THE future of America's cities is lying in isolettes in the neonatal intensive care unit of Bronx-Lebanon hospital.
The bright room is filled with baby misery: babies born months too soon; babies born weighing little more than a hardcover book; babies that look like wizened old men in the last stages of a terminal illness, wrinkled skin clinging to chicken bones; babies who do not cry because their mouths and noses are full of tubes.
Some of these babies' mothers are never coming back. The little boy born in June, the one who has had two operations, two major infections, and who has the enormous head and shrunken limbs of famine children, has had no contact with his mother since the cord was cut.
A little girl is the second child born this year to one woman. Both infants weighed less than two pounds at birth. The first is in a foster home, which is probably a great blessing.
Dr. Ja J. Yoon is head of this department, and the last time we met, seven years ago, she had 24 beds. Soon she will have 40, a meaningless figure since right now her staff is tending 46 babies.
Like school chums we reminisce about the good old days, when the smallest babies were two pounds, when fetal alcohol syndrome and infant heroin addiction seemed the worst cases. Two percent of the babies went from the hospital directly to a foster home.
The figure now is 15 percent.
The reason is crack.
On Nov. 29, 1985 -- only five years ago -- the New York Times ran a story that began: "A new form of cocaine is for sale on the streets of New York, alarming law-enforcement officials and rehabilitation experts because of its tendency to accelerate abuse of the drug, particularly among adolescents. The substance, known as crack, is already processed into the purified form that enables cocaine users to smoke, or free-base, the powerful stimulant of the central nervous system."
In Yoon's hospital, 500 mothers giving birth last year identified themselves as drug users. Urinalysis tests showed that the number was really twice that. Nearly all used crack, and virtually all were black or Hispanic.
Multiply this story and you have an enormous population of minority children positioned south of the starting line before birth.
Only time will tell how bad the damage is. There are those who believe that with proper care and education, children born to crack users can develop as other children do.
Some foster parents say sadly that this is public relations, designed to find more foster homes. They say that their children are hyperactive, aggressive and have difficulty learning even the simplest things.
"I don't imagine he'll ever be like other kids," one woman says of her 4-year-old.
Yoon applied to the federal government for a grant to study her babies as they grew, but she was turned down. She has a proposal to set up group homes for pregnant crack addicts who could kick drugs, eat properly and learn parenting skills all at the same time.
"I work in the South Bronx, and we feel very lonely," she told a congressional committee. One official suggested this was a regional problem, which is how officials sometimes describe an epidemic that largely affects poor people of color.
The crack babies of 1985 are entering kindergarten. The kindergarteners of 1995 are in Yoon's nursery. The crack babies she sees are three times more likely to have physical abnormalities than the babies of mothers who did not use the drug.
Fifteen percent of her patients are HIV positive, probably because their mothers bought crack by selling sex to someone carrying the AIDS virus.
The other problems are harder to quantify. I am staring deep into the eyes of one baby, having some quiet meeting of the minds, when I idly scratch my chin. The baby jumps in his isolette at the motion, begins to shake uncontrollably, wails an unearthly falsetto wail.
"They don't like it if you move too much, these babies," says a nurse. "Some of them don't like it if you hold them, either." A baby who does not like to be held. It is like hearing that the world is flat.
The best thing about a hospital nursery is looking at the future, wrapped in flannel. It is hard to contemplate here. "Each month it gets worse," said Yoon. "We are a disaster area." And as if on cue that horrible hopeless cry begins again.