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It wasn't the malignant ovarian tumor that ruptured during surgery. It wasn't the resulting pleural emboli or the lung that was punctured and collapsed during cath- eterization. It wasn't the cancer that crept into her liver or even the moment her doctor said all hope was lost. What really sent Meg Gaines over the edge—inspiring an emotional outburst that produced a good, strong belly laugh and sent her toppling out of bed—was the suggestion that she might be mentally ill. What else could explain her steady calm? Clearly she'd not understood when the renegade surgeon told her, "We can operate, but your chances of dying on the table are 50-50." Gaines, a professor at the University of Wisconsin Law School, was in her late 30s when her gynecologist palpated what was as- sumed to be a harmless ovarian cyst. When the doctor attempted to surgically remove this cyst—actually a cancerous tumor—it burst. Hope was fizzling fast, the cancer had moved to her liver in the really had one of these laughs, the kind where you're crying and peeing in your pants. I rolled off the bed onto the nasty floor of [our] hotel. "I'm practically giddy thinking about dying on his table!" she explains. "Obviously, the guy has never imagined me lying on a bed in my living room, with my children avoiding the room because they can't stand to look at me, with me in such a morphine haze that I kind of recognize them and kind of don't. Lying there going from 120 pounds to 110 pounds to 90 pounds until I finally…go." This watershed moment is among the many that help Gaines con- nect, again and again, to the experiences of others now trying to navigate the medical system while gravely ill. "It was one of the first moments that it really crystalized for me three chemo-resistant tumors, but the worst was yet to come. By using a type of dye-injection radiography, doctors found that her liver tumors actually numbered 12—at least 12—and told her it was white-flag time: She should focus on the quality instead of the quantity of her remaining days. Gaines' children were just 3 and 1 years old. Thus began her self-described Shakespearean odyssey across the country in search of a cure. "If somebody said to you, 'Sorry, but you're gonna actually have to ditch your kids,' you'd be like an insane, crazed person," she says. We're seated in the second-floor office of the Center for Patient that [health care providers] have such a different thing going on for them," she says. "What's going on for [my doctor] is his trial and his funding, and certainly he's feeling some concern for me—he doesn't want some bat-shit crazy patient on the table, right?—but he doesn't at all know what's going on for me, not even remotely. And, honestly, he doesn't even want to, because I think if he did, he'd feel overwhelmed." But would he have been overwhelmed? Do doctors really have to put up emotional walls as they're taught to do? These are the kinds of questions Gaines asks today, 17 years after Partnerships (CPP) inside the UW Law School. It's a space so mod- est it feels like a converted storage area. A student volunteer has just escorted me to the office by way of squeezing between a file cabinet and a portable fan. This is where Gaines' odyssey has brought her. Gaines welcomes me warmly, offering me something to drink ing with her story. "Because I wasn't leaving my kids…I was gonna do anything. I was at least gonna die trying." That was early 1995. Over the next two years, bearing her can- and leaning back with her arms behind her head. Instead of be- ing the power-suited lawyer I'd expected, she's like some khakis- sporting spitfire who looks like she just finished book club. And for all of her eloquence and acumen, she isn't shy about describing her situation bluntly—a hint of a smile perpetually on her lips as if to say, I'm not bulletproof, but I won't take any bull. "I basically was an insane, crazed person," Gaines says, continu- cer albatross, Gaines learned volumes about the medical world in which a seriously ill person must exist. She became painfully aware of its endless complexities and how easily things could have ended very differently for her were she short on education, confidence, clout, connections or money. She, in all likelihood, would have died. She certainly wouldn't have crossed the country to find a "buc- her diagnosis—and the kind that led her to launch the Center for Patient Partnerships in 2001 after what she calls her "knight and shining armor phase" when her oncologist enlisted her on occa- sion to inspire other seriously ill patients. She often couldn't resist interceding on their behalf, one patient and issue at a time. She knew all too well the complexities they were facing while feeling physically and emotionally ravaged. Eventually she realized that her micro-approach to a macro-problem was not the best use of her passion and skills, and her new mission was born. didn't have to die! It didn't have to happen. I didn't have cancer all over my liver!'" Gaines realizes she's alive today because a lot more than luck "I kept having this recurring daydream," Gaines explains, remembering back to her diagnosis. "I was floating over my own funeral, listening to people talk about how I'd had so much cancer all over my liver, that I'd lived so long considering that, and what a testament it was to how much I loved my kids and what a testament it was to what a fighter I was." Gaines' eyes blaze, and she shakes her head as her intensity rises. "I just remember this feeling of wanting to scream and say, 'No! I caneer" surgeon who would open her up, discover that all but one of her liver tumors were normal fatty growths, and successfully remove the cancer. She might have at least quivered when he warned her of the 50-50 chance of dying during that experimen- tal surgery—one he'd performed only twice, on patients who died within three months. Gaines is lucky he even agreed to do it, de- spite wondering if she was unfit to make the choice. "My dad told me [the surgeon] asked if I'd ever been treated for mental illness," she remembers. "He said I just didn't seem to be getting the seriousness of what he was saying. I just started laughing and laughing. When you've been sick for over a year, you haven't 44 BRAVA Magazine May 2012 played into her favor. Born into a well-to-do family, Gaines had what she describes as an incredible education, which allowed her to then attend law school, which allowed her to develop tenacity and self-esteem. These advantages kept her afloat as she navigated a health system that told her she wasn't going to make it, and there was no sense in trying. "Basically I had the luxury of being able to be a fighter in a system that is completely incomprehensible and like a maze," she says. But what helped her develop the qualities and know-how to weave her way through—and around—the system are things she knows are not necessarily available to everyone. That may be why there's some measure of fury behind her work at the CPP. Gaines won't stand for a system that favors those with privilege and simply isn't user-friendly for the seriously ill. "You feel like they're trying to find a way to get you on the con- veyor belt, on the moving walkway," she says. "Because as long as you're off the moving walkway, you're costing them all kinds of