Eight Days with Tyler by Philip E. Lambdin

philcher - 07:21am Dec 4, 2005 EST

This is the story of a premature baby whose short life inspired and strengthened everyone he touched.

My fraternal twin grandsons were born on November 10, 2005, as the Marine Corps celebrated its 230th birthday. They were delivered by Caesarian Section at the Women’s Center of the Inova Fairfax Hospital in Falls Church, Virginia, near Washington, D.C. Jacob Matthew Smit weighed two pounds eleven ounces, and Tyler Philip Smit weighed just two pounds nine ounces. Their dad, Matt Smit, was recovering from the stomach flu and was not allowed to be in the delivery room, so he, a co-worker, and I spent several stressful hours in the waiting room. When my wife, Cheryl came down to give us the good news, we were ecstatic and relieved at the same time.

My daughter, Kelly had had an extremely difficult pregnancy, starting pre-term labor at just 18 weeks, going on full bed-rest at 20 weeks, and entering the hospital at 24 weeks. She had a number of major contractions while in the hospital and had to undergo debilitating magnesium treatments to slow down the contractions. These treatments made her literally “sick as a dog” and very depressed. Ultimately, in the middle of her 28th week, the treatments no longer worked, and she was forced to deliver. Like the Marines on whose birthday she delivered, she fought with all of her strength and determination to give those boys the best chance to survive, even at the risk of her own health. I have never been more proud of her.

Because of the boys’ extremely critical condition, they were immediately transferred to the hospital’s Neonatal Intensive Care Unit or NICU and placed on full life support. The NICU at Fairfax Hospital is rated among the ten best in the country. There are five treatment rooms capable of caring for a total of 67 infants in various stages of pre-maturity. The doctors, nurses and technicians work 12-hour shifts and, unlike many parts of the medical community which advocate emotional detachment from patients, they mix expert medical care with a healthy dose of personal involvement.

Tyler and Jacob were placed at opposite ends of Room Four and assigned different nursing staffs, so that neither the babies nor their care could be mixed up. They were both doing as well as could be expected for twins born more than 12 weeks before their due date, but Jacob was the stronger of the two. On day three after delivery, he was doing so well, in fact, that his ventilator and Billy Rubin lamp, used to protect against jaundice, were removed. Tyler was not so lucky. He had developed two intraventricular hemorrhages or “brain bleeds” one on each side of his brain. This type of bleeding is graded from one to four in terms of severity. His were a three and a four, the most devastating. Brain tissue was being damaged or destroyed by the extensive bleeding. The doctors were understandably concerned, but noncommittal about his prognosis, saying he could end up with something as simple as a limp or something as severe as cerebral palsy, or mental retardation. They did not seem optimistic, however, that his disability would be minor.

We were all devastated when we heard the news. I remember my normally stoic son-in-law, Matt letting go emotionally, and my daughter, Kelly simply sitting and crying quietly. They were facing a potential crisis that no young couple should have to deal with. My daughter later said that it all seemed like a horrible nightmare that was happening to someone else. But it was real, and they began to find the inner strength to confront their fears and hope for the best. The doctors and nurses were wonderful, taking great care of Tyler, while explaining procedures and providing what comfort they could. Matt and Kelly visited the boys every day, and Cheryl and I went as often as we felt we should without intruding. Matt’s sister, Amy flew in from Michigan to help and was an absolute angel, buoying spirits and taking care of Rylie, the kids’ 20-month old handful of a daughter.

By day five, it was obvious that the babies were heading in different directions. Jacob continued to gain strength and thrive, while Tyler continued to lose ground in his fight for survival. On day six, his grade four brain bleed worsened. The doctors told Matt and Kelly that if he survived, his quality of life would essentially be zero. The kids went home to begin the agonizing process of deciding what to do. On day seven, Tyler continued to lose ground. He developed brain seizures and needed medication to quiet them. In a beautiful and simple ceremony, the hospital chaplain baptized both twins and comforted Kelly and Matt as they each held Tyler. That night, Tyler needed almost constant care to deal with the many problems that were plaguing him.

When Kelly and Matt arrived at the hospital on day eight, they could see that Tyler was in severe distress. They decided then and there to remove all life support and let him go. As soon as the ventilator was disconnected, Tyler stopped breathing. They said what they thought were their last goodbyes and went to be with Jacob. A half hour later, a nurse informed them that Tyler’s heart was still beating and offered to bring him to the NICU’s bereavement room, so the young couple could hold and be with him until he passed away. We all took turns crying and holding Tyler. We were told that the squeaking sounds he made and the movement of his arms and legs were autonomic reactions and not those of conscious activity. But, as I held that little baby, I could feel his waning strength surging into me as if he were telling me that everything was all right.

During the day, Matt’s father and stepmother arrived after driving almost non-stop from Chicago. They were devastated, but thankful that they had a chance to hold and be with Tyler, and they seemed to feel the same strength and peacefulness that I did. Early in the afternoon, the chaplain who had baptized the boys joined us to offer a prayer. His words of comfort and strength were just what were needed to help us all cope with a tragedy that was hard to understand and accept.

Eight hours after the ventilator was removed, Tyler’s tiny heart stopped beating. During his eight days of life, he had waged one of the most heroic and determined battles I have ever witnessed. On November 22, 2005, Tyler was buried in Union Cemetery in Leesburg, Virginia, during a simple, but beautiful ceremony. His indomitable spirit and strength of character in the face of overwhelming adversity will never be forgotten and have, I believe, been transferred to his brother Jacob, to make him even stronger and more resilient as he continues to grow and develop. As I stood at the burial service, I reflected on the many things I wanted to tell Tyler, but never got the chance to say. So, I wrote him the following letter and left it at his grave:

Dear Tyler,
     I can’t imagine a more difficult thing then to say goodbye to a grandson you just said hello to. I didn’t have much time to get to know you during your short life, but I did learn some amazing things about you.
     I learned that you were a tough little guy, fighting like crazy against every challenge. I saw in you the strength of character you got from your mom and dad, and I saw how you passed that strength along to everyone who came in contact with you. I saw how you brought two close-knit families even closer together, and yes, I learned how painful it was to watch you in distress..
     You and I will never get to do the things that granddads and their grandsons do on this earth, but you will have a grandmother and lots of great-grandparents to keep you company until I see you again. That span of time will be but a blink of an eye for you, but it will be an eternity for me.
     Rest easy, grandson, in the fullness of God’s love. Yours was a life well lived.
                                                   Your loving Grandad