'Please, God, not yet' Sunday, November 1, 1998 By CONNIE SCHULTZ PLAIN DEALER REPORTER First of 26 daily articles Four-year-old Christopher Hearey sensed before anyone else that his mother would die soon. No one told him. On that sunny October morning last year, everyone around him was acting as if nothing had changed: Mom was sick, but they were used to that. His father, Clem, had already left for work. His older brothers, C.J., 9, and Michael, 6, had been at school for more than an hour. But Lisa Hearey was acting differently, and her youngest son knew it. He watched her throw up in the kitchen sink, then saw her stumble and nearly fall over tubing that continuously drained fluids from her stomach to a plastic bag she carried everywhere. His mom looked different, too. She was suppposed to drive him to school, but she wasn't even dressed. Her normally curly hair was dirty and matted in clumps against her head, and she was wearing those thick, clunky glasses she hated. At the last minute, she told him she wasn't taking him to school, that she had called a friend to drive him instead. "I'm not going, I won't go to school," Christopher wailed as Lisa tried to get his backpack onto his shoulders. "I want to watch my show." He ran to the television blaring in the next room, holding onto it with both hands as Lisa tried to pry him away. She turned the cartoon off, he turned it back on. She yelled, he yelled back. Usually, Christopher loved going to the preschool, and Lisa was growing desperate, her eyes wide and frightened. I just want to go to bed, she thought as she watched her screaming son. The last couple of nights had been rough. She was having a lot of trouble sleeping, and she was starting to vomit with alarming frequency. Three months ago, she almost died from constant vomiting. The growing tumor in her abdomen was crowding her internal organs and blocking her intestines, so doctors inserted the tube to drain Lisa Hearey, 40, cuddles with fluids. Now her only source of nutrients were 12-hour IV feeds. her son Christopher, 4, two They were keeping her alive, but only for a while. Time would run months before she died. At out. right is her husband Clem (Dale Omori/Plain Dealer Please, God, not yet, she thought. Photographer) I just need sleep, she kept telling herself. Everything will be better if I can just get some rest. But first she had to get Christopher to school. Emaciated at 87 pounds, she was no match for him and she knew it. So, she begged. "Come on, Chris, you've got to go to school," Lisa pleaded, her voice rising. "You've already seen this show. Please. Please put on your backpack and go to school."

She tried to lift the backpack, dropped it, then dropped her stomach bag. Christopher threw himself on the floor at her feet, sobbing. She reached down to lift him but couldn't, repeatedly dropping her stomach bag as she yelled at him to stand up. After 10 minutes of pleading, Christopher reluctantly agreed to leave. Red-faced and whimpering, he walked out the door. But instead of going to the waiting car, he bolted in the opposite direction. He ran past five, six, seven houses, stopped, looked back at his own house. He let out a scream, then headed for his front yard, where he ran round and round, all the while crying and screaming, "No, no, no." Then he stopped dead in his tracks, panting and sweaty. "I have to do something with Mommy," he yelled to himself. Lisa was on her way up the center hallway stairs, but turned to face Christopher when she heard him call. He burst through the door, but then stopped when he saw her. Lisa's legs looked fragile, birdlike, and she grasped her abdomen as she looked wearily at her son. Christopher walked to her, held up his arms and gently grasped her face with both hands, pulling her toward him. Touching his forehead to hers, he locked eyes with Lisa and softly rubbed her face. "OK," he said as he continued to whimper. "I can go now." The next day, Friday, Oct. 10, Lisa was lying in a fetal position in a hospital emergency room, pulling at her hair, her clothes, her bedding as she repeatedly vomited in a cardboard basin and writhed in pain. When she left the hospital two days later, it was the last time she rode in a car. She arrived home with another piece of medical equipment, this one a pump that gave her a steady flow of morphine. In July, occasional morphine pills under the tongue had eased the pain. By late August, she needed morphine patches. The first time she stuck one on her arm, she spoke with dread of what she knew lay ahead. "I guess eventually I'll need the pump," she said. "You get that at the end." She knew that day would come. She just couldn't believe it was here. Before it all Lisa Marie Barthello Hearey loved a party. Her sister, Andy Barthello, 42, likes to imagine Lisa standing in her center hallway, a glass of wine in her left hand as she held court, tossing back her blond, curly head of hair in laughter as she kidded with whoever walked through the door. She was the family mimic, possessing an uncanny ability to imitate relatives and friends with hilarious dead-on accuracy. The middle of five kids - four girls and a boy - she also was the peacemaker, the mediator, of the gregarious Catholic family led by stay-at-home mom, Mary, 64, and her husband, Marc, 64, an Air Force officer. Lisa was shy as a child, a real homebody who rarely went to sleepovers. She sobbed when she left home for college in the fall of 1974. She blossomed, though, at Mary Washington University in Fredericksburg, Va., where she pursued a major in history, only 50 miles from her parents' home in Vienna, Va.

As her confidence grew, Lisa became more outgoing and eager to get out into the world. By the time she graduated in 1978, she decided to pursue a career in business, starting out at a mortgage loan company in Washington, D.C. Lisa loved clothes. She used her first paycheck to buy a fur coat, and spent many after that on expensive, classic designer clothes. At 5-feet-6, 115 pounds, she looked as elegant in blue jeans as evening dresses, and she loved getting dolled up to go out. Despite her newfound freedom, Lisa was still her mother's child. After Lisa became ill, Mary regularly declared Lisa her favorite child. They shared a love for cooking, good wine and entertaining - and for family. Mary describes herself as born to have children, and the closer Lisa got to 30, the more she, too, openly longed for marriage and children. She was flirtatious and coy with guys she met, but usually drew the line at intimacy. She was involved with few men before she crossed paths with Clement James Hearey II in 1984. Lisa met Clem at a party of Wesleyan University grads, including her sister Andy, and Andy's fiance, Bill Ritchie, one of Clem's roommates at the elite college. In many ways, Clem was everything the conservative, rigidly organized Barthellos were not. He was the fifth of seven children, the youngest of four boys in a boisterous Catholic family near Philadelphia. Both his parents worked; his father was a salesman, his mother a hairdresser. A self-described ardent liberal, Clem attended the Connecticut college, where he became an integral member of a tightknit group of friends who remain close today. Clem was also a Peace Corps volunteer in Niger, intense in his desire to help others but also known by fellow volunteers as the guy who loved to stick foreign objects up his nostrils and in his ears. He was easygoing, with an affable smile and a commensurate love for classical music, literature, sports and partying. He had no immediate interest in marriage, and was in the throes of a career in international development. Lisa loved how easy Clem was to talk to, how he really listened to her that night as they huddled together to talk over the raucous partying going on around them. He liked her big, brown eyes, her easy laugh, her intelligence and her firm handshake. Like Lisa, he enjoyed their time together that night, but he left without any plans to call her. Andy, however, had plans. After noticing how they hit it off, she gave them tickets for a concert at the Kennedy Center for the Performing Arts. That clinched it. From then on, they were inseparable. They dated for nearly two years. Clem never mentioned marriage. Lisa, exasperated, began asking Clem to stop at drugstores during dates so she could pick up bridal magazines, and she developed a sudden fondness for warbling the same song over and over: "Goin' to the chapel and we're gonna get married . . .." Finally, nestled in bed with Clem in August 1986, Lisa asked him what he would like for his upcoming 33nd birthday and he responded by proposing. "I can't imagine a better birthday present for me than your agreeing to marry me." Lisa's eyes widened. "Do you mean it?" she asked. They were married on May 2, 1987, at St. Ann's Church in Washington, D.C. "I'm so happy," Lisa said as she modeled her wedding dress for her mother. "I've waited for this day all my life."

'So full of hope' Clem and Lisa moved to California's Bay area, where she had been hired to set up a nationwide telemarketing operation for a mortgage company in Walnut Creek. Clem later landed a job in human resources for the city. Lisa was subsequently hired as an assistant vice president for Wells Fargo Bank and later as senior group operations manager for Bank of America. Two months after their first wedding anniversary, Clement James III, called C.J., was born. Michael was born three years later in 1991; Christopher came in 1992. From the beginning, Clem surfaced as the parent the children usually turned to for comfort when they were hurt or upset. Clem was so close to C.J. that when Lisa was pregnant with Michael she pointed to her swollen belly and said to a friend, "Maybe this one will be mine." Lisa's mother used to marvel at Clem's ability to care for the children. Occasionally, she would be with them when one of the children cried out and Clem immediately responded. "Wow, how did you manage that?" she asked Lisa, who only shrugged her shoulders and smiled. Although Lisa loved her job, she hated being so far away from her parents and siblings. She also resented their constant money problems, which she attributed to Clem's unwillingness to leave the public sector and work for a corporation, where he could earn a higher salary. But Clem was committed to a career in public service, and their arguments over finances left them both hurt and angry at times. "Why can't you appreciate all we already have?" he would plead, but she dismissed his entreaties as sermons.

Lisa accomplishes one of her last goals -- walking her sons to their first day of school in August 1997. Her husband, Clem, is at left. (Dale Omori/Plain Dealer Photographer)

In 1994, Clem accepted a new position in Shaker Heights, where he would work for the city's human resources department. Lisa was thrilled to be moving closer to her family in Virginia; Clem looked forward to being near two of his older siblings. His brother Bruce, an attorney, lived in Shaker Heights with his wife and son; Clem's sister, Denise (Denny) O'Brien, lived with her husband and three sons in Gates Mills. Sitting on the shore of Lake Tahoe that summer, Clem and Lisa watched their three boys play in the sand and speculated on what moving to Shaker would bring. "We were so excited," Clem said. "We were so full of hope." Lisa and Clem bought a tudor home on Grenway Rd. in affluent Shaker Heights, where stay-athome moms are commonplace and two-parent families abound. Grenway was full of young families when the Heareys arrived; the street was home to 60 children, nearly three dozen of them under 6. City officials promoted the street as the quintessential Shaker neighborhood. Residents were friendly and proud of their tightknit community, throwing progressive dinners, annual Fourth of July block parties and impromptu get-togethers on front lawns, where children played and parents visited until midnight.

Overall, Lisa and Clem both described their marriage as strong and enduring, although their tensions over finances persisted. Less than a year after they arrived, Lisa reluctantly took a job at Ohio Savings. "I always wanted Clem to make more money so I wouldn't have to work," Lisa said. "I wanted to do more with the house and for the kids." It was a lament that came back to haunt her in the last weeks of her life, when she was terrified her "constant need to have more" was a sin that would be punished by God. 'This cannot be' In the fall of 1995, Lisa started feeling constantly tired, and by Christmas was complaining of back pain and persistent vaginal bleeding. Colleen Goss, a neighbor who also worked downtown, often drove Lisa to work and became concerned that she was ignoring her symptoms. "You need to see a doctor," she told Lisa several times. "You need to get this checked out." Finally, in January 1996, she took Colleen's advice. After several weeks of tests at Kaiser Permanente, Lisa underwent exploratory surgery at the Cleveland Clinic for what Kaiser doctors speculated was endometriosis, which occurs when the uterus' inner lining grows in abnormal locations in the abdomen. The surgery resulted in a hysterectomy, which she had anticipated, but the diagnosis was far more devastating. As she was being wheeled to the recovery room, Lisa was alert and alarmed. "What's wrong?" she asked Clem. He told her she had ovarian cancer. Lisa was encouraged by the doctors' immediate battle plan: high-level doses of Taxol, a promising chemotherapy drug. Then the pathology report came back. Lisa did not have ovarian cancer. Clem and Lisa sat in shock as the doctor told them he had never before seen her type of cancer and did not know what to do next. Lisa had two cancers: carcinoma of the appendix and adenocarcinoid of the appendix, a cancer so rare that fewer than 300 cases have been reported worldwide, according to the textbook "Cancer Medicine" (Williams and Wilkins, 1997). The cancers had metastasized throughout her abdomen. She was immediately referred to Kaiser oncologist Dr. Ruth Streeter. Streeter echoed every doctor Lisa and Clem spoke to in the days to follow: No one has survived this cancer. There is no known cure. Lisa zeroed in on six terrifying words: You have six months to live. "I went from thinking I had a treatable form of cancer to someone no one was going to help," Lisa said. "I wish I had breast cancer or ovarian cancer. At least then they would know what to do with me." Clem's response to the news was the same one he would have throughout the crises that unfolded over the next two years. This cannot be, he told himself over and over again. We are not giving up. His brother Chuck, a physician, and Adam Goldfarb, a pathologist who was a neighbor, immediately began researching medical journals and the Internet for someone, anyone, who could offer Lisa another chance. They found him at the Washington Institute of Cancer in Washington, D.C.

Lisa had only one question for Dr. Paul Sugarbaker: Can you help me? Sugarbaker made no guarantees. He had seen no patient live longer than two years after he performed a radical procedure that required 11 hours of surgery and then six hours of warm chemotherapy poured directly into the patient's abdomen through a series of tubes. There was a prolonged recovery period with no guarantee of success. Lisa said yes. Kaiser agreed to cover it. "Dr. Sugarbaker seems to be the best hope for us," Lisa wrote in the first page of a journal she kept briefly before her April surgery. "I'm anxious to have the surgery and get on the road to recovery." Throughout Lisa's surgery, Clem sent e-mail updates to a growing support group, including Shaker friends and nearly a dozen Wesleyan graduates, who had rallied around them. They designed an e-mail game titled "Stand By Me," named after Lisa and Clem's special song and intended to facilitate communication within the group. Andy and her husband bought the couple a laptop computer to use for communicating. When the surgery was over, Lisa was declared cancer-free. For a while. 'The tumor is back' Lisa spent three weeks in the hospital, then another two weeks at her parents' home in Virginia recovering. Clem's mother, Michelene Hearey, a widow since 1989, came from New Jersey to stay with the boys in Shaker. Grenway neighbors set up a rotating list of those willing to bring over dinners. For the next 13 months, Lisa lived a normal life. After her initial recovery period, she bounced back quickly, returning to work and celebrating her 40th birthday in September with a blacktie dinner party at her parents' home. Her immediate goal was to get to May 1997, when Sugarbaker would reopen her abdomen for what is called a "second-look" surgery to determine if she was still cancer-free. Eighteen days before her death, Lisa is hooked up to a morphine pump after being rushed to a hospital emergency room for uncontrollable pain and vomiting. At her side is her sister Andy Barthello. (Dale Omori/Plain Dealer Photographer)

In April, though, Lisa started feeling tired again. She also was feeling nauseous and her back pain had returned. She said she told no one but knew that her cancer was back. When Lisa and Clem arrived in Washington, D.C., for her second look, Sugarbaker ordered a CAT scan. "He told me the tumor was back," Lisa said, "that to open me up again would be butchery."

There was nothing more to do. The tumor would soon grow to block Lisa's intestines, making it impossible for her to digest food and requiring a nightly 12-hour IV of nutrients to keep her alive. Clem and Lisa returned home the next day. Two days later, Clem was back on the Internet, searching for leads on new cancer treatments. 'Get me a new life'

By July 3, Lisa was vomiting uncontrollably; she was down to 87 pounds and could not afford to lose any more. That afternoon, a doctor who was on call for Streeter ordered a stomach tube inserted to drain fluids and stop the vomiting. Then he sat Lisa and Clem down. "You have days, maybe weeks left," he told them. Lisa sobbed as Clem held her, and then he began to cry. Immediately, she stopped crying, trying instead to comfort her husband. That same day, Lisa agreed to allow a nurse from Hospice of the Western Reserve to visit her at home. "Can you give me the summer?" she asked Gayetta McMellen, the hospice nurse assigned to her case. "I think we can do that," said McMellen. Dosie Rymond was one of the first of Lisa's friends to call after the doctor told her she would soon die. It was the only time Dosie could remember Lisa sounding vulnerable. "They told me I might only have days left," Lisa told her, sobbing. Dosie started crying, too. "Oh, Lisa, what can I do?" "Get me a new life," said Lisa. 'In denial'? Lisa was determined to make whatever time she had count. She wanted to go to her family's Poconos retreat in July, to her sister Beanie Boniface's horse farm in August and to Boston with several of her friends in October. She also wanted to buy new shoes, swim in Shaker's Thornton Park pool, ride a horse, sail on Pocono Lake, walk her kids to their first day of school. "There are things I want to do and I want to do them my way and maybe that's selfish of me but it's how I feel," Lisa said. "I want to live a normal life for as long as I can." To the surprise of everyone but Clem, she did it all. Others voiced concern - but never to Lisa - that she wasn't preparing enough for her family's life after her death. They were a cadre of friends who consistently described Lisa and Clem as "in denial" of what lay ahead. They cited Clem and Lisa's refusal to hire a summer caregiver for the kids until late August, at a friend's urging, even though they increasingly were home all day unsupervised when Lisa was bedridden; Lisa's unwillingness to be videotaped or write extensive journals as a record for the boys once she was gone; and her decision to start a three-month round of chemotherapy after a doctor in July told her she had only a few weeks to live. 'It's hard letting go' Even after Lisa had made all her goals, she was not ready to die. "It's so hard," she said, sitting in bed where she had remained after her return from the hospital, two weeks before she died. "The pain is hard. It's hard letting go."

When asked if there was anything anyone could do to help her find peace, she shook her head. "Not yet," she said. Even then, friends and family were waiting for Lisa to show them the way. "Lisa was never the strongest personality," said a college friend, Bailey Johnson Schuerer, 41, echoing the opinions expressed by many who knew Lisa. "She was not necessarily the leader. . . . Now she's being a leader. She has something to prove. She's been a champion, she has never wallowed in self-pity. She's teaching all of us how to die." As of that day, Oct. 15, 1997, Lisa had only 13 more days to teach. Messages for Connie Schultz can be left at (216) 999-4249, or send her e-mail to [email protected] ©1998 THE PLAIN DEALER. Used with permission.