Ali Borgen, the cherubic Grand Forks kid whose painful but spirited fight against leukemia captured the concern and admiration of people in her community and beyond, died early Monday.
She was 14 and had spent nearly a third of her brief but high-impact life fighting cancer, enduring excruciating pain from vertebrae fractures that twisted her spine and forced her to spend many months inside a "turtle" back brace. She lived much of her last two years at the Mayo Clinic in Rochester, Minn.
But through her spirit, she became a symbol of hope and courage.
"She had a smile on her face when she died," her mother, Karen Borgen, said.
Ali was one of about a dozen Grand Forks-area children whose cancers were diagnosed in or around 2007, leading to questions about the possibility of a "cancer cluster," an unusual number of such cases in a specific time and area.
Local and state health authorities began an investigation last year, interviewing parents and looking for possible connections. Nothing definitive had been found as of late last year, but the investigation continues.
Ali frequently impressed people with her expressions of concern for others, including her parents and brother and the other area children fighting cancer, even as she grimaced in pain and endured round after round of chemotherapy and other treatments.
"No kid should have to die from leukemia like I am," she once told her mother. "It's ridiculous."
"We're all heartbroken that she had to suffer so with the pain," Karen Borgen said.
"She was too young."
Ali: Don't despair
While two other Grand Forks children among the 2007 cases -- Taylor Vossekuil, 15, and Josie Greenwood, 3 -- also died from leukemia, several of the others are cancer-free and healthy today. Doctors cite cure rates close to 90 percent for some forms of childhood leukemia and better than 80 percent for Ali's.
Ali celebrated the success stories and fought hard to write a happier ending to her own.
Her high-risk acute lymphoblastic leukemia, first diagnosed in March 2007, appeared to be in check by July 2009, and Ali threw herself back into the life she had enjoyed before: playing basketball and volleyball, resuming friendships and cherished routines with her family. She and her mother lobbied state and local officials, and in September a buoyant Ali led the Grand Forks City Council in the Pledge of Allegiance as Mayor Mike Brown declared Childhood Leukemia Awareness Month.
But in January 2010, Ali had to leave a game of basketball, winded after just two minutes. In April, a faulty step led to new back pain, and doctors found suspicious evidence of more vertebrae fractures. In early May, after exhaustive blood work and other tests, they told Karen Borgen that Ali's leukemia had returned.
With characteristic spunk, Ali fought back with more chemotherapy and total body irradiation. Her mother, at her side almost nonstop, maintained a CarePages diary that was funny and sad, poignant and feisty, at times angry and as carefully detailed as a documentary script.
A bone marrow transplant last fall gave the family new hope. But again, the cancer returned, and aggressively.
"She embodied the things we all respect -- the courage, the reaching out to others even when she was having such a hard time," Brown said. "Ali had a gift, an ability to connect with people.
"This is hard news to take. The death of a child -- there are things that just should not be."
Ali was brought back to Grand Forks and -- after a brief, frustrating struggle over eligibility -- she was placed in hospice care at her home, where she died shortly after 5 a.m., her mother said.
Karen Borgen's last "WeLoveAliB" CarePages report, posted a few hours before Ali died, said the little girl's health had declined through the week and especially in the previous 24 hours.
"Time with Ali is slipping away, like sand slipping through desperate fingers," she wrote. "It hurts more than I could ever express."
But there were smiles to remember, she said, and promises to keep.
As she was brought home over New Year's, Ali told her family that she wanted a party, not just a funeral. She wanted to see and talk with people, celebrate "a lifetime" and thank everyone who had helped her and her family with prayers, support and other kindnesses.
And she wanted to "kick butt" in a last personal battle against childhood cancer.
At Ali's "celebration of a lifetime" at the Ramada Inn two weeks ago, more than 1,000 people sang, played and partied with her, and donations to fight childhood cancer topped $14,000. Ali dressed up as Pippi Longstocking, sang "Amazing Grace" with the band and painted henna tattoos on the hands of dozens of other children.
"She enjoyed it so much," Karen Borgen said Monday. "She stayed three hours longer than she had planned. It was everything she had wanted it to be.
"She cried when she heard how much money she had raised. She cried happy.
"And she got me to promise to never stop fighting against childhood cancer. I promised. I promised her I absolutely will keep fighting."
A memorial service is planned at 3 p.m. Sunday at Calvary Lutheran Church in Grand Forks, with visitation at 2 p.m.
"Ali has asked that instead of flowers, she prefers bouquets of smiley-face balloons that can be shared with all children present after the service," Karen Borgen wrote on the CarePages site. "Also, Ali said she didn't want anyone to wear black (pants are okay!) because it's 'too depressing.' She said smiley-face shirts, Ali team shirts, or anything fun is okay!
"Ali said she understands if you're sad, but she wants you to remember her with smiles and to laugh with each other and share memories."