SIDS or Suffocation? How One Baby Died and Saved Another : Transplant: Doctor’s suspicions led to truck driver’s murder conviction. Family accuses police of fabricating confession.

At the age of 3 1/2 months, Paul Rakow took his last breath in a hospital room. Then his respirator was turned off.

The next day, 13-day-old Quinn Kyles took his first breath with his new heart in an operating room 13 miles away. The donor: Baby Paul.

It seemed like a blessing borne of tragedy. One family’s sacrifice becomes another’s precious gift. One baby dies of a mysterious killer, Sudden Infant Death Syndrome; another lives because of that terrible loss. A melodrama both bitter and sweet.

But that’s not how it seemed to one suspicious doctor.

He saw a father too eager to donate his son’s organs and too leery of an autopsy. He feared the hero was really a villain. So he intervened. The police were called. Their investigation began. And, they say, a confession followed.

On Wednesday, Ronald Rakow will be sentenced for suffocating his baby son in December, 1991, because he would not stop crying. The 28-year-old truck driver faces 20 to 60 years in prison.

For one mother, this shocking twist of events is hard to fathom.

“I can’t sit in judgment of that man,” said Theresa Cropper, Quinn’s mother. “No matter what the factual circumstances are, I will always be grateful for that one unselfish act that changed my life.”

“Paul’s heart is really happy in Quinn,” she added. “Every night I give Quinn a big hug for Paul. We say our prayers for that family for a loss they’ll never be able to compensate.”

Two weeks before Christmas of 1991, an ambulance rushed to Wyler Children’s Hospital, part of the University of Chicago Hospitals.

Its cargo was Paul Rakow; this would be the last journey of his short life.

Paul had been born six weeks premature that August. A respiratory problem later required him to be hooked to a portable monitor that would sound an alarm if he stopped breathing while sleeping.

On that day in December, Ronald Rakow, then a hospital security guard, was watching his son while his wife, Angela, was at work. Paul was not hooked to his monitor, but both parents said that wasn’t unusual for afternoon naps.

Paul, who had a slight cold, was crying and restless, despite his father’s efforts to calm him. Angela Rakow returned home at the end of the day.

When Rakow went to change his son’s diaper, Paul wasn’t breathing.

The baby lapsed into a coma; it took at least a half hour to resuscitate him. He was placed on a respirator at the hospital.

Dr. Aaron Zucker, the hospital’s chief of pediatric critical care, soon began wondering what really happened in the Rakow home.

Zucker said he was troubled by Angela Rakow and her mother’s “blase” attitude when he first told them Paul would likely die or have severe brain damage. He grew more alarmed that night when he was notified that the Rakows had inquired about organ transplants.

“They came in and began talking about the possibility of donating his organs from jump street,” he recalls. “It’s the kind of thing people don’t do. They’re too shocked.”

The Rakows, however, insist it was a doctor who initiated the transplant talk. And the defense argued that records showed a call to the donor bank from the hospital hours before Rakow arrived.

Both parents had had experience with transplants: Rakow’s mother received a cornea; Angela said she donated the eyes of her stillborn daughter in 1986.

When Zucker notified the couple an autopsy was likely because it was an unexplained death, he said Angela Rakow adamantly objected, relating a bizarre story of accidentally walking in on a hospital autopsy and being shocked by the doctors’ irreverent behavior.

But Angela Rakow, who calls Zucker “cold and callous,” says her opposition stemmed from personal trauma--her stillborn daughter “looked butchered” after an autopsy.

Zucker, however, says he was more unnerved by Rakow’s behavior: He commandeered conversation, used medical jargon and knew precise times--to the minute--of events on that chaotic day his son stopped breathing.

Zucker paged Rakow on Dec. 14, 1991, after a second test confirmed the baby was brain dead. Rakow said he would come to the hospital, but Zucker left after waiting for hours.

He said he later learned the couple had gone to the pediatrician’s office to voice objections to an autopsy, then did some laundry, and finally went to the hospital to sign organ-donation papers. Another baby received Paul’s liver.

“If only one of those things had occurred, I probably would have not gone very far with this,” Zucker said. “But I kept feeling something tapping me on the shoulder, saying, ‘Here’s another thing that ought to bother you.’ . . . My conscience wouldn’t have let me sit quietly.”

But he didn’t act, he notes, until the Rakows’ pediatrician, aware of the transplant, called to say she was spooked by the couple’s behavior--a feeling shared by other hospital staffers.

For the first time in 15 years as a doctor, Zucker, relying solely on intuition--and no evidence--called the hospital lawyer. He feared a child had been killed, he said.

Eventually, the police were called.

Zucker also relayed his suspicions to a friend, Dr. Robert Kirschner, Cook County’s deputy chief medical examiner, whose office performed the autopsy.

Kirschner said an autopsy cannot distinguish SIDS from suffocation. It’s “always a diagnosis of exclusion,” he said, and more than 90% of cases suspected to be SIDS actually turn out to be that.

As standard procedure, Kirschner dispatched an investigator to interview the Rakows. No foul play was detected. The cause of death remained SIDS.

*

As police investigated a medical mystery in one family, another celebrated a medical marvel.

Dwain Kyles and Theresa Cropper had learned from prenatal tests that their son, Quinn, would have a heart defect. His only chance was a transplant.

“You can’t say, ‘Oh, God, give me a heart,’ ” Cropper said, because it would be inviting pain for another mother.

Quinn’s parents, both lawyers, launched a high-profile publicity campaign for a heart and money for the transplant. Friends and family held a phone-a-thon calling trauma centers nationwide. Their story was featured on local TV news. Singer Stevie Wonder, a friend of Cropper’s, held a fund-raising concert.

On Dec. 15, 1991, Quinn received a heart. It was his mom’s birthday.

Most transplant recipients know little about the donor beyond age, hometown and sex. This case was different.

Both families lived in the same city. Both learned about each other from the media. Both appeared on TV.

But they never met.

*

In April, 1992, Ronald Rakow was brought to the police station.

By this time, detectives had discovered something intriguing: During Rakow’s first marriage, in 1989, his wife came home from work one night to find that the youngest of their three sons was unresponsive. Rakow told her the 3-month-old boy had fallen off the table while he changed a diaper.

The ex-wife said she saw a bruise resembling a handprint on the boy’s back. The child was treated, and no charges were filed.

But now the police wanted to talk about Paul.

Joseph Cavanaugh, who later became Rakow’s attorney, said they questioned his client for hours, then told him his son didn’t die of SIDS, but suffocated because of the way he was placed on his pillow.

They left the room and when they returned, Rakow was on his knees, crying and praying. He was already racked with guilt, Cavanaugh said, but expected to go home--and be charged with neglect for not having the monitor attached.

Instead, the session ended with a six-page statement written by a prosecutor--and signed by Rakow.

It details an exasperated, angry father unsuccessfully trying to soothe his crying son.

According to the statement, Ronald “decided to stop Paul’s crying and the only way he could do it was to stop his breathing. Ronald said he placed Paul’s face down on the pillow and said he didn’t give a ---- anymore and left him there. . . . Let your mother take care of you.”

Rakow said he lied to his wife, “lied to every doctor he spoke to,” opposed an autopsy, fearing it would reveal his son was suffocated and approved the organ donation to conceal what happened, the statement said. It added that he came clean because “he could not live with his lies.”

Cavanaugh said Rakow never even read that statement and those were the prosecutor’s words. He questions why no court reporter was present and no recording made. The statement, he said, is “about manipulation of his grief and distortion of his words.”

Angela Rakow, 27, also says police harassed, coerced and put words in her husband’s mouth.

“If my husband harmed my son, he would not be living,” she said. “I would never allow anyone to harm my children. I would kill him.

“I know my husband did not kill my son.”

A jury disagreed. In August, after a five-day trial, Rakow was convicted of murder.

Prosecutors argued that Rakow knew his son was too weak to lift his head if it was stuck in a pillow.

But the baby was not weak, Cavanaugh said. He presented medical experts who testified that they couldn’t eliminate SIDS and suggested Paul could not have died in the manner prosecutors claimed.

Rakow testified he placed his son on the pillow with his head to the side. His wife testified she was a few feet from the baby and saw nothing amiss.

“The jury just didn’t believe me,” she said. “I find it very puzzling and very sad. I have no reason to lie.”

*

Rakow is appealing his conviction. But there are even more family problems; his wife’s son and two daughters were placed in foster care as a consequence of the case, and she is fighting to regain them.

“I’m still grieving,” she said. “I lost my husband, I lost my children due to this and I lost my son.”

She tries not to think about Quinn Kyles. “I have so much going on in my life that takes precedence,” she said.

As for Quinn, Theresa Cropper reports he is potty trained, attending preschool and doing cartwheels.

She did not follow Rakow’s trial and still has trouble believing what happened. But her thoughts are with the Rakows.

“Somewhere a little baby’s spirit is in heaven . . . an angel still having a lot of pain,” she said. “That family didn’t have to donate Paul’s organs. They made my life a joy. . . . They deserved our prayers before this and I’ll pray for him after.”