Moved Online Due to COVID-19, Dissertation Defense Became a Global Communal Celebration

On Monday, April 20, more than three dozen people from South America, West Africa, and the United States tuned in via Zoom to watch Maria Beatriz Alvarez, PhD ’20, defend her dissertation, “A Phenomenological Study of How the Experiences of Spanish-Speaking Parents/Family Caregivers In a Pediatric Intensive Care Unit Compare to the Principles of Patient- and Family-Centered Care.” Prior to the shift to remote instruction due to COVID-19, Maria Beatriz expected only her husband and two colleagues to join her faculty Examining Committee, chaired by Dr. Jeane Anastas, in witnessing the culmination of her doctoral research.

The dissertation topic was particularly resonant for Maria Beatriz, herself a Spanish-speaking immigrant from Argentina, who served a large Spanish-speaking population during her many years as a social work clinician and later as the Director of Care Coordination and Social Work at NewYork-Presbyterian’s Morgan Stanley Children’s Hospital/Sloane Hospital for Women. Her qualitative research, based on interviews with 36 Spanish-speaking parents and family caregivers of 19 children in a Pediatric Intensive Care Unit (PICU), confirmed a disconnect she had observed in her work between the aims of person- and family-centered care and the reality in a corporate health care system that seeks to move people through as quickly as possible to maximize revenue.

“The philosophy of patient- and family-centered care is that all you do is driven by the patients and their families in collaboration with the health care team,” said Maria Beatriz. “In working with the families in the PICU, you are meant to treat them with dignity and respect and share information in a timely and appropriate manner. But that is contradictory to the way the corporate health care system is organized. Then you throw in the wrench of the language barrier, not to mention the assumptions and discrimination Spanish-speaking families face. It is an aspirational philosophy of care, but you have two ideologies in tension trying to co-exist.”

Maria Beatriz noted that her dissertation defense was a long time in coming. She began the PhD program in 2005, but her progress was interrupted first by her father’s death and then by her mother’s long illness, during which she made frequent trips home to assist with her care and the navigation of Argentina’s health care system. After her mother died in 2018, Maria Beatriz faced her own health care challenge: overcoming uterine cancer with the support of her husband.

There was a point in 2016 when Maria Beatriz asked herself if she really wanted to finish the PhD program. Around the same time, she hired a new oncology social worker, Jennifer Greenman, who was also the international volunteer coordinator for Starfish International, based in The Gambia. That organization’s mission is to uplift Gambian girls by providing a world-class education focused on service to humanity while at the same time creating international service-learning opportunities for the organization’s volunteers. Maria Beatriz was intrigued and became a Starfish International volunteer herself. She went to The Gambia to teach for 10 days in 2016 and has gone back once or twice every year since.

The program staff and participants have become like family to her. “When I was questioning whether to complete my degree, Mam-Yassin Sarr, who is Starfish International’s co-founder, said ‘we need a doctor in the family, so you have to finish this.’ And the girls needed to see that one of them ‒ because I am one of them ‒ could do it and that they can do it, too. My name there is Auntie Maria and now I’m Auntie Dr. Maria.”

Because of the crisis and the use of Zoom, 15 young people in the Starfish International program who are considering pursuing a doctoral degree were able to virtually attend Maria Beatriz’s dissertation defense. “Observing the defense,” she said, “made it more real to them and reachable as well! It was an opening of doors for them, and they were my source of inspiration.”

Other virtual attendees included Maria Beatriz’s mentor and friend, Ana Margarita Cebollero, who trained her at Boston Children’s Hospital more than 20 years ago; her aunt, Maria Cristina Alvarez ‒ the last living member of her family from her father’s side ‒ who wanted to be there to represent Maria Beatriz’s parents, even though she does not understand English; and a doctor friend, Muni Tahzib, who contracted COVID-19 through her work in an urgent care service. Maria Beatriz said of the latter, “She fought for her life for the last three weeks, and she wanted to attend the defense, not only because she is my friend and we worked together in The Gambia but because she had also been a mom with her child gravely ill in the intensive care unit. The topic of the defense was relevant to her as a professional and as a mother.”

In addition to her family and friends, Maria Beatriz said she received support from more people at NYU Silver than she could name, from her professors and mentors to the building staff, whom she said are much less visible but equally important. She did single out Dr. Anastas, who was director of the PhD program when she started and who saw her through to the end. “Jeane received me in the program, believed in me, and had patience while I went through all my life experiences, keeping a balance between understanding my circumstances yet always challenging me and expecting the most of me.”

Maria Beatriz said she was grateful she had the opportunity to have so many people watch her dissertation defense because it was truly a communal achievement. “I would not have been able to reach this goal,” she said, “without a community giving me strength, inspiring me, and sharing their knowledge, expertise, and time.”