Feature Story

Focused on Life

Calvary Hospital marks century of compassionate care to terminally ill

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The patients at Calvary Hospital in the Bronx are all in the advanced stages of cancer, and most will succumb to their illness in a fairly short time.

But to Calvary's dedicated doctors, nurses, technicians and administrators, the people they care for are not dying patients, but patients in the final stages of living.

"Our focus is not on death, but on life," says the medical director, Dr. Michael J. Brescia.

Following a 100-year tradition of compassionate care for its very vulnerable patients, Calvary has upheld a philosophy which has at its core a belief that the sick and the suffering should not feel, or be, abandoned, that they should be bathed in "an ocean of love," and that human life is sacred.

With an approach that is constantly being refined, yet faithful to its underlying mission, the staff provides a holistic program known as palliative care which addresses the patient's physical, mental, emotional and spiritual suffering and tends to the needs of their families as well.

Dr. James E. Cimino, founder of the medical program at the hospital and director of its research and educational Palliative Care Institute, said that the qualities applied in palliative care--including kindness, compassion, listening and keeping promises--constitute "the very humanity of medicine."

The visiting medical students he supervises at Calvary are taught "not so much about end of life care, but about treating people as human beings, with dignity," Dr. Cimino said.

He added, "That's important in all parts of medicine."

Calvary, a modern 200-bed facility in the Morris Park section, has been carrying out its mission since 1899.

Founded by Annie Blount Storrs and the Women of Calvary, a group of Catholic widows who cared for terminally ill women in their own homes, the hospital is sponsored by the archdiocese.

It is the only acute care hospital for terminally ill adults with cancer in the United States, and its program has won acclaim throughout its history.

Frank A. Calamari, the CEO since 1986, sees Calvary's program as the "gold standard" in palliative care against which others should be measured.

"We've been doing what we do for 100 years, well before anyone else thought it important," he said.

Established as the House of Calvary in two brownstones on Perry Street in Manhattan's Greenwich Village, Calvary took women only and had room for 24 patients. It was incorporated as a "special hospital" in 1900, and in 1910 the Dominican Sisters of Blauvelt assigned four sisters to work there at the invitation of Archbishop Michael A. Corrigan.

In 1913, the extension of Seventh Avenue South in the Village forced the facility to find new quarters, and the following year it moved to rented space in downtown Manhattan while construction began on a new hospital at Featherbed Lane and Macombs Road in the Highbridge section of the Bronx.

Patients moved into the new building in 1915, and in 1924 and 1932 wings were added. In 1947, it began taking male patients. The Dominican Sisters of the Sick Poor took over the hospital administration in 1958, after the withdrawal of the Dominican Sisters of Blauvelt.

The building was entirely rebuilt in the early 1960s, and a cancer-care technician program was developed. The technicians, an important part of the patient-care team at Calvary, are para-professionals who deliver hands-on care under supervision of the nursing staff.

"They allow patients to be who they were before they were sick, because all of the things they used to be able to do before are now done for them--so they're not incontinent, they don't smell, their hair is done, their nails are done," Dr. Brescia said.

"It's a way of preserving their dignity."

In 1964, Drs. Cimino and Brescia received international recognition as part of a team who developed the shunt for kidney dialysis patients, and in 1968 Dr. Cimino gave up his private practice and joined Calvary as medical director.

A social work program was started in 1967, and the name was officially changed in 1969 to Calvary Hospital.

By 1970 Dr. Brescia also had terminated his private practice, and along with three other physicians joined Dr. Cimino in developing the medical program in use at Calvary today.

Again outgrowing its quarters, Calvary moved in 1979 to its newly constructed building with 200 beds at Eastchester Road and Waters Place.

The Palliative Care Institute was established the following year, and a certified home health agency was started in 1986.

In 1989 an important addition, the Florence and Camillo D'Urso Patient Activity Center, provided needed space for special events, including Masses for large numbers of people, holiday parties and community meetings.

Now, Calvary is expanding beyond its Bronx headquarters with the planned opening of its first satellite facility in another hospital. An agreement was reached with Lutheran Medical Center in Brooklyn for Calvary to operate 25 beds there.

"Calvary is not going to be franchised," Calamari explained. "This will be a Calvary facility, staffed and run by Calvary employees."

If it's successful, he added, there are plans to expand into northern and southern Manhattan, northern Westchester and central Long Island, in part to allow easier access to families and other visitors in the metropolitan area.

"We realized that if we want to serve these people, we have to reach out," he said.

A continuing challenge, however, is the struggle with HMOs and insurance companies who balk at paying for Calvary's relatively expensive service.

"Many of them see our patients as being within days of death, and the attitude is, 'Why bother to provide the Calvary program of care since they will be dead anyway?' " Calamari explained, adding that he is hoping for legislative relief from Albany.

When it comes to patient care at Calvary, few details are overlooked. Breakfast, for instance, is the most important meal for Calvary patients because it strengthens them for the day.

That's why each patient floor has a kitchen, where breakfasts are cooked to order and where the smell of the coffee brewing and food cooking stimulates the appetites of those who might otherwise turn down the meal.

With spiritual issues important at the end of life, there are chaplains and counselors available around the clock. And although 50 percent of the patients are Catholics and 35 percent other Christian denominations, all religious traditions are accommodated.

Mary T. O'Neill, director of pastoral services, says the hospital will remove the crucifix from the wall of a room if a Jewish patient is uncomfortable with it. She tells of a Buddhist patient who took much comfort last year from a shrine erected on her windowsill by staff members.

"This was something very meaningful for that patient, and the whole staff worked closely with her on it," she said.

The nature of Calvary's patient population often raises the question of how the staff copes. That's difficult to answer, Dr. Brescia said, but he said the patients "give us back far more than we can give them."

To illustrate, he told of a 38-year-old woman, a former drug addict and victim of physical abuse, who was suffering great emotional pain from advanced lung cancer.

Feeling that he had somehow not been able to meet all of her needs in her time as his patient, he decided that he could at least sit with her and be there for her as she died.

"She had, in a sense, a life of abandonment...and I was pretty filled with myself, thinking that this was an opportunity for me to practice my Christian faith, to sit there quietly, to give of myself to this patient, all of that," he said.

But as he sat at her bedside while night fell, she spoke a few soft words: "Dr. Michael," she said, "tonight I will speak your name to God."

Dr. Brescia still gets choked up thinking about that moment. "That's what I mean, that we get back far more than we give," he said. "No one in this world could have given me a gift like this woman gave to me.

"And that was just my story," he said. "There are many others, that's why all of us here are ecstatic about what we do. We're filled with this mission."