They grew up together in a small Mississippi town and met in high school, where they flirted with each other in physics class until he finally summoned enough courage to ask for her telephone number.
He was on the football team. She played in the band. Their romance survived the drama that is the connective tissue of most teenage love stories. When college came, they were still together. And soon, in 2011, they were husband and wife.
Tishana and Quantrel Alford are church-going, God-fearing Baptists and their faith was tested early when they lost a set of twins — Kaitlyn and Connor — five months into her pregnancy. Stillborn in January 2014.
“After that, we focused on school,’’ Tishana, 28, told me. “We won’t worry about having little ones. And then, two years later, here comes Zoey.’’
The news of Tishana’s pregnancy with Zoey was electrifying. And terrifying.
It would eventually land them in Boston, a medical mecca they knew only as a place on a map, as a land where miracles occur. They would come to see it as a destination for salvation.
“This new pregnancy put me back in those same shoes that we were in two or three years before,’’ Quantrel, 27, explained. “You’re excited, of course, but more nervous than excited. But we had another chance to have a child.’’
A trip to their local doctor for an ultrasound — an image they hoped would announce the sex of their new baby — would, instead, provide more heartache: The fetus’s head was misshapen.
A specialist in Tupelo then delivered a prenatal body blow.
“Well, my job is not to give you a pot of gold at the end of the rainbow,’’ Tishana said, recalling doctor’s words that no mother could forget. “My job is to give you the facts. And the facts are your baby is not going to survive past seven months in the womb. So you guys have an option: You can go and schedule [an abortion] today or you can just wait to see if she passes on her own.’’
“And I was like: ‘Those are the only options we’ve got?’ ’’
No, they weren’t. First there was prayer. Then there was hope.
“We’re not going to play God,’’ Quantrel said. “That’s not our decision. If she’s not supposed to be here, then we’ll let Him make that call.’’
The couple were in church every Sunday. Most weekday evenings there were soul-searching discussions.
“What do we do now?” Tishana said, recalling her conversation with Quantrel. “Do we be selfish? Because the way they described it if we keep her, she’s not going to be normal. She’s never going to walk. She’s never going to talk. She’s probably going to have to have special feeding tubes put in. And she’ll be wheelchair bound.
“That’s what we were given. And that most cases terminate. So the discussion was: Well, do we bring her into the world, knowing that she’s not going to have a life? Or do we give her a fighting chance. And, ultimately, we came up with giving her a fighting chance.’’
Zoey Grace Alford was born on April 20, 2015, in Memphis, a full-term baby who weighed 6 pounds, 13 ounces and melted the heart of her parents.
Her father cried. Her mother wrapped the baby girl in her arms.
“I hear her cry and — oh my gosh — I thought: I just had a little girl! My mother instinct was to protect her. I was like, ‘OK. This is mine. Everybody get away, get away. I have to protect this little baby.’ And I’m like, ‘I’m your momma. Here I am finally. That’s me, the one who’s been singing to you.’ I was going to protect her. This is my cherished possession.’’
The doctors were wrong. Zoey would live. She would walk and talk. She would learn her ABCs and her colors and develop a personality that her mother says has made her somewhat of a childhood “diva.’’
She also had a frontal encephalocele, a rare defect. The tissue covering the brain and some of the brain itself protruded from openings in the skull. There were other craniofacial defects. Zoey had a cleft lip and a cleft palate. The left side of her nose never formed properly. Her eyes were spread too far apart.
The little girl developed an outsized love of everything Disney. She can sing and dance. But outside playtime required a special helmet to protect a vulnerable brain. And it sometimes brought heartache.
A young boy at a Walmart once pointed at Zoey and yelled to his mother: “Mom! Look at that baby! She’s ugly! That baby doesn’t have a nose! It’s a monster!’’
When she was just 1 and wrapped in Tishana’s arms, Zoey reached out and touched her mother’s nose. Then she looked in the mirror and touched her own. Even the baby knew something was wrong.
“I cried,’’ Tishana said. “And I said, ‘When she gets to be 3 or 4, and she says, “Momma, I’m different.’’ What do I tell her?’ I just tell her she’s loved and she’s beautiful. She hasn’t asked that question yet, thank God. And by the time she realizes, she’ll be fixed.’’
As their family prayed, Tishana and Quantrel searched for the best treatment. A nearby hospital laid out a medical plan that called for nine to 13 sequential surgeries.
“I’m like, ‘No, that isn’t going to work,’ ’’ Tishana said.
Their research led them to Boston Children’s Hospital. The craniofacial program at Children’s has pioneered the use of 3-D-printed models to help prepare doctors for complex surgery. A quick online search led the Alfords to two of Children’s world-class surgeons: Mark R. Proctor, neurosurgeon in chief, and John G. Meara, plastic surgeon in chief.
“In May of this year, we came with our million and one questions and Dr. Proctor and Dr. Meara took their time and answered every single one of those questions,’’ Tishana said. “And we’re like: ‘It’s a go.’ ’’
Traffic on Longwood Avenue outside Boston Children’s Hospital, normally the vehicular equivalent of dodge-’em cars, looked a little like rural Mississippi just after sunrise last Tuesday morning as Zoey Alford arrived for the daylong surgery that could change her life.
As the anesthesiology team moved in, Zoey dozed in her father’s arms. She wore yellow-and-white pajamas stenciled with these words: “Tired little tiger.’’ And she was. As her IV line was inserted, she scarcely budged.
And then Drs. Proctor and Meara, supported by a team of medical specialists including anesthesiologist Dr. Susan M. Goobie and an all-star team of nurses, went to work.
Zoey’s eyes were sutured shut to keep them safe. The initial incision was made atop her skull, a cut from ear to ear. Her forehead was folded down.
“There’s no bone separating the brain and the skin the way there normally would be,’’ Proctor explained to me earlier. “So we need to take down the scalp very slowly and carefully.’’
Over the course of 10 hours, Zoey’s forehead was rebuilt. The orbits of her eyes were realigned — moved some 10 millimeters or so. Bones were removed and pieced back together. Spinal fluid leaks were plugged.
A cleft lip was made whole as doctors used a bit of fat from her nose to give her lip more plumpness.
The opening in her face — the deformation that drew screams from that little boy at Walmart — was repaired, work that will probably require fine-tuning at some point.
As doctors operated, Zoey’s large extended family held vigil in a waiting room. They told stories about sweet tea and cornbread, about soaring Sunday sermons, and close-knit neighborhoods where people still look out for one another.
Cellphones were checked. Well wishes poured in. “Mr. Jack,’’ Zoey’s bus driver, sent prayers. Her preschool teacher asked for updates.
Her grandmothers sat next to each other for support.
“We have to trust in God and that’s what I have to do,’’ said Doris Smith, Zoey’s maternal grandmother.
“He’s the creator of all things,’’ Ann Alford, Zoey’s paternal grandmother, agreed. “So that’s what we have to trust in. The main thing is: She’s going to be fixed.’’
That type of spirituality comes naturally to Zoey’s family.
Her grandfather is Ronnie Smith, pastor of the First Baptist Church in Pheba, Miss., where he leads a congregation of about 40 every Sunday in song and prayer.
The Rev. Smith said he has beseeched the heavens on behalf of his granddaughter. And, he said, those prayers have been answered. God has sent him a vision of Zoey, her face repaired, her future bright.
“He already showed me that it was going to come to pass,’’ the pastor told me. “So, yes, I already can see her sitting in the front pew of the church healed. I know it’s going to happen.’’
And, presently, it did.
In the early evening, the surgeons addressed the family assembled in a small side room. The operation was rare. The degree of difficulty was high. The news was good.
“I think we made out great,’’ Proctor said. “Everything went as we were hoping. We do take care of a lot of routine stuff here and we get good at it. What we’re particularly good at here is taking care of rare and complex things because we’re privileged enough to get patients coming with those things.’’
Meara said he had been visualizing Zoey’s surgery in his mind for months. There were plenty of things to worry about.
“But it went very, very well,’’ he said. “We had no problems in the operating room. We got the forehead reconstructed, the orbits moved, the lip put back together. Is the nose perfect? As I said, there isn’t enough cartilage in there. There’s a little elevation on one part of the nose, but this area is closed. It was extremely successful.’’
Meara handed me his cellphone and asked for a group photo with a grateful family. He stuck out his hand to Tishana Alford, who was having none of it. She’s a big hugger. And if there were ever a time for a hug, this was it.
By Thursday, Zoey was swollen, but healing — her mother a constant presence by her side after a surgery partially paid for by insurance and partially by contributors to a GoFundMe page established by the family.
“Zoey’s just had life-changing surgery,’’ Tishana told me. “From this point on, she’s going to have the opportunity to just be a normal baby. I’m excited to see where she’s going to go in the future now. I feel the sky’s the limit. And I’m so thankful to Dr. Meara and Dr. Proctor because I feel like they have been her life savers. They just changed my baby’s life forever.’’
Then Tishana Alford collected her things and headed for an elevator to see the little girl in the tiger pajamas.
The little girl who doctors once predicted would not survive.
The 3-year-old who now looks at life through born again eyes.