Twins Find Purpose as Palliative Care Doctors

For identical twin doctors Marissa and Clarissa Araw, the path to becoming Palliative Care providers began when they were 8, and their grandmother was admitted to the hospital.

“She had been living with us — as Filipinos, we are a very close-knit family,” Dr. Marissa Araw says. “When she was home, she was up and about, but when she went to the hospital, she died very quickly after that.”

The seeds were planted that there could be a better end-of-life journey, one that was more natural and compassionate.

Today, they both work for Swedish Medical Group hospitals that are a 30-minute drive apart, and they live together in Seattle. Both say they are grateful for their jobs, which they found through Provider Solutions & Development Senior Recruiter Emi Flaherty.

“Emi really took the time to get to know us. She wanted to make sure we were happy and successful,” Dr. Marissa Araw says. “It wasn’t just about getting us a job. She knew we wanted to work together, and our goal became her goal. She had genuine concern for us as human beings. She even helped with where we could live and recommended great places to eat. She knew we were both foodies.”

Emi helped Dr. Marissa Araw get her job first, then kept in close contact with Swedish Medical Group until a position came open at a neighboring hospital. It only took a few months.

“The first time I talked to Marissa and Clarissa, I knew they were a package deal,” Emi says. “They are so passionate about Palliative Care, and they are so closely bonded as sisters. I was determined to find the perfect roles for each one so they could work within the same health system and colleague network.”

Their first year at Swedish only solidified that they made the right decision, the sisters say. The supportive, mission-driven environment has allowed them to pursue their calling. For them, providing nurturing care to seriously ill and elderly patients is what they were meant to do.

"The most important thing for me is that they are human beings. They are not just patients in a room. They are first and foremost a person. I let them know, I am here for them. They know I’m their advocate, and their families know, too."

Growing up in the Philippines, their father encouraged them to become doctors. The twins went to medical school in their home country before moving to New York for residency and fellowship. Dr. Clarissa Araw remembers learning about Palliative Care for the first time.

“It was a new specialty. I had to look it up,” she says. “I wanted to know all about it, and I thought, ‘This is really for me!’ I just felt it. It’s like, I found my purpose.”

The twins provide care for their patients throughout the course of a serious illness, from diagnosis to resolution — whether that is remission, a cure or death — helping them make decisions based on their values and preferences.

“Palliative Care is about supporting patients and their families as they navigate this time,” Dr. Clarissa Araw says. “My patients really appreciate what I tell them and how honest I am with them. It’s so important for them to understand exactly what is happening to them, and that feels good to be able to help out in that way. I shepherd them in the best way possible on how they can maximize the end of their life.”

Dr. Clarissa Araw says her patients amaze her with their resilience and joy for life.

“I had a wonderful patient-physician relationship with an elderly man who had a blood disorder,” she says. “He needed a transfusion every week, and I would see him in the clinic. He had such strength, to just go through it. He ended up passing away, but he brightened my day every time I saw him. He was smiling and happy, despite his condition. He inspired me. I’ll never forget him.”

Dr. Marissa Araw also had a patient who really touched her life during her residency in New York.

“She was only in her 30s, but she had colon cancer, and the plan was surgery for a cure, but when they went in, they found it had spread throughout her body, and they couldn’t remove it all,” she says. “She received cancer treatment and was back and forth to the hospital. I saw her a lot for her pain, and we became really close.”

She says at the end of her patient’s life, she counseled the woman’s husband on when to transition her to hospice.

“I was there for the end of her life,” she says. “She trusted me completely.”

She tears up telling this story. She says between her and her sister, she’s the more emotional one. “I’m a crier,” she says.

The twins have each other, and that’s a good thing, especially since their work can be stressful and emotionally draining.

“We have this rule,” Dr. Marissa Araw says. “When we get home, we can talk about our work for one hour, and then that’s it. We rely heavily on our faith. We’re Catholic Christians — we attend services at a Catholic parish and a Christian church. We love the outdoors, eating out, going to Canada and spending time with family. That’s how we do our self-care.”

COVID has made things harder. The no-visitor policies have made their patients more vulnerable and depressed. Family meetings to make decisions about care are difficult on Facetime and Zoom.

“We have responded by supporting our patients even more, because they need it,” Dr. Marissa Araw says. “The families need extra support. It has been hard.”

As difficult as the pandemic has been, the twins’ resolve to help remains stronger than ever.

“When I see my patients, I talk to them about their treatment goal, or sometimes I just listen to their story, or I listen as they grieve,” Dr. Marissa Araw says. “The most important thing for me is that they are human beings. They are not just patients in a room. They are first and foremost a person. I let them know, I am here for them. They know I’m their advocate, and their families know, too.”

Dr. Clarissa Araw agrees. “It’s a privilege and an honor to be part of their story, especially to be a part of their difficult journey. We feel so blessed that Emi and PS&D helped connect us with this opportunity at Swedish. I know this is what I was meant to do.”