Brigham, Nantucket Care Teams Ensure Local Couple Gets to Say 'I Do'

Angela Christoforos was overcome with emotion when the double doors of the church opened to reveal her groom, Greg Andrews, waiting for her at the altar.

Certainly, they were swept up in the joy and excitement of their wedding day and all that it symbolized. But for this Danvers couple, the moment was even bigger than that.

That’s because Greg and Angela, now Angela Andrews, had already put “in sickness and in health” to the test before they exchanged vows. Just a week before their wedding day, Greg experienced a medical emergency while on Nantucket — an event that led him first to Nantucket Cottage Hospital’s Emergency Department before being transferred by MedFlight to Brigham and Women’s Hospital. 

Throughout their ordeal, the couple says they were so touched by how their Nantucket and Brigham care teams prioritized Greg’s health and safety while also rallying to get them down the aisle as planned. He was discharged two days before the wedding.

“They cared about my situation. It was beyond fixing me medically. It was more thoughtful and heartfelt than that. I mean, I felt that,” Greg said. “The doctors and nurses were like, ‘We’re getting you to your wedding.’ They would say that every time they talked to me, and it was reassuring because it had been such a stressful week.”

As Greg’s caregiver, Angela says the patient- and family-centered experience left a profound impression on them both.

“What stood out just as much as the medical expertise was the humanity and empathy shown to both of us throughout the entire experience, knowing our wedding day was less than a week away,” she said. “Because of their incredible efforts, Greg was able to be discharged in time for our wedding. Seeing him walk into that room, surrounded by loved ones, healthy enough to be present and part of such a meaningful day — it was something we will never forget. His teams gave us back a moment that we thought might be lost — a moment filled with joy, strength and gratitude.”

Giving new meaning to personalized care

Angela recalled how Richard H. Koehler, MD, who had first cared for Greg at Nantucket Cottage Hospital, called a few days after his transfer to see how he was doing. Throughout Greg’s hospitalization at the Brigham, hospitalist Jeffrey Schnipper, MD, MPHP, MHM, internal medicine resident Divya Manoharan, MD, and the staff on Braunwald Tower 14D put the couple at ease with their warmth, compassion and confidence during a vulnerable time.

After Greg’s discharge from the Brigham, Dr. Schnipper encouraged Angela to stay in close contact about Greg’s recovery. When Greg had bouts of pain or trouble breathing, Angela recalled how Dr. Schnipper was a beacon of calm and support.

“Whether it was a question about his pain meds or that he was having night sweats — all the different things that pop up where you’re like, I have no idea what’s going on,” Angela said. “I was panicking about how much pain he was in, and Dr. Schnipper returned my call at 1:30 a.m. I can’t say enough how much it meant to me to have a doctor from one of the best hospitals in the world get back to me at such an odd hour.” 

In some ways, the experience wasn’t surprising for Angela. She’s a former employee, having previously worked as a senior specialist in external communications at the Brigham, where she pitched stories just like hers to local media. Being on the other side of it reaffirmed what an extraordinary place the Brigham is, she said.

In addition to their marriage ceremony, Greg and Angela were able to enjoy their first dance as newlyweds during their reception and then travel to France for their honeymoon, making some adjustments to assist with Greg’s recovery. Since returning, Greg continues to make gains in his recovery and has been following up with his cardiologist and pulmonologist.

“When people talk about personalized treatment, it's usually about your symptoms,” he said. “This was more than that. This was personalized treatment around an important life event.”

The events leading up to Greg’s hospitalization started while on Nantucket a week before his wedding. He began experiencing intense abdominal pain, unlike anything he had felt before.

“I realized something was wrong. I tried to lie down, shower — nothing was stopping it,” he remembered.

He went to Nantucket Cottage Hospital’s Emergency Department, where he underwent an endoscopy. The exam revealed blood in his digestive tract. Out of an abundance of caution, the care team recommended transferring him to a hospital with more advanced cardiac capabilities due to a congenital heart condition Greg has.

“The pass-off from Nantucket went really smoothly,” Dr. Schnipper said. “When Greg came to the Brigham, he had basically two medical mysteries. The first was a gastric outlet obstruction — no food was getting past his stomach. We scoped him expecting to find an ulcer where the stomach empties into his intestines, but we didn’t find one. The obstruction resolved on its own, which was a little unusual, so the most likely assumption is he had some twisting of his GI tract.”

The other surprising symptom, Dr. Schnipper added, was that Greg had fluid surrounding his lungs, which caused one to partially collapse. The type of fluid buildup he experienced, an exudative pleural effusion, is usually associated with infections, although Greg had no other evidence of an infection. The team theorized it was a case of “bystander inflammation,” triggered by the immune response to his stomach problems.

Ultimately, the team elected to discharge him with a course of antibiotics in case he started feeling worse while in France and coordinated with his outpatient providers to follow up.

“His trajectory really speaks to the value of good general internal medicine and primary care when caring for patients as whole people,” Dr. Manoharan said. “Getting him to his wedding would not have happened without his outpatient team really being enthusiastic about following up with him and coordinating the next steps in his care. Taking care of Greg affirmed for me how critical it is that we focus on primary care as the bedrock of public health and patient-centered medicine. Having a strong outpatient team is what really allows people to succeed and be well.”

The next time Dr. Schnipper heard from the couple, it brought a smile to his face. Angela had texted him a photo from the wedding.

“As hospitalists, we’re often taking care of patients during very important points in their lives, and it was very nice to be part of a happy occasion,” Dr. Schnipper said. “It makes me feel great to know that their story had a happy — well, not ending. Rather, a happy beginning.”