A doctor reborn — on lungs she’ll never take for granted

LEXINGTON, Ky. (April 14, 2025) — As a pathologist, Maria Braman, M.D., is trained to see bodies as a collection of parts, interconnected and working in perfect concert to compose the quiet symphony of life. The heart pumps the blood, oxygenated by the lungs, through miles of vessels to every corner of the body, supplying organs and tissues with the air and nutrients to fuel life.

But it’s because of her training as a medical doctor Braman is all too aware of how even the smallest contagion — mold spores, for example — can disrupt the body’s delicate balance. She spent her career identifying these disruptions in others, never dreaming she would see them in herself.

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Braman’s medical career has taken her all over the country, from her native Washington, D.C., to Montana, to Kentucky. During her Montana years, first working to help establish the state’s first accredited breast center before her appointment as her hospital’s vice president of medical affairs, she and her family embraced an active, adventurous lifestyle. Weekends were spent hiking Montana’s rugged terrain and running 50K races. After a lifetime in busy, congested D.C., Braman savored the clean air of Big Sky Country.

She later discovered the air was not so clean after all.

The Braman’s home was adjacent to a large ranch that grew hay. Flourishing in the hay bales was a type of mold that can lead to serious lung disease when inhaled by those with a particular sensitivity.

Hypersensitivity pneumonitis is considered a relatively rare interstitial lung disease in the United States, affecting roughly three out of every 100,000 people. Prevalence tends to be higher in rural or agricultural regions, where exposure to organic dusts is more common.

“My family and I enjoyed being outdoors in the wilderness, having the windows open at home,” said Braman. “It’s just ironic — you think you’re moving to Montana, where it’s much healthier than living in the city. I should have stayed with the smoke and congestion.”

Braman was diagnosed with hypersensitivity pneumonitis in 2013. Her health declined slowly over the years. First, she realized she could no longer run, but she could still hike. But then hiking became a challenge if the incline was too high. Determined to stay active, she would walk loops on flat ground; over time, that also became too difficult. In 2016, she came to Kentucky, recruited to join the leadership team of Appalachian Regional Healthcare, first as vice president of medical affairs, before being appointed chief medical officer. Once she traded the big sky of Montana for the hollers of Kentucky, she managed her lung health with UK HealthCare pulmonologist Erin Camac, D.O., with medication and lifestyle modification.

Despite her declining lung function, Braman was determined to stay strong for her family. When the gradual loss of ability and independence began to affect her mental health, she enrolled in therapy to improve her mindset and outlook.

“I wouldn't call myself religious, but I have strong faith,” she said. “I really tried not to allow myself to be overwhelmed by it. You've got to move forward, you know? Because there were times, especially when things got really bad, I had to make a choice. Am I going to spend my time worrying about this, or am I going to use what time I have to try and be productive and thankful? I’m still breathing. I’m not in pain. My brain still works. I still have time with my kids.”

A slow decline, then a sudden drop

That strong mindset served her well until March 2024, when she was diagnosed with pneumocystis jirovecii pneumonia (PJP), a rare but serious complication caused by a fungal infection. While a person with healthy lungs could be exposed to the fungal spores and not show symptoms, it spreads easily and can be especially harmful to someone with compromised lung function. Braman was hospitalized for five days; her lungs, already irreparably damaged by the pneumonitis, couldn’t breathe for her anymore.

“Pneumonia can be a major setback for patients with hypersensitivity pneumonitis,” said Naureen Narula, M.D., assistant professor of surgery and pulmonologist in the UK HealthCare Transplant Center. “The inflammation from pneumonia adds stress to already damaged lung tissue and can trigger an acute exacerbation — essentially, a sudden worsening of lung fibrosis. This inflammatory cascade can accelerate scarring, reduce oxygen exchange and lead to a rapid decline in lung function.”

After she was discharged, even little things such as doing laundry, walking around the grocery store or taking a shower felt impossible. The damage from PJP compounded the effects of more than a decade with chronic lung disease. Reliant on a wheelchair and oxygen, the time came for Braman to consider undergoing an evaluation for a double lung transplant.

“In my mind, I was like, ‘Okay, I’ve got pneumonia. I’ve known plenty of people who have pneumonia, get treated, then they get back to where they were,’” she said. “When Dr. Camac came into my hospital room and said it was time to start discussing transplant, it shocked me. I was not at that point thinking that way — I hadn’t even imagined that I was taking that turn.”

But it was her training as a medical doctor that reinforced the reality of her situation.

“There’s no naivete of how bad things were getting. It was clear to me,” she said. “You’re not naive about how serious it is. You can’t escape that.”

With support from Narula and transplant coordinator Ashley Rakitjan, Braman began the intensive, months-long evaluation process. Finally, on Nov. 8, she was placed on the list for a double lung transplant and prepared herself and her family for the agony of a long wait.

As it turns out, they wouldn’t have to wait long at all.

Six days later

Less than a week after being listed, while in the UK Transplant Center clinic for a routine visit with Narula, Ashley informed her that Narula wouldn’t be able to see her that day.

Not a problem, Braman thought. As a doctor herself, she knows how often they get called away for emergencies.

Ashley knelt beside Braman’s wheelchair. “Wouldn’t you like to know why she can’t see you today?” she asked. Braman shrugged and said sure.

“She said, ‘We have lungs for you, Dr. Narula went to go look at them, and we have to admit you right now,’” Braman said. “It’s crazy. I went in for my appointment then was wheeled over to the operating room. It was incredible. It felt miraculous.”

“It was truly one of those rare and beautiful moments that stay with you,” said Narula. “These decisions take time — discussions with the donor team, reviewing imaging and labs, and confirming a crossmatch. By 7:30 a.m., we had accepted the lungs. Coincidentally, Maria arrived for her routine clinic visit just 30 minutes later. She was sitting in the waiting area with her family when we gave her the news in person. The entire room was overcome with emotion — tears, hugs, disbelief. It was a moment of joy and gratitude that our entire team cherished. These moments remind us why we do this work.”

Braman frantically called her family; her mom flew in from Washington D.C., and the family gathered at the hospital and settled in for a long surgery. Many patients on the waiting list have to contend with the possibility of being sent home if the organs may not be a perfect fit, but the stars aligned for Braman. The transplant, performed by Matthias Loebe, M.D., took hours.

When she woke up, her breathing tube was removed and she cautiously took a few short breaths. After living with her damaged lungs and being reliant on oxygen for so long, Braman almost forgot what breathing felt like.

“So that’s something you really have to train your mind on,” she said. “I heard people talk about it and didn’t understand it until I had to go through it. It’s one of the things you keep hearing from lung transplant patients — learning how to breathe again, trusting the new lungs — and it’s terrifying. I’m four-and-a-half months out, and I still have to remind myself, ‘Maria you know you can breathe. You have lungs that expand.’ It gets better, but it’s still not completely natural. We’re still getting to know each other.”

‘You have a responsibility to someone else’

Part of getting to know her new lungs is accepting the gift her donor gave and the sacrifice from their grieving family. Braman doesn’t know anything about her donor, whose decision to be an organ donor is what allows Braman to have more time with her family. The night before her surgery, she didn’t sleep. While her family was celebrating, Braman was heartbroken for her donor’s grieving family. She described the feeling as something akin to survivor’s guilt; she knows she’s not the reason that person lost their life, but it’s that loss that allows her to live. She returned to the same strong mindset that helped her through the darkest days of her lung disease.

“Someone has made this incredible choice to donate, and their hope is not going to be that you live in despair and feel guilty about that,” she said. “The hope in donation is you’re giving someone else the opportunity to fully live.”

Nearly five months after her transplant, Maria feels stronger than she has in years. She walks two miles a day. She relishes her ability to do everyday things, such as walking around the grocery store. She thinks about the future differently; before, she planned for preparing her children and how to provide for them if she were to die. Now she’s doing a different kind of planning — traveling to visit her brother in Costa Rica and vacationing in Italy. Braman hasn’t been cleared to fly on a plane yet, but she’s counting down the days to when she can fully live the life she knows her donor would want for her.

“There’s a responsibility to not only yourself and your family, but now you’ve got someone else,” Braman said. “I sort of talk to my lungs, saying I know we’re still getting to know each other. I try to make sure they’re well taken care of.”

Even after her extensive medical training, years of practicing medicine, followed by months of researching organ transplant, reading testimonials from other recipients and long conversations with her transplant team, Braman is still in awe of the intricacies of the human body — its capacity for renewal, the delicate coordination of organ systems and the science that makes something as complex as organ transplantation possible. She finds it impossible to articulate. You just have to experience it for yourself.

“I don’t know how to explain it,” she said. “It’s an amazing thing that someone else’s lungs are keeping me alive. I’m a doctor — I should be able to grasp this. But there’s such an emotional part that goes beyond logic and medicine.”

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April is Donate Life Month, a time dedicated to raising awareness about the power and importance of organ, eye, and tissue donation. Learn more about organ donation and to register to be an organ donor.