Gabi's Story

A dying mother's gift: A birth, then a death

National Post
Fri 14 Jan 2005
Page: A1 / Front
Section: News
Byline: Heather Sokoloff
Source: National Post
On Saturday, Robert Shore held his baby daughter for the first time. Born premature at 26.5 weeks, and weighing less than a pound and half, she just fit in the palm of his hand. Small as she was, she shrieked with all her might, and flapped her arms and legs, tangling the wires and tubes attached to her tiny body.

Hana Gabriele Helms-Shore was born on Dec. 29, 2004. Two days later, her mother, Gabriele Helms, died.
Four weeks earlier, Ms. Helms, a 38-year-old academic, had discovered that the breast cancer she believed she had beaten three years ago had come back with a vengeance during the 22nd week of a pregnancy she desperately wanted, forcing her to make an unthinkable choice: Terminate the pregnancy and attempt to prolong her life with radiation -- or forgo aggressive treatment for the sake of the baby.

Ms. Helms chose her baby.
It has become cliche to call the birth of premature babies a miracle, but in the case of Hana Gabriele Helms-Shore, the word applies. Ms. Helms spent the last month of her life at St. Paul's Hospital in Vancouver, willing herself to live, despite excruciating pain, so Hana's lungs would be strong enough to give her a chance at survival. On Dec. 29, she was sedated so her baby could be delivered via a C-section. She never woke up.
What is most frightening about Ms. Helms' story is how quickly cancer robbed a woman of a charmed life. Just a month before Mr. Shore took her to St. Paul's Hospital, on Nov. 27, doubled over in pain, she gave a lecture on Emily Carr at the Vancouver Art Gallery, pregnant and beaming.
She had been healthy since early 2002, when she completed seven months of chemotherapy and radiation treatment.
Her professional life was thriving. In June, 2003, she beat out 70 other applicants to land the job of her dreams as an assistant professor at the University of British Columbia, and was well on her way to tenure. The last two years included an emotional trip to her native Germany to present a paper at a conference on Holocaust literature, a new research interest in reality television and a book project on the telling of personal stories through memories of food. Her Ph.D. thesis, published as a book by McGill Queen's University Press called Challenging Canada, had become required reading for scholars of contemporary Canadian literature.
But at the back of her mind, whether she was recovering from her lumpectomy or delivering a dazzling keynote address at an an academic conference, she hoped for a baby.
Ms. Helms was diagnosed with breast cancer at age 35, according to Mr. Shore, who alternatively refers to her as "Gabi, my life partner," "Gabi, my wife" and "Gabi, my love," even though the couple never bothered with a formal marriage ceremony.
In September, 2001, a week after watching the World Trade Center towers crash to the ground on TV from her Vancouver home, Ms. Helms suffered a miscarriage. The doctors had no explanation.

Three weeks later, Ms. Helms felt an unfamiliar lump in her breast. She figured it was nothing -- just a lingering bump from the hormonal rush of the pregnancy. But Mr. Shore worried. He insisted it be checked.

The doctors were stunned when they saw the mammogram results, then alarm after viewing the lump magnified on the ultrasound scan. A biopsy was ordered, right away. It was cancer.
Mr. Shore was terrified by the diagnosis. "It feels like you are walking across the street enjoying a beautiful day and suddenly you are hit by a truck, and you are plastered on the grill of a truck going the other way, totally removed from what your life was earlier," he says.
She had a lumpectomy, followed by a second surgery removing cancer cells in her lymph nodes. Because her tumour was estrogen-negative, hormonal therapies were not an option. That meant she had to undergo chemotherapy and radiation, which could trigger early menopause.
Her oncologist, totally focused on killing the cancer, handed Ms. Helms a referral to an infertility clinic when she asked if she would be able to try for a baby after the treatment.
Only no one told them what service to ask for. So when Mr. Shore called up the Vancouver clinic to ask about egg freezing -- an experimental technology only performed under research conditions -- the attendant who took his call responded curtly: That can't be done, and hung up.
Later, the couple learned they should have been told about embryo freezing, a technology available to infertile couples, and also used by cancer patients. But in the flurry of doctors appointments following the diagnosis when the couple was bombarded with mortality statistics and treatment possibilities, and Ms. Helms scrambled to move back publication dates and re-arrange teaching commitments, questions about a future pregnancy became secondary.
During the seven months of radiation and chemotherapy, Ms. Helms kept mostly to herself, confiding in Mr. Shore and her closest friends. But when it was over, she wanted to talk, and talk. She joined a support group at the BC Cancer Agency, where she met other young cancer survivors facing possible infertility. The women discussed issues relevant to their age group -- such as a diminished sex drive, putting an interrupted career back on track and dating after having a mastectomy.
She helped found a new group for young breast cancer survivors called the Young and the Breastless. The group held a conference in Vancouver, attracting patients and physicians from all over the world. She addressed the conference on her 38th birthday, May 15, 2004, and was the star of the show.

Less than two months later, she was pregnant.
"She had everything she ever wanted," says Mr. Shore. "She was ecstatic."
On Nov. 29, Ms. Helms was experiencing acute back pain. She believed it was caused by the pregnancy, but Mr. Shore was concerned and took her to emergency. The cancer had spread to her liver and bones. And the radiation treatment she needed to keep her alive for a couple more weeks, or a couple more years would severely damage the fetus.
"Gabi said she was not sure how well she would do if she had an abortion and lived," says Mr. Shore. "She would have bought her life at the cost of her child. That would not have been acceptable to her.

"By the time we knew there was a problem, her liver was so extensively involved that the likelihood of Gabi living was very limited. Did she forgo treatment? I guess the answer to that is yes. But how long would more treatment have prolonged her life? The oncologists don't have an answer for that."
A team of more than a dozen doctors at St. Paul's started the gruelling task of keeping Ms. Helms alive. She was able to receive chemotherapy, which doctors believe is safe for the baby, as well as pain killers, but could not have an MRI to see whether the drugs were having any effect. She was given steroids to build up the baby's lungs in preparation for a premature birth.
Mr. Shore slept in the hospital with her the entire month. On Dec. 29, Ms. Helms was taken into the intensive care unit for the C-section. Mr. Shore went home for the first time in a month and slept alone in the couple's bed. Hana Gabriele Helms-Shore was delivered that evening.
Mr. Shore wants his daughter to know how much she was wanted and loved; and he wants the world to know a horrible disease robbed of it of a vibrant and generous individual.
A student of words and life stories, Ms. Helms cut out of the newspaper each obituary of friends, many met through the support groups, who have died, and carefully kept them together in a notebook bound with a red ribbon. Now Mr. Shore will add his wife's obituary to the book.
He hopes her story will remind people that when it comes to breast cancer, and especially premenopausal women getting breast cancer, so many questions remained unanswered.
Ms. Helms, who studied autobiographies, and wrote about how personal stories can be transformed into community stories, would have approved that he's sharing her story, he believes.
Hana is putting on weight and is able to breathe on her own -- but it is tough for him to see his daughter attached to so many tubes and machines, fighting for her life just as his wife did.
She appears to have inherited her mother's desire to live on her own terms. Just like Ms. Helms, little Hana has already figured out how to yank out the irritating tubes doctors put in her throat. Last week, she pulled out a nasal tube, to the cheers of an intern who had treated her mother. "The intern was saying, 'Go Hana, pull out that tube,'" says Mr. Shore. "And the nurses were just looking at us like we were crazy."