Social workers illustrate the Heart of the Hutch

We have been profiling people who illustrate the culture and spirit of Fred Hutchinson Cancer Center with the Heart of the Hutch series. This edition focuses on the many social workers and interns who support patients in active treatment and their families.

While Fred Hutchinson Cancer Center is primarily known for its groundbreaking research in cancer prevention and treatment, its clinical social work program also plays a crucial role in the support of cancer patients and their families.

“It’s an honor to serve patients and families during their most vulnerable times,” said Fred Hutch social worker Sarah McElvaine, LICSW, OSW-C. “I love witnessing the progress patients make in our therapy sessions or seeing their resiliency following several rounds of treatment or even a disease relapse – I’m so inspired by our patients.”

We sat down with McElvaine and other clinical social workers as well as social work interns to learn more about what they do, how they got their start in social work and what they wished patients knew about the program. These transcripts have been lightly edited for clarity.

Longtime Fred Hutch employee tackles social work: Petr Horak

This year marks Petr Horak’s 12^th anniversary working at Fred Hutch. During his time here, he’s worked with various teams including the Thoracic, Head & Neck; Phase 1 Clinical Trials and GI Oncology clinics, as well as with Palliative Care and other Supportive Care Services. While he currently works as a program and department coordinator Monday through Wednesday, Horak spends the rest of the week as an intern in the Oncology Social Work program.

“Although this work is not easy, I feel grateful to be supported by my colleagues and have found great satisfaction in being a part of a patient’s care team,” Horak said. “I am having a hard time imagining a better place to do my specialized internship than Fred Hutch.”

Horak is finishing his master's in social work education at the University of Washington and will be graduating in Spring 2023.

Why choose social work as a career path?

My decision to pursue a career in social work was not straightforward. I grew up in a small rural village under Communist rule in what is now Czechia where my parents struggled to provide for me and my siblings and learned the importance of resilience and survival.

As I grew into adolescence and learned more about the world, I realized that individual choices are often shaped by circumstances and personal history. My experiences also taught me that governments and institutions do not always serve the people they represent and the importance of developing my own voice in the world.

Immigrating to the U.S. marked a huge transition for me and opened my eyes to self-awareness, social justice, civil rights and health advocacy. Through divine grace, I was guided to volunteer at the Seattle Shanti Project and Providence Hospice, where I learned the importance of compassion and setting healthy boundaries.

Working alongside our palliative care team and clinical oncology social workers solidified my calling of serving people diagnosed with life-limiting illnesses. After graduating, I hope to continue supporting patients in an outpatient oncological setting.

What have you learned during your internship?

As a Fred Hutch intern, I’ve obtained expertise in many areas, including:

• Gaining invaluable experience in oncology social work, a growing and critical area of need in healthcare. 
• Working alongside experienced and highly qualified social workers dedicated to providing compassionate care to patients and families. 
• Developing skills in a range of areas including psychosocial assessment, counseling, crisis intervention, advocacy and referral coordination. 
• Being a part of a supportive and collaborative team that values diversity and cultural competency, and who are committed to promoting patient rights and informed consent. 
• Learning about a wide range of resources and training opportunities, including consulting with psychiatry, psychology and other supportive care services within the Fred Hutch medical community. 
• Making a meaningful difference in the lives of patients and families affected by cancer.
• Contributing to important research initiatives aimed at improving cancer care and outcomes. 

In addition to the above, I greatly benefited from shadowing our Palliative Care team. For those who don’t know, palliative care is a specialized medicine that provides an extra layer of support to patients and their families. The goal of palliative care is to provide the best possible quality of life for patients by preventing and relieving the suffering they may experience.

‘The most rewarding and humbling work’: Sarah McElvaine

McElvaine, who has been in healthcare for 12 years, said she chose social work in order to help.

“As with all of us at Fred Hutch, I wanted to help people,” she said. While she obtained her master's in social work, she decided to specialize in healthcare.

“Being a social worker in pediatric and adult healthcare, and specifically cancer care, has been the most rewarding and humbling work,” she said.  

What makes a Fred Hutch social worker unique?

Social workers at Fred Hutch are clinical social workers — this requires obtaining clinical hours, working in a clinical setting and taking a licensing exam which allows you to practice as an independent clinician.

Not all social workers have our clinical expertise. We must partake in ongoing continuing education to provide the best evidence-based interventions. All of our social workers are Licensed Independent Clinical Social Workers (LICSW) or training to become one. As trained clinicians, we can provide therapy in addition to linking patients to resources in the community.

We also work on social reform and protecting our vulnerable populations as mandated reporters. As clinical social workers who work in cancer care, we are skilled in providing support in areas such as grief and loss, end of life, adjustment to illness and anxiety and depression.

In addition to our role on the interdisciplinary care team, our amazing social work department team members participate in other passion projects at Fred Hutch like Death with Dignity, diversity, equity and inclusion (DEI) initiatives, support groups and clinical research.

What do you wish patients knew about our social work program?

Social work support is available to every patient and family at any point during the patient’s treatment. Sometimes patients don’t have social work needs right away or don’t want to meet with a social worker initially, but then their circumstances change.

We want to remind patients, and their loved ones, that social workers can jump in at any time to assess their needs and provide support and referrals to resources or other professionals at Fred Hutch. We’re here whenever you need us! 

Some work simply can't be done at home

Philip Corrin says the nature of his essential job as a genomics specialist in Fred Hutch Shared Resources is like doing a high-wire act in a diving bell.

He spends most of his time alone in the Genomics & Bioinformatics shared resource’s gene modulation lab in the Hutch’s Eastlake Building, where he conducts high-throughput screening and provides custom cell processing services. A longtime Hutch employee, Corrin has created a productive niche for himself, but it didn’t happen overnight.

He worked his way through Fred Hutch’s Parkhurst, Soriano and Paddison labs for 20 years, then shifted to Shared Resources in 2018 where he applied his knowledge and experience to expand the scope of the Genomics & Bioinformatics core, which provides specialized, high-tech services to researchers at the Hutch and beyond.

The procedures are detailed and often unforgiving, and a lot of effort goes into preparation and maintaining a space where this work can take place. “Most people don’t realize how much effort goes into shielding this type of work from disturbances,” he said. “The work I do can’t be done remotely. Working from home was never an option, and there are many people at the Hutch in the same situation.”

The cell processing Corrin performs receives a lot of attention across Fred Hutch, but he believes much of his value lies in training colleagues to design and build custom solutions to fit their experimental needs. “The ability to work around obstacles to research is essential for progress and is a fundamental part of the service and training I provide,” Corrin said.

Corrin understands why Fred Hutch needed to significantly ramp down on-campus work in response to the pandemic, but he views the campus format as one of the Hutch’s strengths. He looks forward to the time when most coworkers return to campus. “From a communication standpoint, physical proximity allows for a higher level of idea transmission than can be supported by telephone, email or Zoom,” he said. “I found that chance interactions with people in a hall or at an espresso bar would often lead to extraordinarily useful exchanges.”

One of the biggest challenges Corrin faces these days is his daily commute from Snohomish County, north of Seattle. The nature of his job requires him to be at his lab at a specific time each day to begin protocols that take six to eight hours to complete. He used to ride a bus to work because they cut surprisingly well through Seattle’s notoriously heavy traffic, via high-occupancy vehicle lanes. However, he has been driving his car to work in order to avoid contact with other commuters this past year, and it’s added a lot of stress to his life. “One may think that driving a car would be as consistent and more convenient, but it is not,” he said.

Corrin said his lab’s workload has increased sharply as campus staffing restrictions have been dialed back and more scientists have needed his services as they’ve ramped their lab research back up.

“This activity directly supports the mission [of the Hutch] and is a good measure of our capacity to do research, even under difficult conditions,” he said.

- By Robert Hood

About this series

Since early March of 2020, when Fred Hutch activated its mandatory remote work policy, followed a couple of weeks later by Gov. Jay Inslee’s “Stay Home” proclamation, we have become familiar with the term “essential worker.”

Fred Hutch’s list of essential workers includes more than 950 scientific and 450 administrative employees. Shelby Barnes, senior director of Communications, works on the Incident Command Team, and she is an essential worker. Barnes said assembling Fred Hutch’s list of essential workers was a distributed effort led by team leaders, operations directors and lab managers.

While more than a third of the Fred Hutch staff is categorized as essential, only a few are on the South Lake Union campus consistently. Foot traffic between buildings is light and doors rarely open. But inside essential workers are providing security, maintaining facilities and cleaning common areas. Most importantly, research continues as most labs, including Shared Resources, are open, developing cures for cancer, COVID-19, HIV and related diseases.

We’ll be profiling these essential workers and hear the stories about working in a half-empty campus over the coming months that illustrate the Heart of the Hutch.

Recruiting and retaining world class talent during a global pandemic

The door to Fred Hutch’s Human Resources department is closed and locked. It’s been that way for roughly a year. But if you walk around to the front of the Yale Building, where HR is housed, and press your face to windows, you might see Amy Garrett-Cowan working alone among the empty offices and silent cubicles. She’s been at the Hutch for decades, working her way up to her current position as the immigration program manager, the most fulfilling role she said she’s had at Fred Hutch.

“I never thought my job could be done remotely, and it isn’t entirely,” she said. “My role is now a hybrid, more like 80%-20%. The 20% I do on campus is essential.”

Garrett-Cowan and the HR team have adapted to their new normal. “We re-examined our operations, especially how we access our physical records,” she said. “While remote work is sufficient and technologically efficient, I miss the value of in-person visa counseling with employees and in-room strategizing with team members. Building trust, rapport, close working relationships, and ensuring understanding of legal processes is best accomplished when the full spectrum of communication — body language, eye contact, facial expression — is shared in person.”

Few people’s jobs were more affected than Garrett-Cowan’s by the last few tumultuous years of immigration proclamations and travel bans, but she is proud of the work she’s done.

“I manage nine types of visas for 300-plus employees,” she said. “I track time limits on visas, and I file petitions, extensions and amendments and changes of status so Fred Hutch can obtain and retain the best talent.”

Garrett-Cowan is hopeful for change that could come in U.S. immigration policy, but for now she is still contending with the previous administration’s impacts. She also said her team is dealing with COVID-19 travel restrictions and limited consular services abroad.

Fortunately, Fred Hutch has been able to continue recruiting international faculty, postdoctoral fellows and other laboratory staff despite the hurdles, since the Hutch has the ability to apply for National Interest Exemptions. Garrett-Cowan said, “We will continue to work just as hard this coming year.”

- By Robert Hood

A ray of sunshine in someone’s darkest moments

It’s difficult for most to be prepared for any sort of crisis — let alone a pandemic — but longtime clinical research registered nurse Corrie Moreau has a unique ability to adapt to these situations. Before coming to Fred Hutch, she worked in Louisiana, where hurricanes, tornados and other natural disasters are common. During Hurricane Katrina, she cared for patients at a charity hospital, an experience which she says prepared her for any crisis to come.

So she’s well-suited to the challenges she faces in her role that’s emerged during the pandemic, as the lead on one of the studies for the COVID-19 Clinical Research Center at Fred Hutch.

The CCRC is a standalone research facility where researchers conduct clinical trials to find effective treatments for study participants who are positive for SARS-CoV-2. Moreau's roles run the gamut of the participant experience: from drawing blood samples to obtaining nasal swabs, starting IVs, administering infusions, checking vital signs and observing for adverse events. She’s also responsible for answering participant questions and writing their reimbursement checks for participation in the study.

The challenges brought by the pandemic have tested her well-honed adaptability.  “Not being able to hug those patients that could just use a hug or hand-holding” has been hard, Moreau said. “My worst fear was bringing COVID home to my family or giving it to one of my more fragile patients. However, the CCRC has been great in ensuring that we have all that we need to safely take care of our COVID-positive population.”

Moreau brings a wealth of direct patient care experience to COVID-19 research. She’s spent the past seven years as a mobile research nurse and a certified infusion nurse specializing in the administration of medications and fluids through an IV line. She moved to Washington state five years ago and has since served cancer patients at Fred Hutch and its clinical care partner, Seattle Cancer Care Alliance.

“I loved how the patients loved both facilities and the many milestones that were being made by each organization. I was impressed by the care, meticulousness and the reputation of both,” she said. “So, when I was approached about working here, combining both my love for research and infusions, it was a no-brainer opportunity for me.”

Moreau knows that compassion, empathy and understanding make the difference between a great health care experience and a horrible one. This rings all the truer at the CCRC, where some participants haven’t seen their families since the pandemic started and have borne the brunt of the economic downturn.

“I want to provide some ray of sunshine in someone’s darkest moments if I can,” she said. “Our COVID-positive participants have been so grateful and wonderful. I appreciate that they are willing to come and donate their time, energy and their self to research as we all find a way to combat and understand this virus.”

- By Connor O'Shaughnessy

In South Africa, HIV research continues amid lockdowns

The onset of the COVID-19 pandemic in South Africa — and the strict lockdowns that followed — put in-person work on hold for Bronwill Herringer and other members of the Cape Town HVTN Immunology Laboratory, or CHIL.

The “HVTN” in the lab’s name refers to the Fred Hutch-based HIV Vaccine Trials Network. Much of CHIL’s work directly supports the HVTN in its mission to develop a safe and effective vaccine for HIV infections globally.  

As the lab’s repository technician, Herringer is responsible for managing the intake and storage of clinical specimens for the state-of-the-art facility, which measures how study participants’ immune systems respond to candidate HIV vaccines being tested in clinical trials in South Africa and throughout the region.

Herringer is also the central contact for lab staff and outside collaborators involved in managing clinical specimens, which required him to come to the lab while his colleagues worked remotely. In those early months, he oversaw the collection and delivery of the liquid nitrogen tanks needed to preserve specimens.

But getting to the lab proved challenging in itself — Herringer was stopped at police checkpoints where he had to produce a signed permit to perform essential services.

“I must admit it was rather scary,” he said. “Each day, in the beginning of lockdown, we had routine checks, not just on the highways, but also in our residential areas. This happened routinely during the day or night.”

“Then I would work at the lab from Monday through Wednesday and work from home Thursday and Friday,” he said. “Now I work full time at the office to ensure pull requests and samples are ready for any analysis taking place.”

Herringer says he is driven by the organization’s mission and the opportunities the lab provides for professional growth.

He still has the 2018 text message from CHIL’s human resources team telling him he got the job, which he keeps as testimony to the reason he started working there in the first place.

“The thought of working in a team to find a vaccine for the HIV virus was a huge reason I took this leap of faith,” he said. “I cannot think of a greater gift we could one day offer humanity.”

— By Connor O'Shaughnessy

A visit to the hidden world above and below campus

Another world exists under your feet and above your head as you walk around the Fred Hutch campus. You feel and hear it more than you see it, because it exists just out of view. You might glimpse it when you pass an open, unmarked basement door. You can see it during the disorienting times when the elevator door opens on one of the interstitial floors. Poke your head through that door, and you’ll discover an essential industrial landscape dotted with blazing hot boilers and massive air handlers. Pipes and cables run every direction. It’s a loud place where electric motors, pumps and fans run constantly.

The inhabitants of this world are different. Hard hats, heavy boots and safety vests seem out of place at a cancer research center. A few of these people are hunched over control panels interpreting colorful flashing lights. Others gather supplies and tools for what appears to be an essential repair or maintenance mission.

In the middle of it all, bright fluorescent light spills out of an open office door. In that small room sits a man staring at his team’s schedule on a computer monitor. He says 24/7 scheduling of campus-wide monitoring and maintenance is one of the most challenging parts of his job.

Kenny Lind has been here almost since the beginning of Fred Hutch’s South Lake Union campus, where the organization moved in the 1990s, and he has been involved with developing it from 350,000 square feet during Phase 1 campus construction to its now nearly two million square feet of research labs and office space. Starting as an operating engineer in 1995, Lind worked his way up, and in 2009 he was selected as the chief engineer.

His job is what they had in mind when the term "essential worker" was coined.

“I’m responsible for supervising the power plant team and the five boiler plants that consist of 15 hot water boilers, two high pressure steam boilers, seven water-cooled chillers with cooling towers, and five air-cooled chillers,” says Lind.

As the chief engineer, Lind is also responsible for developing the training for new hires and apprentices. His goal is to enable new staff member to obtain Seattle steam engineer licenses so he can certify them as "Watch Standers" and get them into his more than 40-person team schedule.

COVID-19 made that schedule much more complicated. At the beginning of the pandemic Lind had to divide his team in two and keep both halves away from each other via two-week campus working rotations. He says it’s gotten easier over time.

Nodding toward teammates outside his office who are loading a cart with tools, Lind says, “Researchers may not fully appreciate the complexity of the operations that support their work. We encourage touring behind the scenes to all those who are interested. However, due to the current COVID protocols, that may have to wait a while.”

— By Robert Hood

Maintain the technology bridge between campus and homes

Looking out from her office door, located in the formerly bustling Weintraub Building atrium, Luna Yu hears the rolling rumble of a package delivery cart two floors below. The sound echoes like distant thunder through the empty halls of one of the biggest buildings on campus. Gazing across the large atrium, Yu says, “Fred Hutch has a beautiful campus, but what really sets it apart are the faculty, the trainees, the students and the support staff.” She says it’s the enthusiasm, intelligence and innovation of the people that matters. Yu’s essential work is to help all those people stay connected.

Many Fred Hutch employees didn’t have to think too hard when the mandatory remote-work policy was announced in March. They took laptop computers home, connected to their WiFi and logged in to the Hutch systems. People like Yu, a divisional information technology senior manager, are why that transition went smoothly. Describing her duties, she says “I manage and perform IT services and support for the Basic Sciences and Human Biology divisions.” Yu’s duties also extend to partnering with other scientific divisions and Center IT to ensure compliance with Hutch-wide and division-specific policies and standards. She’s also responsible for interacting with vendors and troubleshooting in-lab computer problems.

Yu, who started at Fred Hutch in 1994, enjoys being the first point-of-contact for her divisions’ employees who need IT services. Yu believes she is contributing to the accomplishments of the scientific community by helping employees acquire and use technology. “Now, more than ever, IT support is absolutely crucial to Fred Hutch staying productive. Supporting remote work and communication presents many challenges, but it is essential to keeping us connected,” she said.

Supporting platforms, programs and devices across two divisions is difficult, and Yu is quick to praise co-workers Pat Heath and David Chambers. “I can’t do my job alone. I have a strong team. We’re committed,” she said.

Yu’s team has put the quieter on-campus circumstances to good use. She says, “It was very odd to see empty offices and almost-empty wet labs. However, this is prime time for replacement or upgrade of legacy lab computers.” So, with a hopeful eye on the future, Yu and her team continue the essential work of improving Fred Hutch’s information technology infrastructure while most of us continue working from home.

— By Robert Hood

A big job looking at tiny things

Walking into Steve MacFarlane’s workspace feels like stepping into a science-fiction movie. His job as an electron microscopy specialist in Fred Hutch Shared Resources' Cellular Imaging core puts him in front of a dizzying array of microscopes and technology that allow researchers to see deep into our microscopic world. He says he enjoys doing his part for the advancement of science and the solving the cancer puzzle. “Plus, peering at the working parts inside of a cell or a small organism never gets old for me.”

MacFarlane’s duties include maintaining and operating a constellation of specialized equipment, and he’s also responsible for designing and carrying out procedures that lead up to imaging samples. “They are not the kind of microscopes where you bring a sample in and begin imaging right away. If the prep isn't correct and appropriate then the images are difficult, if not impossible, to acquire and interpret, says MacFarlane. Some procedures take weeks, but MacFarlane’s 32 years of experience in electron microscopy allow him to spot pitfalls before they happen. He says, “Attention to minute detail and patience pays off when you provide beautiful and useful images.”

— By Robert Hood

The initial period of Fred Hutch’s stay-home order was difficult for MacFarlane, but he made the most of it. “As a microscopist, there was only so much I could do at home in front of a computer,” he says. His team spent that time making sure their online communications, files and protocols were up to date. After that, he did a lot of online learning, which he says “ended up being pretty valuable.”

As campus access was slowly and carefully dialed up, MacFarlane was part of the first wave of essential employees returning to campus in mid-May to support COVID-19-related research and ongoing cancer patient clinical trials. He says being back in the lab was a relief. “It was a little surreal at first, as if everything was in suspended animation. As soon as more personnel came back on-site, we began getting more requests for EM work and it was great to be able to offer that support again.”

MacFarlane’s workspace in the basement of the Thomas Building currently sounds like a spaceship in dry dock for repairs. It’s being remodeled to accommodate a new cryo-EM-capable device, and MacFarlane has to speak loudly over the sound of hammers and saws when he says, “I am hopeful that once the new microscopes are online and the facility is back to ‘normal’ we will continue to see a steady stream of interesting and challenging projects come our way.”

— By Robert Hood

Typical engineering precision

If you’ve wondered why Fred Hutch’s campus operates so smoothly, it’s because of essential workers like Operating Engineer Mark Hungerford. Hungerford, a 23-year veteran of the Facilities team, manages electrical infrastructure upgrades across campus, including new construction projects.

At the beginning of the pandemic, Hungerford's team had to assume the worst about COVID-19’s contagiousness. With typical engineering precision, they created a plan to ensure their ability to keep the campus up and running. “There was an on-site team, a backup for them, and then a core team held in reserve — working at home to stay isolated and clean in case a major contagion hit the other two groups. I was in the core group. So, I set up a home office and carried on from there,” says Hungerford. “As soon as it was judged to be the safe way to proceed, we were all brought back to campus.” Hungerford is proud of his team’s resilience in helping Fred Hutch scientists adapt and respond to the pandemic. “It’s something to be proud of,” he says.

Hungerford, whose office is located in the blueprint archive room of the Fairview Building, says his day-to-day job hasn’t significantly changed since he returned to his office on campus. “There is a less in-person collaboration with vendors and design engineers, but this industry segment in Seattle has adapted quite well,” he says.

However, for someone who is all about strategic planning, the pandemic has created a unique problem. Hungerford says, “The status of funding for our projects has been more difficult to pin down. That makes it hard to plan.” Glancing over at the hundreds of blueprint drawings in the archive room he continues, “Much of what I work on can take months or longer to execute  so not knowing adds complications when there’s an overarching timeline to get things completed.”

People who drive through campus these days can see Hungerford's strategic plans in action. Two buildings have been torn down where the Seattle Cancer Care Alliance clinic extension is being built. The Minor Building has been renovated to create the COVID-19 Clinical Research Center. The Steam Plant renovation was just completed. Hungerford and his team of essential workers had a hand in all of that. The pandemic won’t last forever. One day, most employees will be able to go back to working on campus, and they will be surprised by how much has been done while they were working from home.

— By Robert Hood