"Strawberry or vanilla?" Lou Yeager asks a cancer patient leaving his office.
"What tastes better?"
"Well, neither really," says Yeager, setting up his client, not with a milkshake order but with an Ensure booster program that will deliver the nutrition supplement free of charge. "Some people can only take food through liquid. And they can't afford the money, so we give it away."
He knows from experience.
Yeager, 57, was diagnosed with terminal lung cancer almost 25 years ago. But instead of admitting defeat, he used his time in chemotherapy treatments to talk to patients, finding there was a broken system – one he needed to do his part to fix.
"Because of the controlling type of person I am, I literally took over the infusion area. I mean 'took it over.' I started scheduling patients, getting there at 6 a.m., wouldn't leave until 8 p.m. And then I'd go with my IV pole from chair to chair, asking people what they needed," says Yeager.
In 1991, he founded Catastrophic Health Planners, knowing a crucial part of the treatment process was missing – that of meeting the financial, legal and family needs that arise during times of personal disaster.
"Patients were saying 'I'm having financial problems,' 'I'm having legal problems,' 'My family just won't talk anymore; they don't know what to say to me, I'm dying.'"
Yeager is not a social worker. Not a doctor. He has no medical training or counseling education. He is simply someone who discovered first hand what needed to be done and decided to do it.
"The day I started I basically gave up and said, 'God, you have to figure out where the money is coming from because I can't do it all,'" says Yeager.
CHP brings in around $300,000 a year – not nearly enough, according to Yeager.
"I could use a million, million and a half just to take care of Maryland's issues. But unless a miracle happens, it's just not going to happen. We don't have that image that we can show a little child that's sick, we have a whole family that's sick that needs help."
Yeager's office sees more than 250 clients a month, working with people who are suffering from disease and abuse or are victims of crimes and accidents. There is no case too big or too small.
"A catastrophic event to me is clarified by the following thing: If you're a truck driver and you break your leg, that's pretty catastrophic to you. We have no requirements about you have to be rich, poor, whatever. If you have a need, we're here for you. We will do whatever we can for you," says Yeager.
CHP has partnered with the Greater Baltimore Medical Center, where Yeager visited for treatment. He travels there once a week to meet with patients who are unable to travel to his offices in Westminster.
"I feel very lucky that we have him here. I feel lucky for our patients, and also for us," says Donna Lewis, manager of Oncology Support Services at the Greater Baltimore Medical Center. "If you don't have resources to offer them we feel like we're letting them down but there's a whole new dimension that he adds to our services."
"He's worth his weight in gold for what he does for his patients. I'm a nurse and a counselor and I think that when you work in oncology in particular there are patients that you see over and over again. With more people surviving cancer these days we aren't dealing with survivorship issues so much now. A lot of the problems are financial issues," says Lewis.
According to a recent study published in Cancer, a peer-reviewed journal of The American Cancer Society, 2 million cancer survivors did not get needed medical services in the previous year because of concerns about cost.
Their stories are often heart-wrenching, and finding the money to help is not easy.
Last month at GBMC, for example, Yeager met with a young woman who was diagnosed with stage four ovarian cancer. She had called doctors, social workers and oncologists to a meeting, searching for help and not wanting to give up.
"The oncologist explains the whole scenario to her and she patient looks at me and says, 'What are they trying to tell me?' Because I've been close to death a couple of times and because I'm not very politically correct, I said, 'If they give you chemo, you're going to die. And if they don't give you chemo, you're going to die. Put your robe and your slippers on. I'm going to get you a hall pass, and I'm going to take you over to hospice, and I'm going to give you a tour of an absolutely wonderful place; it's your house on steroids.'"
After giving her a tour of the facilities and convincing her that she would be better off in hospice because of her exposed wounds, Yeager took her and put her in bed. But the work didn't stop there.
CHP had to take care of legal issues as well because the patient's children were not related to her spouse. "We took care of the guardian issues so that when she passed away, he wouldn't lose custody of them," said Yeager. "And, that's what we do."
Yeager's cases are not all about cancer and they sometimes cross state borders. Yeager tells a story about a young teen robbed of $3 when on spring break in Florida. The criminals set her on fire, causing devastating damage to her face and limbs. Because she left the state of Florida to come home to her family following the incident, she wasn't eligible for the fund the state gives to victims of criminal activity.
"Shame on her, at 17 she wanted to be at home with her parents. Because she came back to Maryland, she wasn't eligible for any benefits. It took us six months to find a surgeon who would put her face back together again," says Yeager.
For his dedication and service, Yeager has received numerous awards, most recently the Greater Baltimore Medical Center's 2010 Making A Difference Award by the Sandra & Malcolm Berman Cancer Institute.
But to Yeager, the awards to him are misplaced; they symbolize something deeper. "All they do is hurt me," he said holding back tears. "You shouldn't get awards when people are dying. The awards should go to the people who are fighting the battle. I'm just a player, you know? I'm just trying to make a difference. How do you get an award for helping somebody die?"
While Yeager's cancer is in remission, he still battles severe health issues due to damage caused by his cancer treatments. "I have heart damage, liver damage, thyroid damage, prostate damage. I have this thing called hemochromatosis, which will eventually kill me. It's iron overload; your organs fill up with iron and eventually stop; they stop moving. It's a drawback. So with the hours that I have available, I continue to sort of figure out what we can do."
The average person in Yeager's situation might give up. He says, "You just take one step at a time I guess there are some nights you go home that you cry and the rest of the world looks at you like you're crazy."
Why does he continue? "I survived death. It's my only answer," says Yeager. "You don't do this because you think you're going to get rich. I guarantee it when I become retirement age, which is right around the corner, I may regret that I've dedicated 20 years. I'm not going to have a pension, but it's a decision that I made 20 years ago that I'm willing to pay the price for…I won't know until the game is over."