Patty Moran’s phone rings in her tiny apartment near Reserve Street.

She picks up and the truth of her life plays out, like a recording that repeatedly rewinds and replays itself.

“I’m feeling pretty good today,” she tells a friend. “I’m doing well and I really appreciate you calling. I’ll talk to you a little later, OK?”

Over the next hour, the phone rings three times, always with someone asking how she’s doing.

With some effort, Patty finally sits back down on the sofa next to her cats, Skeeter and Turbo.

“I’m a pretty private person, but I’ve come to enjoy the calls,” she said. “Sometimes it’s just enough to hear another person’s voice and know you’re not alone. People have really just come out of the woodwork trying to help me.”

That’s what happens in a good town when a good person is dying.

Patty Moran is 52. She has stomach cancer. If she celebrates Thanksgiving 2010, she will be a living miracle.

“When I got the diagnosis, I really couldn’t take it all in,” Patty said recently. “You just hear these words and they’re not what you’re expecting. It’s almost like you wish there was someone else there to say, ‘No, that’s not right.’ But it’s true.”

It would be easy to say that this is a tragic story about someone dying far too early. And it is that.

But it’s also a story about the need for health care reform. And in that way, it’s a story about someone who shouldn’t be dying just yet.

Patty Moran has no health insurance. For the past six years, she has done home health care for a start-up company owned by her brother.

“I knew it was a risk, but I thought as the company grew that maybe he’d be able to afford insurance,” she said. “But it’s tough for small employers out there to afford insurance these days.”

Before working for her brother, Patty worked for St. Patrick Hospital for 22 years in a variety of capacities. She was always covered by the hospital’s plan.

Taking a job without health insurance was a risk, but Patty felt the chance to work for her brother was worth it.

“About my only problems have been being overweight – that’s been the bane of my existence – and smoking,” she said. “I understand the risk of smoking, and I’ve tried to quit. But it’s tough.”

In early 2005, Patty started losing weight. That continued over the next two years, along with some mild nausea.

“I tried changing my diet but I was just starting to feel more uncomfortable over time,” she said. “It wasn’t something I thought about going to the doctor about, in part because I couldn’t afford to go to a doctor.”

By 2007, however, she could hold out no longer. She had on-and-off pain, and was still losing weight.

She went to Missoula County’s Partnership Health Center, which allows patients to pay on a sliding scale according to their incomes.

According to the Mayo Clinic, “Stomach cancer is uncommon in the United States, and the number of people diagnosed with the disease each year is declining.”

Mayo notes that doctors generally vet other possible problems before considering stomach cancer.

Patty first saw a physician assistant who thought she had gallstones.

“My symptoms were a classic sign of that, and the P.A. also talked about getting a surgical consult, but nothing ever came of that,” Patty said.

She eventually saw a Partnership doctor who thought she might have an acid reflux problem.

By October 2008, though, she was vomiting and feeling stressed.

“I was getting pretty freaked out that something was really wrong with me,” she said.

Patty then saw another Partnership doc, Meg Sarnecki, who treated her for what she believed was stomach ulcers.

Sarnecki, herself a forceful advocate for health care reform, also suggested that Patty get a test known as an EGD, for esophagogastroduodenoscopy. Using a small camera inserted down the throat, the EGD examines the lining of the esophagus, the stomach and upper duodenum.

According to Harvard Medical School’s Web site, the EGD “allows the doctor to explore the cause of such symptoms as difficulty swallowing, abdominal pain, vomiting up blood, or passing blood in the stool. It can also diagnose irritation, ulcers, and cancers of the lining of the esophagus and stomach.”

The test would have to be done at a hospital, and Patty’s mind immediately turned to the cost, which was estimated at more than $1,000.

“There’s no way I could do that, but eventually they did put me on a waiting list to get the test,” Patty said. “But I was originally told it would be nine months, then Partnership’s social worker told me it might be 18 months.”

Someone with either insurance or cash would likely have been tested within a month.

By May of this year, Patty had lost 175 pounds, could barely eat and was routinely nauseous.

“I was really to the point where I couldn’t take it anymore,” Patty said. “I feel like Dr. Sarnecki and Partnership were doing their best for me, but they’re part of a system that just can’t provide every sort of medical treatment to people for next to nothing.”

In June of this year, Patty’s brother died unexpectedly of heart failure. She lost another 15 pounds and chalked it up to grief.

Finally, grief stricken and increasingly desperate over her own condition, Patty went to see a friend at St. Pat’s, social worker Marilyn Washburn.

Washburn told Patty that because of her financial condition, St. Pat’s could pay for its part of the EGD test. Sarnecki then helped her get an appointment with gastroenterologist Eric Trevelline.

Patty’s EGD took place on Sept. 22. Everything changed forever that day.

“We were thinking there obviously was some sort of problem, but that it would be something that could be fixed,” she said. “None of my doctors had talked about cancer.”

Trevelline called her on the phone with the unbelievable news – stomach cancer, which had spread to the peritoneum, the thin cell wall that protects the organs inside the abdomen.

 Patty heard more words – terminal, palliative care, hospice.

“I just couldn’t take it all in,” she said. “I couldn’t comprehend it.”

Looking back at what might have been isn’t much of a strategy for coping with your impending death.

So Patty doesn’t spend much time going there.

Instead, she’s carved out more time for friends and hit the road for a must-do family visit.

She also pierced her nose and cut her always long hair.

An English lit major, she’s making a list of favorite quotes and poems, and she’s weeding through her books, yet again.

She has been overwhelmed by the kindness of friends.

“I’ve even had three families say they will take me in if I can’t care for myself,” she said. “But I want to stay here as long as I can. I’m not someone who likes to depend on other people to do things for me.”

And yet she nearly bounces to the ring of the phone.

“It’s nice now just to hear the sound of someone’s voice,” she said.

Doctors have told Patty she has months not years to live.

She has applied for Medicaid and Social Security disability, and been denied for both. She’s appealing those decisions.

Old friends from Loyola Sacred Heart High School have set up a fund to help, as she can no longer work.

“I wanted to keep working, but the doctor told me this: ‘You’re a very sick lady,’ ” she said.

Patty would have developed stomach cancer regardless of whether she was insured. But would medical coverage, insurance that would have helped cover the costs of expensive hospital tests, have led to an earlier discovery of her problem?

It’s certainly possible.

And that is why the very private Patty Moran decided to tell her story.

“There are too many stories like mine,” she said.

In fact, a recent Harvard Medical School study found that about 45,000 Americans per year die basically from lack of insurance and the inability to get full care.

That’s one person every 12 minutes.

At Partnership Health in Missoula, physician Sarnecki said cases like Patty’s are precisely why America’s health care system needs reform.

“These are the people who are falling through cracks even though we know they’re there,” Sarnecki said. “I could call doctors in town who would be willing to do tests for any given patient, but the problem is I have so many I could send them someone every day. They can’t take all those people for free. It would put them out of business.”

Added Patty: “I want people to realize that there are so many people just falling through the cracks. We’re the richest nation in the world, and we can do better than we’re doing.”

Not long ago, Patty read a letter to the editor in the Missoulian. The letter writer called out people without insurance, challenging them to just “get a job.”

“I want that man to know that I’ve had a job all my life,” she said. “I’ve worked and now I can’t work anymore. But this didn’t happen to me because I don’t have a job. And it doesn’t happen to most other people because they don’t have a job. It happens because we have a health care system that isn’t good enough. And we need to fix that. I’d love to see that happen soon.”

Reporter Michael Moore can be reached at 523-5252 or by e-mail at mmoore@missoulian.com.