By Dave Andrusko
Denise Grady is a first-rate Health and medicine reporter at The New York Times. I love reading her stories for her ability to break incredibly complicated medical stories down into layman’s language and to inject a dose of her own humanity.
Which brings us to a pair of terrific complementary stories written by Grady that recently ran in the Times. Both were about still experimental surgery performed on Lexi Royer and her unborn son who’d been prenatally diagnosed with a severe form of spina bifida. As Grady explained
Spina bifida occurs early, at three to four weeks of pregnancy, when the tissue forming the spinal column should fold into a tube but does not close properly. There are 1,500 to 2,000 cases a year in the United States.
In the case of Mrs. Royer’s 24-week unborn baby, “The defect was big and severe, and the brain stem was being pulled down into the spinal column.”
We’re told that “termination” was offered. Lexi and her husband Joshuwa said no.
The surgery took place in September at Texas Children’s Hospital in Houston. Prenatal surgery for spina bifida, as readers of NRL News Today know, is nothing new.
But it wasn’t until a famous study was published in 2011 that those who wondered if the risk/benefits of prenatal surgery outweighed the risks/benefits of operating after birth learned that prenatal surgery was significantly better. “The percentage of children who could walk independently rose to 40 percent from 20 percent,” Grady explained, “and the need for a shunt was cut in half, to 40 percent from 82 percent.”
In Grady’s first, more technical story, “To Mend a Birth Defect, Surgeons Operate on the Patient Within the Patient,” she explains how the new prenatal surgery differs from the old.
During the standard prenatal surgery for spina bifida, surgeons cut open the woman’s abdomen and uterus to reach the fetus. But the newer, experimental approach is different.
Dr. Belfort opened Mrs. Royer’s lower abdomen, but not her uterus. Instead, he eased the uterus out of her body and inserted the fetoscope, and then, through another slit, surgical tools. The doctors drained out the amniotic fluid and pumped in carbon dioxide to keep the uterus expanded, giving them room to work and allowing them to see better and cauterize when needed.
I encourage you to read both stories, but especially the second– “Lights, Camera and, Yes, Music: Reporting From the Operating Room as Doctors Perform Fetal Surgery.”
Suddenly the first story’s “fetus” becomes Mrs. Royer’s “unborn son” in the second. We knew from story one that surgery is not always a “cure” (“This is experimental surgery, with no guarantee,” said Mrs. Royer. “You are the person who will take the risk for another person”), and that there are risks both to the baby and to the mom.
But illustrating what makes her such a good reporter were the many humanizing details found in the second story. For example, the room is so hot it resembles a sauna. (The baby’s heartbeat can slow down too much, If the temperature is too low.)
And that the operating room is crowded.
“Besides Dr. Belfort and a pediatric neurosurgeon, Dr. William Whitehead, there were two anesthesiologists, a pediatric cardiologist and two doctors who would steady the uterus and help to gently hold the fetus in position, as well as several nurses.”
In the second story, Grady moves from objective reporter to fully engaged human being.
Mrs. Royer’s husband, Joshuwa, his mother and Mrs. Royer’s parents were waiting anxiously, and crowded into a small room when Dr. Belfort arrived.
“Everything went very well, so you can relax,” he said, showing them pictures of the fetus’s back, before and after. “So far, so good. Now we have to hope and pray she doesn’t go into preterm labor.”
Mr. Royer was stoic, but the parents, the reporter and the photographer all burst into tears and hugged one another.
Later, Mrs. Royer’s mother, Raquel Bourgeois, said the family understood that the operation was not a cure, and that her grandson would almost certainly have some degree of disability.
“But we’re strong believers in God, and we’re at peace,” Mrs. Bourgeois said. “This baby is going to be so loved. We just don’t care.”
She went on: “Lexi and Josh are very strong together. This is not going to break them. They are the best possible parents for this child in this situation.”
Mrs. Royer’s due date, Grady tells her readers, is January 14.
I am wishing the best for Mrs. and Mr. Royer and their son, and I hope to report on how they’re all doing after he’s born.
A great story, rich in detail and background, and a wonderful account of a family strong in its faith.
Tip of the cap to Life News.