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if reaching toward the light and the world, we imagined Lunchbox was asking all of us, nurses, residents, fellows, and attending physicians alike, to care for her. With her family unable to travel the distance to see her often, we took her in. We cheered her every gained ounce, fretted over her few but concerning setbacks, and sometimes took extra time to sit by her bed just to give her company and find respite in her sturdiness. She was, after all, a miracle, the smallest baby of her birth weight and gestational age to survive and be doing so well. To us, Lunchbox was an emerging individual with a personality and a growing book of stories about her spirit and strength. We all believed Lunchbox was simply determined to survive in this world, find whatever good that world had to offer, and we were there to help her on her way. Of course, we “knew” that Lunchbox was a fragile, delicate soul who needed our help even to survive, but it gave us all hope and strength to imagine Lunchbox as innately strong and beckoning us to care for her. I was not there when Lunchbox was discharged home, but I knew we had sent her out into the world with the best odds our physical and emotional care could provide. Lunchbox would now be a middle-aged woman. Did she remain of small wiry stature, or did she fill out and have a body that matched what we were sure was her personality—forceful and determined, pulling the world in to help her? Did she grow into as sturdy and resolute a toddler and young child as we imagined her to be as a small, premature baby? Did she thrive in school? Did she find a loving partner, become a mother, become a grandmother? It is these very questions about Lunchbox that bring me to the second story from my experiences in the intensive care nursery. As a part of my fellowship in neonatology, we also consulted in the clinic that saw formerly preterm infants now returning as school-aged children and adolescents so that we might understand the long-term impact of their early prematurity. Every family coming to that clinic asked these same questions—Will my child thrive in school, can he or she play sports, will he or she become a parent? But they also asked, not always on their first visit but after they got to know and trust us, could their child’s lung disease of prematurity come back? Was there a chance he or she would become so seriously ill again? What could they do to protect their child against this and other unexpected tragedies that might lie ahead? As a physician in training, confident in the certainty
Introduction 11
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