The Heart of Medicine

Nov 9, 2022

Dana Casadei, Media Relations Specialist

It’s a dinner party full of light conversation, good food, and better company. Then someone asks Dr. Nadia Tremonti what she does for a living, bringing a stop to whatever conversation she was having.

People hear pediatrics and are fine, but then they hear she’s a pediatric hospice and palliative care doctor, it’s something that makes the record scratch.

“When I say that, people, I don’t know, I think they’re envisioning I would be a very depressed person, all dressed in black, and always morose,” she said. “I think a lot of people struggle with that, but for me, I have a lot more appreciation for the blessings and gifts I have, and I have a lot more exposure to the positive things of humanity, like hope and unconditional love.”

She’s anything but morose – Dr. Tremonti describes herself as gregarious, energetic, and happy, all things that ring true when you speak with her – and her favorite color isn’t black, it’s forest green.

Dr. Tremonti will also tell you that her career in hospice and palliative care was serendipitous, an unexpected calling given she had every intention of becoming an OB/GYN upon entering medical school, with very little interest in going into pediatrics.

But everything changed after her pediatrics rotation during medical school. She felt so drawn to working in pediatrics – specifically oncology, where she planned to focus her career – that she ended up canceling her obstetrics interview. It’s clear that she was meant to do this work too.

Given her 15 years in the field, as well as receiving the Hour Detroit Top Docs Award in Hospice and Palliative Medicine for the fourth year in a row this October, she’s also very good at what she does, working both in hospitals and overseeing Angela Hospice’s My Nest is Best pediatric program for terminally ill children.

“Dr. Tremonti is a one-of-a-kind person and a one-of-a-kind physician,” said Dr. James Boal, Angela Hospice Chief Medical Officer, who works with Dr. Tremonti. “She is able to manage the almost emotionally impossible task of caring for dying children with a combination of compassion, energy, and even joy. She brings the light of her care into the darkest fear that any
mother or father of a child could imagine.”

It’s safe to say the hundreds of families who have been cared for by her over the last 15 years at both hospitals and Angela Hospice would agree, and many of those families have known her for years.

When she signs on to a case, Dr. Tremonti becomes their primary care physician, and since children often exceed expectations, a large population of her patients she’s known for 5-10 years. She becomes very involved in their lives, where she gets to learn and hear their stories, no detail too small or unimportant.

“I’ve probably taken care of over 1,000 families… and if you asked me to go down the list, probably 90-percent of those patients I could tell you their whole life story,” she said. “I really do get involved in and listen to people, and can say things like how old their siblings were, and if their parents were high school sweethearts…”

When we spoke, she was at an interesting time in her career, and had recently lost multiple patients, some of whom she’s cared for over 10 years; patients that she met very, very early in her career, who shaped a lot of the way she counsels other families.

That kind of influence has happened with the majority of her patients, who have all left a big impact on her. They’ve all shaped the way she practices medicine, specifically the way she interacts with a family, teaching her to lead with empathy.

She understands that whatever situation someone is facing is the culmination of a million factors, both in their control and out of it. People are simply trying to survive, and find meaning and strength each day.

“I know that in the years before and during my medical training, I would carry fairly flippant ideas of why a person may be on a particular path, thoughts like, ‘If that was me, I never would have done that…’” Dr. Tremonti said. “Then, through years of working with people, I see that that is such a dramatic over-simplification of what families go through.”

Turns out the complexities in family dynamics can be as complex as a medical diagnosis.

And while Dr. Tremonti had known from an early age she wanted to be a doctor, some of what makes her such a specialist in her field isn’t what she learned in the classroom, it’s who Dr. Tremonti is at her core.

It seems her path was destined to be a little bit different than others around her, that her perspective wasn’t typical when it came to the type of doctor she wanted to be.

Take for example her undergraduate degrees from Western Michigan University: Biomedical Science and Comparative Religion. (She also received minors in Chemistry, Psychology, and Philosophy with an emphasis in medical ethics from WMU. Dr. Tremonti then graduated from Wayne State University’s School of Medicine.)

“When I enrolled in college, I had an impression that when people are sick they turn to God or their religion, and that was not something that was really important in my upbringing,” Dr. Tremonti said. “I think I was recognizing that having health issues are more than just about the medicine and the science, and that how people cope is a really important part of things.”

To this day she says that she probably uses her comparative religion major more than any of her science-related degrees.

“I feel like actually, a lot of the reason we went into healthcare is to have relationships and to be a part of something bigger,” she said. “And so I don’t feel any need to check it at the door.”

Dr. Tremonti is the first to admit many doctors often make decisions based on science and data; but families use faith and gut feelings, relying on the former heavily when looking at critical or hard decisions. Because of her comparative religion major she’s able to sit with families and feel comfortable talking about their beliefs, the meaning of life and death, and not automatically jump to the data.

It could also be why she’s so comfortable having conversations that are often so uncomfortable to others, something that she noticed when she was in medical school.

“When I did my pediatrics rotation in medical school, I chose to be on the oncology floor,” she said. “If I’m being very honest, I guess I was actually looking more forward to learning about cancer than I was looking forward to learning about kids.”

But then she had three families with children who were really sick, each eventually passing. She then helped the families navigate what they were going through, and recognized that not everyone was comfortable doing just this, talking about end of life.

From there, her whole plan changed.

“Every rotation I was drawn to the families that were maybe in the hardest of times, and drawn to the conversations and sitting in the rooms, talking to people about their fears and sadnesses, and what if these bad things come to pass,” Dr. Tremonti said. “I felt comfortable in those places, and I felt I had maybe a gift to be able to be comfortable there and help people.”

And thankfully, she didn’t listen to the advice of the president of one hospital she worked at, who told her she would never be able to make a career out of working in palliative care.

Dr. Tremonti would go on to become a member of the first class of doctors who sat for the boards to be board-certified in hospice and palliative medicine in 2008, eventually becoming double board-certified in pediatrics, and hospice and palliative medicine. She also started the palliative care program at Children’s Hospital of Michigan. And her work in palliative care was the focus in the 2019 documentary film, Palliative, which went on to win several awards, including 2019 People’s Choice Award for Best Short Film at the Denver Film Fest

And while some things have changed since she began her medical career, including how more and more people are recognizing just how important palliative care is, one thing remains the same: what a hard thing hospice and palliative care, death and dying, are to talk about.

But, if you find yourself as someone with even an inkling of pursing hospice and palliative care, wanting to be a part of the future, Dr. Tremonti would tell you to pursue it, especially if you’re comfortable talking about those complex issues, about end of life or preparing for the end of life, no matter how far away it is.

“If you have an interest… we need you,” she said.

Dr. James Boal, Angela Hospice Chief Medical Officer, with Dr. Tremonti.

Given what she does day in and day out, it would be easy to understand if she left her work at work, but Dr. Tremonti doesn’t. She never has. Patients and families are often on her mind when she’s at home.

“I feel like actually, a lot of the reason we went into healthcare is to have relationships and to be a part of something bigger,” Dr. Tremonti said. “And so I don’t feel any need to check it at the door.”

Since she’s the primary care physician for all of her patients she’s able to be dedicated completely, and is on-call almost 24/7. Because of that though, nothing is ever lost in the shuffle. Dr. Tremonti doesn’t have to follow up with other doctors on what’s going on with her patients. She’s able to stay involved every step of the way. And considering she has such a close relationship with most of the families she cares for, being on-call 24/7 can be very efficient. (Dr. Tremonti did joke she’s very good at going on vacation when it’s appropriate though.)

She also finds great reward in forming such close-knit relationships with patients and their families, offering constant support for them, much like what she receives in her own life.

Dr. Tremonti is constantly surrounded by people who know every aspect of her, and have her entire life, making it possible to not have to divide too much between work and home. Her being a pediatric doctor in hospice and palliative care is just another layer to the person they already know and love, people who understand her passion for her career because they understand Dr. Tremonti.

Grosse Pointe Park, Mich., is where she grew up and currently lives; met her husband, Mike Gentile, who she’s known since they both attended Grosse Pointe South High School; the city where her two daughters attend the same schools she did; and where her mom still lives in her childhood home, only eight houses away from Mike and their children.

“Community and family is extremely important to me, and has been a major reason I am able to dedicate myself so completely to my work, because I have such a close knit ‘village’ that supports me at home,” she said.

That support starts with Mike, who she’s been married to for 17 years.

“It blows my mind sometimes that she can do what she does at work, and then come home and just can still be an amazing mom and an amazing wife,” Mike said.

At home she’s still a doctor, who may receive a call in the middle of dinner, but she’s able to focus on her love of cooking and eating together as a family, bike riding, exploring nature, and animals, especially Great Danes.

These are simply more pieces of the puzzle that completes who Dr. Tremonti is.

Mike describes how passionate she is about her job, something one picks up on even after chatting with her for only a few minutes. You can hear the fire in her voice when she describes what she does, and the awe in Mike’s.

He also mentioned that because she’s willing to have difficult conversations with people, with patients, that translates to being able to having tough conversations when needed in their personal life as well.

One would think that would be hard, to be married to someone who works in such a tough field, but Mike finds her work and what she does incredible.

“The way I put it, she helps people who are in really tough situations… she’s there to try and make them a little bit better,” he said.

And even though working in pediatric hospice and palliative care is tough, working with children at their most vulnerable, and families who aren’t sure how much time they’ll have left together, Dr. Tremonti wouldn’t change what she does for anything.

“It’s the heart of medicine, and it’s beautiful,” she said.

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