Up to the very end, Judy Marsh kept smiling. She went Christmas shopping for her grandchildren and bought gifts for her friends.
Even when doctors at University Medical Center told her last Thursday she would not live another 24 hours, the 50-year-old Pasadena resident had each of her family members come in for a talk. Then she took medication that would help her sleep.
Marsh never woke up. The woman who had battled Blue Cross/Blue Shield for more than a year to pay for a controversial cancer treatmentdied in her sleep with her family by her side. The cancer that had started in her breasts in 1988 had taken over, spreading to her liver and bones.
"She was well aware of what was happening and what was going to happen," her husband, Roland, said yesterday. "She didn't give up."
Marsh remained active. While going through her many chemotherapy treatments, she continued her home business, transcribing notes for doctors. She remembered birthdays for community children. She worked with other cancer patients at University Medical Center.
"Even in the last few weeks, with all her pain, she took the time and bought a present for my granddaughter," said Cookie Kiser, owner of Cookie's Kitchen, a Mountain Road restaurant the Marshes frequented. "Italways amazed me she could do this when she had all her problems."
In the end, it was the community that came through for Marsh. When Blue Cross of Maryland refused to pay for a special bone-marrow transplant described as the best way for Marsh to survive, friends, neighbors and strangers pitched in and gave her $130,000.
A spaghetti dinner at Cookie's raised $10,000. An auction of an Ocean City condo raised $30,000 -- all on $5 chances. The money got her into Duke University Medical Center in Durham, N.C., for the special treatment.
Roland Marsh said his wife never forgot. He said he believes the treatment, while failing, helped give Marsh an extra year of life, during which the couple took a vacation in Florida and allowed Judy Marsh to enjoy becoming a grandmother for the second time.
"I'm really gladshe had the opportunity to have the procedure," Roland Marsh said. "We tried it, and it gave her more time than she originally had."
The treatment -- an autologous bone-marrow transplant -- was recommended last year by Judy Marsh's doctors.
Duke specialists removed some of her bone marrow and froze it. Then they bombarded her tumors with high doses of chemotherapy before returning the frozen marrow to her system.
Blue Cross officials first told Marsh they would pay forthe risky procedure but then reversed themselves, calling the transplant "experimental."
The donations were enough to get Marsh into the hospital, but covered only about half of the $260,000 bill. RolandMarsh said he still owes about $118,000.
It appeared in February that Marsh would get insurance coverage when a federal district courtjudge ruled against Blue Cross of Maryland in a similar case.
Judge Marvin J. Garbis called a Blue Cross decision to withhold paymentsto two cancer patients "arbitrary and capricious" and ordered the insurer to pay the bills. The ruling forced Blue Cross in Maryland and several other states to change their policy and include covering the bone-marrow transplant.
But the company still would not pay for Judy Marsh's treatment, arguing that the ruling doesn't apply to that case because Roland Marsh is covered under the federal employee program, a separate contract that uses Blue Cross as a carrier. Marsh sued Blue Cross in June, and the case is still pending.
From June on, Judy Marsh got progressively worse. She underwent chemotherapy treatment five times, trying three different experimental drugs. None worked. Last Monday, she ventured out for the last time and went to Hecht'sdepartment store for a Christmas sale.
Last Tuesday, she fell illand was taken to University Medical Center. Two days later, she suffered two painful attacks that doctors feared were blood clots formingin her lungs. Later that night, she died.
Dr. Jeff Abrahms, Marsh's doctor at University Medical Center, said a blood clot was not thecause of death. The cancer, he said, simply took over. "She tried upto the end," Abrahms said. "Judy was a special person who really putup a battle against cancer."
Roland Marsh said his wife told eachfamily member a personal story before dying. "She still smiled and everything," he said. "Everything wasn't normal to her, but she was her normal self . . . And she was a little sweetheart."
Judy Marsh leaves her husband, Roland, their two sons, Michael and Jeffrey, and their wives, Lee and Donna. She had two grandchildren: 2 1/2-year-old Emily and 2-month-old Jeffrey Jr. She had one brother, James Harris, of Virginia, and two sisters, Carol Pritisi of Glen Burnie, and Sandra Freburger of Pasadena. Her mother, Margaret Harris, lives in Pasadena.
The funeral service was conducted Sunday at McCully's Funeral Home in Pasadena. Marsh was buried at the Glen Haven Cemetery in GlenBurnie.