When the message arrived Monday morning, Katie Patel was sitting on the floor in her living room, watching two of her children build a tower from multicolored tiles as her third, a newborn, lay sprawled on a mat beside her. Patel, 32, suddenly faced one of the most difficult choices of her life, so she called her husband, an emergency room doctor at Mercy Hospital South in St. Louis. Busy with patients, he could not pick up then but called her back later that day.