The mothers of my little patients in the NICU often demonstrated uncommon courage and resolve. Jacob’s story illustrates this kind of rare maternal strength and determination. I remember Jacob so clearly - not for his degree of prematurity or the severity of his illness - but for his parents’ challenging situation. His parents became known to me one month before his birth, on the fourth of July weekend, when his mother’s obstetrician consulted me to counsel them. After my OB colleague called to inform me of their situation, I carefully reviewed current statistics for premature babies’ survival and morbidity at every gestational age below 30 weeks gestation. Afterwards, I approached the couple with some apprehension.
A cancer diagnosis while pregnant
We met together in mother’s hospital room since she was not in active labor. She had just been diagnosed with stage two cervical cancer and was pregnant with her son, Jacob, at 24 weeks gestation.
Her husband, a bright and inquisitive chemical engineer, seemed nice, but drilled me with numerous questions about the outcomes of preterm babies born at various gestational ages between 24- and 30-weeks’ gestation. He had already researched this data but listened and took notes from the information I presented. When mom asked me about survival in general, I gave her my usual spiel—that the best cutoff for normal outcomes was around 28 weeks gestation. (This encounter occurred in the late 1980s.) I told her that most babies born at that 28 weeks gestational age grow up to become completely normal children. Obviously, they had been worrying about all possibilities, so they asked many questions about complications related to extreme prematurity.
This young couple was struggling to decide whether to terminate the pregnancy, when and if to deliver their son, and when to begin cancer treatment for her. I learned much later that Jacob’s mother desperately wanted to provide her husband with a legacy—the gift of a son. The day after our meeting, the couple decided, with the guidance of her obstetrician, to wait another month to begin her cancer therapy. She chose to remain pregnant another month rather than start her own treatment. She was given antenatal steroid injections to mature the baby’s lungs and brain.
A premature birth at 28 weeks gestation
Little Jacob was born one month later in August 1987, at 28 weeks gestation, weighing three pounds, four ounces. He entered the world with a robust cry and mature lungs—he was a big, healthy preemie. In the NICU, he had few problems and was relatively easy to care for. He had minimal apnea (breathing pauses), no infections, and no complications. Jacob gained weight well and remained in the NICU for only seven weeks.
His father visited often, was continually pleasant but curious. He asked lots of questions and always took copious notes. Meanwhile, his mother began her cancer treatment and, as a result, was often unable to visit. After delivery, she underwent a radical hysterectomy, which was followed by radiation therapy. Sometime later, she endured chemotherapy as well.
My own son, David, was a little over two years old when I encountered Jacob’s parents again one year later. They had joined the same Methodist church that I attended each Sunday. At the time of our connecting again, Jacob’s mother was very frail and pale, clearly struggling with painful, invasive cervical cancer. Her husband told me that her initial treatments failed, that she was slowly deteriorating. She wanted to attend church with her husband and mother during this time. Tragically, she died when Jacob was only sixteen months old.
A single father cares for his son
This brave, young woman had been willing to sacrifice her own life to save her son’s and to maximize his ultimate outcome. I wondered if I would have done the same thing. When her funeral service was held in our gorgeous cathedral sanctuary, I remember sitting there sobbing, since her death seemed to me such a heartbreaking loss. The associate pastor sitting next to me that day remarked that she “was sorry to see me in so much pain.” During that time, I was agonizing over whether I had influenced her to postpone for another month her own life-saving therapy.
Jacob’s father continued to attend my church, and both our little boys attended the same preschool there. Jacob was a playful, happy, healthy toddler, with a head full of blonde curls. Throughout the next year, we saw each other often and became friends. Jacob’s dad and my husband got along well, since they were both bright, jovial, and sarcastic, and they both liked wine. My husband and I often met Jacob’s dad after church on Sunday, as we gathered up our sons, and all went out together for Sunday lunch. We three enjoyed watching our toddler boys play together happily. That year, Jacob’s dad was an attentive, loving father to his young son, but he often seemed lonely.
A young father ready for connection
After some time passed, he asked me to recommend someone that he could date. Fortunately, I had one single friend who worked as a pediatric ICU nurse in the same hospital I did. She was smart, attractive, and outgoing. I introduced her to Jacob’s dad, they began to date regularly and seemed well-suited. My husband and I could tell that they enjoyed spending time together since we shared a few double dates. Not surprisingly, they were married about a year later and continue to be happily married to this day, some thirty-five years later. Jacob was blessed with a new mother, and his father gained a healthy, loving wife.
Jacob’s parents had another son soon thereafter to complete their family, and, when invited, I joyfully attended their new son’s delivery. It was always fun to attend another healthy life entering the world! His father still laughs as he reminds me that his second son peed on me after his delivery. And, after all these many years, that couple remains two of our best friends. We visit often and have celebrated many Thanksgivings and Christmas holidays together. Jacob’s dad often brags about how I created such a perfect match, and I do feel privileged to have participated in the metamorphosis of their unique family.
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