Portuguese and Azorean immigrants make up 0.4% of the United States population, but they comprise over 6% of the population of Rhode Island. A vast number of Azorean immigrants in this region have made immense contributions to our medical community and the local cultural identity. Within Rhode Island Hospital (RIH), the roles held by staff who are Azorean immigrants are critical in maximizing the quality of care and efficiency of a large academic medical center. To properly illustrate their contributions, we highlight the experiences of four Azorean immigrants with decades of experience at RIH. Much like how the keelson is a structural member that provides continuity and connects the bow stem, frames, and transom to hold a whaleboat or wooden vessel together, these stalwart employees have long done similarly for Rhode Island's only tertiary care center.

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