Ryan James-

There's not a lot I remember before other than being their one and only. I won't lie to you, I was neither overly ecstatic nor deeply dreading the idea of having a little brother. I'm pretty sure mom and dad talked the whole thing up, convincing me of how special it was to claim the role of as an older sister. I was just looking forward to having someone else to play with besides my stuffed bunny, really.

You hadn't arrived yet, when they found something wasn't quite right. Mom had about four months to go, before she became a mom for the second time, and before all of our world's changed forever. Those months flew by, and on a sunny Wednesday in September, there you were.

Dad always describes how healthy you looked; how the nurses went on and on about how pink, chunky, and perfect you were. No one could even tell you were so sick. And there you were; five days old, having your chest opened up to fix your beautiful, structurally flawed heart.

A congenital heart defect called 'Double Outlet Right Ventricle,' is what they spent four separate open-heart surgeries working to correct. St. Louis Children's Hospital was our second home for your first couple of years. I highly doubt we'll ever be able to erase that hospital smell, or the beeping of machines from our minds, but that was something we could deal with, the possibility of losing you, was not.

Time passed, as did a few more surgeries and procedures. After having your chest cracked open more times than anyone would ever want, your doctors discovered a neuroblastoma tumor on your adrenal gland. Resection was a total success, but during tests to see if you had cancer elsewhere, you slipped into cardiac arrest for a full nine minutes. After doctors pounded on your already fragile chest, you came through. And there you were; alive.

Whenever you were able to come home, and hospital stays became less frequent, I felt like things were falling into place. I remember holding you in your green cushioned rocking chair, finally getting to use it. And there you were; so happy, even with that gnarly zipper scar down your chest and oxygen tubes in your nose, I was equally in love and grossed out by you, little brother.

The years have zoomed by quicker than any of us have wanted them to, and you've experienced more scares, more procedures, and more hospitals stays that we anticipated. Tacking onto the CHD, seizures began (having your first one right next to me, thanks for that), dietary issues arose, as well as the congestive heart failure that almost killed you during the summer of 2016. But through all of that, here you are.

I am quite aware that you, my almost 22-year-old, not so little, little brother is well versed in his own medical history, but I'm also aware that it has caused a lot of difficult times and questions, particularly leading with the one, "Why me?"

I wanted to write this to remind you that it's okay to wonder why life dealt you such a crap couple of hands. I wanted to tell you, if I haven't a million and five times already, how I proud I am of you for conquering the hell out of everything that has literally been catapulted your way. I wanted to remind you that even through all of those trying times, you were able to experience some seriously amazing moments; becoming the St. Louis Children's Miracle Network Ambassador, throwing out the first pitch at a Cardinals game, and becoming a camp counselor at Camp Rhythm, where you assisted kids who were born just like you.

You can look back on those times, where you were, during the good, the bad, and the really bad, but always do it with purpose. Remember the strength it took to make it from then to right now, because here you are, still, and that is something truly extraordinary.