Winship Cancer Institute: Precious time

David Kooby
David Kooby, who is expert at laparoscopic removal of pancreatic tumors, was part of a team of specialists treating Stepp at Winship.



From the Executive VP

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When it rains, it pours. Just ask Rachel Stepp.

The 46-year-old from south Georgia had to give up her job as a cashier in the local grocery story—a job she loved—when her husband’s Parkinson’s progressed to the point that he needed her to be at home. His sister helped, but she had health problems of her own. The Stepps’ only son was in Iraq. Little wonder that Stepp felt stomach discomfort and loss of appetite. When her doctor told her he suspected pancreatic cancer, her first thought was that she did not have time for this.

In fact, she had neither time nor money. The only money coming into the household was her husband’s disability check. At least Medicaid covered his doctor visits and medicines. Who would cover hers? She was supposed to be the well one.

Winship Cancer Institute doctors confirmed her doctor’s fears. Advanced pancreatic cancer. The doctors didn’t seem to care about her lack of coverage, only about getting her treatment under way, and fast. Surgical oncologist David Kooby removed as much cancerous tissue as possible. Medical oncologist Bassel El-Rayes started chemotherapy. Radiation therapist Jerome Landry added radiation.

Social worker Carol Rivera tackled the financial issues. Stepp’s care was deemed charity care. Since she lived hours from Atlanta, Rivera arranged for her to stay in the Hope Lodge on Emory’s campus, an American Cancer Society home away from home for patients undergoing chemotherapy and radiation. Winship’s patient assistance fund paid for Stepp’s other medications. Rivera also helped the overwhelmed woman apply to Social Security to receive her own disability check. That check, added to what her husband received, pushed their income over the limit for her to be eligible for regular Medicaid coverage. Rivera helped her apply for a different form of Medicaid, for persons who can document huge ongoing medical bills. Meanwhile, Winship continues to write off the thousands owed after Medicaid pays its part.

The cost to Winship over the past two years has been substantial, but it has given Stepp time to say goodbye to her husband, who recently lost his battle with Parkinson’s. It has also given her time to see her son come home and meet her new granddaughter.

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