Hektoen International

A Journal of Medical Humanities


Laura Loertscher
Portland, Oregon, United States


Photograph of author (Laura Loertscher) and her son.
Personal photograph taken by author’s husband,
Jesus Moreno, and submitted with his permission.

The last food you ever ate was a cup of orange sherbet from the nurses’ station. I saw no reason to make you NPO. After all, you were eating for two. Did you know this would be your last meal?

You came to the hospital on a late Friday afternoon, a direct admit from the cardiology clinic. Right ventricular systolic pressure 75 mm Hg. You had no “chief complaint” but a willingness to share your story. Pulmonary hypertension was a part of life, like a stain on the carpet that you no longer saw. You told me, “Life is for living.” As that new life grew inside, your own breath had become increasingly short. They told you that your condition would never support a pregnancy, but you had made your choice. Did you know that hope for new life would ultimately risk your own?

Our eyes met as I gathered your history. I did not know if my own swollen belly bound us closer together or served as a cruel reminder of the contrary expectations for our two pregnancies. A certain buoyancy afforded by my gravid state contrasted unfairly with the weight of yours. My attending physician made phone calls. He was searching for someone to fix our dilemma: a 21- week baby and a woman’s failing heart. We settled on our true plan: to wait.

With everyone tucked in just after 2:00 am, I retreated to my call room and fell asleep easier than you might think. My pager jolted me awake at 3:46. Room 201. Code blue. I am a runner but secretly willed my legs to slow their arrival at your bedside. As I came around the corner, chest compressions were already underway. Seeing little that I could add to the calamity at your bedside, I stepped out to update your family. Their stricken eyes called me to comfort them, but I also knew that their company provided me refuge from your room. Did you know all along that our plan would fail?

You died at 4:21 am. I sat on the bathroom floor and wept, the swallowed sorrow a hard lump in my throat. I do not know if the tears were for you or for me. I picked myself up to prepare for morning rounds and sighed with both horror and relief. Was my own healthy baby growing safely inside a betrayal to you?

In crisp November just before midnight, the world fell away in the magnificent moment my son was born. You already understood that the fragility of a moment renders it precious. I cannot be all things, but I honor your memory in the life that I live. Today I left work a few minutes early to pick up my son from school. The sun shone warm on our faces and I would like to think I heard you say, “It’s okay. You are enough.”



LAURA LOERTSCHER, MD, practices and teaches internal medicine in Portland, Oregon. She finds particular joy in the small moments that enrich the patient-doctor relationship. She treasures time with friends, family, and her two young sons, particularly exploring the great outdoors.


Spring 2018   |  Sections  |  Birth, Pregnancy, & Obstetrics

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