Baby’s Struggle for Life Teaches Mother How to Love

The baby boy weighed 1 pound, 14 ounces. Born three months premature, he was so weak, he needed a respirator to breathe. Doctors said he had a good chance of survival, but would probably grow up with serious problems: learning disabilities, lung disease, cerebral palsy.

His hand was the size of a thumbnail, his head the size of a fist. To Nicole Smith, who had just given birth to this skinny child, he looked like a grocery store chicken.

He was not hers to care for, not hers to love.

She made sure of that the week she found out she had conceived a child with a married man. She decided on adoption and quickly found the perfect couple--he was a lawyer, she was a schoolteacher. They were everything she wasn’t--stable, responsible, committed.

They desperately wanted to be parents. Nicole never wanted to be a mother.

Five hours after the baby was born, Nicole’s bedside phone rang. It was the adoptive mother.

“Nicole, we don’t feel this is the one for us,” she said. They couldn’t handle the problems--financially or emotionally. Could she understand?

“Go to hell!” Nicole screamed into the phone. “I hope you never have another child!”

What would Nicole do now? Here lay this baby on a warming tray wrapped in tubes and wires, a baby needing more than Nicole was prepared to give.

But over the next six months, Nicole would become everything she never wanted to be.

*

This is Nicole’s story, as she tells it. Although some of the details are known only to her, much of the story was confirmed by hospital officials.

Motherhood was not in Nicole’s plans. A day after she delivered her baby in Harrisburg Hospital in Harrisburg, Pa., she had a tubal ligation to ensure that she would never have another child.

At 25, Nicole was wild and impetuous. With her long auburn hair and big blue eyes, she lived on the edge of trouble and liked it that way. She danced at a strip club for a while and ran cables at a Louisiana shipyard. She had even had a child once before, a girl, and had given her up for adoption.

She joined the Army and was stationed in Korea when she fell in love with a young sergeant. He was strong and handsome and promised to leave his wife and three children for her. She believed him. He even gave her an engagement ring.

When she got pregnant last summer, she had a fleeting fantasy that they would be a family. But she wasn’t surprised when, instead of setting a wedding date, he suggested an abortion. Nicole wouldn’t do that, so she decided again for adoption.

She wasn’t mother material anyway. She wasn’t close to her own mother and couldn’t see herself as one either.

Nonetheless, she wanted to take care of the baby growing inside her. She cut down on her smoking and ate more vegetables. She played soothing chant music and rubbed her belly. But she didn’t allow herself to get too close. This was someone else’s baby.

The pregnancy was fragile from the start. Within the first two months she was in the hospital, bleeding. Her long, rigorous days in the Army didn’t help, so she was discharged and moved home to Marysville, Pa.

Six months into her pregnancy, she rushed to the hospital Jan. 19 with labor pains. She delivered the baby Feb. 3--14 weeks premature.

When the adoptive parents backed out, she was so outraged she picked up the phone and dialed the local paper, the Patriot-News.

She ridiculed the adoptive parents for rejecting the child, “just because he’s not perfect,” and asked for help finding new parents for the baby boy.

But first, the baby needed a name. Alek Nathaniel Smith, she decided. It meant “strength” and “one with God.” He needed both.

Nicole didn’t come back to the hospital to visit Alek until a couple of days later when the newspaper asked her to pose for a picture with the baby.

Alek looked so defenseless. When the nurse pricked his foot for a blood sample, he grimaced, but didn’t cry. He couldn’t cry, couldn’t even make a sound. The ventilator tube down his windpipe prevented his vocal cords from touching.

It hurt Nicole to watch. She reached her hands through the incubator’s portals to caress Alek’s forehead. She stroked him gently, careful not to disturb the catheter in his belly button that delivered an IV solution. The breathing tube taped to his lip was connected to a vibrating oscillator that forced little puffs of oxygen into Alek’s wilting lungs.

Breast milk would be the best thing for him, the nurses said. Since Alek was too premature to know how to suck, swallow and breathe at the same time, Nicole pumped her breasts every three hours. She even set her alarm for the middle of the night. Every day she carried little plastic bottles of milk into the neonatal intensive care unit of Harrisburg Hospital. It was dumped into a sterile bag that dripped into a feeding tube taped to Alek’s nose.

Dr. Kevin Lorah, medical director of the neonatal intensive care unit, knew that getting the baby enough nutrition through the tube would be a battle. Premature babies burn a lot of calories in their struggle to breathe.

Letters poured in from people who had read the newspaper story and wanted to adopt Alek. NBC’s “Today” show called and wanted an interview. More letters arrived--many from people simply expressing their concern and prayers. She read them one by one, looking for another couple to be parents to Alek.

Alek started to grow. Every little ounce of breast milk seemed to help. His sagging skin started to fill out. His hand was still too small to grip her pinkie, so she rolled up a piece of gauze the size of a pencil. He clutched it.

Nicole narrowed down the prospective parents to two. One woman had had a Down syndrome baby who died at the age of 2. Nicole thought she seemed strong enough to handle the challenges of Alek. The other couple sent her a videotape of themselves. Just the way they looked at each other so lovingly made Nicole think they had the capacity for unconditional love. Alek needed that.

She continued her daily pilgrimage to the hospital. She still wasn’t allowed to hold Alek. Any sudden movement could dislodge the tubes and catheters that kept him alive. She made him a soft flannel quilt and brought him a little stuffed puppy. Alek recognized her face, she thought, was soothed by her voice. She called him her “blue-eyed angel.”

Alek knows his mother, the nurses told her.

Nicole rubbed his foot and sang to him, softly:

“Mama’s little baby loves shortening, shortening, Mama’s little baby loves shortening bread. . . .” She hummed the rest.

On March 9 she got an urgent call from the hospital.

Come immediately, the doctor said. Alek might not make it through the night. His lungs could collapse at any moment. If Nicole would like to, she could hold him for the very first time. Alek was 5 weeks old.

Nicole put a little pillow in the crook of her arm and the nurse gently placed Alek--still less than 3 pounds--on top.

She looked down at the bundle in her arms and for a moment she didn’t see the tubes, wires and tape. To Nicole, he looked like a normal little baby boy. And for the first time, Nicole felt pure love, pure joy--and an intense desire to protect this child. She wanted to watch him grow, to take him to Disneyland, to teach him to fish.

As Alek struggled to breathe, she made a vow: If her son survived the night, she would keep him. She would mother him. She would love him, unconditionally.

Alek lived and started gaining strength again.

Months passed and Alek struggled on. Nicole jumped from job to job--installing cable TV, making coffee drinks at a trendy coffeehouse, sorting packages at a shipping company. But she was barely making a living. If she was going to rear Alek, she needed to prepare a better home for him.

A friend told her about a recruiter who helped ex-military people find jobs. When Alek was 5 months old, Nicole was offered a job at a phone company in Cedar Rapids, Iowa, making double her wages. It was 900 miles away from Harrisburg Hospital.

The thought of leaving Alek was heartbreaking, but she decided it was best for their future. Her relatives promised to visit Alek.

She promised her son that she would return every two weeks after payday. During her second week on the job, she got a call from the hospital. Alek needed hernia surgery. She drove for 24 hours to see him just in time for his surgery. She held him close, then drove back to Iowa.

A week later, she got another call. Alek needed more surgery. He couldn’t keep his milk down and it was backing up in the feeding tube and entering his fragile lungs. This time, Nicole took a bus and got there in time. He seemed to be doing well when she left. But a few days later, on Aug. 3, she got the third and final call.

Alek was dying. His lungs were failing. Not enough oxygen was getting to his brain. This time she flew to Harrisburg and arrived before midnight.

The doctors made it clear: Alek was not responding to treatment. He had been deteriorating for two weeks now and wasn’t getting better. Now, Dr. Lorah knew, medicine could delay death but not save Alek’s life. It was up to Nicole to decide whether to disconnect life support.

She held him again. He was 6 months old now and weighed 8 pounds, 3 ounces--the size of a healthy newborn. But he was so pale, she could see his veins through his skin, his eyes through their lids.

Why had he taken this turn for the worse? Only after she moved away did he start to decline so rapidly. Did Alek feel abandoned? Did he lose his will to live?

Alek’s lungs were so damaged and scarred that they could never recover enough to survive off a ventilator, Dr. Lorah said. The hospital staff, he said, had never seen a baby with such severe lung damage live so long.

Illogically, Nicole blamed herself for his decline.

Alek gasped for breath and opened his eyes. Nicole declined further sedation for him. She wanted him to know she was there.

The nurses who had cared for him for six months each wanted to hold him, to say goodbye. He was baptized.

Then Nicole nodded to the doctor to remove the tubes, wires and tape.

For the first time since birth, Alek Nathaniel Smith was unrestrained. Nicole held him close for a moment, then signaled to her father: Let’s go outside, she said. Alek had never been outside.

And so in the wee hours of a warm August morning, Nicole carried her son into the fresh night air. Nicole gently held her son as they listened to the river rushing past the hospital and gazed up at the starry sky. For the first time, Alek felt a cool breeze caress his cheeks.

Nicole’s father picked a black-eyed Susan from the flower bed and brushed the petals against Alek’s face. He crinkled his nose.

“I love you,” Nicole whispered over and over, rocking him in her arms.

Within 40 minutes, Alek took his last breath, cuddled in his mother’s arms.

*

More than a month later, Nicole still lives in Cedar Rapids working for the phone company. She keeps a photo album filled with pictures of Alek in his incubator. One page is filled with pressed black-eyed Susans.