Against All Odds

Courtney Jackson had so much fun blowing out the three candles on her Care Bears birthday cake that when the ritual was over, she declared in her small, husky voice: “Do it again.” Friends and relatives assembled June 20 at her parents’ house in Bloomfield, Iowa, burst into laughter—and the little girl, not sure what everyone found so funny, began to cry. But that was just a passing cloud in what was otherwise the happiest of occasions. “Here we are, and Courtney’s 3 years old,” beams her great-grandmother Esther Van Horn, 75. Adds her other great-grandmother Virginia McAlexander, 76: “To me, everything she does is a miracle.”

This is not your average case of grandmotherly hyperbole. In the summer of 2001, when Courtney was born just 23 weeks into her mother’s pregnancy, she weighed only 460 grams, a fraction over 1 lb. At 11 inches long, she had a total of eight teaspoons of blood and a heart not much bigger than an acorn. Doctors gave Courtney’s parents, Jennifer and Chris, the grim prognosis: As a so-called micro-preemie—the smallest of all premature babies—their daughter had only a 50 percent chance of survival.

But to see the blonde pixie today is to understand what Courtney’s great-grandmother feels. At 28 lbs., the little girl ranks within the normal range for kids her age on growth charts, she plays Legos and knows her letters and has no trouble navigating the backyard in the pink plastic Jeep she got for her birthday. She is intellectually alert and emotionally unscathed, say her doctors. “We can’t make every one of these premature babies survive,” says Dr. John Widness, who led the neonatology team caring for Courtney in the first month of her life. “But when you see one like her do so spectacularly well, it’s what you live for.”

Courtney’s saga began on the evening of June 18, 2001, when her mother, Jennifer, then 25 and pregnant with her first child, was on the phone with her obstetrician to report a splitting headache and vomiting. Suddenly Jennifer began emitting a high-pitched moan. She was having a seizure—the first of four she would endure before being rushed to a medical center 95 miles away. Stricken by eclampsia, a little-understood condition that causes a pregnant woman’s blood pressure to soar—and can kill her unborn child—Jennifer was unconscious when her husband, Chris, then 26, allowed doctors to quickly induce birth.

At 23 weeks, Jennifer’s baby was below the 24-week threshold usually considered necessary for survival. As many as 80 percent of babies this young do not survive, and of the ones who do, many eventually suffer severe physical handicaps including cerebral palsy and blindness. But from the beginning, say her parents, Courtney showed a fierce will to live. “She surprises you every day,” says her mom. Shortly after birth, when doctors inserted a breathing tube, “Courtney grabbed at it and hit our hands while we were working,” one doctor recalled. “She just wanted to get it out of her way.” Courtney breezed through surgery a month later to correct a defect in her heart and battled chronic lung problems. After four months of being fed by IV, she began tasting milk from a syringe. Soon she was strong enough to take a bottle. “You could tell she was going to fight to come home,” says Chris.

Despite all the dark predictions, Courtney was living at home at 5 months old—albeit tethered to an oxygen tank, which Jennifer hauled along as she took Courtney to her job at a nearby daycare center. Courtney’s battle to thrive wasn’t her family’s only struggle. In November 2002, Jennifer gave birth to the couple’s second child, Cameron, who, though healthy, was born six weeks prematurely. Then, in August 2003, Jennifer was back at the emergency room, where doctors recognized her migraines and mental confusion as the sign of a small stroke, possibly related to her bout with eclampsia.

There were no lasting health effects, but another shock came this March, when Jennifer, who intended to delay having any more children, discovered that she was pregnant again. For two months she was depressed, worrying about the health of her unborn child. In the midst of everything, Chris, a carpenter, lost his job and was out of work for six months until he found a job that provides health insurance at a nearby Rubbermaid plant. “Sometimes we worry about how we’ll manage, but then it all generally steers itself around,” he says of the couple’s travails. “Generally, I guess we’re both pretty optimistic.”

Today, despite all her progress, Courtney is still not entirely out of the woods. “She can run, but it’s a bit awkward and not as fluid as some other 3-year-olds,” says her grandmother. Because her lungs are not yet completely developed, she has had three bouts with pneumonia. (“If there is a weakness in her system, it is her respiratory tract,” says pediatrician Dr. Jay Heitsman.) As for her appetite, no problem there. “She packs it away,” says Chris. At the Jacksons’ house, as her third birthday drew to a close, Courtney was out in the driveway, being pushed by her father on a brand-new blue tricycle. “To think that three years ago we started off with this little, itty-bitty thing,” says Chris, watching his daughter struggle to work the pedals. “Now it won’t be long before she learns to ride it herself.”

Susan Schindehette. Giovanna Breu in Bloomfield