Patrick Bouvier Kennedy

Patrick Bouvier Kennedy (August 7, 1963 – August 9, 1963) was the infant child of United States President John F. Kennedy and First Lady Jacqueline Kennedy. He was the younger brother of Caroline and John Jr.; another daughter was stillborn. Born prematurely, Kennedy lived just over 39 hours before desperate attempts to save him failed, putting the First Family and nation into mourning. Three months later, his death was eclipsed by his father's assassination, but the Kennedy infant's death brought hyaline membrane disease (HMD) into the public consciousness and inspired further research.

Background

In August 1963, the 34-year-old Jackie Kennedy was in her third year as First Lady and in the third trimester of her fifth pregnancy. She had suffered a miscarriage in 1955, followed the next year by a stillborn baby girl they planned to name Arabella (after the Arbella ship). Two healthy children had followed, Caroline in 1957 and John Jr. in 1960. As John had also been premature, she asked her obstetrician, John W. Walsh, to accompany her when she and her children spent the summer in Hyannis Port, Massachusetts. Nearby Otis Air Force Base Hospital had also prepared a suite for her in case it was necessary.

On the morning of Wednesday, August 7,Jackie Kennedy took Caroline and John Jr for a pony ride in Osterville, Massachusetts. While the children were riding, Kennedy felt labor pains. Walsh was summoned, and they were taken by helicopter to the Otis Air Force Base.

President Kennedy was at the White House at the time. August 7 was the 20th anniversary of the day the Navy had rescued him in World War II after he had spent five days marooned on an island in the Pacific. Kennedy had been in command of Motor Torpedo Boat PT-109 when it was rammed by a Japanese destroyer, killing two of his crew. His heroics had helped launch his political career. PT-109 and August 7 were never far from his mind; he kept a scale model of the boat on a shelf in the Oval Office and each day used a metal tie clasp shaped like a torpedo boat, with PT 109 stamped across its bow.

All of which may explain why Kennedy's friend and fellow World War II naval veteran Ben Bradlee is certain that when the president's secretary, Evelyn Lincoln, hurried into the Oval Office at 11:43 a.m. on August 7, a Wednesday, to report that Jackie had gone into premature labor on Cape Cod, there was "no way in God's earth" that he did not think, My child is being born 20 years to the day when I was rescued, a coincidence providing an additional emotional dimension to a day that would be among the most traumatic of his life.

— Thurston Clarke, JFK's Last Hundred Days (2013)

Birth and treatment

While his father was aboard Air Force One, Kennedy was delivered by emergency caesarean section at 12:52 p.m. on August 7, 1963, at the Otis Air Force Base Hospital in Bourne, Massachusetts, five and 1/2 weeks prematurely. The caesarean section was performed by Dr. Walsh, who had also delivered John Jr. in 1960. His birth weight was 4 pounds 10 ⁄₂ ounces (2.11 kg). He was the first baby to be born to a sitting U.S. president and First Lady since the 19th century.

Shortly after birth, Kennedy developed symptoms of hyaline membrane disease (HMD), now called infant respiratory distress syndrome (IRDS). It was detected by breathing difficulties within minutes. The president arrived, saw his son in distress, and sent for a chaplain. The infant was quickly baptized with the name of Patrick after his grandfather Joseph Patrick Kennedy (1888–1969) and great-grandfather Patrick Joseph Kennedy (1858–1929), and Bouvier for his mother's maiden name.

The president was allowed to wheel the baby in an incubator to the First Lady's bedside. James E. Drorbaught, the pediatric specialist at Boston Children's Hospital, was flown by helicopter from Boston to consult on his case; he recommended transfer to Boston. Five hours after birth the infant, accompanied by Dr. Drorbaught, was rushed by ambulance to Boston Children's Hospital, 70 miles (110 km) away in under 90 minutes. The transfer to the hospital in Boston was initially reported as a "precautionary measure," the White House said. His condition was accurately reported as HMD, but it was also reported it would take at least four days to assess his condition, and that he was being given medication to assist his condition.

At the time, all that could be done for a baby with hyaline membrane disease was to keep the patient's blood chemistry as close to normal as possible. Led by Dr. Drorbaught, who stayed awake the entire time, the hospital tried everything possible to save his life.Kennedy was given hyperbaric oxygen therapy(HBOT), in which he was placed in a hyperbaric chamber filled with 100 percent oxygen and pressurized to greater than 1 atmosphere. At the time, it was revolutionary; the New York Times described it as "one of the newest interests of medical researchers".

Death and funeral

Kennedy died at 4:04 a.m. on August 9—"despite a desperate medical effort to save him"—having lived 39 hours and 12 minutes. At the time of the infant's death, the president was outside the room with the hyperbaric chamber with his brother, Attorney General Robert F. Kennedy.The First Lady, then 34, remained at Otis Air Force Base Hospital recovering from the caesarean section. She was told of her son's death by Dr. Walsh. (He would console her again after her husband's assassination; he was aboard Air Force One with her as she returned from Dallas with the president's body). She was given a sedative and slept until the president flew from Boston. Very little was said about the family's reaction; White House Press Secretary Pierre Salinger stated of the First Lady's condition, "Given the circumstances, her condition is satisfactory." The president, who had reportedly only slept four hours since the birth, was photographed arriving at Otis Air Force Base looking "grave and appearing tired".

A small funeral mass was held on August 10, 1963, in the private chapel of Cardinal Richard Cushing in Boston. The president's mother was in Paris and told not to return for the funeral, though the First Lady's sister, Lee Radziwill had already flown in from Greece before Kennedy died. Cardinal Cushing, the Archbishop of Boston, performed the funeral mass, as he would for John F. Kennedy, assassinated 104 days later. Siblings Caroline, then 5 years old, and John Jr., 2 1/2, did not attend.

The child was initially buried at Holyhood Cemetery in Brookline, Massachusetts, the president's hometown. His body and that of a stillborn sister, whom Jacqueline Kennedy called Arabella, were re-interred on December 5, 1963, alongside their father at Arlington National Cemetery, and later again moved to their permanent graves in Section 45, Grid U-35.

Kennedy's death made 1963 a "pivotal year" for neonatology, still a relatively new field at the time, according to an examination of the field's history in the journal Neonatology. The increased public awareness of HMD led to a corresponding increase in research of the disease, spurring development of new medical ventilators, blood gas tests, and newborn intensive care practices in both the United States and Europe. The first trials of a potential treatment for HMD, dipalmitoylphosphatidylcholine, were published within a few years, although it was not considered a clinical success. According to Dr. Suhas M. Nafday, director of Newborn Services at the Children's Hospital at Montefiore Medical Center in New York, the child's death "energized the neonatal researchers into action to look for an effective management of respiratory distress syndrome." In a review of advances in clinical medicine, researcher Thor Hansen observed that the "medical profession did not have the tools to help" Kennedy, "the newborn son of arguably the most powerful man in the world," but that fifty years later, treatment of his condition would be considered routine and survival expected.

The First Lady and the President were deeply affected by the death of the child. Secret Service agent Clint Hill recalled the couple having "a distinctly closer relationship" that was visible following Kennedy's death. Press secretary Pierre Salinger believed that while the President and First Lady had been brought closer by the White House, even more so were they by the passing of their last child.