Grantee Profile

Frontline Worker: The Family Center

Sitting at the edge of a hospital bed, hands clasped and resting on the blankets, Haydee Bulos could easily be taken for a priest. The colored beads that dangle from her neck may as well be a rosary. Listening, nodding and offering the occasional affirmative response, Bulos is here to help a client who requires a lot of assistance but has no one else in her life to turn to. Bulos’ voice, cloaked in a trace of accent from her native Puerto Rico, is soft, comforting. But tonight it also betrays a hint of worry.

Haydee Bulo

Haydee Bulos is a Family
Coordinator at The Family
Center. Photo courtesy of
The Family Center.

The sun has set by now, but Bulos’ day in the field has not yet drawn to a close. She is a Family Coordinator at The Family Center, a New York City nonprofit organization dedicated to providing home-based comprehensive legal and social services (such as custody planning) to families affected by serious parental illness.

Working as a translator, advocate and case manager for low-income, predominately minority women with breast cancer, Bulos ensures that her clients receive the proper services they and their families need during and after illness. She is a frontline worker who usually goes into the homes of new clients to do an initial assessment of the family, then coordinates the team of professionals who will provide the necessary multi-disciplinary support. A Komen Greater NYC grant helps support this critical position.

Tonight Bulos is visiting Maria, a Dominican immigrant with no family in the United States, save her two teenage daughters. At 48, Maria was diagnosed with late-stage breast cancer, which has since metastasized. Her prognosis was bleak from the outset, and she was referred to The Family Center to make permanent custody arrangements for her children in the event of her death. Bulos took Maria’s case and a formal plan for the guardianship transfer is now complete.

She has continued to work with Maria for years, meeting with her on a weekly basis to determine her service needs, but also to act as a much-needed friend.

When Bulos enters Maria’s room at NewYork-Presbyterian Hospital, a nurse is taking Maria’s history in English. But Maria’s English is far from fluent and she struggles to convey the crucial bits of information that could influence the care she receives. Maria’s face illuminates when Bulos walks in. Bulos slips fluidly into the medical translator role, asking Maria the nurse’s questions in Spanish, then conveying her responses in English back to the nurse.

Maria takes comfort in Bulos’ presence. When Bulos translates one of the nurse’s questions into Spanish, Maria grows surprised and begins to laugh. After a quick exchange, they are both laughing. Bulos had been translating into Puerto Rican Spanish, but one of the words she used was, unbeknownst to her, a curse word in Dominican slang.

“I find her so amusing!” Bulos says.

“And you translate so well!” Maria responds, still laughing.

As Maria’s cancer has progressed, a large aneurism has also been building in an artery of her heart. The previous night, Maria’s homecare attendant called Bulos in a panic. “Maria is dying!” she said. Bulos called an ambulance and met Maria at the hospital. Maria’s lungs had filled with fluid, which needed to be drained. She would also need to have surgery to implant a stent in the artery with the aneurism to prevent a fatal rupture.

But Maria is now so weak from the cancer that surgery itself is a large risk. She is confused about her condition because most of the time, the medical staff speaks to her in English. She is uneasy about the surgery, about her chance of surviving it.

Though thin and fragile from the cancer, its treatments and her heart problems, Maria still retains a quiet beauty. Her perfectly painted pink nails along with her short, curly hair, clipped back neatly in a barrette, belie the gravity of the illness within. But it is obvious that she is growing tired. Maria asks Bulos to stay until the doctor comes back so that she can translate.

“Of course,” Bulos says.

She tells Bulos that she has been thinking a lot about God and about Jesus. She wonders if maybe Jesus does not speak Spanish—that perhaps she has been praying to the wrong God all along. Bulos listens, nods and lets Maria continue. Maria says she wonders when she will have some reprieve.

Throughout the conversation, which is really more of a monologue of her thoughts and fears, Maria’s eyes begin to tear. The questions she is grappling with now are the most difficult of all. Bulos never stops listening.

Maria and Bulos have been at this together for a long time now.

“I’m very frightened for her,” Bulos says later. Before going into the stent surgery, Maria was saying a lot of goodbyes. “That’s not like her.”

Bulos was no stranger to the services offered by The Family Center when she joined the staff nearly three years ago. In fact, she had previously been a client.

Several years ago, Bulos’ sister, who lived in Puerto Rico, was diagnosed with breast cancer. Bulos became concerned that her sister was not receiving proper treatment so she brought her up to New York to seek better care. But the cancer had spread and the prognosis was poor. A hospice worker referred Bulos’ sister to The Family Center to make arrangements to transfer guardianship of her son to Bulos. Barbara Draimin, DSW, the executive director at that time, took Bulos’ case.

To care for her sister, Bulos took a leave from college just six courses short of her bachelor’s degree. She was not sure if she would ever return. She continued to work with Dr. Draimin for a few years, receiving needed legal and social services and counseling. At the time, Bulos was a medical translator at Mount Sinai Medical Center.

“With coaxing from Barbara, I went back to school and finished my degree,” Bulos says. Out of the blue one day, Dr. Draimin asked her if she had ever considered applying for a job at The Family Center. Bulos had had her eye on a job there for quite a while. It was a done deal.

“The best part of Haydee’s story is that she brings to her clients, in a way that few people do, the mission and the value of the organization,” Dr. Draimin says. “I think Haydee helping her sister do the hardest thing a woman ever has to do in her life has [given her] an appreciation for the speed and intensity at which people can work on these sensitive issues.”

“When Haydee goes out and she meets with our families affected by cancer, she can speak from first-hand experience of what the services meant to her and her family,” says Ivy Gamble Cobb, MSW, executive director of The Family Center.

Bulos also believes that her experience as a client has proved invaluable in her ability to serve her own clients. “The essence of this work is relationship, relationship, relationship,” she says. “The relationships you form with clients come from sitting in hospital rooms, at entitlements, going with them to advocate for their children at school. And I know that.”

Founded in 1994 by four professional colleagues (Gable Cobb and Dr. Draimin, both social workers, along with two public health workers), The Family Center plays a challenging support role in the lives of its clients, promoting the difficult message: “Hoping for the best while planning for the worst,” Gamble Cobb says. “We recognized that serving families affected by illness was different than serving the single person and that there were not a lot of programs geared toward looking at the family as opposed to just the person affected by the illness.” The organization seeks to build greater stability for the families they serve.

With a caseload of 24 clients who are usually at the end of life, Bulos’ job is arduous and emotionally draining. But it is clients like Maria who keep her going: “Knowing that Maria has absolutely no one in this country, that I am making a difference, forming a connection, forming those relationships,” makes the job rewarding, she says. “I have an insatiable need to connect to humanity, and I get that need met at this job.”

By Julia Connors
April 2006

Author’s Note: Maria passed away shortly after the completion of this article on March 25, 2006. “She will finally get her reprieve,” Bulos wrote in an email to the author. “As you well know she was very special to me, and I will miss her dearly.”

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