Related co-workers bring extra dimension to cancer treatment center

When it comes to cancer, family connections can be critical. But most medical centers would be hard pressed to match the family atmosphere at the Seattle Cancer Treatment and Wellness Center.

With barely 30-some employees, the 6-year-old facility has featured, amazingly, five pairs of related co-workers — six if you count the center's cleaning crew, run by Courtney Carlson (daughter of center director Kim Sunner) and her husband.

Twins Melissa and Kimberlee Hartley are job-sharing social workers, counseling cancer patients. Nurses Phu and Hoang Le are sisters, and the accounts manager is the mother of the center's transcriber.

There's oncologist Welby Cox, whose daughter, Annie Cousins (don't even go there), is the center's massage therapist. And this summer, director Sunner occasionally found son and community-college student Chris Carlson at the other end of the intercom as the building's temporary front-desk receptionist.

The center's unique makeup fosters an unusually familial, communicative atmosphere where those linked by blood and life's lessons draw from experience to help others deal with adversity.

Family as refuge, inspiration

Melissa and Kimberlee Hartley, for example. The twins were 4 years old when their younger sister, Amy, was born with a severe form of spina bifida, a birth defect causing permanent disability. In 15 years, she would have 39 major surgeries. It was a stressful, formative childhood that accompanied Melissa and Kimberlee from elementary school into college.

While both had their outlets — softball, chorus, hanging out with friends — life was different at their Guilford, Conn., home. "We were in a constant state of hyper-alertness, watching for any sign that something was wrong," Kimberlee remembers.

Learning the craft of caregiving shaped their lives and taught them that family can be both refuge and inspiration. After their experience, the last thing on their minds was working in a hospital setting, but now, at age 31, they share a desk, sometimes seeing the same patients.

Each can pick up where the other left off. Occasionally one can be mistaken for the other. "We make sure to let patients know who we are if they look at all confused," Melissa says.

"We don't try to trick them," adds Kimberlee, pointing out that Melissa is the one who wears the brighter colors and, as of recently, has longer hair. Kimberlee is somewhat softer in bearing, given to earthier tones of olive and beige.

Besides keeping tabs on how patients are coping and filling them in on available services, resources and treatment options, the two put their experience to work as listeners.

Spina bifida made their younger sister prone to conditions meriting constant attention, forcing mom Diana to quit work while father Mike carried the family financially. When Amy's corrective shunts malfunctioned, they'd have 24 hours to get her to the hospital; the girls often did homework under the lights of hospital waiting areas.

At the time, life expectancy for people with spina bifida was 30, but the trauma of so many major operations in Amy's short life was too much to handle, and she died at 15.

"It's different being siblings when you have something like that in the family," their mother Diana Hartley says. "It's an emotional roller coaster: There's all these surgeries, then you get out of the hospital and grieve, and then you have to stand up and move on, because you don't know when the next one is coming. They had to take on a positive attitude."

"Each person is an individual," Melissa says, summarizing the twins' cancer-center philosophy. "You can't determine ahead of time what a person's will to live is. People are constantly surpassing expectations."

Doctor, patient, survivor

It's not uncommon, of course, for kin to connect within the walls of a big company or family business, but the relatively tiny Cancer Treatment and Wellness Center takes the concept to Brady-Bunchesque levels. "It just sort of evolved," says director Sunner. "In my 20 years in the field, I've never seen it happen."

Part of the Midwest-based Cancer Treatment Centers of America, the center is, ahem, the baby of the family, at the forefront of a movement mixing traditional medicine with complementary and alternative treatments. Oncologists work alongside naturopaths and acupuncturists, meeting weekly to discuss patient issues.

The familial climate isn't always easy. Having a relative aboard means keeping professional boundaries even when urges might be otherwise. And a family crisis can affect two employees instead of one, double trouble for a small facility that sees 15 new patients a month.

On the other hand, similar-job siblings like the Hartleys, and nurses Phu and Hoang Le, can fill in for each other if need be.

When Cox, the oncologist, was hired, the center needed a massage therapist; he recruited daughter Annie Cousins for the job. Cousins had been ready to begin art school when she was hospitalized with Crohn's disease, a chronic illness affecting the intestines.

"School had started," she says. "I couldn't go full-time. I'd always been interested in massage. I thought, what better time to pursue how to make myself and others feel better? My life had completely changed."

When the call came from her dad, she hesitated only a second. "I was thinking, I hope we don't drive each other crazy," she says. "We have a great relationship. We're really good friends."

Now they have across-the-hall offices, and Cox has been a constant resource for his daughter. She's also been there for him: Nearly a year ago, he was diagnosed with low-grade lymphoma, an incurable disease with a reasonable survival rate, and underwent six months of chemotherapy.

While he always aims to be empathetic and compassionate, Cox says his experience as patient and survivor has helped him focus more on patients' quality-of-life issues. "I have found that important to me," he says.

And it's helped him and his daughter better relate to patients and supporters. "Sometimes it's harder for friends and family," Cousins says. "They go a little bit more off the deep end. When my dad was diagnosed, I was the one who freaked out the most. Now I'm just thankful I get to work with him and tell him I love him every day."

'Something to offer'

Six years ago, the center had four employees and one-tenth its current patient load. As it has grown, staffers have pointed family members toward job openings. "I was fearful when Kimberlee was coming on," says Kelly Parker, the center's former marketing manager, of the hiring of Melissa's identical twin. "I thought, 'Uh-oh, we've crossed the family line this time.' "

Melissa, a child-welfare social worker in Boston, came to Seattle in 1997 when her husband began doctoral work at the University of Washington. By the time she got her job, she was pregnant; as her leave approached, the center was struggling to replace her, so she talked sister Kimberlee into filling in.

"I thought the last thing I wanted to do was work in a medical setting," says Kimberlee, who'd been working toward a master's degree at Boston University. "It took me a long time to realize I had something to offer."

When Melissa returned, it was part-time. There was still half a job to fill, and Kimberlee, now an adoring aunt, couldn't turn it down. She hopes to resume her degree at UW next year.

For the twins, their situation is a chance to continue a close, lifelong relationship. "It's the best job-sharing situation I can think of," Melissa says.

Amy's life was a gift, one memorialized in words the Hartleys came upon with her passing. It was just a card they picked up, but it expressed their feelings perfectly: "If I could sit on the porch with God," mom Diana remembers it reading, "I would thank Him for lending me you."

"You do what you have to do," she says. It's not the road she would have chosen, but she and the girls didn't let it defeat them. "I would take Amy back tomorrow. But she definitely made us who we are. She set the stage for the whole family."

Marc Ramirez: 206-464-8102 or mramirez@seattletimes.com