FORT WORTH -- Kate McCasland entered this world prematurely, weighing only 1 pound, 7 ounces -- or, as her father says, looking roughly the size of a Barbie doll.
For 114 days, Kate clung to life in the neonatal intensive care unit at Texas Health Harris Methodist Hospital Fort Worth.
"Nobody expected babies that young or that little to survive," said her father, Mark McCasland. "And if they did, they wouldn't be normal or there would be some problems with them. There was quite a while where we just didn't know."
That was 18 years ago and Kate has defied the odds. The young woman, who plans to become a nurse, returned to the hospital Tuesday with her family to celebrate her 18th birthday with some of the medical workers who helped her survive.
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Nurses and doctors sang Happy Birthday before she sliced the cake.
Dr. David Turbeville, a neonatologist, said he has treated "a bunch" of babies during more than 30 years at the hospital but remembers Kate well.
"I remember that she was small and pretty sick," he said. "It is great to see her now."
McCasland's size wasn't the only reason that hospital officials remember the McCaslands, who live in Midlothian. Her mother was among the first to request the chance to provide "Kangaroo Mother Care" to her premature daughter.
The technique involves holding the baby close against a parent's body, providing skin-to-skin contact that can help regulate temperature and heartbeat.
At the time, it wasn't widely used at the hospital. Jane McCasland learned about it while flipping through television channels while her daughter was in intensive care.
"There was a program about how Third World countries did it and they had a higher survival rate than we did," she said. "We started asking the doctors and they said she was too small. Then one night, the nurse said, 'We're going to try this.'"
In a 1995 Star-Telegram story about the technique, McCasland described the value of the skin-to-skin contact.
"They put her in the middle of my chest, and her heart rate went from over 200 down to 165, and she settled right down and went to sleep," she said. "They had to pry her little body off me."
After seeing how the technique benefited Kate, hospital officials encouraged it as regular treatment for premature babies. For years, Kate's picture was on the hospital pamphlet informing parents about the benefits of Kangaroo Mother Care.
Kate McCasland said she has heard the story of her birth and seen the pictures of her parents cradling her small body in the hospital. She and her mother nominated the medical providers at Harris Methodist for a REAL Award from Save the Children. The award honors health workers for their lifesaving efforts.
She has also visited the neonatal intensive care unit and seen the babies struggling to survive.
"I don't say it out loud, but I whisper, 'Come on. You can do it,'" she said. "I just try to give them the positive reinforcement to help them get through the pain."
Alex Branch, 817-390-7689