For Preschooler with ALL, Sisterly Bond Is a Source of Strength  

The first time Ashley Bernath dropped her then-three-year-old daughter, Charlie, off at preschool, there was no hug, no tears, no long goodbye — just a quick “see you later” and a full-steam-ahead dash for the classroom.

Charlie’s excitement that morning in September 2025 was understandable. She had spent the previous 15 months in active cancer treatment for acute lymphoblastic leukemia (ALL), and even though she still had a ways to go on her two-year treatment protocol, she was stable enough to start this important childhood milestone near the family’s Natick, Mass. home.

“She went right in, and has not looked back,” Ashley recalls with a smile. “It’s incredible how much she loves it. There was a day a few weeks ago when she said to me, ‘I don’t like Saturdays because they’re home days. I want school days.’ I was fearful of the transition, but it’s just been so smooth.”

Ashley and her husband, Ryan, credit two factors for Charlie’s ability to thrive in the classroom and enjoy other passions like dance class while still dealing with cancer treatment. Even before her May 2024 ALL diagnosis, Charlie had an understanding of the challenges that can come with a serious medical condition. Her little sister, Lucy, spent much of her first year of life in and out of the hospital, and at one point both siblings were on feeding tubes — or, as they call them “tubies.”

“Doctor is their favorite game to play,” says Ryan. “Charlie has a port-a-cath for her chemotherapy infusions, and even though Lucy doesn’t have one anymore, Charlie pretends she does so she can check it.”

The other factor is Charlie’s experience in the Childhood Hematologic Malignancy Center at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, particularly in the Jimmy Fund Clinic at Dana-Farber, where she receives chemotherapy and other outpatient care. Filled with games, crafts, and friendly staff and volunteers, the clinic allows pediatric patients to form friendships in between their check-ups, shots, and infusions.

“The Jimmy Fund Clinic became a school for Charlie,” says Ashley. “Even though she wasn’t in school that first year, she was seeing the same kids regularly and doing all these wonderful things. At the same time, it was a safety net for us. I’m truly grateful for the consistency it’s provided in a time when everything else has been chaotic.”

Sisterly struggles

Ashley and Ryan always knew they wanted to have two children close in age. Ryan had a special bond with his own sister, and his sister and brother-in-law had kids who were close in age and strongly attached.

Charlie was 18 months old when Lucy came along in July 2023, but the sisters had precious little time together before Lucy was hospitalized at age three months with a severe case of COVID-19.

Lucy soon developed adenovirus, another respiratory illness, as well as gastroparesis — a condition where the stomach muscles do not properly move food for digestion. The accompanying weight loss necessitated a feeding tube, and Lucy was in the hospital for three months before coming home in February 2024.

“When Lucy came home, she was still struggling to take down food, so we had to come up with all these different formulas to put into her feeding tube six times a day,” explains Ryan. “Charlie loved her little sister, and wanted to be a part of it. She would try and pull Lucy’s tube out.”

As they were dealing with Lucy’s challenges, the family noticed something about Charlie.

“Charlie had the flu, which was pretty typical as a toddler that’s social with friends and her cousins, but was lingering longer than you would expect,” says Ashley. “Then she stopped walking, and after about a week we thought it might be something post-viral and took her for X-rays.”

At first, doctors at their local hospital could not find anything wrong with Charlie. Finally, at Ashley and Ryan’s insistence, additional testing was done, and it was discovered Charlie had a broken left femur.

“She had a really high pain tolerance,” says Ashley. “Even though she wouldn’t walk on it at home, she had been at a play group one day where she walked on it the entire time. By the time they found the break, it was almost healed.”

Ashley and Ryan told doctors there was no incident they knew of that could have caused Charlie’s broken leg, which prompted more tests including a complete blood count. It turned out that an overabundance of immature white blood cells — known as lymphoblasts, or “blasts” — had formed in Charlie’s bone marrow and blood. This left less room for healthy white blood cells, red blood cells, and platelets to form, and weakened her bones.

ALL was the culprit.

Dropoff dreams

Within a few days after Charlie’s May 4, 2024 diagnosis, the family was at Boston Children’s Hospital, where Charlie would spend her early days of treatment as an inpatient and get a “tubie” like Lucy’s. They also met Barbara A. Degar, MD, medical director of inpatient oncology at Dana-Farber/Boston Children’s, who would become Charlie’s primary oncologist. In desperate need of reassurance, Ashley and Ryan found it immediately.

“Dr. Degar is a superhero,” Ashley says. “From the moment we met her, she was like, ‘This is what it is, and this is how we’re going to take care of it.’”

Ryan recalls that every time Degar walked in, there was a sense of calm — a feeling that whatever challenges came, the family and care team would face them together. Charlie was certainly game for whatever came next; despite having a long cast on her left leg, she had her parents push her around the hospital in a wagon to check out the sights.

The clinical team working with Degar made the entire Bernath family feel cared for during those early days, and all days that have followed. Charlie formed a particularly special bond with nurse practitioner Anna Lefebvre, CPNP, who became her primary outpatient provider; when the Bernath family was planning a trip to Disney World, Charlie told Lefebvre she would “say hello to the other [princess] Anna.”

“It never felt like just Charlie was the patient,” says Ashley. “The nurses, the social workers, the staff in the playroom — it feels like everybody is there to support all of us.”

Although ALL is the most common childhood leukemia, and 85% of newly diagnosed pediatric ALL patients go on to event-free survivorship, Charlie has faced obstacles during her two-year protocol. Due to an allergic reaction to one of her chemotherapy medications, she was at the Jimmy Fund Clinic three times weekly for nine months during her first year of treatment. More recently, she endured back-to-back bouts of COVID-19 in February 2026 that landed her in the hospital.

Despite these rough patches, Degar says, Charlie is still scheduled to finish her active treatment in June 2026 — right around the time she has a big dance recital scheduled.

“Charlie’s treatment has been long and at times very challenging, but her outlook is bright,” says Degar. “We expect that she will be able to do anything she sets her mind to, in the short term and in the future.”

Through everything, Charlie’s special connection with Lucy has been a source of strength. The sisters now share a bedroom, and Ashley and Ryan often hear them chatting before they drift off to sleep. Their sibling bond, forged in shared medical challenges, has flourished as both have gotten better — and Ashley says Lucy has started asking her a question when they drop off the big sister she idolizes at the preschool both will attend in September.

“It’s my turn. Can you leave me here now?”