Marjorie Cohen Stanzler, J73, (left) and Ellen Cohen, J79. Photo by Robert Schoen

This is the story of two sisters who are helping to strengthen the role of compassion in the realm of healthcare.

Ellen Cohen, J79, and Marjorie Cohen Stanzler, J73, transformed personal tragedy into a new life’s calling: helping healthcare providers and patients who confront loss and fear— quite literally life and death—to share their stories, their emotions, their psychic dilemmas.

The work is transforming lives, altering the healthcare landscape, and showing all of us the importance of human connection in our modern world.

Their story begins in November 1994 when Cohen’s husband, Kenneth B. Schwartz, was diagnosed with lung cancer at age 40. During his illness, he wrote an eloquent and poignant account of his struggle with cancer that was published in the Boston Globe Magazine in July 1995.

Schwartz, a healthcare attorney, wrote: “I was subjected to chemotherapy, radiation, surgery and news of all kinds, most of it bad. It has been a harrowing experience for me and for my family. And yet, the ordeal has been punctuated by moments of exquisite compassion…. These acts of kindness—the simple human touch from my caregivers—have made the unbearable bearable.”

Schwartz did more than just tell his story. Only days before he died in September 1995, he amended his will to create the Kenneth B. Schwartz Center, dedicated to promoting compassionate healthcare and strengthening the relationship between patients and caregivers.

“If I have learned anything,” Schwartz wrote, “it is that we never know when, how, or whom a serious illness will strike. If and when it does, each one of us wants not simply the best possible care for our body but for our whole being.”
Today, the Schwartz Center reflects equally its founder’s vision as well as the creative and tireless commitment of Cohen and Stanzler.

	Kenneth B. Schwartz was a partner at Mintz, Levin, Cohen, Ferris, Glovsky and Popeo, specializing in healthcare law. Prior to that he served as chief of staff in the Massachusetts Executive Office of Human Services where he advocated for programs that served vulnerable children and adults. His father, William Schwartz, MD, a renowned nephrologist, was chairman of medicine at Tufts-New England Medical Center for many years.

“This is Ken’s legacy,” Cohen said. “Though it began as my own grief work, it quickly became a passion for the need, as Ken said, to rewrite the rules about the relationships between caregivers and patients. Both Margie and I poured ourselves into it.”

What Cohen, the Schwartz Center board president, and Stanzler, the center’s administrative director, have accomplished in just a few short years is a testament to their dedication and expertise.

“Ken did not leave a detailed blueprint for the center” said Cohen, “but Margie and I worked with a smart, creative, and committed board and other professionals on many levels to find ways that the healthcare system, often overwhelmed by financial issues, could rediscover and preserve a culture of compassion and empathy.”

“Today, many thousands of caregivers—doctors, nurses, social workers, and other clinicians—discuss the emotional issues that arise when treating seriously ill patients,” Stanzler said, describing the center’s signature program—The Schwartz Center Rounds. Started at Boston’s Massachusetts General Hospital (MGH) in 1997, the Rounds now take place at 36 hospitals in nine states and are expanding rapidly.

A videotape produced by the center, “Voices of Caregivers,” captures one Schwartz Center Rounds session that makes it clear why demand for this program is growing nationwide. On the tape, caregivers from Emerson Hospital in Concord, Massachusetts, discuss the case of a stillborn baby they resuscitated, knowing the child would live only a very short time.

Clearly still emotional, the caregivers sought help from their colleagues in exploring the unresolved questions: Did the decision cause that mother more pain or was it worth it so that she could at least hold her child warm and alive? When should efforts to bring life back be terminated? How do you deal with the emotional consequences of this decision, for the patient and for yourself?

“By letting caregivers know it is all right to have these feelings and to talk about them, a change occurs at the heart of their professional lives,” Stanzler said. “They realize they are not alone in struggling with stressful situations and feel more a part of the caregiving team.”

The Schwartz Center Rounds are only one component of the fruit of Stanzler’s and Cohen’s labors. Housed at MGH, the center creates, conducts, and sponsors a wide range of educational, training, and support programs, all funded through charitable donations.

These include:

• Clinical Pastoral Education Fellowships that teach physicians, nurses, social workers, and other clinicians how to meet the deepest concerns and spiritual needs of patients and families;
• An annual award to a caregiver who has displayed extraordinary compassion in caring for patients; and
• Speaker series and panel discussions that raise awareness of the patient-caregiver relationship in a changing healthcare environment.

I look at you in bed, a child,
you think you are a man.
You are fading away,
now only your eyes seem to enlarge.
You ask when you can go home,
go back to your life.
This is your life now.
Your family members stand
mute awaiting answers
that are not there.

I will stay the course with you.

“We realize we have struck a chord here that resonates not only in the healthcare profession but also across our technological, often depersonalized world,” Cohen said. “People need connection. It is ironic that we say the world is growing smaller, yet we often feel more isolated. It is not surprising that in healthcare settings, where people must confront the essentials of life and large, universal questions, that the essence of human nature is exposed.”

Other grant-supported programs of the center focus on the following areas:

• Cultural competency: to help caregivers understand the particular healthcare needs and customs of patients from diverse cultures;
• End-of-life/bereavement: to improve end-of-life care for patients, promote earlier referrals to hospice and palliative care programs, and develop model bereavement programs for clinicians and families who have lost loved ones; and
• Communication skills: to improve communication between patients and caregivers and increase empathy.

Grants also fund education programs to ensure that the next generation of clinicians will be trained in compassionate care. One such program was launched in 2003 as a pilot at Tufts University School of Medicine. Schwartz Center funds allowed Tufts to recruit and train patients as educators for third-year medical students. The students interact with patients who simulate a medical condition; students then receive feedback from the patient/educator as well as from faculty members.

“We were impressed by the tactic of training patients as educators capable of providing immediate feedback to students on their strengths and weaknesses in communicating,” Stanzler said.

As a legacy to Schwartz, it is fitting that the initial energy and support for the Schwartz Center came from his family, friends, and colleagues as well as from nurses and doctors at Massachusetts General Hospital who cared for him during his illness. “Ken is really the spiritual center of this enterprise. The outpouring of love for him is still evident,” Cohen said. “He was just one of those people. He touched many lives.”

But if Schwartz is the spirit, Cohen and Stanzler are the heart that keeps the center’s body growing and moving forward. And as if a hand of fate were at work, their own life stories prepared them to fill this selfless and demanding role. Cohen and Stanzler have been close all their lives‹a bond forged as children, when they spent hours sharing secrets and stories as sisters do. And they understand how fortunate they have been to have this strong, central relationship in their lives. From their parents came an understanding of the importance of family.

“Our lives have always been intertwined,” Stanzler said. Cohen and Stanzler also made educational and professional choices as if in readiness for creating the Schwartz Center. A child study major at Tufts, Cohen later earned a dual master of social work/public health degree from Boston University. She worked at child care centers before becoming a social worker at MGH, where she provided psychological support for inpatients. She has also worked as a social worker in the Boston Public Schools and currently consults with elementary school teachers learning the “Open Circle” program, a curriculum focusing on emotional and social learning.

“My work has always been about building relationships, no matter what age or what part of the life cycle,” Cohen said. Stanzler, a sociology major at Tufts during the height of the tumultuous Vietnam era, found herself drawn to public service and the challenges facing health care providers and recipients.

“I always wanted to work for change in our society and people’s lives, and was fascinated by healthcare as was my brother-in-law Ken,” Stanzler said. “We are fortunate that the center’s mission resonates with so many and receives such broad support from all parts of the healthcare community.”

Stanzler worked for the Massachusetts attorney general on health-related consumer issues before joining Boston mayor Kevin White’s staff. Then for many years she worked in the Public Affairs Department of Tufts-New England Medical Center. “My work at the center is a wonderful opportunity to combine my experience in healthcare with my desire to help others,” said Stanzler of her role directing the center’s programming and grant-making activities. “It is the most gratifying job I can imagine.”

In his Globe Magazine article, “A Patient’s Story,” Schwartz evoked another timeless tale: “And when I contemplated not living to see my son grow up or not cherishing my wife for a lifetime, I thought of King Lear, who, at one low point, wailed:

I am bound
Upon a wheel of fire, that mine own tears
Do scald like molten lead.