Would I Have Died? Meconium Aspiration Syndrome

*the following guest blog was written by Maddi McKay, 2012 Curatorial Assistant at the Museum of Health Care

It is my belief that, every once in a while, it is more important to examine the present than the past to truly understand the magnitude of various discoveries, achievements, and failures. This blog post will focus on imparting a (hopefully) touching story of human resilience both in terms of physical determination and of miraculous technological advancement. It’s my sincere hope that by telling you my tale, I will encourage you to make personal connections of your own to those in history, and to gain a solemn appreciation for what has been made possible in our time through humankind’s drive to improve.

When my grandma told me that I had had a new baby brother, my first reaction was to ask if he was healthy. Even at five years old I knew all too well the story of my own birth versus that of my then-three-year-old sister; I had been born with “stuff” in my lungs and had stayed an extra two days in the hospital, while Bethany had been born with rolls of fat and a big smile, and had retuned home the next day. I understood that it was favourable to be born fat and happy and “lung-guck-free,” and that there was a looming fear that this would not be the case for baby Rory. And so I asked with fingers crossed whether or not we were “in the clear” (pun not intended). “No, girls,” Grandma answered me in a soft, steady voice, “he’s not healthy. Right now…your brother is very sick. But we’ll pray for him, and he will get better.”

A few short minutes away at Kingston General Hospital, a huge, heavy baby boy was slowly dying. It sounds dramatic, but it’s the absolute truth. No sooner had Rory’s tiny body fallen into the doctor’s waiting hands, than the umbilical cord was quickly snipped and the same doctor began to run. A mere five hours later, my mum says that she remembers watching the same doctors and nurses run faster than she has ever seen doctors run before or since while pushing a massive incubator to the KGH helicopter pad, where a massive orange chopper waited to ship four medical personnel, one pilot, and a near-dead little boy to Toronto’s Sick Kids Hospital. Just hours after giving birth, my mother and father packed up and drove to Toronto, Mum clutching a blanket that had been given to her by KGH nurses since “no mother should go home empty handed.”

I learned years later that Rory had been shipped to Sick Kids’ because he required a machine called a high frequency oscillator which consistently pumps tiny burst of oxygen into a person’s lungs, and the only one available at KGH was undergoing repairs. Rory lay inside the high frequency oscillator for about a day. My parents tried to sleep on a couch and ate chocolate bars from the vending machine, waiting for hours for any sign of improvement. Then, near the evening, something (to this day, we don’t know exactly what) changed. A siren kept blaring loudly outside Rory’s window for a couple of minutes, and the mere days-old baby who was supposed to be dying lifted his head up and turned toward the noise. And that was it. From that moment on, Rory made leaps and bounds toward health. A week or so later, Rory and my parents were back as KGH, and on a warm and muggy summer evening, my dad excitedly led Bethany and me through the Stuart Street entrance and up to the Neonatal Intensive Care Unit so that Bethany and I could meet the “miracle kid” for ourselves. Today, Rory is a healthy, video game-playing 14-year-old boy who enters grade 9 in the fall, and still likes to remind us every once in a while of “that time I died.”

For Rory, it was never a case of “would he die?” but rather “he should have died, so why didn’t he?” a question to which we still do not quite know the answer. I love telling this story because it demonstrates the immense progress we have made in medicine since the time of Hippocrates and the Four Humours. In the case of Meconium aspiration, a condition defined as respiratory distress in an infant born with Meconium-stained fluid (a sterile and odorless yet thick and black-green liquid released from the bowels of a fetus late in the pregnancy, the question has never been the condition’s discovery, but rather possibilities for treatment. Aristotle himself observed an association between Meconium stained amniotic fluid and a “sleepy state,” or neo-natal depression. It is currently estimated that the passing of fetal Meconium occurs in 8-25% of all births, with about 25 000 cases documented in the USA alone each year (2008), so clearly the world has never been oblivious to the need for a solution.

It appears that critical factors in the treatment of Meconium aspiration syndrome are the use of surfactant to expand airways (a development seen only in the 1980s) and the subsequent addition of a high frequency oscillator to be used in tandem. In terms of prevention, the realization that allowing a fetus to remain in utero past their due date increases the risk of Meconium aspiration has led to an increase in the number of births which occur after inducement. It is almost frightening that all of these strategies gained popularity quite close to Rory’s 1998 birth.

Dr. Michael Flavin is the pediatric respirologist responsible for saving Rory’s life at KGH in 1998. I was privileged enough to discuss with him the science and recent history of Meconium respiration, and he graciously agreed to allow me to post our filmed interview with my blog post.

On a more local level, to me this story  strongly demonstrates the success of KGH, both as a medical institution and as a teaching hospital. The fact that what began as a simple three-story stone building 200 years ago has expanded into a technologically current facility capable of providing amenities such as a helicopter pad and a high-frequency neo-natal oscillator is quite remarkable and humbling. From what my parents have told me, Rory was saved only because of the incredibly fast reaction of the KGH doctors. During my three months working within the KGH system, I have had the privilege of seeing first-hand the hardworking and determined staff care for their patients, and I have also spent a great deal of time and energy researching the history of the hospital and the health professionals who worked to provide a consistently high level of care to the Kingston community. These experiences have only confirmed for me what I already knew after my baby brother’s health struggles, and it gives me immense pleasure to be able to thank the staff, both past and present, who contribute daily to medical progress in my community. A part of me wishes that I could go back in time, if only to show people like Nurse Ann Baillie, Dr. Kenneth Fenwick, Dr. Fowler, etc. what their commitment to medical progress has now accomplished.

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2 thoughts on “Would I Have Died? Meconium Aspiration Syndrome

  1. Hi there! This is my first comment here so I just wanted to give a quick shout out and say I truly enjoy reading through your blog posts. Can you recommend any other blogs/websites/forums that go over the same subjects? Many thanks!

    1. Hi! Thanks for the kind words. There are many great blogs out there on the subject, some of the more popular ones are the chirurgeon’s apprentice, wonders and marvels, the medievalist, the wellcome trust blog, etc.

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