Three-year-old D is a vivacious small child who smiles and giggles freely. Her abdomen is criss-crossed with scars, the result of neonatal surgery for necrotizing enterocolitis for which she had surgical resection of some of her bowel. This was followed by the fashioning of an ileostomy that was closed at two years of age. There is also a scar over her left axilla, which followed a thoracotomy and the closing of a patent ductus arteriosus that had caused heart failure during the early neonatal period. She is the elder of twins, born at an uncertain gestation of 25 weeks weighing 810gs. Both babies were resuscitated at birth, but one twin died on day of life 4. Baby D received prolonged ventilation, required tracheostomy, and was discharged home on a ventilator after many months in the hospital. The daily nursing assistance the family received in their apartment was discontinued following the weaning of ventilation when the baby was aged 15 months. Her early years are remarkable for frequent visits to different specialists in the hospital who have monitored and managed her neurological development, pulmonary status, eyes, and gastrointestinal function. Her family, who have limited economic resources, have undergone the most challenging of economic and emotional strains, and although they have faced the challenges most often with determined stoicism and love, there has often been anguish. However, D has conducted her only known life with the full gamut of emotional sparkle and oppositional irritation that would be expected from any able-bodied child.