MOUNT VERNON, MO. -- The demonstrators have nearly all departed now, with their pup tents and sleeping bags and minivans and small children and scrawled posters ("HOW WOULD YOU LIKE TO BE STARVED TO DEATH?"). Gone too are the big mobile units from TV stations in Kansas City and St. Louis and Springfield -- such an improbable sight in so out-of-the-way a place. State troopers aren't guarding the front doors of the Missouri Rehabilitation Center any longer. A tiny farm town named for George Washington's home on the Potomac is blanketed at the moment with a new coat of white. It started coming down yesterday, the day after Nancy Beth Cruzan died. The snow, not yet having turned filthy from the big trucks out on the interstate, makes Mount Vernon, tucked here in this southwest corner of the state, look so peaceful. Though of course that is illusory.

Two days ago, at 2:55 a.m. on the 12th day after a feeding-hydration tube was removed from her stomach at her family's request, Nancy Cruzan died. The official cause of death was dehydration. The patient died in a hospice unit on the second floor of a state-run hospital where there are colored linens on the beds and TV sets overhead and pullout leatherette sleep sofas for those who keep vigil. Her parents and sister were with her when she died. From all science could tell, the woman who died knew nothing of the medical and ethical debate that had swirled about her for nearly three years, a debate that ultimately took itself to the Supreme Court and then back again to a small hospital in a remote part of America.

Last night at 7 o'clock, 33-year-old Nancy Cruzan's wake was held at the Mason-Woodard Mortuary in nearby Joplin. This afternoon, after a 2:30 funeral service, Cruzan's body will be lowered into the frozen Midwest earth. "Knowing Nancy as only a family can, there remains no question that we made the choice she would want," her parents said in a statement read for them at a press conference six hours after her death. "Nancy, we will always love you and hold your memory in our hearts." In these last days, the Cruzan family has avoided almost all media contact.

She was an unknown 25-year-old woman coming home from a night-shift job at a cheese factory in an old Nash Rambler. The date was Jan. 11, 1983. The two-lane road was icy, the car overturned, and the person driving it was thrown about 35 feet. The paramedics got a heart beating again, a pair of lungs drawing breath. But Nancy Cruzan's brain had been deprived of oxygen for something close to 20 minutes.

No one knew it then, but for the next eight years a woman was going to live in a kind of cruelly irreversible coma that medicine refers to as a "persistent vegetative state." The scientific definitions of that term, though inexact, are a lot easier to come by than the moral ones.

"It's over. All this in rural southwest Missouri, where nothing ever happens -- heck, we just got stoplights last summer," a weary man is saying. He is not related to Nancy Cruzan, but he has been at the epicenter of this storm. His name is Don Lamkins, and he is the director of the Missouri Rehabilitation Center.

"It's over," he is repeating, as if not quite able to believe it himself. "Except it won't be over for a long time. We're trying to start the recovery process. The wounds are there. These kinds of things don't happen in a place like Mount Vernon."

He sits at his ordered desk and the tiredness seems to fall from him in chunks. Part of his fatigue lies in the ironic fact that the director -- along with the great majority of his staff -- was not in sympathy with the court ruling that paved the way for a feeding tube to be removed.

"It just wasn't the protesters on the outside who were against this thing," Lamkins says. "We were against it. I was against it. But I had to uphold the law. I was caught. I felt locked in." He hesitates. "And then, when you went out the door, there were these people from Operation Rescue or wherever yelling 'murderer' at us."

He is about to turn 47. He didn't have a Christmas this year. He is wearing a blue suit and a rep tie. He hasn't slept a full night in weeks. His accent is soft and laced with rural rhythms. Above his head is a painting -- a placid lake scene. On a shelf is a picture of his baby grandchild. He is a devout member of the Church of Christ.

He looks up. "I almost forgot," he says, "I'm teaching tonight."

His hospital is an old TB sanitarium. It was built in 1907. Later it became the Missouri State Chest Hospital. In 1985 the facility became a rehabilitation hospital giving special emphasis to Missourians with extensive head injuries. It also operates one of the largest ventilator programs in the state. But why did it have to happen here, that's what he keeps wondering. Why couldn't the test case in the national fight over the treatment of the hopelessly ill have happened somewhere else, anywhere else, another state altogether?

"I had several people say, 'You should have quit.' Well, first of all, if I had quit, somebody else would have taken my place and nothing different would have happened in regard to Nancy. Then somebody said, 'Well, ignore the law. Do it because it's right. God's law is higher than man's law.' Okay, that can be said. It was just a situation ..."

He doesn't finish. "There was just no way, even though I run this place, and even though I personally wasn't for it -- taking Nancy off the tube -- I could do anything about it. That's all there is to it. Were we taking life away? Everybody agrees the end result is death: You don't have water, you don't have nutrition, you can't live. One side says, 'Yeah, but what we're doing is undoing what would have happened at the accident place had there been no intervention. That group says all we're doing is getting ourselves back out of God's way because had He not had his natural processes interrupted, she would have died at the scene of the accident. And the other group says, 'Okay, but once we have gone and done that {interrupted God's plan}, to get out is killing her. It's murder."

Nancy Cruzan's feeding tube was removed Dec. 14. Within a few days, the vulgar circus had come to town -- press, protesters, hangers-on, the merely curious. There were arrests (the arrested were taken away in wheelchairs), there were inflamed statements. Two days before Christmas Eve, a hospital director went home, sat on the sofa and suddenly said to himself: "I know why you're so tired. You've been fighting this thing with yourself. That's the worst kind of fight. That's why you're so tired." He says now: "It was the internal struggle killing me."

Cruzan was able to breathe without an oxygen tent or respirator. Over the years her body had rigidified, her limbs were severely contorted, her face was described in press reports as bloated. Her eyes seemed to know when a bright light had come on in the room. She was subject to seizures and bleeding gums and vomiting and diarrhea. Until this week she was one of three such "persistent vegetative" patients at Missouri Rehabilitation Center -- and one of an estimated 10,000 such patients nationwide. Cruzan was being cared for at a cost to Missouri taxpayers of $112,000 a year.

"What I really think it is," Don Lamkins says, "is medical technology running out ahead of everything else."

To get out is killing her. It's murder.

Where does the argument stop, and even more blurringly: Where does it begin? Isn't it one hopeless, seamless circle? How do you define a family's love? How can anyone know a patient's true intention? Can living at any price really be thought in any mind to be a supreme goal? How long should a family be made to watch?

Perhaps, in this instance, one must be content just with the questions themselves.

When Nancy Cruzan's stomach tube was removed, her supply of water was cut off. Essentially she starved and dehydrated to death. Doctors estimated it might take two weeks -- it took two days shy of that. Pain medications were carefully administered. The patient was turned frequently to avoid bedsores. By all accounts, her nursing care was superlative.

Three years ago, Nancy Cruzan's physician, James C. Davis -- who lives in Mount Vernon but isn't taking calls from out-of-towners -- testified that he opposed removing the feeding tube. In November of this year, in court, he said he now believes it is in her best interest to end her "living hell."

A line sways. Currents shift -- both morally and legally. It's like standing on a sandbar. On the day two weeks ago that Joe and Joyce Cruzan finally won the legal right to end their child's life, Davis said, "I wouldn't want to live like that." And her father said that day, "Because of Nancy, I suspect hundreds of thousands of people can rest free, knowing that when death beckons they can meet it face to face with dignity, free from the fear of unwanted and useless medical treatment."

Theoretically, Davis was on holiday this holiday week. On Christmas Day, 11 days after the tube was removed, he slipped into Missouri Rehabilitation twice, once in midmorning, once in late afternoon. He successively downgraded his patient's condition from "deteriorating" to "serious" to "critical."

Outside, people who had come from Atlanta and Kenosha, Wis., and Portland, Maine, were camped in sleeping bags and tents, holding prayer vigils.

Around them were signs that said things such as, "While Amer fills their guts on and before Xmas, Nancy lyes starved and dehydrated."

"We can't put bumper stickers on the van because people tend to bash out your windows," he says matter-of-factly; he's wearing a brushy mustache and three layers of sweaters.

Though we do have a portable one in the rear window -- 'Abortion Kills Children,' " she inserts. She's nursing their youngest, Zachary. He's 8 months.

"The reason we hit this is because it's the next big step," he says.

"There was a family here that was willing to let one of its members die," she says.

The battle lost, they are packing up and preparing to go. Their headquarters in Mount Vernon has been the BelAire Motel, which is on the strip out by the interstate.

Their names are Joe and Anne Foreman, and they're in their thirties, and they have five children, and they live -- almost literally -- in a 1985 two-tone Chevy van. They constitute a new breed of American nomads. Children in tow, they go from protest to protest. Usually they are antiabortion protests.

Formally speaking, he puts the word "reverend" before his name. He's a minister, affiliated, he says, with a branch of the Presbyterian Church. He's a pastor, but without a parish. He is one of the founders of Operation Rescue, a national antiabortion group, whose leadership is reported to be splintered.

They were in Des Moines, headed to Denver, when they got word about Nancy Cruzan. They swerved left, and found their way to Lawrence County, Mo. They got here in the middle of the night.

The next day, Joe Foreman led a group of about 25 protesters into the halls and stairwells of Missouri Rehabilitation Center. They didn't want to take over the building, they said. they only wanted to get onto Nancy's floor and hook up her feeding tube again. Troopers and sheriff's deputies took them away in wheelchairs. Nineteen were booked and jailed downtown, on the square, on the other side of the Ben Franklin and Granny's Patchwork Quilts.

"When they asked us our names, we said, 'Nancy Cruzan,' " Joe says.

"Nineteen Nancy Cruzans," Anne adds.

"Because you see, the point is if you can starve anybody to death in this country you can starve all of us," he says.

"It wasn't just sitting around, our protesting here," she says, "it was trying to get as physically close to Nancy as possible. To make something happen."

"Because Jesus said, 'I was hungry and you gave me food, I was thirsty and you gave me drink,' " he says.

Two months ago, Joe Foreman was in jail in Atlanta for trying to close down an abortion clinic. That stint in the Fulton County jail lasted five months. Anne -- she is small and pretty and shoeless at the moment -- took the kids and went to Joe's folks in North Carolina. His parents understand all this, she says. Sort of.

How this itinerant missionary work is financed seems a bit of a mystery. "When you are committed, you make it happen," he says. This particular battle over, the next stop is greater San Diego. Anne's parents live there. They had wanted to reach Escondido by Christmas so their children might know a real tree in a real home. But Christmas this year turned out to be a borrowed tree with a tin-foil star in a meeting room at the BelAire Motel. Their kids didn't care a fig.

"In fact, ask them," he says. "Where's Laurel?"

Laurel Foreman comes in. She's 12, theoldest child. She has on black tennies, a sweat shirt with baby whales on the front. She takes a chair and starts pulling at her sock. Her hair is gathered in the back with a pearl barrette. This reveals the fetching tiny silver earrings she got for Christmas.

"I also got a camera, socks, a journal, a ring," she says. Two of her brothers got battery-powered model cars.

"I don't like to be arrested," Laurel says.


"Ten times."

Had she ever thought what it might be like to have had an entirely different set of parents?

"I'd try to push them," she says, "to just where my parents have taken us."

The word "parents" must have lit something. "While her parents were fighting to put an end to her life, Nancy never had anybody to speak for her. That's what we were doing here. I feel she was sentenced to death," the child says.

Now this child has three color snapshots in her small brown hand. "Here, take a look at these," she says. "What do you see? These are piles of aborted babies. This is from a clinic on Michigan Avenue in Chicago. You can't fake pictures like these, you obviously see these are real."

The pictures look like Technicolor photos of a chain-saw infanticide. They are horrid to behold.

Laurel Foreman, a 12-year-old who possesses her parents' committed chrome-hard belief, isn't recoiling at all.