My mother was born in 1927 in rural Missouri, she is the youngest of eleven children and the only one left alive today. Four of her brothers and sisters didn’t live to see ten. Before antibiotics and vaccines, childhood mortality rates were much higher, and many parents could anticipate burying at least one child.
You don’t think that seeing your grandparents die or your parents die is good fortune, but you would be wrong.
The Friday before Christmas of last year caught up with friend for a coffee break. He was enmeshed in a major project at work that had been keeping him busy six and sometimes seven days a week. We took an hour to catch up and at 5pm he went back to work. He was looking forward to seeing his son the following week, who was in his senior year of college and soon to be home for the holidays.
The following Friday I got a brief e-mail from him: in the week after Christmas his son had collapsed playing catch with some friends and experienced a seizure for a few minutes. This was the first time their son had experienced a seizure so they called 911. A CT scan indicated some bleeding and a “structure” and an MRI indicated a “mass.” The neurosurgeon provided a range of possibilities for what this could be, starting with a “cavernous malformation” which is a set of veins which leak blood forming some pressure on the brain, through to benign and/or malignant tumors.
The son was put on anti-seizure medication and scheduled for exploratory brain surgery for a week later. His symptoms didn’t recur so they discharged him the next day. I reassured myself that if they let him out of the hospital and scheduled the surgery for a week later that the doctors rated the probability of malignancy as very low.
I was reminded of a breakfast meeting in the early 90′s when I got a call from my brother. His wife, nervous about a wet cough their three month old daughter had developed, had taken the daughter to see her pediatrician the afternoon before. As she was in the waiting room a doctor heard the cough and came over immediately, he listened to her breathing with his stethoscope for a few minutes and said “we are going to the ER right now.” She was in congestive heart failure and scheduled for heart surgery. I was shocked, “Don’t you think you should get a second opinion, this seems all very sudden.”
“You don’t understand,” he replied, “there is no time. She will be dead by tomorrow if they can’t fix this, she has a developmental defect in one of her cardiac arteries. This has to happen today.” I suddenly felt very very cold. It had been unthinkable his daughter could die, but I could hear in his voice that it was a very real possibility. I called my father; he was fatalistic about her chances, in his mind there was no way an three month old child could survive heart surgery.
But my niece survived her surgery and recently graduated from college.
My friend’s son survived his surgery but is unlikely to graduate from college. The biopsy results stunned the surgeons, uncovering a high grade advanced stage astroctytoma much more likely to be found in a man in his forties or fifties than one barely in his twenties.
My friend told me, “I am trying to adjust to a horrible situation. He has been such a wonderful son. I am focused on enjoying each day we have with him. Lots of things are tertiary now.”
“Good Fortune: Grandfather Dies, Father Dies, Son Dies.”
Update Jul-17-2013: while the longer term prognosis remains grim a combination of surgery, radiation, and chemotherapy has triggered a remission has enabled the son to graduate from college. The party is this weekend.
“Expect nothing. Live frugally on surprise.”
Update Nov-20-2013: Slate published an excerpt from “Cotton Tenants: Three Families” by James Agree and Walker Evans, it’s reporting from 1936 the life of tenant farmers in Alabama. Here is a passage on childhood mortality:
Of the seven children the Tingles have lost, one lived to be four, and pulled a kettle of scalding water over on him. (Such accidents, with milder results, are not infrequent in large families with distracted mothers.) One lived to be five and ate some bad bologna sausage one night and was dead before morning. The rest died within their first year. One died of colitis. From what people said of it another must have died of infantile paralysis. The rest, they don’t know what they died of, the doctor never told them. Floyd says, “You ain’t never seen trouble till you lose a youngun.”