Pediatrician, hospital administrator, and affordable housing advocate Susan Spear of New York City and Wellfleet died at home on July 30, 2024 after fighting metastatic breast cancer for 10 years. “Her last days were spent in her favorite room overlooking Wellfleet Bay,” said her husband, Ron. She was 78.

The daughter of Paul Spear and Belle (Kazin) Spear, Susan was born in Baltimore on April 25, 1946. Her father was a doctor, and her mother a preschool teacher who had emigrated from Poland. Soon after Susan’s birth, the family moved to the Bronx and later to Manhasset on Long Island’s north shore.

She graduated from Manhasset High School in 1964, earned a degree in political science from Wellesley College in 1968, and became one of only 10 women in her 100-member class at Columbia Medical School. She completed her residency in pediatrics at Columbia Presbyterian Hospital followed by a fellowship in adolescent medicine.

Susan taught for a time at Columbia Medical School, where one of her students, Harvey Makadon, introduced her to his roommate, Ronald Janis, who earned his law degree in 1975. “We never parted after the first 10 days,” Ron said. They married in 1977.

Susan worked part-time at Mt. Sinai Hospital, and in 1978 her son, Sam, was born. The family moved to Ridgewood, N.J. Finding the commute challenging with a small child at home, Susan went into private practice in Tenafly and later Teaneck. Daughter Irene was born in 1981.

In 1992, Susan was put in charge of Columbia’s Allen Pavilion Hospital and Medical Center in northern Manhattan. Her skills as a communicator and collaborator facilitated Columbia’s merger with New York Hospital and Cornell Medical School. The merged hospitals became New York Presbyterian in 1997.

During these years of demanding medical practice and administration, Susan gave herself fully to her children. “I love that my mom inspired me to be able to have both an engaged work life and be an involved parent and partner,” Irene said in her eulogy. “She is the most supportive, loving, fiercely loyal mother there could ever be, always there for me in every imagined way through my entire life.”

Susan and Ron began vacationing in Wellfleet in 1980, renting a house on Lieutenant Island and eventually buying a place on Chequessett Neck Road. They split their time between their New York apartment and Wellfleet. For six years Susan worked three days a week as an executive for EHE Health, a preventive health-care company with offices in New York.

But her heart was in Wellfleet, and she gave herself fully to community, cultural, and civic life in the town. She served on the board and executive committee of Wellfleet Preservation Hall, where she focused her energies on whatever needed to get done.

“She was there from the beginning,” former director Janet Lesniak said, “and her greatest gift was her passion for the Hall as a community center where all town organizations could connect.”

To that end, she helped establish the annual “Taste of the Town” fundraiser, which gave her the opportunity to get to know everyone while demonstrating her skills in development. To memorialize her many contributions, a new art studio at Preservation Hall dedicated to K-12 education in the arts, including music, movement, film, painting, and ceramics, will be named in her honor.

Susan was also committed to supporting the underserved in town, as she had done early in her medical career when she bridged the gap between Columbia University and the under-resourced Dominican community in Washington Heights. She was an enthusiastic supporter of Habitat for Humanity, and she served on the Wellfleet Local Housing Partnership, a committee authorized “to promote, provide, and maintain access to affordable housing,” according to the town website.

Because of “Susan’s inspiration, ideas, connections, and energy,” wrote Irene in an email, plans are in the works for a development that could house 12 local families including teachers and firefighters; the new road required for the development will be named “Susan’s Way,” to honor her role in making the project possible.

In all her commitments, public and private, her priorities were the people she loved, especially her children and grandchildren. “When each of my kids was born,” Irene said, “my mom came for a month to take care of me and my babies. She cooked, did laundry, snuggled babies, and let me sleep.”

Even after her cancer diagnosis, when she needed monthly injections, “she flew home for one day to get her shot and then flew back the same day to keep taking care of us,” Irene said. “She would always answer the phone; she was always available.”

Susan was also always optimistic, seeing the good in everyone she loved and helping them see it in themselves, too. In an email to Irene, Kristin Baldridge wrote: “I met your mom numerous times over the years, and each time she was like a delicious, somewhat naughty breath of fresh air.”

That complexity of character appeared in son Sam’s eulogy. “Susan’s unique gift was to give,” he said, “not sacrificial, but generative. She was truly present.” She had “an incipient bent for adventure,” he added, which she expressed by helping Sam dig trenches for the electric lines to power the house he was building in Washington State.

She also decided in 2020 to join Ron in his Cessna 172, flying with him for the next three years.

Susan is survived by her husband, Ronald Janis of New York City and Wellfleet, son Samuel and wife Liza of Bellingham, Wash., daughter Irene and husband Christopher of Durham, N.C., brother Michael Spear of Wynnewood, Pa., sister Peggy Spear of Swarthmore, Pa., and grandchildren Lilla, Edith, Blaise, and Ocean, who were the lights of her life.

A memorial and celebration of life will take place at 3 p.m. on Sunday, Sept. 29 at Wellfleet Preservation Hall.

In lieu of flowers, contributions in Susan’s honor can be made to Habitat for Humanity of Cape Cod or Wellfleet Preservation Hall.