Cardiac & Resuscitation, Columns

A Reunion With a Patient – 27 Years Later

Issue 6 and Volume 42.

Every provider has pivotal moments in their career when they feel they made a difference, made a decision that saved a life or learned important lessons that they can pass on to others.

I recently had the rare opportunity to be reunited with a 27-year-old that I, my partner and a police officer resuscitated in May 1990 when he was born prematurely at just 27-weeks of gestation. He was born on a stairway, weighed only 2 lbs., 13 oz., and wasn’t breathing.

I wrote about the survival of “Baby Rodney” in the July 2015 issue because I thought the story was over, but it wasn’t.1

I now write the latest chapter in this incredible story, which was a pivotal point in my career that allowed me to see the fruits of my labor not only as a paramedic, but also as the regional EMS director in Eastern Pennsylvania who worked closely with hospitals, committees, physicians and providers to categorize hospitals according to their critical care capabilities.


The Christmas card sent to paramedic A.J. Heightman in 1990,
letting him know that Rodney Barron Jr. had “made it.” Photo A.J. Heightman

Part 1 of My Story

It was 27 years ago, on May 24, 1990, at 01:44 am. A volunteer paramedic for Bethlehem Township (Pa.) Volunteer Fire Company (BTVFC), I was dispatched as a second ALS unit to assist at what started out as a call for a “woman with abdominal pain.” I was updated en route that my unit was dispatched to assist a paramedic unit already on scene at a complicated birth.

When I walked through the kitchen door of the home, the first crew was on the floor attending to the mom who had just delivered a premature baby, just 27 weeks of gestation, weighing 2 lbs., 13 oz., and not breathing.

I wasn’t aware of all that because, as I entered the kitchen, Bethlehem Township Police Officer Scott Lipare turned and handed me a towel like a quarterback handing off a football to a running back and said, “Here’s your patient-just born!”

He had a look in his eyes that I’ll never forget; the same one I’m sure I had on my face as I pulled back the towel and saw the lifeless body of my tiny patient; the smallest patient I’d ever encountered.

There were several key factors that helped me make the split-second decision to begin the resuscitation of Baby Rodney.

My initial thought was that I was being handed a premature stillborn child that couldn’t-or perhaps shouldn’t-be resuscitated. But, several things helped me rapidly decide to resuscitate him.


A.J. Heightman and Rodney Jr. with his mother Dianne Barron
holding Rodney Barron III. Photo A.J. Heightman

First, I trusted Officer Lipare. He was a trained first responder who I’d worked with for many years. Back then, I remember thinking, “Scott must know more than I do right now and is handing me this tiny patient because both he and Brian (the first paramedic on scene) feel resuscitation is in order.”

Second, I was trained in a paramedic program that required us to spend time in the neonatal ICU (NICU). I remember thinking, “Why have us spend time in the NICU? The chances of me seeing and treating a preemie are slim to none.”

Boy, was I wrong. That NICU experience was invaluable in helping me understand what they do there, and, more importantly, the age/size patients they were able to save.

It was in the NICU that I learned that the presence of an apical heartbeat was a key determining factor in the no/no-go resuscitation of a premature infant-the apical heartbeat means the baby couldn’t be categorized as stillborn.

It was in the NICU that I learned that 12-15% of premature babies of this age won’t survive, and that those who did stood a good chance of having neurodevelopmental problems and respiratory distress syndrome.2

It was in the NICU that I learned that at 27 weeks, the premature infant’s tiny lungs aren’t yet fully developed; they’re frequently “sticky” and aren’t capable of proper inflation and gas exchange and would be in need of mechanical ventilation.

And it was in the NICU that I learned that a premature infant’s skin is wrinkled and reddish-purple in color because they haven’t had time to put on any fat. And that they’re so thin that you can see their tiny blood vessels underneath their skin. And that their body is covered with soft fur-like hair, called lanugo. And that their eyelashes may not even be present yet.3


Rodney Barron Jr. meets Bethlehem Township Police Officer Scott
Lipare for the first time in 27 years. Photo Christopher Post

Rodney’s tiny body was covered in that soft hair and his tiny neonatal eyes were closed and lacked eyelashes. I could hear an apical heartbeat when I listened to his tiny chest in the ambulance. As I continued to inflate his fragile lungs with mouth-to-nose breaths, providing small puffs of air into his fragile lungs, my partner intermittently suctioned him with a tiny bulb syringe and wrapped Rodney in an aluminized silver swaddler to ensure we maintained his body heat.

With an initial APGAR score of just 2, I made the decision to divert from the closest hospital six minutes away, where the baby’s mom was being taken, to the neonatal center where I had trained as a student paramedic. It was 20 minutes away, but I knew that this was the best place to take him to give him a chance to survive.

Officer Lipare was behind the wheel of our ambulance so my partner could stay with me in the patient compartment. About a minute into the transport we heard a tiny grunting sound and saw Rodney start to take breathe on his own. I continued to assist him, inserting extra breaths in between his slower, labored breaths.

His skin color started to pink up and he soon began to move his tiny limbs. I then started placed a pediatric mask next to his tiny face to administer “blow-by” oxygen. Again, using my stethoscope to assist me in getting accurate vital signs, I found his tiny respiratory effort to now be 26 and his pulse 140.

I updated the hospital that we had labored respiratory effort by the neonate and that his APGAR was now 7. They advised us that they’d meet us in the ED but that we’d be heading directly up to the NICU.

When we arrived in the NICU, their team literally swarmed the little guy. One nurse rapidly threaded a tiny IV catheter into his antecubital fossa as another suctioned him and placed a small circular oxygen dome over his face and neck.

Their professional approach told me I’d made the right decision to divert him to their specialized unit. But, because we’d done so, we knew that we were depriving his mother of the chance to see her newborn son.

Because the NICU staff trained us and knew us, they invited us to accompany Rodney and participate in his care. It led to another teaching moment: If that relationship hadn’t existed, I don’t think the remainder of this story would’ve occurred and I would’ve always wondered if Rodney had survived.

Part 2 of My Story

My partner and I felt guilty depriving Rodney’s mother of the chance to see her newborn son, so, once they had Rodney settled in the NICU and he seemed to be stabilizing a bit, I got the idea to retrieve a Polaroid camera from our unit-we used it to take and deliver
trauma/mechanism of injury images to flight crews and trauma center staff. I took a few images and brought them to his mother, Diane, at the other hospital. She was very appreciative and it was there that she and her husband learned (and remembered) my name.

I left her hospital room wondering if Baby Rodney would survive. As is still the case today in many EMS systems, the receiving hospital didn’t ever notify us of the outcome of our patients, so I didn’t know his status until a Christmas card came to my home six months later. Inside was a photo of a beautiful, healthy infant on it, with an introductory note that said, “I made it!”


The July 2015 JEMS article detailing how A.J. Heightman heard
from Rodney Barron Jr. on Facebook, is signed by Rodney Jr. and Rodney III.

Photo A.J. Heightman

Part 3 of My Story

Fast-forward 25 years.

I remember checking Facebook on a weekend in May 2015 and seeing a message from Rodney Barron, Baby Rodney’s father. He found me on Facebook and wanted to let me know that, not only was Rodney Jr. now 25-years-old and healthy, but a new
father himself.

Rodney Jr.’s son, Rodney III, was born at full term and weighed in at 8 lbs., 4 oz. The picture made my day and I replied to Rodney Sr. that I’d love to meet Rodney Jr. and Rodney III someday. He wrote back and invited me to do so whenever I was “back East.”

Early this year, Rodney III’s mother messaged me on Facebook to see if I could travel to the East Coast in May to surprise Rodney Jr. at their son’s second birthday party. I couldn’t because of other commitments and was disappointed.

But, fortuitously, my colleagues at BTVFC called me a few weeks later and asked if I could present my two-day MCI workshop back in my old stomping grounds in April.

I accepted and a week before I left to do the class, I got the idea to message Rodney’s dad to see if he could arrange to bring Rodney Jr. and his 2-year-old son to Bethlehem Township on Sunday, April 23, during our lunch break. He thought it was a great idea and agreed to orchestrate it.

Out of courtesy, I informed BTVFC that there was going to be an informal reunion at the Sunday lunch break.

I soon learned that Rick Hasonich-a bright, young, enthusiastic and promising firefighter when I left Bethlehem Township and moved to California to join JEMS in 1995 and was now BTVFC’s vice president and public information officer-sent out a press release to local media to inform them of the reunion that was going to occur. The response he received was amazing and included lots of media interest.

I emailed Rodney Sr. to tell him it might be best to inform Rodney Jr. that local media knew about our little surprise reunion so he wasn’t overwhelmed.

We then corresponded about a documentary that had been done in 1990 called Miracle Babies and featured the resuscitation of Rodney. He wished we could show it at the reunion. I dug through my acre of old slides photos and VCR tape for two days until I found a copy of Miracle Babies safely tucked away.

I packed it for my trip to Pennsylvania and put the word out that we had to find a VCR player … not an easy task these days. It was Rick Hasonich to the rescue again. He found one and had it ready for the reunion.

The Reunion

It was hard for me to stay focused that Sunday morning in the classroom, knowing that a major event in my life-and Rodney’s- would occur in a few short hours. We had the class outside for a morning MCI drill when the media began to arrive. You could cut the anticipation for the reunion with a knife.

Noon approached and I was told that the Barron family was outside, showing Rodney III the helicopter that was on site for our drills.

When Rodney and his family entered the auditorium, I didn’t know whether to smile or cry, so I did both. I instinctively hugged Rodney Jr. and grabbed his 2-year-old son from his arms. I hugged him tightly because, to me the reunion had extra significance because I knew that Rodney III wouldn’t be there with us had it not been for the resuscitation of his dad 27 years earlier.

During the greeting and photo session, Rodney Jr. thanked me and Officer Scott Lipare, still a police officer today, for helping to save his life that fateful day. I asked him to sign the 2015 issue of JEMS that detailed his resuscitation 27 years earlier and also gave a pen to Rodney III to sign the page. The little guy zeroed in on the photo of his Dad holding him and scribbled all over it!

We then showed the Miracle Baby segment to the Barrons and the MCI class. There were a lot of tears as many of the family saw the documentary for the first time and Rodney Jr. saw his now deceased grandparents discuss calling 9-1-1 that morning in 1990. And we all laughed at how young Rodney Sr., his then wife Diane and I looked back then.

After the video, I asked Rodney Jr. if he’d realized how remarkable his survival was. He said he appreciated it more and more as he grew up, began to realize that he had less than a 1% chance to survive, and had amazingly few respiratory problems compared to many premature births born before their lungs are fully developed.

He was in the NICU for seven long weeks, cared for by the other often unrecognized heroes who work upstairs in the NICU.

I thought our reunion was concluded and never expected the media to get wind of the reunion, but they did and many of you emailed and sent me messages of congratulations which I am truly grateful for.

The Good Morning America and Women’s World magazine coverage that followed were great rewards for all of us in a profession where we rarely get to hear whether our critical patients survive, let alone recognize us for what we do.

This was one of the most challenging, memorable and rewarding saves in my long EMS career, and more importantly, one of the few critical patients I managed who lived despite so many odds stacked against them.

References

1. Heightman AJ. Tiny Resuscitation; A Facebook posting brings back precious EMS memory. JEMS. 2015;40(7):14-16.

2. Juul S. (2013.) Birth at 27 weeks of gestation. PENUT Trial. Retrieved May 8, 2017, from www.penut-trial.org/node/45.

3. March of Dimes. (n.d.) What’s the outlook for premature babies born before 28, 31, 33, or 36 weeks? Babycenter. Retrieved May 8, 2017, from www.babycenter.com/0_whats-the-outlook-for-premature-babies-born-before-28-31-33_10300031.bc.