This isn't a traditional Mother's Day column. No flowers, breakfast in bed or Hallmark cards.

This one takes on death.

Resist the urge to turn away because the topic makes you uncomfortable.

If we're honest, many children see Mother's Day as an obligation. Rarely do we reflect on what a mother's love means. Nor do we acknowledge the truth that in time it will be just another Sunday in May.

I thought about all this after receiving an email from Tarvez Tucker, a doctor in the neuroscience intensive care unit at Oregon Health & Science University.

She'd written a tribute to some of her patients who had died – mothers young and old, mothers with grown children and toddlers, a man who grew up in foster care.

Sometimes loss strips away the trappings and leaves us with the recesses of the heart.

And so, a Mother's Day column on death.

***

Tucker, also a professor of neurology and neurocritical care at OHSU, told me that not a week goes by that someone doesn't die in the unit. She's often bedside. In those last moments, she's discovered the most profound expressions of love are the ones between mother and child.

A mother's love isn't better or deeper than the love a father has for a child. It is, though, a different bond. The mother carries the baby in her body. From the moment of birth, she sends her child into the world. And so begins a lifetime of letting go.

Each birthday, while a celebration, is also a time for a mother to realize what was and will never be again. No more nursing, no more crawling and never again first grade.

A mother's silent prayer is that she dies before her children, her work done, the children left to carry on. For those left behind, there is a hope that the mother knew how much she was loved.

"My brother was with my mother when she died," said Tucker. "I couldn't be there because I was in medical school. I'll always have regret. Maybe that's what drove me to write about the mothers."

Years into her career, Tucker was a full-time academic neurologist at a university in Ohio but wanted a challenge after the youngest of her four sons left for college. She applied for a two-year fellowship in neurological critical care at the University of Cincinnati. She believes she was the oldest fellow in the nation.

The world she was thrust into was far different than the classroom and dealing with outpatient cases. A philosophy major in college before deciding to become a doctor, Tucker began carrying a small notebook to gather her impressions of what she witnessed.

As this Mother's Day approached, Tucker turned to the stack of notebooks. She began writing something to memorialize some of the mothers lost in the ICU. Not all are from Oregon, and she changed the names and some details of the cases.

"But they're all true," Tucker said. "They reveal courage and love."

Emily

She had been shot in the head and chest in the crossfire of a senseless drive-by shooting on a rainy night, more typical of Midwestern storms than Portland's. Her injuries were not survivable.

Before she closed her eyes, she spoke softly to the ER nurse.

"Take care of Connor," she said steadily, of her 4-year-old son, waiting at home, who didn't know yet."Thunder scares him."

Kristin

It had started with a brief twinge of pain that shot down from her lower back to her leg. A young mother of five, she ignored it for weeks, thinking she had just pulled a muscle lifting one of her chubby toddlers.

But her family physician, a kind man whose practice spanned 30 years, was worried. He ordered an MRI scan that showed an invasive tumor, Ewing's Sarcoma, which had spread to the bones of her spine and pelvis.

At first, the cancer responded to chemotherapy and radiation. Then, six months later, cooking in the kitchen, she had a seizure. Four walnut-sized tumors had metastasized to her brain. By the time I met her, she had already had three surgeries to resect the tumors, which kept growing back.

Her neurosurgeon strode confidently into the room, white coat so crisp it rustled.

"Let's get this out again, Kristin, just another week or two, and you'll be better ... on your way home. "

She asked how much more time the operation would give her. He replied gently, perhaps one or two months.

She looked at her kids, clambering all over the bed with her, dressed in Sunday clothes for Easter.

She thanked her surgeon, and then went home to dye eggs instead.

Jeanette

The tiny bacteria multiplied quickly in her heart, settling like clinging caterpillar feet on the delicate leaflets of her mitral valve. The species was so unusual we had to look it up, and could hardly pronounce it, staphylococcus lugdunensis.

She hadn't felt sick, just tired, but she was 83, and thought that was just the reason. But then her heart began to fail. The cardiothoracic surgeon was direct: she could be cured.

But not before staying in the hospital for four more weeks, to receive antibiotics through a slender tube inserted into her chest. After that would be open-heart surgery, stopping her heart for several hours on cardiac bypass so that he could replace the failing valve.

To her daughter, and to us, on the other side of the curtain, the decision seemed straightforward.

But for Jeanette, even trying to eat pudding was exhausting.

The letting go, not whatever life remained, was important for her.

And so, she did.

She waited until her daughter had gone home, tired after four nights at her bedside. Determined, at peace, in her daughter's words later, "she set her spirit to wings to cross over."

She left staphylococcus lugdunensis on the bed behind her.

Aya

Their pickup truck was stopped at a red light and struck from behind by a distracted driver going much too fast. Her twin girls strapped in booster seats in the back were killed instantly. Her husband's pelvis and ribs were fractured and Aya's head was thrown into the windshield. She instantly lost consciousness and she arrived in our ICU in a deep coma. She slowly awoke, eight days later.

She never asked.

At first, we thought it was the language barrier, but although she was Japanese, she had learned perfect English.She listened to our plans for her rehabilitation, but hardly ever spoke; just "yes" or "no" to questions about pain.

Months later, in a rehab hospital, she died. We never discovered how.

She died the mother of two girls; all she had ever wanted to be.

Joe

Long before age 89 when he fell down the stairs at home and sustained large bilateral subdural hematomas compressing his brain, Joe had made his end-of-life wishes clear. No surgery, no ventilator, no CPR. He had firm ideas about the dignity of dying, and what life and family meant to him.

Only once, early in their marriage, had he mentioned to his wife of 56 years the story about his mother. She had left him in foster care when he was 9; he never knew why and never saw her again. He had never spoken of her again to his wife, and never at all to his three daughters, throughout his long and happy marriage.

All four "my girls" as he called them were at his side when he died. They thought they knew him with the depth of detail earned by long years of family love. He recognized them, smiled, but his last words were not to them.

He said, "Mom, I have missed you."

***

This Mother's Day, Tucker is flying from Portland to Florida to be with three of her sons.

She knows this weekend, perhaps in her ICU, someone's mother will die, and a child will be there with her.

"I'm exposed to death all the time," Tucker said. "In those last moments, I hear how people love each other."

Tucker's sons think she's too sentimental, calling her mushy when she tries to explain the depth of love for the babies who grew into the men who one day will be by her bedside when her time comes.

She has no idea what her last words will be.

But she wants to leave them a message.

"Maybe," she said, "this story is the message."

--Tom Hallman Jr.

thallman@oregonian.com; 503 221-8224

@thallmanjr