The little boy was born here on a recent Sunday, 5 pounds and 4 ounces of crying pink and physical agony. A scant week later he died, despite a final effort to save him from congestive heart failure in a special facility at a distant hospital.
The death of a newborn is not all that unusual here, for this East Texas region has the highest newborn mortality rate in the state. But doctors and hospital officials say that while the deaths are not unusual, many perhaps at least 70 a year - are unnecessary and occur solely because the 15 county area lacks a neonatologist, a specialist in treating ills peculiar to the newly born.
"If that baby had a neonatologist, he would have made it," said Dr. James L. Bridges, a pediatrician active in a long and so far futile community effort to bring such a specialist to Beaumont.
That effort had seemingly brought success earlier this year when the state Health Facilities Commission authorized construction of an intensive care unit for newborns at Beaumont's St. Elizabeth Hospital and a neonatologist willing to run it was located.
But nothing has happened since, for the doctor is on active duty in the U.S. Navy and despite a Navy acknowledgment that it does not need a full time neonatologist the service has refused requests that it discharge the doctor so he can come to Beaumont.
In part, the Navy said that "in the absence of strong humanitarian conditions," it did not want to establish a precedent that just because a specialist could not be utilized fulltime he should be released early from the service.
At the heart of the dispute, however, lies the impact that one medical specialty can have on life in a community and the sad reality for one that has no access to that care, for whatever reasons.
"I'm not just trying to get out of the Navy," said the doctor, William A. Fawcett IV, who is stationed at the Oakland, Calif., Naval Medical Center with another neonatologist and who says he spends most of his time caring for babies essentially in good health. "It is a matter of a critical need there (in Beaumont), and there are babies dying there."
And so they are. While Beaumont itself has a population of only about 127,000, its three hospitals serve as the medical center for another 450,000 people in outlying areas along the Louisiana border. In the communities scattered among the tall pines, the petrochemical plants and the rice fields, some 8,000 plus babies are born each year.
For each 1,000 births, 19 newborns die. The statewide rate is 13; nationally it is 11.6. Worse, while the new-born death rate is declining in virtually every other part of the state, it is rising in East Texas.
Bridges cites the example of Clark County, Nevada, where the death rate for newborns fell from 15 to eight for each 1,000 births with the arrival of a neonatologist. On that basis and other experience, Bridges estimates that at least 70 newborns could be saved here each year.
"Neonatology is a new field with great advances," he said. "There are so many new techiques to save babies that would have died, and that's why other areas' death rates are going down."
Fawcett's involvement began 2 1/2 years ago when he was vacationing here with his wife, who is from the Beaumont area. He met a physician and mentioned that he was going to begin training in neonatology.
Months later the Beaumont doctor raised the question of Fawcett's coming to Beaumont if his early discharge could be obtained. Fawcett said he agreed on condition that the Navy did not require his neonatal skills.
The trouble was that Fawcett owed the Navy five years of service. In 1972, faced with being drafted as a general medical officer, Fawcett, then a senior in medical school, enlisted in the Navy to become a pediatrician. In exchange, the Navy subsidized his senior year at a cost of $6,000 to $7,000 and provided his pediatric training. Fawcett, in return, was to serve three years on active duty.
Subsequently he began his neonatology training at the Navy's expense and that added another two years to his active duty, he said. The five years began in August.
In January of this year, efforts to secure his discharge began. Direct appeals to the Navy were unsuccessful, efforts through congressional offices were fruitless and a letter to the White House brought only a brief note of response.
In denying Fawcett's discharge, Rear Adm. J. William Cox noted that while Fawcett is not needed as a fulltime neonatologist he still remains available to provide his basic medical specialty - pediatric care for Navy dependants.
Cox, an administrator in the Navy's Bureau of Medicine and Surgery, wrote, "Alternatives to active duty service are not considered feasible in this case. In addition to the justified requirement for his services and in the absence of strong humanitarian conditions, it would not be in the best interests of the Navy to establish a precedent which implicity suggests that unless a subspecialist can be employed full-time in military medical facilities he should be considered for release from active duty."
"We have scoured the country," said Bridges of the efforts to locats a neonatologist. The $43,000 intensive care nursery on St. Elizabeth's third floor is under construction and Fawcett has twice visited Beaumont to train nurses to work in such a facility.
"We have the nurses educated to the essential ingredients," said Ed Fuss, associate administrator of St. Elizabeth. "A neonatalogist is what's absent to get the program off the ground. We would have loved to have had Dr. Fawcett but . . ."