I prepared to let go and wished for more time. There was nothing left but to let my youngest son be at peace. Tomorrow we would unplug the machines.

His transplanted liver was failing, and he was too sick to get another. He coded three days earlier. Now, beneath the sedatives, paralytics and seizure medications, he was convulsing continuously.

There was no hope for meaningful recovery. As a physician, I knew it was the right choice. As a mother, I was heartbroken. How could I reconcile the rightness of the decision with something that felt so wrong?

… You were thirty years old, and your mother was also my patient? What if she said you wouldn’t speak to her? What if she said you told her your grandfather sexually abused you? What if she said, “My father was a lot of things, but he was not a sexual predator”? What if she called you “a liar”? What if she didn’t believe you because your sister denied it happened to her? What if you knew that she knew? What if I couldn’t convince her to validate you? What if you cut off all family ties and turned to drugs? What if you killed yourself?

“We need to leave. Joan’s father just died.”

My husband, Richard, our newborn baby, Andy, and I were in Binghamton, New York, where Richard was interviewing for a postdoctoral fellowship.

I had been in our host’s guest room nursing Andy when someone called Richard to the phone. As I overheard Richard’s words, my consciousness split in half. One part registered the information with dismay. The other continued cooing to Andy, enchanted that he had just awarded me his first smile.