American Red Cross Santa Cruz County Medical Heroes

On Wednesday, May 14th the American Red Cross hosted their annual community heroes breakfast.  Dr. Vanessa Little, Emmi Schambeck, R.N. and Tree Dunbar, R.N. were chosen to be honored as the medical heroes of Santa Cruz County.

Dr. Vanessa Little
As Chief Medical Director at Hospice of Santa Cruz County, Dr. Vanessa Little is overseeing the medical care of 191 patients and their families today.  She leads a team that helps her to perform this important task – a cadre of physicians, nurses, social workers, chaplains, hospice aides and volunteers work together in an interdisciplinary team approach to ensure that individuals facing their final months, days and hours can live in comfort and with dignity.  What makes Dr. Little a genuine hero is her fierce commitment to truth, for it is in having difficult conversations with patients and families that Dr. Little often witnesses profound healing.

Many physicians decide to go into hospice and end-of-life medicine later in her careers, but Dr. Little had a feel for what hospice care could be like at an early age.  “Growing up in my home was pretty interesting,” shares Dr. Little.  “My father was a physician so we grew up hearing conversations about medical situations.  My mother rehabilitated animals so it wasn’t uncommon to have wildlife hospice care happening right in our kitchen.  My mother taught me about the importance of allowing a peaceful and dignified death to happen.”

It was during Dr. Little’s residency at Brown University that she realized her desire to study and practice hospice and palliative care medicine.  She recalls a particular patient who was actively dying and remembers the moment that she spoke with his family.  “The easiest thing to do was to not tell them what I knew from a medical standpoint,” she shares. But she mustered the courage and told the patient’s family that she thought he would die that night.  And, the patient did die that night.  “I was scared – scared of being wrong, scared of making people sad, but I realized the importance of facing those fears,” she describes.  “The truth is too important and you don’t want a patient and family to miss the opportunity to be with that truth and to say goodbye”.

When asked what she loves about working in hospice, Dr. Little mentions the interdisciplinary team that cares for the patients and their family.  “I am one spoke on the wheel of this team,” she shares.  Each day, Dr. Little collaborates with the Hospice of Santa Cruz County physicians, nurses, social workers, chaplains, aides and community medical partners who are caring for the hospice patients and their families.  “A lot of my ideas are around medications and how to make our patients comfortable,” she explains.  And while Dr. Little recognizes that physical comfort is an important piece, she also acknowledges the importance of finding emotional and spiritual reassurance.  The hospice team works together to address these issues that patients and their families are facing.

Dr. Little reflects on the unexpected gift that serious illness can be.  “Illness and death can bring out the best in people,” she shares.  “It demands authenticity.  For me, that authenticity, that truth feeds me.  It’s an honor to be part of people’s lives during this once-in-a-lifetime experience.” Dr. Little also thrives on finding the right solution for a patient and family so they can live in comfort and with dignity.  “It is not a recipe,” she explains.  “We are constantly asking ‘what does this patient, at this time, in this environment, with these caregivers, and with this disease process need?’  People are unique and we do our best to make sure their unique needs are met throughout their time in hospice care”.

We recognize Dr. Little’s medical expertise and the gift of presence, mindfulness and compassion that she brings to hospice staff, physician colleagues, community partners, and the patients and families we serve.  Dr. Vanessa Little is truly a hero and gift to our community.

Dr. Vanessa Little, from left, and nurses Tree Dunbar and Emmi Shambeck.  (Kevin Johnson — Santa Cruz Sentinel)

Tree Dunbar, R.N. and Emmi Schambeck, R.N.
Between the two of them, Hospice of Santa Cruz County nurses Tree Dunbar and Emmi Schambeck have 57 years of experience in caring for the seriously ill and dying in our community.  When asked about what inspires her the most, Emmi answers simply, “Every day inspires me.”  Tree is inspired by the universality of the experience.  Working with people who are dying, knowing that we will all someday experience death, could seem depressing.  These two heroes embrace the challenge and handle the most complex medical and emotional cases because they believe that every one of us is entitled to live, and die, with dignity.

Emmi Schambeck and Tree Dunbar are team leaders at Hospice of Santa Cruz County.  In their role, they each oversee the care of about 60 patients.  They support teams of nurses, social workers, chaplains and aides who provide day-to-day, direct care to patients and their families.  Trust plays an important role in their daily work.  “There is no other situation in which people are so trusting,” Emmi shares.  “Often this is a first time experience for a family and they want guidance”.  Hospice care is provided in residential homes, nursing homes and facilities, and Emmi reflects on both the privilege and responsibility of accompanying a patient and their family on this final journey.  “I offer my expertise and experience and know that the patient and family will choose the tools and support they need.  Each patient and family is different so we first find out what is important to them and then offer our expertise and support.”

The daily activities that these two clinicians perform are diverse and become more complex based on the patient’s needs. Tree and Emmi are skillful multi-taskers.  When they are serving a younger patient, they are busy ordering medications and supplies like a  hospital bed for the home while ensuring  that the patient’s children have the emotional support they need though the process.  When supporting a homeless patient, they can spend hours negotiating with community partners to find appropriate shelter and caregivers so that the patient will be comfortable and safe.   Recently a patient shared that he wanted to marry his longtime partner before he died.  Tree worked with the team to arrange this wish and the team’s chaplain married the couple just days before he died.

Amidst the daily work of management and logistics, Tree and Emmi are deeply drawn to the mystery.  While they feel a sense of accomplishment in treating the physical pain and the emotional and spiritual concerns of their patients, they realize that they are not fully in control of the situation.   “As much as we medicalize it, there is still a mystery to how it unfolds,” Tree shares.  “We try to reassure our patients and families, ease their fears, and help them prepare and understand what to expect.  And then we accompany them through the mystery – it’s an incredible privilege.”

In their respective 30 and 27 years of hospice work, Tree and Emmi have helped thousands of patients and families live, and die, in comfort and with dignity.  They have mentored scores of young nurses, helping them to become seasoned end-of-life care professionals.  Their heroism comes in their openness to show up every day knowing that each patient and family situation they will encounter is unique.  We recognize the profound commitment and dedication these two professionals make to Hospice of Santa Cruz County and to our community.

Dr. Vanessa Little, from left, and nurses Tree Dunbar and Emmi Shambeck. (Kevin Johnson — Santa Cruz Sentinel)