After the turmoil, peace of mind.

M nurse alerted me that our waiting room was filling up with patients, but one patient’s appointment was too crucial to cut short. I had finally convinced her to come in for her prenatal visit after several weeks without seeing her. Over the past few years, I had been seeing Diane for routine gynecologic care. A friendly, down-toearth person, her sincerity and warmth made her very likeable. When she told me her news, I was delighted for her. “Doctor, I met a wonderful man. He’s an attorney, 28, the same age as me. We’re getting married this summer. Hey, you never know—you may be delivering our baby someday.” Her big smile and bright eyes reflected her happiness. Diane and Scott were married in July 1996, and their lives were moving forward positively. With two successful careers, a strong and loving relationship, and everything ahead of them, they seemed destined to enjoy a long and happy life together. Married only 7 months, the young couple’s picture changed drastically when Scott was diagnosed with metastatic colon cancer, stage IV. The prognosis was not favorable, Diane told me when she called. Devastated, the couple wondered, How could this be happening to them? Their dreams were evaporating rapidly. When they came to see me soon after our phone conversation, they did not look like the same couple I had come to know. The strain of the diagnosis was so evident. A subdued mood replaced the one I had usually associated with them. “We were going to wait to have kids, but now we want to get pregnant as soon as possible,” Diane told me. “Once Scott starts his chemotherapy next month, his sperm will be affected.” They said they had evaluated all of their options and considered their decision carefully. They were certain that the choice was the right one for them, even though he might never get to see his child. I raised a number of issues, particularly my worry that she could experience difficulty being a single mother with a full-time job. She assured me that she possessed a strong support system, including parents and a sister who lived close to her. “If we are successful, I realize that I’ll be raising our child as a single parent, but at least a part of Scott will live on. When I look in my child’s eyes, I will be reminded of Scott,” she told me in a soft voice. Her husband was solemn as he assured me that he wanted this baby too. Tears welled up in their eyes as they spoke. I found myself identifying with Scott. I was reminded of my own mortality and the realization that we are only here on earth for a short time. The continuum of life seemed particularly clear to me: as loved ones die, new loved ones are born. It seemed fitting that as the couple came to terms with Scott’s death, they were thinking about a new life. I could see why he would want this pregnancy. I would, too. However, if I had been in his position, I am not sure I would have arrived at the same brave choice. It takes an unusual couple to forge this idea. I might have thought that in having a baby alone, my young wife would carry too heavy a burden. Conversely, I could imagine that if I were going to die at such a young age, I might want to try to perpetuate my life by having a baby. From Rush University Medical Center, Chicago, Illinois.