More than two decades ago, I had a client named Marta. Marta was probably in her late 30s although she looked like she was in her late 50s. She was scrawny, with stringy brown hair, claw-like hands, and twisted limbs that caused her to walk with a limp, from injuries sustained after a former boyfriend had pushed her down the stairs.
I met Marta because of her daughter, Sonya, who was 14 at the time. Sonya was pregnant, and through my job as community development specialist of a North Philadelphia nonprofit agency, I was assigned her as a home visit, to remind her about the importance of prenatal care.
But it was her mother, Marta, who captured my attention. She was gruff, pushy, kept asking if I were really going to help her daughter, and could I help her as well, get into a hospital rehab program, one she’d been trying unsuccessfully to enter for the past six months.
As I started to make phone calls on her behalf, I heard an earful about Marta. She wasn’t well-liked among the social work community. “She’s so pushy,” I heard several times. “Quite abrasive,” and “I avoid her like the plague” were other responses.
I couldn’t tell you why I liked Marta. I kept coming back to their house, despite the smell, the dirt, the cursing. On my first visit, they were squatting in a narrow abandoned house with no running water, a narrow flight of stairs, and a few bare mattresses on the floor. On my final visit, I remember a converted office on a ground floor, with a little porch, and some furniture.
It took me time to understand that Marta, with her abrasive tone and naggy voice, was just being an advocate for her daughter and herself. She had escaped an abusive relationship and was trying to keep her daughter and her future grandchild safe, in the only way she knew how. She was trying to offer them a better life. The problem was that Marta didn’t act like the grateful recipient that the system wanted of her. She didn’t see please or thank you or even act appreciative of the ‘help’ she was getting.
That was the moment I realized that those of us in the helping profession often like to help those who “appreciate” our help. We want shy smiles, whispered thank you’s, ingratiating ‘if you have a moment’s. We don’t like demands, frustration, or impatience.
But when I think of Marta, I see a true patient advocate. She was not apologetic about her needs or embarrassed about asking for them. In me, she saw a possible resource to get her daughter, and herself, better living conditions, more medications, and maybe more for the unborn baby. She was practical, savvy, and slightly manipulative, all skills that would help her family survive, just not skills that would have a social worker want to visit her.
Being part of a new and developing profession, I am often asked, “what does a health advocate do, exactly?” My first line is stating I am helping the client access their healthcare rights, for themselves. I believe that word, themselves is crucial. It is not about my journey, and what I think is right for them, but rather helping them identify what is right, for them, and then assisting them to access those services.
People in crisis are not always pleasant or grateful; that does not make them any less in need. I believe it is our job as health advocates to serve those who need, not those who serve our ego.