Hattie Mobley must have a new pancreas, or she might not live to see her next birthday.
You wouldn't know this from just listening to her. Mobley, 37, laughs a lot and talks enthusiastically about the joys of crocheting.
But if you look closely, you'll see that she is connected to a nutrition machine, which looks like a hatrack on wheels that holds bags of liquid nutrients. She is bonded to it via a catheter in her chest, and it is her constant companion from 6 p.m. to 8 a.m. each day.
"Without my pal, I'd be dead," she said with a grateful smile.
But according to her doctors, her "pal" may not do her much good much longer.
Mobley was placed on the Total Patient Nutrition machine, or TPN as it is called, a year ago. It worked superbly -- at first. Then, about five months ago, she began waking up with dangerously low blood sugar levels and suffering from severe fatigue. She also had become vulnerable to infections.
Doctors say she needs the transplant as soon as possible. But insurance regulations call pancreas transplants "experimental," and insurers have refused to pay for them.
This has left Mobley with no way to pay the $44,000 that area hospitals say the delicate operation will cost.
"It's sad how her life has come down to a matter of money," said Dennis Camp, Mobley's fiancee, as they sat in their apartment in Northwest Washington yesterday. "Why does it have to be that you live if you're rich and die if you're poor?"
"God will give me a pancreas," Mobley reassured him.
Mobley was diagnosed as having inherited, chronic pancreatitis in 1982. Since then, doctors say, everything that has been done for her has failed or is failing to suffice.
Yet, on most mornings, Mobley still manages to prepare breakfast for Camp and her three children, although the smell of food nauseates her. On Thanksgiving Day, after family members had worked hard to prepare dinner, she forced herself to sit at the table and watch her loved ones enjoy themselves.
"I'm determined to stay a part of the living," she said. "Right now, it's my family and this machine that keeps me going."
Her encounters with the medical establishment, however, have sometimes left her feeling like calling it quits. Her surgeons -- who include Clive O. Callender, Norman Rogers and Edward Cornwell III of Howard University Hospital -- are exemplary. But they share her frustration over convoluted insurance regulations.
"If you have a problem where only the pancreas is involved -- because that is less common -- you become a victim," said Callender, who is director of Howard Hospital's Transplant Center. "Insurance companies call pancreas transplants 'experimental' because we do so few of them. But if you have the more common ailments that involve both kidney and pancreas, then you can get both organs transplanted without much trouble."
"It makes you wish that Hattie's kidneys would go bad so the pancreas problem could be taken care of," said Kathy Warner, president of The Friends of the Howard University Transplant Center. "It also makes you wonder how the government puts a value on certain organs."
Two weeks ago, The Friends group, which is based at Warner's home in west Hyattsville, sponsored a benefit gospel concert, which raised $16,000 for Mobley.
That was not enough.
Camp, a professional painter, tried his hand at fund-raising.
"I asked my employer if he could ask the people on my job to donate something," he said. "My boss said, 'Sorry, Dennis. Everybody's got problems.' "
On Friday, gospel radio station WYCB-AM will take pledges from listeners to help Mobley.
Until the money is raised, Mobley will continue spending 14 hours a day connected to the machine, which replaces the functions of her digestive system that were damaged by her malfunctioning pancreas.
"All I need is this organ, and I could get a good night sleep for a change," Mobley said, laughing. "Does anybody realize how badly I yearn for the taste of a steak and potato?"
Although Mobley expressed nothing but gratitude for the reprieve that the TPN had given her, the look in her eye was of a woman who hoped the day would soon come when she could live without it.
"When neighbors see me walking with my machine in tow, and hoses coming out of me, they stare like I'm from outer space," she said. "I used to be embarrassed, but I've accepted the fact that it is keeping me alive."