Travis Maestasgmartin/201 BAMD/BAMD Essays/Travis.doc · Web viewI thought that it had something to do with a cold or flu, but later I learned that Shaun was born with Pierre Robin

Travis MaestasA Breath of Fresh AirHMHV 201December 11, 2007Page 1 of 16

A Breath of Fresh Air

In a white Chrysler Concorde, I, along with my aunt, cousin Cece, and Cece’s newborn

baby, Shaun, drive to pick up my nana. The short two minute drive is nothing compared to the

drive we are about to embark on. As we drive up to my nana’s house, my aunt honks the horn

and tells me, “Travis, go tell nana to hurry up.” I exit the car as my aunt continues to honk the

horn. This startles the baby, and I can hear Shaun’s crackling and snore-like cry as I slam the

door shut. Inside, my nana is putting on her coat and grabbing her keys when we hear another

honk. My nana yells back in response to the honks, “Wait! Wait!” as we slowly make our way

outside.

After we’re all settled in and buckled up we head out on our journey from Seboyeta to

Santuario. Santuario is a religious sanctuary where people pilgrimage every year during Good

Friday. The people that go there usually worship God and ask for his healing powers. Our

journey is somewhat similar. As we drive out of Seboyeta on the three hour journey to

Santuario, I admire the landscape. Seboyeta is one of the few remaining Spanish Land Grants in

New Mexico. This land was granted to 30 Spanish families (one of which was my family) by the

King of Spain over 200 years ago, and since then has been the home to my family and ancestors.

Seboyeta sits at the bottom of a valley between mountain-like mesas. The road leading in

and out of Seboyeta winds and follows along an arroyo with a small stream that runs from a

forested canyon in the mountains down and into our town. The land is flat and is filled with dry

grassy patches where cattle graze. The citizens of Seboyeta are some of the most genuine and

kind-hearted people I know. They are the type of people who will come together as a

Travis MaestasA Breath of Fresh AirPage 2 of 16

community and hold a fundraiser to help a family in need. This sparsely populated area is home

to no more than 1000 residents, one convenience store, and one tavern. To the west is the closest

city, Grants, about 30 minutes away, and to the east about an hour or so away is Albuquerque.

As we continue our drive to Santuario we pass through Albuquerque. The scenery

transitions from a small town setting with cows and horses along the road to a congested freeway

with buildings and houses filling every available space. This new setting is a drastic change

from the country life of Seboyeta. Two hours later we arrive in Santuario. We all get out of the

car and stretch from sitting for so long. We enter the church and as we walk in each of us dips

our index and middle finger into the holy water to make the sign of the cross. The church is

beautiful, with high arched ceilings and southwestern accents. In the church, we kneel and pay

our respects as we pray for loved ones as devout Catholics.

After we pray, we enter a room that reminds me of a shrine or museum. The walls

consist of pictures, prayers, crutches, casts, and all sorts of objects which people have hung for

prayer and healing. Cece with Shaun in her arms walks up to an empty space on the wall and

hangs something. We all watch in silence as she performs this ceremony. Her addition to the

wall is something of Shaun’s. It is something that at one point became flesh with Shaun for a

large portion of his infancy. That day, we left Santuario anxious and with high hopes that this

ceremony was the answer.

* * *

When Shaun was born Cece was only 17 years old, and a senior in high school.

Although I was only nine years old when Shaun was born, his birth day is still fresh in my mind.

Shaun’s estimated due date for delivery was sometime in mid March, but that time had come and


gone; now we were in late March with an appointment to induce labor on April 5th. That

morning we all drove the 67 miles from Seboyeta to Albuquerque.

Cece had the option to give birth in Grants, which would have been a lot closer; however,

like most people in our town, she did not trust the hospital facilities of smaller communities, so

instead she chose Albuquerque. Shaun was born early that spring morning weighing 7 lbs and

12 ounces. I was sitting in the waiting room with other family members because my mom was in

the delivery room with Cece. The waiting room walls were a bright white, with the typical

hospital chairs of maroon and teal to make it a bit more lively. The lively colors didn’t cheer me

up after I had been left in the waiting room. I begged my mother to take me with her, but the

nurses said I was too young. What should have been an exciting day because of the birth of a

new baby had for a short time become a solemn day when I was separated from my mother.

Regardless of what the nurses had to say, after Shaun’s birth, my mom snuck me into the

delivery room. I felt like a villain, and I looked at everyone suspiciously as I walked down the

hallway to Cece’s hospital room. My mom said, “Hurry, so that we don’t get in trouble.” I

walked fast so that I could steal a quick peek at my cute, little newborn baby cousin. As I think

back to that day, he wasn’t so cute, as most babies aren’t when they are born. He was wrinkly,

red, and annoyingly loud. Now that I think about it, he looked like something from outer space.

I remember looking at my older cousin, Cece, and thinking how tired she looked. She

looked drained, as if she had just finished running the 4x4 relay after one of her high school track

meets. To this day I will never hope to imagine how it feels to give birth. The doctor told us all

that it was time to leave so that she could get some rest. It was later that I learned from Cece that

the doctors told everyone to leave because of a “complication.”


A day later when the two were scheduled to come home from the hospital, my mom told

me that Shaun and Cece weren’t coming home yet. At that time I didn’t really know what was

going on, but from movies that I had seen I knew that it was customary for the baby to come

home the next day unless something was wrong.

I asked my mom, “Why aren’t they coming home today?”

She replied with a vague answer, “I’m not too sure yet, but Shaun might be ‘sick’.” At

the time, I didn’t know what “sick” meant. I thought that it had something to do with a cold or

flu, but later I learned that Shaun was born with Pierre Robin Syndrome.

Pierre Robin Syndrome is a birth defect which is indicated by micrognathia, a small and

underdeveloped lower jaw, as well as a cleft palate, which is essentially a hole in the roof of the

mouth. As a result, the baby’s tongue tends to fall backwards and downwards into the airway.

This defect is known as glossoptosis. These defects all contribute to associated upper airway

obstruction, feeding difficulties, and growth retardation The cause of Pierre Robin syndrome is

thought to be genetic, and because of this genetic mishap, the jaw which usually develops early

during pregnancy doesn’t fully develop. I used to think that if the doctors let the process happen

naturally instead of inducing labor early, that Shaun’s jaw and cleft palate would have developed

fully. It wasn’t until I was older and in high school and college, that I decided to research Pierre

Robin Syndrome and learned of the possible genetic causes. It was then when I realized the

severity of Shaun’s situation.

I’ve learned that in minor cases, the jaw will gradually grow over time and if the baby is

kept face down in a prone position the tongue will fall forward and keep the airway open.

However, in more moderate cases, a plastic tube is necessary in the nose to allow for air passage.


In other cases suturing or stitching of the tongue to the lower lip can be performed to

prevent the airway from being obstructed. In Shaun’s case, surgery was necessary.

I asked Cece if the doctors knew from birth that Shaun had this disorder, but she said they

realized something was wrong when they tried to feed him and he couldn’t take to a baby bottle

because of his underdeveloped jaw and cleft palate. Like in all cases, Shaun had trouble

breathing and needed the aid of an oxygen tube.

Shaun’s genetic disorder was the trigger of a series of events that occurred soon after his

birth. Because of the severity, Shaun had to undergo a surgery to prevent airway obstruction. As

a child, I never knew what this surgery was called, all I knew was that they cut a hole in Shaun’s

neck and stuck a tube in his throat so that he could breathe easier. Later, I learned that the more

technical term for this type of surgery was a tracheotomy.

For almost a year, Shaun’s artificial trachea tube became a part of his life. It was a blue

transparent tube about the diameter of a nickel that funneled down to half that size as it

penetrated through his throat. The exterior had flaps on the side with a Velcro strap that wrapped

around his neck to secure the tube. Shaun’s trachea tube would have to be covered by a filter cap

whenever he went outside in order to prevent foreign objects, like dirt, from entering and causing

choking or infection.

No one in my family had ever been born with any type of illness. What was this about?

The only illnesses that were common to me were colds, strep throat, etc. The only other illnesses

that I’d heard about were the ones my tata (grandfather) Serafin and aunt Cecilia had. Both had

heart conditions, and both died before I was born. Many thought that it was from the Uranium

mine that my tata had worked at for most of his life. But, as far as I know, this is still a mystery.


I’ve tried to ask my mom and other relatives about this to find out more information, wondering

if there were something more, but my discovery ended shortly because nobody seems to know

any specifics. Either way, illnesses such as Shaun’s birth defects were new to my family.

Because the doctors told us that Pierre Robin Syndrome could be genetic, I later learned

that there is a possible correlation between it and the disregulation of the SOX9 and KCNJ2

genes. Today I think back and wonder where it could have come from. Like I said, no one in

my family had ever experienced this. Could this be something from Shaun’s dad? Who, still to

this day, remains unknown to most of the family, with the exception of Cece and her mother. In

biology we learn that offspring get half of their genes from the mother and the other half from

the father. So this must be it: Shaun’s dad gave him this genetic syndrome. Right? As much as

many of us may want to blame him for this, we never knew who he was, and there was nothing

we could do if we had known. It’s not as if he purposely gave this to his son.

To this day Shaun doesn’t know his father, and I’m not sure if he ever will. It’s always

been one of those issues that no one ever really talks about, but everyone has their speculations.

In a small town like Seboyeta, everyone pretty much knows everyone else’s business. Although

we have our speculations, no one knows if his dad ever even attempted to be a part of Shaun’s

life, or if Cece even wanted him to be. I’m sure if he had really wanted to he would have come

forth a long time ago, or at least now that Shaun is able to understand. I’m not sure how Shaun

feels on this subject, because I’ve always been too afraid to ask; I don’t want to put him out of

place and make him feel uncomfortable. He’s never mentioned the topic before, but today as a

preteen, I’m sure he’s old enough to understand the situation, and know for himself what’s going

on. I wonder sometimes, how things might have been different if Shaun’s father was there


through his son’s earlier years. This would have definitely been a whole lot easier on Cece, a

single mother raising a son with Pierre Robin Syndrome.

This syndrome, not only affected the development of Shaun’s jaw, but also the way he

ate, acted, and breathed. One night we got a very unexpected call to my house. My dad was out

of town, so it was only me, my mom, and my sister Sarah. We were all getting ready for bed

when the phone rang. I remember my sister had answered the phone and she ran into where me

and my mom were and said that Shaun had stopped breathing. With no time for questions my

mom told us, “Hurry and put your shoes on so we can go.” I ran down the hall to get my shoes

and then ran down to the garage where my mom was waiting for my sister and I. But my sister

never came. My mom got worried and asked me to run back into the house to see if she was still

there, but she was nowhere to be found. My mom and I searched outside to make sure she

hadn’t fallen, but still we couldn’t find her. As it turned out, the minute my sister told us about

what happened to Shaun she ran down the hill to Cece’s house.

The paramedics, police, and my sister were already at the scene when we arrived. We

ran into the kitchen to find my 11 month old baby cousin with an oxygen mask on. The

paramedics were taking his vitals as one of the police officers was interviewing Cece. She was

in tears as she tried to answer the officer’s questions. I remember her telling him that she was

watching TV in the living room when she heard Shaun coughing. She said that she went to

check on him and noticed that he wasn’t breathing and was turning blue. She immediately put

on his oxygen mask and called for help. As the police officer continued to ask Cece questions,

one of the paramedics asked me to wait outside. I didn’t take this lightly, but felt as if they were

asking me to leave because I was in the way.


I stood outside alone crying as I viewed through the window the paramedics caring for

Shaun. As I stood there one of the police officers noticed that I was crying and came up to ask if

I was doing okay. I wiped my tears and nodded my head for assurance. That night the

paramedics stabilized Shaun, but felt that it was necessary to take him to the hospital. My mom,

sister, and I all watched as Shaun and Cece were taken away in the ambulance. The next day

Shaun had returned home from the hospital. The doctors had said he had a mild case of

pneumonia which somehow lead to shortness of breath. That night Shaun gave everyone a scare,

which put everything about the severity of his situation into perspective.

* * *

Because of the underdeveloped jaw, Shaun couldn’t drink from a bottle like a “normal”

baby. (When talking about Shaun, people always refer to other babies as “normal,” but I’m

hesitant to use that word because in my eyes I never saw anything abnormal about him; he was

just a child who had more trouble at some things than others.) Because Shaun couldn’t adapt to

breast feeding, the doctors tried a baby bottle. However, like breast feeding, Shaun wasn’t able

to feed through a typical baby bottle either. It was then that the doctors decided to try another

baby bottle with specialized tip for babies who had trouble feeding using traditional methods.

This seemed to have worked a little better than the others, but the doctors still were concerned.

Shaun’s physicians were still worried about Shaun’s nutrition, and didn’t want him to become

malnourished from lack of food.

Because of the fear of malnourishment the doctors inserted a feeding tube in Shaun’s

stomach. The tube stuck out of his belly about 6 inches, and was a brownish rubber somewhat


like a rubber band. To feed Shaun, another tube coming from the feeding pump with the milk

was connected to the feeding tube in Shaun’s stomach, where the milk would dispense.

As Shaun got older he became more active and began crawling. The tube would hang

from Shaun’s stomach, and there was even an instance when he accidentally pulled it out. The

doctor’s found this to become an issue so they resorted to another option. The feeding tube was

replaced by what we called a “button.” With the same purpose as the feeding tube, this “button”

seemed a little more high tech. It was white and small, and about the size of a small button, the

ones we find on collared button up shirts.

This feeding “button” was covered at all times with a cap, to prevent exposure to dust and

other airborne particles. The cap had to be removed for feeding and with the same feeding

pump, we would screw on the tip of a hose from the feeding pump onto the “button.” There

were times when Cece would also feed Shuan from the specialized baby bottle. I used to think

that she did this to feel more “motherly” as a mother does to feed her child, but I later learned

that the doctor recommended this so that Shaun’s jaw could develop stronger and become

adjusted to being fed from the mouth.

* * *

Shaun’s syndrome also affected the way he acted and cried. Shaun never cried like most

babies, but instead sounds of scratchy snores would excrete from his mouth. This was partially

due to the underdeveloped jaw, but mainly due to the tracheotomy tube in his throat. The mucus

that would build up would contribute to his snore-like cries. Every few hours or so, the mucus

from the trachea tube had to be suctioned out by what appeared to be a mini-vacuum.


I used to watch Cece do this all the time. First, she would dispense two drops of saline

fluid into the trachea. With this you could hear him semi choke and cough it out. The saline was

used just to loosen the mucus build-up. Next, with gloves on, she would connect a sterile

spaghetti-like string tube to the mini vacuum. The tube had measurement marks on the side like

a ruler which were used to determine how far to stick the suction in. As she stuck this into the

tube, and began to clean and suck up all the mucus build-up I would watch with amazement.

Then one day, Cece “gave me the honors” and let me perform what seemed to me to be a

“medical procedure.”

This was the first time Cece had ever asked me to take part in what seemed to be a vital

process to ensure Shaun’s health. For the first time I felt important, I wasn’t asked to stand on

the sidelines, but rather I was asked to be a part of something. I was so nervous the first time

that I was jittery and my hands were shaking like my nana’s hands do from her old age.

Doing my best to steady myself, I performed the “procedure” with Cece watching over

me. I looked toward her for approval, as I was getting ready to suction the mucus. She gave me

the okay, and as I proceeded she stopped me and told me,

“Don’t go in too far and make sure when you suction that you swirl the suction while

inside to make sure you get everything.”

“Okay,” I nervously replied.

I took this advice with caution, and entered what to me was the “unknown.” It wasn’t

until later in my life that I would realize that this “unknown” marked the beginning of a

medically related future.

* * *


Throughout Shaun’s childhood, I would spend almost everyday with him and learn every

“medical procedure” pertaining to him such as cleaning his trachea tube and feeding tube. Each

and every week a nurse would commute the 67 miles from Albuquerque to Seboyeta for a

weekly check up. Every week, I would make it a priority to be there when the nurse came. The

nurse would weigh Shaun, measure him, check his pulse, and even change his Trachea tube.

The first time the nurse removed his Trachea tube was the first time I heard him cry like a

“normal” baby without the scratchy and raspy snore sounds. When the trachea tube was

removed he would cry as he gasped for a breath of fresh air. The first time I heard his real cry I

got chills down my spine from the foreign sound of what should be “normal.” This excitement

sparked my interest, and the nurse even saw this, so she allowed me to become her “assistant”

and help with her weekly routines as Cece has done previously. I felt so important and

professional doing this. It was because of this that family, specifically my nana, began calling

me “Dr. Maestas.” After a while, I got used to the name, and as it grew on me, it was something

that I wanted to be called.

Along with gaining a new found title to my name, I gained new relationships with my

two cousins: Shaun and Cece. Before this, Cece and I were never really as close as we’ve

become. She would always give me a hard time and just joke around, but since then we’ve

become great friends. I would even consider her as a second sister. I’m usually really reserved

about my feelings, but she has become one of those few people I can count on and tell almost

anything too.

Because Cece entered motherhood at the young age of 17, she was forced to mature faster

than most girls her age. One time when I realized this was when Shaun was one year old.


Because both of my parents worked fulltime, Cece would be the one to pick me up and drop me

off from school. There was this one instance when Cece picked me up after a school field trip to

the zoo in Albuquerque. On the hour ride back to school, I had an “accident” in my pants

because at the time only one gas station between Albuquerque and Seboyeta, which we already

had passed. I hid this “accident” from the other kids by covering myself with my jacket for fear

of being made fun of. No one noticed, but when I got into the car with Cece, her motherly

instinct took over and asked what was wrong when she saw my embarrassment. I showed her

what had happened, and she took me to my house to get a change of clothes. We went back to

her house and trying to make me feel better she told me that, “It’s okay, Shaun does this all the

time.”

I smiled and said, “Yeah, but he’s a baby, its okay for him to do that.”

With a comforting reply, “So? It can happen to anyone.”

I accepted what she said, and went into the kitchen where she had prepared an after

school snack.

* * *

Biologically, Shaun is only my second cousin, but I consider him something a lot closer.

He has become the brother that I’ve never had. I used to take care of Shaun a lot when he was

younger, and I still do even to this day. On weekends, Shaun likes to stay at my house with me

and my family; he has even already tried taking over my bedroom when I’m away by rearranging

it and putting up some of his belongings. Shaun refers and calls me his brother and I feel that he

looks up to me for a lot of things. I’ve always had my sister to look up to, but I’ve never been


the one being looked up to. Shaun looks up to me as an older brother, and it’s partially because

of him that I do the best that I can as I know he’s always watching my every move.

One time in particular where I realized my influence over him was one night when I was

reading. Every weekend when he comes to my house in Seboyeta to visit, I would always tell

him to bring some of his books to read, but every time he always seemed to “forget.”

Because of this I usually tell him, “Go get one of my old books from the shelves in my

closet and read those.”

But, every time he seems to escape the burden and says, “I think your dad just called

me,” while he runs out.

Every weekend, he sees me studying or reading, and finally one weekend, while I was

reading for my Health, Medicine, and Human Values (HMHV) class he went to my closet and

pulled out, “Funny Bones,” which was one of my favorite childhood books. Shaun then lay

down next to me on my bed and too began to read.

I asked him, “I thought you didn’t like to read?”

And he replied, “There is nothing else to do.”

I know he could have watched TV or played with his toys, but I didn’t question it, I just

smiled and went on reading. He lay there the entire time until he finished reading the book, and

fell asleep. I continued reading, and as he fell into a deeper sleep I could hear his little snores

which reminded me of how his cry used to sound with his trachea tube. I think back to that time,

and I can’t seem to imagine how far we both have come from the time of his birth. The

amazement is enough to end the day on a good note, so I put my book up and turn off light.

* * *


Up until last year, I never really realized that Shaun helped determine my future. If it

wasn’t for this life changing event, I may not be on the path that I am currently on. If it weren’t

because of this experience, I may not be able to answer the question; “At age 18, what makes you

so sure that you want to be a doctor?”

This question was one of the first questions directed towards me by Dr. Sylvia Ramos.

Sylvia Ramos is a native Puerto Rican who received her MD from the Albert Einstein’s College

of Medicine at Yeshiva University in New York. Now after many years of experience, she is a

General Surgeon at the Rehabilitation Hospital of New Mexico, and serves on the board of

admissions for the University of New Mexico’s BA/MD program.

The BA/MD program is a scholarship which grants early acceptance into UNM’s School

of Medicine to high school seniors with the hopes of serving New Mexico. On this admissions

board, Dr Ramos is one of 16 physicians who would decide my fate, but first I had to answer her

pressing question if I wanted to decide my own fate with this program.

I thought to myself for what seemed like a second but it must have been much longer

because Dr. Ramos broke the silence by saying, “I know at your age I had no idea that I wanted

to be a physician; I wanted to be an artist, so what is it that makes YOU so sure?.” I knew my

answer to her question would determine my future, but why couldn’t I get the words to come

out? Now that I think back, did I second guess myself for a moment? No, then it came to me. I

wasn’t second guessing myself; it must have just been nerves, because if anyone were to take a

look at the sweat rings on the underarms of my shirt after my interview they would know I was

nervous, but I was sure of myself.


The nervousness ended and the answer came to me like a breath of fresh air. It was so

obvious. Why hadn’t I thought of it right away? It was something that had been a part of almost

my entire life, just like Shaun’s trachea tube…that at one point became flesh with him for a large

portion of his infancy. The answer was Shaun! My passion for pursuing a career in medicine

was sparked 10 years ago with the birth of my younger cousin Shaun.

I told Dr. Ramos my story, and how today, no one would ever be able to notice that

Shaun had a genetic disorder growing up unless they saw a picture of him when he was younger.

I spoke of how Shaun had these conditions for almost two years, and it was because of modern

day medicine and technology that lead to his full recovery. Shaun doesn’t remember much of

what he had, but he sees his scar on his neck and stomach which reminds him that he had an

illness. Today he refers to the scar on his stomach as a second belly button. He knows that he

was fed through his stomach and that he had a Trachea tube to breathe, but he doesn’t know why.

Finally, I spoke about when I was younger and how I didn’t know why either, but as I got older,

my interest lead me to find out more, and that interest had led me to where I am today.

I left the interview with satisfaction and anxiety. This anxiety was the same that I felt 10

years ago when Cece performed a ceremony and hung Shaun’s trachea tube on the wall in

Santuario. The same quest for answers, certainty, and faith, once again overwhelmed me. That

day in Santuario, none of us knew whether or not Shaun would fully recover, but we had hope. I

had hope. The hope that what was meant to happen would. Everything in life happens for a

reason. Was Shaun’s illness the key to my future? Was I what this program was looking for?

These were the questions that I had asked myself almost everyday for three months. I knew I


had done my best in my interview, and deep down I knew that this was my calling in life. I can’t

explain it, but it’s just something I feel.

I received my acceptance letter in April, the month of Shaun’s birthday. Since then,

everyone always asks me what type of physician I want to be when I’m older. I always think

about Shaun, and I reply that I want to become a Pediatrician. It was his experience that led me

to this, and it’s this profession that I’m going to pursue because I once again want to be an

influence in someone’s life when they too experience their own breath of fresh air.

Documents

Travis Maestasgmartin/201 BAMD/BAMD Essays/Travis.doc · Web viewI thought that it had something to do with a cold or flu, but later I learned that Shaun was born with Pierre Robin