Hazel Crabbe is lying in bed, as she must these days. Her dressing gown is aqua, her carefully styled hair is gray and her skin is yellow -- jaundiced, from the cancer.
Birthday balloons float on their strings from the bedposts, celebrating not only the day but also the fact that Crabbe lived to see it. When she left Greater Baltimore Medical Center in early January, more than a month after learning she has cancer of the pancreas, she was given a month or two to live.
Crabbe does not pretend that it is easy. She says the pain is getting worse and that "at times you feel so alone" -- especially with no relatives in the area.
What she has, though, is the attention of three women she calls her "lovely ladies:" Sarah Hardy shuttles in and out between her duties as an employe of the Towson apartment complex where Crabbe lives, preparing meals and spending the night; Barbara Smith and Mary Claire Walsh are volunteer "house callers" in a medical center program that gives support to cancer patients.
"I really don't think I would have made it without them," Crabbe said.
Smith and Walsh might never have been there if Dr. John M. McGovern had not had cancer. McGovern, who was the medical center's chief of staff and chairman of its department of obstetrics, became ill in 1982. From then until his death a year ago, he and his wife Margaret helped lay the foundation for the hospital's program.
Margaret McGovern, a nurse, said she and her husband were "better able to cope than others but still woefully short of information. The people in the hospital were very helpful, but their efforts were not coordinated."
But, she said, the hospital's cancer committee was becoming aware "that cancer should be treated as a multidisciplinary, coordinated effort."
As a result, the medical center has the John M. McGovern, M.D., Memorial Oncology Support Program. Marlene Mason, a nurse with a master's degree in counseling and education, oversees the program, aiming for a unified effort by professionals, other staff members and volunteers. And Margaret McGovern is coordinator of the volunteers.
The program is part of the hospital's emphasis on cancer care, which includes a radiation oncology wing dedicated in January. Staff members said the scope of the hospital's attention to cancer is more typical of large teaching hospitals than of community hospitals such as the medical center.
McGovern said the program's goal is to meet with the patient as soon after diagnosis as possible and to provide "all the emotional, psychological, physical and spiritual assistance that we can possibly muster" -- during and after the hospital stay. That support often continues for the family after a patient's death, she said.
Mason said the program "emphasizes the quality of life" and individual needs of the patients. The needs are varied, she said, as are the patients: There are men and women, people living alone or with families, and with backgrounds ranging from nursing to law, business to teaching.
One volunteer might find a patient who simply needs a shoulder to cry on. Another might stay with a patient so his wife can go to the hairdresser. And another, as happened in one case, might be the one to convince a patient that she should have the CAT scan her doctor has advised.
Patients without family in the area often benefit most from the program, staff members said. "People want to maintain their independence as much as possible," Mason said, and without the program some of them "might have to be in extended care facilities."
McGovern said the program works with facilities such as nursing homes and hospices when necessary. But because most of the patients involved are not terminally ill, the goal is to help the patients live at home.
Several types of support programs are available to Washington area cancer patients. At George Washington University Medical Center, for example, a team of professionals provides home care and Susan Keating, a nurse with mental health training, organizes groups in which patients help each other learn to cope with their illnesses. Washington Hospital Center offers a self-help program in conjunction with the American Cancer Society.
Known as CanSurmount, the program has been successful in various parts of the country, according to cancer society spokeswoman Lois Callahan. The society provides services ranging from presurgical counseling to paid household help, Callahan said.
Participants in the McGovern program in Towson are particularly proud that they have been able to build a coordinated network of support at a community hospital.
The program may be a sign of things to come. Keating, of GWU Medical Center, said, "We're going to see more and more of a need for liaisons between hospital and home" and said the McGovern program sounded "pretty fantastic."