What It’s Like: Stories From Philly’s Medical Heroes

Ever since 1751, when Benjamin Franklin and physician Thomas Bond opened Pennsylvania Hospital — the first medical facility in our 13 colonies of scrappy go-getters — medicine has shaped and helped define this city.

How much defining are we talking about? Consider: Health care is now a $29 billion regional industry that powers our local economy, employs almost 20 percent of us, and affects Americans from sea to shining sea: An astonishing one in six U.S. doctors has trained right here. And the innovations that our institutions (and the talent therein) have brought to the world have been life-changing: the first children’s hospital, pharmacy, and heart-lung machine; gene editing and cell therapies; new vaccines, fetal surgery, and more breakthroughs in the works — all designed to give people more time. More birthdays, more chances, more ordinary days to relish.

You probably already know most of this, though. What you don’t know — can’t know, no matter how many episodes of The Pitt you watch — is what it actually feels like to be dispensing that care, to be inside those moments, doing this work.

So we asked the people who live there. Their answers are all different, as you might imagine. But in one way, they are also all the same. They are all defined by time.

They race time to catch a cancer early enough to cure it, to reverse a stroke before brain cells die, to move a fragile life into the world while survival is still possible. They slow it by listening closely enough to understand what a patient is really saying, by staying with cases others can’t manage, by committing years, even decades, to research that may one day save lives.

They protect time for us, endure it with us, help us make the most of what’s left of it. And on the very best days, they actually manage to give us a little more of it — sometimes a lot more of it. Here’s what that’s like, moment to moment.

What It’s Like to Fly Someone to the Hospital

as told by PennSTAR pilot Mark Brennan

I might go a day or two just waiting around at the airfield. But then a call comes in and I’m in the air in no more than 10 minutes, after I notify the FAA and get a flight plan in place.

We are essentially a flying ICU that can handle just about anything: heart attacks, severe burns, dismemberment, you name it. I completely separate myself from the medical stuff. I do see things — the patient is three feet away from me — but I need to concentrate on flying. I can’t get emotional, even if it’s a little baby. I can’t explain how I block it out.

I don’t generally need to worry about where I’m landing, because the local first responders who call in for a medevac are trained to know where I can and cannot land: I generally need a 150-by-150-foot space that’s free of any power lines or obstructions. If I can’t land right where the patient is, I might find another LZ [landing zone], like a little league field or the parking lot of a Boscov’s, and they bring the person to me. A big reason I might reject an LZ is if there’s a huge crowd there when I arrive. Too many humans is a big problem, but there’s always another LZ nearby.

We might show up and we think we’re taking the patient to one hospital, but then it turns out they need a stent, so we have to find a cath lab, which in Philly is at Presbyterian. And you’ll be damn glad we show up if you need to get to Presby from Bucks County at rush hour on a Friday. I don’t need to worry about school zones or I-95 or the Schuylkill or anything like that: I can get you there in 10 minutes flat. And then? It’s all out of my hands.

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What It’s Like to Prep a Child for Surgery

as told by CHOP Child Life specialist Melanie Moreno

Moreno helps sick kids (and their families) cope in stressful times. Here’s how she prepares a four-year-old for a tonsillectomy.

During their vitals, we say the blood pressure test gives your arm a hug. The pulse ox around your finger is a little light Band-Aid that does a beep, beep sound. “Can you help me hear the beep-beeps to hear your heart beating? Do you see the lines going up and down on your monitor? Look at your blue mountains.” We have pictures of every single step of the process so they get a visual and have opportunities to ask questions. We use dolls or stuffed animals that they bring from home. We’ll use a stethoscope to listen to a stuffy’s heart. We put the pulse ox around a little paw. We talk about what they want going into surgery. “What’s your favorite song? Do you want to watch a favorite video? Is it Bluey? Perfect. Let’s have Bluey on the screen. Do you want to do a scavenger hunt?” We hide little dinosaurs, and on our way to the operating room, they help us find where they all are. There’s a moment where you can actually hear a child take a big sigh of relief. They’ve been carrying so much on their shoulders and on their minds in anticipation. It really is magical to see.

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What It’s Like to Say Yes to a Lung Transplant Candidate Patient After Everyone Else Has Said No

as told by Rachel Criner, pulmonologist at Temple Lung Center, which performs more lung transplants than any other transplant program in the country

Describe your first meeting with the patient. It’s intense. They’ve been carrying the weight of past conversations where they were told the surgery is too dangerous — there’s nothing else to do. They come to us, we evaluate them and decide we can transplant. They’re overwhelmed with relief — “I can finally get to the next chapter of my life!” For me, the moment is more complicated. I know what lies ahead for them.Transplant isn’t a miracle switch that you flip. The surgery is enormous. The recovery can be brutal. And even when everything goes well, life after transplant is demanding. At that moment, it’s my job to communicate both truths at the same time: This could add years to your life. And the climb to get there is going to be steep.

Why do others turn them down? Age is a big factor. Most centers won’t even meet with anyone over 70; they reject them right over the phone. But we just did a 79-year-old. Or they’re unable to manage patients with complex swallowing issues that cause aspiration of food or liquid into the lungs. We know how to manage that. Coronary artery disease can also be a big disqualifier. But we can do a transplant and heart bypass at the same time.

Last year, Temple performed 179 lung transplants — the most in the United States. What’s behind that number? In transplant medicine, volume matters. The more you do something this complex, the more experienced your team becomes — the surgeons, pulmonologists, ICU staff, nurses, respiratory therapists, and rehab teams. We’ve developed a level of expertise that lets us treat some of the hardest cases. You learn from that: Surgical techniques improve. Protocols evolve. And what you discover can push the entire field of lung transplantation forward.

What’s it like to see a patient make it to the other side of a successful transplant? Incredible! I’ve seen patients completely change their lives. One man was widowed and hadn’t dated in years. After his recovery, he started online dating, fell in love, and got engaged — at 65! Others are just so glad to do little things again. One patient was ecstatic because she could push a shopping cart through Costco and not be short of breath. A year before, she couldn’t even cross a room without oxygen. Now she’s just living her life.

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What It’s Like to Learn You’ve Won a Nobel Prize

as told by Penn researchers Katalin Karikó and Drew Weissman

In the early-morning hours of October 2, 2023, Karikó and Weissman each received a phone call with the news that they had won a Nobel Prize for their work on mRNA — research that was vital to the success of COVID-19 vaccine developers.

Karikó: After the Nobel call, I was suspicious when Drew didn’t call me. I sent him a text message and asked whether he’d talked to Thomas, because Thomas Perlmann was who called me. Drew texted back, “Thomas who?”

Weissman: The first thing that came to my mind is this is another crazy anti-vaccine person playing a prank. I get threatening emails, postcards, letters — probably more often than weekly. Thomas called me around 4:35, and I started to believe it. They had a 6 a.m. internet video announcement, and then I fully believed it.

Karikó: I was with my husband. Five minutes after the announcement, television was at our door.

Weissman: A bunch of people banged on my door at one minute after 6 a.m.

Karikó: I called my high school teacher.

Weissman: I was with my wife. I called my daughters. I think I called Tony Fauci also.

Karikó: We received so many awards the prior two years. We were overwhelmed because we are not the kind of people that like to be in the spotlight. But we understood that it was for the scientists, for science, and we represented them.

Weissman: I was happy to be done and get back to work. I actually had a few science meetings in the afternoon that I didn’t cancel.

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What It’s Like to Update Families in the O.R. Waiting Room During a Child’s Heart Surgery

as told by CHOP registered nurse Shannon McDonald, one of the liaisons who keeps them in the loop

Some families want to know everything. Some will say right off the bat, “I don’t really want the details.” We give hourly updates: They put them to sleep. They put the breathing tube in. The patient is on the heart-lung machine. They’re working on the repair. They’re putting in wires. A lot of kids come back intubated, with an open chest [amid a pause during long surgeries]. Nobody wants to see their child not moving, sedated. When the parents come back, the first time they see their child, I don’t want that to be the open chest. I get everything looking nice and organized, putting a blanket over the patient. If they would like to see the chest, they can. I’ve heard, “Oh, we actually Googled it.” Some ask that you leave the blanket on. It’s about making it as comfortable as it can be.

I absolutely love what I do. I didn’t expect getting O.R. trained would be so family-oriented.

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What It’s Like to Pray With a Patient

as told by Hazel Mack, DD, staff chaplain at Temple Health

Before my morning rounds at the hospital, I ask God to let me be a blessing to whoever I meet that day — patients, families, nurses, security, dietary staff, anybody. I walk down the halls, and God uses my senses — I hear someone crying or see a worried forehead — to guide me to the right person at the right time. There are people of many faiths here. I’m a Christian, but I never want to use my words in a way that might offend someone else’s beliefs.

When I walk into a patient’s room, I don’t know the burden the person may be holding. I don’t come in with a script. I don’t assume they want prayer. I just say, “Hello, I’m Dr. Mack. Is there anything you need today?” Just asking the question can open up a flood of emotion. They start to talk. They cry. They tell me what the doctor just said, or how they’re afraid they won’t make it, or how lonely they are because they’ve done things that made family give up on them and now no one comes to visit. I say, “Well, I’m here for you.”

When they ask me to hold their hand, I’ll say, “Hang on, let me just get some gloves, to protect you, okay?” Half the time, they just need someone to listen while they empty their heart. That’s its own form of prayer.

All the time, I’m thinking, Lord, guide me. Afterward, people say, “You’re a godsend — you knew exactly what to say!” They write me letters. I tell them, “That comes from God. I can’t take the credit.”

I do this eight to 10 times a day. I never feel burned out. Not even if I’m with a patient who’s angry and upset or families whose loved one just passed right in front of us. Loving people is uplifting. It’s a privilege. I’m blessed that God chose this path for me.

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What It’s Like to Work Any Given Shift in the Emergency Room

as told by an ER doctor in a Philly-area hospital system. (Our doctor requested anonymity, concerned about getting permission to speak freely about a busy emergency department.)

Mondays are busy, traditionally. I assume that’s because people are like, I can push things off until after this family gathering or this thing I’ve been looking forward to. But really, you can never predict the flow, or what’s going to show up. I always scan the parking lot when I drive in — it gives me an idea of what I’m walking into. More often than not, we’re usually full, because of the way everything is now: COVID changed everything. We lost a lot of staff. It accelerated the closure of more hospitals, but people gotta go somewhere, so it increased the burden on the whole system. The job is definitely harder now. It’s always “Do more with less.” Though I can’t imagine doing anything else. Ultimately, I’m there to help people. I do feel like in a couple years, we’ll just have beds in the parking lot.

I used to walk through the waiting room to go in, but it can be stressful — you feel bad for people. There’s more people to see than I can possibly get through. You do your best. But now I typically walk through the ambulance entrance. And then, first thing, I look at the board and see how many nurses we have. That will flavor your shift, for sure. Most days, we’re down at least one nurse. And then it’s looking at whether we have beds. Depending on the hospital, you’re typically in a pod, which means you’re responsible for certain rooms. And anyone put in those rooms is who you treat. It’s sort of akin to waiting tables in that way.

Our shifts are between eight and 10 hours; holidays are 12. I don’t take breaks — that’s not how the job works. The number of people you see in an hour depends on the number of nurses you have and bed availability, and, of course, what people show up with. And you see really … everything. The most common complaints are chest or abdominal pain or something related to trauma, like a fall. It’s sort of fun to see someone who is sick — not that I want people to be sick, but because I get to do all the things you need to do to figure out how to help this person.

What I don’t love — something that makes me nervous, still — is any sort of complicated delivery: a baby with a prolapsed cord or a shoulder dystocia, where the shoulder is caught. You can call a specialist, but they’re not always in the hospital. And the substance abuse issues — tranq wounds, people in withdrawal — are also hard. Depressing. You can only do so much. Our current treatments for withdrawal aren’t perfect, because the amounts of fentanyl and adulterants that are in street drugs now are just wild.

The hardest things — and this is exceptionally rare, thankfully — are the little kids. A pediatric code or a bad car crash. When I’ve had these patients, they’ve almost always been close to the same age as my own children. I don’t think I outwardly appear anxious or upset. I try not to. I try to stay calm as possible for everybody. But yeah, there are cases it’s hard to leave at the hospital. You question yourself sometimes. Oh, man, did I do the right thing?

Sometimes, I do save someone. It feels great. I definitely hold on to those cases where you do everything right. You get a great outcome. And it’s funny, because I go and visit them in the ICU afterwards. And I say, “Hey, how are you doing? I was your doctor.” And they never remember me. [Laughs] They never do.

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What It’s Like to Feel a Dislocated Shoulder Pop Back Into Place

as told by Sommer Hammoud, head team physician for St. Joseph’s University athletics and orthopedic sports medicine surgeon at Rothman Orthopaedics

With a dislocation, the ball of the shoulder has slipped out of the socket, like a golf ball knocked off the tee. Everything around it is under stress — nerves, muscles, bone, cartilage — because of the malpositioning. The pain is miserable. My goal is simple: Put it back! In the ER, I confirm the dislocation with an X-ray and check the patient’s nerves and blood flow to avoid damage. Then I slowly rotate the arm outward and apply a gentle, pulling force to free the bone from where it’s caught. You can feel when it pops back into place. People think of it as a dramatic tha-lunk, but it’s more like a suction seal releasing and then resealing. The joint settles back where it belongs. The relief is instant. Orthopedic surgeons love moments like that. A joint is out of place; you put it back. It’s so satisfying.

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What It’s Like to Manage a Hospital Disaster

as told by Ryan Hay, vice president for emergency preparedness at Jefferson Health

On the evening of February 3rd, a catastrophic fire broke out in an outpatient wing of Jefferson’s Lehigh Valley Hospital–Dickson City, in Lackawanna County. Hay served as an incident commander during the event and its aftermath. More than 70 patients were evacuated, but no injuries were reported, and the hospital reopened on February 13th.

It was about 9:30 p.m. when I got the call about the fire, and I immediately activated our emergency-incident management team. Bryan Evans, who heads our medevac and emergency transport systems in the Lehigh Valley, happens to be my neighbor. We carpooled to the hospital. The whole way there, I’m on the phone with the ER charge nurse, getting updates from the floors, relaying information to others. The first priority was to ensure that everyone was evacuated, accounted for, and uninjured. The second was ensuring we had coordinated relocation of patients to other hospitals. As we got closer, we could see the fire glowing on the horizon before we even saw the building. We knew we were dealing with a pretty significant, dynamic incident. It was a little bit of a helpless feeling.

When we got there, the scene was busy. I wouldn’t say chaotic. The staff at the bedsides in the hospital were the ones doing the work of evacuation, and they did a remarkable job. It took just 10 minutes for the ER to evacuate, and a little longer for the inpatient floors. The site leadership was managing patients. We had a lot of resources, including 20 ambulances. Physicians and nurses and other volunteers from the community showed up to help. The fire, police, and EMS had a separate command structure that our team worked with. My role was to serve as incident manager, which was a matter of making good use of the resources, bringing a little bit of order to the situation, and figuring out what the next steps were. It was freezing cold. We had to get patients who had been moved outside back inside. Staff moved some people into an adjacent building where it was warm.

For triage, we had to coordinate with other hospitals in our system and in the region. Hospitals we compete with every day were the first ones to call and say, “What do you need?” We were able to get everybody placed within a few hours. We have a lot of tools and systems in place, and a lot of training to deal with minor emergencies. But sometimes in a situation like this one, the best recourse is picking up the phone. It’s direct and it’s quick.

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What It’s Like to Remove a Breast

as told by Elena Lamb, breast surgical oncologist at Jefferson Einstein Philadelphia 

In the preoperative area, I mark the patient’s chest with incision lines. If she’s having reconstruction, the plastic surgeon and I mark the patient’s skin together. Where the incisions will go depends on the type of surgery — nipple-sparing, skin-sparing, or something else. Most patients are nervous. This is a big day. Even though they’ve seen me multiple times and we’ve gone over everything, I always ask if they have any last-minute questions. The rest of the team checks in — anesthesia, the nurses, everyone who will care for her.

In the O.R., the patient goes to sleep first. We run through safety checks: confirming the patient’s name, the procedure, and which side has the cancer. Anesthesia performs a regional block for better pain control afterward. Then we do what’s called a “timeout.” I lead the entire operating room through the details — the patient’s allergies, the procedure we’re doing, the specimens we expect to send to pathology. Everyone has a chance to ask questions or raise concerns.

After all of that, I start. My entire focus is on the patient. The O.R. is my world. Nothing else exists outside of it.

I inject a blue dye and radioactive tracer into the breast to identify the sentinel lymph node — the first lymph node the breast drains to. We prep the surgical field — the chest, armpit, and often the opposite breast, so the plastic surgeon can ensure symmetry later.

I make the first cut, working in a very specific plane between the breast tissue and the skin. It’s a little like Goldilocks — it has to be just right. You leave enough tissue for the skin to survive, but not extra tissue that could leave cancer behind. Once the breast is removed, I place the specimen in a machine that takes a 3-D image. The radiologist and I confirm that the cancer and the biopsy clip — a tiny marking device that gets placed during biopsy — are inside. If the patient has chosen to go flat, I insert drains in her chest to remove the fluid that builds up after surgery, then I close the incision. If she’s having reconstruction, the plastic surgeon takes over from here. I meet with the family, and you can feel their relief. A significant part of the journey is behind us. We can move to the next steps.

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What It’s Like to End Life

as told by University of Pennsylvania palliative and hospice care physician Miguel Paniagua

I help people die. That is to say, I help people die in as pain-free and as dignified a manner as possible. When someone has a terminal illness, they work with a doctor who treats the disease, and they work with me. I’m here to advocate for what the patient wants. Do they want chemo or not want chemo? Maybe they want to do whatever it takes to live until September so they can see their son get married. Maybe they just want to go home and be with their dogs and cats even if that means they have days instead of weeks or weeks instead of months to live. For some people, if they can no longer wipe their own butt and walk to the kitchen to get a cup of coffee, that’s it for them. They don’t want to go on.

When it comes to the idea of turning off a ventilator — what some people refer to as “pulling the plug” — some patients and families worry that they are going to be gasping for air when that support is removed, that they are going to be terrified and in pain. But we have anti-anxiety medications and other ways of preventing that. I also explain to them exactly what to expect. You remember record players? When you turn them off, the record doesn’t just suddenly stop. You watch it slowly go in circles; you watch it slow down more and more. That is what death in this case is like. I’m guiding the patient across the precipice into a new transition, but instead of being an obstetrician and bringing someone into life, I am helping someone into death.

Then, sometimes, you have a patient who wants to go on living no matter what, by any means necessary, no matter their quality of life. That’s not what I would want for myself but … I’ve had Holocaust survivors as patients tell me, “I want as many hours and days and minutes as possible on this planet. The Nazis are gone. I am not. I’m 97, and this is me sticking it to the Third Reich.” And who am I to argue with that?

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What It’s Like to Deliver a One-Pound Baby

as told by Carlene Quashie, attending maternal-fetal medicine physician at Jefferson Einstein Philadelphia

At 23 weeks, the average weight of a fetus is 500 grams, or a pound; at 25 weeks, about a pound and a half, maybe six inches long. Most of these babies aren’t breathing when they come out, so my focus is How quickly can we pass them to the neonatology team for resuscitation? They’re so delicate; their bones are fragile; their skin is thin and can tear. Vaginal delivery is preferable to a C-section. As they come through the cervix into the vagina, we can manipulate them more easily. With a C-section, you have to make sure your incision is big enough, then you’re manually extracting them out of the uterus. They’re warm from the mother’s body, wet and slippery, sometimes with poor tone — they’re very, very soft. Some babies are feisty and the pediatricians get a good response. Other times they don’t, and the outcome is much different. You always hope for a good outcome, but you can’t predict.

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What It’s Like to Deal With the Aftermath of a Plane Crash

as told by Jefferson Torresdale neurosurgeon Tareq M. Yaseen

In 2025, Yaseen performed the initial brain surgery on 10-year-old Andre “Trey” Howard, who was injured when a medical transport plane crashed on Cottman Avenue, where Trey had been a passenger in a car.

When I first looked at Trey’s scan I saw two large pieces of bone from his skull that had sliced all the way inside his brain to where there are a ton of blood vessels. I had seen this sort of injury before, but never this deep. He was not going to survive long enough to be transferred to Children’s Hospital.

We rushed him to the O.R., where it’s always teamwork. You won’t be able to save a patient, no matter how skillful a surgeon you are, without people on your side. They stabilized him, and placed a breathing tube and IV lines, and made sure he wasn’t losing too much blood.

I started with a big incision — the goal was to remove as much of his skull as possible to give his brain some room to swell, and then take out the smaller bone fragments and shut down any bleeding vessels. I had to be quick and efficient. The number one priority is controlling the bleeding.

It was a very scary surgery, to be honest with you. He’s the same age as my son, and I’m seeing my boy. And I had seen his family, how scared they were.

The clock is ticking, people are watching, the family is waiting, and you’re representing a big institution. Most importantly, you want to save the patient. Saving the patient is what you have been training to do your whole life. But the brain is bleeding from everywhere. And you only have two hands. You wish you had 10 hands. I would pack one bleeding area of the brain and my assistant would put pressure on that area with her finger, and then we would move on to the next one, and so on.

Once we did all that I drilled down the pieces of skull that were piercing his brain, because you can’t just pull them out. Two hours in, I knew the surgery was successful after we had controlled his bleeding and I saw how the brain looked — a little bit relaxed, and pulsating.

Last April, I met Trey back here at the hospital. He walked into the room and gave me a hug. It brought joy, and tears, to my eyes. We have a bond that is going to stay with us forever.

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What It’s Like to Reverse a Stroke

as told by Preethi Ramchand, interventional neurologist and director of neurocritical care at Main Line Health

The moment a blood vessel in the brain gets blocked, brain cells start dying. In our field, there’s a saying: “Time is brain.” So I’m thinking we’ve got to reopen that vessel fast.

The process usually starts in an ambulance. Our EMS partners are adept at identifying classic stroke symptoms, and they call ahead to us with a “stroke alert.” By the time they arrive the ER is ready and the CT scanner has been freed up. Within minutes we’re looking at scans that show exactly where the clot is. If the patient is a good candidate, I’ll perform a mechanical thrombectomy — a minimally invasive procedure where I guide a tiny catheter through the blood vessels, usually from the wrist or groin, into the brain to remove the clot.

But first I speak with the patient’s family. I explain in simple words what’s happening. Sometimes it’s over the phone, in the middle of the night. They’re hearing about the stroke for the first time. It’s a lot to take in. I keep the conversation focused and kind — but brief. Time is brain.

Sometimes the clot comes out quickly. Sometimes it takes several attempts. Sometimes it’s just too big, and the person’s recovery will be severely impacted.

Many times the change in the patient is immediate. I’ve had people who couldn’t move or speak when they arrived, and an hour after the procedure they’re sitting up and talking. It’s amazing — it never gets old! One patient’s clot was in the basilar artery, which supplies the brain stem, the part that controls heart rate, blood pressure, breathing. Without removing the clot, it’s a non-survivable injury. Fifteen years ago, he would’ve died, but the science has advanced light-years. A few hours after his procedure he was back to baseline normal. And — I love this part of the story — five days later he was out on the golf course.

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What It’s Like to Practice Trauma Surgery in War and at Home

as told by John Chovanes, trauma surgeon at Cooper University Hospital 

Chovanes is also a U.S. Army Reserve colonel and founding medical director of Cooper’s Section of Military, Diplomatic, and Field Surgical Affairs, which provides elite, real-world trauma training for U.S. military, diplomatic, and federal personnel.

I’ve been a trauma surgeon for about 20 years, including almost 15 at Cooper. I’ve also spent more than 20 years in the U.S. Army Reserve, with six deployments — five of them to war zones. When I’m not on active duty as a reservist, I still get to be in the trenches. I love that. It puts wind in my sails.

I’ve learned something that might surprise people: Civilian and military trauma medicine constantly inform each other. What you do and learn in one setting flips over to the other. It goes back and forth. The knowledge is complementary — even exponential.

Take topical hemostatics, the dressings that help stop severe bleeding. Those were used more in war zones before surgeons like me and others began using them widely in civilian hospitals. Techniques developed for the battlefield eventually make their way into places like Camden.

Sometimes the battlefield doesn’t have the equipment and supplies that we always have on hand at Cooper. I remember being in Afghanistan and calling the CEO of Johnson & Johnson — I know him — because we desperately needed more venous catheters. So many little children were being hurt picking up Russian land mines. The company shipped us what we needed.

No matter where injuries happen, they can look surprisingly similar. A soldier wounded in combat. A soccer mom injured in an accident on the Blue Route. A little boy shot in Camden. What you learn from one patient can help another. Knowledge from the mom’s case might help the soldier. Something you learned treating the soldier might help the boy. In trauma medicine, you have to put it all together fast, often with very limited information. You’re assembling a crazy puzzle in real time. You’ve got to nail it.

On the battlefield, trauma surgery isn’t always life and death. Sometimes it’s a broken hand or arm. But it’s still a person who’s suffering, and you give your all to help.

I’m very high-intensity about being the best I can be. I never want to see a patient and think, I didn’t do everything in my power to save them. The Army and Cooper are places that have allowed me to blend civilian and military trauma medicine in ways that improve care for everyone. I feel very proud of that. Because trauma should have no geopolitical boundaries.

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What It’s Like to Hold a Human Heart

as told by Mariano Brizzio, Main Line Health cardiac surgeon

I’ve been holding human hearts in my hand nearly every day for almost 30 years. It’s what I do. Some days, several different hearts. It can be slimy and slippery, like it wants to jump out of my hand, but I cannot let it. This is a very intense thing for me. Extremely intense. And, really, quite hard to describe. But I realize that when I hold a heart, I am literally holding life. It’s strong — all the time pumping. And every time it beats in my hand, I translate that beating as the person telling me: I. Want. To. Live.

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What It’s Like to Care for Kids With Severe Burns

as told by Mellisa Hanneman, staff nurse in the pediatric burn unit at St. Christopher’s Hospital for Children

How do kids end up in the burn unit? For babies and toddlers, the bathwater scalds them, they pull a cup of hot coffee off a table, they put their hands on an oven door that was left open to heat the house. Sometimes the burns might be from abuse. That’s really upsetting, but you have to stay professional when you see that. With older kids, I’ve seen everything. TikTok challenges gone wrong; I hate TikTok. Teenage girls get chemical burns on their scalp from products they use to braid their hair. We have to shave their heads; they need skin grafts. I had a boy who fell into a bonfire. His burns were really severe. But the biggest culprit — 50 percent of the time, easily — is Oodles of Noodles. Kids take the bowl out of the microwave, but it’s too hot and they drop it. It spills down their front.

What’s the hardest part of treatment? Changing the dressings. Burned skin dies, and the dead tissue has to constantly be removed so new skin can grow and eventually receive a skin graft. Otherwise, bacteria colonizes in the wound. Burned skin smells like singed hair; infected burns smell really foul. We take off the old dressing, clean the wound, remove the dead tissue, and then apply treatment products. The process is painful; we often sedate children for it. Waking up, they might shiver or hallucinate, or become disoriented. They experience a kind of delirium where their nights and their days feel mixed up. But some are like, “Can I eat now?”

Why do you do this work? I absolutely love the skin and how our body heals. The therapy has evolved so much over the years. We now have a medication that can dissolve dead skin in four hours, which can cut down on the need for constant dressing changes. I love being there for children who are going through something so hard. You have to build a rapport and trust. In the beginning they think every time you come near them you’re going to hurt them. They have such bad anxiety. I become their social worker, their nutritionist, a coach to get them through. I coach the family, too, because they have to learn how to do dressing changes at home. They’re like, “Can I handle this? Can I do this?” You let them know this is part of their journey; they’re going to get back to their day-to-day.

Do you ever have favorite patients? I shouldn’t but I do. I admit it. It was the boy who fell into the bonfire. He had second- and third-degree burns all over his legs. Burn recovery isn’t a straight line. In his case it was sometimes three steps forward, five steps back. One day he’d be hopeful and engaged. The next he’d shut down. Even just getting out of bed can feel impossible when your skin — the very thing that protects you — is so damaged. But we formed a bond. I remember the day we worked on getting him walking again. He had been through so much already — surgeries, dressing changes, skin grafts, infections. His body was healing, but his confidence needed to heal too. He was so scared to even try. Then he took a step and another one. I vividly remember. They were really slow, but he was doing it. I was crying. His mom was crying. He was moving forward — literally and emotionally. I think it was when he realized he could have normal moments again. He didn’t have to stay stuck in that fire. As a reward, I treated him to lunch in the cafeteria. We sat there talking and laughing like he had done the most amazing thing in the world. Because he did. He fought his way back to something as normal as walking.

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What It’s Like to Realize Your Experimental Research Is Working

as told by CHOP’s Rebecca Ahrens-Nicklas and Penn Medicine’s Kiran Musunuru

Babies need protein for healthy development, but those born with severe urea cycle disorders can’t safely take in enough of the stuff to get growing. More than half don’t survive. In 2025, Ahrens-Nicklas and Musunuru became the first doctors in the world to successfully treat a UCD patient — six-month-old KJ Muldoon — using the gene-editing technology CRISPR. A year later, KJ is thriving, and the doctors are planning clinical trials that could eventually make a therapy widely available.

Ahrens-Nicklas: My biggest sigh of relief was when we didn’t have any negative side effects. After the first infusion, we were able to increase the amount of protein that KJ was able to take in his diet. It was amazing every day to wake up at 4 a.m. and check the labs and see that he really was doing okay.

Musunuru: I was in Ireland for a gene editing conference, five hours ahead. Becca would text me. So I was already up and anticipating, okay, when’s the number coming?

Ahrens-Nicklas: His dad asked me, “Are you optimistic that we’re seeing something?” And I said, “I am cautiously optimistic.” He said that was by far the most positive response he had ever heard come out of my mouth. He said, “I’ll take it.”

Musunuru: There wasn’t any one event where we said, “Eureka. Let’s celebrate.” But it could have taken much longer. It wasn’t overnight, but it was pretty quick in the grand scheme of things.

Ahrens-Nicklas: He had a really nice growth spurt.

Musunuru: Before he got his first infusion, he was in the ninth percentile of body weight for his age. When he was ready to go home from the hospital, he was at around the 40th percentile. That’s a pretty remarkable change.

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What It’s Like to Give Bad News to a Cancer Patient. And Good News to a Cancer Patient

as told by Christopher Cann, director of the Young Adult Cancer Program at Fox Chase Cancer Program

My focus is on treating younger adults. They’re building professional lives, maybe planning to start a family or already raising young kids; sometimes they’re taking care of older parents, too. Cancer lands in the middle of all of that. It rearranges everything. I recently treated a 30-year-old guy whose mild abdominal pain turned out to be metastatic esophageal cancer. He’d spent his 20s focusing on his career. He’d just finished his master’s degree and was back in the dating scene.

When the scan results showed his cancer had progressed, a pit opened up in my stomach. Giving bad news is hard, but giving it to someone that you put everything into, trying to get them to the adult milestones they were hoping to reach — and realizing they may not get there, that it’s out of your control — the word is, I guess, devastating. I already know the conversation I’m going to have to have. You can rehearse in your head how to bring it up, but it doesn’t make it easier. He was so sad. He said, “My life is supposed to be starting, and it’s ending.”

When the patient is in the prime of their life, like he was, it makes this conversation much more difficult. It affects you not just on the job, but at home. I always wonder: Did I do enough? Did I do the right things? Did I provide enough support? I still think about him all the time, even though he died a few months ago. It’s a kind of grieving. Not the same as losing a family member, but still a sense of loss for someone you tried so hard to help.

When I call people with good news, it’s the exact opposite. I don’t have to rehearse anything, and I never make them wait. They’ve been on pins and needles. I say, “I’m going to cut to the chase — there’s no evidence of cancer!” I had a conversation like that just two weeks ago with a 45-year-old mom who has an eight-year-old child. She had an aggressive neuroendocrine cancer and had gone through six months of chemotherapy, two and a half months of radiation, and then surgery. I told her the scans were clear. She cried. Finally, good tears. For months, cancer had dominated every part of her life. She had to step away from work, explain to her child why she was so sick all the time. Now that chapter can begin to close. We talked about the next steps of her treatment, but it was about moving her life forward, not just saving it. She can think about the future again.

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What It’s Like to Support Teens Traumatized by Gun Violence

as told by Cassis Boateng, a nurse and doctoral student at Penn Nursing, who facilitates peer discussions where young people in West Philadelphia open up about the effects of neighborhood gun violence

A big issue is sleep-related problems. Most of them have undiagnosed PTSD or insomnia. A lot have nightmares. They share, “I saw somebody being shot in a dream. I was being chased.” They wake up in the morning feeling super exhausted. It affects their ability to function, and creates mental fog, mood swings, and irritability, and impacts the immune system. It’s a precursor for a lot of other health conditions. I build trust over time. I create an environment where they can open up. They’ll ask me, “Are you okay with me telling you? I know sharing the experience burdens you, the listener.” At that age. Just having that space for them where they can express themselves and me having genuine interest, without correcting or evaluating them, is extremely important. I facilitate sometimes with faith leaders, because the teens know them. Many are very involved in their religious communities, either Islam or Christianity, and when they feel overwhelmed at night, they say a short prayer. Even the ones that don’t use any religious label. I think this works because it creates a sense of comfort or connection with a higher power when everything around them seems to be failing. I’m often humbled by the sheer level of sincerity and honesty. I’m moved by the resilience and the tenacity that they show in the midst of very difficult challenges — emotionally, physically, and sometimes financially.

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What It’s Like to Prep a Body for the Hospital Morgue

as told by former cardiac nurse Mary Lou Rittenhouse

I’m with another nurse and we clean up the room and wash the patient’s body, close their eyes, and remove any tubes or lines they have — unless an autopsy is planned; in that case, we have to leave them be. If their dentures are nearby, we put them back in their mouth. We put a small, rolled-up towel under their chin to hold their mouth closed. Then we pull the sheets up to their shoulders but leave a hand exposed for the family to hold when they come in to say goodbye. We want the patient to look peaceful.

After the family leaves, we put ID tags on the toe and a few other places. We cross the hands in repose and tie them loosely with a gauze strip so the arms won’t flop through the gurney railings while they’re being wheeled to the morgue. We wrap the body in a plastic shroud, rolling the body from one side to the other to get the shroud under it, then tie it closed in a few places, like a package. When I was new, I watched an older nurse do one final thing before the orderly came for the body. She opened the window. I asked why, and she said it was to let the patient’s spirit fly free: “They’ve just gone through something traumatic, and they don’t want to be stuck in this room one minute longer.” After that, any time I prepped bodies for the morgue, I cracked the window. It just felt like a nice thing to do. One last way to take care of them.

Published as “What It’s Like” in the May 2026 issue of Philadelphia magazine.