Brescia was born in the Bronx on January 11, 1933, and grew up in a small apartment in the borough with his parents and three sisters. “I slept in the living room on what’s called in Italian a branda, a foldout bed, that was kept in the closet when it wasn’t used,” he said in the book Just Kids from the Bronx (Holt, 2015).

His father, a public housing superintendent, hoped that his son would find a lucrative career as a plumber. But one day when Brescia was a boy, a well-dressed physician made a house call to their building.

“There was a lot of talk and excitement about this guy, this doctor,” Brescia recalled. “I was absolutely awed and said, ‘That looks like something I’d like to be.’”

Creating a Revolutionary Medical Procedure

Brescia enrolled at Fordham in 1950, becoming the first member of his extended family to go to college. Four years later, he earned a bachelor’s degree in biochemistry from Fordham College at Rose Hill.

“He adored Fordham and the education the Jesuits provided,” said his son Christopher Brescia, who added that his father always wore his class ring. “His love of Fordham was so contagious that five of his nieces and nephews and one granddaughter graduated from there. Ultimately, it was the combination of the spiritual and intellectual excellence of Fordham that propelled him through his entire career.”

He followed his time at Rose Hill by earning an M.D. from Georgetown University in 1958 and completing his medical residency at a Veterans Administration hospital in the Bronx. It was there that he and another physician, Dr. James Cimino, developed a technique to improve kidney dialysis.

At the time, patients could be kept on blood-cleansing dialysis machines only for limited periods of time before risking severe damage to their arteries, among other side effects. Brescia and Cimino discovered a way to stitch an artery and vein together that allowed them to safely and repeatedly use the same location on the body to move blood between the patient and the machine.

That lifesaving breakthrough, known as the Cimino-Brescia fistula, was seen as a source of huge potential profits, and the doctors began dealing with investors to set up dialysis centers around the country. As the contracts sat in legal limbo, though, Brescia said his father encouraged him to give it away. If he didn’t, he said he would be haunted by “the faces of the children … who should be with their parents,” Brescia told Fordham Magazine in 2016.

He and Cimino decided to publish their findings in The New England Journal of Medicine in 1966. Brescia later said that he never made money from the technology. “We took a road. To the left, it looked shiny and gold. But to the right, it looked happier to us.”

An ‘Individualized Approach’ to Palliative Care

In 1962, Brescia, along with Cimino, began working at what was then known as the House of Calvary, a nonprofit medical facility founded in 1899 by a group of widows to care for women in poverty with terminal illnesses in Greenwich Village. By the time Brescia arrived, it had moved to the Bronx and was sponsored by the Roman Catholic Archdiocese of New York.

In the years that followed, with Brescia as attending physician and Cimino first as chief of medicine and later as medical director, Calvary became fully accredited. It was renamed Calvary Hospital in 1969 and moved to its current location on Eastchester Road in 1978. Brescia was named executive medical director in 1994. Today, Calvary is widely regarded as a leader in end-of-life care, with a mission “to serve where the need is greatest among those who suffer most,” Brescia once said, “to equally relieve their physical, emotional, and spiritual pain.”

Joseph M. McShane, S.J., president emeritus of Fordham, recalled working as an orderly at Calvary in the early 1960s, when he was a Jesuit novice.

“I well remember my time there,” Father McShane said, noting that all novices in what was then the New York Province of the Society of Jesus were required to work at Calvary for at least a month as part of their training. “It was a time of great grace for all of us. As one of the nursing sisters at the hospital told us when we arrived, ‘God walks the halls around here—24 hours a day.’ She was right.”

For Jessica Morales, FCRH ’97, who slept on a cot in her mother’s room at Calvary for months while she was being treated for aspiration pneumonia, that presence of God was evident in the kind of care her mother received.

“The care there was so different from the beginning,” she told Fordham Magazine in 2016, noting that hospital staff turned her mother in her bed every two hours, brushed her hair the way she liked, and played her favorite Mexican music to soothe her. “It was an individualized approach.”

“Every time we have a meeting here, everybody’s hugging,” Brescia said. “You have to touch your patients. You have to hold their hands. And it’s got to mean something to you.”

A Lasting Legacy at Calvary, Fordham, and Beyond

The kind of palliative care Brescia and his team offered at Calvary Hospital made him a natural fit to return to his alma mater, which he said gave him “the gift of faith.”

He came back to campus to speak with students and faculty, including at a 2015 symposium titled “Humanizing Medicine: The Achievements and Future of Palliative Care.” Fordham students and faculty have also conducted research at Calvary, and other Calvary medical staff have lectured at the University.

“I was fortunate to hear a couple of presentations by Dr. Brescia,” said Cathy Berkman, Ph.D., director of the palliative care fellowship program at Fordham’s Graduate School of Social Service, which has seen a number of its students and graduates take internships and jobs at Calvary. “It was clear that I was in the presence of a very special physician. The concern, and I think love, that he had for patients at Calvary was so deep and genuine. I know many excellent and dedicated health care professionals, but Dr. Brescia stands out as someone we can all admire and hope to emulate.”

In 1994, Fordham awarded Brescia an honorary doctorate of humane letters. The citation in that year’s commencement program reads in part, “He helps the sick lead productive lives; he leads the dying into the vestibule of heaven.”

Brescia is survived by six children—three of whom are physicians—and nine grandchildren. His wife of 53 years, Monica, died in 2007 of a brain aneurysm.

Months into her battle with Alzheimer’s, Jessica Morales’ mom developed aspiration pneumonia—the most common cause of death for Alzheimer’s patients. Breathing problems and infections led to frequent and frustrating trips to the emergency room. Morales knew her mother was dying. But she also knew she needed more extensive care than could be provided at home. So she brought her to Calvary Hospital in the Bronx, where staff treated her physical symptoms and so much more.

“I knew I needed the support to get through this time with her,” said Morales, FCRH ’97, an actress who grew up on the Lower East Side of Manhattan. ““The care there was so different from the beginning.” Hospital staff turned her mother in her bed every two hours, she said, brushed her hair the way she liked, and played her favorite Mexican music to soothe her. “It was an individualized approach.”

“Every time we have a meeting here, everybody’s hugging,” said Michael J. Brescia, MD, FCRH ’54, Calvary’s executive medical director. It’s a side effect, he said, of the culture of the facility, where alleviating emotional and spiritual suffering is as crucial as treating the physical symptoms of disease. “You have to touch your patients. You have to hold their hands. And it’s got to mean something to you.”

Fordham and Calvary have enjoyed a close relationship for years, forged in part by Brescia’s love for his alma mater. “Fordham gave me the gift of faith,” said Brescia, who says a silent prayer each time he enters a patient’s room. That personal connection led to a professional partnership. Fordham faculty have conducted research at Calvary, and Calvary medical staff have lectured in Fordham programs. An October 20 symposium at the University highlighted that research, fostering a discussion on the complex issues surrounding palliative care.

Mary Beth Morrissey, PhD, FCRH ’79, LAW ’82, GSS ’11, a healthcare attorney and researcher, and the director of Fordham’s Healthcare Management Certificate Program in Public Health, Palliative Care, and Long-Term Care, organized the conference.

“The relationship with Calvary is a very meaningful one for Fordham,” she said, particularly when it comes to research. “Our faculty is working across the whole spectrum of palliative care.” In one study, Fordham psychologist Barry Rosenfeld, PhD, and Fordham psychology graduate students explored meaning-centered talk therapy with Calvary patients as a way to provide a sense of peace at the end of life. “We’re trying to understand that palliative care is both medical and social,” Morrissey said.

Insurance companies have been slow to fund palliative care, and so Morrissey and her colleagues aim to put it in the larger context of healthcare reform and value. “This is really about changing a cultural paradigm,” she said. “I think the problem is, in our Western culture, we have been very reluctant as a society to engage in any discussions about limits on care or how we’re going to allocate resources.”

Fixing a Broken System

Presenting the keynote at the October 20 conference was Philip Pizzo, MD, FCRH ’66, pediatric oncologist and former dean of the Stanford School of Medicine. A nationally respected policy advocate, Pizzo has helped lead major studies on palliative care and end-of-life care for the Institute of Medicine: the groundbreaking Relieving Pain in America, published in 2011, and last year’s Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.

“It’s not whether to choose more or less care, but whether to honor individual preferences,” said Pizzo, a microbiology and immunology professor at Stanford and founding director of the university’s Distinguished Careers Institute. And pain, he points out, is not just an end-of-life issue. An estimated 100 million people in America suffer from chronic pain. A few years ago, he became one of them. “It became very personal,” he said of the chronic neuropathic pain he experienced after an injury. “Suddenly I was completely incapacitated, so I absolutely appreciated how it literally saps the energy and the sense of purpose from anyone.”

At Calvary, Brescia and his staff view depression and psychological pain as one of several types of suffering to focus on when caring for patients. Patients also struggle with spiritual suffering, he said, asking themselves, “Is there a supreme God that loves me and knows what I’m going through?” And Calvary staff are equally cognizant of familial suffering. Morales, who slept on a cot in her mother’s room during her stay at Calvary, received a massage through the Family Care Center, which she called “a little haven.” And when her mom died, a Calvary chaplain was there at Morales’ side.

When it comes to physical suffering, hospital staff fight aggressively, Brescia said. Calvary physicians have worked to find alternate methods of delivering opioids for pain relief, and they’ve perfected techniques like using a gastrostomy tube to alleviate nausea common in end-stage cancer patients.

Cost Versus Value

That kind of comprehensive care is not without its costs. Calvary, a nonprofit, loses millions of dollars a year, much of it made up in fundraising. But the world-renowned physician was never in this work for the money.

Before he got involved in palliative care, Brescia achieved fame in the mid-1960s for the Brescia-Cimino fistula, a surgically created connection between veins and arteries used in hemodialysis patients. People came to the Bronx from all over to be treated for chronic kidney disease, he said, and Calvary was beginning to collect full compensation for dialysis so they could build a new facility.

“But I went to tell my father, a little Italian immigrant,” Brescia said. He explained the invention and said that centers would open around the world in a year’s time, and he’d stand to make quite a bit of money. The older man said, “A year? Why a year?” When Brescia explained that it would take time to set up the lucrative contracts, his father asked, “How many die in a year?” Brescia told him 50,000, and his father’s face dropped. “‘Give it away,’” he told his son in Italian. When Brescia protested, his father said, “‘When you shave in the morning, the faces of the children will appear in the mirror, [children]who should be with their parents. They will not be because my son, who I should be so proud of, has to have five cars, five boats, five houses.” Brescia knew his father was right. “I left his house and [we]published [the research].”

Clinicians began using the procedure and contacting Brescia for his expertise. “Doors just opened,” said Brescia, who is considered a pioneer in modern palliative care. “They wanted to hear about all the renal work. The price of that was that they had to hear about the palliative work,” which he was now doing at Calvary. He said he and his colleagues were able to get many federal laws passed “that enabled us to survive and prosper.”

Collaborating on Care

But getting insurance companies to cover the cost of palliative care is still a challenge, despite the empirical evidence that it lowers hospital readmission rates, said Falguni Sen, PhD. Sen directs the Global Healthcare Innovation Management Center at Fordham, which presented the October 20 panel discussion in conjunction with the Fordham Science Council.

“Palliative care, in my opinion, has been the first group that has really tried to look at healthcare in an integrated way,” he said, noting that the Affordable Care Act has given providers some options through which they can include palliative care. He cited new accountable care organizations that accept a total fee for the care and well-being of Medicare patients rather than a traditional fee-for-service arrangement.

Sen said his center, part of the Gabelli School of Business, aims to build on Fordham’s collaborations with Calvary Hospital to explore programs based on these new provisions. He hopes to expand the University’s certificate program in palliative care—which includes Calvary medical staff as instructors—to offer “more skill-based” programs. The University’s Graduate School of Social Service also offers an increasingly popular palliative care program, which has MSW students completing fieldwork at Calvary. And Sen anticipates Fordham faculty from several disciplines wanting to make a difference in the way care is delivered.

“We’ve got to move out of the purely medical care model on palliative care. It’s not just a question of managing pain through medication,” he said. “Pain is something that is so complicated … and it requires care and consideration on so many levels.”

Listen to Dr. Pizzo discuss palliative care and his work at the Distinguished Careers Institute on WFUV’s Fordham Conversations.