On the first mile of her three-mile swim Sunday morning, Susan Spencer concentrated on the 25 names written in black marker on her right arm — those of friends and family members who had succumbed to cancer.
On her second lap, the Baltimore lawyer reflected on the 14 names of cancer survivors or those in remission scrawled on her left arm.
For the final mile, Spencer, 61, said she thought of "everyone and anyone affected by the disease."
She was not alone. In the cove off Gibson Island or in the pool at Meadowbrook Aquatic and Fitness Center in North Baltimore, more than 500 swimmers participated in Swim Across America, Baltimore edition, to raise money for the Sidney Kimmel Cancer Center at Johns Hopkins.
Many wore the name of a loved one on their swim cap, suit or skin. They swam alone or as part of a team. They burst with enthusiasm or swam strokes of silent determination.
"We do this," said Will Cosgarea, a McDonogh School junior, "because we can."
In the Baltimore swim's three years, participants have raised well over $1 million, enough to fund basic research, clinical trials, two intern positions and patient support programs, said Dr. Luis Diaz, associate professor of oncology and director of translational medicine at the cancer center.
Swim Across America has proved so successful and popular that its name is on a hospital laboratory. Next month, money raised by swimmers will pay for a retreat — the first — for couples dealing with one or both spouses' incurable cancer.
Diaz said the annual fund-raiser "just keeps getting better."
"It's starting to make a real difference," he said.
Before dawn on Sunday, the pasture at Waltjen Shedlick Farm slowly filled with swimmers of all skill levels struggling to stay warm in the fall air. A small armada of kayaks, canoes and jet skis bobbed along the course to keep everyone safe.
As they checked in, Rose Bloomberg and Grace Pollack of Baltimore rolled up their sleeves so volunteers could stencil "Rookie" on their forearms.
"Just one mile," said Bloomberg, who was there to swim in memory of a friend who died on Friday. "Otherwise, I'll be at the bottom."
At the other end of the skill scale was Ian Silverman, 16, a McDonogh School junior and London Paralympic gold medalist, who set a world record in the 400-meter freestyle of 4 minutes, 1.91 seconds. He was swimming for Joe Gorman, a good friend who died last year of leukemia at the age of 15.
Open-water swimming requires a different approach, Silverman said.
"In a pool, you have a whole lane to yourself and you know how far you're going. In open water, you hope you don't miss a buoy and swim 500 yards off-course. It's everyone for themselves, and there's arms and legs everywhere," he said.
Silverman led the pack from start to finish, swimming three miles in about 52 minutes.
For swimmers a little leery of the expanse of blue water, 15 members of Team Angel — all strong swimmers — were never more than a few strokes away. They were led this year by Cosgarea, whose older brother, Alec, a fellow McDonogh swimmer, died July 9 in a car accident.
"I took up my brother's job," said Cosgarea at the finish line after his charges were safely wrapped in towels. "He's the true angel and he's here today. No doubt, he's here."
Diaz said the swim has created a bond between the community and cancer center that can't be broken.
"It makes me really happy about Baltimore," he said. "It makes me feel a part of a larger community, and I know it makes our staff and patients feel part of a larger community."