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She Laid Him in My Arms
by Dr. James H. Luther
T he expected call finally came. My daughter, Jenni, had been taken to the birthing center; and my long-awaited first grandson would soon take center stage. Jennifer placed little Jacob Alexander in my arms the next day, a beautiful, “perfect” baby boy. There are few events in life more enjoyable than the birth of a new baby. Feeling him on my chest brought an intense joy to my heart unlike any that I have experienced.
While we were playing with Jacob that sunny Saturday morning, two days after Independence Day, the birth midwife arrived and was brought into the excitement of our family celebration. After her careful examination of Jacob, she grew somewhat serious and encouraged us to return to the doctor’s office on Monday morning. She had detected a slight blue tint in his gums. Relatively unconcerned, since my daughter had just returned from the doctor’s office a few hours earlier, we spent the rest of the weekend reveling in the joy of our happy welcome and new acquaintance with this beautiful newborn child.
During the Monday exam, little Jacob began to cry, and turned a deeper shade of blue. Alarmed, the doctor ordered his admittance into Tallahassee Memorial Hospital. A dose of prostaglandin, a medicine based on a hormone found inside the mother’s womb that signals to the baby it is yet unborn, re-opened a duct called the patent ductus arteriosus. This activated Jacob’s temporary circulation system once more; a system that had started to shut down in favor of his permanent heart-lung circulation. This medicine reversed the trend toward oxygen starvation, and he improved. It was a strong clue that there was a problem in the connection between his heart and the pulmonary arteries, a condition found in as many as one out of a hundred babies. While all of these complications are serious, some can be treated more successfully than others.
Upon being medivaced to Shands Hospital at the University of Florida, doctors there confirmed our worst fears. Jacob must have open-heart surgery to connect his pulmonary arteries, and remove an obstruction in one of them. Additionally, part of his heart was not well developed; an irreversible condition that he would live with, if only these other problems could be repaired.
 Ominously, the statistics were not
encouraging. Less than 40% of such
infants can successfully wean
themselves from this temporary
life-giving miracle machine.
To see little Jacob Alexander placed in the neo-natal intensive care unit, attached to large and ominous monitors was heartbreaking to my daughter. Every instinct and desire she possessed filled her with a longing to simply hold him to her breast, and rock him to sleep. But, those times were over for Jenni. Now her days would be given to structured visits in sterile gowns, soft touches to his head and cheeks by freshly scrubbed hands, and persistent efforts to wrest some good news from a cautious medical staff. She began to use a breast pump to save her milk pending the day that Jacob could once again partake of that God designed, perfect nutrition. Her nights would be spent in the Ronald McDonald House, attempting to encourage and be encouraged by the mothers of other stricken children.
The results from Jacob’s surgery were mixed. The technical part of the surgery had gone well. He had survived this major invasion of his six-pound body. The bad news involved his difficulty in accepting these changes to his brave little heart. For now, he had to remain on the fearsome ECHMO machine, a miniature portable heart lung machine. Ominously, the statistics were not encouraging. Less than 40% of such infants can successfully wean themselves from this temporary life-giving miracle machine.
To our family, this medical marvel presented a dreadful vision. Already surrounded by monitors and sensitive instruments, our fragile baby now had two relatively large tubes running out of his diminutive chest. These trailed off to a fascinating instrument about the size of a large copy machine. One tube filled with dark blood depleted by the voracious cells of the body is mysteriously channeled into the machine and enriched with life-giving oxygen. This visibly brighter blood is directed back into the beating heart through the other tube, thereby sustaining Jacob’s life. As I stood there beside the temperature controlled bed, I counted 14 needles, tubes, and probes attached to this tiny boy. It was almost overwhelming.
Our family developed a love-hate relationship with the ECHMO machine. It was responsible for keeping our precious baby alive; but we desperately wanted to see it gone from him. Unless he could be weaned from it, he would surely die. After nearly 10 days, Jacob won his first major victory. He was breathing on his own, and our hopes lifted! But, his condition was still very grave.
 Continued on Page Two
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