The Neediest Cases: After 3 Strokes, Woman in Wheelchair Focuses on the Here and Now

Michelle V. Agins/The New York Times

Fabienne Kirk, who relies on home health aides, joined a pooled trust to help afford more care.

It was February 2003, and Fabienne Kirk was waiting for a friend at a restaurant on West 23rd Street in Manhattan.

For the past 100 years, The New York Times Neediest Cases Fund has provided direct assistance to children, families and the elderly in New York. To celebrate the 101st campaign, an article will appear daily through Jan. 25. Each profile will illustrate the difference that even a modest amount of money can make in easing the struggles of the poor.

Last year donors contributed $7,003,854, which was distributed to those in need through seven New York charities.

2012-13 Campaign

Previously recorded:

$3,242,170

Recorded Monday:

120,708

*Total:

$3,362,878

Last year to date:

$3,282,127

*Includes $596,609 contributed to the Hurricane Sandy relief efforts.

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"I went to stand up to see if my friend had arrived, and couldn't get up," Ms. Kirk, 60, recalled. "I looked down at my foot. It wasn't hurting or anything." The next thing she knew, she was waking up in Cabrini Medical Center, recovering from brain surgery, and several days had passed.

In the restaurant, Ms. Kirk, then the social services director at a nonprofit group, had passed out after having a near-fatal stroke. The operation saved her life. That stroke was the first of three — she had another in 2006 and one in September 2011 — that would debilitate her, paralyze the right side of her body and put her in a wheelchair.

Ms. Kirk told her story recently at her Harlem home, which is like a well-organized exhibit — decorated with hand-colored photographs of musical greats like Miles Davis, Count Basie and Duke Ellington, along with small wooden sculptures from Ghana.

"I just got them at auctions," she said. "I like to surround myself with them. This is just who I am."

Ms. Kirk grew up in St. Louis and graduated from the University of Missouri at Columbia with a bachelor's degree in social work. She traveled across the United States for about a year after graduating, then returned to St. Louis to teach.

Long drawn to the pace of New York City, the variety of its people and the excitement of Broadway, she moved to the Upper West Side in 1974. She earned a second bachelor's degree in human services in 1980 from the Audrey Cohen College, then received a master's in social work in 1982 from Columbia, she said.

"I always enjoyed meeting people, and reaching out to people," Ms. Kirk said. "I liked helping people move their life to the next step — whether it was a new job, housing, a relationship."

When she had her first stroke, Ms. Kirk was working at Abyssinian Development Corporation, a nonprofit organization affiliated with Abyssinian Baptist Church in Harlem, where she had been a member since she arrived in New York. After the stroke, she was unable to return to work.

Ms. Kirk said she did not think much about the consequences of her condition during her rehabilitation over several months.

"It wasn't so much how's my life going to change," she said. "It was all pretty much tied into right now. And that's not different than how I live now. I think about the future, but my focus is on today."

Most days, Ms. Kirk rises early, and an aide arrives soon after to help with breakfast. After that aide leaves, another one arrives at noon, and she and Ms. Kirk run errands — to deal with Social Security issues, to visit the bank, to go shopping. That is also when Ms. Kirk does a lot of her socializing. "I see so many people when I'm out," she said.

The aides are a lifeline for Ms. Kirk, and she said she would benefit from having more care. But with her monthly income of about $2,000 in disability benefits, she could not afford it. Nearly half of her income goes to her nursing care, and most of the rest to utilities, food and rent, she said.

By month's end, she said, she is "down to almost nothing," which leaves miscellaneous medical bills either "unpaid or not paid as often" as she would like.

To find out about her eligibility for Medicaid, Ms. Kirk called the help line of Community Health Advocates, a state-designated health insurance consumer assistance program. She learned that her income was too high for her to qualify, by more than $1,000 a month. But establishing a pooled trust, she found out, would give her a place to put income above the amount Medicaid allows her to keep, and use it for basic monthly bills. Medicaid would then cover her additional home health aide costs. But such trusts have fees and a required minimum balance.

An advocate from the help line suggested she contact the Community Service Society of New York, Community Health Advocates' parent organization and one of the agencies supported by The New York Times Neediest Cases Fund. In October, the society drew $1,454 from the fund to cover Ms. Kirk's minimum balance and fees for the pooled trust.

"I was excited when the money came through," she said. "It was a positive move toward being eligible for getting more health aid services."

With all of her challenges, Ms. Kirk finds that focusing on the present is best. "I don't like not being able to get out of this chair right now," she said. "I'm not happy about it. But I wouldn't say I'm sad, either. I would say that that's what life is right now. So I deal with it."

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