What Resilience Means

Episode 1: What Resilience Means 

What does resilience mean when a child is sick? Clay Culp, Janet Sellers, and parent Sara Lohse talk about resilience, or the ability to bounce back, when a child has a serious illness. Sara says “resilient” is the last thing she felt as her family navigated her daughter Madi’s cancer diagnosis and treatment. She shares one of the hardest moments their family experienced. The group talks about how resilience can mean acceptance and taking the next step.

A special thank you to our host Clay Culp, senior social worker at St. Jude; Janet Sellers, manager of the St. Jude Staff Resilience Center; and parent Sara Lohse.

Learn more about Madi’s diagnosis of acute myeloid leukemia (AML) and emotional support and daily life on Together by St. Jude™.

This episode was recorded April 24, 2025.

The book that Sara references in the episode is It’s Not Supposed to Be This Way by Lysa TerKeurst.

St. Jude does not endorse any branded product or organization mentioned in this podcast.

Episode Transcript

Narrator (00:02) 
A child's diagnosis of cancer or another serious disease is difficult. Families, guardians, and loved ones experience a range of emotions and often need support related to their child's diagnosis and treatment. St. Jude Children's Research Hospital brings you Caregivers SHARE, a St. Jude podcast. SHARE stands for support, honor, advise, reflect, encourage. In this series, you'll hear stories and insights directly from the experiences of St. Jude families and care providers.

Clay Culp (00:37) 
Resilience is a term that comes up a lot when a child is sick, but what is it that actually helps families be resilient? I'm Clay Culp, a senior social worker at St. Jude Children's Research Hospital. In this episode of Caregivers SHARE, a St. Jude podcast, I'm talking with caregiver Sara Lohse and resilience expert Janet Sellers about having resilience as your child goes through serious illness. Janet, can you introduce yourself?

Janet Sellers (01:05) 
Sure. I'm Janet Sellers, manager of the Resilience Center at St. Jude, and this topic is important to me because I know that deep down, we are all inherently resilient. We come to this time and place having navigated the ups and downs of our life and knowing that we can be intentional about practicing resilience and further strengthening that important muscle. Resilience involves vulnerability, acceptance, and seeking support.

Clay (01:34) 
Sara, could you introduce yourself and tell us a little bit about your journey?

Sara Lohse (01:38) 
Sure. So, my daughter Madilyn was diagnosed with acute myeloid leukemia in January of 2020. She was presented just with some regular cold symptoms. We brought her back and forth to the doctor, and we went from cold to, I'm really sorry, your child has cancer, in the same day. It was obviously very traumatic. With that cancer diagnosis also came and you’re moving out of state for the next six to nine months to go fight for her life.

And as you can imagine, that was very traumatic for our family. And… it was hard—it was hard not just to receive that news, but then to have to leave at a moment's notice. It definitely shattered our family and set a journey ahead of us that was life-changing. But today, Madi is 15. She is a freshman in high school. And if you looked at her, you would never know that she was sick. She is healthy, she is thriving, and she is truly living every parent's dream for what they would want their child to be. And I am so proud to be her mom and to look at her.

Clay (03:23) 
Wow. Talk about resilience. I'm excited to hear more of your story and get that out to our listeners today. But before we do, let's talk a little bit about what resilience actually is. I find that it can be hard to put a label on it or to put words to it exactly, but we're going to try. So, Janet, maybe start with you. How would you describe resilience?

Janet (03:47) 
Sure. I think of resilience as the opportunity to acknowledge the struggle and discover tools to help. So, resilience isn't about saying that something isn't good and calling it good, right? It's not making everything positive or everything okay, but it's recognizing, this is difficult, and, what’s my next intentional step? This is hard, this is not what I want, and what can I choose now? What can I do now? How can I move forward? It’s that intentional choice, even when things aren’t so good.

Sara (04:23) 
That's really good, Janet, because I felt like when Madi was diagnosed, I felt like our whole world was just turned upside down, right? I wasn’t thinking of being strong. I wasn’t thinking of, wow, we’re just really ready for this fight. People kept saying things like, Madi is such a fighter, and you guys are so strong. But I didn’t feel that. I felt broken. I didn’t know which way was up. I felt like I had been knocked down.

For me and my family, I felt like we were operating from a place of brokenness and unfamiliarity. I liked control, and I felt like things were out of control. When we got to the hospital, I remember Brandon—my husband—looking at me and asking, Are you ready for this? I felt like I just wanted to smack him, because I think he was just saying that in desperation, not really knowing what else to say. We didn’t know what emotions to have. And I just didn’t want to be there. I didn’t want my kid to have cancer.

Clay (05:38) 
Well, Sara, you said something a second ago about I felt like we were broken. When I think about resilience, I’m thinking, what is our stance toward life when we’re in that broken place. It’s sort of a way of approaching ourselves, the people around us, and the suffering that we’re experiencing. I’m curious—what were some of the things that helped in the moment, even while you were facing that brokenness? What did you do to tap into resilience?

Sara (06:14) 
That’s a really good question because I don’t think you’re really thinking about resilience in the moment. You’re in survival mode. You go from feeling like a victim of something really hard that happened to you, to living one step at a time—eat, breathe, sleep. Everything I was doing was to fight for my child’s life. I wasn’t really thinking of myself or how I could grow stronger. I was just trying to grasp every daily move one step at a time.

The number one thing I wanted to do was isolate and be by myself. I had to force myself to, first of all, accept help and learn to speak up and advocate for myself. That meant allowing others to make meals for my family and accept help when I really wanted to do it all on my own. I had to learn to be what I call “blessable,” which was really hard for me. I wanted to do everything on my own, but I just couldn’t be everywhere at once. I had to rely on the strength of others around me. Because we were out of state, I had to rely on families back at home.

Janet (07:54) 
There’s so much of what you said that underscores what resilience can look like. You didn’t always recognize it in the moment. You didn’t see yourself as being resilient. You just saw yourself as taking the next step—eating, sleeping, and breathing. Simple things, right? But those underscore what it can mean to be resilient, what it might look like. It doesn’t have to be something grand and big, but just showing up and just being there. 

Even in our weakest moments, when life feels like dust and we feel shattered, we can still be strong. Strength in those moments might look like just showing up, just breathing, just taking care of ourselves, and just continuing to be there. Even in the midst of the dust, there is strength and power in that resilience.

Clay (08:51) 
You know, I’m also struck by this idea that resilience isn’t just about what’s inside of us. It’s also something we do with others, actually.

Janet (09:06) 
Yes, I think resilience is something that we can demonstrate and use to take care of ourselves, but we can also see the strength and resilience in others. That can then become an inspiration for us. Sometimes it’s your child you’re caring for—you want to be a strong role model for them. But then there are also times when they are resilient and you are struck by that, inspired by their example.

Sara (09:30) 
Oh man. I feel like the simple mind of a child is so amazing. I was a wreck most of the time. There was one day we came into the hospital and the entrance had been changed. It was something simple, but we had gotten so comfortable with routine, and that routine gave us safety. On that particular day, the entrance was closed, so we had to check in at a different table. I cried. It sounds silly, but that was how maxed out I was.

Here was Madi, weak and beat up in a wheelchair from all of the treatments, and she looked at me and said, Why are you crying, Mom? It’s just a different entrance. Let’s check in over there. I remember thinking, I don’t know why I’m crying. I was just so maxed out. But to see the resiliency and the tenacity of my child, to see how she always just took things as they came, taught me something profound.

She never seemed overwhelmed, while I constantly felt like I was operating at a base level. She was always up for the next thing. She was always ready to find something fun to do. The tenacity and resiliency of kids really taught me to keep things simple, to take each day for what it was. She never got too far ahead of herself.

Someone once gave me advice: Sara, how would you eat an elephant? Meaning something so big and overwhelming. The answer: one bite at a time. I remember thinking, you’re right. I could get myself so far ahead of things I couldn’t control, but if I just take everything moment by moment, like Madi did—even in those silly moments like the hospital entrance—that taught me to keep it simple. 

Clay (11:37) 
I love that example. You talked about Madi’s tenacity. To me, in that way, she really was a fighter. But at the same time, you’re highlighting something different—this idea of surrender in the fight. Allowing things to be as they are. When you told that story about Madi, about her just going with the flow even when things were unexpected, it reminded me of that idea of surrender in the fight.

Janet (12:15) 
Well, and resilience can mean acceptance without agreement.

Sara (12:20) 
Yeah. Right.

Janet (12:20) 
Having a child with a cancer diagnosis and going through treatment doesn’t mean you have to like it, or welcome it, or certainly want it. But being resilient can mean accepting it and saying, This is where we are, and this is how I’m going to show up. This is how I want to be for my child. This is what I want them to see in me. This is who I want to be. That idea of acceptance, or surrender as you so beautifully said, Sara.

Sara (12:49) 
There were so many times when I knew I couldn’t control the outcome—the ultimate outcome of this journey. But I could control how we were going to do this journey. I wanted to be an example for Madi. But what amazed me was how much she taught me too.

There were many times when I had to sit back and think, How do I want to do this? How do I want Madi to look back and remember our time here, no matter how much time we had? I’m thankful because Madi remembers the good and the fun. She doesn’t remember much about the treatment. She remembers the one thousand card games we played, the makeover parties, the movies, the zoo, all of the fun memories. I am so thankful for that.

But I am also thankful for the times when I consciously decided to put away what was feeding my fear and to focus instead on what was feeding my peace. Sometimes that meant reading or learning, growing in my knowledge of her diagnosis and treatment. But other times, I had to set that aside and spend time with my child. I had to figure out what was feeding our joy, giving me time to breathe and enjoy the moment, instead of what was feeding my fear and making me more anxious and trying to control the situation.

So I had to take captive of my mind and my mental health, such as taking time to take a walk. That looked different at the beginning, the middle, and toward the end of our journey. In the beginning, it was simply lying there.

Janet (15:10) 
That’s such a good point, because resilience is flexible. What works at the beginning of a journey might not be the resilience strategies you need in the middle, or even at the end. You have to be open to changing what you need along the way. There isn’t one right way to do it.

For some people, taking a walk might be what they need. For others, it could be phoning a friend, having a conversation, taking a breath, talking to a professional, or being part of a support group. There’s no one way. The important thing is to recognize, Whoa, I need to do something right now.

Sara (15:48) 
One thing that was really important, and that I had to learn, was to have grace for myself. I didn’t feel like I was enough a lot of the time. I didn’t feel qualified. There was so much I had to learn. There was a lot of guilt and shame. I remember one of the first things our doctor said when we arrived at the hospital was, This is not your fault.

I was Madi’s mom, and I felt like, What did I do that brought us here? Hearing This is not your fault released a lot of that guilt. I was supposed to protect Madi—so why were we in the hospital? Part of being resilient was releasing those thoughts, because they wasted mental energy I needed to save for Madi. I had to focus on lightening the situation and making our journey healthy and good. Having grace for myself provided a cushion, knowing that I wasn’t going to be productive like I would be on a normal day at home. It meant having patience and grace for myself and the situation and trusting the process.

Janet (17:10) 
Yes. Resilience isn’t about doing things perfectly. It’s just about doing the next thing.

Clay (17:17) 
I’m so glad you said that, Sara, because that was exactly what was on my mind—the word grace. In my experience as a social worker, parents put so much pressure on themselves. You think, If I’m tougher on myself, if I beat myself up, that will motivate me to do everything I need to do and to be resilient. But in reality, starting with kindness toward yourself is what actually gives you the space and freedom to take that next right step.

Sara (17:52) 
Yes. And honestly, for me it was a discipline. It was a conscious choice. Because honestly, it’s easier to be hard on yourself. It takes discipline to say, Sara, have some grace. Have some compassion for yourself in this situation. It’s something I’m still working on, even after this journey.

Clay (18:18) 
I love that—it’s easier to be hard on yourself. That resonates with me so much. And it reminds me of something else you said earlier, because I think about grace, and I also think about hope. I know hope has been so important in your resilience, but you also said hope can be uncomfortable. Could you share a little about that?

Sara (18:44) 
Sure. One of the hardest days in our journey was when Madi wasn’t doing well. She was in the ICU, hooked up to all the machines. Brandon was out of state taking care of our other kids, so I was with her alone. She had a procedure to clean out some infection in her lungs. It was supposed to be routine, but her body was weak.

Afterward, they said she wasn’t coming off some of the supporting machines. That wasn’t what we were expecting. The doctors told me, We think it’s important that Brandon get here as soon as possible. Madi may not make it through the night. That was really hard. That was our lowest day.

We live about six hours away, and in that moment I could have lost hope. But I thought, maybe now my hope just needed to change. My hope became, I hope my husband can get here in time. It became smaller, closer, but still hope. We weren’t going to lose hope because hope was going to get us to the next step. We called Brandon and he got there as soon as possible. It was during the pandemic, in 2020, so only one caregiver was allowed.

When he arrived, I hadn’t seen him in a long time. We hugged each other, and then I watched him walk into the room, collapse onto Madi’s bed, and I had to leave. Hope was really hard that night. Hope was uncomfortable. But I knew I couldn’t let go of it. I didn’t know the outcome, but I couldn’t lose hope.

Madi made it through the night. The sun rose the next morning. She made it through the next day, and the next. Our hope shifted farther out again. Even if we had to surrender her life, even if her story ended differently, I knew her life would still be praiseworthy. I knew that if we lost her, her legacy would live on. There would be life after her death. There would still be newness and good even in the bad, in the devastation. In that I knew that there could be purpose in our pain.

And when I say it was really hard—it was really hard.

Janet (22:27) 
I can’t imagine, Sara. That’s such a powerful story. It’s a tremendous example of resilience. When your life feels like dust, shattered all around you, that doesn’t have to be the end. Fortunately, in your situation, things worked out so well for Madi and your family. But in those moments, it likely didn’t feel like strength. And yet, the sun did rise. The next day did come. Even when it feels like dust all around, resilience is choosing to keep showing up and to keep making choices.

We talked at the beginning about resilience as a muscle. That muscle keeps working. It doesn’t have to be about seeing forever into the future. Sometimes it’s just about making it through the next minute, the next hour. That is resilience power right there.

Clay (23:18) 
Maybe that’s partly why going through hard times can actually strengthen us. Resilience is a muscle, and like any muscle, it can be strengthened. When you go through difficult experiences and believe they can make you stronger, you carry something forward. The next time, maybe it’s a little easier, or maybe you find hope a little quicker, because that muscle has been exercised before.

Janet (23:48) 
Yes. And I wonder how this journey has shaped your family, because resilience is often something you only see in hindsight. Practicing and strengthening that muscle—what has it meant for you and your family?

Sara (24:03) 
That’s a really good question. For me, resilience was hard to identify in myself. I didn’t look at myself and think, I’m resilient. In fact, I often looked at other families and thought, Wow, you’re amazing. You’re an inspiration. But looking back now, I realize—we did it.

As a family, we have this tradition. Whenever we overcome something hard, we choose a rock. On the bottom of that rock, we write down the hard thing we overcame. Then we put it outside, sort of like a monument. We’ve got quite a little stack of rocks now. Those rocks remind us of the hard things that we have overcome as a family.

It’s easy to forget, in the middle of something hard, how much you’ve already overcome. The rocks remind us: we’ve done hard things before, and we can get through this too. It strengthens us. It reminds our kids that they are stronger than they think, even when they don’t feel strong, even when they feel weak or broken or shattered.

Resilience doesn’t always feel like strength. It’s just taking the next step. And with cancer, the journey isn’t linear. It’s not a straight path. It’s forward, then backward, up and down, messy and unpredictable. But even in that, it’s still fighting forward. And we held onto the truth that this season, as hard as it was, would not last forever.

Clay (26:33) 
That makes so much sense. And it makes me think of those rocks—how you’re actually collecting symbols of hard things. There’s something important about keeping the memory of even the hard times alive. That reminds me of something you’ve shared before, about stress. You said, Stress doesn’t exhaust us. Stress without purpose does. Do you think those rocks connect to that sense of purpose?

Sara (27:09) 
Yes. When your child is in the hospital, there are so many mundane days. It’s hard to feel like you have purpose. A lot of the time, it feels like you’re just waiting, not doing anything, not fighting. It can feel like a mental game.

So I had to ask myself, What is our purpose today? What are we working toward? That was difficult to hold onto daily, because so much of it blurred together. Some days were eventful—we didn’t want them to be, but they were. Other days were quiet. But looking back, I see that all of it built toward a greater purpose. And that was the ultimate rock on the pile. We labeled it, and we dated it, and it represents something huge. And it helps keep life as a whole in perspective. 

That’s what the rocks represent. They help me keep perspective. They remind me that when I get caught up in little things that don’t matter, I look at that rock and I think, what I truly strove for every day during Madi’s treatment was to get back home, back to my family, back to my life. Those rocks remind me of what was really important. Everything else—the busyness and distractions of life—pales in comparison.

Janet (29:46) 
You’ve talked about this journey as a season, or as a chapter. And that’s so important, because you don’t have to stay in the dust. It’s easy, even comfortable sometimes, to stay there. But resilience work is about the intentional next step. That’s the practice of the muscle—recognizing what’s happening and asking, Now how do I want to be? How do I want to show up? What’s my hope? What’s my purpose?

Clay (30:23) 
That’s the neat thing too, because resilience also includes acceptance and allowance. It’s about honoring the reality of your story. You don’t pretend it didn’t happen or that it didn’t change you. You might wish it hadn’t happened, but resilience is allowing it to be part of your story.

Sara (30:51) 
I think that was the most important part. I was really angry in the beginning—and honestly, angry through a lot of it. I didn’t want to be there. I kept asking, Why us? Why are we here? I was angry about what it took from our family. It felt like we were grieving from the moment of diagnosis.

But eventually, I realized I didn’t want all that pain to be wasted. I wanted it to be for a purpose. That’s the beauty of the analogy of dust. When you feel shattered, it’s like dust—you can’t glue dust back together. You can’t rebuild that. But you can create something new from it. I read that in a book, and I really identified with that. This can’t be the end. But I can come out of it stronger, better, and create something new.

So much of the journey was out of my control. But what I did have control over was the newness in me—what I was going to do with that dust, and how Madi and I were going to live through it. That was our choice. I wanted to come out of it better.

A lot of that came after we got home. During treatment, I didn’t have energy for much beyond caring for Madi. But once we got back home, breathing in the smells of home and returning to life, I realized I was different. I was a new Sara. And I wanted to embrace that. It took time. It took healing. But we didn’t just survive that time, the hard. We acknowledged it. I went to therapy. I healed from it. I didn’t rush it.

It reminds me of pottery—the potter and the clay. Sometimes the pot has some cracks in it. But light can shine through those cracks. That’s what I want to be: someone who helps others see that even in brokenness, there’s strength, and there’s light. I want to run back in and say, You can do this. It’s really hard, but you can do this. Seeing Madi thrive—not just survive, but thrive—continues to inspire me.

Janet (34:07) 
And there’s such vulnerability in that. Resilience includes saying, This was hard. I didn’t want to do it. But I did. 

This was difficult. This was a trying time. This was one of the hardest things I’ve ever done. Acknowledging the struggle is part of resilience. It’s part of letting the light shine through those cracks. And saying yes, they are there, and it’s part of our story now. 

Clay (34:33) 
I love that you’ve shared the spectrum—from those moments in the middle when resilience simply meant getting up that day and doing what was needed for Madi, to now, where you’re reflecting and recognizing transformation. That shift over time is beautiful, because people who hear this will be in all different stages.

Janet (35:09) 
Yes, agreed. There isn’t one way to do it. Your story—and Madi’s story—show that resilience can come from within, but it can also come from others. Sharing your resilience and vulnerability helps others discover what their own season, their own chapter, might look like.

Sara (35:34) 
There were days that weren’t pretty. But those days made the beautiful days even more beautiful. Those are the days you hope for and look for. For other caregivers who might be in the middle of really hard days, I just want to say: don’t lose hope. Even if today feels like a really hard day, tomorrow the sun will rise. Keep fighting forward, even if you don’t feel like it.

Clay (36:30) 
Let me check in with you both. We’ve gone on quite the journey—grace, hope, doubts, and everything in between. Before we close, is there anything else you’d like to share with our listeners?

Janet (36:50) 
I think it’s important to recognize, like we’ve said, resilience isn’t pretending everything is fine. It isn’t calling something great when it doesn’t feel that way. Resilience is acknowledging the hard moments, acknowledging the dust of the life around you, and then asking, What’s my next step? What’s my next moment? How am I going to show up?

It doesn’t have to be great or grand. It doesn’t have to look like what the person next to you is doing. It’s just about asking, What’s that next step going to look like for me today? And then allowing grace and acceptance to follow.

Sara (37:31) 
Yes, I appreciate that you said that. Because when you’re really low, advice or encouragement doesn’t always feel great. Sometimes the best medicine is just someone sitting with you and crying with you. Sometimes it’s mourning together or laughing together. Just being in it with someone else feels healing.

For me, being with others who were walking the same path was the best medicine. Hugging someone without saying anything could feel more comforting than anything else. I’m thankful for the chance to share our story today—validating hurtful hearts but also giving hope. Because it’s important for caregivers to know you don’t have to stay in your hurt. This is a season. It’s hard, yes, but it’s not forever. There is hope, even when you can’t always feel it.

Clay (38:58) 
Janet and Sara, that’s such a beautiful note to end on. It speaks to the truth that wherever you are, wherever life finds you as you are listening to this, however you’re feeling, it is okay. Acknowledging that reality—just being with it—can be one of the most important starting points for resilience. And that can be enough to say that you are being resilient today.

So thank you both for your time, your intention, and your vulnerability.

Janet (39:36) 
Thank you for the chance to talk about resilience and to continue such an important conversation.

Sara (39:42) 
Yes, thank you for having me. I appreciate you listening to our journey and hearing about my Madi girl. Going through this has been life-changing, and I hope we can do our best to encourage other families going though the same thing. 

Clay (40:06) 
Thank you.

Narrator (40:08)

Thank you for listening to Caregiver SHARE, a podcast lovingly brought to you by Patient Family Centered Care and Psychosocial Services at St. Jude Children's Research Hospital.

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Accuracy and availability of Caregivers SHARE: A St. Jude Podcast transcripts may vary. Transcript text may be revised to correct errors or match updates to audio. Audio on stjude.org may be edited after its original publication. The authoritative record of Caregivers SHARE: A St. Jude Podcast episode content is the audio record. 

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