BEFORE SHE got sick, Hannah Max was many things: stellar math and biology student, passionate horse rider, lover of sushi.
Since her diagnosis with Stage IV, high-risk neuroblastoma - a rare and deadly childhood cancer that attacks the nervous system - the 13-year-old is now a medical trailblazer, too.
And you, Daily News readers, are partially responsible for that. So thank you for what you've done, not just for Hannah but for other children in desperate need of cancer care in Philadelphia.
It's been 18 months since I first wrote about Hannah, who lives in Rotterdam, Netherlands, with brother Sam and parents Rachel Browne and Randy Max, musicians with the Rotterdam Philharmonic Orchestra. British-born Rachel plays violin, and American-born Randy is a timpanist.
Hannah had been responding well to her treatment at Rotterdam's Erasmus Medical Center, but her parents needed to shift her medical care to Philadelphia, where Children's Hospital had accepted Hannah into a cutting-edge immunotherapy program unavailable in the Netherlands.
The treatment could boost her survival odds by 20 percent, but her government insurance provider, IZA, wouldn't pay for the overseas care despite months of negotiations from her medical team. That left the Maxes in the impossible position of raising $400,000 for therapy that might save their daughter's life.
I got wind of Hannah's plight from a friend of her family, who sought help to stage a Rotterdam Philharmonic concert here in Philly (while the orchestra was on a U.S. tour) to raise money for Hannah's care. The result: a few well-connected Good Samaritans who arranged the Philly concert, which I promoted in this column.
Public reaction was wonderful, with readers offering donations large and small. But in Rotterdam, where my column was also published (and where the orchestra planned an additional concert for Hannah), there was outrage.
Why was the Max family reduced to asking for help from Philadelphians, the public demanded to know (in newspaper editorials and TV newscasts), when the Dutch government should be taking care of its own?
Let's just say that IZA was shamed into doing the right thing, and Hannah made it to CHOP. She is doing well, receives chemo once a month, became a bat mitzvah last spring and has just started high school in Rotterdam.
But the story doesn't end there.
Thanks to her three-month battle with the insurance company, the negative press it generated and Hannah's subsequent, excellent treatment in Philly, Dutch insurance providers had a change of heart when it comes to sending neuroblastoma patients to CHOP.
"Approvals that used to take weeks and months are now usually approved in days," says Dr. John Maris, CHOP oncology director and the world's leading neuroblastoma expert. "Hannah was a trailblazer in that she was the first Dutch patient to have to go through a complex set of procedures to set up things from the medical and the financial sides."
Now, he says, referrals from the Netherlands are so common, "when I walk through the waiting room some days, I hear people speaking Dutch more than I hear English."
CHOP's new office of international patient services deserves much of the credit. Formed just as Hannah's odyssey was beginning, its staff learned from her case how to finesse relationships between individual families and foreign governments, insurance agencies, philanthropic organizations and private insurers to cut the red tape of providing care across international borders.
Now, says medical director Rodney Finalle, CHOP can assess foreign requests for care in cases like Hannah's within 48 hours.
"We've got our game down," he says.
Which makes life easier for patients of Hannah's Dutch oncologist, Max M. van Noesel.
"We no longer have trouble convincing insurance companies that immunotherapy should be part of standard treatment" for certain kinds of neuroblastoma, he says. "We're not at the point where we have 'formalized' approval - we still get some phone calls and requests for additional information - but compared to what we went through with Hannah, it's a huge difference."
Hannah's legacy thrills her parents and those who worked so hard to bring her to Philly (a big shout-out here to restaurateur Jeff Benjamin and arts philanthropist Lee Schlifer).
"No matter what happens with Hannah, so much good has come out of her treatment in Philly, and I think everyone can take a little credit," says Rachel, who knows that her daughter's health, though stable, could falter if new treatment doesn't soon become available.
"So many people from so many societies rallied around us that it changed medical care for all Dutch children. It's amazing."
And it's quite a legacy for a pint-size, elfin-smiled 13-year-old named Hannah - who, for now, brims with energy.