Hektoen International

A Journal of Medical Humanities

La Pieta

Rachel Fleishman
Philadelphia, Pennsylvania, United States


La Pieta, 1498–1499, Michelangelo, St. Peter’s Basilica, Vatican City. Via Wikipedia. CC BY 2.5.

A mother holds her dead child. His body flops open without resistance, freshly dead. His head is cocked back, shoulder lifted, arms release the last vestige of grip. Her face sullen, her hand beside him open and offering, she holds but does not touch her son. A single moment of intimacy frozen in stone. One mother, one child, one death. Beauty in the dichotomy of softness etched in cold, firm marble.

Stone cannot capture the heaving chest of a woman, silent or screaming, who has just lost her child. The heaving is irregular, like the tempo of a child just learning violin. Some notes are long and wan; some staccato, punctuated and shrill. These women, these mothers clutch their children; their hands do not offer the bodies grown from their own flesh for the world to pilfer. They cling.

And into these raw moments you, the doctor, insert yourself. Your job is to listen: the last rumble of a heartbeat, the last cellophane crinkle of lung opening deep in the chest. While the beautiful stone matron is frozen in graceful acceptance, the mothers you shepherd are raw, wet with their own saliva, and aching. You do more than channel their wishes. One last kiss, one last photo, one last nuzzle of scalp under chin or forehead pressed into the hollow of cheek. You touch them, these women, as they draw their children back into themselves. Your hand over their hands: purposeful, firm.

You have read that Michelangelo did not want his sculpture to depict death. You, the doctor, would like him to witness the death of a child as you witness it. You imagine him, twenty-five years old, perhaps before he sprouted his coiled beard, standing in the doorway to see bravery in a final goodbye.

The nine-year-old boy who battled leukemia; thickened blood caught in the capillaries of his brain caused a sudden stroke. His mother in bed coiled around him when the tension of life left his muscles limp beneath the hospital blankets.

The infant whose mother woke to find him stiff, smothered by the couch cushion in the wee hours of the night. Without thought, his mother had timed her own breaths with his CPR all the way from their home to your ER. His jaw so stiff you could not pass a tube through his lips; you stopped fighting. When you kneeled beside her to whisper his death into being, she stopped breathing without a measure for her own inhales. You wiped the stool from his bottom before you handed her his body which she squeezed to her chest, tight. Their two forms domed together in a ball of flesh.

The small boy, as old then as your son is now, who slipped beneath a boat for some minutes too long. Ultimately, you crouched beneath his mother, too. With the gentle nod from another doctor as she nuzzled the stethoscope from her ears, you said her child’s name and the word dead in one crisp phrase. This mother shielded her child; her own body resigned to gravity, layered in between the catheters in his wrists and the large bore needles perpendicular to his shins.

You believe if Michelangelo had been a pediatrician, he could have carved a different version of purity. Mothers who witness their children die on stretchers and motorized beds between hospital walls do not have faces soft with longing, they do not open their arms to the world. The air around these women is silent so they can take up space, emit a heaving remorse because they could not protect their own flesh. If you had years to carve your compassion into marble, each tap of the chisel echoing the pulse of children you have lost, you would capture the ache you see in these mothers’ faces with raw lines; bulging brows; lips parsed, peeling and down-turned; muscles taught. The perfect anatomy of the Renaissance, every muscle balanced and full, is a myth at the moment a child’s body fails. There is a truer beauty in the ugly, un-sanitized reality of loss.



RACHEL FLEISHMAN, MD, is an academic neonatologist, a mother of two boys, and a wife. She has been a writer since childhood.


Highlighted in Frontispiece Volume 11, Issue 4 – Fall 2019
Winter 2019  |  Sections  |  End of Life

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