The more I see foster children in my office, the more my eyes are opened to the ugliness in the world. Compared to them, my childhood was steeped in privilege. I ache for them to know love and security, not to worry who will tuck them in at night, or whether they will be separated from their siblings. I fight hard to hang onto my foster kids once a relationship is established. Having the same health care provider as they grow up can lend an element of safety and stability to their unpredictable lives. Below is one such story, of love and loss.
The State Foster Care director asked I take on a patient who had been
designated the highest care level, known as BRS (Behavioral Rehabilitation
Services). These particular children tend
to have history of heavy trauma and increased adverse childhood experience (ACE)
scores. Being cared for by complete
strangers as they move from home to home brings perpetual uncertainty. Processing life forces these children to work
through pain and adversity most adults do not face in a lifetime.
I will always see a little of this one special girl in every new foster
child who walks through my door. Maleka (Arabic for Queen) was 8 years old when
I first met her. What an odd choice for a
little girl with blonde hair and blue eyes, I thought to myself. Her life story was no different than that of
other BRS foster children. There is
always a primary caregiver who could not cope and was addicted to drugs, followed
by an older relative who stepped in to help.
That individual gets ill, dies, or can no longer manage and yet another
child is thrust into an unfamiliar world.
Each new home is always temporary.
In this particular tale, one home contained adults who were later convicted
on multiple accounts of sexual molestation.
She was a victim as was her half-sibling, who was placed somewhere else
in the state.
What a start in life for this brilliant young mind, huh? By the time she arrived in my office, she was
on 8 heavy medications and carried 6 diagnoses including ADD, Oppositional
Defiance Disorder, Conduct Disorder, PTSD, Reactive Attachment Disorder, and a
Learning Disability. She had been
treated with every major psychiatric medication on the market and then
some. She was on 3 times the maximum dose
of anti-psychotic medication and having daily accidents at school, likely due
to the sedating nature of the medications.
How could she focus on schoolwork, let alone her bodily needs? Common for children shuffled from county to
county, each new physician adds to the regimen; sometimes forgetting to wean
them off of others.
On that first visit, I saw her fear as plain as day. So many people had harmed her, how could it
possibly be any other way? I took a history,
completed an exam skipping uncomfortable parts for now, and decreased the
sedating medication by two-thirds. She
seemed intrigued by this physician who seemed different from the others. Unfortunately, I needed to draw blood and
make sure she still had adequate liver and kidney function which destroyed any
rapport built that day.
I was honest and direct, explaining what needed to be done. “Nope.
Take it or leave it lady.” It took
four of us to hold her down. Her anger
was apparent as she threw punches until she had little fight left. The tears followed as I tried to reassure her
to the best of my ability. “I will never
listen to you,” she hissed. Before
Maleka, when trying to comfort these hurting souls, I mostly felt lost. She helped me find my way.
After she recovered, I said, “Your name is beautiful. Do you know what it means?” She shook her head indicating no. “Would you like to find out?” I asked. She nodded.
“It means Queen in Arabic and I think it means you are pretty special.” She sat straight up and grinned ever so
slightly before leaving.
Over the next two years, she returned many times; I always looked forward to
seeing her on my schedule. She weaned
down to one medication for ADHD. She
tested into the gifted program and lost 30lbs. once she weaned off the mood
stabilizers and sedating anti-psychotics.
She and I fell into a rhythm during her appointments; she always hugged
me tightly on the way out the door. It
was as if she knew our relationship was only meant to be temporary.
Out of nowhere, a long lost relative in a faraway state suddenly popped up
on the radar. The couple wanted to adopt
her and her half-sibling. I was the one
who was terrified now; I cannot imagine how this little girl felt. She was thriving in a wonderful foster home, attending
a school she loved, and had a stable health care situation likely for the first
time in her life. I hated letting her go
to another unknown place. She and her half-sibling were adopted by that couple
and I pray she is thriving. It has been
a decade now and I imagine she will be entering college soon.
While there will always be cruelty in the world, this story is more about
triumph in the face of overwhelming adversity.
With each new foster child I wonder if there will be another who teaches
me so much. To genuinely stand with these
forgotten children between their rocks and hard places is something Maleka
taught me to do. Our time together was
far too short, but thank you darling child for allowing me into your
heart. Wherever you are, I wish you
happiness, health, security, and love.
You deserve everything extraordinary life has to offer.
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