A day after Susan M. Torres delivered a baby girl by Caesarean section at the Virginia Hospital Center in Arlington, her husband made the decision to remove his wife from the life support machines that had kept her — and their child — alive for the past three months.
Susan Torres, 26, had been 17 weeks pregnant when she lost consciousness May 7 due to a cancerous brain tumor that had started to bleed. She was declared brain-dead with no hope for recovery, but doctors kept her on artificial life support so that her baby might survive.
The baby, Susan Anne Catherine Torres, was delivered last Tuesday at 8:18 a.m. at the gestational age of 27 weeks — well before her original due date of Oct. 31. Yet at 13.5 inches long and weighing 1 pound, 13 ounces, neonatal specialists at the hospital said the baby appears to be healthy and vigorous.
"This is obviously a bittersweet time for our family," said Justin Torres, Susan Torres' brother-in-law. "We are overjoyed at the birth of Baby Susan and deeply grieved at the loss of her mother. From the beginning, we knew that two things would get us through to the baby's birth: God's providence and Susan's determination."
Susan Torres had lived in Arlington and worked as a vaccine researcher at the National Institutes of Health in Bethesda. Her husband, Jason Torres, had slept in a reclining chair by his wife's side for the past three months in a hospital suite decorated with pictures and filled with letters of support from around the globe.
Doctors unhooked Susan Torres from the life support machines early Wednesday morning at the request of her husband. The Rev. Paul Scalia of St. Rita's Catholic Church in Alexandria offered her the final sacrament of the Roman Catholic Church and said a prayer called "Hail, Holy Queen."
"I was struck by a line in that prayer: 'Mourning and weeping in this valley of tears.'" said Justin Torres, speaking Wednesday on behalf of the family. "That is today for us. We're thrilled with the baby, but this is a very difficult day."
SUSAN TORRES was diagnosed with melanoma when she was 17 and her doctors at the time believed it was in remission following surgery. But the melanoma apparently laid dormant for nearly a decade.
When she was admitted to the Virginia Medical Center in May, the melanoma had metastasized in her brain. Eventually, the cancer spread throughout her body.
Doctors decided Monday night they could not wait any longer before attempting to deliver the baby because the cancer was starting to spread extremely rapidly and the risk of infection was becoming a growing cause for concern.
"By continuing the pregnancy, we believe she may been deteriorating," said Dr. Rodney McLaren, the hospital's medical director for maternal fetal medicine, who oversaw the delivery.
Jason Torres and Susan Torres' parents waited outside and watched the delivery through a window.
"We were overjoyed at the birth of Baby Susan," Justin Torres said. "But we knew what was coming next. It was tinged with the knowledge of what was coming next and the decisions that had to be made."
Dr. Christopher McManus, the attending physician, said that although she was brain-dead, Susan Torres clearly fought hard for her baby.
"I hope they can take solace in the fact that by giving her life for her baby, she made the biggest sacrifice a human being can make," McManus said.
FOR A BRAIN-DEAD WOMAN to successfully give birth was "somewhat miraculous," McManus said.
Since 1979, there have been only a dozen documented cases of brain-dead women giving birth.
Additionally, there have been only 19 cases in which mothers with the aggressive type of melanoma that struck Susan Torres have given birth. In five of those cases, the cancer spread to the baby through the placenta.
An initial examination indicated the cancer did not affect the placenta in Susan Torres' case, increasing the likelihood the baby will not develop melanoma.
McManus said he believes there have been no other documented cases in which a brain-dead woman with cancer has given birth.
"She is very unique," he said. "We are overjoyed to be able to accomplish this goal, which three months ago seemed somewhat tenuous."
Susan Torres' case drew the attention from around the world after the family decided to go public to seek help with climbing medical costs. Her friends and family created the Susan M. Torres Fund, which has collected more than $600,000 since May.
The family estimates Susan Torres' medical bills will cost at least $400,000 after insurance. The baby's uncovered health care costs remain unknown. Any excess funds will be put toward creating a college savings plan for the baby and Peter, her two-year-old brother.
THE BABY WILL REMAIN in the hospital's Neonatal Intensive Care Unit for the next three months, though she appears to be as healthy as most premature babies, said Dr. Donna Tilden-Archer, the hospital's medical director of neonatology.
"We are ecstatic that she is here and that she seems to be healthy," Tilden-Archer said. "We'll just strive to do everything we can to do right by her. She is a precious baby, as they all are."
There is a slightly less than 10 percent mortality rate among babies born at 27 weeks.
The baby is breathing with the help of a respirator, though her lungs appear to be healthy, Tilden-Archer said.
Doctors are closely monitoring her nutrition because her gastro-intestinal system is not fully developed. Her immune system is also immature, prompting fears of infection.
Jason Torres will remain in the hospital with his daughter until she is released on Oct. 31, Justin Torres said.
The Torres' other child, Peter, has been staying with his grandparents and spending much of his time with cousins.
"We've tried to broach the idea with him about a baby coming home, but he's not too enthused," Justin Torres said with a grin. "Peter is not a boy who has a lot of interest in babies."