As his liver was failing, House Speaker Michael E. Busch denied he was sick to everyone — even himself.
General Assembly colleagues, lifelong friends, his staff, the media, even family asking after his health got the same response: "I'm fine."
Those close to him watched with growing concern as his weight drop precipitously and his skin turned pale.
So when the 70-year-old Busch called his middle sister in late May asking her to gather their siblings, she expected the worst.
"I thought he was going to tell us he that was dying, and he wanted us to make sure that we knew what his wishes were for his children," Kathleen "Laurie" Bernhardt said.
Instead, gathered around a kitchen table at Bernhardt's house, one of the most powerful men in Maryland politics asked his three younger sisters for half a liver.
"I said, 'Look, I'm in dire need here,'" Busch recalled Thursday. "None of them blinked an eye."
All three immediately volunteered, and doctors picked Bernhardt, 59, as the best donor.
"We were sort of relieved," she said."Is that all you need to keep you alive? Fine."
Three and a half months after the liver transplant, Busch and his sister spoke publicly for the first time Thursday about the surgery that saved his life and renewed the bond between them.
In the House of Delegates lounge at the Maryland State House, Bernhardt rapped Busch on the back to remind him to sit up straight. She ruffled his hair disapprovingly and turned to his surgeon.
"His hair thinned out back here," she said. "Think you can make it grow back thick like mine?"
Busch laughed and shrugged.
"I'm like the family pet."
Busch said he thought his liver condition was manageable until mid-May, when a doctor asked the age of his eldest daughter. The doctor suggested she donate part of her liver to save him.
"It was a pretty traumatic moment," Busch said. "I had thought after the [legislative] session, with the lack of the stress of the session, that I could get more rest. That some of this would take care of itself.
"That was not the case."
It was around the time that Busch filed for reelection to the seat he's held since 1987. He still plans to return in January as speaker and, next November, seek his ninth four-year term in office.
The Anne Arundel County Democrat is the longest-serving House speaker in Maryland history. A college football player at Temple University, his athleticism has defined his political persona — delegates affectionately call him "coach."
His illness began unfolding in public last fall, but doctors did not diagnose him with nonalcoholic steatohepatitis until May. By then, Busch, a nondrinker, had packed 16 liters — 30 pounds — of fluid on his abdomen. He couldn't take off his own shoes.
He was so weak, his sister dressed him in his hospital gown after putting on her own.
"All your vanity is gone when you're in those gowns," Busch said.
Just six weeks earlier, on the hectic, final day of the General Assembly session, Busch had put his No. 2 in charge of the House while he rested in his office. He told reporters he just had the sniffles, and was feeling "better than ever."
His sisters had been worried for more than a year.
"My sisters and I would say to each other, 'Don't you think he looks bad?' 'He looks bad.' 'He says he's fine," Bernhardt said.
"And then we'd see him at another family gathering, and he's not getting better. [He'd say,] 'I have a bit of fluid and it's pressing on my stomach, but I'm taking pills and it's going away, blah, blah, blah,'" Bernhardt said. "Each time we saw him, he did not look any better. But he kept telling us that he was fine, that he was getting better."
Five weeks ago, Busch was still recovering and unable to return to work or eat much. A state trooper on his security detail would drive him from his Annapolis home to the State House to collect mail, and Busch would convene impromptu staff meetings in the backseat of his SUV, call House Democrats facing tough reelection bids and, in between medical appointments, grant interviews about how a Confederate-era statue should be removed from State House grounds.
Busch said Thursday he feels he finally turned a corner last month.
"I still think it's day by day, you know what I mean? I'm just happy to be where I am now, and I'm eternally grateful that my sisters stepped up to the plate," he said. "I didn't know that they thought I was going to tell them I was dying. But I was going to do everything I could to live. I have two daughters."
"And a wife," Bernhardt reminded him.
Busch and Bernhardt pitched themselves as poster children for the benefits of the University of Maryland's living donor program, one of the largest transplant operations in the country.
"What we want you to do is advertise that donation is a good thing," she told a reporter. "Put in there that the liver does regenerate itself, and people can donate and still — after recuperation — remain healthy and retain their active lifestyles."
The operation that saved Busch's life was rare just 10 years ago, said his surgeon, Rolf Barth, the head of the University of Maryland Medical Center's transplant program.
Now the hospital is on pace to do about 170 transplants this year, and the medical community has come to recommend living donors because patients don't have to get as ill before they qualify for a transplant.
Not everything about the operation was perfect. The surgeons asked what type of music Busch wanted played while they cut out his scarred, failing liver.
He requested The Eagles. He got Britney Spears.
Barth echoed Bernhardt's message: After a two-month recovery, he said, livers grow back.
"Life after donation is the same as life before donation," he said. "The only thing she can't do is donate again. But otherwise, she will be perfect."
Barth, who started treating Busch after a transplant was recommended, said the speaker's condition had been deteriorating to the point that he would need to live in a hospital for treatment. But the speaker's mind was alert and going "100 mph" during his illness, up until the day of the surgery.
"Your body is sometimes sending you messages that your brain is not ready to receive," Barth said.
Bernhardt hopes that now her big brother will finally get the legislation to outlaw puppy mills that she and her sisters have been pushing passed. They've protested outside his office, to no avail. But that was before they all offered to surrender part of their livers.
"It's a win-win," she joked. "Those bills won't stay in the drawer, right, Mike? Those bills will touch the floor and won't get shoved in a drawer again, right, Mike?
"Yes," Busch said in a flat, sarcastic monotone. "Absolutely, 100 percent."