Lisa Swinton McLaughlin was an overachiever: a trained lawyer and doctor and a high-ranking American Red Cross executive who traveled the country educating people about sickle cell disease.
Yet for all of her success, what she wanted most in life eluded her — having children. Then last year, at age 56, came a miracle. The recent Baltimore resident became pregnant through in vitro fertilization using donor eggs and sperm. Her twins boys, Jordan and Dylan, were born in December.
But in the end, she won't raise those kids. The new mother who had longed for babies for so long died before her boys ever left the hospital. An autopsy found that a bowel obstruction had been fatal.
Now her husband, Mike McLaughlin, 10 years her senior, must embrace her dream. He recently brought the couple's babies home from a Montgomery County hospital. With the help of a nanny he has found himself thrust into the role of single fatherhood, a life of round-the-clock diaper changes and bottle feeding.
"This probably wasn't my vision of retirement, but I tend to think what is meant to be is meant to be," he said. "I just have to make sure they have a great education and become great people. I will raise them well for their mother."
Swinton McLaughlin followed in her parents' career footsteps. She first became an educator, like her mother, then went to law school, like her father. She developed into a top-notch lawyer specializing in juvenile issues over 14 years in Nebraska, including a stint as assistant attorney general with a focus on child abuse cases.
In her 30s, when many people are finding their career groove, Swinton McLaughlin decided to jump again. She began going to a local college to take science classes and soon enrolled in medical school in Charleston, S.C.
After becoming a doctor, one of her first jobs was as medical officer at the Red Cross of the Chesapeake Region in Baltimore. She became an active member of the community, including participating in the Greater Baltimore Committee's leadership program for rising stars.
Richard Benjamin, chief medical officer of the American Red Cross who hired Swinton McLaughlin in 2009, said he knew she would quickly rise through the ranks.
"She was a rock star at what she did," Benjamin said.
The national office hired her two years later. There she pushed efforts to attract more minority blood donors and helped coordinate the domestic treatment of Ebola patients last fall.
Through all of her career changes, Swinton McLaughlin also was attempting to get pregnant; even before she met her husband. She had a couple of miscarriages, he said. But mostly the fertility procedures — so many her husband stopped counting — never ended up in pregnancy.
"Her lifelong dream was to have what every other woman had — and that was children," her husband said. "She just had this need to have children and she would go into these treatments. And they were grueling. She'd have to take shots and hormones. Of course if it failed, then she would be depressed for a while. Then she would buck up and try again."
The efforts were a source of tension in their marriage. He admits it was the one thing they disagreed about — with her determined to try again and him worried about how the treatments might wear on her body.
With the help of a D.C.-area fertility doctor her husband declined to identify, she tried again last year and succeeded. For the first two months, worried about jinxing the pregnancy, she spoke little about it. But soon excitement abounded. She started preparing for motherhood, buying her unborn sons baby cowboy boots and outfits.
"She was just elated she was actually carrying children," her husband said.
Pregnancy at Swinton-McLaughlin's age is exceedingly uncommon, although transferring embryos from a young egg donor, as Swinton McLaughlin did, makes pregnancy possible at any age if a woman has a normal uterus, said Dr. Eugene Katz with Shady Grove Fertility, a Rockville practice that did not treat her.
Shady Grove ties treatments to the natural age of menopause and won't perform fertility treatments on anyone older than age 51. Katz said there is very little data on the risks of conception to women in their 50s, and potential medical hazards include increased risks of hypertension, diabetes and need for a cesarean section.
The Ethics Committee of the American Society for Reproductive Medicine said in a paper that "some women over the age of 50, particularly in the age range of 50–54, who are healthy and well-prepared for parenting, are candidates to receive donated eggs."
The committee urged health screenings, a medical evaluation and counseling. It also strongly recommended only transferring a single embryo for patients in this age group.
"In view of the lack of data about maternal and fetal safety, providing donor oocytes or embryos for transfer to any woman over 55 years of age, even when she has no underlying medical problems, should be discouraged," the paper said.
The first months of Swinton McLaughlin's pregnancy progressed smoothly, her husband said. She developed gestational diabetes, but insulin kept her glucose levels normal.
Ten weeks before her due date, Swinton McLaughlin began to have contractions. Doctors hospitalized her for the final weeks of her pregnancy. She gave birth by cesarean on Dec. 27. Jordan weighed 3 pounds 3 ounces and Dylan was a little lighter at 3 pounds.
"She was so happy," her husband said. "She was just touching the babies like they were the most precious things in the world."
Michael McLaughlin remembers his wife suffering from a lot of pain when she left the hospital.
"My wife didn't complain a lot," McLaughlin said, "but she did complain that her pain was greater than 10 and they wouldn't give her any more pain relief.
Her abdominal area remained distended, her legs and feet puffy and swollen. McLaughlin said he called her doctor, who said she should walk around, but she couldn't because of the pain. She complained of being hungry but wouldn't eat.
On Jan. 4, as McLaughlin walked his wife from the bathroom to the bedroom, she collapsed to the floor, dead.
An autopsy concluded that she died from a bowel obstruction, her husband said. A bowel obstruction is anything that blocks part or all of the large or small intestine preventing food, gas or fluids from passing through. The symptoms of an obstruction — nausea, vomiting and pain — are similar to those of other illnesses. It can only be diagnosed with an X-ray or C-scan.
Hernias and scar tissue and adhesions from previous surgeries are the most common cause of intestinal obstruction, but other things can lead to blockages too, including tumors, said Dr. Matilda Hagan, an inflammatory bowel disease specialist at the Center for Inflammatory Bowel and Colorectal Diseases at Mercy Medical Center.
Complete blockages can kill patient in a matter of days if not treated, said Hagan, who did not treat the patient. The cells in part of the intestine die, causing an infection that can spread to the bloodstream, she explained.
For now McLaughlin said he is too focused on his two young sons to think about anything else.He took parenting classes and bought bottle warmers. The first few days were like starting a new career, he said.
When the babies are older and stronger, McLaughlin plans to move to Omaha, Neb., where he met his wife, but also where he has family.
He told his boys he won't spoil them like mom planned to do.
"I already told them I can't afford the world," he said. "I told them I was old school. They aren't going to get everything they want."
He misses his wife every day.
"I will raise my sons so that you will see her in them," he said.