The Heart of BIDMC
Inspired to Save Lives
James Rodrigue, PhD, never set out to specialize in transplant psychology, but midway through college the business major chose a different path.
Looking back, it was a combination of an influential psychology professor and his parents' grief over the loss of his brother Freddy, who had kidney disease, which made Rodrigue switch majors.
"Freddy never had the opportunity for a transplant and died at the age of five, one year before I was born," Rodrigue says.
After receiving his PhD, Rodrigue spent 18 years at the University of Florida providing psychological care to pediatric and adult transplant patients. In 2005 the Maine native returned to New England.
With two exceptional job offers on the table, Rodrigue says the choice was clear. BIDMC's
Transplant Institute was unique. Unlike most transplantation centers, the entire transplant staff here is housed and fully integrated in one location.
"It is unusual if you think about all the specialties of transplant," Rodrigue says. "Earlier today, one of my patients saw the transplant surgeon, nephrologist, social worker, and nutritionist - all without leaving the 7th Floor of the Lowry Building. By the end of the day, we consulted with each other about her care and we settled on a treatment plan going forward. A fully integrated Transplant Institute makes that level of care and efficiency possible."
Rodrigue's specific role is to help patients and their families navigate the complex demands of organ transplantation. The stress of medical problems, uncertainty about the future, fear that a new organ may not be made available in time, the lifestyle changes that are required, the decline in quality of life --all weigh heavily on those in need of transplant. "It's like running a marathon," Rodrigue says. "You need both the physical and emotional strength to get through the transplant process." Helping patients stay strong through the process offers its own reward.
"What I love about transplantation is that the end result is life-altering, not only for the patient who has been given their life back but for the loved ones who have been taking care of them during their illness," says Rodrigue.
Through his work at BIDMC, Rodrigue also connects with a special community of transplant patients. While researching the number of live donor kidney transplants (LDKT) performed on patients, he found a disparity between the number of blacks and whites receiving them. Blacks receive this important type of transplant far less often than do white patients. This is also true for low-income patients as well, regardless of race or ethnicity.
To increase the number of LDKT for black and low-income patients, Rodrigue created a program that educates patients, families, and friends where they feel most comfortable - in their homes. It's called the Home Based Educational Program and its success is currently being studied by a research grant from the National Institutes of Health.
"We'll go to the patient's home and they can invite anyone they want - coworkers, family members, friends," he says, adding that it's much easier to get loved-ones to go to the patient's home than to travel into Boston. "We educate everyone in the room about kidney transplant, dialysis, living donation and much more. By giving everyone who cares about the patient first-hand information, you empower them to be ambassadors on behalf of the patient and help to identify potential living donors."
Rodrigue says his research has shown that by bringing education into the home, the participants not only learn more, the patient is much more likely to find a living donor and to receive a transplant.
"It's funny that this program is considered 'novel,'" Rodrigue says, noting it has served as a model for other programs around the country and is even being studied in the Netherlands "This isn't all that different than an old-fashioned house-call - the way healthcare used to be practiced."
Rodrigue and his Transplant Institute colleagues do about four of these home sessions each month. Not long ago, he traveled to the home of one African American patient, a mother, who works full-time. Rodrigue says her kidney disease is worsening and her health, deteriorating.
"She usually comes to her appointments alone, because her family is always working," he says, adding he is never quite sure what to expect with a home visit. "I walked in and there were 24 people there - coworkers, friends from her church, extended family. We talked for 2 ½ hours. The amount of caring and love in that room was just so impressive that you wanted to do everything you could to help this woman."
As he was leaving, the woman's three-year-old grandchild approached him.
"She ran up to me and gave me this giant hug," he recalls. "No words needed to be spoken. Everyone wants the life of the person they know back. It's incredibly moving."
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted January 2010