In the midst of the pain and the fear triggered by doctors measuring his life in months, 16-year-old Mark Steinacker leans on his friends in his Pelham Avenue neighborhood of Northeast Baltimore.
"When it gets hard," he says, "they help me out."
They hang out with him. They sympathize. But they're tough.
"If he says something about dying," says Carol Steinacker, his mother, "they say, 'Mark, we don't want to hear you talk like that.' "
Now another "friend," one he has never met and whose name he does not know, will try to save his life even more dramatically.
Since last May, when he first heard the word leukemia and his name uttered in the same breath, Mark has been treated with chemotherapy while he waited for a bone marrow transplant.
He had fevers of 107 degrees. The chemicals produced wrenching tremors in his body. His weight fell from 142 to 119 pounds before his body began to adjust.
His doctors searched without success for someone whose blood tests suggested bone marrow that would match Mark's. His two brothers, his sister and his parents were tested. No one in his family had the right blood characteristics. Neighbors were tested, too -- with the same discouraging results.
Doctors also consulted the National Marrow Registry, a computerized listing of 500,000 people who have had their blood tested and are ready to serve as bone marrow donors.
In late February, Mark Steinacker hit the bone marrow lottery. Doctors called to say they had a donor. "Without a transplant," the Lake Clifton High School student said yesterday, "the doctors said I might not live another three years."
His survival chances are no better than 10 percent with the chemotherapy alone, his mother said, but 70 percent with the bone marrow transplant. All over the country, private citizens are working with medical authorities to make the odds better, to create more saving outcomes such as the one Mrs. Steinacker is praying for.
In Annapolis today, for example, free blood tests will be given from 9:30 a.m. to 6 p.m. in the Calvert Room of the State House as part of a program to recruit donors from every county in Maryland.
"We're starting at the legislature so we'll have people from all over the state who are familiar with what we're trying to do," says Lois G. Hoffer, coordinator of the Unrelated Bone Marrow Program at the Johns Hopkins Hospital. In all, doctors have performed 1,031 transplants with the help of the national registry since it was started four years ago. About a dozen of these have been done at Johns Hopkins.
Though today's testing in Annapolis will be free, donors such as the one found for Mark Steinacker pay $55 or more for the test. When doctors find a potential match, more sophisticated testing follows, and a donor may elect to withdraw from the program at any time. Finally, the marrow donor is hospitalized over night for the procedure. The marrow is taken by syringe from the hip under general or epidural anesthesia, which numbs the entire lower body.
To cover the $28,000 cost of the transplant and related medical bills, Mark's neighbors and friends are holding raffles and a dinner-dance on Friday, March 27, at the Teamsters Hall, 6000 Erdman Ave. Tickets are $15 in advance, $20 at the door. They can be obtained by calling Anna Bevins at 325-9264.
Mrs. Steinacker, who is employed as a teacher's aide at the Red Balloon Daycare Center in Waverly, wishes she knew the donor's name. "I'd give the biggest hug I ever gave anybody in my life," she says.
Mark is pleased, too, but the worry is persistent, even now.
"If it's got to be this way, it's got to be this way," he says.
And if, even now, he talks about dying, his mother says, "It's like a knife going through me." She wants to be strong for her son. No tears, she says. None he can see.
"I say, 'Mark, you're going to have my grandchildren one of these days.' "
With the registry and Mark's anonymous friend, the odds she is right are much improved.