Sarah Rusnell: Catching Her Breath
For 35 years, Sarah Rusnell was forced to focus on her health in order to stay alive. She was born with Cystic Fibrosis (CF), a rare, progressive and terminal genetic disease that started ticking as soon as she took her first gasp of air. She’s been tenaciously fighting to survive ever since.
CF causes a buildup of thick, sticky mucus in the lungs; untreated, it makes breathing impossible. The disease also affects digestion, the pancreas and other body organs. Sarah’s grown up with CF side effects that have impacted her ability to breathe, kept her malnourished, gave her diabetes, and left her with recurring infections requiring frequent intervention and weeks of hospitalizations. She’s spent multiple hours every single day of her life on airway clearance, inhaled medication and oral medication in order to manage her disease.
And management is critical. Thirty years ago, children with CF were unlikely to live past their teen years. Sarah’s disciplined approach to her medical regimen helped control the disease, but the singular physical, mental and emotional requirements of surviving CF understandably shaped her serious worldview.
It also developed her resilience, perseverance and grit — traits that Sarah brought with her to the workplace and have fueled her successful career at Treasury.
Tax Path
Starting her tax career in collections at GC Services while working her way through Michigan State University, Sarah was exposed to a lot of Michigan Department of Treasury tax processes. After training, she was moved over to GC’s businesses taxes where she stayed for four years, developing communication and customer service skills that scaffolded her future in Treasury Outreach.
After graduating with a bachelor’s degree in communications, Sarah signed on as a limited-term customer service representative at Treasury in a role designed to help the department transition to a new processing system. She worked in customer service for Sales, Use & Withholding for a couple of years, then jumped at the opportunity to become an analyst in Business Tax Technical where she offered situation-specific tax law guidance to business taxpayers.
The position used both Sarah’s processing and customer service background and expanded her tax knowledge — preparing her to work on the Michigan Treasury Online (MTO) optimization project. Sarah was part of a small group dedicated to enhancing MTO as a forward-facing web resource for taxpayers; she used her previous experience to influence how the web system worked and ensured it functioned well for the taxpayers.
Unfortunately, the original MTO launch did not go smoothly and the website made a poor first impression on its stakeholders. Sarah took the opportunity to make multiple public speaking presentations, diving into tough conversations and educating taxpayers on MTO’s improved product. Using all of her communication skills, Sarah calmed MTO’s critics and engaged its users, essentially laying the tracks for her next position with the brand new Treasury Outreach. Educating the public on tax topics and tax-adjacent issues became Sarah’s entire job.
As manager of an expanded Outreach since 2021, Sarah oversees a team responsible for coordinating and producing straightforward public education resources on important tax information for Treasury’s customers. The team develops content for the Taxes website, produces and presents workshops online and in-person, and participates in communication projects with forward-facing components.
As a result of Outreach’s efforts, Treasury has witnessed an increase in customer service, greater compliance with tax laws, policies and procedures, and improved innovation and efficiency in Treasury’s administration of taxes.
Much of Sarah’s success at Treasury has been based on her drive to improve processes, serve stakeholders, and find solutions for projects with problems. Most of her co-workers would never guess that their energetic, dedicated colleague actually worked two fulltime jobs: one at Treasury, and one called ‘staying alive’.
An Invisible Disability
Sarah’s career has rested on enormous personal effort to keep CF from derailing both her health and her professional path.
“I remember when I first came to Treasury as a limited-term employee,” says Sarah. “I had to be hospitalized within the first month of my employment. My manager, Brandi Branson, made sure that I could go into the hospital, start my treatment, get discharged, come back to work with IV antibiotics and continue to work so I didn’t lose my job and health insurance.
“It was hard for me, but the support of the wonderful people that work at Treasury helped immeasurably. They treated me as if I was valuable and smart and needed, as opposed to me being a problem, and that being sick was an issue that compromised productivity. That was a change!
“It’s been difficult in the past to be able to trust that being open about having a disability wouldn’t impact me at work. So I put on a brave face just to get through the times I was dealing with my disease…and I spent 35 years doing that.”
A New Life
In January 2020, just two months before the pandemic hit, Sarah was introduced to Trikafta. The miraculous new drug treats the basic defect from specific genetic mutations that cause CF and corrects the disease at the cellular level. Nicknamed “The Purge”, Trikafta stops production of the thick, sticky mucus in the lungs.
Early funding for the drug was provided by the non-profit Cystic Fibrosis Foundation, which utilized all of its donations to attract a drug development company to research and custom-develop a drug for CF patients.
The drug works insanely fast; within 24 hours, for the very first time in her life, Sarah could breathe without interference. Overnight, her world shifted from staying alive, to having a life — and then figuring out what to do with it, now that her primary focus wasn’t simply on existence.
“Trikafta is not a cure, but my CF is much less of a daily issue,” Sarah reflects. “You think that would be wonderful, right? And it is, because now I can get back to normal life. Except, fighting CF was my ‘normal’ for 35 years. Now, I’m dealing with the gratitude of being able to have a different life while also grappling with a life that is brand new.”
New decisions, new choices, and lots of change can be overwhelmingly stressful. While rebuilding her life from the inside out, Sarah has taken positive steps to cultivate a rewarding system of advocacy, self-care and support.
Riding and caring for her horse, Paris, at her family’s farm near Ionia has provided Sarah with a healthy outlet from the stressors of personal life and the demanding nature of the work she does for Treasury.
Using her communication skills, Sarah has become a patient advocate for her CF clinic in Grand Rapids. As a cystic fibrosis success story, Sarah’s healthcare team recommended her for the volunteer position, and it’s a role she takes very seriously.
“We talk about some of the new issues that came up after Trikafta, and the fact that damage done by the disease is not reversible,” Sarah explains. “Trikafta can’t fix my diabetes. Other CF patients have reproductive health issues or liver issues — CF really affects the body in so many ways. And not everyone with CF can take the new genetic modifiers.
“We discuss the mental shift, too. How are we are able to navigate a life after the ravages of day-in, day-out CF? How can we care for our mental health and deal with this monster still lurking? There’s still a lot of work to be done to reach our eventual goal, which is a cure for this disease.”
Balancing the Future
Maintaining health insurance is essential for someone who has a preexisting condition in the USA. As a high-performing employee, Sarah was partially driven by the fear of losing her coverage and felt the constant need to be the absolute best in absolutely everything that she did. After spending so many years funneling all of her energy into her health and her Treasury career, Sarah now has the luxury of figuring out her own work-life balance.
“The work that I do at Treasury is very rewarding,” says Sarah. “The support that I get from my teammates and the people at Treasury as a whole — I really feel that support, and it helps me continue to decode this new iteration of life.
“Cystic fibrosis doesn’t define me, but it did make me who I am. I am proud of that person, but I have to learn how to create balance and how to shift my focus on what’s important. That’s really hard to do in your mid-30s, but I’m figuring it out.
“I always said that cystic fibrosis wouldn’t kill me,” she adds. “That was my mantra, and it got me through many challenges. I told myself, I’m gonna beat it; I’m gonna be the one that makes it to 80.”
Sarah’s mantra gave her purpose and focused her on what she needed to do to survive. The lessons that CF taught her, earned from years of struggle — the courage, perseverance, advocacy, and empathy — these are hers to keep. Sarah can finally pause to catch her breath while she thoughtfully decides on an all-new mantra. One that looks far beyond CF, a mantra appropriate for her future and a whole new life. ~
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