Heritage Snapshot: Part 72

Meanwhile, at the other end of Canada, another drama was unfolding. Because Canada provides healthcare for Canadian citizens and because of some logistic problems in arranging for an air ambulance, a friend of Gordon and Alice Holc, out of desperation, went to the Canadian news media to try to pressure the Canadian government into cutting the red tape. The story spread to the Canadian wire services and from there to the American wire services. Seventeen news camera crews from Canada and all over the United States converged on Loma Linda. On October 15, 1987, the Holcs arrived at Ontario International Airport at 6 a.m., after a five-hour flight from Vancouver International Airport in British Columbia. A cesarean-section delivery and a heart transplant were tentatively scheduled. Fog diverted Baby Gabriel’s plane from nearby Norton Air Force Base to Los Angeles International Airport almost four hours later. She arrived in Loma Linda by ground ambulance at 11:45 a.m. Then a major complication developed that threatened to postpone the landmark surgery. Tests showed that Baby Gabriel was a questionable donor. Her brain death was verified by a team of pediatric neurologists, but her heart was not contracting normally. Dehydration, which could be treated easily, might be the cause. The transplant team decided to wait to determine if overnight therapy could improve the donor’s condition. Tests the following morning determined that Baby Gabriel’s heart was contracting well. Now she was an acceptable donor. A cesarean-section delivery was scheduled for later that morning—October 16. This time, serious complications developed that further threatened the transplant. The first problem was not life-threatening to the recipient baby. If Baby Gabriel had been determined to be an unsuitable donor, the unborn baby would not have been in jeopardy. He was still safe in his mother’s womb. Another donor might become available. However, now another life-threatening problem arose. Baby Paul was delivered by Dr. Elmar Sakala at 10:54 a.m. The baby, weighing 6 pounds, 6 and three quarter ounces, took one breath and started to die. His ductus arteriosis (a significant remnant of his fetal-blood-circulation system) closed immediately. Frequently the closing of this vessel takes time—hours, days, or even weeks, depending on its size—and is a natural process. But in Paul’s case, the vessel closed—maybe after just one breath—and, because of his malformed heart, the baby deteriorated rapidly. Severe abnormalities in blood gases required immediate mechanical ventilation with a respirator. The baby’s lungs retained fluid. Circulation in his extremities was poor, especially in his left leg. Intermittent mottling was evident in his upper extremities. If Joyce Peabody, MD, then chief of Loma Linda’s Division of Neonatology, or another one of her neonatologists (physicians who specialize in the care of premature/sick babies), had not been standing by during the delivery, the baby would not have made it to transplant surgery. It was a team effort. Paul was handed through a special window from a high-risk delivery room into the neonatal intensive-care unit. This facility was designed to permit premature/sick newborns to be handed to specialists as soon as possible. Peabody immediately placed umbilical venous and arterial lines and started the baby on prostaglandin E1 (a drug that opens the ductus), cyclosporine, antibiotics, and steroids (drugs designed to prevent infection and organ rejection). The pallor and poor perfusion improved dramatically with the infusion of prostaglandin. Within an hour the baby had been stabilized enough to proceed. Three hours after the infant was born, Dr. Bailey and his team began a heart transplant on the youngest person in the world to undergo an organ transplant of any kind. Sewing the one-ounce heart into the tiny chest took 47 minutes. When Baby Paul was transported to his room after four and a half hours in the surgery suite, his vital signs were stable. His parents got a brief look at him as he was wheeled into his room. The next day, Baby Paul gradually woke up and began moving his arms and legs. Dr. Josiah Lowry of Soldier’s Hospital reported that Baby Gabriel’s parents were pleased about what was happening in Loma Linda. “They see it as the one positive thing in this,” she said. Robert Brehl, a reporter for the Toronto Star, interviewed Gabriel’s parents, identified later as Karen and Fred Schouten, and said they were “bursting with pride.” “Some people work their whole lives to do something memorable,” said Karen. “Gabriel did it in two days. We’re just praying the other baby will make it.” “I immediately fell in love with her the first time I touched her,” said Fred. “I want the whole world to know about Gabriel. Our baby has done something phenomenal. This feeling of being so proud has taken away the grievance, period.” Tears flowed freely down his face. “We don’t want anyone to feel sorry or pity us,” said Karen. “Sure we cry. We cry constantly. But it’s a happy cry.” Baby Paul was hospitalized for 35 days and discharged from the Medical Center in good condition. More than 100 people on the heart-transplant team had been involved in his care. Paul Holc’s story was dramatized in a two-hour, made-for-television movie of the week, “Heart of a Child,” broadcast nationwide by the NBC television network on May 9, 1994. The final scenes show Paul Holc meeting Karen Schouten in a hug, with two close-up “freeze frames” and accompanying captions. The caption for Paul says, “Paul Holc, who portrays himself in the film, is an active first grader who loves to play baseball.” This is followed by a close-up of the actress portraying Baby Gabriel’s mother, with the caption saying, “Karen Schouten recently gave birth to a perfectly healthy baby boy, named Sam.”