Written by Steven Blackburn Photography by Stan Godlewski
When the vast majority of doctors have remained at the same hospital and division for 20 years or more, it’s clear that something is working. Such is the case with Charlotte Hungerford Hospital’s cardiology team, which includes Dr. Carrie A. Wolfberg, who established the practice in 1992; Dr. Joseph Abreu, who joined in 2000; Dr. Michael Fowler, who followed in 2002; and Dr. Martinez Fidel, who came aboard more than a year ago. In fact, that’s one of the reasons why Dr. Parmanand Singh recently decided to serve at the Torrington hospital and became a doctor there at the end of March. The practice is part of the Hartford HealthCare Heart & Vascular Institute, a national leader in cardiovascular disease prevention, treatment, surgery and research with locations across Connecticut and western Rhode Island.
“That was a big part of my decision to relocate to Torrington since the doctors have really been here a long time,” said Dr. Singh, who came from Cornell as an academic researcher to broaden his narrow, specialized cardiological focus at a community clinical practice.
For Drs. Abreu and Fowler, they’ve stayed at Charlotte Hungerford as long as they have because of the positive working conditions, their colleagues, the sense of community and the feeling that they belong. “I don’t love it when it snows more than six inches, but it comes with the territory,” said Dr. Abreu. “Part of it is the comfort of knowing that the job we’re doing matters. It keeps you engaged and makes you want to continuously improve.”
Dr. Fowler agreed, also citing how his wife works at Charlotte Hungerford as a physician in a different capacity and how the area was a perfect place to raise their kids. “I like the fact that when a patient comes here, they know that they are going to see their doctor,” he commented. “They are not going to see 18 layers of trainees and students.”
A cardiology team that’s passionate about their line of work
Regardless of when or why they came to Charlotte Hungerford, everyone on Charlotte Hungerford’s cardiology team can recall what drew them to this particular field. Dr. Fidel remembered that it was one of the few specialties that would allow him to see patients in and out of a hospital. Procedures like EKGs also attracted him.
For Dr. Abreu, he described it as his destiny. “That might be too cliche, but I always wanted to be at a practice in a small community where we did meaningful work.” Interestingly, Dr. Singh distinctly remembered a colleague at Harvard Medical School saying those same words to him. But Dr. Singh explains his passion differently. “I was just fascinated by the heart, partly because of the implications that a heart has on your quality of life. It’s a field that is constantly trying to innovate and change the paradigm of what we do, which makes it revolutionary.”
Meanwhile, Dr. Fowler just naturally gravitated to the practice and wanted to work in a smaller community like Dr. Abreu. But Dr. Fowler was influenced more by experiencing what it was like to work at a much larger facility where there were at least 600 hospital beds. “It was something I just wasn’t interested in,” he recalled. “But then I heard about an opportunity in Torrington that was away from all of the craziness, and it seemed like a great fit.”
More robust technology and onsite training to streamline care
Charlotte Hungerford’s cardiology practice has been undergoing extensive growth over the last few years. In 2019, the hospital joined Hartford HealthCare, which has allowed the Torrington team to expand or improve upon many aspects of their work, including electrophysiology studies to diagnose abnormal heartbeats or arrhythmia, and the use of defibrillators, which restore normal heartbeats.
Hartford HealthCare’s additional resources give Charlotte Hungerford’s cardiology team the means to provide a much more streamlined experience for heart failure patients. For example, the team was able to purchase new technology like CardioMEMS, a device that’s implanted into patients to monitor their condition remotely. This greatly improves the way in which Charlotte Hungerford can manage their patients.
“It gives us a heads up on who is declining more than any other of our other clinical procedures,” said Dr. Fowler about CardioMEMS. “This also allows us to monitor them here without having to schlep the patient off to a big hospital for a fairly simple procedure.”
To use this technology effectively, the team at Charlotte Hungerford leveraged its affiliation with Hartford HealthCare to arrange the comprehensive network’s own interventionalists to visit the Torrington hospital onsite to train one of their interventionist radiologists.
“Through our affiliation with Hartford HealthCare, we were able to add services we desperately needed to advance our programs and expand the hospital.”
Expanding reach to more remote areas of Connecticut
Charlotte Hungerford’s cardiology physicians benefit from the new Hartford HealthCare Heart & Vascular Institute office in Winsted about 15 minutes away. They perform cardiac rehabilitation and other services there for members of the community who would rather not travel down Route 8 to Torrington. Hartford heart specialists also visit the Winsted office to see Charlotte Hungerford’s patients who need additional cardio or vascular consultations.
“There are folks who would not have schlepped to New Haven or Hartford for a more advanced look at their heart failure,” said Dr. Fowler. “They can easily do it now by just running up Route 8 and getting off the highway in Winsted.”
This arrangement benefits not only Winsted residents but those who live in more remote areas further away from Torrington like Colebrook, Barkhamsted and especially Norfolk. “There’s not that much else around here,” said Dr. Fowler. “There’s a small cardiology presence in New Milford. And I know that Sharon doesn’t have an integrated team with advanced practitioners, so we’re the only nearby choice for most folks.”
“The northern part of Connecticut can be a challenging place to connect since it is very expansive and the providers can be sparce,” added Dr. Singh. “To connect those providers that are part of the system from different specialists is quite a task, and Hartford has done an excellent job of doing that.”
Direct communication with the right specialists immediately
Charlotte Hungerford can now provide expedited services for patients in need, thanks to Hartford HealthCare’s expanded network, which gives the cardiology team a direct line of communication to a special tertiary care center where there are different cardiology specialists.
“When a patient needs to go directly to the cath lab at Hartford Hospital, I can talk to a cath lab doctor immediately. Or if I need to speak to a surgeon directly, I don’t have to go through all of the bureaucracy,” said Dr. Abreu. “This allows us to save the patient’s time when getting them evaluated or prepared for potential urgent surgery. We just have to call who we need to speak with.”
Dr. Abreu recently benefited from this direct line of communication when a stress test identified that one of his patients at the Torrington office had an abnormality in their anterior wall. “I was able to call the interventional cardiologist in Hartford, explained the situation and the symptoms, and the patient was seen in two days, got a cath, and had two stints replaced. The patient came to me this week. He was very pleased and had no symptoms. His problem was completely resolved.”
For Dr. Fowler, he is able to co-manage four heart transplant patients with a heart failure team at Hartford Hospital. “Being affiliated with them has made the process much easier,” he commented. “Patients feel more comfortable knowing we are all in the same system, that we can see what everyone is doing, that we know what the test results are, and that we can clearly see where we are in the process.”
Charlotte Hungerford also collaborates with Hartford Hospital in cardio-oncology for patients with cardiovascular diseases caused by cancer therapies. “Collaboration between different specialists improves the overall quality of care that the patient receives,” said Dr. Singh. “It also improves their quality of life in a sense that it can improve their overall outcome and life expectancy. And it reduces the risk of any complications.”
Since Dr. Singh has only been at Charlotte Hungerford for a short time, he’s much more aware of how much the Torrington hospital and the overarching Hartford system stand out from the competition. “It’s more obvious to me since I have more of a basis for comparison,” he said. “But what’s impressed me is that Hartford HealthCare has an infrastructure that supports a more seamless line of communication amongst providers from different fields than some other places where I have been.”
“You would think that you would have to be in New York City, LA, Boston or Cedars-Sinai to get this kind of care, but that’s not the case,” Dr. Singh continued speaking from his unique perspective, making it sound like he would likely stay at Charlotte Hungerford for as long as Dr. Fowler and Dr. Abreu have, if not longer. “The quality of health care amongst our cardiology group and our collaborations here in Torrington is really top-notch.”
chronic conditions. One of the reasons that I chose family medicine is that there are always unexpected challenges and whether those happen day to day or patient to patient, that’s what kind of keeps it spicy.”
Steven Blackburn is a freelance writer with more than 10 years of journalism experience in various fields, including U.S. education and Connecticut community interest stories. He lives in Winsted.
Stan Godlewski is an editorial, corporate and healthcare photographer based in Connecticut and working primarily between Boston and New York City.