When Dominic Gundrum first came to Boston Children’s Hospital late in 2012, his future was very much unknown.
He was born with a large, triangle-shaped gap running from his upper lip through the middle of his nose and forehead, known to the medical community as a Tessier midline facial cleft. His cleft was so large that fluid and tissue from his brain, normally encased in the skull, had seeped outwards, forming a golf ball-sized bubble underneath the skin of his forehead. It’s a condition called an encephalocele, and Dominic’s was so severe doctors weren’t sure how much they would be able to help him.
Dominic Gundrum’s smile is truly special. Or, more accurately, there’s something really special about his smiles. They light up a room, even though they’re the result of a rare and extremely difficult to correct birth defect. Still, despite how atypical they seem at first, Dominic’s giggling smiles are surprisingly disarming.
To have something look so different—but still spread such joy—is truly unique. And, in a way, that uniqueness defines Dominic perfectly.
An uncertain beginning
During a routine 20-week ultrasound in their home state of Wisconsin, Dominic’s parents, Mark and Mary, were excited to find out if they were having a boy or girl. But when doctors looked at Mary’s grainy ultrasound they discovered more than Dominic’s sex. Though it was hard to tell for sure, the ultrasound image showed that Dominic’s skull hadn’t fused together properly early in the pregnancy, leaving a large, triangle-shaped gap running from his upper lip through the middle of his nose and forehead—a condition known in the medical world as a Tessier midline facial cleft.
But the cleft wasn’t the only issue Dominic was facing: some fluid and tissue from his brain, normally encased in the skull, had seeped outwards through the cleft, forming a golf ball-sized bubble underneath the skin of his forehead. (A condition called an encephalocele.)
This September a team from Children’s Hospital Boston went on a medical and educational mission to the war-torn city of Grozny, Chechnya. As representatives of Children’s Global Surgery Program, Children’s Plastic-Surgeon-in-Chief John Meara, MD, DMD, MBA, pediatric anesthesiologist Craig McClain, MD, MPH, nurse anesthetist Nelson Aquino, CRNA, MS and staff nurse II Jay Hartford, RN, BSN, SNI spent a week treating Chechen children and training local doctors to improve their delivery of pediatric perioperative healthcare at the recently constructed Gronzny Children’s Hospital.