A Young Physician Survives Lung Failure with a Double Lung Transplant, and Finds a New Calling

In the summer of 2021, just weeks after graduating from medical school, Shirene Philipose, MD, began her first year of residency at a hospital in Kansas City. It was a season of beginnings—new colleagues and new challenges awaited the 25-year-old as she stepped into the role she had worked years to earn. But that July, as the world continued to grapple with COVID-19, her life took a devastating turn: Her father, Ben, was diagnosed with Stage 4 lung cancer.

“It was a difficult time all around,” she recalls. Between long workweeks and the emotional weight of her father’s diagnosis, Shirene traveled home to St. Louis for Thanksgiving. It was a chance to see her family and take a breath if only for a few days.

Shortly after arriving home for the holiday, however, she began to feel sick. On the Wednesday before Thanksgiving, she noticed she couldn’t taste or smell anything. Shirene had recently been caring for COVID patients. “I thought, ‘Maybe I have COVID,’” she remembers. By that Friday, she was vomiting and weak.

Her parents took her to the Emergency Department at a different hospital system, where providers determined that Shirene’s blood pressure was dangerously low and admitted her to the hospital. Test after test came back negative, including repeated COVID swabs. As her symptoms worsened, she developed severe shortness of breath and was placed on oxygen.

Having spent months caring for COVID patients, Shirene knew what this meant. “We’re not headed in a great direction,” she remembers thinking.

By then, even chewing solid food left her breathless. She had her mother read her oxygen levels every hour. When her oxygen plummeted one evening, a rapid response team rushed in. “We have to intubate you,” they told her, referring to the procedure in which a patient has a tube inserted into their windpipe to help them breathe. She would also need a ventilator, which breathes for patients.

“I wasn’t ready for that,” Shirene recalls, and she asked for more time before being intubated. She wrote down a list of phone numbers—her residency program director’s and associate program director’s included—and handed them to her parents. “If anything happens, call these people,” she told them.

The next day, Shirene realized she was having too much difficulty breathing on her own and asked to be intubated.

Fighting for air

Word of Shirene’s critical condition reached her residency program. One of the pulmonary critical care physicians there, who had trained at Barnes-Jewish Hospital, recommended that her family transfer her to Barnes-Jewish for further advanced care.

At Barnes-Jewish, WashU Medicine physicians worked to diagnose and treat Shirene, but tests for autoimmune disorders and infectious diseases all returned negative. She was placed on emergency extracorporeal membrane oxygenation, or ECMO, a treatment that oxygenates a patient’s blood. As Shirene’s lungs continued to deteriorate, the conversation turned toward organ transplant and finding her a new pair of healthy lungs.

The nationally ranked pulmonology program at the WashU Medicine and Barnes-Jewish Transplant Center provides advanced care for patients navigating lung failure and other complicated lung diseases. WashU Medicine surgeons were also pioneers in lung transplant, performing the first successful adult lung transplant at Barnes-Jewish Hospital in 1988. Since then, they have performed more than 2,100 transplants, making the program one of the most experienced in the country.

Shirene was unconscious, so the decision of whether to list her for transplant fell to her parents and sister. Her father was in favor; other family members wrestled with the decision. If God had given her those lungs, wouldn’t he heal them? They turned to a Bible verse, John 15:13, that talks about giving up one’s life for a friend. They also remembered something: When Shirene was 16, she signed the back of her driver’s license, indicating she wanted to be an organ donor. Her family realized that if she would give an organ, she would accept one.

On Dec. 26, 2021, Shirene was listed for a lung transplant. On Feb. 11, 2022, she was matched with a donor, and the next day, underwent a double lung transplant performed by WashU Medicine thoracic surgeon Ruben Nava Bahena, MD.

Later, the final pathology of Shirene’s lungs showed acute interstitial pneumonia—a rare and often fatal condition typically seen in older adults. A WashU Medicine pathologist showed her the slides that contained tissue from her old lungs.

“Lungs are supposed to have large air sacs so that oxygen exchanges. Mine had lots of scarring,” she says. “Seeing those slides gave me closure. There was no way air could go in and out of my lungs. I needed the transplant.”

Healing while heartbroken

After surgery, Shirene’s recovery took time as she worked to wean herself off the ventilator. “I felt so scared to come off the ventilator,” she says. “I was dependent on it.”

While Shirene worked up to breathing on her own, without the ventilator, the care she received extended beyond medical treatment. On Shirene’s birthday, a nurse swabbed a melted orange ice pop in her mouth when she couldn’t eat. One occupational therapist prayed with her several times during her stay. Her clinical team organized a trip outdoors with 10 staff members carefully wheeling her and her equipment so she could take her first breath of fresh air in months.

On March 7, her 26th birthday, Shirene got a visit from her dad. Because of his cancer, it was the first time the father and daughter had seen each other in person since her transplant. Two days later, he was admitted to a different hospital’s ICU and passed away.

That night, nurses came to Shirene’s bedside so she wouldn’t be alone.

Redefining her role

By late May 2022, Shirene was discharged from Barnes-Jewish after nearly six months. She took a year off work to focus on rehabilitation and rebuilding her strength. It was a time of uncertainty—she questioned whether she would still be able to practice medicine, but, she says, “my lung transplant doctors told me not to let any of this stop me.”

She found community, first in her pulmonary rehab group, and then in an online network of physicians who are also transplant recipients. “There are more than 70 of us now from around the world,” she says. “Seeing younger people with a transplant still practicing medicine and being advocates gave me the spark that I needed to continue.”

Today, Shirene’s experience has transformed the vision she has for her career. She plans to work in primary care with a focus on caring for pre- and post-transplant patients to bridge the gap between transplant teams and patients’ everyday health needs. “Patients need additional backing to their care,” she says.

Six months after her surgery, Shirene wrote a letter to her donor’s family. “It’s hard to find the right words,” she says. “But I’m so thankful for my donor, for my donor’s family, and for their decision.”

Also remaining close to Shirene’s heart are her WashU Medicine transplant surgeon, Dr. Nava, and the team of nurses and therapists at Barnes-Jewish.

“They didn’t just treat me medically,” she says. “They attended to my emotional health, my spiritual health, and helped my family as a whole. I’m so glad I was in St. Louis at the time I was. Who knows what would’ve happened if I wasn’t.”

Learn more about the WashU Medicine and Barnes-Jewish Transplant Center.