ORANGE — Fifty-one years and four months ago, Jeff Tanksley was lying in a blanket-lined drawer in the glow of a single light bulb, fighting for his life. All 26 1/2 ounces of him.
Born three months premature, he created a sensation at Downey Community Hospital, where doctors and nurses--and reporters--hovered over the tiniest infant to be born up to that time in the hospital.
They couldn't do much else. It was 1940 and the medical specialty that has come to be called neonatology was unknown. Most severely premature babies died, and Tanksley was the smallest of the small. The prescription: keep him warm (the light bulb), watch him, and hope.
It worked. Today, Tanksley is 5-feet-11, weighs 185 pounds and is a 20-year veteran of the Orange Fire Department.
Still, he remains aware of his own perilous infancy, and particularly the hardship such experiences can work on anxious parents who must hand their baby, at least for the time being, over to the care of others.
So, whenever he finds himself at St. Joseph Hospital in Orange--after transporting a medical emergency case, for instance--Tanksley pays a visit to the neonatal unit, considered one of the most advanced in the county, to offer the parents concrete hope that their child can develop normally.
"They'll call me up sometimes and I'll go in and talk and it sort of reassures the young parents," said Tanksley. "The parents don't realize what's involved in premature delivery sometimes. I encourage them, give them a little bit of my history, explain to them that their child can turn out to be normal and healthy because of the advancements in the way they care for them nowadays, as opposed to what I had. It's amazing what they can do now."
Indeed, doctors in 1940 might be popeyed at the sight of the intermediate care nursery at St. Joseph. It is a thicket of glowing monitors, high-tech incubators and other advanced medical equipment specifically designed for premature infants.
It is that final point--specific equipment--on which the modern evolution of neonatal care turns, said Dr. Ragnar Amlie, the medical director of the neonatal units at St. Joseph.
"I think (modern care) sort of started in the early 1970s, because up to that time the equipment used for newborns was modified adult equipment," he said. "About that time we began to realize that babies need specialized care. Until then, there was no such specialty as newborn care. We know now that newborns react differently than adults. For instance, if you're under stress, your heart rate goes up, but with a newborn it goes down. We want to be alerted if the heart rate drops."
And they are. As part of the cardiac monitoring in the nursery, an alarm in the monitor will sound if the baby's heartbeat drops dangerously low. The results are almost instantaneous, because the monitor counts the heart rate every three seconds and automatically multiplies it by 20 to determine the projected number of beats per minute.
Just how far is a machine like the infant cardiac monitor from the care Tanksley got in 1940? Amlie said care in the United States before World War II was similar to what he saw on a recent visit to a hospital in Belize.
"They had shelves with 100-watt bulbs hanging down and the babies under aluminum foil" to keep them warm, said Amlie. "They had one big oxygen tank over in a corner and a flow meter to control it and they were flooding this oxygen into the incubators. But they were not monitoring anything. They had no monitoring equipment. They were too poor.
"That would have been about the same amount of equipment we would have had in 1940."
Why did Tanksley survive? Strong genes, mostly, guessed Amlie.
"He must have been very active at birth," he said, "and relatively pink. The main thing was to keep him warm. And he must have been fed early. Apart from that, it was survival of the fittest."
He also had constant care. Tanksley said that three nurses and one overseeing nurse were assigned to him around the clock (their names appear in his baby book). "And my mom had to be there almost constantly to feed me," he said. "I was so fragile at that size."
He didn't stay that way. After three months in the hospital nursery, he went home. By the beginning of February, 1941, he weighed 6 pounds, 4 1/2 ounces.
"I've had a normal, active life," he said. "They gave me a lot of oxygen when I was first born and they thought that it might cause some eyesight loss, but it didn't, until I was about 40 and I started wearing bifocals. I caught up to normal size about the fourth or fifth grade, and I swam in high school for three years on the swim team and the water polo team, and when I was a senior I played right tackle on the football team."
The statistics of the time suggest that Tanksley should never have developed normally, or even survived. Amlie estimated that between 5% and 10% of the babies born premature in 1940 who weighed as little as Tanksley at birth would survive. Today, he said, that figure is between 80% and 90%.