They are children whose bodies survived drowning but whose brains did not. They are victims of car accidents. Some were just born with the wrong number of chromosomes. One young man was in the wrong place at the wrong time, struck by a stray bullet from a drive-by shooting while walking out of an Oakland movie theater.

There are currently 35 patients at Sub-Acute Saratoga. The youngest is only a few weeks old, while the shooting victim is the oldest at 21.

Some of them may recover. Many may not. However, they all need a level of care that requires a tremendous amount of time and dedication.

For parents of medically fragile children, that level of dedication can be a commitment that rules out a career and limits time spent with other loved ones and friends.

Mike Zarcone has known all his life there are families out there struggling to care for their loved ones with special needs. He knows how they struggle for time, how they struggle emotionally and often how they struggle financially. He learned this growing up with two brothers who are developmentally disabled.

Zarcone had worked as a pharmacist at the Stanford University Medical Center before starting a home IV therapy business. It was while running his business and visiting the homes of families caring for medically fragile loved ones that an idea began to take shape for a place where special-needs children could come to get the high level of care they needed. "Patients needed a bridge between hospital and home," he explains.

"I grew up in that environment," he says. "I saw what my folks went through."

While running his medical business, Zarcone envisioned a facility that could provide the sub-acute care that so many children needed.

The hospital

It might seem like an unlikely place for a hospital. It is located in a residential neighborhood surrounded by nice homes. That means part of Zarcone's job is trying to remain a good neighbor to nearby residents. But the residential location is also part of the hospital's appeal. In fact, some parents chose to move to Saratoga to be closer to the hospital's pediatric day care center, called Scribbles and Giggles, which opened in 1994.

From the outside, the cluster of one-story buildings and modular units appears to be a small school campus. However, inside there is no doubt this is a hospital. Orderlies wheel metal carts down hallways. Nurses walk briskly. A doctor performs his rounds. Children in wheelchairs connected to ventilators and heart monitors play with caregivers in the day room.

It is a hospital, but the blue, yellow, purple and green walls covered with murals of fish, mermaids and butterflies give the place a warm, kid-friendly feel.

"The hospital right now is totally dedicated to pediatrics," Zarcone says. It had been a long-term care convalescent home when Zarcone took it over in 1987. He planned to change it to a sub-acute facility for children, but people had no idea what that was all about. He successfully lobbied to pass legislation that allowed for the establishment of a pediatric sub-acute program for California. He then re-opened the facility in 1989 as Sub-Acute Saratoga.

Intensive care units at hospitals such as Valley Medical Center or El Camino Hospital fight to save the lives of children who are in life and death circumstances. But once a child's condition has stabilized, hospitals come under pressure to free ICU beds for patients needing immediate acute care. Parents can find themselves bringing home a child with a traumatic brain injury, or on a ventilator or a heart monitor. The state and private insurance companies are under pressure to find cost-effective solutions to long-term care for these sub-acute patients.

Tracheostomy and ventilator care, enteral feedings or electrocardiographic monitoring can be a struggle for parents under the best of circumstances, never mind those raising other children or trying to hold down a full-time job.

"When the ICUs are filled, there's no place for the kids to go," Zarcone says. "What we are able to do here is allow kids that are stable, but need a lot of nursing care, to come here and get the care they need."

Zarcone says his facility is attractive to both the state and to insurance companies because it frees hospital beds for acute patients while being more cost-effective than a home nurse.

Sub-Acute Saratoga also provides medically fragile children with educational services and recreational activities, such as barbecues and picnics on the hospital's backyard lawn.

Zarcone's vision for a sub-acute care facility for children has been a reality for almost two decades now. He serves as the president and CEO and has expanded the facilities to include the Children's Recovery Center and Scribbles and Giggles, the first pediatric day health care center in California.

The grandmother

Jaevan Cordia-King turns 5 years old in May. His grandmother, Lynn Cordia, explains how when Jaevan was 15 months old, he fell into a swimming pool while his babysitter was napping. Jaevan was under water for possibly 30 minutes, she says. "He basically drowned."

After being pulled out of the pool, Jaevan was rushed to an emergency room. "Doctors said he had died," Cordia says. "But God sent him back to us."

Cordia recalls that after a week Jaevan's doctors said he would not regain brain function and could not survive without a ventilator. The family was told that they should remove him from his ventilator and let him go.

They made their preparations, and Jaevan's ventilator was removed. "He wasn't supposed to live but he did," Cordia says.

But after seven weeks, the family was asked to take Jaevan home. With his condition stabilized, Jaevan's bed was needed for acute patients.

While at home, Jaevan no longer needed a ventilator but he still had to be fed through a feeding tube. He developed an infection and had to be hospitalized again.

Then on Jan. 1, 2003, a spot opened at Sub-Acute Saratoga. "We took him there," Cordia says. "He gets 24/7 care."

Jaevan's mother, Kimberly, works as a certified nursing assistant at El Camino Hospital. "She couldn't do it all," Cordia explains. "She can come and visit whenever she needs to. Sub-Acute enables her to work."

Cordia says the staff at Sub-Acute Saratoga provides Jaevan with a family atmosphere and with stimulation. "The staff is caring. A lot of these people have become my friends."

Umbilical cord blood from Jaevan's brother was saved in the hope that stem cells in the cord blood might some day be used to provide a cure. Even though the odds are against it, Cordia holds out hope that her grandson may one day pull through.

"They find cures for things all the time," she says. "You've got to have faith."

Cordia visits her grandson every Sunday. She holds his hand, and he squeezes her fingers.

"Things happen, and you have to accept it. You hope for the best and accept what you're given. I believe in miracles. We've had miracles already."

The staff

Paul Quintana, M.D., is the medical director at Sub-Acute Saratoga. He worked as a pediatrician for 30 years before retiring. Then six years ago, Zarcone asked him to come work for him.

"It keeps me active," Quintana says.

Quintana walks from room to room, chatting with each child, switching seamlessly from English to Spanish, throwing high fives and addressing each child by name. He explains the dense medical terminology that designates the diseases and injuries that afflict each of his young patients. He explains the machinery and devices that beep and click as they keep these children alive.

While the explanations and terminology might seem complex, often it was simply an everyday activity, such as crossing the street or going to the beach, that changed the lives of these children and their families forever.

"I think many people don't realize how devastating these injuries are," he said. "When kids emerge and start to make progress, it's what we work for. We win and lose by tiny steps."

Rose Silver, Sub-Acute Saratoga's director of nursing, leads a team of between 50 to 60 full-time and part-time licensed nurses. "Mike has set up a philosophy here of doing whatever it takes to meet the needs of the kids both physically and emotionally," she explains. "We try to touch their souls with love."

Christy Pybrum, the facility's director of respiratory therapy, says providing this level of care is not for everyone. "You have to come here every day and be able to stay in the moment and see the goodness and not only the sadness."

"Sometimes you don't know how much gets in because they don't have an output system," Silver adds. "Our goal is to make each child's life the best it can be with what they have."

In a smaller building next to the main facility, Mary Scates runs a school for the patients at Sub-Acute Saratoga. While it serves the special needs of the facility's patients, the Santa Clara County Office of Education runs the school.

Scates taught special education for 13 years at Rogers Middle School in San Jose before taking over the education program at Sub-Acute Saratoga two years ago. By law, all children in the county must be provided an education, she explains. Before she came to Sub-Acute, the educational services the children here got was often only a bedside visit from a teacher.

"It was a new program being developed," Scates says. "I thought it would be interesting to come over here and meet the needs of students who weren't getting the educational services they needed."

School starts with bedside visits to the less mobile students every weekday at 8:30 a.m. Then Scates and her staff teach pre-school up to high school for the rest of the day, tailoring the lessons for each child. Special computers, toys and games allow the students to communicate to their teachers and classmates and exercise their minds. There is even a room in the back with disco lights and a sound system for school dances.

"We're a one-of-a-kind program," Scates says.

Scribbles and Giggles

While Sub-Acute Saratoga provides specialized care for patients from all over Northern California, Zarcone saw a need for a daycare facility for medically fragile children who had returned home but whose parents still needed assistance.

He started Scribbles and Giggles Pediatric Day Health Care Center to fulfill that need. The children at Scribbles and Giggles are local whose parents live and work in the area. Nurses are on hand from 6:30 a.m. until 6 p.m. Monday through Friday. Parents drop their children off before going to work, knowing that a professional staff will be taking care of them.

Edith Cruickshank, who works for Hewlett-Packard, has been sending her 11-year-old daughter, Amanda, to Scribbles and Giggles for the last 10 years.

Amanda has cerebral palsy. She is non-verbal, confined to a wheelchair and has to be fed through a gastronomy tube. "There are very limited choices for children that are medically fragile," Cruickshank explains. "We knew that we were going to be dropping her off and picking her up every day, so we wanted to be in the vicinity.

"Amanda is bright. You see it when you talk to her. She's very social and has this humungous smile. She loves to be talked to."

Every morning, Cruickshank packs up her three kids and heads out the door. She first drops off Amanda at Scribbles and Giggles before taking her other daughter to Forest Hill Elementary School and her son to Westmont High School.

"Scribbles and Giggles is vital to us," Cruickshank continues. "Without them, I wouldn't be able to work."

Scribbles and Giggles provides one service that Cruickshank says she always takes advantage of. It's called "Date Night." Once a month, parents can drop off their special-needs children, along with their siblings, at Scribbles and Giggles for the evening. Then mom and dad can spend a romantic evening together knowing that all their children are in good hands.

"Having a special-needs child is like having an infant forever," Cruickshank says. "Having a place you can turn to for some help and to get some breaks I think is crucial to our sanity."

Cruickshank sums up what Sub-Acute Saratoga and Scribbles and Giggles mean to her and to parents like her. "It's a saving grace."