Patient Advocacy for the Parents & Kids of EMNet’s WIND Study

Cassie Crifase
Cassandra “Cassie” Crifase ’17, Project 55 Fellow at Massachusetts General Hospital

Cassie Crifase is from small-town Illinois and the daughter of a neonatal nurse who inspired her to pursue a career in medicine. At Princeton, she concentrated in the Woodrow Wilson School of Public and International Affairs, focusing on policy informing global health and access to healthcare. In the future, she intends to pursue a medical education focusing on reproductive and child health in underprivileged areas. She enjoys trivia, crosswords, travel, and photography. And, as a former gymnast, she also enjoys yoga and strength training as well as watching and coaching gymnastics.

 

I’m currently entering the last quarter of my Project 55 Fellowship year at the Emergency Medicine Network (EMNet). EMNet is a clinical research coordinating center at Massachusetts General Hospital (MGH) in Boston. EMNet’s mission is to advance public health objectives through diverse projects in emergency care, particularly through multicenter clinical research. These projects focus on three main areas: respiratory and allergy emergencies, health services in emergency care, and public health. At EMNet, I serve as a Clinical Research Coordinator (CRC) and a predoctoral research fellow within the realm of respiratory and allergies emergencies, working predominantly on the 35th Multicenter Airway Research Collaboration (MARC-35), colloquially referred to as the WIND Study.

The WIND Study is a multicenter longitudinal cohort study following 1,000 children who were hospitalized at infancy due to RSV bronchiolitis, a viral infection in the small airways (bronchioles) of the lung and the most common cause of infant hospitalization in the United States. Studies show that half of the children with this diagnosis will go on to develop asthma, but we still do not know how to predict which ones. The WIND Study has been following our cohort for the last seven years and captures data in the forms of biannual telephone follow-up interviews with parents, medical record review, and sample collection through in-person visits. The EMNet Team has produced dozens of research articles using this data, and is working on using it to develop a tool, the Wheezing INDex (WIND), that health care providers can use to predict which children are at greater risk for asthma, improving the care for millions of children with respiratory problems.

This past year working at EMNet has been a very powerful and enriching learning experience, working clinically with parents, and professionally alongside physicians-scientists. MARC-35 is the largest federally-funded study investigating the link between RSV bronchiolitis and asthma, and it’s unlike any other study in the field with participants from all socioeconomic levels across the country, all records being reviewed by physicians, and spanning more than 6 years of life. The quality of work that we do and the commitment that each member of our team offers toward our collective goal has been inspiring and motivating.

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Cassie at her desk at EMNet

The two aspects at the heart of any clinical profession are communicating with and physically caring for the patient.  Carrying out phone interviews in English and Spanish has been one of my greatest responsibilities at EMNet as well as the most impactful of my responsibilities. These interviews allow us to check in our participants’ day-to-day health, ask parents questions about the health and home environment, and learn about the social and environmental factors that may be influencing the child’s health. I’m entrusted by our parents daily with their children’s medical histories and aspects of their home lives. In these interviews, I must often exercise the delicate practice of having difficult conversations about topics such as complex social situations, challenging life experiences, and the burden of illness. It is these experiences, however, that continue to drive my interest in patient advocacy and the intersections of public policy and healthcare. Working on the WIND Study has granted me a unique window into the lives of our participants, offering me multiple perspectives into the storied history of each parent and child, which enables us to come to know our participants quite well through our work. In addition to challenges the work has presented, it, too, has illuminated the precious moments of trust and connection, the relief and joy of successful treatments and good health, as well as gratitude for the art of medicine. These feelings have become increasingly profound as the relationships with our patients deepen.

While I fully expected to gain experience in healthcare and carry out research that I found to be important, my Fellowship year has also instilled in me a fervor for my chosen career as a physician as well as a humanity that can sometimes be lost in the study of a physiology textbook or the sterility of an operating theatre. The lessons I’ve gained from this year have helped evolve my conceptualization of the type of physician I aspire to be, and they are lessons that I intend to bring with me as I turn my focus toward physical care.

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