For Joan Winer Brown, the medical setbacks began in August 1984, when a stray bullet came barreling into her Bronx home, shattering an arm bone.
The next year, Ms. Brown's husband, Thomas, underwent a heart transplant. And two years later, he developed the lymphoma that would eventually kill him.
As for Ms. Brown, she developed cancer in one breast in 1986, and in the second breast in 1993.
Ms. Brown, who has three children, was naturally left reeling by these multiple misfortunes. But she has fought her illness hard. She has made countless visits to doctors, had 11 years of chemotherapy and had both breasts removed. And now, at age 52, her doctors have stopped the chemotherapy and she now believes she is cancer-free.
But she faces a new specter: rapidly vanishing savings. With a mountain of expenses and a modest salary, Ms. Brown, who now lives in New Rochelle, N.Y., thinks she may go broke in a year or less.
"I need prebankruptcy counseling," she said. "As hard as I try, I still seem to be short $30,000 each year."
Ms. Brown's finances weren't as close to the edge in 1988, when she received a $140,000 life insurance payment after the death of her husband. But she used some of it for a down payment on her three-bedroom house and has dipped into the remainder for other reasons over the years. Now she is down to $31,000 -- all the savings she has.
Financial planning long ago would have helped. But Ms. Brown avoided planning because she thought the stress would worsen her health. Anyway, she said, "People who are always close to death turn to what has value, and that often is not money."
And when she sought advice a few years ago, she became frustrated, breaking down in tears at a meeting with a banker.
"It seemed like the services that were being offered were primarily for people who were being smart about their retirements," she said. "I was just trying to stay alive."
Earlier this year, however, Ms. Brown said she became terrified by some large, looming expenses -- like the nearly $3,000 she owed for preprofessional dance lessons for her younger daughter, Deborah, 13, a dedicated dancer.
Such outlays are typical of Ms. Brown's generosity toward her children, whom she shielded from her illness for seven years. She has spent an estimated $30,000 on private schooling for them, and bought high-end computer equipment for their use.
And last summer she sent her older daughter, Alice, 16, to Europe, to sing with her high school chorale. (Her son, Joshua, 22, who attends the State University of New York at Buffalo, is now largely self-supporting thanks to student loans.)
For herself, though, Ms. Brown makes do without a dishwasher and drives a 1983 Buick. She doesn't have to spend much on her one indulgence -- the piano, which she says helps her "survive" -- because she helps out at the music school where she has her lessons.
But such corner-cutting doesn't make up for the children's expenses, nor for the basic monthly bills, like the $1,941 mortgage payment on her house, $330 for electric and gas bills and $200 for the phone. There is also a whopping $5,036 in credit-card debt, with the annual interest rates on three of the cards at 21 percent or more.
Across the ledger from these bills is Ms. Brown's $36,000 salary as a fund-raiser and grants writer at National Medical Fellowships, a nonprofit group that provides fellowships to members of minority groups.
The family also receives Brown's Social Security benefits -- $12,000 last year -- and income from Ms. Brown's freelance writing. In 1996, she received $6,000 in royalties for college study guides she has written and $19,000 for a book commemorating the 150th anniversary of Xavier High School in Manhattan.
But last year was a happy exception; freelancing has often been less lucrative. This year, the college-guide royalties have dropped 75 percent after Ms. Brown, because of job commitments, decided not to handle the guides' revisions.
Then there is her book, "Simon the Pointer." This meditation is ostensibly about a dog with a serious heart condition, but was in fact a tribute to Ms. Brown's husband and to the many heart patients she encountered while her husband was ill. Published last year by Viking, the book has been translated into French, Finnish, Italian and Japanese. But it hasn't generated a wide American audience and Ms. Brown thinks she knows why: It's on the wrong shelf.
"The book is about loss, love and courage, but bookstores keep sticking it in the pet department," Ms. Brown said. " 'Jonathan Livingston Seagull' spent a full year in the aviation department of bookstores."
Ms. Brown may need to worry about 20 years from now as well as about tomorrow. Her retirement savings, in a 401(k) plan, added up to about $11,000 at the end of June. She has never actively managed the money, which is sitting in a guaranteed investment contract, a fixed-income instrument that is the plan's most conservative option.
And her illness still shadows her, financially speaking. She wants to increase her $110,000 in life insurance, for instance, but that has been impossible because of her medical history.
How should Ms. Brown grapple with her multiple money problems? The New York Times asked for advice from Percy E. Bolton and Patti Drivanos, planners who specialize, respectively, in financial-crisis counseling and in planning for cancer victims.
Both planners said they thought Ms. Brown's first priority is to cut spending sharply. "Her take-home pay has to take care of her life style; I don't see any other way for this to work," said Bolton, who works in Los Angeles.
Their biggest recommendation was that Ms. Brown sell her house -- which needs work -- and move into something cheaper.
"She can't afford to spend more than 40 percent of her take-home pay" on housing, Bolton said. Currently, the mortgage, which carries only modest tax advantages given her low tax bracket, eats up virtually all her monthly pay.
If Ms. Brown can retrieve the $60,000 of equity that she has in her home, and add it to her $31,000 in savings, she could have a nice income supplement, the planners said. At an interest rate of just 5 percent, it would mean $380 more before taxes each month. And if she were to rent an apartment for, say, $1,000 a month, that would be $941 less than she pays on her mortgage.
The planners also said Ms. Brown should be financially realistic in spending money on her children.
"She's going through the surviving-parent syndrome, which makes parents think they have to make things up to their kids," said Ms. Drivanos, who works in Manhattan. "It's going to be tough to put the brakes on something that has been going on for years, so the family may need some counseling."
Bolton agreed and added that the children, who are generally aware of the family's finances, should be mre involved in them. "The kids need to bring more support to the table," he said.
Both planners also think Ms. Brown should rein in her credit card debt. Bolton recommends that she pay off the debt by obtaining a loan that would have a lower interest rate than the cards. One possible source, he said, is a municipal credit union, given that her husband had been a New York City employee.
What about the 401(k)? Because of Ms. Brown's medical history, Ms. Drivanos advised her not to plunge into stocks. Rather, she might put a total of 30 percent in the 401(k)'s stock funds and 70 percent in its bond funds, and be content with a 7 or 8 percent annual return.
"You need to be much more conservative when you have health problems," Ms. Drivanos said. "You need to invest as if you were doing it for your Great-Aunt Sophie, who is 80."
The health history also make insurance a high priority. Ms. Drivanos said a professional organization like a writer's group might sell Ms. Brown more life insurance, or she could try for a "guaranteed issue" policy from a company like Physicians Mutual or Savings Bank Life Insurance. While such policies usually have small face values and can cost $1,300 a year for a $25,000 policy, the issuers generally don't ask health questions, Ms. Drivanos said.
If Ms. Brown cannot obtain more life insurance and insists on keeping her home, Bolton advised that she get mortgage insurance -- despite its high cost -- so that the children wouldn't be stuck with high monthly payments if she became disabled or died. And while Ms. Brown already has disability insurance at her job, Ms. Drivanos thinks she needs more to cover her freelancing.
Some states, including New York, now require that breast cancer survivors be eligible for such policies if they have been free of cancer for one year, she said.
Bolton wants Ms. Brown to move quickly on her finances. "It takes about five years for people to change their money habits, but this investor has only about a year before her income goes," he said.
Ms. Brown agreed with most of the advisers' recommendations, including the need for speed. But she planned to proceed with great care on one front: acquainting her children with the family's financial life.
"I have to do it in a way that doesn't threaten them with things that are suddenly disappearing," Ms. Brown said. "I have to go in with a plan. I'll let them know this is going to be an adventure for all of us, but that we'll find a way."
© Copyright 1997, New York Times.