As the COVID-19 pandemic was ravaging Connecticut, Newtown resident and palliative care physician Jo-Ann Maroto-Soltis reached out to The Newtown Bee with an idea of telling a comprehensive story about her career and her work in the hope of better educating the public about this misunderstood aspect of health care. This is the first installment of that series.

When Dr Jo-Ann Maroto-Soltis was 10 years old, she remembers listening to her father moan in pain from her parents’ bedroom at night during the months before he died. Joseph Maroto, who worked for years as a local barber in downtown Danbury, was diagnosed with metastatic colon cancer at the age of 48.

“I remembers vividly watching Father transform very quickly from a tall, healthy, energetic man to a thin, fragile man who really suffered at the end of his life,” she recalled.

“I always had this childlike belief that I was somehow going to develop the ability to cure him,” she said. “I would pray at my bedside and then quietly slip into his bedroom while he was sleeping so that I could place my hands on his distended abdomen with the hope that the miracle could happen.”

Unfortunately, the miracle never came and Joseph Maroto passed away at Danbury Hospital after several attempts at failed treatments.

“The most difficult part of this time for me was watching my tall, strong, loving father crippled by a disease when I desperately just wanted to have him around as I grew up. It was during this period that the field of hospice was just beginning, and few physicians were skilled at managing patients with terminal symptoms,” Dr Maroto-Soltis said. “People with serious illnesses usually died in the hospital with IVs in place and sometimes with a loved one close by if they were lucky.

“I learned early on in life that compassionate care for those with serious illness was not something routinely provided, but so critically important to all of us. It was this experience that led me to eventually pursue a career path which included palliative care medicine.”

For many years after her internal medicine residency, Dr Maroto-Soltis’s focus was solely on hospital medicine.

“I have always been drawn to trying to make a difference in peoples’ lives when they are going through abrupt changes in health. I felt as though I could make more of an impact when people were being faced with acute critical illness which often involves major health care decisions and the need for a strong physician guide,” she said.

Palliative Is Not Hospice

“During my 15-plus years as a hospitalist, I became more aware of the gaps that existed for those patients faced with severe chronic or terminal illness. As a healthcare provider, there is nothing more satisfying than being able to offer a medication or treatment that provides a cure for a particular ailment,” Dr Maroto-Soltis said. “However, as people age and live longer, we are often faced with developing limiting illnesses which often creates burdensome symptoms that impact a person’s quality of life.”

Often, Dr Maroto-Soltis said, it is not one particular disease, but the combination of various illnesses that together impact a person’s ability to function.

“For example, many people who have vascular disease or diabetes often develop complications such as kidney disease or stroke, which together compound their quality of life,” she said. “Palliative care is about taking care of patients with life-limiting illness who need medical support as well as psycho-social, spiritual, and social support.

“The word ‘palliate’ is taken from the Latin and means to cloak or cover up. The image that is often referenced is that of a cold, ill, frail person being wrapped in a warm blanket by a friend or neighbor,” Dr Maroto-Soltis said. “It is also important to understand that palliative care may be helpful for a short time when one is diagnosed with a serious illness, such as cancer.

“Palliative care providers often work closely with cancer networks to provide support and care to those receiving treatments such as chemotherapy or radiation therapy. Many patients react in a concerned or frightened way when they hear the word ‘palliative,’ because they associate palliative care with hospice, or care needed when everything else has failed,” she continued.

“But it is so important for people to understand that palliative care is not hospice care. Palliative care may transition to hospice care, but that is not always the case.”

According to Dr Maroto-Soltis, palliative care is helpful when the stress of an illness requires an extra layer of support with clinicians who are experts in the treatment of symptoms such as pain, depression, chemotherapy-associated nausea and vomiting, weight loss, or anxiety.

“Our goal is to help provide care to patients when the burden of illness is great, with the hope that we will help them to regain the quality of life that is most valuable to them,” she said. “If and when people are cured, we celebrate and move on — and if they progress with their illness or relapse down the road, we are there for them.”

A Team Approach

One of the aspects of palliative care that Dr Maroto-Soltis said she loves the most is the privilege of being able to take care of patients with a team of experienced nurses, social workers, spiritual care practitioners, and behavioral health clinicians.

“The suffering that people experience is so individual and unique based on a person’s medical history, upbringing, coping mechanisms, support systems, beliefs, and faith background. There is no ‘one size fits all’ algorithm for my patients. Each patient tells their own story and it is my job to figure out how to ease their burdens, walk with them on their journey and help them to use their energy on what is most important to them,” she said.

“In 2016, Danbury Hospital became the first hospital in our area to pilot a palliative care at home program, and I was asked to spearhead the program with the goal of trying to reach patients who were too ill to travel into the office to see their health care providers,” Dr Maroto-Soltis said. “At that time, I had only been working in the hospital setting for my entire career and was drawn to the idea of circling back to the home as more of a primary care provider.

“My job has been to provide care to people with advanced illnesses in their home environment by collaborating with various home care agencies and learning how to network to provide the best possible care for people at home. It has truly been a life and career changing experience.

“I never imagined how much you can learn about a person’s day-to-day struggles until I was their sitting with them at their kitchen tables, or at their bedsides,” she said. “You quickly learn many things about their family and support systems, how the medications are being stored and taken, how much (and the type) of food that may or may not be available, and most importantly, how the person’s disease is impacting their ability to function.

“When you are allowed the privilege of being accepted into someone’s home to care for them, it is a bit of a game changer. Over time, the relationship usually takes on more than just that of a physician-patient,” Dr Maroto-Soltis said. “I feel as though I am a part of their inner circle of people whom they can depend on, and with that responsibility, I am always inspired to do everything possible to make their lives easier. It becomes a rich, intimate relationship that would not exist in an office environment.”

In the next installment of this series, Newtown Bee readers will meet a few of the patients who have come under the care of Dr Maroto-Soltis. For anyone interested in considering palliative care for themselves or for a loved one, contact the palliative care team at Danbury Hospital by calling 203-739-6662 — or visit westernconnecticuthealthnetwork.org/danbury/home/departments/palliative-care/palliative-care.