Artist Elaine Fleck was in the chair next to her hospital bed, awaiting discharge. Still sore from her recent operation, she was debating whether to ask the nurse for an ibuprofen tablet.

Fleck wanted pain relief, but she did not want another charge on her bill. When a visitor pulled a bottle of Advil from her purse, she laughed.

Fleck, who does not have health insurance, mentally calculated the bill from her uterine-cancer surgery and six-day stay in Carilion Roanoke Memorial Hospital: the hospital, the surgeon, the urologist who was whisked in when the surgeon nicked her urethra mid-operation.

Then there were the IVs, the bandages, all those tiny post-op ginger ales.

The bill could easily top $100,000, she was told, but it was too soon to tell. The predicament has angered her artist friends, inspiring them to take action - for Fleck's sake and to raise awareness of the 44 million other uninsured Americans.

"I think people get the idea: If you don't have health insurance, you're a loser," said Fleck, 49.

"You are, darlin'," said friend and fellow artist Kristen Reynolds, who is coordinating Saturday's "FUND-raiser" for Elaine Fleck.

The humor was edgy, tinged by the weeks Fleck had spent consulting lawyers, doctors, relatives and friends since her December diagnosis. She heard horror stories about people losing their homes, about people being forced to decide between surgery and their kids' educations.

A well-known painter in the region - she has twice won the Roanoke City Art Show - Fleck lives a humble existence with her husband, Richard Normand, and their son. For years, they rented a $370-a-month apartment in Old Southwest while saving to buy a house.

Fleck cleans houses when she isn't in her studio, and Normand is a self-employed massage therapist who also works part time at the Roanoke YMCA. The family could get health insurance if Normand worked full time at the Y.

"But the first two weeks' salary of every month would go toward paying for it," he said.

After scrimping for five years, they came up with the down payment for a circa-1904 fixer-upper on Mountain Avenue.

While the Flecks meet the income requirements for Carilion Health System's Charity Care program - being well under the guideline of $31,340 for a family of three - they were initially rejected because of the equity in their home. A family can have up to $30,000 in home equity before it affects their Charity Care status: the Flecks have about $35,000.

Last week, Carilion notified Fleck that it would write off $28,000, most of the hospital's bills. She will be responsible for $10,000 to $15,000 in physician fees.

When Reynolds, a fellow painter, heard about Fleck's bills, she got on the phone. "I'm 42, and Elaine is my fourth friend to come down with massive health problems recently, and two of them didn't have insurance."

One of the latter is "literally going blind because she can't pay for a surgery she needs for glaucoma," Reynolds said.

Reynolds wasn't on the phone long before a plan emerged:

Roses are red,

Violets are blue.

Elaine is freaked

and you would be too!

So began the publicity materials for an art party/fund-raiser that takes place from 2 to 8 p.m. Saturday at Market Gallery & Studios. More than 30 area artists have donated works to sell, with proceeds going toward Fleck's bills.

"Elaine has been so active with all the volunteering ... there are a lot of people who want to give that energy back to her," Reynolds said.

It's one of the trade-offs Fleck has made in living the artist's life: She can't afford health insurance, but she's had the time to participate fully in her community.

An Old Southwest neighborhood activist, Fleck helped police combat drug dealing and prostitution on her block last year. The daughter of an Army colonel, she was not intimidated when johns mistook her for a prostitute and approached her in her front yard - even though she was dressed in her garden jeans.

An avid gardener, she also developed the fountain garden in Highland Park six years ago and has maintained it ever since.

"Elaine works very hard just to have a place to live and to buy paint and food," said Mary Jane Burtch, who donated a painting for Saturday's fund-raiser.

Like many of the artists Reynolds phoned, Burtch had her own hospitalization horror stories to tell. Her 66-year-old husband, Bill, who operates Marizel's Flowers in Salem, had open-heart surgery a few years ago.

Even with full health insurance, their savings and their children's college funds were wiped out, she said, explaining that they had to hire a lawyer to get their insurance company to pay $5,000 of one $300,000 bill.

"We would've sold the business by now and retired," Burtch said. "But we have no money; it's amazing to me we have anything at all."

Fleck technically doesn't have a lawyer, but an attorney housekeeping client gives her free legal advice. He told her to worry about her health first and the bills second. So did her surgeon.

"Good advice. ... But the reality is, you can't not worry about the bills," Fleck said. She's back at home, recovering from her radical hysterectomy, and is considered cancer-free.

Her sister, Elizabeth Fleck, flew in from Santa Rosa, Calif., to play nurse, help care for the couple's 11-year-old son, Tai - and try to make sense of the mound of bills.

While Elaine praised the care she received at the hospital, "Getting out felt like getting out of a concentration camp. Having surgery is just such a psychological and physical trauma," she said.

Friends have phoned, and Fleck received so many visitors at the hospital that relatives had to post a "no visitors" sign so she could get some rest.

And every day another sympathetic artist phones to contribute a painting or sculpture for the event.

"We have a lot of friends who don't have insurance and own houses, and they're all watching how this unfolds," Fleck said.

Though still too sick to sketch, she has an idea for her next painting. When coming out of anesthesia, Fleck dreamed that she was startled by a loud flapping noise in her garden. She looked up to discover dozens of snowy owls hovering along the periphery, flapping their wings.

"I was scared - but also awed," she said.

Asked what the owls symbolized, her sister offered, "Death?"

Maybe, Fleck said.

Or maybe something equally ominous: medical bills.