As a medical center social worker, people often ask me, “What is it that you actually do?” This is always a difficult question to answer because our responsibilities change all the time. We do everything from meeting a family’s basic needs to supporting families through the biggest crisis of their lives. Here is one example of my role as an Oncology social worker and what it has meant for one amazing family.

10-year old Steven arrived in the U.S. in the spring of 2008 to reunite with his family. He had been separated from them for half his life. When he was just 5 years old, civil war broke out in his village in Africa. His father was killed in the violence of this war, and he and one of his sisters were separated from the rest of the family. As the months and years went by, his mother refused to give up on finding her two youngest children. Just before she and the rest of the family were to come to the U.S. as refugees in 2006, she found out where they were. She spent two more years and all the money she had to get Steven and his sister to the U.S. Only two weeks after arriving, he began having seizures and was admitted to Cook Children’s. That’s when I first met this family. I was working in the seizure unit at that time and immediately recognized the challenging situation that this child was experiencing, so I went to his mother, Mariama, to offer support and services. She was completely overwhelmed by her social situation and scared for her child’s health. She was also trying to learn about seizures and figure out how to communicate and bond with her son who had been away from her for five years. They didn’t even speak the same language anymore. To add to her incredible stress, she had just been laid off from her job. I was able to offer her emotional support and help her find some assistance with household items that the family needed. This meeting began a bond of trust that would continue for years.

The doctors discovered that Steven’s seizures were caused by a low-grade tumor in his brain that had probably been there for many years. Over the next two years, Steven underwent multiple surgeries, first for tumor removal, then for a lobectomy to try to get his seizures under control. Throughout that time, I talked with Mariama frequently, in the medical center, the Oncology clinic and over the phone. Mariama had very little formal education growing up in Africa, so I spent a lot of time with her to make sure she understood everything that the doctors were telling her and I helped her get clarification when she felt confused. Although she spoke English very well, she was not able to read it. I often helped her understand the documents and other written information that she had been given. I listened as she shared her fears and concerns about her son and her ability to take care of her family. She struggled so hard to find a job that would understand that Steven’s medical needs were so complex and would often pull her away from a job during the day. I worked continuously with Mariama to help her find financial resources and assistance with job placement. 

My heart broke for this family because I knew how hard his mother was working to take care of him and try to provide for her family with very little support. No matter how hard she tried, it seemed that they were just continuously stuck in a terrible situation. One of the hardest things about being a social worker is the feeling that you cannot “fix” a problem for a family, no matter how hard you try. I sometimes felt helpless in my ability to help Steven’s family in a meaningful way. 

Steven’s seizures eventually got so frequent and debilitating that he required homebound schooling for several months and his mother could not work. At that point, I helped her to apply for Social Security for Steven so they would have a small amount of income. I also assisted her in applying for a program that would provide help for her at home to care for Steven.

Recognizing that this family’s needs went beyond the child’s medical needs, I decided to refer Steven’s family to a program through Presbyterian Children’s Home and Services (PCHAS) that could help the family beyond what we could do through Cook Children’s. Through a partnership with Mariama’s case worker at PCHAS, I continued to help in any way that was possible. With the case worker’s help, Mariama applied for every job she could find, but had no luck. With such complex and challenging needs, I went with Mariama and her case worker to present the family’s case at a Community Resource Collaboration Group to get ideas about new ways to help and empower this family. This was our last hope to help a family that was stuck in what seemed to be a never-ending cycle of bad luck.

An idea from a member of this group proved to be the step that would transform this family’s grim situation. Through a program suggested at this meeting, Mariama was accepted into a paid job-training program that would guarantee her hours and would assist her in permanent job placement after completion. Through this program, Mariama will finally be able to provide for her family while still meeting the medical needs of her child.

I don’t hear from Mariama as frequently as I once did, but I did bump in to her at the medical center recently. She told me about her most recent accomplishment. She became a United States citizen. She is so proud. Her case worker with PCHAS sent me this picture of Mariama at her citizenship ceremony.

A Journey to Empowerment

As the social worker for this family and others, it is an honor to be able to serve. I get to be there for emotional support, to listen to a mother’s fears, concerns and talk her through the crisis that she and her family have experienced. I am able to be an advocate for them, communicating with staff about the family’s and patient’s educational needs and help them get the various services that could help them. I am able to be a referral source for them and connect them with a variety of programs to help with their medical needs. And ultimately, I get to partner with community agencies to help meet the family’s social and financial needs.

There were many times in the three years that I have worked with this family that it would have been easy to walk away and say, “There is nothing more that we can do to help you.” There were times that seemed to be the truth, but I could not let myself give up on this family while watching them work so hard and struggle to survive. But, the ultimate goal of social work is not just to do things for a family, but to empower them and teach them the skills so that they can ultimately learn to help themselves. Through a three year journey to empowerment, Steven’s family is finally at a place where they can help themselves and stand on their own feet. This is the ultimate reward for me, knowing that a child is safer, better cared for and has a greater chance to succeed in life because of work that I have been a part of.


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Crystal Williamson is a licensed master social worker at Cook Children’s in the Case Management department, working in Hematology and Oncology. She grew up in Arlington, TX and married her high school sweetheart. Her 18 month old little boy keeps her very busy, but when she has time she loves to write about almost anything and read historic or adventure fantasy fiction. Her favorites include Francine Rivers novels, Harry Potter and The Chronicles of Narnia.