A Second Home On The Medical Mile.

When Bobbie Crigler gave birth to her son after only 26 weeks, doctors in West Plains, Mo., told her they couldn’t save her newborn. The nearest hospital that could was in Springfield, two hours away. But Bobbie didn’t have a place to live. Then she found the home she desperately needed.

story by Sarah Elms / photos by Dan Oshinsky
published June 13, 2012

Amber Reynolds pulls into work, but she can’t keep her mind from drifting back to a conversation from earlier this morning. She had been getting organized for the day, listening to the rhythmic tapping of raindrops on her bedroom window, when her phone rang. The sound had been a bit startling — who would be calling this early? The voice on the other end of the line belonged to Bobbie Crigler.

Bobbie is Amber’s best friend, and she lives in Alton, Mo., a small southeastern Missouri town with a population that hovers just under 900. After seven years of friendship, the two have become like sisters. Amber could hear the concern in her friend’s voice. Bobbie was experiencing persistent, shooting pains in her lower abdomen, and she wanted to know if that was normal for someone about to enter her third trimester of pregnancy.

Those couldn’t be labor pains already, Amber thought. She calmly gave Bobbie the only advice she could: Get yourself to a doctor.

It’s been hours since she last heard from her friend, and Bobbie isn’t picking up her phone. Surely, Amber thinks, she’ll hear from Bobbie soon.

Amber walks into work at the Southern Missouri Community Health Center in West Plains, a half-hour drive from Alton. Her boss, pediatrician Dr. Garry Finke, is nowhere to be found. “The nurse that was working with him at the time said, ‘He’s off to deliver a premature baby,’ and my heart sank,” Amber says. She knew it had to be Bobbie.

Amber is a mother and a nurse, and in the back of her mind is one thought: A 26-week-old infant would be riding a fine line between life and death from the moment he takes his first breath.

She gets right back into her car and drives to the hospital.

The first person she sees at Ozarks Medical Center is Bobbie’s husband, Scott. He’s a wreck, Amber remembers thinking. He’s worried about the baby. He’s worried about his 11-year-old son, Sawyer. And, in the back of his mind, he’s worried about the hospital bills — for the Criglers, medical insurance is going to be an issue.

Most of all, he’s worried about his wife, Bobbie. Doctors tell him they’ll need to perform an emergency C-section. Amber and Scott stand together in the hallway, waiting, and pray for the best.

Bobbie is going under anesthesia. The doctors start asking, “Is she out? Is she out?” But Bobbie’s thinking, Don’t cut me open! I’m still here! Then everything goes black.

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The doctors go to work. The baby comes out, but he’s not breathing. His heartbeat is still, and no air is flowing in or out of his tiny lungs. Doctors always say that if the baby is screaming, that’s a good sign. It means the baby is responsive and alert. But this baby is silent.

For 30 critical seconds, the doctors work to revive the child. He needs to breathe.

And then he does. Stormy Crigler [1], all 1-pound, 12-ounces of him, takes his first breath in this world. His entire head fits in the palm of the doctor’s hand.

Bobbie comes to, and the doctors deliver two pieces of news:

The good news is, the baby is alive, and breathing. He’s resting, his tiny body practically engulfed by the two saline bags keeping him warm.

The bad news is, West Plains doesn’t have the facilities needed to care for Stormy. The baby boy has to get to a neonatal intensive care unit (NICU). His chances of survival are already slim, but without special care, the odds of Stormy making it get even slimmer.

The nearest NICU is in Springfield, two hours to the northwest at Cox South.

Soon, the Baby Buggie arrives to take the newborn to Cox. The Baby Buggie is a special ambulance specifically for cases like this. It’s used to transport neonatal intensive care unit nursing staff, respiratory therapists and neonatologists to outlying hospitals, where they can care for, stabilize and transport newly born babies in distress back to the NICU at Cox South.

Bobbie can’t make the journey with her newborn son, though. “They brought him to me and let me see him, and then they took him out to Springfield,” Bobbie says. “That was horrible.” She has to rest and recover for at least 48 hours before she will have the energy to make the three-hour trip out to Cox to see Stormy again.

It’s been a chaotic day already. But the chaos of the pregnancy — the journey for Stormy from hospital to home — has only just begun.

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The donor wall at the Ronald McDonald House, showcasing those who've helped fund the House since 1988.
(At top) Donnetta Ghys, right, Ronald McDonald House manager, and Bailey Shaw, associate house manager. (Above) The donor wall at the Ronald McDonald House, showcasing those who’ve helped fund the House since 1988.

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While Bobbie is at home in Alton, Mo., recovering, a group of strangers 150 miles northeast are already putting a support system in place for her. These strangers will soon become her friends, and Springfield’s Ronald McDonald House — the place where these strangers work or volunteer — will become a vital part of her life over the next three months.

Since 1988, the Springfield Ronald McDonald House has provided a home away from home to almost 8,000 families with children, ages ranging from pre-birth through age 21, all of whom are undergoing treatment at a Springfield medical facility. Families with nowhere else to stay during the course of their child’s care can find refuge here.

Located on the appropriately named Medical Mile in Springfield [2], the House is a welcome contrast to the sterile medical facilities that tower around it. The building, with its warm brick exterior and lush green lawn, looks more like a home than a temporary place to crash. More importantly, though, it feels like a true home.

A quaint concrete porch leads you up to the front door. Baskets of purple, pink and white petunias hang gently from the ceiling, while magenta rose bushes and small perennials stare sweetly up from the white railing. By the time you’ve reached the door, you already feel as though you are stepping into a friendly space. Not just a hotel, and not just a shelter.

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For families like the Criglers, locating a place to stay upon arrival Springfield is the last thing they want to worry about. The Criglers can’t afford a hotel room for more than a couple of nights, and they don’t have any friends or relatives living in the area who they can stay with. That’s where the Ronald McDonald House enters the picture.

The 14,000-square-foot building houses 14 cozy bedrooms, a kitchen with a never-empty fridge, a spacious dining area, two living rooms, a playroom, laundry facilities and a large backyard complete with a deck, playground and garden area. Each bedroom has its own private bathroom, always stocked with soap, shampoo, toothpaste and other toiletries.

Donnetta Ghys, the Springfield House’s manager, says the majority of the families that stay at the house have permanent addresses upwards of three hours away — some even further. They have a lot on their minds when they arrive in Springfield, Ghys says.

First and foremost, they are worried about the health of their child. Then there’s the added stress of how to split time between Springfield and lives back home, not to mention the transportation costs for getting there and back. On top of all that are the inevitable expenses of medical bills, always looming in the background.

“Any stress that we can help alleviate is a blessing,” Ghys says. The RMH asks families for $7 per night [3], but no one is ever turned away because of the inability to pay.

There are more than 300 Ronald McDonald Houses in 52 different countries and regions, all working under the principle that “nothing else should matter when a family is focused on healing their child – not where they can afford to stay, where they will get their next meal or where they will lay their head at night to rest.”

Ghys gets a pained look on her face when she’s asked to consider a Springfield without the Ronald McDonald House. Because of the rural geography of southwestern Missouri and northern Arkansas, people from all over the region pour in to Springfield to receive medical care. Without the House, Ghys fears that families would turn to drastic measures to receive care in the city.

“Families would be sleeping on the floors in the hospitals,” Ghys says. “Or they would sleep in their cars.”

The House does not merely give these families a safe, clean place to sleep. It provides each family with its own room, furnished with a cozy bed, plush armchair and dresser. Each room has a large window, soft carpeting and access to a private bathroom. Volunteers also provide a home-cooked meal each night around 6 p.m., and the fridge and pantry are always full for the families’ convenience.

In addition, the RMH provides laundry facilities on each floor — and the detergent to go with them — so families can wash the few outfits they have with them during their stay. In some cases, Ghys says, families check in with only the clothes they have on their backs. “It makes you aware of all the things we take for granted,” Ghys says.

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An exhausted Bobbie and her mother arrive in Springfield at 3 a.m. Saturday, three days after Stormy is born. It’s Feb. 18, 2012. They stay across the street from Cox South at the Cox Plaza Hotel [4] for the night, and the next day, the two move to the Ronald McDonald House. She appreciates the new location. Whenever Bobbie has a request, the House’s staff seems to find a way to accommodate it.

Every Sunday through Wednesday, Bobbie spends most of her waking hours at the hospital with Stormy. On Wednesday nights, Bobbie leaves the hospital at around 10 p.m. and makes the three-hour drive back to Alton to be with Sawyer and Scott for a few days. She rolls into her driveway at around 1 a.m. Thursday and stays until Saturday, at which point she heads back out to Springfield.

And so it goes for the time that was supposed to be the last three months of Bobbie’s pregnancy. “I would cry when I would leave Springfield, and then I would cry when I would leave home,” she says. “But it had to be done.”

Stormy is on a ventilator for less than 24 hours his first night in the NICU at Cox, a surprisingly short duration because of his size. However, he stays in an incubator for more than two months because he is unable to maintain a high enough body temperature on his own. While he is in the incubator, Bobbie is only able to hold her son every three hours — when the doctors are done feeding him through a tube in his mouth.

Once he finishes eating, Bobbie is allowed to change his diaper, take his temperature and clean his mouth out. “And that was every three hours, so you want to be there so you can hold him and see him,” she says. “I would absolutely make sure I was there.”

The rest of the day, when Stormy is resting in the incubator, the only way Crigler can touch him is through a small portal in the glass. He is still so tiny and sensitive that any sort of stroking motion would hurt, “so all you could do was stick your hand in and cup his head or his butt,” she says.

She also reads Stormy a children’s Bible storybook through the hole, whispering to him as he sleeps. Once a month, the hospital gives Stormy a book with his footprints on it for her to read to him.

Once Stormy grows more stable, the Criglers are allowed to practice Kangaroo Care, a technique where the infant is held skin-to-skin on the chest of an adult. Doctors gently place Stormy between Bobbie’s shirt and skin, and as long as he stays warm enough, she can hold him like that for hours.

“They wanted him up against you because he could hear the mother’s heartbeat and voice, and they said that was really good for him,” Bobbie says. “They let my husband do it too.”

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Bobbie, 33, and Scott, 31, have known each other almost all their lives. Both were born and raised in Alton, a small town in Oregon County. The couple still lives in Alton, as do both sides of their family.

Scott owns and runs a sawmill behind their home, and Crigler worked as a caretaker up until well into her second trimester with Stormy. While both have held steady jobs, the couple is uninsured. They don’t qualify for state or federal aid because Scott’s income is too high.

The Criglers are not alone. According to the most recent U.S. Census data, the uninsured rate in the South is the highest in the nation, coming in at 19.1 percent. Nationwide, the uninsured rate for people living outside of metropolitan areas increased from 15.5 percent in 2009 to 16.2 percent in 2010.

The lack of health insurance affects every decision the Criglers make about health care. The morning of Stormy’s birth, Bobbie and Scott first go to the family’s usual doctor at the clinic instead of going straight to the hospital. “If we could avoid an unnecessary hospital bill, we would,” Bobbie says.

But the Criglers are given a lifeline thanks to the state of Missouri. Stormy is considered a special needs child, so he qualifies for insurance paid for by the state. It covers all of his hospital bills, but the insurance is dropped 10 days after the Criglers bring Stormy home.

Insurance isn’t the only issue facing families like the Criglers. In the rural communities that surround the Ozarks, healthcare is not easily accessible. Country roads thin out and populations shrink as the distance between home and Springfield-proper grows. And while there are doctors’ offices and hospitals outside of the city, they are just as small and spread out as the towns they serve.

Their services are also limited. The Springfield medical facilities of CoxHealth and Mercy exercise some of the best medical technology in the nation, and it is not uncommon for people to travel hundreds of miles to receive treatment in Springfield instead of seeking care at hospitals nearer to home.

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Arts and crafts made by families at the Springfield Ronald McDonald House.
Arts and crafts made by families at the Springfield Ronald McDonald House.

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Every night between 6:30 and 7:30 is the shift change at the hospital, which means Crigler can’t be in Stormy’s room. During that time, Crigler returns to the Ronald McDonald House and enjoys a home-cooked meal. Sometimes, that’s the only meal she eats during the day.

At around 10 or 11 each night, Crigler heads back to her room to try and catch some sleep after a long day at the hospital. Oftentimes, she finds small gifts for Stormy waiting for her outside her door. A homemade blanket, a plush stuffed animal, whatever it was, the message was the same: You’re not going through this alone.

“It was really thoughtful, you know, at a time when you’re going through stuff like that, for people to think about you like that,” Crigler says.

According to the Springfield Ronald McDonald House’s April 2012 report, premature birth is the top diagnosis affecting the families who stay at the house. 31 perecent of the families in April 2012 stayed at the house because of a premature baby receiving treatment at a hospital in Springfield.

“They become like family,” Ghys says. “Especially the ones that have premature babies and stay in the House until their regular gestation period is up.”

Bobbie, like many women before her, spends what would have been her last trimester of pregnancy in and out of the hospital and the Ronald McDonald House.

“They always had a place for me. I would just have to call on my way up and they would have something ready,” Crigler says. “If it wasn’t for them, I don’t know what we would have done.”

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It’s now four months after Stormy’s birth — only one month after his May 18, 2012, due date — and the Criglers are adapting to a new life. The whirlwind of time spent in the NICU is over.

But more bad news hit the Crigler family this week. Scott broke his leg and — in yet another twist — came to Springfield to receive medical care.

Luckily for the Criglers, Scott’s sawmill is a family business. His brother will continue to operate the mill until Scott recovers.

But for the moment, both Crigler parents are out of work, making money tighter than ever.

Things are looking better for Stormy, though. Bobbie says Stormy is healthier than ever. He weighs in at 6-pounds, 12-ounces, and he is getting stronger every day. He is still hooked up to a constant flow of oxygen — Amber, the West Plains nurse, says a month’s supply of oxygen costs $500, out-of-pocket. Contact with the outside world is limited to weekly doctor visits, but he is doing exceptionally well, all things considered.

Amber thinks back to how difficult it was to stay optimistic about Stormy’s condition. She says there are no words that can truly describe the journey he has made. “He’s a little fighter,” she says. “He’s a Crigler, that’s for sure.”

After the C-section, doctors discover what had triggered the premature labor. Bobbie had developed a blood clot, causing the placenta to detach from her uterine wall. “It happened so fast for everyone,” Bobbie says. “It’s like a big blur.”

Stormy has once-a-week checkups at the clinic in West Plains, and every other week, Bobbie takes him out to the hospital for blood work. Every six months, Stormy sees a pediatric cardiologist there as well, to monitor a small hole between the top two chambers of his heart [5] The Criglers pay for these weekly, bi-weekly and bi-annual doctor visits out of pocket.

But the bottom line for Bobbie is that her son is healthy and alive.

“It’s really amazing that he’s even here,” she says. “I think God definitely has a purpose for him, or else he wouldn’t be here.”

On this spring afternoon, Bobbie straps Stormy’s car bed [6] securely into the back seat of her car. She loads her baby bag full of diapers, wipes and bottles of breast milk in after it and checks the time. It’s time for another visit to West Plains.

After spending three months confined between four sterile walls, Stormy has finally made it finally home. The rollercoaster ride is over, but his journey is just beginning.