Monday, June 30, 2008

Birth Day

I was born into a much different America on this date in 1946. There were half as many people in it, and these days it seems they were also about half the size of people today. Since I was the first born of my generation on both sides of the family, there were a lot of relatives who came to see me. My grandfather Severini was just 53, and he had survived poison gas in World War I in Italy. If there was anyone who was 85 year old among my visitors, that person would have been an toddler when Abraham Lincoln signed the Emancipation Proclamation.

1946 was a miserable year in Europe, but a good one and a hopeful one in the United States. I was born less than a year after Hiroshima, and there was still an international consensus--including the U.S. government and U.S. military--that atomic weapons would have to be banned. A couple of weeks before I was born, the United Nations Commission on Atomic Energy met for the first time, and discussed proposals for international control of atomic energy put forward by the U.S. and by the Soviet Union. Even two years later, U.S. General Omar Bradley would observe, "The world has achieved brilliance without wisdom, power without conscience. Ours is a world of nuclear giants and ethical infants."

That hope probably died the day I was born--with the first big postwar atomic bomb tests in the Pacific, called Crossroads. And indeed it was the crossroads. America and the Soviet Union would pursue nuclear supremacy, and soon Omar Bradley would be lobbying for the U.S. to develop the hydrogen bomb. The world has been living on borrowed time ever since, though that was much more a part of conscious life, and the national unconscious erupting into sudden panics and bug-eyed monster movies, when I was a child, adolescent, student.

As for my personal history, it seems I almost did not live beyond my first week after my birth on that Sunday afternoon. Some ten or so years ago, when I first researched what might have been wrong based on the few clues I'd had over the years, there wasn't a whole lot readily available. Now there's so much more on the Internet. And I found a book in the university library entirely devoted to the research on what came to be known by various names, most simply as Rh Disease.

This disease generally occurs when the mother has Rh negative blood, and the father Rh positive. (The - and + after the ABO blood types indicate this separate Rh Factor.) The cause is somewhat complicated. If the mother has been exposed to Rh positive blood, through a transfusion or a prior childbirth, her blood may develop antibodies to fight off Rh. If a subsequent child is Rh positive, these antibodies may then attack his or her blood.

The result is often catastrophic. Some die in the womb or are stillborn. This may have been a major cause of stillbirths for centuries--Hippocrates mentions something like this disease. But it can attack after birth as well, usually within hours. I knew that babies die of this--some say up to 90%. What I didn't know was the effects some children who live may carry with them, which includes severe organ damage and severe brain damage.

I am missing quite a bit of specific information about my "case," including the mystery of why I was part of a very small minority of first-borns to have this affliction. But the family legend is very clear on one point: everyone was exclaiming on my appearance. My skin was golden. Only my grandmother understood that this meant something was wrong. The golden color is often the first sign of Rh Disease: it indicates jaundice. And things get worse from there.

I know that I received a blood transfusion. I know that the appropriate blood wasn't on hand, and my mother kept a list of names--I think there were six--of possible donors, including the one who donated the blood that was soon placed in my veins.

What I don't know is what kind of transfusion this was. Various kinds were tried for this disease over at least a decade, with limited success, but the most effective ones weren't developed until 1944 and 1945, even 1946. They were various methods of "exchange transfusions," in which nearly all the baby's blood is removed while new blood is dripped in. Standard transfusions had limited success; exchange transfusions were much more effective, and saved hundreds of thousands of lives before a preventive vaccine was developed in the mid 1960s.

Few people now even know of the existence of this disease. But it was once a very, very serious matter. It led to suggestions that Rh incompatible couples should not be permitted to have children. Various states introduced legislation that came close to this eugenics approach.

The research to find a vaccine led to many other innovations. Before this, there was no fetal medicine or fetal research. It was considered too invasive. The amniocentesis that's become standard for pregnant women today was developed as a direct result of Rh Disease research.

But it's especially striking to me that so much happened regarding this condition around the year of my birth. The Rh Factor itself had been discovered only in 1940. Blood Banks in general wouldn't be routinely testing for it until 1950. It is just barely possible that some form of exchange transfusion was being done by the end of June 1946 at the western Pennsylvania hospital where I was born. I hope to find out whether that's what I received. It could be that my case was mild enough to respond to a standard transfusion.

It's very rare for a first-born to have this, unless the mother had a transfusion with Rh positive blood earlier in her life. But it wasn't unknown, and the theory was that an even more rare trait of the father's blood was responsible, but these cases usually were comparatively mild. So I might not have been in such mortal danger.

I've pieced together enough to be pretty sure that I was transfused with Rh negative blood. It was probably done over three days. The only effect of the disease that's shown up so far is probably my one deaf ear. I don't know if this exactly qualifies as borrowed time. But it does seem that from the beginning my life was very much embedded in its time and place.

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