To Melanie Shouse, the issue of health care reform was not an abstract issue being debated in Washington, but one with deep personal implications. Ms. Shouse, a breast cancer survivor, spent the last four years of her life fighting for health care reform while dealing with the personal reality of being unable to afford the medical treatments she needed to treat her breast cancer. Ms. Shouse died Saturday, Jan. 30, 2010, at her home in Overland. She was 41.

Ms. Shouse had been diagnosed with terminal stage four breast cancer a year after finding a lump in her breast. She had been unable to afford a doctor because she and her partner had used their savings to open a business. During the next four years, which included the 2008 presidential campaign, she strongly advocated for health care reform, and joined street demonstrations in favor of the proposed plan advocated by President Barack Obama, but which has been stalled in Congress.

An active member of Central Reform Congregation, Ms. Shouse was also an advocate for clean energy, economic reform and public transportation. Rabbi Susan Talve of Central Reform Congregation called her “an extraordinary woman who never gave up hope that she could make a difference.”

Ms. Shouse’s support of President Barack Obama’s health care reform quest was noted by Obama himself in remarks he made last Thursday night at a meeting of the Democratic National Committee in Washington. In his remarks, Obama cited Ms. Shouse’s death and her support of health care reform as described in her obituary in the St. Louis Post-Dispatch, which his staff called to his attention.

“I got a letter–I got a note today from one of my staff — they forwarded it to me — from a woman in St. Louis who had been part of our campaign, very active, who had passed away from breast cancer,” Obama said. “She didn’t have insurance. She couldn’t afford it, so she had put off having the kind of exams that she needed. And she had fought a tough battle for four years. All through the campaign she was fighting it, but finally she succumbed to it. How can I say to her, ‘You know what? We’re giving up? How can I say to her family, ‘This is too hard?’

Ms. Shouse had health insurance, but she said she was denied the coverage she needed to treat her cancer. At her request, her remains were cremated while wearing an Obama T-shirt.

Ms. Shouse spent her childhood in Indiana. Later she graduated from high school in Plano, Texas and then from Texas A &M University with a major in biology. After moving to San Francisco, she met her partner, Steve Hart on a picket line. The couple spent 20 years together.

Ms. Shouse and Hart moved to St. Louis and opened Sweet Meat Stix in St. Ann, selling humanely raised beef.

Friends and family have scheduled a celebration of Ms. Shouse’s life at 2:30 p.m., Sunday, Feb. 14, at Central Reform Congregation.

In addition to her partner, survivors include her parents, Marianne and Carl Shouse of Prairie Village, Kan.; two sisters, Maria Duda of Tampa, Fla. and Michele Macready of Vancouver, British Columbia and her grandmother, Kay Holtzman of Overland.

Memorial contributions can be made to Women’s Voices Raised for Social Justice, 412 Greenleaf Drive, Kirkwood, Mo. 63112; Susan G. Komen for the Cure, St. Louis affiliate, P.O. Box 790129, Dep SK, St. Louis, 63170-0129, or St. Louis Jobs with Justice, 2725 Clifton Street, St. Louis, Mo., 63130.