Written By Robin Warshaw, Contributing Writer
Maria Linares worked for a small mom-and-pop company for 15 years, yet she had no health insurance. After finding a lump in her breast, she spent many hours calling around Houston, Texas, looking for inexpensive mammogram services. Then 40 years old, Maria had a daughter in college and no spare money for medical bills.
Her search brought her to The Rose, a nonprofit organization that provides breast health care to insured and uninsured women. Maria had a mammogram there and learned she had early-stage breast cancer. Then a patient navigator helped Maria find out she qualified for treatment under the state Medicaid for Breast and Cervical Cancer program (also available in other states) for low-income, uninsured women.
At first, The Rose couldn’t find a plastic surgeon who would accept Medicaid coverage for reconstruction. Finally, a major cancer center in downtown Houston agreed to provide all treatment.
“The gratitude I felt toward the organization (The Rose) and my patient navigator was enormous,” Maria says.
Looking back, she remembers feeling scared as she made phone call after phone call, looking for help. “I was born here and speak [English] well. I could see that someone who did not speak as well would give up and hang up that phone,” she says.
Maria didn’t know it at the time, but soon she would be involved in changing that experience for other women.
Support and Solidarity
A year before her diagnosis, Maria fell in love with Mexican folk dancing. She joined a folk dance group and performed at weddings, quinceañeras (15th birthday celebrations), community events and recitals. The group became “a family I created for myself,” Maria says. During and after treatment, “dancing was always part of my therapy.”
In her troupe, female dancers pin their hair up in buns and attach hairpieces decorated with flowers or yarn braided with ribbons. When Maria lost her hair from chemotherapy, she felt well enough to perform but thought she couldn’t dance without the hairpieces needed to complete her costume. She feared a wig would fall off as she danced.
The group’s teacher said Maria could wear a scarf to cover her head. The dancers decided they didn’t want her to feel embarrassed by the difference, so they asked to wear headscarves as well.
“Every lady covered every inch of their hair….I felt like the most blessed and loved woman in the world,” Maria says.
Taking New Steps
After treatment ended, Maria quit her job to attend community college. “Don’t ask me how my bills got paid,” she says with a laugh. She received educational grants. Friends and family helped. Her uncle moved in to share rent.
At college, Maria saw a brochure about becoming a community health worker and thought, ‘That’s for me!’” She also began volunteering for The Rose. After completing her courses and a hospital internship, she became a certified community health worker.
She landed a paying job as a patient navigator for The Rose. Now, when women are diagnosed, she explains what breast cancer is and what type they have. She helps complete paperwork and locates funding and services.
“I go with them on their first doctor visit, to hold their hand for emotional support, but also to ask that first question,” Maria says. “Especially if the woman doesn’t speak English well enough to understand fully.”
Healthcare providers may speak European Spanish, but Maria speaks Spanish from Central America and Mexico spoken by many in Texas. This helps her explain medical information in everyday language.
She bridges other cultural gaps as well. Clients advised to have daily radiation often want mastectomy to avoid losing time from work. Maria helps them understand their options.
“I tell them, ‘I’m not a nurse, but my supervisor is a nurse and we want you to know whatever the pros and cons are of any decision,’” she says.
While studying for certification, Maria had to teach health information to a community audience. Her first students were women from her dance group. She used a video showing breast self-exams and small breast forms to instruct them.
Now she’s comfortable doing outreach to people she never met before. She went to the state capital to advocate for more support for health initiatives and met the Texas lieutenant governor. When she speaks publicly, she tells her personal story of breast cancer diagnosis, treatment and her life afterwards.
Says Maria, “I want them to know you can move forward.”
This article was supported by Cooperative Agreement Number DP11-1111 from The Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.