The sign hanging on the fireplace in Alice Helm's Bethesda home reads "No smoking please." Nearby, there is a stack of about 50 cards and letters from friends wishing her well.
She is trying to write back to everybody, though her energy has waned. She still makes calls, but only in the mornings -- she's too tired by afternoon -- and has made it to a few meetings. She has also planned her funeral, down to who will speak.
"I'm just trying to live my life," said the diminutive 75-year-old civic activist, "trying to be the same person I've been."
Last fall, in a cruel twist of irony, Helm, an anti-smoking advocate and lifelong non-smoker, learned that she had advanced lung cancer. Doctors estimated in October that she had about five months to live; friends and family say she is facing her illness with the same fearlessness and biting humor that has made her legendary in Montgomery County politics.
"She's not afraid of a darn thing," said Joan Deacon, librarian at the Montgomery County Detention Center. "There is not an ounce of dissembling about her; she is dedicated to her causes, and she just goes all the way."
Born into a family of stalwart New York Republicans, Alice Kupferman was named after Theodore Roosevelt's oldest child. Her father, Samuel H. Kupferman, ran for the New York state legislature and the U.S. House of Representatives. Her brother, Theodore Roosevelt Kupferman, served two terms in Congress and was a New York state judge.
She graduated from Columbia University's law school in 1950 and moved the next year to Washington, where she spent more than three decades working as a lawyer for the Justice Department, Department of Commerce and the Federal Elections Commission. She met Lewis Helm on a double date in 1952, and by 1953 they were married.
At the same time, she accumulated a list of civic activities uncommonly long even by the standards of hyper-engaged Montgomery County, including the Library Advisory Committee, the Montgomery County Commission on Aging and advocacy for animal rights. Her retirement from the federal government in 1986 led to even more projects.
"I used to kid people and say, 'I'll have to go back and get a full-time job because I don't have any time for myself anymore,' " Helm said.
"She's the very model of an excellent civic activist," said former Montgomery County Council member Blair G. Ewing (D), for whom Alice and Lewis Helm campaigned last fall. "I've always valued people like Alice, and Alice in particular, because they make it necessary for government to justify itself."
It was as co-chairwoman of the Montgomery Smoke Free Coalition that Helm gained perhaps the most notoriety. In a contentious debate, she helped the group successfully lobby the Montgomery County Council to ban smoking in the county's bars and restaurants.
She became so identified with the anti-smoking movement that opponents gave out buttons urging people to "Say no to Anti Alice Helms." She relished the fight. One day she came upon a restaurant worker wearing the button.
"Have you met Alice Helms?" she asked.
"No," the worker said.
"Well, I'm Alice Helms," she said. "Would you like me to autograph that button for you?"
A Montgomery County Circuit Court judge struck down the ban in June 2000, and the council appealed the ruling to the Maryland Court of Special Appeals, which has not handed down an opinion.
Hints that something was seriously wrong for Alice surfaced last summer, when she and Lewis were in Vancouver, B.C., for a cruise. When they boarded, and smelled cigarette smoke on a ship they'd been promised was non-smoking, they canceled.
But there was something else nagging at Helm -- lower back pain that seemed to be getting worse. Two months, several doctors and many tests later, she was diagnosed with lung cancer, which had spread to her spine.
She has been taking Iressa, an experimental lung-cancer drug that is in clinical trials pending approval by the Food and Drug Administration. Her tumors have been reduced 25 percent, Helm said, and she feels much better than she did months ago.
According to the American Cancer Society, non-smokers account for 13 percent of the estimated 157,000 lung cancer deaths each year. Radon, cadmium and other chemicals are known to cause lung cancer, as is secondhand smoke.
"There's no definitive way of establishing the cause of a cancer in an individual," said Michael J. Thun, who heads epidemiological research for the American Cancer Society. "Are there people that develop lung cancer without exposures [to any of the known cancer-causing agents]? No one knows."
It was tobacco, and what they saw as its huge financial influence, that drove the Helms out of the Republican Party in 1996. Lewis Helm held various posts in the Nixon administration and was assistant secretary for public affairs for the Department of Health, Education and Welfare. He was also chairman of the Washington Suburban Sanitary Commission in 1993-94 and ran for the Montgomery County Council as a Republican in 1994.
His basement study is festooned with Nixon and Reagan campaign paraphernalia. But outside, in the driveway, both cars have bumper stickers for Chris Van Hollen, a Democrat who defeated longtime incumbent Republican Constance A. Morella in the Eighth Congressional District race last fall.
"The party left us, we didn't leave the party," Alice Helm said.
Her mother, Gertrude Kupferman Davenport, lived with the Helms for 13 years, until her death in 1988. The struggle to secure proper health care for her mother spurred Helms to advocate -- she would say agitate -- for better services for seniors. Now, as time slips away, she's got one last cause -- herself.
After buzzing repeatedly for a nurse while in George Washington Hospital in September, she lost patience and marched, IV in her arm, toward the hallway.
"Excuse me," she remembers saying to a cluster of doctors standing not far away. "But I need some help here. You wouldn't have a job if it wasn't for people like me. I'm a patient and I need some help."
An attendant was summoned to change Helm's sheets, which had become soaked with sweat -- a result of her tossing and turning from the intense pain caused by a lung biopsy.
"So often, seniors are so reticent," she said. "I always say, what can they do to you? You might as well go make a stink."