Hospitals' 'hope coaches'

Cancer treatments had turned Marina Pena's once-full head of hair into a few wispy strands. Embarrassed, she hid them under a ratty blue fleece hat, one hardly suited for an 85-year-old grandmother.

Anne McNerney knew how Pena felt. Years ago, the moment McNerney realized her own fight with cancer was taking her hair, she bought a wig and had her husband give her a buzz cut.

So, one recent morning while Pena was getting her chemotherapy, McNerney appeared with a shopping bag kept in her desk drawer for just such occasions. Inside was a wig. The style, a short, Hillary Clinton 'do, but a few shades darker, was perfect.

Pena was giddy. She rolled her IV pole down the hall to get a look in the mirror, the wig's tag still hanging over her left ear. "It makes me look young," she said with a laugh.

McNerney smiled. She was doing her job.

McNerney is the patient navigator at the University of Maryland Medical Center. Her charge: To ease the life of the hospital's cancer patients in any way she can. That may mean finding help to pay for the tolls and gas to get to Baltimore for treatment, translating the arcane language of cancer treatment into plain English, or just holding a hand if that's what the patient needs.

Her job title - which didn't exist a few years ago - came about to deal with a health care system that can be overwhelming, even frightening, especially patients are the sickest. They wonder if they're going to die. They wonder if their insurance will cover the bill. They wonder if they'll ever make it through the maze of treatments and appointments and who-knows-what-else that lies ahead.

"Once you're diagnosed, you're free-falling for awhile," she said. "You're like a deer in headlights. You have a million questions ... . They just want someone to listen. Ninety-eight percent of the time we connect. They don't know what to expect and I've already been there."

McNerney's own cancer story brought her here. When she got the news in 1992, she was 39, with four children under 5, and a high-stress job in an office with a harbor view. She had breast cancer.

Her four months of treatment covered the gamut of therapies - 16 rounds of chemo, radiation and surgery that turned her life upside down. Somehow, she pulled through.

She tried to go back to the life she had before - but couldn't. She was a changed person. She quit her job - "I didn't buy expensive shoes anymore, but I didn't care" - and stayed home to raise her kids and help with her husband's construction business. She was happy.

A few years later, her husband suggested she volunteer at St. Agnes Hospital near their Ten Hills home, where she had been treated. Absolutely not, she said. "I don't even drive by that hospital without feeling waves of nausea," she told him.

In the end, she returned to the place that cured her. She volunteered at St. Agnes. She was there so often that they gave her a job.

In 2005, she came to the University of Maryland as the American Cancer Society's first patient navigator in the region that stretches from Delaware to Georgia (The ACS and the hospital share her salary). Now there are 30, with more navigators planned.

Today, at 55, Anne McNerney works the sunny cancer treatment room on the hospital's ground floor as if she is greeting old friends. And that's how many have come to think of her. She knows what illnesses they have. She knows their prognoses. She knows about their children, their troubled marriages.

Sometimes their needs are simple: McNerney points them toward support groups, explains counseling options, finds help to pay for parking if the patient is strapped for cash. She might offer a list of outside organizations that can help with bigger expenses.

Sometimes their needs are more complicated.

McNerney recalls a patient coming off radiation therapy last year who had no more treatment options. The only possibility was the clinical trial of an experimental drug. But to qualify, he was required to have a telephone.

The man's illness had left him destitute. He could no longer work. He was renting a room in someone else's home. He couldn't afford a phone.

A nurse called McNerney. Could she find him a cell phone? McNerney wasn't sure. She made some calls, and eventually the hospital's social work department got him a prepaid cell phone.

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