Weary Father Left To Count the Days

And so, a rare medical drama -- only 11 similar cases have been reported since 1979 -- began to unfold.

Even without the complication of cancer, sustaining Susan Torres's body is an enormously difficult task.

With no brain function, she has to be hooked to a ventilator to breathe, which in turn keeps her heart pumping and blood circulating to her vital organs, most importantly the placenta. She must be given nutrition and hydration intravenously. A catheter must be used to eliminate waste. Although it has not been an issue in Susan's case, blood pressure can become a problem: too low and the fetus may not receive enough oxygen and nutrition; too high and the placenta can separate from the uterus.

Over time, the treatments themselves can become problematic: All the openings for tubes offer bacteria a way in, raising the possibility of infection. Simply lying in one place can cause sores as soft tissue breaks down. Susan Torres has already fought off one attack of pneumonia.

"It gets harder because of the nutritional issues, because of the integration of systems required to maintain blood pressure, oxygenation, tissues. We just can't control all that in an ICU," said Elena Gates, a professor of obstetrics, gynecology and reproductive science at the University of California at San Francisco, who co-wrote a paper on maternal brain death during pregnancy. "As things go along, your systems start to fail -- the kidney, the liver, the pituitary glands -- and the heart is sensitive to changes in electrolytes, calcium, potassium, so you might see more problems with heart function."

Then, of course, there is the cancer: melanoma, which is particularly insidious in that it is one of the most aggressive forms and one of the few that can penetrate the placenta.

Susan Torres's melanoma had been diagnosed when she was 17, when she had a malformed freckle on her arm, but after it was removed, doctors believed she had no reason to worry.

Apparently, however, the cancer cells remained dormant in her body all these years, and, for reasons scientists spend their entire lives trying to figure out, they became active, eventually, with only the faintest of symptoms -- headaches and nausea -- forming a tumor at the back of her neck.

"It's not a situation where I'd say, 'How did that happen?' " said David H. Lawson, a professor of medicine and melanoma expert at Winship Cancer Institute at Emory University in Atlanta, explaining that doctors probably were not at fault for missing it. "No, I see very well how that could have happened."

The melanoma has metastasized, the cancerous cells traveling through Susan Torres's bloodstream, searching for a place to grow. So far, they have found the lymph nodes under her arms and, last week, her lungs.

Lawson said there is no strong pattern to where the cells tend to plant, although typical places are the skin, the brain, the lungs and the liver.

It seems less common for the melanoma to grow in the placenta, and a 2003 study in the Journal of Clinical Oncology found that of 27 cases where metastasis melanoma reached the placenta, the fetus was affected in just six cases; in five of those six cases, the infants lived 12 hours in one case, two years in others.