On August 7, 1963, at 12:52pm in Cape Cod, Jacqueline Kennedy gave birth to her and husband John F. Kennedy's son Patrick Bouvier Kennedy, named in honor of JFK's grandfather, the first child born to a president of the United States while in office in 65 years.
He was the couple's fourth child: their first, Arabella, was born stillborn in 1956, their daughter Caroline was almost six years old, and son John Jr. was two-and-a-half. "The President flew from Washington to Cape Cod but arrived 40 minutes after the baby was born," it read on the front page of the New York Times the following day.
"Having a baby for a couple is a dream, a dream of who they will be individually as a mother and a father," R. Benyamin Cirlin, LCSW, executive director of the Center for Loss & Renewal tells HELLO!. "That dream has been growing for nine months," he adds, and when a couple loses that baby, as the Kennedys eventually did, "that dream is shattered."
"A few hours later the premature infant was rushed to Boston for treatment of a respiratory ailment," the newspaper then also reported at the time, noting the baby was born five weeks prematurely, and had difficulty breathing, a struggle later attributed to underdeveloped lungs.
© Getty Images39 hours and 12 minutes later, Patrick, who was born 17 inches long and weighing 4 lbs. and 10.5 ozs, would become the third child the Kennedys lost — though not the last — following a miscarriage at three months in 1955, and Arabella's death the following year.
"He didn't look like a healthy bouncing baby boy ... But he didn't look like a baby in extremis."
That death however, heartbreaking as it was, would not too long after be overshadowed by President Kennedy's own untimely death just four months later, when Lee Harvey Oswald shot the president while he was riding in the back of an uncovered car in Dallas, Texas, the image of Jackie reaching in her bloodied, pink tweed suit for fragments of her husband's skull ingrained in millions of people's brains for eternity.
Still, four months earlier, it was Patrick's 39-hour battle for his life that, as with many tragedies and scandals the Kennedy family has infamously faced, had the public watching with bated breath — and it became not only a turning point for the family, but for neonatal medicine in America.
© Getty ImagesThe hour-by-hour fight to save Patrick
Patrick was born "a well-formed child with light brown hair," writes Steven Levingston in his book Twilight of Camelot: The Short Life and Long Legacy of Patrick Bouvier Kennedy.
Veteran Secret Service agent Clint Hill — who just months after Patrick's birth and death would become forever known for how he leapt into the limousine carrying the Kennedys when the president was shot in Dallas — told the author Patrick was "beautiful." However: "He was clearly fighting for each breath, as his poor little chest struggled to get the oxygen he needed to survive."
Some five hours after Patrick's birth, the infant was transferred via ambulance from Otis Air Force Base Hospital in Cape Cod, where Jackie stayed back to recuperate, to Boston Children's Hospital. There, Levingston details in his book, Dr. James Hughes, the hospital's chief resident in pediatrics, received a call from the president, hoping to check on his son, who had yet to arrive. Crowds were already growing along the route to and outside the hospital, hoping to get a glimpse of the motorcade — and of newborn Patrick himself, who would arrive around 7pm, then be wheeled through the lobby in his incubator to Room 2534.
"He didn't look like a healthy bouncing baby boy," Dr. Hughes recalled in an interview with Levingston, though, he noted: "He didn't look like a baby in extremis."
© Getty Images"Doctors immediately set to work," Levingston writes. The specialists connected the baby's incubator to an external oxygen tank, took X-rays, which revealed a "haziness" in his lungs, inserted an IV line, and drew blood, to evaluate his oxygen and carbon dioxide levels. The procedure required ten times more blood than what is needed today for such evaluations; today, doctors would immediately be able to recognize that Patrick's lungs had not had time enough to develop sufficient surfactant, or surface active agent, to help him take in oxygen.
But in 1963 — when, Levingston reveals in his book, Jackie requested (and received) a cigarette before going into her C-section — there were few to no modern neonatal devices or treatments to help Patrick's chances of survival, so trying to do so was uncharted territory. "There wasn't all that much once we got him into the room that we could do," Dr. Hughes told Levingston. "The most doctors could do," he writes, was "chart his course," monitor whether he was improving, make adjustments to his oxygen and incubator… But Patrick's fate relied largely on his own ability to fight for his life, which he did, for 39 hours and 12 minutes.
"The president and first lady's exalted position, glamour, and wealth were of no matter now: they were just Jack and Jackie, the same as any parents confronting an illness of a child."
"Prayers for baby," read the headline to a short entry in the New York Times on August 8. "In such moments of supreme personal trial, each of us is reminded of the irrelevancy of the daily tribulations that normally loom so monumental. What price the cold war, the posturings of General de Gaulle, the threat of a rail strike or slow motion in Congress when measured against the value of this tiny life? All Americans and countless millions across the seas are united in prayer that the youngest of the Kennedys will soon be well."
The crowds that followed President Kennedy from his brief visit to Jackie in the Cape Cod hospital back to Patrick in Boston proved that last line true. Quoting The Washington Evening Star's Mary McGrory, Levingston writes that people at Logan airport, seemingly unaware of Patrick's condition, "screamed and jumped up and down like campaign crowds." At the hospital, another eager throng awaited "the anguished father," who appeared "very pale," and "expressionless."
© Getty ImagesBy 10pm, President Kennedy had left the hospital, settling in at the Ritz-Carlton. Meanwhile his press secretary Pierre Salinger addressed reporters from a makeshift pressroom at the Statler Hotel, where he acknowledged Patrick's "breathing ailment" for the first time, albeit it playing it down as a condition "not uncommon in premature infants."
Crowds outside both Jackie and Patrick's hospital had initially begun to dwindle, however, overnight, the newborn's hospitalization turned into "a full-blown national sensation": a photographer snuck into Patrick's hospital, a photo of his incubator appearing on the cover of Life; hundreds if not thousands called up the hospital offering prayers and medical advice; and newspapers all around the world printed their own takes on Patrick's battle. The White House had essentially become one made of glass, as French newspaper Le Monde wrote — the whole world was watching. Still, Levingston writes: "The president and first lady's exalted position, glamour, and wealth were of no matter now: they were just Jack and Jackie, the same as any parents confronting an illness of a child."
Neonatal care at the time could be a mad scramble in the dark, and doctors were virtually powerless to treat Patrick's collapsing lungs. (The modern neonatal intensive care unit was only invented in 1960). Patrick was given a fifty-fifty chance of surviving, and Levingston notes: "Treatments were so primitive that medical intervention scarcely worked into the equation." Dr. Mildred Stahlman at Vanderbilt University in Nashville, Tennessee, and Dr. Maria Delivoria-Papadopoulos at the Hospital for Sick Children in Toronto, Canada, were experimenting with ventilators for premature infants at the time, but the ventilators they had, which were being used by their own patients, could not be transported to Patrick, and he could not be transferred to them.
In a last-ditch effort, doctors placed Patrick in a hyperbaric oxygen chamber. But at 4:04am on August 9, 1963, with his father watching from the chamber's porthole, the baby's heart — his lungs unable to collect oxygen successfully — stopped.
© Getty ImagesJackie and JFK's "shattered" dream
Jackie led a largely private personal life until her 1994 death, and did not really indulge the media with insight into her grief, particularly regarding Patrick. Levingston however has suggested she and the president, with whom she'd famously had marital ups and downs, grew closer after the death in their shared sorrow.
According to the CDC, roughly 1 million families experience pregnancy and infant loss each year.
"There's a sense of having to come to grips with a new reality."
"Grief is really about, in many ways, shattered dreams, and shattered dreams impact us emotionally, physically, socially, spiritually, psychologically," and particularly for a woman, who, in the case of Jackie, carried the baby almost to term, "she's contending not only with the psychological piece, but the the physical recovery."
"That loss of the dream is going to be interpreted differently by both persons based on their histories, based on their hopes, based on their previous loss experiences," he says of grieving couples, noting that human beings, and their brains, are "prediction organs." We as humans "make predictions, and for nine months [couples] have been living on the prediction that come nine months, 'We are going to be parents,' and so that expectation continues to play."
"That loop continues to play after the baby has died," Cirlin maintains. "There's a sense of having to come to grips with a new reality." It is especially hard when couples have been anticipating the arrival of their newborn for nine months, thinking: "I'm going to be a parent. I imagine that I'm going to be waking up with a baby. I imagine I'm going to be going to sleep with a baby. I imagine I'm going to be going to family functions with a baby."
"That prediction," he argues, "continues to play, and the parent is faced with the reality that something has changed, and so coping with the reality of that is the first really major task."
The grieving process is complex. "There's sadness and there's pain, and there's loss and there's anger. There's often guilt. There's often having to deal with, 'How did this happen to me? This is severely unfair.' And that sometimes gets challenged as both husband and wife, or the two partners, whoever they are, have different abilities and resilience for managing that kind of pain, and so there becomes some added stress in their relationship, and that is one of the challenges."
© Getty ImagesPatrick Bouvier Kennedy's impact on modern neonatal care
The loss of Patrick had a lasting impact not only on his mother and father, but on neonatal care as a whole. Today, doctors treating Patrick would have very quickly been able to not only identify the issue with his lungs, but be able to treat it, a development that stands now as part of his legacy six decades after the fact.
At the time of Patrick's birth and death, his condition, hyaline membrane disease (now known as respiratory distress syndrome) killed about 25,000 children a year, per ABC News. But the death of a president's baby sparked a seismic shift in premature infant care. "This event energized the neonatal researchers into action to look for an effective management of RDS," Dr. Suhas M. Nafday, director of Newborn Services at the Children's Hospital at Montefiore Medical Center in New York, said in 2013.
Kennedy channeled his grief into action, and in what would be one of his last acts as president before his own untimely death, he signed into law a large grant that authorized $265 million (almost $3 billion in today's dollars) to be used primarily for newborn research.
"We have come a long way," neonatologist Dr. Jay Greenspan also said in 2013. "It was so tragic that the family went through this — and you wish you could have been there. It was a simple fix. … The baby was really just slightly premature. He would be sort of an afterthought now in the after-care nursery."
