This longtime connection has shaped Eappen’s understanding of the Brigham’s culture and what matters to the people who work here. As interim president, he emphasized that his focus is on ensuring staff feel heard and supported, advancing the Brigham’s mission and goals, building greater transparency into institutional and systemwide processes, continuing to build momentum around equity and enhancing the patient experience through greater system integration.

“I feel like I have a great advantage because I’ve lived and grown up in the Brigham,” he said. “These are people I’ve known for the last 25 years — whether they’re folks in the cafeteria, Operating Rooms, Emergency Department or on our floors. We don’t have a shy group here, so when I walk down the hallways, people come up and tell me what they’re thinking, which is fantastic because this role has given me an opportunity to make a difference in a new way.”

Recently, a staff member suggested to Eappen that the members of the Brigham’s Board of Trustees should be identified on the hospital’s website — an increase in transparency that was quickly implemented. When a group of residents expressed their interest in sharing their lessons learned from the front lines of the COVID-19 pandemic, they were invited to participate in a deeper conversation with Eappen about what could be incorporated into future emergency preparedness work. In recent weeks, Eappen has also been meeting with members of the Brigham research community to better understand what’s needed to support the next wave of innovation and discovery.

As CMO, many of his priorities overlapped with the president’s office, so certain aspects of his new role are familiar to him. Now, the scale and scope are bigger, and there is also new and evolving work, particularly as the MGB system collectively moves toward greater alignment. To understand and meet these new challenges, Eappen has been able to build on existing relationships with leaders, faculty, staff and trainees across the Brigham and Mass General Brigham (MGB).

“It’s been a learning experience,” Eappen said. “As we’ve seen, there’s just so much change happening at our system level and it affects what we do at the academic medical center level. For me, it’s really been about integrating where we are trying to go with how we get there, how we retain our unique identity and how we can play a leadership role within the system.”

Moving the Needle

Eappen explained that achieving a fully integrated system of care across MGB will require change, which can sometimes feel uneasy, he acknowledged, but also has the potential to be transformative for employees, patients and local communities.

“One important point to understand is that being part of a system doesn’t mean we’re going to lose our culture,” he said. “The second part is that there’s a really — I mean, really — compelling reason to do this. We aren’t delivering the best patient care possible to our patients until we can fully realize this opportunity.”

Consider these scenarios, Eappen said: A Brigham patient trying to make a cardiology appointment discovers his physician is booked up for the next six weeks, but perhaps there is an appointment available at Massachusetts General Hospital the following week. Or a Brigham patient who lives in Newton needs a chest X-ray; getting it performed at Newton-Wellesley Hospital might be considerably more convenient than driving to the Brigham.

“It doesn’t change our interaction with the patient. It doesn’t change the way we as colleagues interact with each other. It just made our patient’s life easier and better, and we continue to deliver the great care,” Eappen said.

The power of “systemness” extends beyond patient care. The progress and energy behind addressing structural racism and advancing equity — both at the Brigham and across MGB — have been particularly exciting to see in recent months, Eappen said.

“Our nation has had this reckoning with the fact that we haven’t made as much progress as a lot of people felt we had,” he said. “The iron is hot, and we need to capitalize on that movement as an integrated organization across our city. And we can’t slow down — we have to keep working on it. The organizational structures we’ve created here and across MGB are really important now. This is not a temporary initiative. This is a long-term commitment for us.”

Transparency and goal-driven action are two founding principles to this work, he added.

“It comes down to this: How do we make the health of everyone in our community better? We know institutional racism exists everywhere, including here, so what can we tangibly do to measure and eradicate it?” Eappen explained. “For example, we’re looking forward to sharing our diversity data across our departments and hospital-wide, and what we’re striving to achieve in each of those areas.”

Caring for the community includes caring for ourselves, which is why staff wellness and mental health have also been a priority, Eappen said. Senior leaders at the Brigham are exploring pilot programs around behavioral health that he hopes can become a model for systemwide improvements.

“I’ve seen what happens when people aren’t taken care of — through COVID and even before that. We’ve got to take care of ourselves first to be able to provide great, kind, compassionate world-class patient care,” he said. “In terms of benefits, I’ve felt that we don’t deliver the same level of behavioral and mental health care for our employees as we do on the medical care front, and I believe that we can be better on that.”

A new patient and visitor entrance at 75 Francis St. will streamline the check-in and screening experience.

A new entrance at 75 Francis St., which opened May 12, provides an indoor area for patients and visitors to begin the process for check-in, symptom screening and masking before being directed to their destination in the hospital.

The long entryway, whose windows overlook the Valet plaza outside 75 Francis St., runs parallel to the building and was built in a former seating area of Au Bon Pain.

“We’re really excited about how much this new entrance will enhance the patient and visitor experience,” said Sheila Harris, vice president of Patient Access Services. “Having this additional space will provide a much smoother flow and more comfortable experience for our patients and visitors.”

Hospital leaders said the project — managed by Beatriz Gomez, senior project manager in Real Estate and Facilities — was driven by the need to address logistical challenges the pandemic had caused at patient and visitor entrances.

“From the outset of this pandemic, our 75 Francis St. lobby has never felt so small,” said Andrew Shinn, a senior planner in Real Estate and Facilities. “The increase of screening staff, masking stations, trash for used masks, stanchions, attestation kiosks, distancing dots and acrylic barriers transformed our hospital arrival experience.”

Because of space limitations in the lobby and physical distancing requirements, patients and visitors arriving at 75 Francis St. during busy times of day occasionally had to wait outside before completing check-in and symptom screening.

“The front desk staff, now Safe Care Commitment team, have performed remarkably well in their ability to be versatile while continually and safely admitting thousands of people each day through these doors,” Shinn said. “The new entry offers our patients and visitors a little more space to swap masks and start the screening process inside.”

As part of the project, the revolving doors at 75 Francis St. will now be an exit-only door for patients and visitors leaving the hospital.

While the new entrance is designed to address an immediate need, Shinn noted that the space will likely evolve to continue enhancing the patient and visitor experience after the pandemic ends.

“At some point, perhaps as entry protocols ease, the new indoor space may provide new out-facing seating and become a discharge lounge for patients, who will be able to see when their car is ready,” Shinn said. “For now, we hope this small effort brings a big relief for patients, visitors and front desk staff.”

Mirana Varfi

Brigham and Women’s Hospital mourns the loss of Mirana Varfi, unit coordinator for Shapiro 9/10, who died on April 29 after an illness. She was 44.

Ms. Varfi joined the Brigham 12 years ago. Colleagues remember her caring, generous, thoughtful and witty nature, said Ermelina Prifti-Taho, operations manager for Shapiro 9/10.

“As a unit coordinator, Mirana had an impressive capacity to not only meet the needs of staff and patients, but an ability to anticipate her units’ needs with such insight and knowledge,” said Prifti-Taho.

Marie Caulfield, MSN, RN, of Shapiro 9/10, agreed. “Mirana always came into work with the most beautiful spirit and energy,” she said. “She had a way of making you feel taken care of and took great pride in her position and as a team player. Everyone respected her, loved her and loved working with her.”

Born in Albania, Ms. Varfi came to the U.S. for her education, became a citizen in 2016 and dedicated herself to the study of her true passion: art.

“Mirana was a talented artist who made everything around her more beautiful,” said Prifti-Taho. “She will be deeply missed by all who knew her.”

Ms. Varfi received her Master of Fine Arts degree in painting from Syracuse University, where she taught and served as a prop artisan for the Syracuse Stage. She moved to Boston to be closer to her late mother, who was a unit coordinator on Shapiro 6 East.

Pursuing her interest in art conservation and restoration, Ms. Varfi previously worked at the Peabody Essex Museum, the Carmichael Art Conservation and the L.H. Freedman Studios, where she assisted in restoring the mosaic at the Isabella Stewart Gardner Museum courtyard fountain, the main entrance walls at the Museum of Fine Arts and a ceiling medallion at the Boston Old State House.

She had many other hobbies and interests that she pursued vigorously. She was an avid reader, adventurous cook, a sculler at the Boston Community Rowing Club and an aspiring archer. She also ran the 2017 Erie marathon in Pennsylvania.

“We had a special bond in running as I assisted in her training regimen,” said Caulfield, a veteran marathon runner. “I asked her after if she would do another marathon, and she said with a big smile, ‘Absolutely not.’ She was a determined woman who achieved what she set out to do.”

Ms. Varfi is survived by her father, Ruben Varfi; her sister, Elonia; brother-in-law, Andy Skillen; and aunts, uncles and cousins. She is predeceased by her mother, Yllka Varfi.

“We didn’t really connect the dots at first because the episodes in high school had never really been that bad,” says Abby McGillivray, on the recurring fainting episodes she started experiencing in her late teens.

Nursing student Abby McGillivray, 20, remembers getting fitted for her prom dress in high school when she was struck by one of her first fainting spells. It was unexpected, but she figured it was a fluke — nothing to seriously worry about.

Then her episodes started to get worse.

McGillivray developed a post-concussion syndrome after hitting her head during a fainting spell in college. She started having weekly, then almost daily episodes and she knew she needed to get help.

That led her to Brigham cardiac electrophysiologist Sunil Kapur, MD, of the Division of Cardiovascular Medicine, to determine what was causing her debilitating fainting episodes and how they could be treated.

Kapur determined that there was nothing wrong with either McGillivray’s brain or her heart; instead, she was experiencing neurocardiogenic syncope — a miscommunication between the brain and the heart that is extremely difficult to treat.

“I got very good at being able to tell the signs of when an episode was coming,” McGillivray said. “I would get really bad tunnel vision, and there’d be immense pressure in my head. I would just be exhausted and sweaty, and there’d be ringing and pounding in my ear. And then I would just collapse.”

Ultimately, a multidisciplinary team led by Kapur performed an extremely rare procedure on McGillivray known as a cardiac neuroablation. Performed only a handful of times in the U.S. and Europe, this minimally invasive procedure involves inserting catheters into the heart via a vein the top of the leg to cauterize, or burn off, defective nerve endings.

“We constantly try and innovate in new procedures and techniques, but this was the first time we had performed a procedure this rare,” Kapur said. “We were optimistic that Abby would do well, and we are very pleased that she has done this well so far. It is always hard to predict how people will do in a procedure with such little data, but so far, she and I are both very happy with the results.”

Pinpointing the Cause

McGillivray’s mother also has neurocardiogenic syncope and had a pacemaker implanted to treat the condition when she was in her 50s after experiencing a series of fainting spells. To figure out if they had the same condition, McGillivray was given a heart monitor so that Kapur could observe her heart’s activity.

“We didn’t really connect the dots at first because the episodes in high school had never really been that bad,” she said. “But then all of a sudden college hits. I fainted once, got sent home for a pandemic and then any little bit of stress, dehydration, lack of sleep, headaches, noises too loud, whatever —would just trigger it,” McGillivray said.

A few weeks after receiving the heart monitor, McGillivray experienced another fainting episode. Her heart rate spiked to more than 100 beats per minute, a state known as tachycardic.  Meanwhile, the communication between her heart and brain misfired yet again. The nerves connecting her brain and heart should have been carrying a message telling her heart to slow down. Instead, her heart would stop altogether.

After concluding that McGillivray’s condition was the same as her mom’s, Kapur at first told her that her options were either a pacemaker or medications, both of which have the limited success and real important side effects.

“The classic way of treating this is by implanting a permanent pacemaker. Unfortunately, medicines do not work for many patients. However, for young people, having an artificial device in them for the rest of their life can lead to real problems,” Kapur said. “Being a young woman, she wanted to avoid this, so we discussed this relatively new procedure as another option.”

During the procedure, Kapur used electrical mapping of the heart nerves in McGillivray to determine which nerves were defective. In the end, four of McGillivray’s nerves around her heart were remodeled.

While it was nerve-wracking to have such a rare heart procedure at 20 years old, McGillivray said her care team kept her feeling positive.

“All of the nurses and doctors were so funny, talkative and engaging,” McGillivray said. “They were so nice to keep me upbeat, and they kept complimenting me and telling me I was handling this so well.”

McGillivray underwent the procedure on March 2, and she hasn’t had a fainting spell since.

“We hope that this will be curative, meaning that she will no longer have to deal with this,” Kapur said. “Again, we don’t know long-term outcomes from this relatively new procedure, but we remain optimistic.”

McGillivray said she is making tremendous progress in physical therapy for her post-concussion syndrome. She can now walk on the treadmill, drive, read and listen to music and podcasts without having a blinding migraine. She’s also excited for the future, with plans to return to Emmanuel College as a nursing student in the fall.

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A new, interactive exhibit on the Pike highlights the importance of employee wellness by inviting Brigham staff to express what they’re grateful for and share ways they practice self-care.

Studies have shown that cultivating gratitude — that is, taking a moment to notice and appreciate what’s good in your life — is linked to better well-being. Staff can visit the display, known informally as the Wellness Wall, to share their own reflections or read others’ contributions for inspiration.

The first messages posted on the two-sided exhibit, which will be up through June 1, represented a diverse range of perspectives — thought-provoking, personal, light-hearted, simple and more.

In reflecting on what makes them feel grateful, one staff member acknowledged their “co-workers for their support and encouragement.” The writer added, “I could not do this without them.”

Another employee posted, “I’m very grateful for my last successful operation!”

The exhibit was the brainchild of Kayla Methot, BSN, RN, a Labor & Delivery nurse on CWN 5, who first conceived of the idea after reflecting on her own journey to cultivate gratitude and practice self-care after an especially difficult year, personally and professionally.

“It’s just been so cool to see how the project has blossomed into something so big that everybody can participate in,” Methot said.

In addition to the unprecedented challenges of being a health care professional during the pandemic, Methot noticed her own health was deteriorating last year. She was eventually hospitalized and diagnosed with lupus, a chronic inflammatory disease. To help improve her quality of life, she began practicing yoga. In January, she enrolled in a yearlong yoga-teacher training program.

Methot, who was the first person to post a message on the Wellness Wall, shared her favorite self-care quote: “The better you take care of the tree, the better the fruit it can provide.”

She reflected on this quote again when she stopped by the exhibit again later in the day to see the newest contributions.

“When I left work and walked by it with my co-workers, just seeing the wall and how many people posted something on it was really special,” she said. “Reading what people wrote and knowing that I played a part in it — my heart feels so full. I want people to care for themselves, and if we can help each other, it’s going to help all of us on this journey together.”

Jeffrey Robbins and Noemie Bechu meet in person for the first time, and say goodbye, on the final day of Bechu’s internship.

Coming into her clinical social work internship this fall, Noemie Bechu had no idea what to expect. She would be fully remote for the duration of her internship in outpatient Neurology, where she would work under the supervision of a Brigham social worker to perform assessments and counsel patients with dementia, epilepsy and traumatic brain injuries.

The experience turned out to be one of the most challenging and rewarding experiences she’s ever had, said Bechu, one of eight graduate students who made up the Brigham’s first class of Social Work interns after the pandemic’s initial surge, completing their program on April 30.

Social work trainees who had been placed at the Brigham for the 2019–20 academic year had their internships cut short in March 2020 when the hospital paused many educational programs as COVID-19 began to spread in the Boston area.

For the cohort who joined the Brigham this past fall, the experience was filled with the usual mix of excitement and uncertainty surrounding a new internship — learning how to work in a large academic medical center while also taking on their own patients for the first time. But it was also coupled with the added challenges of pandemic, chiefly learning to accomplish many of these tasks remotely.

“I don’t think I could have learned more in this internship experience,” said Bechu, who trained under the supervision of Jeffrey Robbins, LICSW, a senior social worker in the Department of Neurology. “I started this internship with not a lot of confidence in my clinical skills, and I’m leaving with so much more confidence. That’s very much thanks to Jeff and how supportive he was as a supervisor.”

Robbins said he was continually impressed by Bechu’s flexibility, growth and dogged commitment to finding creative solutions to support patients and families.

“I know that an intern has a good year and good supervision from me when I get at least as much out of the experience — if not more — than I give,” he said. “Supervision is a two-way street — people bring their own unique perspectives and the sum of their own life experiences into their internship here, and if I’m not learning from a student then I feel like I’m failing as a supervisor. Noemie was not only a trooper this year, but she was also just fabulous at her work and grew exponentially.”

Catherine Arnold, MSW, LICSW, ACHP-SW, manager of Education and Professional Development for Social Work, said the training program’s supervisors, also known as field instructors, and Social Work’s Field Education Committee did a tremendous amount of work over the summer to ensure supervisors and interns alike had ample support structures in place. She said she was not surprised to see both supervisors and interns rise to the challenges of this past year and thrive.

“Social workers are used to thinking outside the box and being creative with limited resources,” said Arnold, who also serves as manager of Palliative Care Social Work. “Social workers are able to embrace ambiguity, and this was a year they were called on to do that — and they stepped right up.”

Andrea Johnson, MSW, LICSW, director of Social Work, expressed her appreciation to the education program’s field instructors, interns and leadership for their dedication and flexibility this past year.

“I cannot begin to express how excited I am about the continued success of the Field Education Program,” Johnson said. “Even in the face of the pandemic, both field instructors and interns embraced their responsibilities as providers in a very complex and ever-changing workflow.”

Gaining a ‘Solid Foundation’

Despite the steep learning curve in the beginning, Bechu said she soon got acclimated and even found that working remotely provided opportunities to enhance her practice. While helping one patient with housing assistance over Zoom, she was able share her screen and go over the application form in detail with them. During a session with another patient, Bechu realized that seeing her own face on video was unexpectedly informative.

“Seeing my eyes widen with surprise in response to something the patient said gave me a chance to reflect on whether that was an appropriate expression, which isn’t something I would really be able to see in person,” said Bechu, who will earn her master’s degree from Boston University this month.

When this year’s class of interns began in September, all were fully remote. Some, such as Bechu, stayed remote throughout their internship because the unit, service or clinic where they were placed was also operating in a remote capacity. Other interns such as Dennis Falcione, who completed his training in Lung Transplant and Thoracic Surgery, began their internship remotely and eventually transitioned to on-site work.

“None of us could have imagined what this past year would look like, what we’d be able to do and how we’d have to overcome these challenging circumstances,” said Falcione, who will obtain his master’s from Boston College this month. “On the flip side, doing this in the grips of a pandemic and having to be adaptive has been a great learning opportunity. Especially as I get ready to enter the field, I feel like I’ve gained such a solid foundation to build on as a social worker.”

Having the support of a caring and encouraging supervisor was pivotal to making this year successful, said Falcione, who trained under the supervision of Beth Flanzbaum, MSW, LICSW, a clinical social worker in Thoracic Surgery and the Mesothelioma Program.

“It would be impossible to do all this without that extra support to navigate complex situations as you’re trying to get a feel for the work,” he said.

Flanzbaum said it filled her with pride to see Falcione grow so much as a social worker in just a few months.

“I think this is going to be one of the most resilient groups of social workers there is,” she said. “These interns flourished. I don’t know how they did it, but they did. They got a solid foundation in hospital social work. They figured things out and invented new ways of doing things. And they developed a lot of resiliency in the process, which I think will help them as they go forward into the field.”

A cascade of public health crises — including a new and highly contagious variant of COVID-19, extreme shortages of medical supplies, low vaccine availability and a powerful surge of infections — have all contributed to the devastation that has gripped India in recent weeks.

Sunil Eappen, MD, MBA, Brigham interim president and chief medical officer, expressed his concern and support for members of the Brigham community who have been affected by the dire situation in India.

“We care. Period. — that’s one of our core values. We embrace a culture of shared humanity and dignity, where our diverse community of patients, families and employees all feel welcome, cared for and valued,” said Eappen. “As members of the global community, we are watching the worsening COVID-19 crisis in India, and know that many in our community, particularly those with families and friends who live there, are hurting deeply. The Brigham community is here for you, and I encourage anyone in our community who needs support to take advantage of the resources that are available.”

Moved by reports of the rapidly deteriorating situation on the ground, several members of the Brigham community have mobilized to support the international response.

A Mask Mission

Ranu Dhillon, MD, of the Division of Global Health Equity, and Abraar Karan, MD, MPH, DTM&H, an aspiring infectious diseases specialist and medical resident in the Hiatt Residency in Global Health Equity program, have made it their mission to get better face masks into the hands of people who need them most.

From left: Ranu Dhillon and Abraar Karan

Throughout the pandemic, Dhillon and Karan have become passionate advocates for encouraging governments, health care organizations and mask manufacturers work together to ensure that people in high-risk environments have access to high-filtration masks, such as surgical masks and N95 respirators. Cloth masks are still widely used in India, and higher-grade options are in scarce supply.

When Karan, who was born in India, first started hearing about the crisis in his native country from loved ones living there, he knew what he had to do next.

“When India was getting crushed, I thought that we’ve got to do something,” he said. “I worked on masks this whole year and developed tons of connections, and I wanted to leverage my expertise on this topic.”

Dhillon was similarly inspired to take action.

“My family came from India, and I’ve been working there to improve the health system for a number years,” he said. “We want to do all we can to stop the surge in India. There are lots of low-hanging opportunities to make an impact.”

Both have been working with Armbrust American, a mask manufacturer in Texas, and Indian government officials to arrange for large donations of surgical masks and N95s, as well as donations from Fix the Mask, a California-based company that produces accessories to secure loose-fitting masks more tightly against the face.

Karan is coordinating an initial donation of 1 million surgical masks and N95s to Delhi, India’s capital territory, with plans to send more masks in the future, along with a donation of 10,000 mask fitters.

Dhillon has been working with a nongovernmental organization (NGO) in Madhya Pardesh — a large state in central India, where more than a third of the population lives below the poverty line — to mobilize mask donations as well. While this effort is also still in the planning stages, Dhillon estimates the team will distribute more than a half-million masks. The team is also working with Fix the Mask to promote the use of mask fitters in this area.

“We are also working with local government leaders to ensure a supply of oxygen and planning for isolation of large numbers of patients,” Dhillon said. “In addition, we are looking into expanding the deployment of rapid diagnostic tests, but we are still working on the supply and details of this.”

Dhillon and Karan said they and their partners in this effort are exploring the possibility of establishing a nonprofit to have a more structured approach if — or, more likely, when — similar situations arise elsewhere around the globe.

“We’re realizing this is going to be an issue in a lot of unvaccinated countries, so getting better masks to places before they surge is going to be key going forward,” Karan said.

Supporting Vulnerable Populations

The deadly surge of COVID-19 has not spared the small, rural and remote villages of Rajasthan, one of India’s northern states. And yet these areas lack access to testing, medical resources and more. This weighs heavily on the mind of Neha Limaye, MD, a resident in Internal Medicine at the Brigham and in Pediatrics with the Boston Combined Residency Program in Pediatrics.

Neha Limaye

For the past decade, Limaye has been working with a nongovernment organization called Educate for Life, which supports education and community health programs for an indigenous and historically marginalized population in rural Rajasthan. She volunteers as the health trustee for the organization, providing public health guidance to local teams on the ground.

“When we were preparing for COVID last year, we were really worried something like what we’re seeing now would happen,” said Limaye, also a trainee in the Hiatt Residency in Global Health Equity program. “In the villages where we focus our efforts, there’s no real testing available, but many people have viral syndromes — about one per house is what our community health team estimates.”

In recent weeks, Limaye has been working to advise teams on the ground on how to inform residents about how to stay safe and to help patients manage symptoms at home and access medical care if needed.

As the surge has worsened, however, infections have spread among the community health workers themselves and their own families. Whereas workers previously visited homes in the village in-person, they now check in on residents by phone.

“It’s honestly quite scary to know all of what’s happening while being so far away, and I do feel genuine worry because I know so many people in this village as well as our team on the ground,” Limaye said. “At the same time, it’s been very motivating and inspiring to be part of this team and try to figure out solutions together.”

Limaye has also been connected with India COVID SOS, a newly formed, grassroots coalition of scientists, clinicians, engineers, policymakers, epidemiologists and others from around the world working to coordinate several disaster response efforts.

“I have a lot of family in India, so I’ve been hearing from folks on the ground in various different cities how bad things really are,” she said. “It’s been quite stressful, but one positive that’s come out of this is seeing the number of people who have united around trying to support India in whatever way possible.”

Extending Knowledge, Providing Advocacy

For Joia Mukherjee, MD, MPH, of the Division of Global Health Equity, responding to the crisis in India is both a personal and professional endeavor.

Joia Mukherjee

“My dad was an immigrant, and I still have family and friends in India. I know the situation is dire,” she said.

In addition to her role at the Brigham, Mukherjee is chief medical officer for the nonprofit Partners In Health (PIH), which works with governments in 11 countries to ensure quality health care is available in some of the world’s most vulnerable communities. While PIH doesn’t have direct ties to India, the resources it has created are now actively being shared with clinicians there.

“Early in the pandemic, physicians and nurses working with Partners In Health affiliated with the Brigham’s departments of Medicine and Emergency Medicine developed and openly shared COVID protocols for delivering COVID care in low- and middle-income countries,” she said.

The United States Agency for International Development asked these Brigham clinicians and PIH to join forces with the University of California San Francisco Institute for Global Health Sciences to make the protocols web-based. Within weeks, the website was up and running, and it continues to be updated regularly as our understanding of the virus evolves. These protocols are now being actively shared with clinicians in India.

“What we see in developing countries, or even in non-trauma hospitals in the U.S., is that knowledge such as how to manage oxygen or take care of critically ill patients is not widely disseminated,” Mukherjee said. “Until you need it, you don’t look it up. Now, in India, they are considering field hospitals, and they need to know how to manage oxygen with or without ventilators — and we have knowledge to share.”

Mukherjee is also working hard to make the point that until everyone gets vaccinated across the globe, we won’t get control over this crisis. She recently published a commentary about this topic on WBUR’s Cognoscenti site. On May 5, Mukherjee appeared on MSNBC’s Rachel Maddow Show after the Biden Administration vowed to allow for patent flexibilities to mass produce the vaccine.

“Today, it feels very much like the AIDS pandemic: We have tools — in the case of COVID-19, vaccination and therapies — but they are not yet available around the world. We need hundreds of billions of dollars in investment to get this right,” she said. “The global economy has lost trillions of dollars from COVID. It makes good economic sense to make this investment. But more importantly, it’s good moral sense, and that’s what I’m focused on.”

Helping Alleviate the Oxygen Shortage

Brigham anesthesiologists Sujatha Pentakota, MD, and Lalitha Sundararaman, MD, of the Department of Anesthesiology, Perioperative and Pain Medicine, are working in coordination with several organizations to help coordinate delivery of oxygen concentrators and other essential supplies to India.

From left: Sujatha Pentakota and Lalitha Sundararaman

They have been collaborating with the American Association of Physicians of Indian Origin and, to support local relief efforts on the ground in Bangalore, with CARE India, a nonprofit dedicated to alleviating poverty and social injustice. Additionally, Pentakota is working with the Indian Chamber of Commerce to ensure any equipment delivered gets into the right hands.

“We have been working tirelessly — on U.S. and Indian time — to help combat the COVID catastrophe there,” Sundararaman said.

To generate awareness and mobilize action for the public health crisis, Sundararaman also recently published a call to action in the ASA Monitor, the official news publication of the American Society of Anesthesiologists.

“We all became doctors because we care. Both Sujatha and I are doctors from India, and when we heard personal accounts of how the lack of oxygen — a drug we take for granted here in the USA — is causing so many deaths in India, we could not stay as observers,” Sundararaman said. “We decided to do what we could to raise awareness and help as many people as we could live to see another day.”

Sundararaman and Pentakota  have started a fund to support on-the-ground efforts to assist rural areas with poor infrastructure to combat the crisis, with Pentakota managing the logistics.

Sundararaman was also recently interviewed on the podcast Post Call as part of a special episode highlighting the crisis in India.

“I was an anesthesiologist in India as well, and I still have many contacts among anesthesiologists and intensivists there who keep telling me heartbreaking stories,” Sundararaman said on the May 2 episode of the podcast. “People are dying on the streets — and I mean literally on the streets. Hospital beds are in such a deficiency that people are hiring ambulances with oxygen tanks so that they can live off of the oxygen tanks while they wait for a spot to open up inside the hospitals.”

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The simulated spacecraft medical bay in the Neil and Elise Wallace STRATUS Center got ready for its big-screen debut as a Hollywood production crew visited to film the environment for NASA training videos on April 27.

Crews from Radiant Images filmed the setting — modeled after the International Space Station’s medical bay — to capture a realistic, 3D environment for astronaut training scenarios and just-in-time education. For the next stage of the project, crews will film actors in Los Angeles simulating a series of emergency scenarios developed by the STRATUS Center’s Roger Dias, MD, PhD, MBA, and Charles Pozner, MD, of the Department of Emergency Medicine, and their colleagues.

Ultimately, the actors will be superimposed on footage of the STRATUS Center’s facility, and learners will be able to interact with the scenario using virtual/augmented reality headsets.

When filming at the center, production crews used a mix of 3D, photogrammetry and mixed-reality cinematic techniques for maximum realism.

The STRATUS team has been engaged in a two-year, grant-funded partnership with the Translational Research Institute for Space Health to develop novel solutions to some of NASA’s highest-priority concerns around human health during deep-space exploration missions.

Top row, from left: Jodi Sherman, Gaurab Basu and Gregg Furie; Bottom row, from left: Bernie Jones and Renee Salas

The climate is warming due to human activity, and from the perspective of Brigham primary care physician Gregg Furie, MD, the hospital’s renewed focus on addressing the implications of climate change for health care could not come at a more critical time.

“I’m grateful to the leadership of the institution who recognize that the close linkages between climate change, health care’s environmental impacts and human health really compel us to action,” said Furie, one of four experts who participated in a discussion on climate change and sustainability during the second Lead the Change forum on Earth Day, April 22. “They’ve signaled a commitment to effecting change at the Brigham and beyond, which I think will help protect the health of our patients, populations more broadly and the planet that supports them.”

The event was moderated by Bernie Jones, EdM, vice president of Public Policy and co-chair of the Brigham’s Climate Action Council, who opened the forum by announcing that Furie, a member of the council, will step into the new role of medical director for Climate and Sustainability at the Brigham.

“The consequences of global climate change we know are far reaching,” Furie said. “They’re already being felt not just across oceans, but right here at home. And while the cost of achieving aggressive reductions in greenhouse gas emissions is significant, it really pales in comparison to the cost of doing nothing.”

Jones also announced that the Mass General Brigham joined We Mean Business, a coalition of over 300 businesses catalyzing business action and driving policymakers to accelerate the zero-carbon transition. On Earth Day, We Mean Business called for the Biden administration to reduce emissions by at least 50 percent below 2005 levels by 2030. President Biden agreed to that target on the same day.

Climate Change Affects Health Care

To reflect how close to home climate change is occurring, panelist Renee Salas, MD, MPH, an Emergency Medicine physician at Massachusetts General Hospital, recalled working a shift on a record-breaking hot day in Boston and saw a patient who was experiencing a fever. The patient’s wife had called 911 because he was acting confused.

Knowing how extreme the weather was that day, Salas was skeptical that the fever was due to a conventional cause, such as a virus or infection. The emergency medical services (EMS) crew who transported the patient said that the patient and his wife had walked up many flights of stairs to reach the upper level of their apartment building.

When first responders opened the door to this patient’s apartment, they were struck by a wave of heat. The couple only had a window that was partially cracked. There was no air conditioning. Salas found that the patient’s core body temperature was 106 degrees Fahrenheit — making it clear that he was suffering from a heatstroke, a life-threatening form of heat illness.

“I often think about that patient, but I also think about his wife because she was left behind in that very same environment,” Salas said. “That really started making me think about how we need to begin applying what I often call a ‘climate lens’ to our clinical practice.”

Climate change and extreme weather can cause catastrophic health effects, such as vector-borne diseases, water-borne illnesses and heatstroke, which can lead to cardiac and respiratory disease.

“We have to think about the public health, clinical practice and health care system silos. We often think public health is ‘over here,’ people who work on health care systems are ‘here’ and, as providers, we’re in our clinical practice bubble,” Salas said. “But I want to erase those lines and recognize that we all have to work in an integrated fashion. Because I think unlike any other time before, the COVID-19 pandemic has shown us that when public health fails to prevent, the health care system bears the brunt.”

Health Care Affects Climate Change

Panelist Jodi Sherman, MD, an anesthesiologist and the medical director of Sustainability at Yale New Haven Health, remembered noticing as a trainee that her hospital was using and discarding many materials that could cause harm to the environment.

“That began my own journey of collaborating with environmental engineers and doing research to try and put some numbers behind what this harm is and to start making it better,” Sherman said.

America’s health care industry has the highest per capita greenhouse gas emissions compared to any other nation. Globally, health care accounts for nearly 5 percent of total greenhouse gas emissions — a quarter of which stems just from the U.S., which only makes up 4 percent of the world’s population.

“Globally, a quarter of health care services are deemed inappropriate or low value, meaning that they’re unneeded, unwanted, ineffective, unaffordable, inequitable and irresponsible in the consumption of resources. I would further add they cause preventable pollution,” Sherman said. “We actually found no correlation between health care access and quality and these emissions in the US. In other words, there are ways to reduce emissions without compromising health care quality and access.”

About 80 percent of these emissions come from supply chains, including pharmaceuticals, chemicals, medical devices and supplies, and food, Sherman said. She suggested that hospitals could improve climate change outcomes by using durable, rather than single-use disposable goods, and improving the environmental performance of the supplies, in addition to reducing wasteful practices.

Climate Change as a Health Equity Issue

Panelist Gaurab Basu, MD, a primary care physician and co-director for the Center for Health Equity Education and Advocacy at the Cambridge Health Alliance, noted that the consequences of climate change can be more severe for people in lower-income communities due to historic, discriminatory practices in housing, transportation and urban planning. He emphasized that individual actions must be married with systemic changes to be effective.

“We’ve got to be honest that we put fossil fuel infrastructure in some places, and not others — that we have not been thinking enough about the Black and brown children who are living across the Chelsea Creek and near the polluted water, and across the Tobin bridge, where they are exposed to air pollution, and making them go to the emergency room with asthma exacerbation instead of staying in school,” Basu said.

Salas said that climate action is a prescription for health and health equity. The speakers agreed that a climate lens is needed in every aspect of their work to understand the impact climate change has on their patients and practices.

“This is emotional, and big and overwhelming, and it can feel so paralyzing at times,” Basu said. “But what we need here is action. We need to do this together, and then to move forward to create an equitable, just, sustainable future.”

Save the date for the next Lead the Change events:

• Addiction, Recovery and Mental Health, Thursday, May 20, noon–1 p.m., via Zoom
• Gun Violence, Friday, June 4, noon–1 p.m., via Zoom

Jessica Pacheco is the only occupational therapist for the Brigham’s Neonatal Intensive Care Unit.

The goal of occupational therapy is to help people achieve independence for whatever it is that “occupies” their day. Jessica Pacheco, MOT, OTR/L, CNT, an occupational therapy clinical specialist in the Neonatal Intensive Care Unit (NICU) and NICU Follow-Up Program, is specially trained to help premature and medically complex babies participate in their “occupations.” This includes bonding and communicating with caregivers, developing self-regulation skills to cope with experiences outside the womb, and integrating and developing the sensory and motor skills needed to effectively interact, explore and play within their environment.

Part of Rehabilitation Services, the Occupational Therapy team consists of 12 inpatient occupational therapists (OTs) and six outpatient OTs who support clinics at the main campus, Chestnut Hill and Foxborough.

Pacheco, who joined the Brigham in October 2019, is the only OT for the NICU and Follow-Up Program, where she collaborates with a multidisciplinary team to promote optimal sensory and motor development in premature and medically complex babies in both inpatient and outpatient settings.

“Jessica came to us highly skilled and with excellent experience,” said Nancy Kelly, clinical supervisor for Occupational Therapy. “We’re just really thrilled that she’s been able to take on this role and perform at such a high level of skill. Because of her expertise, she was able to provide excellent care from day one.”

Pacheco was hired a few months before the COVID-19 pandemic started. While some of the hospital’s clinical services were initially scaled back at the beginning of the pandemic to limit the spread of infection, care in the NICU never stopped or slowed down. In fact, the unit saw a much higher intake of babies than ever before, and Pacheco’s work continued even when the outpatient clinic went virtual due to the pandemic.

“Being an OT in the NICU is a really unique and specialized role within the profession of OT. I feel very fortunate and grateful that my career has led me in this direction,” Pacheco said. “As an expectant mother, caregiver or parent preparing to bring life into the world, you’re not necessarily expecting or thinking your baby will begin life in an ICU setting. For families involved, it is often a traumatic, life-altering event, and we do our best as a team to help support an infant’s neurodevelopmental progression along their journey.”

Since joining the unit, Pacheco and her colleagues helped implement a standardized assessment known as the Test of Infant Motor Performance (TIMP) for infants in the NICU so that their motor skills, movements and response to visual stimulation and orientation to sound can be tracked over time, including after they are discharged. She also works to help parents and families build their confidence by teaching them how infants communicate their needs and different techniques for handling premature infants, who can be born as early as 23 weeks old.

“What’s unique about my role is my ability to work with infants and families in the NICU, and then support them in our NICU Follow-Up Program at Brigham, which allows for continuity of developmental care and skill progression,” Pacheco said.

Pacheco’s enthusiasm, collaboration and level of specialization have already made a tremendous difference for NICU patients and families, Kelly said.

“She’s just a delight to work with and I’m just so pleased that we have somebody with her expertise working with our littlest patients,” Kelly said.

Supporting Premature Infants, Families in the NICU

Pacheco always knew she wanted to have a career in the health science field. She explored different therapies and ultimately gravitated towards the field of OT, allowing her to work with individuals to support their ability to participate in daily and meaningful occupations. During her studies, she became intrigued by the work that could be facilitated in pediatrics.

“The NICU is just one setting within the many different pediatric settings you can possibly work in as an OT,” Pacheco said. “During my time as an inpatient pediatric OT, I began developing a passion for this specific population.”

Carmina Erdei, MD, a neonatologist in the Department of Pediatric Newborn Medicine and director of the Growth and Development subunit of the NICU, works with Pacheco in the inpatient setting and the NICU Follow-Up outpatient program. Erdei described Pacheco as an outstanding colleague who brings so much to the NICU environment and the outpatient program with her very valuable skill set.

“When babies are born prematurely or at neurodevelopmental risk, they often need to spend weeks or even months in the NICU. While in the NICU environment, many of these infants’ experiences and the way they’re learning about the world around them are very different from what they would be exposed to if they were healthy and at home with their families,” Erdei said. “Thanks to the work of highly skilled professionals such as Jessica, our tiny patients get the opportunity to have motor and other sensory experiences that are framed more positively. This is very important to their overall progress and recovery, and prepares infants and families for a more successful transition to home.”

Historically, Erdei said, NICUs in general have focused heavily on the medical aspects of care of fragile infants. More recently, the Brigham NICU team’s knowledge and practice have evolved to ensure these vulnerable patients also receive high-quality, expert neurodevelopmental care, including occupational therapy, to set up families for long-term success.

“We are very fortunate to have Jessica as a highly experienced and valued member of our team,” Erdei added.

Pacheco said it’s been gratifying to play such an important role in the lives of her patients and their loved ones.

“The infants and families can really integrate all of the knowledge they’ve learned in the NICU environment, take it home with them to carry on with their infant’s developmental progression, and then come to the Follow-Up clinic for additional guidance,” she said. “We meet the infants and caregivers where they’re at, and then take next steps to create goals to set them up for success once they leave the walls of the NICU and step foot into the community.”

Occupational Therapy Month is held every April to honor occupational therapists’ (OTs) substantial role in improving health and quality of life. In celebration of Brigham OTs, Brigham Bulletin is highlighting one of the many exceptional OTs to cap off Occupational Therapy Month this year.

Hearts on the Bridge, a new display on the Shapiro bridge, honors the lives saved and lost at the Brigham due to COVID-19 and provides staff an opportunity to leave their own remembrances.

After spending several days on high-flow oxygen and still struggling to breathe, a patient with COVID-19 being cared for in the Medical Intensive Care Unit (MICU) turned to his nurse, Jessica Thompson, BSN, RN. He had hoped to avoid the need for intubation, but the time for an intervention had come. “I can’t do this anymore,” he told her.

With tenderness and compassion, Thompson sat with her patient and explained what would happen next. He nodded. As she began preparing the room for the intubation team, Thompson saw her patient take out his smartphone and begin watching videos of his grandchildren. Tears rolled down his cheeks.

The moment hit close to home for Thompson, who said she would remember that patient forever.

“I know that’s what my parents would have done,” said Thompson, sharing the memory during a virtual Remembrance Ceremony on April 20, which provided an opportunity for the Brigham community to collectively honor the lives saved during the pandemic, remember those lost due to COVID-19 and look forward with hope.

The 30-minute ceremony, hosted by Spiritual Care Services and webcast via Zoom, also featured reflections from hospital leaders, music, a reading in Spanish and a discussion about resiliency and support resources for staff. The timing of the event closely coincided with when the Brigham’s COVID-19 census peaked during the first surge, hitting 171 patients on April 22, 2020.

The ceremony also marked the launch of a new display, Hearts on the Bridge, located on the Shapiro bridge. The display features more than 1,700 blue hearts to symbolize the number of patients with COVID-19 who were cared for and discharged from the Brigham, as well as 176 yellow hearts to represent the number of patients who passed away due to COVID-19 since last March.

Between April 20 and May 4, staff are encouraged to view the display and use white hearts to write their own remembrances in memory or in honor of someone affected by COVID-19, or a short personal message, and post it on the designated windows in Shapiro.

Sasha DuBois (right) sings “Amazing Grace,” with piano accompaniment by Andrew Heintz (left), during the ceremony.

Kathleen Gallivan, SDNdeN, PhD, director of Spiritual Care Services, opened the Remembrance Ceremony by recognizing the collective trauma this pandemic has caused and the healing process that many people continue to navigate.

Sunny Eappen, MD, interim president and chief medical officer, reflected on the enormous effect the pandemic has had on our lives over the past year and encouraged staff to pause, grieve if needed and find some measure of peace.

“All of us have been impacted in some way. It might’ve been someone you cared for, whom you served food to or whose room you may have cleaned,” said Eappen, who mourned the loss of his own uncle due to COVID-19. “It’s been an incredibly challenging time for all of us, and we’ll forever be changed as a result of being here at the Brigham during this time. We are now seeing a light — a light for today and a light for the future.”

The ceremony also featured a musical selection, “Amazing Grace,” performed by Sasha DuBois, MSN, RN, nursing director for the IV Therapy Team and PCA Float Pool, with piano accompaniment by Andrew Heintz, M.Div, STM, a chaplain in Spiritual Care Services.

Mayra Scott, shipping coordinator in Materials Management, led a Spanish-language reading of the poem “We Remember Them” by Rabbi Sylvan Kamens and Rabbi Jack Riemer.

Sejal Shah, MD, chief of the Division of Medical Psychiatry, provided an overview of resources available to support staff and tips for building resiliency.

Thompson, who cared for the first COVID-positive ICU patient admitted to the Brigham, was invited to share her perspective as a front-line provider during the event.

“I think we’ve all been through a lot as a community, and we’re all changed for it. I’m one of a hundred nurses on my unit, and we all have stories like this,” she said. “But we all have a little bit of hope now — hope that the worst is behind us and that maybe this year is going to be better than the last.”

View a recording of the virtual Remembrance Ceremony.

Clockwise, from upper left: Rahsaan Peters, Scott Weiner, Mardi Chadwick Balcom and Katherine Palm

Gun violence and community violence are among the most tragic injuries Scott Weiner, MD, MPH, says he witnesses on a regular basis as a physician in the Emergency Department.

“It’s just heartbreaking,” he said. “We’re so lucky to have a team with us at the Brigham that’s working on this, both for prevention and for response after violence occurs in a community.”

That team is the Violence Recovery Program (VRP), which was founded in 2011 as a collaboration between the Center for Community Health and Health Equity (CCHHE) and the Division of Trauma, Burn and Surgical Critical Care to advocate for survivors of community violence and patients with gunshot or stab wounds. An estimated 89 percent of patients in the VRP between 2018 and 2020 experienced trauma from a gunshot wound.

The group’s work was highlighted during Thorndike Quality and Safety Grand Rounds on April 9, which featured a panel discussion about addressing community violence with Mardi Chadwick Balcom, JD, senior director of the CCHHE, Katherine Palm, MSW, LCSW, an injury prevention and outreach coordinator for the Division of Trauma, Burn and Surgical Critical Care, and Rahsaan Peters, Violence Recovery program coordinator. Weiner served as the discussion’s moderator.

As a certified Level 1 trauma center, the Brigham can provide total care for every aspect of injury — from prevention through rehabilitation.

Palm opened the conversation by discussing the importance of injury prevention. When caring for a survivor of community violence, she aims to prevent, treat and reduce injury-related disability and death.

“As injury prevention professionals, what we do is very broad,” Palm said. “We influence policy and legislation, we mobilize neighborhoods and communities, we change internal practices and policies, and promote community education.”

To set the stage for what drives gun and community violence, Chadwick Balcom shared a quote from Paul Farmer, MD, PhD, chief of the Division of Global Health Equity: “Structural violence is visited upon all those whose social status denies them access to the fruits of scientific and social progress.”

Gun violence is on the rise in Boston. The number of aggravated assaults involving a firearm increased dramatically between 2019 and 2020 — from 94 to 632 per year, according to crime statistics collected by the Massachusetts Executive Office of Public Safety and Security.

When asked by an audience member about whether COVID-19 affected these statistics, Chadwick Balcom hypothesized that the stress of the pandemic, including stay-at-home orders and other restrictions, may have created additional tensions that led to violence.

VRP advocates work together with survivors of gun or community violence to begin the process of physical, emotional and spiritual healing from a traumatic experience. Their mission is to reduce the burden of someone’s exposure to violence when they leave the Brigham.

“Being a VRP advocate, you can meet a family on the worst day of their life,” Peters said. “Just being there and having compassion and empathy for that family and that patient is so important.”

Violence Recovery Program in Practice

By surveying patients who had received support from the VRP, the team learned that the most common patient needs after receiving hospital care at the Brigham are basic needs such as food and shelter, safety planning and trauma/mental health. Following a traumatic event, the VRP meets patient needs by providing services, including crisis intervention, legal advocacy, access to community resources and assistance in navigating education, employment and housing.

As the program coordinator and a VRP advocate, Peters collaborates with multidisciplinary colleagues to meet with patients as they enter the Emergency Department (ED), remain with them throughout their stay in the hospital and make frequent visits after they re-enter their community.

“There’s a lot that goes into it. I definitely feel inspired just being a part of the medical team, and they put a lot of trust in knowing that we’re going to follow up,” Peters said. “Part of my work wouldn’t be possible without a nurse doing their job or a social worker connecting us with a patient and their family. I want to thank the overall system of support that VRP has in the hospital.”

Chadwick Balcom emphasized the importance of the VRP providing continuity when caring for patients of gun violence who experience multiple transitions of care in the hospital.

“If you’re in the Emergency Department, you’re going to have one care team, and then, upon admission, you’re going to have a different team that’s taking care of you, then after discharge you’re going to go to your follow-up appointment — I think for any of us who have navigated our own system, it’s a real wakeup call,” she said. “Even for those of us who understand the system, it can be hard.”

Men, particularly men of color, are disproportionately affected by gun violence. Seventy-eight percent of VRP patients are male. Of that group, 54 percent identified as Black, 28 percent identified as Hispanic/Latinx and 16 percent identified as white.

“I think we have to be really thoughtful about the structural violence and the impact of structural racism, and how that plays out in who we’re seeing and how folks are impacted,” Chadwick Balcom said.

During the panel, Peters reviewed a case of a patient who passed away after experiencing multiple gunshot wounds. The VRP assisted the family in planning the patient’s funeral, provided emotional support and reconnected with the family three months later in group therapy at the Louis D. Brown Peace Institute, a local nonprofit that supports families of homicide victims.

In another case of a patient with a non-life-threatening gunshot wound, Peters shared how the VRP met him at bedside to introduce the program, coordinated and attended family meetings with social workers, and assisted him with employment opportunities after he was discharged.

“He got himself healed up and stayed in communication with VRP and was interested in putting some goals together and getting a career,” Peters said. He connected the patient with a trade union and set up a job interview. “Just being able to have that opportunity was a big resource moving forward for that young man.”

The VRP and Stepping Strong Injury Prevention Program have teamed up for the Mother’s Day Walk for Peace to support the Louis D. Brown Institute. Learn more.

Christina Nix holds her twin boys, Weston (left) and James (right), in the Neonatal Intensive Care Unit.

As an emergency department nurse, Christina Nix regularly encounters complex medical challenges. But nothing prepared her for being the expectant mother of monochorionic diamniotic (Mo-Di) twins.

Mo-Di twins are genetically identical, originating from one egg that split into two embryos after fertilization. The babies share a placenta and blood supply, but each has their own amniotic sac, which surrounds the baby during pregnancy. Due to their shared blood supply, Mo-Di twins are at greater risk for certain complications and tend to be born prematurely.

Nix and her husband, Bryan, were thrilled to find out they would be having twins last year. When tests revealed the babies were Mo-Di twins, however, they began to worry.

“We went online and learned about all the bad things that can happen,” Nix said. “My obstetrics office couldn’t even handle this type of pregnancy because they didn’t have appropriate monitoring, so friends of mine recommended I go to Brigham and Women’s Hospital.”

Twelve weeks into the pregnancy, Christina had her first visit with Carolina Bibbo, MD, a maternal-fetal medicine specialist and director of the Brigham’s new Comprehensive Care Center for Multiples.

Launched in December, the Center for Multiples specializes in caring for pregnant women carrying two or more babies, including those that are at higher risk of complications, such as Mo-Di twin pregnancies. The clinic’s multidisciplinary team draws on their extensive experience in caring for multiples — providing expert medical care as well as compassionate psychosocial support and patient education to help families navigate the unique joys and challenges of welcoming twins, triplets or more.

The center is the only one of its kind in Massachusetts and one of just a few dedicated clinics in the country providing specialized care for mothers expecting multiples.

“Having multiples can be very exciting but overwhelming at the same time,” Bibbo said. “These pregnancies can be accompanied by higher risks of complications, but most moms and babies do extremely well. We’re really focused on making moms the centerpiece of care.”

Staff nurse Lucy Graves, MSN, RN, CBS, agreed the team is committed to making sure families feel supported.

“During a high-risk pregnancy, patients are often coming in every one to two weeks, so we really form a bond,” Graves said. “Because of our experience, and the fact that we care for twin and triplet pregnancies every day, I think we also bring a level of calm that reassures patients. You can’t guarantee everything will always go smoothly, but we can promise that we’ll be right there with them every step of the way.”

Providing a Range of Support

Over the ensuing months of Nix’s pregnancy, her care team kept a watchful eye on the babies’ growth while also offering the family reassurance. Early imaging had suggested one of the twins was smaller than expected and possibly missing out on nutrients due to the shared placenta.

Christina and Bryan Nix at home with their twin boys, James (left) and Weston (right)

At week 28, Nix was admitted to the Brigham for a projected 30 days of continuous monitoring. Four weeks later, new abnormalities were detected on her ultrasound. Nix was brought to Labor and Delivery, where her care team discovered she had developed preeclampsia, a condition characterized by high blood pressure that poses risks to both mothers and babies. Both babies were safely delivered via cesarean section, each weighing under 4 pounds, and transferred to the Neonatal Intensive Care Unit (NICU). Under the care of NICU staff, the twins got stronger, healthier and thrived — and headed home with their parents this January.

“Dr. Bibbo is like a saint,” Nix said. “From the first appointment there, she was very involved, talking with us every week and even taking time after hours to explain how we could move forward with things.”

Bibbo said she first became aware of the need for more personalized care for families with multiples when she was a clinical fellow in the Brigham’s former Twin Clinic, a predecessor to the Center for Multiples. Over time, she noticed patients continually express that they wished appointments covered more than just the mother’s and babies’ physical health.

“Mothers carrying multiple babies have many other psychosocial and emotional stressors that make their pregnancy experience completely different from those mothers carrying a singleton,” she said.

To address this, the center’s team includes a dedicated social worker, lactation specialist and childbirth educator. The team also collaborates with other providers in the Department of Maternal-Fetal Medicine to connect patients with nutritional support, genetic counseling, hematology services, research study opportunities and more.

In addition to hosting childbirth and breastfeeding classes specifically tailored for families of multiples, the team hosts a monthly Q&A session via Zoom with Bibbo and Graves for patients in their third trimester. The group sessions enable patients to talk to their care team — and each other — about what to expect during delivery and how to prepare their home for the babies’ arrival.

“Patients really enjoy having that safe space to talk and connect with one another,” Bibbo said. “We are blessed in Boston to have so many good hospitals with excellent specialists, but I think the need for psychosocial care, maternal needs and specialized education is often overlooked. They are all really important for helping these moms feel better prepared for the joy of the babies’ arrival and any challenges they might experience along the way.”

Francisco Marty

The Brigham community mourns the loss of Francisco Marty, MD, of the Division of Infectious Diseases, who died April 8 after a tragic accident while hiking in the Dominican Republic. He was 53.

A member of the Brigham community for more than 20 years, Dr. Marty is remembered as a masterful physician, researcher and mentor who specialized in the treatment of infectious diseases affecting transplant and cancer patients. Along with Lindsey Baden, MD, he built and led the clinical infectious disease consult service for patients at Dana-Farber Cancer Institute. In addition to his work at the Brigham, he was editor-in-chief of the journal Transplant Infectious Disease.

“Francisco was foremost an extraordinary doctor — totally committed to caring for his patients. In an era when much of medicine seems overly technical and rushed, he always devoted the time to hear people’s stories, review their records and studies, and confer with other experts,” said Paul Sax, MD, clinical director of the Division of Infectious Diseases. “He added to this fundamental skill exceptional achievements in both clinical research and teaching. Many of us eagerly awaited his cogent interpretation of clinical trials, and he himself led many important studies. That he brought junior colleagues and trainees along for their learning made his accomplishments all the more impressive.”

As a scientist, Dr. Marty led numerous multicenter trials to study the safety and efficacy of novel treatments for influenza, cytomegalovirus, invasive fungal infections and COVID-19.

Most recently, he was the principal investigator for two clinical trials that looked at the use of remdesivir, an antiviral medication, for COVID-19 patients. They were among several studies that led the U.S. Food and Drug Administration to expand its emergency use authorization for remdesivir to treat all hospitalized patients with COVID-19.

“Francisco was an outstanding clinician, a brilliant clinical investigator and a dedicated teacher and mentor,” said Daniel Kuritzkes, MD, chief of Infectious Diseases. “He was the expert on whom we all relied for any question involving fungal infections and could identify nearly all species of yeasts and molds from a wet mount or a histopathology slide.”

Kuritzkes recalled that during the first COVID-19 surge in Massachusetts, Dr. Marty was “personally responsible for enrolling more than 300 participants into remdesivir trials, including many Spanish-speaking Latinx patients who might otherwise have declined to participate in a clinical trial.”

As illustrious as his academic achievements were, Dr. Marty is equally remembered by colleagues for his tireless commitment to his patients, mentorship, creative problem-solving and unwavering warmth and kindness.

Sophia Koo, MD, an attending physician in Infectious Diseases and Dr. Marty’s mentee, recalled meeting Dr. Marty on her first day as a Brigham intern when he provided a consult for one of her patients. The patient, who had a severe parasitic infection, could not take the oral medication needed to resolve the infection due to the inflammation in his gut. Dr. Marty devised a novel solution — seeking permission from the U.S. Food and Drug Administration (FDA) to administer a veterinary formulation of the drug intravenously, which had never been done before with that medication. The FDA approved the request, and the patient thrived.

The experience inspired Koo to follow in his footsteps and enter the field of transplant infectious diseases.

“Francisco had such a contagious love of medicine and discovery and such deep love and compassion for his patients,” Koo said. “He was truly a maestro in the art and science of medicine. People all over the world turned to him for advice for their most challenging diagnostic and therapeutic dilemmas, and he always came through with a thoughtful and well-informed opinion.”

Jose Orejas, MD, a research fellow in the Division of Pulmonary and Critical Care Medicine, previously served as a research fellow in Infectious Diseases and participated in more than a dozen studies with Dr. Marty over his three years with the division. In that time, Orejas said he came to cherish Dr. Marty as a mentor and continued to seek out opportunities to collaborate on research.

“Francisco transformed the way I was through his guiding example,” Orejas said. “He taught me precision and compassion. He made his clinical research feel so natural that you couldn’t tell we were developing the medicine of the future. He was an absolute mastermind. Losing my mentor in such an unexpected way hurts so much and is a major loss for transplant patients all over the world. I will miss him.”

Colleagues also fondly remembered that, as serious as Dr. Marty was about his work, he embraced opportunities to bring joy to others.

“He loved puns and taking selfies with all of his many friends in the hospital,” said Sarah Hammond, MD, a former Brigham attending in Infectious Diseases who now practices at Massachusetts General Hospital. “He was the kind of colleague who would track me down if he knew I was having a really difficult day on the inpatient service and bring me a snack or offer to help.”

A man of many talents, Dr. Marty was also known as a gifted photographer — traveling around the world to capture the beauty of architecture, natural landscapes and, a favorite of his, scenic views of New England’s lighthouses. Several of his photos are on display in the Division of Infectious Diseases’ offices, and he regularly showcased his work at the Department of Medicine’s annual “Medicine and the Muse” event.

In a 2018 interview with Brigham Bulletin, Dr. Marty explained he was first drawn to photography while attending medical school in his home country of Venezuela.

“In addition to helping me find a meaningful work-life balance, art is a very good way to communicate with colleagues, trainees and patients,” he said at the time. “When my patients find out I do photography, it becomes a way to talk about something that’s different from their illness — it provides a common ground, solace and hope for so many of them.”

Dr. Marty earned his medical degree from Jose Maria Vargas School of Medicine, Universidad Central de Venezuela, and completed his residency at the Jacobi Medical Center of Albert Einstein College of Medicine in New York, where he served as chief resident. He completed his infectious diseases fellowship at the Brigham.

A memorial Mass will be celebrated for Dr. Marty on Saturday, April 17, at 11 a.m., at St. Mary of the Assumption Church, 420 High St., Dedham, with a reception to follow. The Mass will be livestreamed from the parish website. For more information, please call 617-738-7348.

Left photo: Da’Marcus Baymon; Middle photo, from left: Hannah Green, Daniel Egan and Karen Lewis Brownell; Right photo: Sophonie Bernard

Bruising from N95 respirators, feelings of isolation and uncertainty about when normalcy will return — these are just a few of the images, memories and themes that came to mind for a group of Emergency Department staff when asked to reflect on their experiences over the past year as part of a novel music therapy project that transforms front-line staff’s personal reflections into lyrics and song.

The program, called Frontline Songs, was created by a Massachusetts General Hospital physician to provide healing via music to health care workers who have and continue to serve on the front lines of the COVID-19 pandemic. Participants are interviewed over Zoom by a songwriter about their experiences, and their stories are crafted into an original piece of music.

At the Brigham, Da’Marcus Baymon, MD, chief resident in the ED, Sophonie Bernard, emergency services assistant, Daniel Egan, MD, emergency physician, Hannah Green, PA-C, physician assistant and Karen Lewis Brownell, RN, an ED nurse, worked with Frontline Songs team member and Grammy-nominated American folk singer-songwriter Mary Gauthier to create a song that would articulate what they went through during the pandemic.

“I find a lot of times that it’s really hard for me to put into words what we, as health care workers, have been through when family or friends ask us. They see it all on TV, but when they actually ask you what’s going on, it is difficult to articulate what we experience day to day and all the emotions that go along with it,” Green said.

Green said reflecting on memories from the past year to brainstorm lyrics served as a great way to bond with her team and acknowledge, process and cope with what they went through as health care workers.

“This session allowed us all to share our own perspectives and emotions,” Green said. “It was comforting to hear from my coworkers that they’re feeling very similarly, and it was therapeutic to collaborate and form lyrics that help reflect these experiences and emotions.”

Baymon started singing and writing songs as a way to process and release his thoughts at 8 years old. He learned to play the violin in elementary school, then moved on to the saxophone in middle school. In college, he even considered changing his major from pre-med to music.

He hasn’t had much time to work on songwriting this past year, so Baymon saw this as a great opportunity to reignite his musical talents in a meaningful way.

“It was remarkable that all of us could talk about our different experiences and come up with a product that ultimately braids our experiences together,” Baymon said. “I felt closer to my colleagues. These are the people that I work with, but we don’t really get to talk as much on shift or share our experiences and the things that we’re struggling with outside of work that are totally a part of who we are as humans. It’s really connected us on a different level.”

Bernard also found the experience to be extremely therapeutic.

“Having a song that touches on everything that was hard to cope with at the time is like being able to tell the story of COVID in a different way,” Bernard said. “If I am looking at it from the positive side, what came from this whole experience was growth and resiliency — learning to not only be there for the patients but also for our family, community and ourselves.

During the two-hour songwriting session, the team discussed the difficulties they faced not only at the bedside but also outside of work. Although health care workers were celebrated nationwide as heroes during the pandemic, staff who participated in the session said they also felt stigmatized at times due to their proximity to infected patients. ED staff also spoke about the loneliness of coming back to an empty home, as many lived apart or stayed away from family earlier in the pandemic to avoid the risk of potentially exposing loved ones.

“In the beginning of the pandemic, we were all called ‘health care heroes,’ and we appreciated the appreciation. But at the end of the day, this is our job. This is what we were trained to do, and this is what we want to do,” Green said. “Fast-forward a few months later, and all of a sudden we were looked at as almost being contaminated.”

Lewis Brownell discussed the obstacles she faced when taking care of her elderly parents and her young grandchildren as a front-line nurse during the pandemic. She was excited to have a creative space to share her emotions and experiences.

“I love reflection. I keep a five-year journal, and each year I write a few things I’m grateful for every day. I’m on year four of this one book and just to read what I’ve been through exactly a year before — we’ve come so far, but to reflect back on it, that year was really tough,” Lewis Brownell said.

Before the session, Lewis Brownell asked other nurses what words came to mind when they looked back on the last year. They responded with phrases like resilient, courage, strength and coming together.

“It just lightened my heart to really put it into words and then to watch Mary’s creative process,” Lewis Brownell said. “Within three hours, we came up with this beautiful song that says we’re stronger together and we’ve been through all of the hard times, and the song ends on such a positive note with vaccinations and getting closer to being normal.”

Egan, the Emergency Department program director, said the experience was impactful and brought the ED members together.

“While we all have different roles in the ED, what we and the songwriter quickly realized is that there were so many shared experiences between us,” Egan said. “It was amazing to take such broad thoughts and distill them into short phrases that tried to capture the full range of emotions that felt truthful and resonated with all of us. At the end of it, I left feeling hopeful and optimistic which I think comes through in the song.”

Listen to the team’s original song, “Normal Soon.”

Top row, from left: Bernie Jones, Zara Cooper and Maddy Pearson; Middle row, from left: Cheri Blauwet, Shelly Anderson and Allison Moriarty; Bottom: Wanda McClain

When reflecting on the complex balancing act that women in the workplace must often navigate, Zara Cooper, MD, MSc, FACS, Kessler director of the Center for Surgery and Public Health, finds comfort in a quote from Orpah Winfrey: “You can have it all. You just can’t have it all at one time.”

Those words of wisdom were among several inspirational quotes that female leaders at the Brigham shared to kick off a broader discussion about women’s experiences during the first Lead the Change forum on March 30. The new series’ inaugural event, held in conjunction with Women’s History Month, featured reflections from a panel of six leaders about the challenges and opportunities they’ve faced in their personal and professional lives.

Moderated by Bernie Jones, EdM, vice president of Public Policy, Lead the Change is a new, virtual monthly forum dedicated to exploring ideas and views on issues related to public policy, advocacy, social justice and health care innovation.

Cooper — an acute care surgeon, trauma surgeon and surgical intensivist — said she has learned that having supportive family, friends and colleagues can make all the difference in personal and professional success.

“One thing that that has helped me is that I really let go of my pride and leaned on ‘the village,’” Cooper said. “At work, it’s recognizing that I’m part of a clinical and administrative team. COVID has also added this layer of transparency and humanity to all of us. Our co-workers see into our homes and see our children come through the door, and that’s actually improved and enriched the relationships I have here at work.”

Shelly Anderson, MPM, executive vice president and chief operating officer, noted that support networks don’t have to be limited to close contacts and encouraged all women leaders to help create opportunities for women in more junior positions.

“We all need to help each other to the next rung,” Anderson said.

Work and Family

The demands of supporting a family while juggling a career was a central theme that several panelists explored.

Allison Moriarty, vice president of Research Operations, recalled her decision to return to the workforce after taking some time off to raise two children.

“What I actually learned during that period was that I really missed being able to work, and I felt like working brought a really important balance to my life,” Moriarty said. “While I know there can be incredible pressures and strains that come from many different responsibilities, I’ve found that I’m a much better mother by virtue of having so much in my life professionally and socially.”

Maddy Pearson, DNP, RN, NEA-BC, senior vice president of Clinical Services and chief nursing officer, acknowledged the challenges of being a working mother — remembering how she was rarely able to stay home with her two children when the schools declared a snow day because, as a nurse, she was expected to report to work. At the same time, she added, the role-modeling that took place set a valuable example during her children’s formative years.

“I have always said I’ve been a better mother because I worked full-time ever since my kids were 6 weeks of age,” Pearson said. “In prepping for this conversation, I asked both of my children what they thought. I said, ‘I’ve worked all my life. Did you miss me?’ They said, ‘Of course we missed you, Mom. We love you.’ But they both articulated to me that they have grown and learned so much by seeing my professional life and how I balance both worlds.”

Panelists discussed the unjust expectation that society places on women to be the primary caregiver for children or other family members. Speakers also acknowledged that many working mothers face significant financial barriers, particularly given the steep costs of child care —an expense on par with college tuition. According to the Economic Policy Institute, Massachusetts ranks second in the nation for most expensive infant care.

“Our child care system now is so dependent on socioeconomic status. In sports, we say something is a pay-to-play system. It’s the same for child care,” said Cheri Blauwet, MD, a sports medicine specialist in the Department of Physical Medicine and Rehabilitation and the Department of Orthopaedic Surgery and director of the Kelley Adaptive Sports Research Institute at Spaulding Rehabilitation Hospital. “Some women have options while others don’t, and it’s so unjust and exacerbates all of the inequities that we’ve seen play out through COVID. These are very expensive services, and we could do better and emulate other parts of the world where the systems are quite different.”

Wanda McClain, MPA, vice president of Community Health and Health Equity, noted that working women may also be coping with other family responsibilities, such as elder care.

“We often don’t know what people are bringing into the workplace with them, so having that opportunity to be open and supportive of people within whatever stage of their life they might find themselves is really important,” McClain said.

Helping all staff achieve better work-life balance is an area where institutional culture can play a significant role, Anderson said.

“I think some of the culture work we’ve done around the Brigham Experience over the past couple of years brought up that. As a community, we’re perfectionists — we’re very ambitious and often take on too much,” Anderson said. “We’re all trying to be much more cognizant of what we’re putting on everyone’s plates so that we can all have more balance. It’s not a gender issue. It’s a workplace issue, and we need to look at it across the board.”

Embracing Intersectionality

Panelists also explored the intersecting identities some women navigate in the workplace.

“As a Black woman, when I step into a room I step in as both identities,” McClain said. “If there’s any potential interaction that feels a little off, is it because I’m a woman or is it because I’m Black? I can’t separate them.”

Blauwet, a wheelchair user, reflected on her experiences as a woman and physician with a visible disability, recalling how challenging it can be to be perceived as a one-dimensional identity rather than a complex, full person.

“I’ve seen that shift over the last five or 10 years. There’s been an increasing recognition of intersectionality adding value to our environment,” she said. “It’s been really encouraging to see that, and I hope it continues to evolve.”

Accepting one’s identity as a leader can also be an unexpected experience for many women, panelists said.

“Think about where you can make a difference,” Cooper said. “One of the things that’s been very refreshing is my imposter syndrome hasn’t gone away, even at this level. Everybody has it, so get over it. If you’re not going to be at the table, who is?”

The next Lead the Change event, “Earth Day Climate Change and Sustainability Forum,” will be held Thursday, April 22, at noon.

From left: Paulette Cooper, Sunny Eappen and Rosalie Bryan share a moment outside the Hale vaccination clinic after booking vaccine appointments for Cooper and Bryan.

Paulette Cooper, a patient care associate (PCA) on Braunwald Tower 8AB, was alarmed by what she was reading and hearing about the COVID-19 vaccine on social media and in the news this past winter.

“You heard people say it’s going to change your metabolism or that they’re going to put a chip in your body and track you. Maybe it sounds silly, but it was frightening,” Cooper said. “I remember watching the news and this woman from New York took it and got Bell’s palsy. That got me scared.”

As the Brigham started to roll out its employee vaccination program, Cooper agonized over what to do. In some moments, she was certain she would get the vaccine. But then her mind would race with “what if” scenarios and she decided, no, it wasn’t for her. She went back and forth in this pattern for weeks.

“I remember one day I was on the floor and ran into a co-worker who was so excited. She was saying, ‘Paulette, what do you think about the vaccine? I’m going to get mine today,’” Cooper recalled. “I said, ‘OK, you get it and tell me about it.’ I still didn’t know what I was going to do.”

All three COVID-19 vaccines being administered in the United States — Johnson & Johnson, Moderna and Pfizer-BioNTech — have been tested in large, diverse populations in clinical trials and shown to be safe and effective.

Health care workers became eligible in phase 1 of the state’s COVID-19 vaccination plan, which launched in December 2020. To date, about 75 percent of Mass General Brigham employees have received the vaccine. While that rate well exceeds the general population — about 32 percent of Massachusetts residents have received one dose — it still means about one in four employees across the system have chosen not to get vaccinated or remain undecided.

For some who are unsure about receiving the vaccine, unanswered questions about how it could affect certain health conditions, such as pregnancy, remain a significant concern. For others, misinformation on social media about possible risks has created seeds of doubt. The speed of the vaccine’s development, as well as cultural or religious perspectives, have also led some to distrust it. For some people, the reality that the vaccine is so new may be reason enough for discomfort.

But there is also a population of COVID-19 vaccine “converts” — those who were once reluctant and then chose to get vaccinated after learning more about the science.

Linda Harkess

“In deciding whether to get the vaccine, I went from skepticism to certainty,” said Linda Harkess, MSN, RN, a nurse on Braunwald Tower 11ABD. “My skepticism stemmed from who I am, coupled with my experiences as a patient. I am an immigrant and a person of color — someone who has been on the receiving end of culturally incompetent care and a stereotype on numerous occasions, leading to a lack of trust in the health care system.”

As Harkess witnessed patients in a similar demographic to her die from COVID-19 at a disproportionately higher rates, she said she was initially leery of claims about the vaccine’s safety and decided against getting it. But as time went on, she kept an open mind and challenged herself to learn more.

“I was curious as to why a certain population of people are more susceptible to contracting and succumbing to this deadly virus. That curiosity provoked me to examine the affected population more closely,” Harkess said. “I focused special attention on the high-risk criteria, the clinical trials and the scientist who developed these vaccinations. I also studied the mRNA mechanism of action and how it counteracts the SARS-CoV-2 virus, the possible side effects and benefits of the vaccine and long-term illness from the COVID-19 disease. After a thorough review of reliable resources and learning the pertinent facts about the vaccine and the deadly COVID-19 disease, I made the informed decision and became the first member of my household to be vaccinated.”

‘I Have That Extra Protection Now’

Even after talking to more colleagues and family members about their experiences with the vaccine, Cooper still found herself conflicted — that is, until she and several of her colleagues received a visit at work from an employee vaccination taskforce comprising several clinical and equity leaders at the Brigham. Over the past several months, the group has reached out to groups of staff to answer questions about the vaccine, hear their concerns and help separate myth from fact.

Cooper attended the educational session with her sister, Rosalie Bryan, who is also a PCA on Braunwald Tower 8AB and was, at the time, even more reluctant about getting vaccinated. They both listened eagerly to medical experts in the room, led by Sunny Eappen, MD, the Brigham’s interim president and chief medical officer.

“I was afraid I would die if I took the vaccine,” Bryan said. “I told the doctor that I didn’t know what to do because the media has been saying all these things, and you don’t know what road to choose. But when he came and broke it all down, I felt a lot better. I said to him that I would take it, but I was scared to go.”

In response, Eappen offered to go with her. Bryan and Cooper looked at each other and smiled. “I said, ‘OK, let’s go,’” Cooper recalled.

After the session ended, Eappen accompanied them to the vaccination clinic in the Hale building to help schedule their appointments. The two sisters are now fully vaccinated.

“It’s a wonderful feeling being vaccinated,” Bryan said.

Cooper agreed. “I feel safer. If I’m exposed to the virus, I know I have that extra protection now to help me,” she said. “Having the doctor break it all down helped me understand the vaccine better, and my sister helped me make up my mind too. All my family was getting it at that point, and I said I’m not going to be the only one left.”

Pregnant and Vaccinated

As a resident in Obstetrics and Gynecology, Alice Abernathy, MD, has witnessed firsthand how COVID-19 has affected women during pregnancy and childbirth.

At 24 weeks pregnant, Alice Abernathy decided to get the COVID-19 vaccine. In this January 2020 photo, she celebrates receiving her second dose a few weeks later.

“I carefully monitor our pregnant patients, and not uncommonly I gown up, put on my N95 mask and wheel a patient to the intensive care unit for respiratory support,” Abernathy recently wrote in a column for Brigham Clinical & Research News. “The data, reports and articles informing their care buzz constantly through my brain. I can recount in excruciating detail each patient’s clinical decline to intubation and all the steps that lead to delivery by Caesarean section while the mother remains passive, sedated on a ventilator.”

As a pregnant person herself, this knowledge has also hit especially close to home.

“I look closely at these future parents — their bellies often similar in size to my own — and I fear for them and for myself,” she wrote. “Their faces remain with me. I wonder, could I too be a patient for whom pregnancy ends with unknowingly experiencing the birth of my first child?”

When the Brigham first offered the vaccine to employees, Abernathy found herself reluctant. Pregnant women are at higher risk for a severe form of the disease, and infection also increases the risk of preterm birth. Yet none of the vaccine trials had included pregnant or lactating women — a common practice in clinical trials — leaving her with unanswered questions about if or how the vaccine could affect her baby.

After doing more research and speaking with colleagues in maternal-fetal medicine and reproductive infectious disease to weigh the benefits and potential risks, Abernathy made her decision. At 24 weeks into her pregnancy, she received the vaccine.

“I promptly felt tears well up in my eyes. I suddenly realized that the weight of the fear I was carrying, and diligently ignoring, was slowly receding,” Abernathy wrote. “I felt overwhelmingly privileged to be offered the vaccine and to have the opinion of my colleagues to help guide my decision to take the vaccine.”

More information about COVID-19 vaccination for staff is available on PikeNotes.

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Teams from the Brigham and the Roxbury Tenants of Harvard Association (RTH) joined forces to administer nearly 800 doses of the COVID-19 vaccine to RTH residents and staff over two days. Hosted on March 28 and March 30, the community-based initiative invited RTH residents and staff to the Hale clinic for a safe, comfortable and convenient vaccination experience. In total, approximately 50 employees helped staff the two clinics.

Monica Aurilio, BSN, RN, nurse-in-charge in Neurosciences Intermediate Care, had been excited to kick off 2020 by launching a wellness initiative for her colleagues on the night shift as the new year got underway. But those plans, like so many others, were paused as the pandemic emerged. This year, Aurilio was delighted to find another way to promote health and wellness for nurses: by discussing her experiences on a new resiliency-focused podcast produced by the Department of Nursing.

“I was really excited to learn about the podcast and be asked to participate on an episode about sleep health with Dr. Charles Czeisler,” said Aurilio, who has worked overnights for 25 years in Neurosciences Intermediate Care.

After the immense challenges of the first surge of the pandemic, nursing leaders sought a new way to provide information and tools focused on resiliency and self-care for nurses.

“We thought a podcast would be powerful because nurses can access it anytime, regardless of their work schedules,” said Danika Medina, MBA, RN, FACHE, NEA-BC, associate chief nurse for Ambulatory Services and Procedural Areas. “The topics we cover are relevant to nurses everywhere — at the Brigham, across the Mass General Brigham system and beyond. Throughout the pandemic, nurses everywhere have experienced stress, grief, fear and uncertainty like never before.”

The eight-episode series, hosted by Maddy Pearson, DNP, RN, NEA-BC, senior vice president of Clinical Services and chief nursing officer, features conversations with Brigham clinical nurses and interprofessional colleagues who share their expertise and experiences.

From left: Podcast guest Massiel Eversley and host Maddy Pearson outside the recording studio

“We wanted to create this series to give back to nurses after all they have given of themselves this past year,” said Pearson. “I have learned so much from our guests, and I hope that the information and experiences they share will inspire nurses and others to take care of themselves. They have certainly inspired me.”

Pearson and guests delve into topics including trauma-informed self-care, sleep health, moral distress and cultivating joy and a sense of belonging, among others. While most episodes cover the effects of the pandemic on nurses, the practices, tools and information that guests provide can be accessed by nurses, clinicians and anyone interested in prioritizing self-care at any time.

Christine Murphy, MS, PMHCNS-BC, CARN-AP, program director of the Brigham’s Psychiatric Nursing Resource Service, participated in a podcast episode about how the “health care superhero” label can negatively affect nurses’ well-being.

“The hero construct places an expectation of heroism on nurses, with little acknowledgment of our limitations and experiences as humans,” she explained. “The pandemic has had a significant impact on nurses, and the hero label can be detrimental when nurses assume a hero role and are so focused on taking care of others that they aren’t taking care of their own needs.”

In that episode, Murphy was joined by Susan Gabriel, MSN, RN, CCRN, of the Cardiac Surgery ICU, who shared her perspective on caring for critically ill COVID-19 patients during the first surge. The two also provided listeners with tips for self-care practices, urging nurses to carve out time to care for themselves.

“More than ever, we as nurses need to put the oxygen mask on ourselves first so that we can continue to do what we love, which is taking care of people,” Murphy said.

Episodes will be released weekly, beginning March 24, for eight weeks.

For more information about how to listen, visit brighamandwomens.org/podcasts/resiliency-roadmap.

Samantha Cothias, a former Brigham nurse who will be graduating from medical school this spring, celebrates her match at the Brigham.

As a child, Samantha Cothias, BSN, RN, spent car rides to school pestering her father, a nurse, with questions about the human body: “What is cancer?” she recalls asking. “How does the heart work?”

Growing up in Port au Prince, Haiti, where political turmoil often prompted violence, Cothias was no stranger to injuries or blood. “There were a lot of deaths around me,” she said. “As a young child, I began to wonder, ‘How is it that I can help these people?’” She decided that she wanted to become a doctor someday.

March 19 was a landmark day for Cothias, as it was the date that she and 77 others learned of their acceptance into the Brigham’s Internal Medicine Residency Program. Of that incoming class, 55 percent are women and 30 percent are underrepresented minorities in medicine. Across all Brigham residency programs participating in Match Day — when thousands of medical school students across the country learn where they will continue their medical training — 223 aspiring physicians matched at the hospital this year.

“Between politics, public displays of racism and the global COVID-19 pandemic, this has been an exceptionally challenging year for our patients and our staff, including for the hardworking residents on the front line of care,” said Joel Katz, MD, director of the Internal Medicine Residency Program.

“We are so delighted by our Match Day results and to be able to welcome this amazing group of interns, who bring altruism, innovation, diverse domains of achievement and exceptional talent,” Katz added. “This year, we are also so thrilled by the diverse backgrounds from which these talented physicians come, adding an important dimension to their potential as local and national health care leaders. I am very hopeful that, in regard to both the pandemic and the health and well-being of our patients, brighter days lie ahead.”

The match is a homecoming for Cothias, who served as a hematology-oncology nurse at the Brigham for close to four years and has family ties at the hospital as well. After her family moved to Massachusetts when she was 12, her father, Jean Martel Cothias, BSN, RN, now a nurse on Shapiro 7 East, began working as a patient care assistant (PCA) in the Brigham’s Emergency Department before obtaining his nursing degree over a decade ago. Marching in his footsteps, Cothias volunteered at the Brigham, helping transport patients, when she was still in high school. While pursuing her nursing degree at the University of Massachusetts Boston, she completed an obstetric rotation at the Brigham and worked as a PCA at the hospital for three years.

Cothias unveils her Match Day results.

As a nurse, Cothias enjoyed interacting with patients, but she soon realized that she craved some of the responsibilities and opportunities that being a physician would create. Therefore, while still working as a nurse, she continued her education and was accepted into New York Medical College.

Though she will bear a new title when she returns to the Brigham, Cothias anticipates that the environment will feel familiar. “The Brigham does a very good job at making people feel equal,” she said. “The community at Brigham is not just the physicians; it’s also the nurses, the ancillary support, transport. We all have a mentality that everyone is our patient, and I’m excited to be going back to a community that has nurtured me for so long.”

As a physician, Cothias has emerging hopes of being involved in research. Unanswered questions related to COVID-19 infections are particularly compelling to her, given their overlap with her passion for cardiology and relationship to inflammatory phenomena she has observed as a hematology-oncology nurse.

Cothias’ family shared in her joy on Match Day as her parents, brother and sister-in-law got together on FaceTime to experience the big reveal together.

“We were so excited. My wife was crying. I was crying. My son and his wife were crying. It was all tears of joy. The only one not crying was the dog, who was trying to figure out what was going on with everyone,” said her father, Jean Martel. “There are really no words to express our happiness. They say money can help you have a good life, but some things are worth a lot more — the joy this match brings to my family. It was an awesome day.”

When Cothias made the decision to go to medical school, Jean Martel remembered his daughter showing him the four hospital ID badges she had already acquired from her previous roles at the Brigham.

“She told me, ‘Dad, I’ll be back for the fifth one,’” he remembered. “She had so many residency interviews, but she said the only place she wanted to match at was the Brigham. This hospital is in her blood. I’m so proud of her. She has not only followed in my footsteps but also is going further than I, which is what you hope to see your kids do.”

For Cothias, the match is dream come true. “I had a goal for myself since I was little: I wanted to be a doctor, and I wanted to be in an institution that nourishes individuals,” she said. “It’s not often that someone my age can say that they have accomplished their dream, and that was the overwhelming sensation I had on Match Day. I felt that ‘little me’ was looking up and telling me, ‘You’ve made it. You can only go up from here.’”

In their work as athletic trainers and physical therapists, Michael Belanger ATC, PT, MSPT, and Jim Zachazewski, ATC, PT, DPT, both of the Sports Medicine Service in the Department of Orthopaedic Surgery at Brigham and Women’s/Mass General Health Care Center, Foxborough, can often be seen sprinting onto the field to assist an injured athlete, attending to players on the sidelines or collaborating with physicians to provide injury treatment and prevention programs.

Michael Belanger

During the pandemic, their role as liaisons between student athletes and their care providers has taken on added importance and, like many other health care professionals, expanded in scope to meet their community’s rapidly evolving needs.

Belanger and Zachazewski — two of the 10 staff supporting the Brigham’s Athletic Training team — are now not only evaluating injuries, providing immediate and rehabilitative care for injured high school athletes or taping ankles, but they are also educating local school system administrators, athletic directors, coaches, parents and student athletes on how to minimize the spread of COVID-19.  Additionally, they have played an integral role in creating national policies to prevent the spread of COVID-19 among student athletes across the U.S. for the National Athletic Trainers’ Association (NATA).

Infection control has always been part of athletic training policies, but it has mostly concerned the risk of bloodborne infections in injuries, such as those that might occur with a laceration or fracture. Respiratory illnesses historically haven’t been a major focus for the field.

Although Belanger and Zachazewski acknowledge that they are not infection control experts, as the pandemic emerged, they saw an unmet need — and an opportunity to adapt the expertly crafted, evidence-based policies in place at the Brigham for their community. In February 2020, they launched themselves into establishing COVID-19 protocols for student athletes when athletic trainers and facilities needed it most.

Jim Zachazewski

“There really were not any clinical research papers, policies or standards relative to the prevention and transmission of influenza or upper respiratory infection in athletic training facilities,” let alone any COVID-specific materials, Zachazewski said. “So we had to jump in, just like a lot of primary care providers and nurses when the pandemic started.”

After 10 days of drafting and tailoring the infection control policies put in place at the Brigham to fit athletic training facilities, Belanger and Zachazewski uploaded their finished work to the NATA’s online forum. It was downloaded more than 4,000 times. In recognition of their efforts, Belanger and Zachazewski were asked to join NATA’s taskforce for infection control. They worked with 18 other experts from across the country to produce professional standards for athletic training facilities nationwide.

The issues addressed in Belanger and Zachazewski’s policy to curtail infection spread included relocating common materials found inside a training facility, such as water coolers and gear, to minimize traffic; maintaining proper cleaning of hard surfaces, medical kits and equipment; and providing necessary personal protective equipment and proper disposal procedures.

Belanger and Zachazewski first noticed the need for COVID-19 protocols at a local level. With the Brigham, they provide an athletic training outreach program and team physician coverage to Carver High School, Foxborough High School, King Philip High School, Pembroke High School and Tri-County Regional Vocational Technical High School.

Belanger, who also cares for patients through Rehabilitation Services and serves as clinical supervisor of Athletic Training for Orthopaedic Surgery, said the schools’ athletic training facilities — which are typically small, shared spaces — needed to have the same standard of care as a physical therapy clinic or a physician’s office at the Brigham to limit the spread.

“One of the strengths of working at the Brigham is that there’s a wealth of information and a depth of knowledge, process, policy and procedure that is available to draw on. We realized that what we needed to do was adapt existing resources, rather than create new ones,” Zachazewski said.

An Evolving Field

Belanger and Zachazewski first learned about the athletic training profession as high school students. Belanger saw the athletic trainer at his high school as a role model and the profession as a way to participate in sports throughout his life as a contributor rather than solely as a fan. Zachazewski was a student athletic trainer for his high school and eventually his college.

“I’ve been taping ankles and taking care of injured student athletes since 1970,” Zachazewski said. “I feel strongly that we’ve got to bring the high-quality standards of health care into student athletics.”

Belanger said the pandemic has prompted the athletic training field to change for the better.

“Typically, as an athletic trainer, we tend to think about dealing with athletes from the standpoint of injury and occasionally illness. Now, illness has really been brought to the forefront,” Belanger said. “Infection can happen on the field and on the sidelines. At a game, there needs to be a certain standard for my surroundings to be able to prevent and control the spread of infection.”

Belanger and Zachazewski said building policy at a national level for other athletic trainers has been a very rewarding experience.

“This pandemic has shown that we all need to be able to manage what’s in the best interest of the student athlete,” Belanger said.

Carl J. Shapiro

The Brigham community mourns the loss of Carl J. Shapiro, a distinguished philanthropist and longtime supporter of the Brigham, who died on March 7. He was 108 years old.

Mr. Shapiro and his late wife, Ruth, created the Shapiro Family Foundation in 1961, and were well-known in Boston and beyond for their abundant generosity and dedication to advancing health care, education and the arts.

“Through their extraordinary generosity and vision, Carl and Ruth Shapiro displayed an unwavering commitment to the Brigham for more than 30 years. Their legacy will endure in our community for generations to come,” said Sunil Eappen, MD, MBA, interim president and chief medical officer.

The Shapiro family’s most recognizable contribution was a momentous 2005 gift that supported the construction and establishment of the Carl J. and Ruth Shapiro Cardiovascular Center — enabling an effort to transform cardiology care at the Brigham.

In addition, the Shapiro family’s gifts have supported several initiatives across Emergency Medicine, Oncology, Women’s Health and many other vital research and education programs.

“Carl and Ruth’s legendary philanthropy has helped the Brigham dramatically transform care for countless patients and their loved ones,” Eappen said.

Born in Boston, Mr. Shapiro began his career during the Great Depression — leaving his studies at Boston University to work for his father’s coat-manufacturing business. In 1939, he transformed it into a women’s dress company, Kay Windsor, and continued to grow the business and guide its success until selling it to Vanity Fair in 1971.

“He became known as ‘the Cotton King’ for bringing inexpensive cotton dresses into every woman’s closet,” loved ones wrote in Mr. Shapiro’s obituary. “With his captivating sense of humor and the capacity to approach life with a ‘glass-half-full’ philosophy, he met life’s challenges with determination, optimism and infinite hard work.”

Through the Shapiro Family Foundation, Mr. and Mrs. Shapiro supported numerous nonprofits in Boston and beyond. In the past decade, the foundation has awarded approximately $6.4 million in grants to more than 80 community-based organizations in such areas as disability inclusion, youth arts and youth empowerment.

“[Mr. Shapiro] enjoyed teaching his daughters his values and emphasized the importance of helping others,” his obituary stated. “What he had earned in business, he believed, should be shared to help those in need.”

Loved ones described Mr. Shapiro as a “hands-on partner” with the organizations he supported.

“Carl was known for poring over architectural plans, participating in many ‘hard hat’ visits, consulting with the groups who would occupy a building and making innumerable suggestions to improve the project,” his obituary stated. “He would say that no detail is insignificant, from the size of the patient rooms to the art on the walls, which he believed strongly was good for patient morale.”

In addition to his wife, Ruth, Mr. Shapiro is predeceased by his daughter Rhonda (Ronny) Zinner. He is survived by his daughters Ellen Jaffe and Linda Waintrup; his son-in-law, Michael Zinner; and many grandchildren, great-grandchildren and other loved ones.

From left: Sunny Eappen, Shelly Anderson and Giles Boland listen as George Player responds to an employee question during the forum’s question-and-answer session.

One year after the World Health Organization declared COVID-19 a pandemic, members of the Brigham’s senior leadership team gathered to reflect on lessons learned from the past year, current areas of focus for the organization and the Brigham’s path forward in this next stage of pandemic recovery.

Hosted as a virtual forum for staff on March 11, the event featured a wide-ranging conversation between Sunny Eappen, MD, interim president and chief medical officer, Shelly Anderson, MPM, executive vice president and chief operating officer, and Giles Boland, MD, president of the Brigham and Women’s Physicians Organization, followed by an interactive question-and-answer session.

Eappen opened the discussion by acknowledging all that the Brigham community has endured over the past year.

“It has been really hard. I know it. I see it as I walk around and as I work. People are tired, exhausted and a little bit scared. The future, although I am optimistic, still remains a little bit uncertain,” Eappen said. “As leaders, all of us want to acknowledge that we appreciate the stress that all of you have been through and commend all of the work that you’ve done. It’s phenomenal.”

Anderson noted how the past year has reaffirmed the Brigham’s institutional values: We Care, We’re Stronger Together, We Pursue Excellence and We Create Breakthroughs.

“Our values are alive, and they’ve been achieved in many amazing ways over the past year,” Anderson said. “They are what will hold us together as we move forward into the unknown — but with a lot of hope — to the end of the tunnel that we’ve been in.”

Boland said he has been profoundly impressed by the resilience and strength staff have demonstrated in the face of such trying and prolonged circumstances.

“We’ve really worked hard together, and we’re so much better for it,” Boland said. “That goes so much to who we are here at the Brigham — our culture and the way we work together, the way we respect each other, the way we reach out. I know many of you stepped up and helped the organization and patients. In some ways, it has been the best part of my career to see this work we’ve all done.”

Looking Ahead

In reflecting on lessons learned over the past year, leaders noted how the pandemic’s challenges inspired a wave of innovation and agility as the organization embraced new ways of working. Examples include the rapid and successful adoption of virtual care, making equity a priority in everything the Brigham does and collaborating more closely across the Mass General Brigham system.

Looking ahead to the coming year and beyond, the leadership team highlighted several areas of focus, such as strengthening the institution’s financial foundation; elevating the patient and employee experience; advancing diversity, equity and inclusion through initiatives such as United Against Racism and a reinvigorated focus on community health; and developing structures to better manage performance and prioritization of initiatives.

The past year has also brought the importance of work-life balance and staff wellness sharply into focus. Leaders expressed their concern about burnout and asked departments and teams to reevaluate practices that don’t support staff wellness, such as holding non-emergency meetings outside of normal working hours.

“We have two modes right now, and one of them is crisis mode. I think we all have to take time to reflect and determine whether or not the issue of the moment is really a crisis or something that we can work on in a relatively normal fashion,” Anderson said. “People have been in crisis mode for a solid year, so we all need to start taking a step back and saying, OK, what are my personal boundaries again?”

In the face of so much transition, Eappen emphasized that change always requires balance.

“I was here when we first formed Partners and now Mass General Brigham. I have never seen the movement towards systemness and aligning like I have in the last six months or so, and I think it is really good. I am completely committed to working within MGB to create this seamless patient experience that goes across all our hospitals,” Eappen said. “I’m also committed to completely maintaining the phenomenal culture that we have here at the Brigham and the uniqueness that we have. We need both of those things to really grow and excel.”

Lora Bankova recently launched a clinical trial to better understand post-COVID anosmia.

Last March, Kara VanGuilder took a sip of her morning coffee and nearly gagged. It tasted off — almost foul.

As the day went on, VanGuilder noticed that, in fact, nothing tasted right. Her mind flashed back to recent headlines about the emerging coronavirus epidemic in Europe and Asia and a new, unusual symptom that people were experiencing: the loss of taste and smell.

VanGuilder remembers the unsettling realization that came next. “Oh, my God. I think I have COVID,” she recalled thinking.

Sure enough, VanGuilder, a fellowship coordinator in the Division of Allergy and Clinical Immunology, was diagnosed with COVID-19 in early March 2020, just days before the World Health Organization declared a pandemic. Soon after, VanGuilder completely lost her sense of taste and smell — a phenomenon known as anosmia. Even after recovering from other symptoms, she couldn’t smell or taste anything for two months.

One year later, VanGuilder has regained only about 50 percent of both senses. In addition to her decreased sense of taste and smell, she now experiences phantom odors, such as natural gas, which has caused her to worry there’s a gas leak in her apartment. Meanwhile, certain tastes and smells still don’t sit right. Foods she used to enjoy, such as chocolate and peanut butter, taste rancid.

“It’s lowered my quality of life,” VanGuilder said. “I definitely took my senses of smell and taste for granted until I lost them.”

Anosmia is now regarded as one of COVID-19’s most common — and puzzling — symptoms, with scientists still struggling to understand its causes, why it only affects some people with COVID-19 and why some regain their senses quickly while others never recover them.

Inspired by an unexpected connection with a colleague-turned-patient, one Brigham allergist and researcher is working to solve the mystery behind this perplexing and often distressing symptom.

An Unexpected Link

When she isn’t caring for patients at the Allergy and Clinical Immunology clinic at 850 Boylston St., Lora Bankova, MD, studies the relationship between allergies and inflammation at the Jeff and Penny Vinik Center for Allergic Disease Research in the Hale Building for Transformative Medicine.

Prior to the pandemic, Bankova had begun investigating how exposure to allergens affected the olfactory mucosa — a small region in upper nasal cavity that contains the cells responsible for our sense of smell.

“We were thinking eventually of looking into how viruses affect this region, but then COVID hit and, all of a sudden, we were seeing a virus that caused people to profoundly lose their sense of smell very abruptly,” Bankova said. “As the months went on, we started realizing that not everybody gets their sense of smell back right away — that for some people it’s partial recovery, where they recover 20 to 30 percent fairly rapidly and then very slowly their sense of smell comes back. But there are some rare people out there who, six months or almost a year later, still haven’t fully recovered their sense of smell.”

Bankova happens to work just steps away from one of those rare people living with long-term, post-COVID anosmia: VanGuilder, who has an office next door to Bankova’s in the Hale building.

It wasn’t long before the two started chatting about VanGuilder’s personal experiences with anosmia — first as casual conversations between officemates and, eventually, as doctor and patient in the clinic.

The alignment between Bankova’s own research interests and the evolving pandemic, as well as an unexpected personal connection, stimulated both her curiosity and compassion.

Inspired to dig deeper into the mysteries surrounding post-COVID anosmia, Bankova and her research colleagues recently launched a clinical trial that will look at the differences in olfactory mucosa cells of people with and without post-COVID anosmia. The team hopes to understand why some people regain their sense of smell and/or taste and uncover any biological clues that may point to a potential treatment.

For a scientist who never envisioned herself conducting human studies, Bankova says launching this trial was an unexpected career twist.

“I always imagined that the way I would be a physician-scientist is by talking to patients, becoming interested in a clinical question and then conducting mouse studies to find the answer from a mechanistic standpoint,” Bankova said. “I think that if it wasn’t for Kara, I probably still would’ve just been intrigued by this problem and read a lot about it. Between this personal connection and it being the right time, in terms of where my research was headed, I felt an additional motivation to get this study going.”

Exploring the Mystery

A large part of what makes this area ripe for investigation is that there are still so many unknowns surrounding post-COVID anosmia, Bankova said.

“As a patient, you never want to be the ‘interesting’ patient,” she said. “But as a scientist, it’s always exciting to work on a mystery. For most things in medicine, we can come up with some hypothesis for why something might be happening, and we don’t have a very good one yet here.”

When people lose their sense of smell, Bankova explained, there often are three explanations: inflammation usually manifested as congestion, trauma that has damaged the olfactory mucosa or a defect of the signaling from the olfactory mucosa to the brain. None of those is clearly present in people with COVID-19.

One challenging aspect of studying post-COVID anosmia is that it can be difficult to access the area of the nose that’s responsible for our sense of smell, Bankova added.

“It’s very high up in the nose, and in humans it’s a tiny, tiny little area,” she explained. “Most studies that have looked into COVID in the nose so far have been doing nasal swabs in the part of the nose that conducts air, but not the part that’s responsible for our sense of smell.”

For their trial, Bankova and her team will provide study participants with sponges to collect nasal fluids and compare how those samples change over time in three groups: people who lost and regained their sense of smell and/or taste, people who continue to experience post-COVID anosmia and healthy individuals who never had COVID-19. The team will also use specialized swabs that can comfortably reach the olfactory mucosa, collect cells from that area and then conduct genetic sequencing to better understand the differences in those cells between the three groups.

While the trial is just getting started, VanGuilder said she is excited to enroll as a participant and remains optimistic that science will point to a solution.

“I believe that Dr. Bankova’s work is going to be transformative,” she said. “Maybe one day I’ll wake up and coffee will taste great again. In the meantime, I’m staying hopeful.”

Jennifer “Jay” Martell

The Brigham and Women’s community mourns the loss of Jennifer “Jay” Martell, BSN, RN, of the Intermediate Care Float Pool, who died Jan. 17 of stomach cancer. She was 54.

Mrs. Martell joined the Brigham 22 years ago on Braunwald Tower 10CD, the Neurosciences Intermediate Care Unit, and later transitioned to the Float Pool.

“Jennifer was one of a kind,” said Melissa Coughlin, BSN, RN, of Braunwald Tower 10BCD. “She was one of the strongest women I know. A funny, smart, caring, willful, determined, generous, warrior-type of woman. If nurses had numbers like athletes, hers would need to be retired.”

Siobhan Raftery, BSN, RN, CNRN, assistant nursing director of Braunwald Tower 10A and 10BCD, said she felt fortunate to have worked with Mrs. Martell.

“She was a gift, a rare gem. She always stopped to ask you how you were doing, about your family and kids,” she said. “She was a phenomenal storyteller, a dedicated nurse, mother and daughter who lived her life fully until her last moment. I will never forget her and will always miss her.”

Andrea Fonseca, MSN, RN, ANP-C, of Shapiro 8, reflected on the personal and professional lessons she learned from Mrs. Martell.

“I was a brand-new nurse when Jennifer and I met, and she taught me so many things — things about being a nurse, about standing up for what’s right, about navigating this world as a lesbian, about how to create a family and about how to be yourself and not care what anyone thinks of it,” Fonseca said. “Jennifer has left an everlasting impression on my life.”

Mrs. Martell loved adventure — skydiving, traveling and riding a motorcycle — but she was happiest at home, tinkering with something or working on a puzzle with her children and making everyone laugh, said her wife, Amy Hartmann Martell.

“Jay loved being a nurse, and she embodied all that being a nurse means. She created meaning in her life by taking care of others and would always make time for a friend, whether for conversation over coffee or to fix their broken lawnmower,” Hartmann Martell shared. “She was a problem-solver, a quintessential MacGyver and believed in working hard and getting a job done without fuss and fanfare. She had a magnetic personality. If you knew her, you loved her.”

In addition to her wife, Mrs. Martell is survived by their children, Lilja and Theo; her father, Robert “Jake” Jacobson; her brother, Erik Jacobson; and many other family members and friends.

In lieu of flowers, contributions in Mrs. Martell’s name may be made to Debbie’s Dream Foundation, 2 S University Dr., #326, Plantation, FL 33324.

Bernard Lown

The Brigham community mourns the loss of Bernard Lown, MD, a retired Brigham cardiologist, Nobel Peace Prize recipient, pioneering innovator and a luminary in his field. Dr. Lown died Feb. 16 of complications related to congestive heart failure. He was 99.

In a career that spanned more than five decades, Dr. Lown made pivotal contributions to cardiovascular medicine and helped changed its practice. He was also an activist and advocate for peace, and one of the co-founders of International Physicians for the Prevention of Nuclear War (IPPNW), an organization that won the 1985 Nobel Peace Prize for its campaign against nuclear war.

“The world has lost a great clinician, inventor, teacher and peace activist,” said James Muller, MD, of the Division of Cardiovascular Medicine. Muller, a fellow founding member of IPPNW, recalled Dr. Lown’s courage and skillful, dedicated leadership. “As will all who knew him, I will miss him greatly and treasure the moments when I was able to observe his heroic acts.”

During his long and storied research career, Dr. Lown focused on major challenges in cardiovascular medicine. His investigations led to many breakthroughs, including the direct current defibrillator, now the standard of care for cardiac resuscitation. He also developed a device called the cardioverter for correcting disordered heart rhythms and introduced the use of the drug lidocaine to control heart rhythms. All of these advancements have helped make possible modern coronary care units.

Dr. Lown’s research also helped illuminate the role of psychological factors — such as stress — in heart disease, and he was among the first physicians to emphasize the importance of diet and exercise in treating heart disease.

Dr. Lown left an indelible mark on his students, many of whom vividly recalled his teachings and described Dr. Lown’s influence on their careers. The Brigham’s Bernard Lown Award for Excellence in Teaching, established in 2010, is named after Dr. Lown and celebrates physicians who are outstanding clinical teachers.

“He really was a Brigham great,” said Marshall Wolf, MD, director emeritus of the Brigham’s Medical Residency Programs, who trained under Dr. Lown during his internship year and completed a fellowship with him. “He was a great physician teacher and was beloved both by his patients and his students. He was a role model for me — someone who really cared about his patients and made sure they got the best care.”

Charles Blatt, MD, a physician in the Lown Cardiovascular Group, began working with Dr. Lown as a medical student when he spent a summer doing research in Dr. Lown’s laboratory. Blatt stayed on after his fellowship, became an associate in Dr. Lown’s practice and has been a part of the Lown Cardiovascular Group ever since. Blatt fondly recalled conducting rounds with Dr. Lown during his medical training.

“He instilled in me that it was a privilege to be a physician taking part in that very intimate interaction with the patient — to learn about their lives and to be trusted. Each person’s story was like a part of a play, and you had a front-row seat,” said Blatt. “I’ve tried to emulate the way he would teach his students in the way he taught me. There’s a handful of teachers who stand out in one’s whole career. For me, Dr. Lown stands at the top of that list.”

Dr. Lown is survived by his three children, Anne, Fredric and Naomi Lown, and five grandchildren. He was predeceased by his wife, Louise Lown.

Fittingly for Valentine’s Day, Aubrey Love went home with her family on Feb. 14, following a 15-day stay in the NICU.

Everyone knows love is in the air on Valentine’s Day, but one for family, the holiday was cause for an extra-special celebration this year.

Aubrey Love was born prematurely at 33 weeks and three days gestation, weighing just 4 pounds and 15.7 ounces. After 15 days in the Brigham’s Neonatal Intensive Care Unit (NICU), she was able to go home with her parents, Jennifer Love and Robert Hall, on Feb. 14 — right on time for Valentine’s Day.

“Bringing Aubrey home was the second-best day of my life, other than the day I gave birth to her,” said her mother, Jennifer. “I would just like to thank everyone that was involved in Aubrey’s birth and NICU stay. She couldn’t have been in better hands. We are so thankful and blessed.”

Contributing to the Love and Hall family’s outstanding experience was the superb nursing care they received, Jennifer added.

“From the minute I arrived at Brigham and Women’s, all of the nurses were so amazing, especially my nurse in the delivery room, Kirsten [Loveland, BSN, RN]. She was so awesome to me during my labor. I don’t know how I would have done it without her,” she said. “Aubrey’s NICU nurses were all amazing, but her favorites were Alli [Manzelli, BSN, RN] and Katie [Clements, BSN, RN]. They were so sweet to her and really went above and beyond to make her feel comfortable.”

Lynn Detwiler

The Brigham community mourns the loss of Lynn Detwiler, BSN, RN, an oncology case manager in Care Continuum Management, who died Jan. 16 of breast cancer. She was 55.

A member of the Brigham community since 2019, Mrs. Detwiler is remembered by colleagues for her comforting presence and warm, loving nature.

“Lynn was the kindest soul and very generous with her love,” said Ania Noel-Edwards, BSN, RN, care coordination nurse. “She always had a beautiful smile and way of making you laugh, and she never really worried too much, even when her patient load was heavy. Her favorite words were, ‘It’s OK, my dear. I love you.’”

As an oncology case manager, Mrs. Detwiler was responsible for helping cancer patients and their families navigate the intricacies of admission, discharge, insurance questions, medication coverage and post-discharge services, such as connecting them with a visiting nurse or rehabilitation facility.

Above all, it was Mrs. Detwiler’s unwavering commitment to her patients and their families — even while managing her own illness — that left her colleagues in awe.

“Lynn was always interested in helping people and never complained about anything she was going through, no matter how much pain she was having or any of the side effects she had,” said Carolyn Molina, BSN, RN, care coordination nurse. “She had so much strength and this ability to make you feel at ease and welcome every time you talked to her. She was a genuine and sweet person whom I am honored to call my friend, and I greatly miss her.”

Alexandra Koffman, MSN, RN, care coordination nurse, felt a special bond with Mrs. Detwiler not only as a friend and colleague but also because they had both lived with breast cancer. Koffman, like her colleagues, also recalled how Mrs. Detwiler’s tireless work ethic and soothing words were an inspiration.

“She worked hard when most would have given into her disease,” Koffman said. “I never heard her say a discouraging word, and she was always smiling.  I will miss her.”

Lalitha Mantha, MPH, RN, a staff nurse on CWN 7 who also works as a per-diem care coordination nurse, recalled how she got to know Mrs. Detwiler after covering one of her shifts. From there, their friendship blossomed.

“Lynn is the only person who approached me to find out if there were any gaps in her work and how she could improve. I was struck by the sincerity of her request,” Mantha said. “Shortly after, I learned she was sick. I remain in awe of her ability to face the reality of her condition daily, in the lives of other cancer patients. It is my good fortune that our paths crossed and that she was my friend. I will miss her raw sense of humor and her texts with heart emojis.”

Nursing was truly Mrs. Detwiler’s calling, Noel-Edwards said.

“During my last conversation with her before she passed, Lynn said how much she missed the Brigham family. She enjoyed being here with the team,” she said. “She was extremely dedicated to her patients. There were occasions when she had a chemotherapy appointment at Dana-Farber in the afternoon and she would come into work that morning. We would tell her to stay home and rest, but she was very committed.”

Mrs. Detwiler is survived by her husband, Gregg, and their daughter, Elena. She is predeceased by her son, José Vincente.

From left: PACE physician assistants Marissa Jurkiewicz and Marissa Cauley converse with PACE hospitalist Elizabeth Petersen during morning rounds on Shapiro 7.

Physician assistant (PA) Erin Kelly-Makol, PA-C, remembers the flood of emotions she and her colleagues felt last spring as they began caring for a rapidly growing number of patients with COVID-19.

As members of the Brigham’s Physician Assistant Clinical Educator (PACE) Service — a general medical service staffed by attending hospitalists and PAs — Kelly-Makol and her colleagues were among the first medical teams that were reassigned to care for hospitalized patients with COVID-19 in March 2020. Nearly one year later, PACE clinicians remain on the pandemic’s front lines — along with nurses, residents, respiratory therapists and other interprofessional team members — continuing to care for COVID-19 patients without interruption.

Amid concerns about caring for very sick patients, navigating rapidly changing clinical protocols and fearing they would catch the virus themselves, Kelly-Makol recalled another strong feeling from those early days of the pandemic: unity.

“As tight-knit as we were on the General Medicine units, the COVID teams have made us even closer,” said Kelly-Makol, who has been part of the PACE Service for eight years. “When we were starting to provide care on the Special Pathogens Unit, there was a lot of anxiety. We started this group text that became a stream-of-consciousness thread for our thoughts, concerns and occasionally humor. It kept us all smiling and feeling like we weren’t alone.”

Established in 2005, the PACE Service is one of four branches of the Brigham’s Hospitalist Service, which delivers inpatient care for the wide range of conditions that general medicine covers. This can include patients with anything from asthma exacerbations to heart failure, HIV, gastrointestinal bleeds, new cancer diagnoses, acute rheumatology disorders and more. While PACE’s role has evolved considerably due to the pandemic, its clinicians say their culture — defined by multidisciplinary collaboration, mutual respect and heartfelt connections — has remained the same since day one.

“The core value of PACE is that we are in this together. There’s an understanding that nobody can do this work by themselves,” said Matthew Vitale, MD, medical director of the PACE Service. “My favorite part of this job is watching the ways team members help each other grow and support one another in circumstances that can be very trying. These incredible clinicians care for each other, acknowledge their struggles and come together to do a phenomenal job every day.”

Marissa Cauley, PA-C, one of the service’s two chief PAs, said PACE strives to create an environment where all perspectives are heard.

“What makes PACE special is the interdisciplinary collegiality between physician assistants and attending physicians. We really work together as a team,” Cauley said. “When you feel respected and that your opinion matters, it makes coming to work that much more enjoyable. You’re valued, and that means a lot.”

Team-Based Care

Until PACE was formed, the Brigham’s Hospitalist Service was made up of teaching services consisting of attendings, residents and interns. In 2003, a nationwide regulatory change went into effect that limited resident work hours. While the new restrictions represented an important milestone in workplace safety and well-being for trainees, they also created staffing challenges at hospitals around the country, including the Brigham.

The Brigham sought to bridge this gap by tapping a historically overlooked pipeline of advanced practice providers — physician assistants. The PACE Service was born.

Jurkiewicz, Cauley and Peterson review care plans during rounds.

During a typical shift, each PACE team is staffed by two PAs and an attending hospitalist who round together, develop clinical plans and care for patients in collaboration with nurses, social workers, Care Coordination staff, physical therapists and other multidisciplinary colleagues. Overnight, the teams are covered by a member of the Hospital Medicine Nocturnist Service.

One point of pride for PAs is that PACE is not a triaged service, meaning that patients aren’t assigned to a PA team or resident team based on the complexity of their illness. Both teams are considered equally capable of delivering advanced, expert care in partnership with attending physicians on the General Medicine and Special Pathogens units.

“There is no patient too complex for our PA team,” said Leanne Wines, PA-C, co-chief PA of the PACE Service. “We’re really proud to be an essential part of the General Medicine Service.”

When PACE first launched, it consisted of one team of five PAs and three attendings, with a typical daily census of about 15 patients. Today, PACE now comprises three teams — known as PACE A, B and C — supported by a total of 17 PAs and up to 40 attendings, caring for up to 44 patients per day.

“We were one of the first academic medical centers in the country to adopt this model,” said Christopher Roy, MD, medical director of the Hospitalist Service, who led the PACE Service’s launch. “I’m so proud of how the service has grown.”

The service’s team-based approach to care is at the heart of its clinical operations, Vitale said.

“Attendings and PAs jointly make decisions about how to proceed in an area of ambiguity, such as a medically complicated patient at end of life whose family is making a choice between ICU or comfort measures,” Vitale said. “We put our heads together to come up with the best answer we can, based on the patient’s and family’s goals of care.”

Wines noted that the breadth of expertise and diverse backgrounds in PACE can be especially useful in caring for general medicine patients, whose medical needs are often varied and complex.

“The range of experience on the team is really impressive,” Wines said. “Marissa and I came from cardiac surgery, so we bring those cardiology skills. We also have PAs who came from neurosurgery, urogynecology, primary care and more. There are people on the team with 15 years of experience and some who just graduated last spring. All of this means we’re constantly learning from each other and tapping into different skill sets.”

Responding to the Surge — and Beyond

Since the arrival of COVID-19, the PACE Service has played a vital role in pandemic response. But when the spring 2020 surge set in, the teams quickly realized they needed more help. To manage the sharp increase in patient volume and complexity during the initial surge, about 40 PAs from other areas of the hospital were temporarily reassigned to the PA Special Pathogen Teams.

To help their colleagues acclimate to this new assignment, PACE PAs quickly created information packets, training manuals and in-person training shifts so that reassigned PAs would have the resources they needed to succeed.

“We were not only caring for COVID patients, but we were also training PAs from Surgery and OB/GYN on how to care for General Medicine patients,” Wines said. “It was a lot on our team during an already stressful time, but we were so grateful for the help because we absolutely needed it.”

Kelly-Makol said the extraordinary compassion, teamwork and dedication she’s witnessed over the past year has reminded her of what being part of PACE is all about.

“Once you’re in, you feel like family,” she said. “It’s a special group of people, and there’s never been a time when I felt unsupported. You truly know that, no matter what you’re facing in the day, you’ll have the support of your peers. We’re there for each other no matter what.”

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

Angel Colon

The Brigham community mourns the loss of Angel Colon, who passed away on Dec. 22 following an illness. He was 56.

Mr. Colon had been a member of the Brigham family since 2003. He is remembered as a hardworking, kind and thoughtful colleague and friend.

He was beloved by those he worked with who will miss his positive spirit.

“Losing Angel is like losing a close friend,” said Labina Shrestha, operations manager in Environmental Services. “We miss him every day. He was a kind-hearted person who enjoyed helping others. Angel worked very diligently and always had a smile on his face. He will be in our hearts forever.”

A project technician in Environmental Services for more than 17 years, Mr. Colon was responsible for many tasks throughout the hospital, including groundskeeping, snow removal, floor maintenance and more. He was known by many people at the Brigham, including long-time colleague Vilma Vargas, a supervisor in the department.

“What it means to lose someone like Angel is very hard to describe in a few words,” Vargas said. “I can say that I’ve never met anyone else who was so humble and honest. Angel had a beautiful soul. We are going to miss him, and he’ll be in our memories forever.”

Rachel Hall, a manager in Environmental Services, was always struck by how seriously Mr. Colon took his responsibilities at work and how much he cared for those around him.

“He had the innate ability to sincerely be a kind and hardworking colleague to all,” Hall said. “He spoke to everyone he walked by while being dutiful at his job. He wasn’t a man of many words, but he was a man of high energy and a positive spirit.”

Mr. Colon is survived by his wife, Maria Pinto; his sons, Nathaniel Pinto and Luis Colon; his daughter, Norma J. Colon; five grandsons, three granddaughters and many other family members, friends and loved ones.

Coleen Dozier

The Brigham community mourns the loss of Coleen Dozier, BSN, RN, of the Post-Anesthesia Care Unit (PACU), who died on Jan. 10 of cancer. She was 46.

Mrs. Dozier is remembered by her PACU colleagues for her devotion to caring for others: her patients and their families, her colleagues and her own family, including husband Jarrett, stepson Sean and twin 4-year old sons Gavin and Owen.

“Coleen leaves a beautiful legacy,” said Heather Ankiewicz, RN, of the PACU. “Her ability to radiate love brought many together in countless ways throughout her journey.”

Mrs. Dozier, who earned her bachelor’s degree in nursing from UMass Boston, joined the Brigham family 21 years ago, finding “a second home and her vocation when she arrived in the PACU,” said Jarrett. “As she relentlessly battled her own illness these last few years, those sister angel nurses of Coleen’s Crew and her whole BWH family fought along with her. They provided their own tremendous strength and care to Coleen and our family around the clock in her final days, on their own time with full hearts.”

The PACU team held a virtual celebration of Mrs. Dozier’s life on Jan. 19 to grieve, support each other and share precious memories.

“Coleen touched this PACU family in so many ways with her kind soul and quiet light,” said Varina Bednarz, BSN, RN, of the PACU.

Jarrett wrote of the joyful, warm home Coleen created for her family in Weymouth, “where the food, laughter and love is always abundant,” he said. “Her passion may have been caring for others, but her true calling was caring for her own. Our blessings increased when the greatest lights in her life arrived with the birth of her boys, Gavin and Owen. Her smile was always astonishingly radiant and genuine, but never so much as when she was smiling about all of her boys.”

In lieu of flowers, donations may be made to The Dozier Boys’ Fund, c/o TD Bank, 754 Main St., Weymouth, MA 02190.

From left: Meg Nemitz (left), Winifred Caddeus, Ana Hoffman and Marinos Sotiropoulos reflect on their experiences receiving the COVID-19 vaccine.

When Medical Intensive Care Unit (MICU) nurse Meg Nemitz, BSN, RN, learned she and her colleagues were eligible to join the hospital’s first group of employees to be vaccinated against COVID-19, it felt like a gift. It contained something precious, something she hadn’t felt in months — a sense of control.

“Going down to Hale for the vaccine on that first day made me feel empowered,” she said. “It felt like there was finally some way to fight back. We no longer needed to feel so powerless.”

Since the Brigham’s COVID-19 Employee Vaccination Program launched on Dec. 17, more than 12,000 members of the Brigham community have received their first dose of the vaccine. Nemitz is among the 2,600-plus staff at the Brigham who have now obtained their second dose. Across the Mass General Brigham (MGB) system, more than 43,000 employees have received their first dose, and over 7,100 have gotten their second shot.

“I have confidence in the science — and the scientists — that this vaccine is safe and effective. The trials had such a high success rate,” Nemitz said. “And if people don’t get it, what’s the alternative? Are we just going to keep doing what we’re doing? How many more lives are we going to have to lose?”

When Winifred Caddeus, first cook in Food Services, became eligible to be vaccinated in December, he had no hesitations about getting the shot either.

“With that virus out there, I want to protect myself. The best thing to do is to just take the shot,” he said. “I still have to wear the mask, wash my hands and keep my distance, but it feels good to have that protection.”

Caddeus said he experienced some minor fatigue after receiving his first dose of the vaccine. He returned for his second dose on Jan. 7 and has had no additional side effects.

Such experiences with the vaccine are typical, according to a systemwide analysis of reported side effects from vaccinated employees across MGB. As of Jan. 13, slightly more than half of vaccinated employees reported no symptoms after their first or second dose of the vaccine.

Mild symptoms — such as mild fatigue, mild body aches or low-grade fever — were reported by 39 percent of vaccinated staff after their first dose. Of that group, only one in 10 saw their symptoms last for more than a day.

About 8 percent of vaccinated staff experienced symptoms they categorized as more severe or typical of a COVID-19 infection. While the vaccine cannot give someone COVID-19, testing is still mandatory for staff who experience these symptoms after vaccination to ensure they were not unknowingly infected before the vaccine gave them immunity.

Allergic reactions, which include mild pain at the injection site, followed a similar pattern. For those who received their first dose, 48 percent reported no allergic reactions and half of vaccinated staff said they only had mild discomfort where they received the vaccine in their arm. One percent reported a rash, and a fraction of a percent had moderate allergic reactions.

“I know a lot of people are scared to take it. I don’t know what they’ve heard, but I want to tell them it’s the best way to protect yourself,” Caddeus said. “Just give it a shot. If we get more people protected, it’s better for us — not only in the hospital but everywhere people go outside of work.”

Starting a Dialogue

Ana Hoffman, a Spanish-language medical interpreter in Interpreter Services, described getting her first dose on Dec. 17 as an “early birthday gift” that she was excited, honored and grateful to receive.

“The best way to stop this pandemic is if everyone gets vaccinated. I want to go back to a normal life,” said Hoffman, who received her second dose on Jan. 7. “We see so many people sick and dying from this virus. I see these patients every day, and the family meetings are so sad and difficult. Honestly, it’s awful and traumatic. The way we change things is if each one of us does our part by getting vaccinated.”

A passionate advocate for vaccination, Hoffman has spoken with colleagues, family, friends and members of her community about her experiences and reassured them that the vaccine is safe and effective. To help kickstart conversations, she began wearing a button that she made, bearing a simple message: “I’m vaccinated and I feel great! ASK ME.” Since then, she has created 100 more buttons and passed them out to vaccinated colleagues.

“I feel responsible to lead and encourage others to be vaccinated. There are people who are apprehensive,” Hoffman said. “My arm was a little sore where they injected the vaccine, and for the first one or two days, I had a headache, which might have been because I didn’t have any coffee that morning. But that’s it. I trust science and believe our infectious disease experts.”

‘The Beginning of the End’

Marinos Sotiropoulos, MD, a research fellow in the Translational Neuroimmunology Research Center, said he was eagerly watching his email for the announcement that his vaccine eligibility group, Wave C, was open for scheduling.

“We’re all looking for a way out of this, and it’s easy to lose hope, especially as this pandemic drags on and on. But this vaccine is the beginning of the end,” said Sotiropoulos, who works in a laboratory that processes clinical samples. “By having more and more people get this vaccine, we will achieve a level of herd immunity soon enough that this virus will not be able to spread.”

After getting his first dose on Jan. 6, Sotiropoulos said he experienced some mild side effects: soreness in his arm, fatigue and mild body aches. But rather than be concerned, he was encouraged by the reaction.

“It was my immune system showing me something was happening,” he said.

He also noted that it’s important for staff to engage colleagues, loved ones and community members in discussions about the importance of vaccination.

“As members of the health care workforce, everyone is watching what we do and say. Our friends and relatives in outside fields will be looking to us for guidance and advice,” he said. “By leading this wave of trust towards the science, the vaccine and its safety, hopefully we will inspire others to get vaccinated as well.”

The Skin of Color team, from left: Deborah Scott, Kristina Liu, Sotonye Imadojemu and Jennifer Lin

Inez Dover listened carefully while her longtime Brigham dermatologist, Jennifer Lin, MD, asked a series of questions over the phone about a hot, prickly rash that Dover had discovered on her body recently. One of her doctor’s first inquiries: What color was the lesion?

“Some of it was red and some of it was brown,” Dover recalled. “I was thinking, aren’t rashes supposed to be all red? Or pink? But Dr. Lin said, ‘Yes, that’s OK. It’s because of your complexion.’ She explained that, because I am a woman of color, a rash would look like that on my skin. And when she prescribed medication for it, she advised me not to use it for too long because it could lighten my skin.”

Dover, who is African American, remembers the interaction as a refreshing departure from other experiences she’s had as a person of color in the health care system.

“The disproportionate way people of color are treated and dehumanized in the health care system is a major concern for me,” she said. “As a Black woman, I have had negative experiences with physicians, and when I was choosing a dermatologist, it was critically important that I selected someone who understands women of color’s skin. It’s a change-maker.”

To help address the historic disparities, frustrations and indignities that patients of color like Dover have experienced in trying to obtain care for skin and hair disorders, a group of Brigham dermatologists came together in 2011 to create the Skin of Color Dermatology Program. Staffed by a team of four attending dermatologists, the program provides individualized, culturally sensitive care to patients of color.

“As doctors, we see everyone as equivalent. Everyone is someone I want to help. In some ways, we’re colorblind when we’re examining our patients, and yet in dermatology, we do have to pay attention to color, acknowledge and celebrate it,” said Lin, one of the program’s founding co-directors. “Being part of a program that creates the space to do that is a real privilege for me, especially as someone who has lived with having skin of color myself.”

‘Skin Is Skin, but Skin Is Not Skin’

The Skin of Color program has grown steadily over the year, now offering specialized services at two locations: 221 Longwood Ave. in Boston and 850 Boylston St. in Chestnut Hill. In addition to patient care, the program provides education and training opportunities for dermatology residents. And as its momentum continues to build, the team is beginning to explore research opportunities to help grow the number of studies focusing on skin of color.

“Skin is skin, but skin is not skin. There are differences in the way different skin tones respond to injury and certain skin diseases,” said Deborah Scott, MD, also a founding co-director of the program. “You might think, why do we need a dedicated program for this? In an ideal world, we wouldn’t. But it’s not an ideal world, and it’s important for us to not only be able to treat patients appropriately but also to ensure our trainees are prepared to care for all skin types after they complete their training and go out into the world.”

Dover, who began seeing Lin before the Skin of Color program formed, said she has been continually impressed with her dermatologist’s thoughtful, personalized and patient-centered approach.

“Dr. Lin is the best. She is very detailed and explicit in her explanations, and her bedside manner is impeccable,” said Dover, a retired educator, ordained minister and grandmother of three. “Whatever recommendations she makes for me, she’s always thinking about my background and what differences might be seen in my complexion.”

Acknowledging the Gaps

Chronic diseases such as discoid lupus and sarcoidosis, both of which cause skin inflammation, are more common in darker skin types, particularly among people of African descent. Meanwhile, many treatments for skin conditions, including lasers and certain ointments, can affect darker skin tones differently than lighter ones.

Some disorders can be more noticeable, and devastating, on people with darker skin — including conditions such as hyperpigmentation and vitiligo, which respectively cause an excess or loss of skin pigment.

“When patients have a skin disease, it’s often not their choice whether they disclose it or not. It is particularly true with vitiligo, which can be quite noticeable,” said Kristina Liu, MD, MHS, a dermatologist in the Skin of Color program and director of the Vitiligo Clinic. “There is a lot of misunderstanding about the disease, and vitiligo patients with skin of color experience much higher levels of stigma and distress.”

Scott and Lin co-founded the Skin of Color program with former colleague Vaneeta Sheth, MD, after seeing these conditions and needs addressed inadequately, or sometimes not at all, by existing systems of care.

“I’m African American, and when I first started practicing 30 years ago, I would see patients who said another dermatologist sent them to me because their dermatologist didn’t know how to treat their hair. I thought that was appalling,” said Scott, who also serves as director of the Laser & Skin Health Center and co-director of the Hair Loss Clinic. “I certainly knew how to treat patients whose hair didn’t look like mine. That’s what triggered my specialization in hair, actually. It wasn’t that I was particularly interested in the topic as much as I felt I needed to be a resource for patients who were being ignored or having their issues minimized.”

Reshaping Dermatology

While dermatology practice and education has evolved considerably since then, there is a continued need to address gaps and inequities through a program like Skin of Color.

“I am not someone who thinks that you can only care for patients who look like you. That’s not our goal at all. In fact, this is a clinic that should be obsolete. Every dermatologist has the ability to care for patients with darker skin,” said Lin, who also serves as co-director of the Melanoma Risk and Prevention Clinic. “But for now, there’s value in having a dedicated clinic where patients feel comfortable that the people taking care of them have had some extra training and a special interest in caring for skin of color.”

Part of the challenge lies in dermatology education, as geography and local demographics often determine the patient populations residents are exposed to during training. That is, residents who train in clinics that see mostly white patients often don’t get experience in how skin and hair disorders may appear in patients of color. Compounding the issue is the fact that photographs used in medical textbooks often depict lesions and disorders on white skin by default.

To help ensure trainees have more exposure to caring for patients of color, Skin of Color dermatologist Sotonye Imadojemu, MD, leads one of the program’s resident clinics to provide dedicated time for dermatology trainees to learn about caring for patients with skin of color.

“It’s been really well-received by the residents so far, and one important point to note is that it’s not an elective. It’s part of the general dermatology training experience, just like any other clinic,” Imadojemu said. “We deliberately did not want to make it seem like skin of color was a specialized niche.”

Imadojemu, who is dual board-certified in internal medicine and dermatology and is director of the Cutaneous Sarcoidosis and Granulomatous Diseases Clinic, said contributing to the field in this way and being part of the Skin of Color team has been a rewarding experience.

“I can’t even count how many times patients say, ‘I’m so happy to see you,’” she said. “It feels like my presence as a Black doctor is filling a need in the community. It’s not necessarily specific to being a Skin of Color dermatologist, but rather just being a doctor — helping people heal, making an impact on educating the next generation of dermatologists and reshaping the way we think about skin of color in dermatology.”