Dr. Kate Brazzale Treats Vulnerable Patients With Compassion And Understanding

Dr. Kate Brazzale still makes house calls. However, as director of pediatrics for Trustbridge, a nonprofit hospice organization serving Palm Beach and Broward counties, Brazzale is probably the last physician parents want to see coming to their door — and the compassionate Brazzale understands the dilemma.

“I’m not a savior, I’m not an angel,” the English-born Brazzale said. “There are so few resources for terminally ill children outside of the hospital. While hospice and children shouldn’t be in the same sentence, the limited time that a terminally-ill child has left should be spent at home with their family.”

Her territory where she makes home visits includes all of Palm Beach County, and she can go from trailers to multi-million-dollar mansions in less than an hour. It’s not the house that matters to Brazzale, it’s the family inside. She holds the child in her arms. She sees them deteriorate.

“I’m the last person they want to see,” said Brazzale, who has lived in Wellington for more than 10 years. “I’m a doctor first; my instinct is to improve upon possibilities. Contrary to what people may think, I’m here to try to carve out some positive time for people and families in dire situations. I don’t want people to be suffering and merely waiting for death — I want them to be living right up until they die.”

But it takes a toll on Brazzale. A regular cozy movie night with her husband and two young children at their home surrounded by trees becomes a welcome respite from particularly arduous days.

Dr. Faustino Gonzalez, chief medical officer of hospice services at Trustbridge, is extremely proud of Brazzale. He trained her, and she was the first graduate of their fellowship in hospice and palliative medicine program in 2009.

“She set the bar,” Gonzalez said. “She is the yardstick that we measure other graduates by. She has a visceral understanding of what it takes to care, the empathy, the ability to put herself in the shoes of the patient and the patient’s family.”

Brazzale took a meandering path to becoming a physician. Both her parents are doctors in England, but she opted to try other professions. At first, she wanted to be an architect, attending the prestigious Bartlett School of Architecture in London. That lasted a semester. She opted to switch courses and went on to earn a bachelor’s degree with honors in human sciences at University College London. During that time, Brazzale had multiple temporary jobs at Whittington Hospital, working with oncologists and palliative nurses. Immediately following her undergraduate years, she worked in pharmaceutical sales before deciding to study further, returning to medical school at the very same university at age 24. “Everything seemed to pull me that way,” Brazzale recalled.

Currently, Brazzale treats approximately 130 patients in hospice care, all based at home, and sees them in order of need.  She also does some work on inpatient hospice facilities, as well as palliative consultations. “Children are always less predictable and need closer supervision,” said Brazzale, who usually spends about an hour visiting with each patient and their family.

Her goal is to visit about 25 patients per week when making house calls. However, when doing rounds on various inpatient hospitals and facilities, that number swells greatly. The paperwork involved with each case accounts for almost doubling the work load.

“I have some great nurses,” Brazzale said. “Motivated, enthusiastic nurses make a team. We all share our ideas. Hospice is physician-lead, but nurse-run. There’s no room for any egos.”

Gonzalez marvels at Brazzale’s skills, especially for her calm demeanor and empathy toward patients nearing the end of their lives.

“She’s a whole person, a classic physician, someone who’s well-rounded… there’s more to them than their clinical skills,” Gonzalez said. “Therapeutically, she’s an excellent physician. Taking care of people [in hospice] requires the ability to empathize without taking it home. She’s kind, she’s smart.”

After a day on the road, Brazzale completes her work in her home office, dictating notes, writing prescriptions, sending out e-mails and texts, and organizing herself and the team for the next day. But she always tries to make time for her family.

“Having children made me more confident,” said Brazzale, who describes herself as an introvert. “My children ground me and help me value core life principles. Many times, they inadvertently offer me wisdom via their ability to verbalize exactly what is on their minds in straight talk.”

Brazzale loves to read and said that for her, running is “incredibly therapeutic.” She also plays the cello and piano, and enjoys art and sculpture, so much so that she often puts large canvases flat on the front lawn and, together with the children, gets creative, artistic and messy, resulting in several “masterpieces” that grace the wall of the family home.

“I have yet to conquer my kid’s homework — the curriculum is very different from the way I learned,” said Brazzale, who also admitted to working on her cooking skills, creating new dinners together with her enthusiastic seven-year-old daughter every Wednesday night.

Brazzale believes curiosity about people and their lives can lead to helping a great deal.

“I get to hear so many amazing stories,” Brazzale said. “I am privileged to be shown so many wedding photos, vacation photos, family snapshots — it reminds you that each encounter is with a whole person who has touched many others. I truly believe it is very important to all us clinicians to see the person as they were in their prime — before they became ravaged by sickness and exhaustion. The simplest way this can be done is perhaps with a beautiful, typical portrait-type photograph or cheerful snapshot displayed near their bed, whether they are home or in a facility. All those involved in their care are grateful to be reminded of their humanity and appreciate the ability to relate.”

In addition to her position at Trustbridge, Brazzale has been a clinical assistant professor at the Department of Family Medicine at Nova Southeastern University in Fort Lauderdale since 2012 and an affiliate assistant professor of medicine at the Miller School of Medicine at the University of Miami since 2013.

She believes the most important teaching lessons happen during the discussions that take place during brief car rides in between patient visits. Her first directive — don’t wear a white coat to home visits, because most people are more comfortable having medical personnel in their home without this typical, more formal apparel.

She also teaches the students that they must blend in and respect the family and household within minutes of walking through the door. They must be able to pick up on cues, and echo the environment, setting the tense family and patient at ease. She believes that without making the family and client feel comfortable, there is no way to invite the trust necessary to enable any form of team work.

“I love teaching, I want to re-enthuse them, remind them why they got into the job,” Brazzale said. “I am passionate about what I do. Every child I am privileged to care for teaches me more; every parent I encounter humbles me further.  Every day I hope my knowledge and awareness continue to grow. I cannot imagine doing anything else.”

Learn more about hospice services through Trustbridge at www.trustbridge.com.