This week, as high school seniors across Utah don caps and gowns, the Deseret Morning News is profiling five graduates who have overcome daunting obstacles to receive their diplomas. This is the first of those profiles.
Sindy Manzano knows her way around the hospital bureaucracy, health insurance, month-to-month bills and budgeting.
She's been overwhelmed with bills and sleepless nights, and she knows what it's like to raise children, attend parent-teacher conferences and provide for a family.
But Manzano is only 18.
She doesn't have friends, doesn't go to the mall or movies or dances. But she knows more about being grown up than many adults, leading her family through medical complications, financial difficulties, language barriers and day-to-day life in the United States.
Manzano's family moved to the United States from Mexico when she was 12. She had loved school in the past, but here, since she only spoke Spanish, it was tough for a while.
Her mother was never allowed to go to school, so she can't read or write, and her father has only a third-grade education.
"My dad brought us over here so we could study, have a career and have a great life he wanted us to have the education that he never had," Manzano said.
She learned the language and became an A student, setting an example for her siblings and helping her non-English-speaking parents.
Things were going well and she dreamed of becoming a nurse after high school, but her life was turned upside down last year when she noticed her brother's nose was bleeding constantly.
Cruz, who is one year younger than Sindy, had become alarmingly thin and suffered violent nosebleeds. She took him to a doctor, who discovered his kidneys were not functioning correctly.
"His kidneys were working only 5 percent of what they should have been, and he looked so sick . . . it was scary," she said.
He needed dialysis and a transplant. He needed to be cared for, taken to doctor's visits and dialysis treatments. And her parents needed someone to talk to doctors and social workers, sign papers and find insurance while they held down their own jobs.
Sindy answered the call, but it made it hard to attend school every day.
Last fall, doctors found a donor match in Sindy's mother, Maria. But it is not an easy procedure, and her mother had to quit her job. After the operation, Cruz was fine but Maria suffered complications, among them pancreatitis.
Maria was in the hospital for more than a month and a half racking up overwhelming medical costs.
Sindy had to put her senior year of school at Hunter High on the back burner and get a job to help pay bills, insurance and make up for her mother not working.
"I had to work because of all the expenses at home, and my dad wasn't able to keep up with it all," Sindy said.
When she wasn't at her job at Burger King she was taking care of things at the hospital, talking to social workers, calling insurance companies and looking for ways to get out from under the cumbersome debt not to mention caring for her siblings, ages 17, 11, 4 and 2.
"She was just torn, there was nothing else she could do her family needed her," said Jill Lemmon, Sindy's AP English teacher. "She is so unique in that she has taken on that much and handled it."
She was able to attend school occasionally, but her grades went from A's to F's within a month. A bright student, she was enrolled in both AP English and AP Spanish, honors math and advanced orchestra.
"It really made me sad, my grades were all A's and only sometimes B's before," said Sindy. "I really liked school."
By early spring, her mother recovered and returned to work, which allowed Sindy to go back to school.
Still, with such steep bills she had to continue working 30 to 40 hours a week, sort through bills, care for her young siblings while her parents are at work, take Cruz to frequent doctor appointments and catch up on the months of school she has missed.
But with the help of understanding teachers like Lemmon she was able to catch up and graduate though her grades aren't exactly where she wanted them to be.
"She has worked really hard and caught up, it's amazing what she has done," said Lemmon.
Sindy said life is still stressful, with $30,000 in medical debts on top of everything else.
"Like today, my dad gets paid. Tomorrow, I get home, go through the bills to see which ones we are able to send out and if I can't, I have to make calls and say 'I can't send you money, I have to wait 'til next time,' " she said.
She admits to occasional emotion when she is alone. "Sometimes it just seems really hard," she said, getting a little teary in their two-bedroom Glendale apartment.
But she is breathing a little easier these days. Her family is healthy, and she is getting a diploma fulfilling both her and her dad's dream.
She still has hopes of becoming a nurse, but not for a while."I am just going to take a break for a while, get another job to clear out some of these bills then I can focus on my education," Sindy said.