I. The Birth of Baby Alyssa

The light of their lives was born 12 inches long. She weighed just one pound four ounces. Her skin fit like a baggy suit. But from the moment Baby Alyssa arrived 14 weeks early, she was the biggest thing in the Shinn family's world. Day and night, they were at her Isolette in the neonatal-intensive-care unit. They took videos that show a happy family basking in its joy and good luck. Richard, in his Dallas Cowboys jersey, strokes Alyssa's tiny hand, no bigger than his thumbnail. In the background, Kathleen's laughing voice can be heard, urging her daughter to open her eyes.

As days turned to weeks, the Shinns became optimistic. Despite Alyssa's tiny size, she had none of the most worrying neonatal deficits—no bleeding in the brain or skin problems or blood vessels that wouldn't close. She was gaining weight. At three weeks, the doctors took out her breathing tube. She was able to breathe on her own.

That was November 8, 2006. "I called her name, and she opened her eyes and looked right at me. She knew me," Kathleen recalls. "It was the most comforting sensation I've ever had. It's really almost indescribable, the recognition."

Kathleen, 36 at the time, was well aware of the risks her daughter faced. She had worked as a nurse in cardiac, oncology, and intensive-care units. Five years earlier, she and her husband had relocated from New Jersey to Las Vegas, where she worked as the nursing supervisor at Southern Hills Hospital & Medical Center and served on its medication-safety team.

The couple had spent three years trying for a baby before the fertility treatments finally worked. Kathleen was so nauseous during pregnancy that she lost 25 pounds. After she developed hypertension, her doctor admitted her to Summerlin Hospital Medical Center, just five minutes from her home, because it has one of only four neonatal-intensive-care units in the area. More life-threatening complications led doctors to perform an emergency C-section at only 24 weeks.

Health care was the family profession. Richard worked in medical records. His mother worked at Summerlin on the housekeeping staff. Kathleen's mother, Carol Schiavo, had worked in home health care. They'd weathered her stepcousin Michael's battle to let his wife, Terry Schiavo, die after she'd lapsed into a persistent vegetative state, a family crisis that morphed into a national ordeal. The fact that Alyssa was alive had led Kathleen to return to church for the first time in 15 years.