Breast cancer hits women of color especially hard. Black women are twice as likely to be diagnosed with an aggressive type that’s harder to treat, and for Latina women, breast cancer is a leading cause of cancer-related death.
Beatrice W. Welters, a noted businesswoman and former U.S. ambassador to Trinidad and Tobago, was successfully treated for the disease at NYU Langone Health’s Perlmutter Cancer Center. In 2016, she helped fund the initiative that bears her name to educate women—particularly those from at-risk populations who live in medically underserved communities throughout New York City—about the importance of screening and early detection.
The program’s co-directors are Kathie-Ann Joseph, MD, MPH, professor in the Departments of Surgery and Population Health at NYU Langone and director of breast surgery at NYC Health + Hospitals/Bellevue, and Joseph E. Ravenell, MD, associate professor in the Departments of Population Health and Medicine and associate dean for diversity affairs and inclusion at NYU Grossman School of Medicine.
At the heart of the Beatrice W. Welters Breast Health Outreach and Navigation Program are five patient navigators who help women secure free or low-cost mammograms through community outreach efforts and guide recently diagnosed patients through the healthcare system. So far, the program has enrolled more than 2,000 people, nearly 20 percent of whom have become patients at Perlmutter Cancer Center.
“Some of my patients don’t have family members nearby, or they may not want to discuss certain things with their family. And they have so many other issues in their lives. These are the patients I have the strongest bond with.”
—Jackie Barry, Patient Navigator, Perlmutter Cancer Center’s Beatrice W. Welters Breast Health Outreach and Navigation Program
Here, Jackie Barry, who has been a patient navigator since the program’s inception, serving the Brooklyn communities of Sunset Park and Flatbush, discusses the unique challenges and immense rewards of supporting women through the ordeal that is breast cancer.
Why do some patients need a navigator?
Some of my patients don’t have family members nearby, or they may not want to discuss certain things with their family. And they have so many other issues in their lives. These are the patients I have the strongest bond with. I see who’s coming into the Family Health Centers at NYU Langone, and if they’re not compliant with their mammograms, I reach out to them.
If a woman is diagnosed with breast cancer, I connect her with as many resources as possible, eliminating all the barriers within my power. We provide free transportation for medical appointments. We help patients find small grants when they lose income. We help them get a wig when they lose their hair. A lot of these women have always focused on others, so I tell them: “Just one day a week, I want you to turn off everything and everybody and focus on yourself.”
When women are hesitant to get a mammogram, how do you reassure them?
There’s a lot of misinformation and fear relating to mammograms. When you have reliable information, you have less fear, less resistance. I emphasize that when breast cancer is found early, the outcomes are much better. I tell women that whatever pain they may experience during a 10-minute mammogram is nothing compared to treatments for advanced disease. I remind them that the amount of radiation they’re exposed to in an airplane is greater than from a mammogram. If they’re still resistant, I say: “Let’s do an ultrasound and see what happens.”
How do you earn a patient’s trust during such a terrifying time?
I take time to listen. Once you start listening to patients, they open up and you can better help them. I’m nonjudgmental. Rather than advise patients, I guide them. Even if someone looks OK, there may be something inside that they’ve never shared with anyone. I try to peel away the layers of the onion. If you’re not holding on to anything, it could make your recovery process better.
You’re known for going above and beyond for your patients. Can you share an example?
One patient called me at 3:00AM in a panic, telling me that she was afraid to die. After a lengthy conversation, I texted our medical director, Dr. Joseph, as well as our nurse coordinator. Within seconds, they responded with a plan to address some of the patient’s health issues.
That’s what I’m here for, even if it’s just holding a patient’s hand at the doctor’s office.
What makes you so well suited for this role?
I connect with people very easily from having lived in several countries and having been exposed to different cultures. My master’s degree is in disability studies and I’ve volunteered as an interpreter because I’m fluent in Spanish, French, and Creole. On my mother’s side, the men from my great grandfather down were doctors and pharmacists, and the women were nurses. I’ve always been interested in people’s wellbeing. Whenever traditional medicine was failing someone, I was always trying to find something that could help them.
What are your biggest day-to-day challenges?
My work has a very heavy emotional burden. Many of my patients are single mothers in their mid 30s or early 40s with the most aggressive cancers. Some of them have been in abusive relationships, and they have very young children. The ones with the worst illness have very heavy emotional baggage. I don’t know if that’s a coincidence or if stress has just depleted their immune systems. I wake up at 4:30AM and meditate, and then again at night. I take care of my energetic self.
What makes your day?
Whenever I get news that something actually shifted as a result of what we were able to do for a patient. The best experience is when a patient actually makes it out of the tunnel. Then I have a friend for life. For years they’ll talk about how they don’t know how they would have made it without this program. Just watching someone find the conviction that they’re going to make it, is cause for celebration. But everybody has a destiny, and when the outcome is heartbreaking, the reward is knowing that you did every single thing possible for them. And hearing them say, “I’m grateful that you were here with me on this journey.”