Advocacy at Work

From pediatric cancer survivor to patient rights activist: Why one man believes the next great advocacy movement isn't about cure rates, it's about preventing health insurance from killing you

In 1995, Matthew Zachary was a classically trained concert pianist entering his senior year of graduate school when his left hand stopped working.

He ignored it.

He was 21. He was invincible. So he ignored the headaches, the fainting spells, the gradual loss of function. He got through the semester. Then came the fainting spell that couldn’t be ignored, followed by misdiagnosis after misdiagnosis until finally: a terminal pediatric brain tumor in his cerebellum.

He survived. Craniotomy. Radiation. But he lost his music. He lost the career he’d built his life around. He lost his certainty about the future.

And he didn’t die.

For years, he meandered through the 1990s, he describes it, like Cain roaming the earth with no purpose. He worked fixing toner for ad agencies. He was alive, but untethered. Then, seven years after his diagnosis, he found his first cancer buddy: a man named Craig who was bald, Jewish, had brain cancer in his twenties, was from New York City, and had gone to his college.

“There’s people like me,” Matthew realized.

And in that moment, everything went from black and white to color.

The Birth of Stupid Cancer: Giving Permission to Be Angry

In the early 2000s, the cancer survivor community was united by one dominant voice: Livestrong. Lance Armstrong’s foundation dominated the landscape with inspirational messaging, yellow wristbands, and a narrative of triumph.

Matthew saw something missing: permission to be angry.

“Everything was pink blenders and pink jets and yellow wristbands and pretty people in photographs looking perfectly fine,” he recalls. “And I just wanted to be very Gen X about it. Very angry, but smart, satirical, sardonic, pop-cultural. There was no populism in anything back then.”

So he created Stupid Cancer. The name itself was irreverent, shocking, even, for its time. The approach was radical in its realness: angry, funny, smart, and unapologetically honest about what it felt like to be young and sick in America.

This was 1984 internet. No Facebook (well, not yet). No YouTube. No podcasts. Everything was analog and guerrilla. Matthew was broadcasting a live talk radio show over dial-up internet. He was jumping on every emerging platform, MySpace, Facebook, Twitter, YouTube, as they appeared, staying perpetually ahead of the curve.

“It was a terrible privilege to have so much fun meeting people,” he says. “They’re sick, they’re dying, but you’re giving them a good time to figure this out together.”

For thirteen and a half years, he ran Stupid Cancer. He built a global community. He mentored a generation of young adult cancer patients and advocates. He watched his “disciples of kindling” grow into leaders like Trevor Maxwell at Man Up to Cancer, planting seeds that would grow into the modern cancer community we see today.

But somewhere along the way, something shifted. The landscape changed. And Matthew realized the real enemy wasn’t cancer anymore.

The Evolution: When Health Insurance Becomes the Greater Threat

Matthew’s definition of advocacy has evolved dramatically over thirty years.

When his cancer buddy Craig asked him to become a “cancer advocate,” Matthew didn’t know what that meant. Craig’s answer was brilliant in its simplicity: “You can help the next person have a much less shitty time.”

For many years, that’s exactly what advocacy meant. Being there for the next person. Creating community. Helping someone feel less alone. Stupid Cancer did that masterfully.

But Matthew has evolved his thinking into what he calls “Advocacy 2.0”—a framework focused on civic power, organizing, and a single unifying issue: health insurance determining whether people live or die.

“It isn’t just your tumor,” Matthew explains. “The modern challenge in oncology is health insurance and what they’re doing to us.”

Consider the timeline: In the 1990s, the real fight was against cancer. The mortality rates were high. Survival was the goal. Today, if you’re fortunate enough to survive cancer, you face a different enemy: medical debt. Insurance denials. Fighting for your doctor’s recommendation to be honored instead of overruled by a profit-seeking corporation.

“We’re not all dying as much, which is good,” Matthew says. “It’s different, it’s better, it’s worse, but it’s different. Today it’s differently shitty.”

“We the Patients”: A Book for This Moment

Matthew didn’t write a memoir. That surprised people.

“Most people that write books that have trauma write a memoir,” he explains. “And there’s nothing wrong with that. But I didn’t feel that that was what the readership of the country needed to hear or feel or see or think.”

Instead, he wrote a policy book. A call to action. A patient rights manifesto for a moment in American history when health insurance has become predatory.

The book reaches back to 1910, when Teddy Roosevelt proposed universal healthcare and J.P. Morgan essentially paid the American Medical Association to block it. It spans a century of American healthcare history. But it focuses on now, on a moment when the Affordable Care Act is under attack, when drug companies are exploiting loopholes, when insurance companies are denying life-saving treatments, when families are diluting baby food to afford chemotherapy.

“This book is written now and not earlier,” Matthew says, “because we’re at a critical point in American history.”

He’s experienced the full arc: global thermonuclear war threats of the Cold War, 9/11, recessions, pandemics. But today’s threat is different.

“The one missing thing now is the next great second generation of patients rights movements.”

The Single Issue: Health Insurance Can't Be the Gatekeeper to Life

What unites the cancer community? What single issue could mobilize millions of patients, caregivers, families, and doctors?

Matthew’s answer: No one should go broke or be denied care because of health insurance.

That’s it. That’s the issue.

It doesn’t matter if you’re conservative or liberal, Christian or Jewish, straight or gay, black or white. That single threat, the possibility that a corporate algorithm might determine whether you live or die, affects everyone.

“I don’t care who you voted for,” Matthew says. “But no one voted to have this happen to them and their families. No one wants their health insurance to bankrupt them. No one wants health insurance to get in the way of their care. No one wants their health insurance to play God and tell their doctor what to do.”

This is where advocacy becomes activism becomes organizing.

From Community Care to Civic Power

Matthew is careful to distinguish his original message from his new one.

“Cancer is not going away. There’s always going to be a need to be there for the next person. I’m not taking that away,” he says.

But there’s an “upstream strategy” now. A level above individual support.

The example he gives is Act Up during the AIDS crisis. They didn’t just support each other. They organized. They shamed. They made noise. They forced political response through the only thing that moves Congress: the threat of electoral consequences.

“What’s the one thing that every cancer patient, family caregiver would want beyond not dying?” Matthew asks. “That our doctors are our sacred bond. That we get access to the drugs we need. That health insurance isn’t our Lord and savior determining whether we live or die.”

Advocacy 2.0 is organizing around that single issue, dropping other agendas, recognizing that this threat is greater than any political difference.

“Organizing is really about dropping your ego, dropping your other political agendas,” he explains. “You organize under that specific issue. I don’t care if you’re gay, straight, black, brown, green, blue. No one that I’m aware of wants health insurance to bankrupt them.”

A Day in the Revolution

If barriers disappeared—no gatekeepers, no budget limits, no waiting for permission—what does one day of Matthew’s revolution actually look like?

It looks like millions of people unified around the principle that health insurance should never determine who lives and who dies. It looks like politicians understanding that opposing healthcare reform is electoral suicide. It looks like regulations, oversight, and transparency on insurance company denials.

It looks like doctors being trusted. It looks like treatments being available. It looks like families not being bankrupted by the cost of staying alive.

“The civil liberties of the cancer community are not infringed upon by the private sector’s profit motives,” he says simply.

A Piano, a Tumor, a Voice

Matthew Zachary didn’t set out to be a revolutionary.

He was a concert pianist. Then he was a survivor. Then he was a community builder. Then he was an entrepreneur running a nonprofit.

And now he’s an organizer.

The loss of his left hand meant he could never be a classical concert pianist again. But it freed him for something larger—speaking into a microphone, building community, organizing civic power.

“What do you do with the mad that you feel?” he quotes Mr. Rogers.

For Matthew, the answer is: organize. Build movements. Refuse to accept that health insurance companies should determine who lives and who dies. Write a book that explains why. Ask millions of Americans to understand that they have power when they organize.

The piano was one path. This is another.

And it might change healthcare in America.

Connect With Matthew and “We The Patients”

If you’re ready to organize:

* Website: wethepatients.org — Take the national poll on healthcare and find the book

* Book: “We the Patients” — Available everywhere books are sold

* Personal Website: matthewzachary.com

* Learn More: About organizing for healthcare reform and joining the patient rights movement

* Stupid Cancer: The community he founded that continues to serve young adult cancer survivors

I have one specific request: please take their unprecedented, bipartisan national poll on consumer perspective of healthcare. This data matters. Your voice matters.

Final Thoughts

Matthew Zachary survived pediatric brain cancer in an era when most pediatric cancer patients didn’t survive. He built a community that changed what it meant to be young and sick in America. He mentored thousands of people.

But his greatest work might be what he’s doing now: organizing.

Because you can survive cancer and still lose everything to medical debt. You can beat your tumor and have your treatment denied by insurance. You can do everything right and still be destroyed by a system that prioritizes profit over people.

Matthew is asking us to organize. To drop our other agendas. To recognize that we have power when we unite around a single issue: the belief that health insurance should never determine whether we live or die.

That’s not politics. That’s not partisanship. That’s basic human dignity.

And it might just be the revolution we need.

Are you fighting health insurance denials? Watching insurance companies override your doctor’s recommendations? Consider organizing. Connect with We the Patients. Read the book. Take the poll. Because alone, we’re patients. Together, we’re a movement.

When Debbie Lundberg was getting her driver’s license, she did something that surprised her parents: she wanted to sign up as an organ donor.

She was young. She wasn’t facing a health crisis. She hadn’t studied medical school or worked in healthcare. She just thought: Of course that’s what I would want to do.

Her mom, a nurse, and her brother pushed back. The whole conversation felt foreign to them. How could someone so young be thinking about donating an organ? It didn’t make sense.

But Debbie held onto that impulse. It stayed with her through high school, through building a successful coaching and speaking business, through marriage and life.

And then, one evening about fifteen years ago, everything crystallized. She was standing in the operating room at Tampa General Hospital, on a stool because she’s only five foot two, watching surgeons remove a 23-year-old woman’s damaged lungs and replace them with new ones. She was asked twice if she needed to step down because she was visibly emotional.

“Those new lungs,” she recalls, “when they took the old lungs out, they were small and dark. And when they brought this gift of life, they looked like angel wings to me. They looked white, they looked big and beautiful.”

In that moment, standing in an operating room watching a life be saved, Debbie’s childhood impulse—the one her parents had questioned—became a calling.

The White Coat Program: When a Hospital Invites You Inside

Debbie’s story of becoming an advocate is unusual because it doesn’t start with illness or crisis.

It starts with recognition.

Tampa General Hospital reached out to her, a community leader, someone active in the area, and invited her to participate in their White Coat internship program. It’s an exclusive experience where community leaders get paired with a doctor or surgeon, shadow them for a day, wear scrubs and a white coat with their name on it, and see the real work of a teaching hospital.

On the day Debbie participated, the cardiologist she was paired with spent time asking her what she wanted to see. After rounds and surgeries and family conversations, he said: “I’ve got to find something sexy for an hour.”

Debbie laughed and asked what a cardiologist thinks is sexy.

“A lung transplant,” he said.

What happened in that operating room became the moment that transformed Debbie from someone with a childhood impulse into someone with a mission. She watched new life enter a body that had been slowly suffocating. She felt the weight of it. She understood, viscerally, what organ donation meant.

Nearly ten years later, when she learned about the thousands of people dying every year waiting for transplants, something shifted. She decided to get tested. She was approved. And then COVID hit, and everything paused.

But Debbie didn’t wait.

The Pandemic Gift: Donating Alone, Together

In February 2020, Debbie was tested to become a living kidney donor. In early March, while she and her husband Michael were in California golfing with her aunt and uncle, she got the call: she was approved.

Then they flew back. COVID shut down the country.

Debbie was told she could opt out if she wanted. People were dying. The hospital was overwhelmed. No one would blame her for waiting.

She asked: “But aren’t people still going to die?”

She went through with it.

What followed was a profoundly lonely experience in a moment of profound connection. Because of COVID restrictions, Michael couldn’t attend a single appointment with her. He didn’t meet her coordinator or her surgeon. He couldn’t accompany her in the hospital or wait inside with her. He had to drop her off at the entrance and drive away.

For both of them, that isolation was strange. But Michael found a way to show up differently.

He had people send her cards, over a hundred of them. He got them to her transplant coordinator, Candace, who snuck them into Debbie’s hospital room so that when she woke up after surgery, she could open them and feel comforted by voices and love even though no one could visit in person.

Debbie recovered quickly. After about 28 hours in the hospital, she was ready to go home with one kidney. And Michael made a decision: he would become a kidney donor too.

Not because Debbie pressured him. Not because he felt obligated. But because he had heard their surgeon, Dr. Wong, speak about the statistics. And something clicked. He saw the need. He decided to do it.

“He’s the cutest copycat you’ll ever meet,” Debbie laughs.

Michael’s process was faster because he already knew what to expect. He went through testing quickly. And a couple of years later, when COVID restrictions eased, he had his surgery.

Now they call themselves “two one beaners”—a couple who each have one kidney. And they’re part of an extraordinarily small group: couples who both donated kidneys, not to each other, but to strangers in the donation chain.

Angel Wings and Beyond: When Your Donor Life Becomes Your Identity

Here’s something unexpected about Debbie and Michael’s journey: neither of them knows the person who received Debbie’s kidney. They have no relationship. It was a chain donation, and the kidney went where it was needed, to someone they’ve never met.

But Michael’s kidney went to someone who has become part of their lives. Someone who hugs Michael in public and tells him: “The only thing we had planned was my husband’s funeral. Now they’ve had over five years of amazing life together.”

Those are very different experiences. And Debbie learned something crucial from the Kidney Donor Athletes community (an organization of over a thousand donor-athletes, where she became immediately active): you can’t control what relationship, if any, you’ll have with your recipient.

Some donors don’t want to meet their recipients because they’re afraid that if complications arise, they’ll feel responsible. Some recipients don’t want to meet donors because they’re processing their own trauma. Some become like family. Some remain beautiful strangers.

“You can’t have in your mind what you’d like the relationship to be,” Debbie explains. “Because you may not know the recipient. You might know them, but you don’t have anything in common. Or they might not want to meet you if you’re altruistic. So there’s all this stuff that I don’t know. I had this fantasy, I might go running with this person and that didn’t happen and it’s never going to happen. And that’s all okay, because back to your question about advocacy, if you do it for the right reason, no matter how it shakes out, it’s how it’s supposed to be.”

That’s a profound wisdom: the gift isn’t about the relationship it creates. It’s about the life it saves.

Turning Tragedy Into Advocacy

A couple of years after their surgeries, Debbie and Michael experienced something most of us would consider catastrophic: they lost their home in a hurricane. Everything except the clothes on their backs was gone.

Most people, faced with that loss, would understandably go into survival mode. Debbie and Michael did something different. They turned their loss into action.

They organized a fundraiser where people could literally throw bricks through the windows of their destroyed home. Every brick thrown raised money. All the proceeds went to charity—the National Kidney Foundation’s Kidney Walk, the Crisis Center, the University of South Florida’s Women in Leadership and Philanthropy scholarship program.

They were over 600 days without a permanent home. And instead of focusing on their own loss, they focused on creating something bigger than their suffering.

“We may not have much at times,” Debbie says, “but if someone else can use it more, we’re going to give it to them.”

This isn’t noble suffering. It’s not toxic positivity. It’s a clear-eyed choice: We can sit and sulk and wait, or we can take action and create a new environment.

They chose action. Together.

The Hospital Council: Understanding Patient Experience From the Other Side

One of Debbie’s most impactful roles is serving on Tampa General Hospital’s Patient and Family Advisory Council (PFAC). What’s remarkable is that she’s there not as a patient, but as a living donor.

Being on this council has given her a window into the entire patient experience at the hospital—cancer care, neonatal services, heart and lung and liver transplants, emergency departments. She and Michael even co-chaired the transplant division.

But what she’s learned goes beyond the specifics of medical care. She’s learned something fundamental about hospitals:

“There are only two types of people who check into a hospital, really happy living organ donors and people who are going to have healthy babies. But everyone else goes into a hospital and they’re scared or they’re nervous or they’re at least apprehensive because not a lot of it is elective in a hospital.”

This understanding has shaped how she thinks about advocacy and healthcare. When she speaks to nurses, techs, doctors, and hospital staff, she says: “You’re meeting people who aren’t at their best. So thank you for giving us your best.”

It’s a simple reframing. A reminder that healthcare workers aren’t just treating conditions, they’re caring for people at vulnerable moments. And that matters.

Debbie’s Definition of Advocacy: Kindness Without Expectation

When Debbie defines advocacy, she cuts through a lot of noise.

“Advocacy is whatever you can do that can assist someone else, whether they know that you’ve done it or not. I associate advocacy a lot with kindness.”

She goes further: “I encourage people to be kindly direct and directly kind. If you do something for someone and you expect something in return, that’s like a business relationship that’s not really kindness. And if you expect people to give you accolades for it, that’s a bit of showmanship.”

Real advocacy, in Debbie’s view, comes from a place of genuine wanting to help. It doesn’t come with strings attached. It doesn’t demand recognition.

This is radically different from how we often think about advocacy. We imagine activists with megaphones, patients testifying before Congress, campaigns fighting for policy change. And all of that matters.

But Debbie’s vision of advocacy is quieter. It’s about the woman who mentors over 20 people who want to become organ donors. It’s about sitting on a hospital council and quietly insisting that patient voices are heard when a new building is being designed. It’s about throwing fundraisers after losing everything.

It’s about doing good because it’s good.

The Dream: Planting Seeds Across America

If resources were no object, what would Debbie do?

She’d travel to middle schools, high schools, and colleges across the country. She’d talk about the power of organ donation. She’d show healthy, thriving people who have donated kidneys and livers and parts of their livers. She’d explain what actually happens in organ donation, dispelling myths and fears.

Because here’s what people don’t understand: some people refuse to become donors because they believe hospitals will let them die to harvest their organs. They think being a donor means less care. It’s a myth, but it’s a powerful one that costs lives.

Debbie wants to plant the seed of donation early. She wants young people to see real donors, healthy people who’ve gone on to run marathons and play sports and live full lives. She wants them to understand the process. She wants them, when they turn 18, to make an informed choice to sign up.

“That can make the difference in people living or dying,” she says.

The Pattern: Converting Circumstance Into Community Action

What strikes me most about Debbie’s story is the pattern: she has a remarkable ability to take personal circumstances—a white coat program, a lung transplant, kidney donation, a hurricane, loss—and convert them into community action.

Is this a philosophy? A coping mechanism? A bit of both?

Debbie suggests it’s all of the above. But it’s also a choice. Again and again, she and Michael have chosen action over passivity, purpose over despair, community over isolation.

When they lost their home, they could have withdrawn. Instead, they threw a brick-smashing fundraiser.

When Debbie decided to donate a kidney during a pandemic when hospitals were overwhelmed, she could have waited. Instead, she asked: “But aren’t people still going to die?”

When Michael heard statistics about how many people needed transplants, he didn’t think about his own safety or comfort. He thought about need. He decided to help.

This is what real advocacy looks like, Debbie suggests: not as a grand gesture or a career, but as a pattern of choosing compassion when you could choose comfort.

Connect With Debbie

If you want to learn more about Debbie’s work:

* Website: Presenting Powerfully (for her coaching and speaking work)

* Email: [email protected]

* Social Media: Search “Debbie Lundberg” on TikTok, LinkedIn, and other platforms

* Kidney Donor Athletes: An incredible community for living kidney donors (thousands of members, with transplant games and ongoing support)

* Donate Life: If you want to become an organ donor, sign up through DonateLife.net

* Tampa General Hospital Patient & Family Advisory Council: If you’re interested in having a voice in hospital policy and design

Final Thoughts

Debbie Lundberg’s story is a reminder that advocacy doesn’t require a crisis diagnosis. You don’t have to be a patient to be an advocate. You don’t have to be angry at a system to want to change it.

Sometimes advocacy starts with a young person at a DMV counter thinking, Of course that’s what I would want to do.

Sometimes it’s a moment in an operating room watching angel wings come to life.

Sometimes it’s a choice to ask, What if I could help? And then actually doing it.

Debbie’s lived kidney donation from a place of abundance, not scarcity. From a place of asking who needs this more than I do? rather than what will I get in return?

And in doing that, she’s shown that advocacy isn’t just about fighting for laws to change. It’s about choosing kindness repeatedly, in small and large ways, until it becomes a pattern that shapes your entire life.

That pattern, multiplied across the country, across all of us asking what we can give instead of what we can get, could literally save lives.

“Plant that seed much sooner and much wider,” Debbie says about organ donation education.

But she could be talking about advocacy itself. Plant the seed. Show up. Choose compassion. See what grows.

Are you interested in becoming an organ donor? Visit DonateLife.net. If you’re already a donor and want community and support, Kidney Donor Athletes is waiting for you. And if you’re inspired by Debbie’s approach to turning hardship into purpose, ask yourself: what circumstance in my life could become an opportunity to help someone else?

There’s a statistic Dr. Carlos Garcia carries with him: from the time a man experiences his first mental health symptom to the time he actually seeks help, on average seven years pass.

Seven years.

“If you sprained an ankle, you wouldn’t wait seven hours to go see a doctor,” Carlos says. “Much less seven years for something like mental health.”

For him, those seven years, or something close to it, were filled with struggle. Anxiety. Depression. PTSD. All while serving as a Marine Corps veteran, firefighter, and paramedic. All while trying to handle it on his own, coping in “ways that were less than healthy with alcohol and other things.”

Then came the breaking point. “My pain and suffering had gotten to be too much. I just couldn’t bear the suffering anymore,” he recalls. “I was like, I need help. If I don’t get help, I’m not going to stay on this earth.”

That admission, that surrender, changed everything. It led him to therapy. It led him to become a clinical psychologist. And it’s led him to spend the last decade in a profession built on something most of us are taught to hide: vulnerability.

His story is an invitation to the rest of us who are still waiting those seven years.

Being a Therapist Who Gets It Because He Lived It

Carlos has been practicing psychology for just over a decade. But his real expertise comes from something no graduate program could teach: he’s been where his clients are.

He knows what depression feels like. He knows the weight of PTSD. He knows what it’s like to struggle alone, convinced that you can handle it yourself. He knows the moment when you can’t anymore.

This lived experience is everything. And he’s acutely aware of it.

“I didn’t learn this stuff in school,” Carlos tells me, describing a moment with a depressed client. “You’re talking from a place of real life experience, and there’s a connection in that moment where some of the walls fall away, the trust deepens.”

It’s the difference between someone who has read about depression in a textbook and someone who has felt it in their body, in their mind, in their bones. Clients can sense that difference immediately. Walls come down. Trust deepens. Real work becomes possible.

This is what separates authentic advocates from authority figures. You can feel it. You just can.

From Broken to Healer: The Why Behind the Work

Carlos describes a moment after he’d recovered from his struggles, that point when you realize you’ve actually made it through to the other side. Something shifts. An internal voice says: There has to be a reason for this. There has to be a way I can use this to serve others.

Before graduate school, he made himself a promise: “If I just help one other person heal, then it will have been worth me going through six years of graduate school and all of that stuff.”

But there was more to it than that. He’d been blessed with compassionate therapists and psychologists along the way—people who showed him patience, love, and understanding in his darkest moments. He wanted to pass that forward.

“I wanted to pull from that. There was a way that inspired me,” he says. “And you could see it as soon as I had my first client in front of me and I was on the other side of that couch, that I was embodying these people that had come before me and able to give the gift that they gave me.”

This is the real origin story of an advocate: not from guilt, not from obligation, but from genuine gratitude and a desire to pay forward the kindness that saved you.

The Ripple Effect: Measuring What Matters

One of the most profound questions in any helping profession is: How do you actually measure impact?

You can’t put a dollar sign on it. You can’t reduce it to metrics. So how do you know you’re making a difference?

Carlos describes a client he’s been working with for four years, someone who came in at a dark place. Through their work together, the client has healed. His relationships with his kids improved. He became part of a church community. He started running a men’s group and now gets to see the impact he’s having on other men because of things he learned in therapy.

“What a blessing that I get to go home at the end of the day and see the evidence of that,” Carlos reflects.

But the impact extends far beyond the therapy room. About seven or eight years ago, he had a realization: Why do we hide this healing process behind closed doors? Why do we hide it behind shame?

That question led him to get out and speak. To share his story. To become, as he puts it, “a walking permission slip for people to take off their mask, the mask that we hide behind our struggle and our shame.”

Now he gets messages from people after his talks: “You have no idea. I needed to hear that today.” Or: “This is going to help me go help somebody in my life.” He gets cards from clients he saw six, seven years ago telling him he has no idea what impact he had.

“Those things, those are the things that remind me every day why I get up, why I keep doing this, and why there’s still so much more work to do,” he says.

The impact isn’t measured in dollars or quarterly reports. It’s measured in conversations. In permission slips. In ripples.

Advocacy as Service: The Definition That Changed How I Think About This

When I asked Carlos to define advocacy, his answer was simple but profound:

“Advocacy, I think it’s about taking what gifts we’ve been given and what things we have learned in life and giving that over to others through service, whether it’s through the work that we do, whether it’s through the way we parent, whether it’s through being there as a friend, taking those gifts and serving humanity with them.”

Not activism. Not policy work. Not necessarily politics.

Service.

Taking what you’ve learned, especially what you’ve learned through pain, and giving it to others. That’s advocacy.

It reframes everything. Your struggle isn’t wasted. Your recovery isn’t just for you. What you learned in your darkest moments becomes a gift you can give.

The Therapeutic Nature of Helping Others (And Why That Matters)

Here’s something I noticed when talking to Carlos: his work as a healer is also deeply healing for him.

When I asked if advocacy felt therapeutic, he laughed. “Oh, profoundly. And I would say that’s still happening, right?”

He describes the privilege of sitting with people at their most vulnerable. Of witnessing their struggle and their resilience. Of seeing “the fingerprint that is each individual.” And of being trusted with that intimate work.

“I get to see that every day and how moving that people even get to trust me with that kind of work. And so yeah, it feels therapeutic because then I get to pull from a lot of my examples,” he says.

This is important, especially for anyone thinking about getting into advocacy work: you’re allowed to benefit from it too. You’re allowed to be healed by the work of helping others. That’s not selfish. That’s human.

Being Married to Another Therapist: What Could Go Wrong?

Near the end of our conversation, Carlos reveals something that made me laugh: he’s married to a marriage and family therapist. They have a four-year-old son.

“So it’s really fascinating to see, I say this, either this child is going to grow up to be the most psychologically and emotionally healthy child, or we have developed probably new ways of somehow messing him up,” he jokes.

The truth is probably somewhere in between. But there’s something beautiful about two people dedicated to healing raising a child together. All those conversations at home. All that emotional intelligence. All that modeling of what it looks like to do this work with intention and love.

Their kid is watching two parents choose vulnerability. Choose to keep learning. Choose to show up for others. That’s a different kind of education.

The Dream: Healing Across the Globe

If resources were no object, what would Carlos want to see?

“The vision would be to bring healing across the globe, across the world,” he says. Facilities where people can come for yoga and therapy and all the modalities that help us become the best versions of ourselves. Conversations that ripple outward, building “a world that’s more grounded in love and compassion and understanding.”

It’s beautiful in its simplicity. Not a specific legislative victory. Not a particular protocol change. Just: more healing. More ripples. More love and compassion.

His vision for advocacy is a world where fewer people have to wait seven years for help. Where vulnerability isn’t shameful. Where your struggle becomes your superpower.

The Power of Lived Experience: Why You’re Qualified to Help

Here’s what I keep coming back to from this conversation: Carlos is effective as a therapist and advocate precisely because he’s been through it.

He didn’t learn depression from a textbook. He experienced it. He didn’t read about PTSD in a clinical manual. He carried it. He didn’t intellectually understand what it means to feel like you can’t stay on this earth, he felt it.

And now, when he sits with a client struggling with those same things, they don’t have to wonder if he really gets it. They know he does.

That’s the opposite of what our culture usually teaches us. We’re trained to hide our struggles, to present as having it all figured out, to never let anyone see we’ve been broken.

But Carlos inverted that. He took his brokenness and made it foundational to his work. He became a walking permission slip for others to be human, to struggle, to ask for help.

If you’ve been through something difficult, you’re not disqualified from advocacy. You’re qualified. Your pain becomes your credential. Your recovery becomes your expertise.

What Seven Years Costs Us

That statistic haunts me: seven years between when a man experiences his first mental health symptom and when he seeks help.

What happens in those seven years? What relationships are lost? What potential is unrealized? What unnecessary suffering happens?

For Carlos, those years involved coping mechanisms that didn’t work, struggling alone, and nearly losing his life. For countless other men, it’s the same story.

But it doesn’t have to be.

If even one person reads this and decides not to wait seven years, that’s everything. If one person decides they don’t have to figure it out alone, that’s transformational.

Carlos became a therapist because he wanted to be the person for others that his own therapists were for him. Someone who shows up with compassion. Someone who doesn’t judge. Someone who says: I know how dark this is, and I’m still here.

Connect With Carlos

If you want to learn more about his work and philosophy:

* Instagram: @dr.carlos.a.garcia — He posts regularly about mental health, healing, and the human experience

* Podcast: The Human Experience Podcast — A warm, conversational show about the ups and downs of life, co-hosted with a friend. About 20 episodes in, and reviewers say it feels like sitting down with a cup of coffee and chatting with someone who gets it.

Both spaces are invitations to vulnerability and connection. Both are places where healing happens.

Final Thoughts

Carlos’s story is a reminder that advocacy isn’t just for policy experts or career activists. It’s for anyone who’s been through something and decided to use that experience to help others.

It’s for the Marine who struggled with PTSD and became a therapist.

It’s for the person who waited too long for help and now makes sure others don’t have to.

It’s for anyone willing to be a walking permission slip, someone who shows vulnerability so others feel safe being vulnerable too.

Your struggle might be the exact thing someone else needs to hear to get help. Your recovery might be the proof someone else needs that healing is possible.

Don’t wait seven years. And don’t let your story go untold. Someone out there needs to know they’re not alone.

That’s the real power of advocacy.

Are you struggling and waiting to seek help? That’s the first ripple of change—reaching out. The National Suicide Prevention Lifeline (988) is available 24/7. You’re not alone.

Have your own story of healing? Or are you thinking about how your pain could become service? I’d love to hear from you in the comments.

There’s a moment in most survivor stories where everything pivots, where the person standing on the other side of a catastrophe decides what that catastrophe is going to mean. For Vincent A. Lanci, that moment came slowly, quietly, in the form of a support group at Tampa General Hospital, where a young man who had once been left for dead on a Tampa street started to realize that his story could do something for someone else.

That realization would take thirteen years to fully unfold. But the trajectory it set in motion, from trauma to testimony to a life built entirely around helping others, is the subject of the latest episode of Advocacy at Work.

The Night That Changed Everything

Vincent’s story begins with a decision that shouldn’t have been consequential. Walking home after a night out, he chose to pass on a ride from someone who’d been drinking. It was the safe call. And then a car leaving a bar hit him.

He woke up from a coma at Tampa General Hospital.

“I had to relearn to walk and talk. Spell my name. You name it, I had to restart life.”

Vincent had been a finance major pursuing his MBA, mapping out a career in the conventional sense: salary, corner office, title. The accident didn’t just injure him; it erased the version of himself he’d been building toward. Doctors told him he might need 24/7 care for the rest of his life. He might not return to school. The list of things that might never come back was long.

What followed was years of quiet, grinding work — physical, cognitive, emotional. He leaned on what his traumatic brain injury (TBI) had made harder: reading, writing, repeating. Where he once could glance at a study sheet before an exam, he now had to read, write, type, and listen again and again just to retain a fragment of information. He kept at it anyway, because he understood, viscerally, the power of keeping the brain active.

“I wouldn’t let someone I’ve never met ruin my life and my family and friends’ lives forever. I can work my way back. It just may not look the same.”

Left for Dead. Coming Alive. Living Proof.

The arc of Vincent’s recovery isn’t just personal, it became the literal framework for his professional life.

His company is called Left for Dead Incorporated. Under that umbrella sits Coming Alive, a podcast production company, and Living Proof, his TBI coaching practice. The naming wasn’t accidental. It’s a map of the journey: you don’t begin as living proof. You begin with what happened. You find your way back. And then, eventually, you become evidence that the comeback was possible.

“Left for Dead to coming back alive. Now we’re living proof — trying to walk. If I can do it, you can definitely do it. I am 100% no more special or gifted than anybody else out there.”

Along the way, Vincent wrote. A lot. He published Left for Dead, a TBI recovery memoir, in January 2026, thirteen years to the anniversary of his accident. He wrote children’s mental health books, including one where a fifth-grade teacher takes kids on a “mental health week” school trip in the style of the Magic School Bus. He launched multiple podcasts, including A Mental Health Break, which is where he and Tim McDonald first connected. He built a ghostwriting and book coaching practice. He formalized a podcast production service for others who want to share their stories.

None of it was linear. COVID ended his school speaking career before it really started. Finance roles he’d returned to never quite fit the post-TBI version of himself. Each dead end pushed him further toward what actually felt like his work.

Advocacy Is Just Sharing Your Story

When asked to define patient advocacy, Vincent doesn’t reach for a clinical definition.

“Advocacy to me is sharing your story.”

He’s quick to acknowledge that this sounds simpler than it feels. For a long time, he didn’t think anyone would care what he had to say. He didn’t want to be defined by the accident, to become, in his mind, “the kid who got hit by the car.” What changed it was attending those early TBI support groups at Tampa General and watching what happened after he spoke. People would come up to him afterward and say it helped. That feedback loop, small as it was, made him want to do it again.

“Once you lean into it a little bit, hearing someone say those things makes you kind of want to do it again to help a few more people.”

That’s the nature of advocacy he describes: it starts inward, with your own need to process and connect, and it slowly reveals itself as something that belongs to other people too. Sharing your story isn’t an act of ego. It’s an act of service.

The Broken Wrist Question

Perhaps the sharpest moment in the conversation comes when Vincent poses a question that reframes the entire mental health conversation.

“If you break your wrist, what do you do?”

You rehab it. You take time. You get surgery if you need to. You don’t go back to work until it’s healed. Nobody questions whether you deserve that recovery time.

“Now what if you’re going through a bunch of anxiety at work? You have no sick days, you have no PTO. Why is treating your mental health, while it’s still treatable, not the same thing?”

His argument is for prevention: that the same logic we apply to physical injury should apply to mental health. Taking a week to rest, eat well, get sunlight, exercise — these are interventions that can stop anxiety or depression from becoming something chronic and debilitating. The failure to treat mental health with the same institutional seriousness as physical health isn’t just a cultural gap. It’s a public health failure.

“I’d love to see that we take preventative actions for mental health like we would if you broke your wrist.”

One Is Enough

Vincent closes with a message that feels like the distillation of everything he’s lived.

“It only takes one piece of something to bring your momentum to the other side. One conversation, one networking event, one anything. One can change everything.”

He’s speaking from experience. He knows what it feels like to be in the dark. He also knows that somewhere in every seemingly ordinary moment — a support group, an email from a stranger, a podcast recording — there’s the possibility of a pivot. The work of advocacy, as he practices it, is about staying in motion long enough for that one thing to arrive.

To connect with Vincent, visit his website at vincentalanci.com, where you can learn about his books, coaching, podcast production services, and his podcast A Mental Health Break. He’s also offering a free ebook for anyone whose story this episode touches, no strings attached.

If you’re not yet subscribed to Advocacy at Work, now’s a great time. And if you know someone whose story belongs on this show, reach out — Tim wants to hear from you.

There’s a pattern I keep noticing with the advocates I interview.

Almost none of them set out to become one.

Scott K. Johnson is a perfect example. He’s lived with type 1 diabetes since the age of five, back when it was still called juvenile diabetes, before we understood that this autoimmune condition can strike at any age. He didn’t grow up planning a career in advocacy. He just got to a point in his young adult years where he was wrestling with the emotional weight of living with a chronic illness, couldn’t find the resources he needed, and decided to start talking about it.

He started a blog. He found his people. And one thing led to another.

Sound familiar?

Advocacy as therapy

One of the things I love most about these conversations is the honesty. Scott didn’t frame his early blogging as impact work or community building or any of the language we now use around patient advocacy. He described it as something much simpler: he needed people like him.

Not the inspirational stories of professional athletes crushing it despite a diagnosis. He needed the everyday people, the ones struggling to take their kids for a walk without interruption, to mow the lawn without their blood sugar throwing everything off. The ordinary, relatable, I’m not doing this perfectly either kind of people.

And when he found them, something shifted. The things he thought were personal failures: struggling to accurately count carbohydrates, getting the insulin math wrong after all these years, turned out to be nearly universal experiences. That realization alone was healing.

I said it on the episode and I’ll say it here: I keep finding that for most of us, whatever form our advocacy takes, it starts as therapy. It started that way for me too.

You don’t have to do it all

Scott said something that I think every advocate, new and experienced, needs to hear:

You can’t do all of it. And that’s okay.

Advocacy isn’t one thing. There’s legislative work, research advocacy, awareness building, fundraising, peer support, storytelling. I write about four distinct buckets in From Patient to Advocate, and I’ll be honest, fundraising is one of them and it’s the one I barely touch. It just doesn’t fill my bucket the way legislative and research advocacy do.

Scott’s the same way. He’s never been one to obsess over website traffic or social media metrics. He measured impact the old-fashioned way: did something I said reach someone? Did they tell me? Did I run into them at a conference and see it in their face?

That’s enough. That has always been enough.

The hospital room phone call

I shared a story in this episode that I don’t tell often enough.

I was recovering from my liver transplant, three years ago now, in the transplant wing. The medical team had been very clear: no work for six months. And there I am on my cell phone, talking for half an hour with another colorectal cancer patient who was pursuing a liver transplant himself. Answering his questions. Connecting him with my transplant surgeon. Doing exactly what they told me not to do.

My nurse waited the whole time. She heard everything.

When I hung up, I looked at her and said: This is the best medicine I can have.

Happy to report that man received his transplant about a year ago and is doing well.

There is no metric for that. There is no dashboard that captures what that phone call meant to either of us. And Scott agreed — advocacy, at its best, becomes a self-feeding loop. You receive help, you heal, you give it back. Around and around it goes.

What Scott is working on now

Today, Scott channels most of his energy into Blue Circle Health, the nonprofit organization where he works. Blue Circle Health provides free care, education, and peer support to adults living with type 1 diabetes. The organization is currently available in 20 states and continuing to grow.

If resources were no object, Scott’s wish is straightforward: he wants every person living with diabetes to have access to the medicines and devices that already exist and are already proven to work. Not a cure, though progress is being made there too, just access. That’s it. The tools are there. The barrier is access.

It’s a quiet but urgent kind of advocacy. And it’s very much his lane.

You can find Scott’s blog — still up, still worth reading — at scottsdiabetes.com, and learn more about Blue Circle Health at bluecirclehealth.org.

And if this conversation resonated with you, whether you’re living with diabetes, supporting someone who is, or just figuring out what your own advocacy lane looks like, I’d love to hear from you.

Subscribe to Advocacy at Work at advocacyatwork.com so you never miss an episode or a post. And if you know someone who needs to hear this one, share it with them.

That’s the whole point, after all.

— Tim

How one mother's determination to help her son led to saving lives across San Diego—and why small, local victories matter as much as Capitol Hill battles.

January 10th, 2019. That’s the date Jessica Cella’s life changed forever.

Her youngest son was diagnosed with primary adrenal insufficiency at Rady Children’s Hospital in San Diego. The diagnosis came with a sentence that would stay with her: “rare condition.” And then came the kicker that would fuel years of advocacy work: the hospital told her that if her son went into an adrenal crisis, San Diego Fire Rescue paramedics couldn’t give him the medication he needed. They didn’t carry it. Not a single ambulance in the city had it.

Jessica describes the feeling with a vivid metaphor: “I felt like my husband and I were standing on the island of Hawaii. There was nobody else coming. We were all alone.”

That moment, that isolation, that helplessness, didn’t break her. It mobilized her. Seven years later, Jessica was honored as the California Senate District 40 Woman of the Year for her work. But more importantly, she’s helped change the emergency medical landscape in San Diego in ways that are directly saving lives.

Her story is a masterclass in something we don’t talk about enough in advocacy: the power of starting small, thinking locally, and building genuine impact in your own community.

Understanding Adrenal Insufficiency (The Simple Version)

Jessica often tells people: “To manage it day to day, it’s very complex, but in an emergency situation, it’s very simple.”

Here’s the layman’s version: Your adrenal glands produce cortisol and aldosterone—hormones that help your body respond to stress. When you face something scary or stressful, your body has a “fight or flight” response. Cortisol helps you survive that stress.

People with primary adrenal insufficiency don’t have working adrenal glands. Their bodies can’t produce cortisol on their own. So they need to take steroids every day, three times daily in Jessica’s son’s case, to replicate what healthy adrenal glands do naturally.

But here’s where it gets dangerous: when stress hits, illness, injury, even the flu, their bodies can’t ramp up cortisol production like yours and mine can. That’s when you need an emergency injection of Solu-Cortef, a specialty steroid. Without it, an adrenal crisis can be life-threatening.

Jessica’s son carries this medication with him everywhere. But for years, if he’d gone into crisis in San Diego, the paramedics who arrived couldn’t administer it.

The Island of Isolation: Realizing You’re on Your Own

When Jessica left the hospital that January day, she faced a reality that every parent of a chronically ill child knows: the vast majority of your child’s care now falls on you.

At eight years old, her son needed her to be an expert on a condition she’d never heard of. She needed to know the signs and symptoms. She needed to manage his medications. She needed to always have Solu-Cortef injections ready—in the house, in the car, in emergency kits. She needed to understand what an adrenal crisis was and how to respond.

“That’s a lot of pressure on a family,” Jessica reflects. But that pressure also became her motivation.

The turning point came when she attended a conference with other adrenal insufficiency patients. She talked to about 200 people personally. What she learned was sobering: for most people, it took three to five years on average to get diagnosed with adrenal insufficiency. Many had received terrible care at hospitals or from endocrinologists. Horror stories vastly outnumbered success stories.

That’s when Jessica realized something crucial: they actually had a success story. They had gotten the right diagnosis, the right doctor, the right hospital. Many others hadn’t.

“I realized at that moment that we actually had a success story. Obviously as hard as it was that my son was diagnosed with a rare condition, we had a lot of things that went right,” she says. “And I think there’s a part of me that feels a little bit guilty about that, and I want to make sure that I lessen the burden on other caregivers.”

That guilt, that awareness of privilege in the midst of crisis, became the seed of her advocacy work.

Starting Small: Emergency Kits and Filling Local Gaps

Here’s what I love about Jessica’s approach to advocacy: she didn’t try to save the world. She identified a specific gap and filled it.

After her son’s first year of diagnosis, she noticed that many newly diagnosed patients didn’t know what an emergency kit should contain. They didn’t know where to get the supplies. Many struggled to get the needles they needed, and a Solu-Cortef injection without needles is useless.

“I can’t save the world. I can’t save everybody,” Jessica told herself. “But I’m going to carve out this little piece of a gap that I’ve identified that I think I can give back to the community in this small way.”

She started helping newly diagnosed families create emergency kits. She organized local meetups and roundtables. She connected patients and families. It wasn’t glamorous. It didn’t make headlines. But it saved lives.

Then she started getting messages from families years later: “Jessica, we still use the emergency kit you helped us create five years ago. Thank you so much.” Or: “My son went into an adrenal crisis and we were prepared because of you and because of the training that you’ve done.”

Those messages, that direct feedback from people whose lives she’d touched, became more powerful than any award.

“I think the smaller wins that keep us going are really at the patient grassroots level,” Jessica says. “Those little things when you hear from the community specifically, I think probably power me more so than standing on Capitol Hill advocating or getting Woman of the Year.”

This is crucial for anyone thinking about advocacy: you don’t need Capitol Hill to make a difference. Sometimes the most impactful work happens in your living room, at a local hospital, or in conversations with families who are where you once were.

The Paramedic Protocol Victory: Local Change That Saves Lives

Jessica’s biggest win, the one that earned her Woman of the Year recognition, shows what happens when you commit to a specific, achievable goal.

She identified a clear problem: San Diego Fire Rescue paramedics couldn’t administer the steroids that adrenal insufficiency patients need in an emergency. She partnered with six endocrinologists across the country and conducted training for 1,100 paramedics in San Diego on how to administer a “patient’s physician prescribed medication”.

Then came the real victory: she worked with San Diego County to develop a brand new protocol that allows paramedics to administer patient’s physician prescribed for children ages zero through 13. That protocol will go live on July 1st, 2026.

“Protocols are very hard to put into place,” Jessica notes. And she’s right, changing emergency medical protocols is bureaucratic, time-consuming, and requires sustained effort. But she did it. In her community. Where it matters most.

Think about what that means: a child with adrenal insufficiency who goes into crisis in San Diego now has paramedics trained to help them. A protocol is in place. Lives will be saved.

That’s not small. That’s transformational.

The Landscape Shift: Pharma Companies as Resources (Not Villains)

When Jessica’s son was first diagnosed in 2019, there was only one pharmaceutical company involved in the adrenal insufficiency space: Pfizer. Today, there are several, which means more treatment options for patients—and, importantly, more resources.

Jessica is thoughtful about this evolution. She welcomes pharmaceutical partnerships while being clear-eyed about what they are. “More therapies is always a good thing, always options for patients. And in addition to that, it can also be a resource for patients,” she explains.

The adrenal insufficiency nonprofit community is small. There are only about three nonprofits in the space, running on approximately $150,000 per year each (except for one larger organization). With such limited resources, partnerships with companies that can provide funding, education materials, and research support genuinely help.

“Resources are scarce,” Jessica acknowledges. “And so it’s really tough to move the needle when you don’t have a lot of those resources. And so I think that was when things shifted a little bit is when the pharmaceutical companies came into the picture and were able to help some of those nonprofits from a resource standpoint.”

This is a nuanced view of advocacy that doesn’t fit neatly into ideology. Yes, pharma companies have profit motives. But they also have resources that can genuinely help rare disease communities. The question isn’t whether to partner with them, but how to do so authentically and transparently.

The Personal Foundation: A Mother’s Determination Born From Her Own Scarcity

Near the end of our conversation, Jessica shares something deeply personal: she was raised by a single mother who struggled with drugs and alcohol. She grew up without resources. She didn’t have access to top hospitals or specialists.

“If I had adrenal insufficiency when I was younger, my mom didn’t have a college degree and she didn’t have the resources to send me to a Rady Children’s or have the top endocrinologist,” she reflects.

This history informs everything she does. She doesn’t advocate for her own son—he has resources, a supportive two-parent household, access to excellent care. She advocates for the children and families who don’t have that luxury.

“I always tell my son, I don’t actually advocate for my son,” Jessica says with clarity. “I advocate for children and families and patients who don’t have that luxury that my family has. And like I said, growing up that I didn’t have.”

This is the beating heart of authentic advocacy. It’s not guilt. It’s not charity. It’s recognition that some people have been handed advantages, and using those advantages to level the playing field for others.

The Magic Wand: A Vision for Emergency Response Across America

If Jessica could wave a magic wand, and this is her phrase, her “magic wand list,” what would she change?

She’d ensure that EMS agencies across the entire country have education and protocols for adrenal insufficiency. She’d make sure that paramedics at least know what the condition is and can respond appropriately. She’d eliminate the “transport only” agencies that currently just move patients to hospitals without being able to administer emergency medication.

“Unfortunately right now there’s a lot of areas that are transport only, and that’s how we’re losing patients is that they’re just being transported and they’re losing their life in transport,” she says.

The parallel to rural healthcare challenges is stark. In rural areas, where specialists are scarce and resources are limited, a child with adrenal insufficiency faces exponentially greater risk. Jessica knows this. She’s working on it. And she’s not waiting for the federal government to move. She’s doing it city by city, region by region.

The Real Power of Local Advocacy

What strikes me most about Jessica’s story is this: she’s accomplished something tangible in her community that many advocates spend years chasing at the federal level.

I made a powerful observation: “You talk about making change in your neighborhood, in the city and the county where you live. And I think that’s just so important for people to understand.”

There’s a Capitol Hill in almost every state. There’s a county health department in every county. There are school boards and city councils and hospital protocols. These institutions determine how care is delivered, how emergencies are handled, how patients are treated.

Jessica didn’t need to change federal law to save lives. She needed to train paramedics, develop protocols, educate hospitals, and connect families. She did that work. And it’s working.

“I can’t save the world, but I’m going to carve out this little piece,” she said. And then she did.

For anyone thinking about getting involved in advocacy, that’s the invitation: you don’t need a massive platform or unlimited resources. You need a problem you’ve identified, a community you care about, and the willingness to show up consistently.

How to Get Involved

If Jessica’s work resonates with you, here’s how you can learn more:

* Connect with local adrenal insufficiency support communities and nonprofits

* Reach out to your county or city health department about gaps in emergency preparedness

* Talk to paramedics and emergency responders in your community about rare diseases and how to respond

* If you or a loved one has adrenal insufficiency, consider mentoring newly diagnosed families—that personal connection is invaluable

* Advocate locally for protocol changes and training initiatives that can save lives in your community

Final Thoughts

Jessica Cella’s story is a reminder that advocacy isn’t just about speaking at Congress or testifying before committees. It’s about identifying problems in your community and solving them. It’s about turning the isolation you felt into a bridge that helps others not feel alone.

Her son’s diagnosis was devastating. But Jessica transformed that devastation into something concrete: emergency kits that save lives, paramedics trained to respond, protocols in place, families supported.

That’s not small. That’s the entire point.

And it all started because one mother, standing alone on an island, decided she wouldn’t let other families feel that way.

Have your own story of local advocacy impact? Or are you thinking about getting involved in your community? Share in the comments—I’d love to hear from you.

When David Russo discovered he had precancerous polyps after fighting for a colonoscopy, he uncovered a family secret: colorectal cancer had silently killed his grandfather and two cousins. Nobody had talked about it. Nobody wanted to admit it. The stigma was so strong that his own father, who’d been getting polyps removed since his forties, never connected his condition to the disease that took his father’s life.

That moment of realization sparked a question: What if people could talk about colorectal cancer without shame? What if, instead of whispering about it in the dark, we celebrated our butts proudly and openly? Out of that spark came Cheeky Charity, a nonprofit that uses humor, vulnerability, and creative activism to do something radical: make colorectal and anal cancer impossible to ignore. Five years later, David has built a movement that’s proving sometimes the cheekiest approach is also the most effective.

The Origin Story: From COVID Van to Cancer Advocacy

David’s journey to founding Cheeky Charity began, improbably, in a converted Sprinter van during a pandemic-era “Eat, Pray, Love” adventure across America. While traveling solo through national parks, he had limited resources—a camera and a social media account. But he had something more valuable: a clear purpose.

Five or six years earlier, he’d fought with his primary care physician for a colonoscopy. It took months. When he finally got one, doctors found precancerous polyps. Had he waited much longer, those polyps might have become cancer. The experience triggered a deeper investigation into his family history, revealing the cancer deaths that had been whispered about and hidden away.

Around that same time, David read alarming research from Yale University showing an uptick in colorectal cancer diagnoses among young adults. The pieces clicked together: this disease was serious, it was getting worse, and it lived under a thick blanket of stigma that prevented people from talking about it, getting screened, or seeking help.

“What can I do about it?” became the driving question. And David’s answer was distinctly creative: what if people posted photos of their butts on Instagram with public health messages attached?

Thus was born Cheeky Charity, an Instagram profile dedicated to “cheeky” photos with a purpose. At the most extreme, David would find stunning vistas in national parks and photograph his own backside against beautiful landscapes. At the more modest level, he’d post with varying degrees of cheekiness, always paired with messaging about colorectal cancer awareness, screening, and prevention.

“I would go into the most beautiful areas of national parks and more or less take butt picks,” David explains. The goal was simple but ambitious: gain a following, build an audience, and create space to educate people about a disease they’d rather not think about.

It worked. Within a year, Cheeky Charity had 5,000 followers. The concept was novel, the tone was irreverent, and people were paying attention.

From Idea to Organization: The Power of Collaboration

What happened next illustrates a crucial principle of successful advocacy: surround yourself with talented people who believe in the mission.

When David decided to expand beyond solo social media posts, he reached out to his network. A friend named Taylor who worked in design at Google created the logo—and when David’s first instinct was to dismiss it as “too basic,” Taylor pushed back. That logo became foundational to Cheeky Charity’s brand identity. Jake helped build out graphic design and social media infrastructure. Andrew Wartman became director of development, graphic designer, and website developer all in one, creating the visual ecosystem that makes Cheeky Charity instantly recognizable.

“I had some of the most incredible people in the world come on to help me,” David reflects. “They weren’t necessarily people that had a connection to colorectal cancer, they were just people that were passionate.”

With this team in place, David launched the Cheeky Challenge, asking people to post their own cheeky content on social media. The campaign resonated. It led to connections with organizations like the Prevent Cancer Foundation, secured the organization’s first grant for local work in Palm Springs, and eventually earned Cheeky Charity an invitation to present at the American Cancer Society’s National Colorectal Cancer Roundtable (NCCRT).

David remembers walking into that first major advocacy conference as an outsider—”this random kid who’s posting wacky stuff”—terrified of judgment. Instead, he found an entire community of passionate advocates dedicated to colorectal cancer awareness. “I was completely embraced,” he recalls. “Everybody was incredibly wonderful.” More than that, he discovered a landscape of programs and initiatives he never knew existed, organizations doing incredible work to raise awareness and support patients.

The experience taught him something essential: in advocacy, you’re not alone. And collaboration amplifies impact exponentially.

Amplifying the Message: From Solo Creator to Movement

One of the most powerful moments in Cheeky Charity’s evolution came when David received photos from a Pride Festival he wasn’t attending. A group of volunteers had set up a Cheeky Charity booth, complete with the branded tent, backdrop, and table, and were representing the organization independently.

“That was one of the most amazing feelings that I feel like I might’ve ever had in my life,” David says. “This thing that was nothing, that kind of went from being an idea into reality, is now being amplified through people that are also passionate.”

Today, Cheeky Charity’s primary activation happens at Pride Festivals across the country. The organization maintains at least 10 by 10 booths at Pride events where volunteers and community members show up to represent the brand, engage visitors, and spread the message about screening and prevention.

But David is honest about a gap in the organization’s infrastructure: they don’t yet have a formal system for empowering, onboarding, and supporting these ambassadors. “I feel like I could do a much better job of making people feel more connected,” he admits. “There’s no formal, we honestly don’t really have a formal system for helping empower and onboard and educate and making people feel like they’re part of the cheeky charity community, even though I know of hundreds of people who are.”

This vulnerability, acknowledging the gap while recognizing the reality of what’s already happening organically, is characteristic of David’s leadership. He’s building something real, recognizing its power, and being honest about where it needs to grow.

Butts and Badges: Making Healthcare Providers Part of the Solution

Cheeky Charity’s newest initiative reveals how the organization is scaling its impact through creative, accessible strategies. The Butts and Badges program is elegantly simple: send cheeky pins to healthcare providers, who wear them next to their name badges in clinical settings.

The theory is straightforward but powerful: when a provider wears a Cheeky Charity pin, it starts conversations. Patients see it and ask about it. That opens a dialogue about colorectal cancer screening and prevention. The nudge becomes a conversation; the conversation becomes a screening; the screening saves a life.

Cheeky Charity sent out 15,000 of these pins to healthcare providers across the country in the program’s initial rollout. But David’s vision goes much bigger.

“The Butts and Badges program implies that it’s a person wearing a badge, but I think there’s opportunity to basically empower anybody,” he explains. “Any individual who’s out there to wear our pin or share our logo or share our message, they can become what I’m currently tossing around as a cheeky champion.”

A cheeky champion isn’t a formal role. It’s simply someone—provider, patient, survivor, advocate, friend—who believes in the mission enough to wear the pin, share the message, or start the conversation. By lowering the barrier to entry, Cheeky Charity can scale beyond what any single person or organization could accomplish alone.

The Introvert’s Dilemma: Pushing to Show Up

One of David’s most striking revelations comes late in the conversation: he’s an introvert. A very large introvert. “Being in crowds is very draining to me,” he admits. “I’m constantly pushing myself to put myself out there.”

Yet every time someone encounters David at a cancer advocacy event, they see a person fully present, engaged, and energized. How does an introvert become the face of a growing national movement?

David explains that in college, he became an RA to force himself to engage. He joined the Ambulance Corps for the same reason. He pursued an MBA specifically to improve his communication skills despite an engineering background. “I’ve kind of always been doing these kind of masochistic things to kind of torture myself, but I absolutely love it,” he says with self-aware humor.

This is an important lesson for anyone in advocacy: you don’t have to be an extrovert to do this work. You just have to be willing to push yourself beyond comfort for a cause you believe in. And when you do, you meet extraordinary people and expand your life exponentially.

“I’m so grateful for pushing myself because I’ve met such unbelievable people and it’s expanded the quality of my life exponentially,” David reflects. The relationships formed through Cheeky Charity. with fellow advocates, with people in the cancer community, with collaborators, have enriched his life in ways he couldn’t have anticipated.

The Dream: Celebrity, Vulnerability, and Museum Exhibits

If resources were unlimited, what would David want to do with Cheeky Charity?

His answer is ambitious and artistically compelling: a professional photography campaign featuring celebrities—modeled on ESPN’s famous “ESPN Bodies” issue that showcased nude photography of elite athletes. But instead of celebrating athletic achievement, David’s vision would celebrate vulnerability and human connection through the lens of colorectal and anal cancer.

The photos would become a rotating museum exhibit traveling to major museums worldwide. Alongside the photographs would be video documentation of the shoots, behind-the-scenes content, and audio of the participants’ stories—survivors, advocates, celebrities—sharing why they stepped forward.

“So as people are kind of walking around the exhibit, they’re hearing the message of people’s stories and feeling that impact,” David explains. The goal is to normalize conversations about these cancers by placing them in high-art contexts, to show vulnerability as strength, and to demonstrate that everyone—no matter how famous or accomplished—faces the same human fears and needs.

“It’s basically a pipe dream that is on the shelf that I’m, every once in a while I’ll be like, is this feasible? No. Okay, let’s keep going,” David says with a laugh. But the dream is there, fully formed, waiting for the day when resources align with vision.

Collaboration as Priority: The Real Secret to Scaling

Before the lightning round questions, David emphasizes something he realizes is equally important as the initiatives themselves: collaboration.

“One of the big things that I’m trying to focus on is building very, very strong collaborative relationships with all of the other organizations that are in the space. I feel like that’s so critical,” he stresses. Collaboration isn’t just nice-to-have; it’s foundational to maximizing impact.

This commitment to partnership is evident in how Cheeky Charity operates. The organization doesn’t see itself as competing with established advocacy groups. Instead, it sees itself as part of an ecosystem where each organization brings unique strengths. Cheeky Charity’s strength is breaking taboos and reaching young people through humor and vulnerability. Other organizations excel in different areas. Together, they can accomplish more than any single entity.

For newer organizations building advocacy programs, this is essential wisdom: the most sustainable path isn’t building a standalone empire. It’s finding your niche, excelling at your unique mission, and collaborating generously with others working toward the same goal.

Getting Involved: How to Become a Cheeky Champion

For anyone inspired by Cheeky Charity’s approach, the path to involvement is accessible:

Visit cheekycharity.org to learn about the organization’s work and programs. Follow them on Instagram at @CheekyCharity for ongoing awareness campaigns and community engagement. Check out ScreenYourButt.org, their new educational platform focused on making screening information accessible and approachable.

If you’re a healthcare provider interested in the Butts and Badges program, you can participate by wearing a pin and starting conversations with patients about screening. If you’re interested in volunteering at Pride events or other community activations, reach out to the organization about how to get involved.

Most importantly: if you believe in using humor, vulnerability, and creativity to break down stigma around colorectal and anal cancer, you can become a cheeky champion right now. Wear a pin if you have one. Share the message. Start the conversation. That’s what advocacy looks like at Cheeky Charity.

The Unseen Work: Building Movements Takes Time

What stands out about David’s story is how he’s managed to build something real—501(c)(3) nonprofit status, national reach, media partnerships, professional execution—while remaining humble about how much work remains.

He acknowledges the gaps in their ambassador program. He admits being an introvert pushing himself into crowds. He shares his “pipe dream” of a museum exhibit with the self-aware humor of someone who knows it’s a long shot. Yet he’s moving forward anyway, steadily amplifying the message through Pride events, the Butts and Badges program, and the collaborative relationships he’s nurturing across the advocacy landscape.

This is the real work of advocacy: showing up, being honest about limitations, celebrating small wins, collaborating generously, and always—always—keeping the mission front and center. Not everyone who does this work needs to be a natural extrovert or have all the answers. They just need to care enough to start, be willing to learn, and build with others who share the vision.

David Russo and Cheeky Charity prove that the cheekiest approach isn’t frivolous—it’s sometimes the most effective way to get people to pay attention to something that matters. And once you have their attention? That’s when the real advocacy begins.

Final Thoughts

In a healthcare landscape often defined by solemnity and medical jargon, Cheeky Charity dares to be different. By combining humor with genuine passion, vulnerability with professional execution, and individual initiative with collaborative partnership, David Russo has built something that might seem unlikely but is deeply necessary: a movement that makes it okay—even fun—to talk about colorectal cancer.

That’s not just creative advocacy. That’s cultural change.

The Eczema That Nobody Takes Seriously

Close to 31 million Americans have eczema. That’s roughly 10% of the population. Yet when most people think of eczema, they think of a minor rash—something temporary, something that goes away, something that isn’t serious.

They’re wrong.

“There are a lot of people who may just assume that eczema is mild. We say that we have a campaign called ‘More Than Just a Rash,’ that it’s just a rash that it’ll go away, that it’s a very temporary thing that doesn’t have lasting impacts,” explains Nora Eigenbrodt, Associate Director for Grassroots Advocacy at the National Eczema Association (NEA).

But the reality is far different for the millions living with severe eczema.

Nora talks about patients who experience sleepless nights because their itching won’t stop. Patients who have to spend hours in the bathtub because it’s the only place they get relief. Children on playgrounds being avoided by other kids who think eczema is contagious or don’t want to touch them.

The mental health impacts. The social isolation. The constant battle with insurance companies over access to treatment.

“It’s about amplifying that voice and sharing lived experiences is the best way that we have to help people understand who aren’t directly impacted,” Nora says.

This is the work of the National Eczema Association, and Nora is at the forefront of it.

Understanding the National Eczema Association

The NEA is a patient advocacy organization representing those 31 million Americans with eczema. But they’re not just focused on patients—they serve caregivers, researchers, and healthcare providers as well.

“We kind of tried to be the resource and the hub for people with eczema, for caregivers as well as for researchers and healthcare providers as well,” Nora explains.

The organization works to:

* Raise awareness about the true burden of eczema

* Improve access to care by dismantling hurdles to treatment

* Fund research to advance eczema treatment options

* Serve the whole journey, whether someone has mild eczema and just needs skincare recommendations, or has severe eczema and is navigating expensive new treatments and insurance barriers

In her role as Associate Director for Grassroots Advocacy, Nora works directly with patients and caregivers, helping them leverage their personal stories to create system-wide change, primarily at federal and state levels.

Defining Advocacy: Giving Individuals a Platform

When asked to define advocacy, Nora’s answer cuts to the heart of what advocacy really is:

“It’s taking an individual and giving them a platform.”

This is crucial. Advocacy isn’t about a professional advocate sharing their own story on behalf of patients. It’s about creating pathways for patients themselves to be heard—to have their voices amplified so they can create change at a scale larger than just their own individual struggle.

“It’s not about me going to the hill and telling my story as someone who works at NEA, but it’s about how can I find ways to be that sort of seat at the table for our patients and for our caregivers to help them be able to share their story, make their voice heard in a way that can have change that’s larger than just at the individual level,” she explains.

This reframing is powerful. Many people struggling with insurance issues or access to treatment feel like they’re fighting alone. But Nora helps them see that their individual struggle is often part of a larger systemic issue that could be solved through federal or state legislation—legislation that, if passed, wouldn’t just help them, but everyone in their situation.

The Ambassador Program: Three Tracks of Engagement

The NEA’s ambassador program, started in 2020, is uniquely structured with three tracks that work simultaneously:

Track 1: Advocacy

This is the traditional advocacy track—the ambassadors who will go to Capitol Hill, participate in virtual Hill Days, and provide testimony to lawmakers. These are the most invested, most active advocates.

Track 2: Community Engagement

Some ambassadors focus on community outreach—tabling at local fairs, working with school systems and school nurses, conducting educational activities in their communities. This work was already happening organically in communities; the NEA formalized it and provided resources and support.

Track 3: Research

This is the unique track. NEA hosts a monthly research journal club where ambassadors—some with medical or scientific backgrounds, many without—learn to read and analyze new eczema research, present it to the group, and discuss what it means.

“You have to become an expert overnight in whatever your illness is, whatever your condition is,” Nora notes. “You also have to become an expert in advocacy.”

By giving patients research literacy skills, the NEA empowers them to understand why research funding matters and to advocate more effectively for it.

The Rapidly Changing Eczema Research Landscape

Understanding the evolution of eczema treatment is key to understanding why advocacy and research funding are so critical.

Ten to fifteen years ago, eczema treatment options were extremely limited. Topical steroid creams and moisturizers were essentially the only options available.

Then, around 2017, the first biologic treatment for eczema was introduced. Since then, the field has exploded with new treatment options.

But with new treatments comes a new problem: utilization management and insurance barriers.

“That treatment might be the perfect one for you, but it might be too expensive or not covered by your insurance, or you might not be able to find a specialist that can get you in order to prescribe it,” Nora explains.

This is where advocacy becomes essential. Without patients and advocates advocating for better access policies, people won’t be able to access treatments that could dramatically improve their lives—even when those treatments exist.

Measuring Impact in Legislative Work: A Marathon, Not a Sprint

One of the most challenging aspects of advocacy work is measuring impact when legislative change takes years or even decades.

Nora points to a concrete example: the Peer Reviewed Medical Research Program (PRMRP), a Department of Defense program that provides high-impact research funding. Congress must approve a list of eligible conditions each year, but only conditions that are advocated for get included.

“It’s a totally one-to-one sort of, if you advocate for it, you have a chance. And if you don’t, in most cases researchers will miss out on that funding in your disease area,” Nora explains.

Through an educational campaign about the military service connection to eczema, NEA was successful in getting eczema on that list for FY 25 and FY 26. Now they’re measuring the impact not just by being on the list, but by whether they’re actually funding quality eczema research through that program.

But not all victories are that clean or measurable.

Congressional timelines are unpredictable. Bills have to be reintroduced. Progress can feel glacially slow. As Nora notes, “Congress is a marathon, not a sprint.”

This is why Nora redefines what “impact” means in advocacy work:

* Building eczema champions on the Hill through consistent relationship-building with legislators and their staff

* Deepening engagement with the organization itself—do advocates feel heard? Are they more empowered? Do they get involved in research or clinical trials?

* Legislative persistence—recognizing that momentum carries forward, that relationships built this year matter in year five when a bill finally passes

“Reintroducing the same legislation and inching closer to passage every session can be a frustrating experience and can be something that feels harder to measure impact,” Nora acknowledges. “So I think it has to be on multiple levels.”

The Evolution of Digital Advocacy

When Nora started at NEA three years ago, there was an ambassadors program, but no formal digital grassroots advocacy platform. She built that out.

This was crucial because not everyone wants to or can go to Capitol Hill. Building an “engagement ladder” means meeting people where they are—digitally, locally, in whatever way they can participate.

“I wanted to make sure that we were building the base of that engagement ladder and meeting people where they are,” Nora explains.

Through monthly digital campaigns around policy priorities, NEA can:

* Gauge what their community cares about

* Send action alerts and track which ones perform best

* Identify who in the digital advocacy space might be interested in stepping up to become an ambassador

* Build digital touchpoints with legislators

This data also informs their ambassador program and helps ensure they’re focusing on what actually matters to their community.

Why Patient-Centered Research Matters

NEA takes seriously what it means to do patient-centered research. When they fund research or conduct surveys and studies, they actively involve patients and caregivers.

For example, NEA recently conducted a 2025 survey on access to prescription treatments for eczema patients—an update to a 2021 study. This data directly informs their policy priorities.

“When it comes to our advocacy program and our policy priorities, they’re absolutely informed and selected by what we hear from the community,” Nora says.

This isn’t about checking a “patient involvement” box. It’s about genuinely building research around what patients experience and need.

The Bigger Vision: Regional Hubs for Deeper Engagement

If resources were unlimited, Nora’s vision for NEA’s expansion is clear: regional and state hubs.

Currently, as a small team, their reach by necessity is limited. Virtual opportunities are accessible, but many ambassadors have expressed interest in in-person events and opportunities.

Regional hubs would allow NEA to:

* Deepen engagement with ambassadors who want in-person community

* Invest more in in-state and in-district advocacy

* Build relationships with local and state legislative offices (increasingly important as the federal level gets busier)

* Support state-level legislative efforts

“Building relationships with those offices I think can be strategically very important over time to getting things done,” Nora explains.

This is the work that will happen while waiting for federal bills to move through Congress—the foundation that eventually enables larger victories.

What Advocacy Means in the Eczema Space

For Nora and NEA, advocacy has become essential because eczema is so widely misunderstood.

It’s not “just a rash.” It’s a complex, sometimes severely disabling condition that affects millions of Americans. It impacts mental health, sleep, social interaction, work, school attendance, and quality of life.

The world needs to understand this. And patients need to know that their individual struggles—the sleepless nights, the insurance battles, the social isolation—are actually systemic issues that can be addressed through advocacy and policy change.

How to Get Involved

If you or someone you know has eczema, or if you’re a healthcare provider, researcher, or caregiver interested in supporting this work, NEA is actively recruiting ambassadors.

You can learn more at: ambassadors.nationaleczema.org

The NEA offers opportunities for:

* Patients with eczema (mild or severe)

* Caregivers of people with eczema

* Healthcare providers and dermatologists

* Anyone passionate about understanding and supporting the eczema community

What Nora Wants You to Know

If you have eczema, you’re not alone. Those 31 million Americans? They’re out there, experiencing what you’re experiencing. And there’s a community working to make sure your voice is heard—not just by other patients, but by legislators, by researchers, by healthcare providers.

Advocacy isn’t something that happens to you. It’s something you can be part of. Whether that’s sharing your story, going to Capitol Hill, reading research papers, or organizing community education efforts—there’s a place for your voice.

And if you’re someone without eczema, understand this: what seems like a minor rash to you is a serious, sometimes debilitating condition for millions of Americans. When you hear eczema advocacy, it’s not about a temporary rash going away. It’s about sleepless nights, about social isolation, about access to life-changing treatments, about allowing people to live full and healthy lives.

Persistence matters. Relationships matter. Small wins build toward bigger ones. And every individual voice amplified through advocacy creates change that reaches far beyond that one person.

To learn more about turning your own health journey into purpose and impact, get your copy of From Patient To Advocate, where you’ll find resources, stories, and practical guidance for advocates at every stage of their journey.

The Barriers Nobody Talks About

When most people think of colorectal cancer advocacy, they might picture statistics, awareness campaigns, or calls to get screened. But for Marielle McLeod, the work goes much deeper.

Nine years out from her colorectal cancer diagnosis, Marielle has become a fierce advocate for the Latino community. Not just talking about screening, but confronting the cultural stigmas that keep people silent, suffering, and diagnosed at advanced stages.

“We don’t talk about things like these,” she explains simply. “Oftentimes as Latino patients were diagnosed automatically at later stages, and we don’t really talk about our family history just like many other cultures.”

The barriers are cultural, deeply rooted, and rarely discussed outside these communities.

“We don’t like to discuss our poop just like a lot of people do, but it’s even more so that it’s really, really gross and we just suffer in silence because we don’t have anyone that we can go to,” Marielle says candidly. “Finding the courage to go to our medical provider and say, this is really happening to me takes a lot, particularly within our community.”

This is the work of patient advocacy that nobody teaches you about in health class.

The Unspeakable Topic That Saves Lives

One of Marielle’s most powerful contributions to advocacy is her willingness to talk openly about colonoscopy prep, bowel symptoms, and all the things that most people would rather suffer in silence about.

“It’s so funny too because it’s like who would’ve thought that in our advocacy we’d be doing so many conversations in regards to butts and poop and colonoscopy prep,” she laughs. “Now it’s just second language to us and we just talk to everybody.”

She jokes that her staff gives her the side eye when she gets excited about someone getting a colonoscopy, becoming their “biggest hype girl” for the procedure. But this willingness to make the unspeakable speakable is exactly what breaks down barriers.

For communities where these topics are taboo, where discussions about private parts, sexual intimacy, or bowel movements are simply not done, having someone enthusiastically, matter-of-factly talking about colonoscopy prep can be revolutionary.

It normalizes the conversation. It makes it less shameful. It potentially saves lives.

Breaking Down Barriers Through Education

But talking about it herself is only part of the solution. Marielle’s real work is creating safe spaces where entire communities can learn to talk about these things.

“We do have a lot of work in making sure that we provide a comfortable space to have these discussions. Regardless of what language we’re doing it in, we’re discussing a lot of very intimate details and information,” she explains.

Her approach involves:

Culturally appropriate materials that don’t just educate the individual receiving them, but are digestible enough that people feel confident sharing them with others—family members, friends, community members.

Accessible language that respects both language barriers and health literacy, ensuring people understand not just the “what” but the “why” of colorectal cancer screening and awareness.

Empowerment that goes beyond information-sharing—helping people feel confident enough to ask important questions of their providers about signs, symptoms, and treatment options.

Comprehensive education that covers the full journey: screening, diagnosis, treatment options (regardless of age, access, or insurance coverage), and clinical trial options.

Biomarkers: The Critical Information Nobody Explains

One of the most important things Marielle advocates for is biomarker education—and she learned this lesson the hard way.

Despite having 20+ years of healthcare experience before her own diagnosis, when she became a patient, “it all completely flew out the window.”

When she finished treatment and stepped into advocacy, she started asking her doctors about her biomarkers. Their response? “Why do you need to know that?”

But she persisted. And she discovered she was MSS (microsatellite stable).

“I was like, well, I’m glad that wasn’t a factor in my treatment back then. Like what would I’ve done had that been what they were going to be putting me being a determining factor as to what my treatment was going to look like,” she reflects.

This is why biomarker education matters so much. Your biomarker status determines:

* What treatments you’re eligible for

* How you’ll respond to specific therapies

* Whether immunotherapy is an option

* What clinical trials match your profile

Even with a healthcare background, even with 20+ years of medical knowledge, Marielle didn’t fully understand her biomarkers until years after diagnosis. Most patients have far less medical knowledge.

And yet, most patients are never fully educated on what their biomarkers mean and why they matter.

Defining Advocacy: Giving Others Their Voice

When asked to define advocacy, Marielle’s answer reveals why she’s been so effective:

“For me, advocacy is helping others find their voice, empowering them to champion for others.”

She emphasizes that advocacy looks different for different people. Some excel at policy work. Some at clinical trial research. Some in community settings. Some in industry partnerships.

“There’s not a one size fits all, but in order for you to become a patient advocate, there’s a lot of work that goes on behind the scenes that others are not open to it or exposed to.”

More importantly: you don’t have to be a patient to be an advocate.

“You can still be an advocate regardless of what your role is, because the intention behind it is definitely that driver for you. We’re here to help others, not to elevate ourselves.”

This reframing is crucial. Advocacy isn’t about making yourself visible. It’s about empowering a community larger than yourself.

The Four Buckets of Advocacy: Finding Your Strength

Marielle aligns with the framework of advocacy having four distinct areas:

1. Awareness — This is where Marielle spends the majority of her time, helping people understand their power, their opportunities for knowledge and education.

2. Clinical Trial Advocacy — In recent years, this has become a major focus for her, working with SWOG, FDA, and DOD on clinical trial design and patient participation.

3. Legislative — She doesn’t focus here primarily, but recognizes its importance and participates in opportunities like Call on Congress.

4. Fundraising — This is the one bucket Marielle intentionally avoids. As she says, “I’m great at all of these things. You need money. You tell me, I’ll be your hype person. I’ll recruit people for you. But I was like, I can never put myself in that fundraising capacity.”

The beauty of this framework is that you don’t have to excel at everything. You find your strength and go deep there.

Clinical Trial Advocacy: Bringing Patient Voice to Research Design

One of Marielle’s key focus areas is ensuring that patients have a voice in clinical trial design from the very beginning.

“What I do currently as a clinical trial research advocate is that we bring the patient voice into the various parts of clinical trial and design,” she explains.

This includes:

* Patient reported outcomes — What quality-of-life measures and functionality benchmarks need to be tracked?

* Treatment toxicities — How do we acknowledge and prepare for the side effects patients will experience?

* Practical considerations — How often will patients need to travel for appointments? What labs and blood work are required? What barriers might patients face in participation?

* Access and equity — How do we bring trials into community centers, not just major NCI centers, so patients don’t have to travel hours or days?

One of her biggest champions is bringing clinical trials to community centers—where many patients actually receive their care.

“The data is important,” Marielle emphasizes. “A great deal of patients are being treated at community centers that don’t necessarily, by no fault of theirs, don’t have access to travel to the large NCI centers where majority of these are.”

By removing barriers to trial participation, more patients—especially young-onset patients—will be represented in research data, leading to better treatments for everyone.

Evolution: From Patient to Mentor

Almost nine years out from diagnosis, Marielle’s advocacy has evolved dramatically. She’s moved from finding her voice to helping others find theirs.

“Being almost nine years out, I have found a great strength in my voice. I am a lot more confident with not just how I share my story, but how I empower others,” she reflects.

What she’s discovered she loves most is developing talent in others.

“When I find a particular advocate that is making their way and trying to find their voice in the landscape of advocacy, I love being able to connect and empower them and share other resources with them,” she explains. “Just kind of seeing them grow from afar, sitting in the sidelines for the new generation of advocates has been completely wonderful.”

She calls herself a “jack of all trades, but queen of none”—constantly learning, adapting, and evolving as new treatments and approaches emerge. This flexibility is crucial, because the landscape of cancer care is rapidly changing. New biomarkers, new immunotherapies, new trials emerge regularly. Advocates have to keep learning to stay relevant and effective.

The Purpose That Keeps You Going

Research shows something remarkable: patients with meaning and purpose have better outcomes than patients without.

For Marielle, finding advocacy gave her that purpose during and after treatment.

“When I was going through treatment, there were days that you are very defeated. You can be the strongest person and have the hardest mental health. It is hard, and you have to decide how you show up every single day, not just for yourself, but for others,” she explains.

She kept asking herself: There has to be some purpose behind this.

And then she found advocacy.

“I was like, this is where I’m meant to be. This is what I’m going to use all this experience for.”

This sense of purpose—of using your lived experience to help others, not just yourself—is what separates advocacy that burns people out from advocacy that sustains them.

The BS Meter: Knowing Real Advocacy From Performative Advocacy

Marielle and I share something that comes from years in this space: the ability to sense when someone is doing advocacy for the right reasons versus for self-elevation.

“You could always tell the people doing it the right way, and there are people doing it the wrong way,” I noted. “I always said I had a good BS meter now.”

Marielle laughs. “Sometimes I feel a little bit cynical when my BS meter kind of goes on the upright, but I was like, no, I see it coming.”

Real advocacy is about the community. It’s about empowerment. It’s about leaving yourself out of the spotlight while shining it on the people you’re helping.

When that’s missing, people can sense it.

The Unseen Work Behind Visible Advocacy

One of Marielle’s most important points is this: there’s a lot of work going on behind the scenes that others are not exposed to.

“We do all this hard work, and I’ve loved seeing you with your book and this everyday life following those last few years because it’s true what you say. We have to dig our way up this very invisible mountain,” she tells Tim.

This isn’t glamorous work. It’s not always visible. But it’s essential:

* Research to understand community barriers

* Conversations with healthcare providers about clinical trial design

* Creating culturally appropriate educational materials

* Building relationships with legislators and industry

* Supporting and mentoring emerging advocates

* Continuously learning about new treatments and research

This is the work that happens before the awareness campaign, before the policy change, before the news appearance.

What Marielle Wants You to Know

If you’re newly diagnosed with colorectal cancer, if you’re struggling with a diagnosis, if you’re from a community where these topics are taboo:

Your voice matters. Your experience matters. Your willingness to talk about the unspeakable—colonoscopy prep, bowel symptoms, treatment side effects—can save someone’s life.

You don’t have to be perfect. You don’t have to have all the answers. You just have to be willing to share what you’ve learned.

And if you’re struggling with side effects like neuropathy (Marielle noted she can barely feel her fingertips due to chemotherapy damage), there are advocates fighting to develop better treatments that don’t cause such permanent damage.

You’re not alone. And there are people like Marielle fighting not just for survival, but for quality of life during and after treatment.

How to Connect With Marielle

You can find Marielle on:

* Instagram

* LinkedIn

She welcomes connections and conversations. As she says, “If you see me down the street or an event, just please come find me.”

A Loss That Sparked Purpose

In 2004, Casie Shimanski’s younger sister Kellie died at just 18 years old.

Kellie wasn’t diagnosed with cancer. But the similarities haunted Casie—the symptoms that mimicked what friends and cancer patients would later describe, the multiple organ system failure that doctors could never pinpoint to a single cause.

The loss could have ended there. But for Casie and her sister, Kellie’s death became a catalyst for action.

“My youngest sister is a marathon runner as well, so she also does a lot of fundraising for a variety of organizations, both of us working in memory of Kellie,” Casie explains.

For Casie, that purpose eventually found its way to children’s cancer research through St. Baldrick’s Foundation. But it didn’t start with a master plan.

It started with a photographer.

From Photography to Passion

In 2011, Casie was working as a photographer—weddings, families, portraiture. Through connections and what she calls “six degrees of separation,” St. Baldrick’s Foundation found her and asked if she’d photograph their fundraising event.

She said yes.

“I showed up that one event back in 2011, learned the realities of children’s cancer. I think most people go into it thinking it’s a rare thing. It’s really not that rare. Every two minutes worldwide a child is diagnosed,” she recalls.

In the time it takes to have a conversation, children are being diagnosed with cancer.

At that event, Casie watched women and men shave their heads for the cause. She watched the power of that moment. She saw two women go bald and thought: “I could do that.”

She didn’t shave that day—she was just the photographer. But something was activated in her.

The next year, she brought a friend back. In 2013, she and her dad and now-husband shaved their heads together, launching “Team Live Out Loud.”

She’d made a promise to wait until after she was married to shave her own head. A few years later, when that promise was fulfilled, everything changed.

The First Year: $600 to $200,000

Casie’s first year of fundraising brought in $600. She didn’t even shave her head that year. She was just volunteering, photographing, showing up.

“I raised $600. I didn’t even shave or cut my hair, do anything that year. I was just volunteering and photographing again. And then I think as a team, so that would be, I think we had a team of maybe five or six that year. We raised maybe 2 or 3000,” she recalls.

It wasn’t much. But it was a start. It was proof of concept. It was a spark.

What came next was 16 years of something that most people underestimate: consistency.

Every year, Casie showed up. Every year, she reminded people. Every September, she’d start the fundraising cycle again. Every January 2nd, she’d be back at it. Every March, there was a shave event.

The numbers grew: $10,000 in 2015. When Casie finally shaved 19 inches of purple hair in 2018 (just two days after her wedding), she raised $26,000.” —> the team went on to raise I think $28k+ that year. The years kept building. Now, 16 years later, Team Live Out Loud and Casie are closing in on $200,000 raised for children’s cancer research.

For eight consecutive years, Casie has been a top fundraiser for St. Baldrick’s. Her team has been a top fundraising team for eight consecutive years.

The Secret: Consistency (Not Magic)

When people ask Casie how she raises so much money, they want an easy answer. They want to hear that big checks just roll in. They want to believe in overnight success.

Casie’s answer is harder, and more honest: consistency.

“The number one question I think I’ve gotten over the years is how do you raise that much money and it’s consistency. I think people want the easy answer of I just ask people for money and it shows up. I would love for that to happen. Big checks rolling in, that would make my work a lot easier. But it’s the consistency, it’s the community aspect of it, it’s showing up, it’s doing the work, and most people don’t want to hear that. They want the easy answer and there’s not one,” she explains.

This is the unglamorous truth about fundraising and advocacy: it’s work. It’s showing up when you’re tired. It’s posting when you don’t feel like posting. It’s asking for $5 knowing that $5 is a lot of money in today’s world.

“I am actually really terrible at asking people for money specifically,” Casie admits. “But going back to 2011, Casie asking for $5 is a lot. It still is.”

Yet she asks. Because every year, people say yes.

The Strategy Behind Showing Up

While consistency is the foundation, Casie has learned specific strategies that keep momentum building:

1. Integrate It Into Your Life

Casie got married at the venue where she shaves her head. Her vows included a fundraising ask. Her honeymoon was tied into the fundraising narrative.

“I had posts that were scheduled out to go live, as we said, I do reminding people we are now married. This is a part of this whole weekend event. And just kind of, again, tying people into it that way,” she explains.

This isn’t opportunistic—it’s strategic integration. She’s not separating her fundraising life from her personal life. She’s weaving them together.

2. Build on Prior Momentum

“It is just a lot of showing up and again, sort of harnessing that energy that you built on from the year prior and every year is really different,” Casie says.

She doesn’t start from zero each year. She references previous years, reminds people of what they’ve accomplished together, and builds on that foundation.

3. Make It Feel Fun, Even When It’s Work

One of Casie’s most important insights: if you don’t make it look fun, people won’t want to participate.

But she’s clear: “I have to constantly remind people it’s not easy. I don’t just get to ask people for money and have it show up. I have to keep chipping away at it.”

There’s a balance between making something feel light and enjoyable, while being honest about the work required.

4. Use Multiple Channels

Casie combines social media content, blog writing, videos, podcasting, and one-on-one conversations. She uses email campaigns around World Cancer Day. She paints her nails orange for Children’s Cancer Awareness Month.

“Even one of the things I had my nails painted once for, I think Children’s Cancer Awareness Month, that just orange, and I had a little ribbon on one of them, and I was at a doctor’s appointment and the receptionist asked me, said, oh, I love your nails. And I said, oh, thanks. They’re for Children’s Cancer Awareness Month. And she said, oh, I didn’t realize that was a thing. And we just got into talking and I kind of shared some things, and by the end of the day, she had a hundred dollars at my link, and I didn’t even ask her for money,” Casie recalls.

You plant seeds. Some of them grow into flowers.

The Power of Shaving Your Head

One of the most visible aspects of Casie’s advocacy is shaving her head. But what does that actually accomplish?

“A lot of it is, it’s a conversation starter and it is really showing the kids that bald is beautiful,” Casie explains.

Children with cancer lose their hair from treatment. Seeing adults voluntarily shave their heads sends a message: bald is beautiful. You’re still beautiful.

“You have girls of all ages from high school to two years old losing their hair. Hair. And so showing them that bald is beautiful. It’s actually one of my favorite looks,” she says.

This is also why she doesn’t need your hair—she needs your money. The hair is symbolic. The money is what funds the research that keeps children alive.

Understanding the Need

Casie has educated herself and others about the realities of children’s cancer:

* Every two minutes, a child is diagnosed with cancer worldwide

* One in five won’t survive

* Of those who do survive, an overwhelming majority will have lifelong disabilities, disorders, or diseases

* Children are often treated with adult chemotherapy and radiation doses, even though a child’s body is smaller

* There are 27 different types of children’s cancer, many with no connection to behavior or lifestyle (kids don’t smoke, don’t drink)

* Children are treated in hospitals when they should be living normal childhoods

The research St. Baldrick’s funds is working toward safer treatments that will extend lives, not just by years, but into healthy seventies and beyond.

Defining Advocacy: Consistency With Heart

When asked how she defines advocacy, Casie’s answer reveals the philosophy behind 16 years of work:

“It’s really just showing up continuously for a cause. And usually that cause is something you’re quite passionate about, but it’s the consistency part of it. Yes, I know the facts and the stats and I can kind of rattle off numbers, but it’s the heart behind it and why it’s so important and why this cause needs attention.”

Consistency. Heart. Purpose.

Measuring Impact Beyond Numbers

While Casie tracks the dollars—nearly $200,000 toward children’s cancer research—she measures impact in other ways too:

The work itself: She puts in at least 200 hours of volunteer work almost every year. She’s done legislative work, advocated for funding, appeared at events across the country.

The quiet after the storm: There’s a pattern to her energy. She fuels it, pushes through to March, then has a “lull” where she recharges. But she always comes back.

The stories: A woman at a doctor’s appointment who saw her orange nails and ended up donating $100. People who tie their participation to major life events—anniversaries, milestones, memories.

The momentum building: Every thousand dollars funds a potentially lifesaving clinical trial. Team Live Out Loud has generated enough to fund 200 potentially lifesaving trials.

The Pragmatism of Advocacy

Casie is remarkably pragmatic about her work:

“I obviously look at the numbers. Oddly, I’m not a numbers person either, but the past 16 years have shown me that I actually am.”

She knows exactly where they stand toward their next milestone. She knew 2024 would be difficult, so she set a realistic goal of $5,000 (just to hit $200,000) instead of pushing for more. But in difficult years, they’ve still raised at least $10,000.

“I’ve had to train myself to not just assume that or not take that number for what it is, but also what I’ve put into it,” she says.

This is important for anyone considering fundraising or advocacy work: results are tied to effort. If you want different results, you need to put in different work.

The Vision

When asked what she’d like to see happen, Casie’s answer is simple but expansive:

“I would obviously love to find a cure for all of them.”

But she also knows the practical path: better science, more funding, better legislation, more research backing. She knows that every thousand dollars funds a clinical trial. She knows that if the money flowed differently in the world, they could do so much more.

For now, she does what she can—and she does it consistently, year after year, with heart and a sense of community.

How to Support

Casie’s fundraising link is active year round. Because of how she’s set it up with St. Baldrick’s, every link redirects to the current year’s fundraising page, no matter when you donate.

You can find her easily by searching her name online. Her handle is Captain Casie, and her team is Team Live Out Loud.

Whether it’s $5, $100, or more—whether it’s during the intense March fundraising push or in the quiet months after—every dollar goes toward research that keeps children alive and gives them back their childhoods.

What Casie Wants You to Know

If you’re thinking about getting involved in fundraising or advocacy work, know this:

It’s not as easy as it looks. But you can make it look easy enough that people want to participate.

Consistency matters more than dramatic gestures. Show up. Do it again next year. Do it the year after that. The compound effect of showing up is what changes outcomes.

You don’t need perfect conditions to start. Casie started with $600 and no clear plan. What she had was a cause, a willingness to try, and a commitment to show up again the next year.

People want to be part of something. They want to feel the heartbeat. They want to know their $5 matters. They want to see the work being done. Give them that, and they’ll return year after year.

Most importantly: “I need your money. The hair is a nice to have.”

Your support matters. Your consistency matters. Your willingness to show up, again and again, is what changes lives.

To learn more about turning your own health journey into purpose and impact, visit

https://frompatienttoadvocate.com

where you’ll find resources, stories, and practical guidance for advocates at every stage of their journey.