Born Early: When Life Begins in the NICU

Inside the neonatal intensive care unit (NICU), a hospital’s smallest, most fragile patients fight for their lives. Members of America’s Essential Hospitals run some of the most advanced NICUs in the country. And they’ve let us inside.

Full photo essay by Maya Linson and Sandy Laycox available at

That’s Jacob. You’ll meet him soon. Through Jacob, we met his doctor, Rangasamy Ramanathan, MD. Together, they showed us what’s possible when a NICU performs at its best. It is a delicate balance of heart and science, and it exists more often than not in essential hospitals.

Jacob is 4 (he told me in Chinese). We just met, on Facetime. He isn’t quite ready to let me in. Fair enough. He’s holding a set of drumsticks, so I ask about music. He starts beating the sticks together. His mom, Cat, reaches for his small Chinese drum. He begins to play.

First slowly, then faster. The beat takes off, building toward a crescendo, then abruptly stops, about face, and heads down a different road. This one slower, but just as rhythmic.

No one taught Jacob how to drum. He learned by watching his dad — and YouTube. He also likes to perform Chinese lion dancing with his dad. He runs across the room and picks up a giant Chinese lion head and peeks out through its mouth. “Hi Sandy,” he says.

Unit 4: Jacob’s First Home LAC+USC Medical Center, Los Angeles, California

Jacob was born at 27 weeks and weighed 14 ounces — only 2 ounces more than a soda can. Cat has only one kidney, which makes pregnancy difficult. He wasn’t getting enough blood and had stopped growing. “I was scared,” Cat admits.

“I just kept praying and praying. But he’s a fighter, a strong little boy. I’m blessed,” she says with a smile.

Jacob was one of the smallest babies ever born at LAC+USC Medical Center. When Cat arrived there for an emergency Cesarean section, his heart rate was dropping and her kidney function was failing.

“There wasn’t much blood going from the placenta to the fetus. We thought that if the pregnancy continued, he could die,” says Ramanathan, who is medical director of the LAC+USC NICU.

Here to Fight | LAC+USC Medical Center, Los Angeles, California | LAC+USC is part of the Los Angeles County Department of Health Services, the second-largest public health care system in the nation.

Ramanathan — Dr. Ram — moved from India to the United States in 1981 because he was tired of watching so many babies die in India without being able to help them. He read the research coming out of other countries. He saw that with the right care, these babies could live.

He arrived at LAC+USC Medical Center for training in 1984. He left in 1986, then returned for good in 1988. “Most of the people who started with me are still here,” he adds. He notes the changes in neonatology in the past 20-plus years.

“With advances in technology and everything else, you have a fighting chance. That’s what makes me get up and come to work every day.”

Essential hospitals have led many of these advances. For example, LAC+USC is one of the few hospitals in California that provides follow-up care until age 6, including all specialty and well-child care, for babies born less than 3.3 pounds. “We are their pediatrician,” Ramanathan says.

Continue the story in the full photo essay at

Originally published at

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