Natalie Elliott Handy (with her sister JJ Elliott Hill) 7/29/25

(This interview has been edited and condensed for length)

Zack: Natalie, thank you so much for being here. Could you please share your caregiver story with us?

Natalie:  I'm happy to be here and happy to share my experience. I have been a paid caregiver because I've worked in the mental health field for over twenty-five years, and I've worked with children, foster families, and their families. But it wasn't until my husband was diagnosed with a head and neck cancer in February 2022 that I came into the caregiver role.

Like so many other caregivers, I never self-identified as a caregiver. I was simply my husband's wife. We had this terrible diagnosis that had been given to us. When he went to the doctor, he had no clue that he was going to be diagnosed with cancer. We just thought something was wrong, and nobody ever dreams that it's going to be something as terrible and what feels like a death sentence. And the reality is that it wasn't a death sentence, but it took some effort to get to the right place and to get to the right care. … we are big believers in God, and God had his hand in every bit of his treatment in the direction that we went.

We live in Virginia and moved to New York City to receive treatment at Memorial Sloan Kettering… When we went up there for his second opinion, he was eligible for a clinical trial that reduced his radiation and chemotherapy treatments in half… And for two months, we lived in the City, and we went back and forth, and we did all the treatments and things like that.

And I'm going to tell you, I'm a mental health professional. I train on regulation… I train on how to get calm, to remain calm in stressful situations, because I deal with crisis situations all the time. I can tell you I wasn't remotely calm at times… my emotions were going up and down. And I used a lot of my strategies, like when I would write and update people about how Jason was doing, it ended up turning into my journal.

During those times, there were a lot of interventions and strategies that I applied that I didn't even realize I was applying to myself. And by the way, I worked the entire time. I am someone who is a working caregiver. I took intermittent FMLA and only took off three and a half weeks during the ten months from the beginning of diagnosis to when I felt like I could be back at work and my brain was working. I didn't self-identify as a caregiver until after I had returned home from his treatment…

The first time that I took some time off was when I came back… I could not figure out what I was supposed to do next because my life had just been these appointments and getting from point A to point B, and the ups and downs. I felt like I was on this bipolar high. And when I came down, I really did crash. And that's when I talked to my amazing sisters, who were huge supporters for me.

JJ is my older sister. I always like to point out she's older than me. So, if you do see a photo, you will notice a difference. And, everybody will know that I'm completely lying, Zack.  Because JJ looks like the youngest out of all of us. Then I have an amazing younger sister, Emily… who moved from another state to care for my animals. She was a caregiver to a caregiver. She lived in my home for two months so that my animals were taken care of because for Jason and me, our children are our dogs. And so that was very important for us and something we didn't have to stress about…

So, I said to the sisters, I don't know what's wrong with me. I feel angry. I feel depressed. I feel all these different feelings. And, they said, “Wow, me too.” I think at that moment, we started acknowledging the feelings and emotions of caring for someone else. And that's when we realized and finally self-identified as caregivers.

Zack:  I'd love to hear a little bit from JJ's perspective… JJ could you give us a little bit of insight, what it’s like to be, as Natalie called you, a supporting actor to your sister, who was the caregiver?

JJ: … My sisters are my heart, and I'm the emotional one… Natalie did a great thing while she was going through that, and that was she expressed her emotions. She shared the story on Caring Bridge, so everybody was kept up to date. But for her to call and for us to hear her stories, just to be an ear… even to talk to Jason during the times, and to send jello or pudding because we needed to get his proteins up… There was nothing that we really could do, and I think to be that supporting actress, that supporting caregiver, you just needed to be there. I just needed to listen to her. I think that out of everything that Emily, our youngest sister, and I could have done, was just to listen. I was scared for her, but you don't want to tell her that… But, just listening to… what she's going through was what she needed the most.

Natalie:  And that validation for me was crucial… Sometimes I just need to say the things that don't feel socially appropriate. I need to say I'm having a really hard time, and I'm mad or I'm angry because I can't do this, or I'm not doing this right. And mostly, my anger and guilt and fear that I experienced as a caregiver were related to my feelings of self-doubt and inadequacy because I don't make any qualms about it. I cannot cook for nothing. And in my mind, I was going to cook, and I was going to do these great things because I'm good at work, but I am not good at cooking. When I failed, and I mean failed, but the reality was I didn't fail. Jason had his head radiated, and so his mouth was like the sun. It was burned. They told us. They described that when he swallowed, it would be like swallowing glass. There wouldn't have been anything I could have given him or made for him that would have been okay. I had to find alternatives that helped me to preserve both my sanity and my relationship with him, and the sisters always talked me off the edge.

When I was a full snot sandwich crying, saying I'd felt like I was just doing a terrible job, and Emily or JJ would be like, I got you. And then magically, sometimes things would arrive, like a case of protein drinks, and Jason would call JJ. And even in those moments when my husband was talking to JJ, he gave me a break because it allowed him to share his experience with somebody differently, and I could just have a moment to myself. I mean, I have great sisters.  I don't care what they say about them. I like my sisters.

Selma:  Natalie, a lot of times when people want to support caregivers, they say something like, “Just let me know what I can do to help you.” One of our podcast guests commented that it places an additional burden on the caregiver to come up with what they need and that people who want to help should tell them how, like, I’ll make you a meal, or clean your house, etc. What are your thoughts about that?

Natalie:  I would agree with that wholeheartedly, and I will tell you we were so blessed to have people. But I would say the thing that was very different…is think about how well you know the person? And when somebody makes it personal, that really demonstrates a level of caring that is hard to find. It is a true authenticity… I didn't ask JJ to send me Ensure, but she did because she heard me… JJ knew I needed some Ensure because she knew I didn't even know what Ensure was. I think it's when you can personalize and number one, listen. Just listen. And then say, I'd like to do this for you. And sometimes you just do it and let it show up.

Zack:  There was a term you threw out, Caring Bridge. Could you please share with our readers what Caring Bridge is?

Natalie:  Oh, yeah. Shout out to Caring Bridge. We love the Caring Bridge. And, friends, I'm going to tell you, this is caringbridge.org, and you can go to their website. It is an online place where you can provide updates and invite people to check in, and they do take donations. But the reality is, because this is their nonprofit, that's how they get paid for the platform… A friend of mine recommended the Caring Bridge because I was sending out every update... I would send out between 15 and 20 texts to different text groups. And it became a job… It was not my job to update people about my husband… So, what she said is you're going to drive yourself crazy trying to please people… So, I went to Caring Bridge and I put in pictures. I made it funny… Because if you're not laughing a little, you're probably crying…

Zack:  I love it. Thank you for sharing that. Now to the quick question for both of you. Briefly, tell us how work was impacted, both as a caregiver and as a supporting caregiver. I mean, we all know about absenteeism, presenteeism, fatigue, exhaustion, and burnout. How did this impact your work?

Natalie:  I'm going to tell you I was fairly annoyed by Jason's cancer because my career was going in a very good place. A month later, I was named CEO of a behavioral health company in Virginia… I should have told my boss that we needed to delay it. And he was like, Oh, you can do it. And I was like, of course, I can do it. Superwoman. Of course, I can work full-time while my husband's going through the worst cancer treatments, but that's fine. I will tell you, do not do what I did. The best thing that happened to me was a very kind HR person named Heather Hinkle. She said, Natalie, you need to take intermittent FMLA. It protects you because I didn't want to take it. I didn't want people to think that there was a problem. I didn't want people to think I wasn't good enough. I mean, this is about me. There's the external sign, but then there's the me. So, I kept working, and I worked any time that Jason was in treatment or sleeping, I worked. It's exactly why I crashed and burned. It was exactly why I always used to think I was the only person who would argue with a cancer patient. I know I'm not. But it was because I did not do a good job of allowing myself to grieve what was going on.

Ultimately, and this is not uncommon, after I got back, I was very disenchanted. I had less patience for my work, and I was very dissatisfied. It was one of the reasons we started the podcast, because I was so unhappy. I ultimately quit my job six months after. And most people would be like, Who would quit your job as CEO? And I'm like, me. Because I was different as a caregiver. When I started on February 13, I was a different person. When he got diagnosed on February 14, everything changed. And going through that experience, I was different, and that's okay.

Zack:  How about you, JJ?

JJ:  As the best supporting actress, which is my title, I will tell you, I was in corporate America. I was in the banking industry for almost twenty years, and I was not in that role when Jason went through his cancer treatments… I own my own business, and I had a free schedule, and I could close my door and tell my staff I'm on the phone with my sister. I could sit in my office and cry with her if I needed to, and that was okay. I don't think I could have ever worked for a large bank and been in tears and said to somebody, I'm on the phone with my sister, and I need to cry with her too. You know? They've had a really bad day.

Natalie:  … Do you think that's the culture of your employment, though that didn't permit you to have those moments, no different than women who need to breast pump?... When you think about it, what did your employer tell you? Because you perceived that you didn't have permission to do that. Right?

JJ:  … I think it would be a sign of weakness. Like, I don't know why you're bringing that here at work. And I'm like, well, it didn't arrive at 10:00 at night. It arrived at 10:00 am, and I got to handle it now. She wasn't having a breakdown last night at 10:00. We're having a breakdown this morning at 10:00. And I think, regardless of if you are employed, I think having to be that emotional or having to take those phone calls and to say having to be that caregiver's caregiver in that position, it's not acceptable. It's like, well, your husband doesn't have cancer, so you're not allowed to take this moment. I think it would have been very different if I had not had the freedom to say, Hey, guys. I'll be back.

Selma:  Natalie, did you share with your employer that your husband had cancer and you were his caregiver?

Natalie:  100%. And remember, my boss was the owner of the company. I had been promoted to the CEO position, and there was never a moment when he paused to say, Maybe this isn't the right time. But my personality, I know this is going to come across as surprising, but I am a dominant personality, and I am a type A. And I just think I can do it all… I made Jason's cancer diagnosis and everything else another task on my to-do list. I mean, learn from me, people. I don't mind… I would rather acknowledge the false thinking that I can do this all… and it wasn't healthy for me, period.

Selma:  How did that crash and burn show up? What did it look like?

Natalie: I remember very specifically… I came home. My home felt very foreign to me. Jason felt like he had left cancer in New York. That's how he associated it. I missed New York. I missed all the liveliness. I don't know why I missed it, but I just missed it… I remember very clearly sitting at our kitchen table, and Jason said to me, “What are you going to do today?” And I looked at him and I said, “I have no clue, and I don't even know where to start.” … I felt like Stella had lost her groove, and I needed to have something to pull myself back and to feel passionate about because I wasn't passionate about what I came from, and I had no clue I was experiencing caregiver grief.

Zack:  I heard you on a podcast say two things that were striking to me. One, that cancer was a mistress. And two, that you don't feel your role as a wife anymore. Can you share a little bit more about that?

Natalie: Yeah. Both things are true. What we didn't realize was that we thought we left the cancer in New York. And then when we came home, she sat right in between us. Every commercial. Like, you don't realize until you have a diagnosis or tell something specific. And then it was like cancer's on TV, cancer's in a newspaper, … And Jason just wanted to forget that it had ever happened. And she just sits there, and anytime we would have a closeness or a moment that felt like normalcy, she showed up. It wasn't until I accepted her and welcomed that this is a part of our life. It does not define who we are; it is a piece of who we are that she faded into the background. 

Now I've talked about this, and I appreciate you bringing it up. I calculated, while we were gone, that I had done during the week 42 different roles. I've been in utilization review… If you talk about all the roles that caregivers do, I had calculated 42 while Jason was getting his hydration. I call it a spa day when he was getting hydration from chemo. And on the list, you would not find wife. And it took close to nine months after coming home for us to feel, I don't want to say intimate from a sexual nature, but intimate. I had been telling Jason what to do like he was an employee for months. To shift that and bring us back to an equal positioning so that we're husband and wife, that took a lot of time to relearn.

And I was slightly pissed about the fact that this is what our life is. We did not expect this to happen, and our life was really upside down, and we were trying to find the new normal. And I'm going to tell you, you can't go back. And the question you have to ask yourself is … what are you going to take with this opportunity? … I can remember sitting at Sutton Place Park. And I remember looking at Roosevelt Island and the sun shining on us, and we were just like everyone else. No one knew we had cancer because I felt like I had cancer too.