On March 9, while recovering from treating a lymphoma relapse, Kezia Fitzgerald was medically cleared to leave her home near Boston.
Within a week the state, like the rest of the northeastern U.S., had shut down. The 36-year-old mother and small business owner had to immediately return to a quarantine life.
Fitzgerald was frustrated. But she turned her attention to her business, , which specialized in devices that secure patients' catheters and feeding tubes. A friend working in infectious disease control told her that many healthcare workers suddenly needed more medical gowns.
Fitzgerald and her colleagues did not make such gowns and knew little about their design or production. But they got to work anyways.
Now the gowns and COVID-19 masks make up about half of CareAline's business; demand continues along with the pandemic.
Such flexibility and resiliency are Fitzgerald's trademark. After surviving her first bout with cancer while simultaneously losing a child to neuroblastoma, she fought off the disease again. A photographer by trade, she carved a niche in the medical supply business. Then when the pandemic struck, that company quickly created new needed products.
"The people most prepared for [the pandemic] were us – the families and the patients with chronic illness or terminal disease. Because we've done this before," in June. "We've done this ourselves more times than we would like to ever have."
Making a company out of tragedy
Fitzgerald grew up in Andover, just north of Boston, met her husband Mike at art school in Chicago and settled back in Massachusetts.
In January 2011 she was diagnosed with stage 3 Hodgkin's lymphoma. Three months later, her 11-month-old daughter, Saoirse, was diagnosed with the neuroblastoma. "My treatment became secondary," Kezia said.
Her daughter kept toying with her PICC and central lines, so Fitzgerald developed a sleeve to stop her. The sleeve worked and soon was the envy of other families at the hospital, so she crafted a few for them. When a nurse asked her if she had a website, she realized she had a popular idea.
Fitzgerald went into remission that summer. But Saoirse did not make it, dying in December.
For most of that December and January, she and Mike "shut ourselves off from the world," she said. They took to walking around local malls, searching for answers both personal and professional.
When they returned from an introspective trip to Ireland in February, they met with manufacturers. "We could decide it's too hard because we would have to tell the story of our child all the time," she said. Or: "We could keep her alive in this way, keep talking about her." She also believed they could help a lot of people.
CareAline ("Care for a line") was incorporated in October 2012. They developed the sleeves that Fitzgerald had designed for her daughter, as well as accompanying wraps. Clinical partners University Hospitals of Cleveland, Boston Children's Hospital, and NYU Langone Medical Center.
The sleeve is designed well, said Colleen Nixon, MSN, hematology/oncology clinical educator at Boston Children's. It is a stable, "functional product" that prevents kids from pulling on their lines. "Obviously [Fitzgerald] worked hard to make this product," Nixon said. "She knew it made a difference for her and I think she knew it would make a difference for other people."
The business grew steadily and, in 2013, so did their family: Mike and Kezia had another child -- a son named Lochlan.
"I really admire both her and Mike, and what they have done for patients and families," Nixon said.
Adjusting on the fly again
But eight months later, in March 2014, Kezia's lymphoma returned. She was crushed: "I have tried not to let my family and friends see my disappointment, but it has been almost impossible to hide," that year.
She put off conventional treatment for two years as the disease stabilized, seeking integrative therapies and focusing on raising her son and running CareAline. After three years of treatment, she was declared in remission. She underwent a stem cell transplant and four final rounds of chemo. Last December, she was hospitalized for a lung complication. Doctors then ordered she quarantine at home.
A clean scan March 9 allowed her to end her isolation -- for a few days. "We are pretty good at lockdowns; we're pros," she quipped, smiling during a digital video conversation with app recently.
Launching the gowns was challenging, she said; they had to meet unfamiliar testing standards and new clients' needs. A $25,000 grant from the state helped and soon CareAline had a popular new line of care.
The FDA-certified reusable gowns feature a velcro neck, high collars, and waist closure overlap on the back; they were designed to be used up to 75 times. CareAline has also begun developing the masks during the pandemic, selling to hospitals, school systems, and dental practices.
Early in the pandemic, the Seattle-area endodontist practice of Kristi Donley, DDS, was scrambling to find affordable gowns. On a Zoom call while Donley was vetting CareAline in May, Kezia and Mike discussed their company's inspiration. Donley got the sense they were not just trying to capitalize on the pandemic, that they had put a lot of thought into the gowns. "This is exactly what I wanted," Donley said. "It looks professional; it still looks new even when we reuse."
Fitzgerald expects the gowns and masks will remain a mainstay of their business after the pandemic.
Whenever that will be remains to be seen. Until then, she is focused on whatever life throws at her. She has already been through cancer twice, and her daughter's illness and death. What is a little -- er, big -- pandemic?
"There is no going 'back to normal'; you can only create a new one," she wrote in the June blog post. Just as she could not rescind cancer diagnoses for herself or her daughter, "we can't take this back either."