My Career Choice: Sage Bolte – Executive Director, Life With Cancer

Surviving cancer is bittersweet. Yes, the individual goes on living, but the life that follows will never be the same. Those managing this transition are fortunate to have someone like Sage Bolte guiding them. As the executive director of Life with Cancer, Bolte works with cancer survivors and their families helping them to find a new normal that will work for them.

Bolte came to Life with Cancer in June 2004, after completing two years of psychosocial oncology research and patient care at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. Sage joined the staff to help develop a program that specifically addresses the needs of the women, men and families impacted by metastatic breast cancer. She provides individual, couples and family counseling and facilitates several support groups including the breast, metastatic breast and young adult groups. Her areas of interests and expertise are sexuality and cancer and the various issues that face those both those with metastatic disease and the young adult population. She received her master’s in social work from the University of Michigan and graduated in May 2010 with a Ph.D. of social work from The Catholic University, in Washington, DC.  Originally from the West Coast, Sage resides in Fairfax County with her husband, Jeff and sons Gavin and Jecen.

For more information, go to her website.

Can you point to one event that triggered your interest in your career?
Absolutely. The third day of my internship for my master’s degree was on September 11, 2001. I was working in the radiation oncology department with patients who were in the middle of their cancer treatments. In the waiting rooms they sat huddled together watching all of the events of that day unfold. They were already so vulnerable and going through their own personal crises, and I was so moved by their resilience and strength in the midst of this national crisis. It also shed light on the fact that people have the ability to withstand tremendous challenges and are often much stronger than we give them credit for. I was inspired by the way they took care of each other and further inspired by the health care professionals I was working with as they continued focusing on the task at hand—caring for each individual person—despite what was happening in our world. It was a life changing moment, and I remember thinking, “These are the kind of people I want to work with and for.” I knew I would forever be working in the field of oncology.

My interest in sexual health and cancer was brought about sort of serendipitously. Early in my career I realized that people diagnosed with cancer often faced multiple assaults to their sexual health, body image, sexuality, etc., and there was little information being provided to them about how they could address these changes. Interestingly enough, I have always been comfortable with discussing the topic of sexuality and sexual health. Through great mentors and colleagues who nudged me (well, forcibly pushed me!), I started creating lectures and writing around this topic, which inspired me even further to get my sex therapy certification.

What about this career choice did you find most appealing? 
I chose social work because I believed in the philosophy of the field that advocates for the wellbeing of individuals, communities and the larger society as a whole. I knew I wanted to do oncology social work because of the population and the variety of ways that I could interact with patients and their families. What was so attractive about the field of clinical social work is that it offers both the clinical and therapeutic skills needed to provide support to an individual/family, and also integrates the importance of the many community networks, social structures, etc., that are critical to a person’s wellbeing and success.

A cancer diagnosis is truly life changing, and these individuals are willing to open up and have a dialogue about topics that people don’t often talk about like body image, sexual health, dying, loneliness and fear. There is often such an open awareness of life and a willingness to explore strengths they didn’t know they had, fears they had been avoiding or questions about “who am I, what in my life is meaningful,” that it is a complete and total honor to work with people in this significant but often small segment of their lives. People frequently say, “Gosh Sage, your work must be so depressing,” and I have never found that to be true. Certainly there are moments that are sad or moments when I cry with or for a patient I work with. However, I always say that it is an amazing honor and opportunity to walk with people and help them construct a life after cancer that they desire. If their cancer is incurable, it is an incredible gift to be able to help people walk through the last phases of their life and define their “best death.”

At Life with Cancer, which is the educational and emotional support program of the Inova Schar Cancer Institute, we are able to serve individuals in our community who are impacted by cancer regardless of how cancer has impacted their lives and at no cost. From wellness and exercise programs to educational seminars and family counseling, we’re working hard every day to be a one-of-a-kind source of support for our friends and neighbors in the metropolitan DC community. Being a part of this and being able to serve the community in this way is extremely fulfilling.

Working with people to help enhance the ways they feel about their sexual selves during and after a cancer diagnosis is unbelievably rewarding. I knew I would forever be working in the field of oncology; I can’t imagine doing anything else.

What steps did you take to begin your education or training?
I started by getting a dual bachelor’s degree in psychology and social work at an accredited college. Knowing that I wanted to do more clinical work and counseling, I also received a master’s degree in social work. I felt I might be able to make a bigger dent in the care of persons with cancer if I had my PhD and could do research that might inform practice. To be honest, while working with physicians and many others with terminal degrees in a health care system, I believed it might also be helpful to be introduced as a peer leader.

Along the way, were people encouraging or discouraging?
I’ve never had anyone try to discourage me, though sometimes people ask if I wish I chose a career that made more money. I didn’t set out in this career to make a lot of money, but I feel that this is what I was called to do. I’ve had phenomenal mentors along the way from various disciplines who have given me incredible platforms and I truly feel that I’ve been encouraged by those mentors. The feedback I get from patients and loved ones I work with has been positive, as they confirm that the work in sexual health and recovery has been critical to their overall quality of life.

I’ve also been really encouraged by the support Life with Cancer has received from the community. We only receive 30 percent of our budget from Inova Health System and rely on support from the community in order to provide our services. Every donation counts toward helping continue the great work we do.

Did you ever doubt your decision and attempt a career change?
Never. The only thing I’ve ever considered after I received my PhD is getting a medical degree, but I realized that doing so might mean losing the type of patient contact that I currently have and love. Besides, I am not sure my family could sustain me going through another several years of education!

When did your career reach a tipping point?
I feel like right now I am on an exciting trajectory in my career as I recently made a decision to move into an administrative role as executive director in which I am less of a direct care provider (although I am still maintaining a small clinical practice). This administrative role has allowed me to continue to grow my skills and best advocate for my patients and their loved ones.

Can you describe a challenge you had to overcome?
Finding your place as a social worker in general can be a little bit challenging and sometimes daunting. When you are part of a healthcare team full of phenomenal providers, social workers can be seen as the icing on the cake or the bottom of the totem pole rather than a needed ingredient. As social workers, we have to advocate for our profession and why it matters to help patients do well during and after their experience, which can be challenging. Our oncology social workers and I have been fortunate to receive incredible support not only from the leaders and staff at the Inova Schar Cancer Institute, but also from colleagues at Life with Cancer.

In order to create change, I’ve had to learn a lot about myself and the people I work with and for. I have a very strong personality with lots of ideas and high energy, and I have learned this can be overwhelming for some people. Therefore, I’ve had to learn that going into a situation as a “tornado” is not always the most effective strategy and less may be achieved. Again, great mentorship has helped me stretch and challenge myself in ways I never would have without honest and sometimes painful feedback. I’ve learned to really think about how my passion might be interpreted and think about whom I’m working with, the best way to approach them and what their needs are. This approach has helped me slow down when necessary to achieve both my goals and the goals of those I am working with.

Outside of work, I’m also constantly learning how to be an engaged parent and a supportive partner while continuing to grow my career. Being a career mom is definitely a tough balancing act.

What single skill has proven to be most useful?
Active listening.

What accomplishment are you most proud of?
I’m so proud that I go to work every day and see that my colleagues love what they do while always remaining fully supportive. It’s also a point of pride to see so many people using the services that we offer at Life with Cancer–there were 30,000 visits last year alone, which tells me that the work we’re doing every day is really making an impact.

In the midst of working full-time and growing a career, I’m also really proud to have been able to get my PhD (through two pregnancies), maintain activities that bring me balance and still be home every night to make dinner for my family.

Any advice for others entering your profession?
Networking and mentoring are absolutely essential in order to make the connections to grow your career. I would advise people not to go into this field if you’re looking to solve your own problems or if you want to be a millionaire.

You need to be comfortable sitting with the unknown and you have to be willing to accept that not everything is fixable. Cancer can’t always be “fixed”, but the ways we can learn to cope with it and the skills we teach at Life with Cancer help improve lives in spite of an illness.

This is an incredibly rewarding field with incredibly diverse ways and settings to apply the degree. I certainly am biased toward health care and oncology social work, and believe a career as an oncology social worker is one that affords much opportunity that is both professionally and personally gratifying.

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