1 of 4
Angela Macri Hale works with Carter, one of her young patients. Photo by Sarah Walor
2 of 4
Nurse-midwife Leslie Fehan assists Merilee Despain with her third pregnancy at The Woman’s Center at St. Francis. Photo by Ash Daniel
3 of 4
Patricia Fulco works with patients at VCU’s Infectious Disease Clinic. Photo by Isaac Harrell
4 of 4
The Rev. Charles Hunt, director of pastoral care at Johnston-Willis Hospital, is assisted by Frasier, a black lab therapy dog. Photo by Sarah Walor
Integrating the Senses
Occupational therapist connects with children
Imagine experiencing a gentle touch as a pinprick and actively avoiding the unpleasant feeling. Angela Macri Hale helps children who process sensory information differently to learn standard responses to stimuli.
Hale, a licensed pediatric occupational therapist in private practice in Henrico County, is certified in sensory integration. Her patients have autism, attention deficit hyperactivity disorder (ADHD) and behavioral and emotional challenges.
"We all get information from our senses. We see, hear and interact with our environment," she explains. Sensory integration looks at what happens neurologically and the body's response, and then works to normalize reactions.
Hale also is a certified yoga therapist who works individually or in groups with special populations. "I find it helps round out the intervention approach," she says. "The yoga benefit is all about teaching self-control," including body awareness, calmness and relaxation, and focus.
Her collaboration with parents and strong engagement with children impressed Jennine Moritz, whose psychology practice is located at Hanover Family Physicians. "She uses language they understand, like ‘Is your engine running too fast?' She has good energy and is really knowledgeable about occupational therapy and is a good teacher and trainer about the field to people in other disciplines." Moritz and Hale worked together at the Virginia Treatment Center for Children, a psychiatric program at VCU Medical Center. When Hale left that job seven years ago, she led the occupational therapy department. Now, they occasionally refer patients to each other, "or I'll be working with someone and then I find out they see Angie," Moritz says.
Hale, explaining the importance of involving parents, says treatment is most effective when everyone works together. "We talk at the end and go over my notes, and consult before each session to go over homework." —MJS
Guardian of Normalcy
Nurse-midwife promotes natural birth in or outside of a hospital
When certified nurse-midwife Leslie Fehan returned to Richmond in 1996 after living in Colorado for six years, she remembers feeling astounded that there were no options in the area for women seeking a hospital-based midwife. "I just felt like somebody needed to change this culture for my daughters," Fehan says.
In 1998, Fehan started a practice at VCU Medical Center, working around the clock as the sole hospital-based midwife for two years before the hospital hired additional full-time midwives. Almost a decade later, the 48-year-old Powhatan County mother of two teenage daughters co-founded a midwifery program at Bon Secours St. Francis Medical Center.
"Her approach to her patients is very holistic," says Dr. Michelle Lynam, an anesthesiologist who works with Fehan. "She addresses the mind, body and spirit of each woman."
In Virginia, about 4 percent of babies are delivered with midwives, compared with an 11 percent national average, Fehan says. "The joy for me as a midwife is in helping women realize their potential."
Fehan uses massage, aromatherapy, encouraging words and body position changes to ease the pains of labor for the women she works with.
"She is dedicated to natural types of birthing and is able to create as close to a natural environment as you can get in a hospital," says Dr. James Marquardt, medical director of The Woman's Center at St. Francis.
However, after more than 25 years spent working in hospitals, Fehan will transition in May to the Complete Care Center for Women. The birthing center opened last year on Chippenham Hospital's campus.
Through her work, Fehan hopes to support what she calls the normalcy of birth. "Our bodies are designed for this," she says. "We start philosophically from a foundation that pregnancy, labor and delivery [are] normal. I think it's important that that's protected." —AD
‘An Encyclopedic Knowledge'
Clinical pharmacist dispenses more than pills
While there is still no cure for AIDS, treatment has come a long way since 1981, when the disease was first recognized in five gay men from Los Angeles.
"These patients, if they're on medicines, will live only about eight years less than the lifespan of a person who's not infected," says Patricia Fulco, a clinical pharmacist with VCU Medical Center. According to the federal Centers for Disease Control and Prevention (CDC), deaths from HIV, the virus that causes AIDS, have steadily decreased over the past nine years through prevention programs and better treatment plans.
Fulco spends much of her day solving a Rubik's cube of drug interactions for HIV-positive patients at VCU's Infectious Disease Clinic.
"[HIV] medications have a number of interactions, they have side effects, and these patients are on them for life," Fulco says of the people she sees every week who range in age from 20 to 70 years old. "To me, it's just exciting to make sure the patient is getting the best care."
Fulco, 42, says she hopes the work she does with HIV-positive patients helps them live a full, normal life. Before she had children, Fulco, now the mother of 3-year-old twins, would volunteer every summer as a counselor for Transformation Retreats, a camp for HIV-positive patients. For four days at a time, Fulco assisted with educational programs aimed at helping people come to grips with the disease.
"[Fulco] is far beyond the pharmacist at the window dispensing pills and advice," says Dr. Ron Clark, chief medical officer with the VCU Health System. "She has an encyclopedic knowledge about the medications and their side effects. When any of us have a particularly complex patient and complex drug regimen, she's one of our go-to resources." —AD
A Listening Presence
Chaplain offers patients comfort during difficult times
Occasionally, a 6-year-old black lab therapy dog named Frasier will accompany the Rev. Charles Hunt during patient visits.
"You use a variety of things to minister," Hunt says.
The director of pastoral care at Johnston-Willis Hospital recalls visiting a terminally ill cancer patient with Frasier a few years ago. "[The patient] talked about how at least with pets, they put them to sleep," Hunt says. "That opened the door to a major conversation about where he was in his end-of-life process." After Hunt left, Frasier stayed curled up in bed with the patient for a while. The patient died the next day.
Hunt, who grew up attending Bon Air Baptist Church, says he felt a call to ministry at a young age. Before joining Johnston-Willis in 1986, the 68-year-old Brandermill resident was a chaplain in the military and at a group home for runaway children.
In addition to his administrative duties, Hunt is on the hospital floors with patients and their families every day. Over the years, he has gravitated toward working closely with the critical care units.
"With that group, I'm often dealing with a very serious illness," Hunt says, "often with end-of-life issues, making some of those tough decisions about, ‘Do we continue? Do we move to comfort care versus aggressive cure care?' "
As chaplain, Hunt is in hospital rooms for about 300 deaths every year. He says he is comfortable with death and dying. "A part of that comes from being fairly comfortable with my own mortality," he says. "I think, because of my journey, I've been practicing what I preach."
Besides helping patients and their families along the continuum of life and death, Hunt is often called on as a counselor after a patient receives a difficult diagnosis.
"He's such a calming influence for folks that are going through what is usually the most difficult time in their life," says Dr. Thomas Eichler, a radiation oncologist who has worked with Hunt for the past 10 years.
Hunt says he hopes to serve as a vessel for God to work through. "I do that predominantly as a listening presence," he says. "I'm not here to preach. I'm just here to help in any way I can." —AD
A Tenacious Advocate
Medical social worker Ellen Gerszten doesn't take ‘no' for an answer
Whether she's working to get patients access to health care, medications for those on limited incomes, or disability determinations for needed services, she just makes it happen. Her efforts led nine medical professionals to nominate Gerszten for special honors.
"Her ‘patients first' attitude is legendary among doctors and nurses who have called upon her to assist with patient needs," says Dr. Ron Clark, chief medical officer with the VCU Health System, where Gerszten has been a social worker since 1990. "She treats everyone with genuine respect and compassion regardless of their situation, background or need. A true angel."
A humble Gerszten responds, "Everything's a challenge, but I love to get it done." For a patient who could not get an operation in Richmond, she handled every detail to help them get treated at an out-of-state hospital. She worked within the local community to find housing for a homeless patient, clearing the way for an operation that would not have been performed without a discharge plan. Doctors even note that she continues follow-ups on weekends and when she's on vacation.
"Social workers get such little recognition," says Dr. Susan Wolver, a VCU primary care physician who urged Gerszten's boss to name her employee of the month. "I actually asked her supervisor how I get her nominated for ‘Social Worker of the Universe.' That's what I think of her."
Gerszten started working at VCU when her husband, Enrique, was doing his medical residency there in the early 1960s. Her social worker career began in the Infectious Disease Clinic, where she assisted patients with HIV. About a year ago, she moved to the outpatient primary care and medical specialties clinic.
"She excels at everything she does," Wolver says. "She is able to come up with ideas and execute plans that most of the providers would have said were impossible." —MJS
