By Michelle Brusio, MSN RN, CCM

As a child, sitting in church every Sunday and listening to the Gospel, it was instilled in me to love and care for one another.  This became my 'why' and my purpose as a nurse and a person. Ensuring I do what is right, good, just and keep my promises has also been important to me.  

About twenty years ago, on my birthday, my “why” shifted.  I was going to have my second baby, and about eighteen weeks of gestation, I found out that my alpha-fetoprotein levels were very high. Alpha-fetoprotein level is a blood test that, when high, indicates a possible neural defect. An ultrasound with a fetal specialist confirmed our baby was a boy with anencephaly. The words “Not compatible with life” shook me to my core.   

 Anencephaly is where the neural tube does not close properly, and the baby’s brain, skull, and scalp are absent.  We were told of our options, and amongst the shock and hurt, I wanted more for our son. So, I had a long conversation with my doctor about delivering him peacefully, whole, and with dignity.   Two weeks after being notified of a problem, we began the birthing process on my husband’s birthday.   Our son was born the next day. 

My husband and I were surprised, since our first pregnancy and delivery went smoothly.  The pain of grief, guilt, and loss of control was real. There was not a lot of support for parent loss at this time for us. We had to navigate through, knowing that at times our emotions or arguing was about loss and grief.  

I learned a great deal about myself and my new “why.”  I didn’t have a case manager to navigate me from diagnosis to delivery, or the months after, where depression and anxiety reared their head.   I was very lonely; people didn’t know how to talk to my husband and me. He needed support, too, as dads are often forgotten in grieving and supporting their partner. Together, we learned about resilience through the grief of our son.  

My new 'why' was, and remains, to support people through wholistic case management.  I help people navigate complex medical issues, advocate for them, nurture their well-being, and guide them through the medical system or a challenging situation. Being lonely and isolated are real issues, whether they are presented physically, mentally, or a combination, and must be addressed. The little boy who would never be in this world, taught me so much about myself and humbled me to understand others.  

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Bio: Michelle Brusio, MSN RN, CCM has been a RN for 26 years and in Case Managment for 20 + years. She is currently the Clinical Manager for Population Health, Care Transformation Organization and Primary Care at University of Maryland Upper Chesapeake Health. Michelle has acute care, payer, primary care, and outpatient case management experience. She loves to mentor other case managers and is always looking for ways to be a better leader to her team. Michelle serves on several local committees including the Geriatric Assistance Information Network, The Harford County Advisory Board on Aging, and recently asked to join a committee to find the next Health Officer for Harford County. Michelle also serves on several CMSA committees and is currently pursuing her Doctorate in Nursing. On a personal note, Michelle is a fierce allergy mom and advocate and recently became a certified pet therapy team with her dog, Gunnar Henderson.