Just after Crystal Gibson lost her job, the Minneapolis single mother of four found out she had an aggressive form of breast cancer. While she was in chemotherapy after a double mastectomy, a nurse asked if she needed help paying bills.

Gibson declined. "I don't like sympathy," she said. But the nurse gently persisted. "She made me feel like maybe there's nothing wrong with accepting help at this time."

Gibson, 45, is one of nearly 2,000 Minnesota women who've gotten emergency funds while in active treatment for breast, cervical, ovarian or uterine cancer. The money — a $1,500 no-strings-attached grant — comes from the Pay It Forward Fund (payitforwardfund.net).

The fund was founded in 2005 by Michelle Morey and her husband, Scott Bissen, after Morey faced her own breast cancer fight. So far, Pay It Forward has distributed $2.2 million to help patients pay their rent, mortgage or utility bills, to buy groceries or fix a car so they can get to treatment.

In an era of high-deductible health insurance plans, various copay costs and rising pharmaceutical bills, expenses for an unexpected diagnosis can quickly mount. Some patients resort to online crowdfunding or hospital charity programs. Others take on credit-card debt or seek loans from family members to pay out-of-pocket bills. The Pay It Forward Fund is unusual in its ability to offer cash relief to local women.

"We have a significant underserved population," said Dr. Dana Carlson, a breast surgeon who serves on the advisory board of Pay It Forward. "There are women who can't follow up because they don't have a ride."

Even her middle-class patients can quickly fall in debt when they're too sick to work, Carlson said. That's where Morey's fund comes in.

"The money from Pay It Forward relieves so much stress for them," Carlson said. "Then they feel like their health can be a priority, and that directly affects their recovery and psychological well-being."

Firsthand experience

Morey, an Orono mother of two, was 37 when her breast cancer was diagnosed. In 2004, she had a double mastectomy, followed by a year of chemotherapy.

Even so, she considered herself lucky. She had plenty of help with "kids, rides, meals." And although she couldn't work for three months at the family-owned tech company she runs, she didn't need financial help.

The experience, however, made her "think about women who didn't have the support network that I had."

During chemotherapy, Morey formed a special bond with Jean Pupkes, a clinical nurse specialist who guided Morey through her maze of appointments at North Memorial Medical Center in Robbinsdale. One day, while Morey was hooked up to an IV for chemotherapy, she shared an idea with Pupkes.

"Michelle told me, 'Scott and I want to give you money to give to women who can't make ends meet,' " Pupkes recalled. "She said, 'You listen to their stories and you know who needs help.' "

The couple pledged a monthly gift of $500 for Pupkes to distribute. On the day Pupkes got their first check, she came to the aid of a patient who was going to have her water shut off.

Morey was overjoyed, and even more aware of the need.

"I knew paying one bill wasn't enough," she said. "The money problem was bigger than that, and no one talks about it."

After that, Morey and Pupkes quickly pulled together a fundraiser. Since then, the annual event has grown in size and scope, with a guest list of 600, sponsors, a raffle and silent auction.

Pay It Forward partners with 13 local hospitals where oncology nurses identify women who are in need. Once a simple application form has been approved, the fund pays creditors directly. The fund is managed by the Ridgeview Foundation, which absorbs its administrative costs, so 100 percent of money raised goes directly to patients.

That allows Pay It Forward to be all volunteer-run. Morey, Pupkes and others who raise the money and disburse the funds draw no salary.

"Michelle brought her business background and connections in the community to build this into the organization it's become," Carlson said. "She's such a dynamic leader; she makes people want to go the extra mile."

Caring for the caretakers

Tall and fit, Morey, 50, is known for her self-deprecating wit and her ability to shift the credit for the success of her vision to others. She's comfortable bragging about her teenage sons, her fishing skills maybe, but not about the fund that has eased the worry weighing down hundreds of cancer survivors in the state.

"Women see themselves as caretakers. When they're the recipient, they feel guilty, like they should be able to do it on their own," Morey said. "By calling it the Pay It Forward Fund, we say, you can take help now because when you get back on your feet, you will help someone else. You will give a meal, a ride, a donation."

Marissa Vickerman took that concept to heart.

She was found to have breast cancer in 2010, shortly after starting a job as a restaurant manager at Redstone American Grill in Eden Prairie.

"After the surgery, Jean [Pupkes] walked into my hospital room and asked if I wanted help paying my bills. I said, no, not interested, I have a job and insurance," said Vickerman, now 37.

But with no accumulated vacation or sick time and a two-week waiting period to access short-term disability, her budget quickly came up short.

"During chemo I could only work part time. My spouse had just graduated from college and was working a temp job. When Jean asked again, I said, 'To tell the truth, we could use the help,' " Vickerman said.

"As soon as I took it, I was able to take a breath. Things were taken care of, and getting healthy moved to the top of my list."

A few years later, Vickerman, who had been promoted in the Redstone group, heard that her company was looking for a charity to support during Breast Cancer Awareness Month.

Vickerman suggested Pay It Forward. For the past six years the restaurant has donated all proceeds from pink cocktails sold every October — a total of $130,000.

"In the thick of it, Pay It Forward lifted me up," Vickerman said. "I could never do enough for them."

Kevyn Burger is a Minneapolis-based freelance broadcaster and writer.