“Thorby had two choices. Be adopted quietly or make a fuss and be adopted anyhow”

 Robert A. Heinlein, Citizen of the Galaxy

The lead social worker on her case at Saint —— facility mentioned that while reading M’s extensive medical records she had to pause often. The trauma described seemed too insurmountable. She was in awe that M had survived at all. And here’s the thing about M: she can be so infuriating, so manipulative, so idiotic, but then on rare occasions you notice the bravery in her eyes, the timorous hope and sometimes the real love she has to offer despite it all and your heart melts.

She’s a pretty girl too, her ugliness is all on the inside. This is a blessing and a curse. Because she looks so “normal” people have a hard time believing that she struggles to understand basic things. She comes to bizarre conclusions. On one exam her atypicality measurements were through the roof. What this means in the real world is that she’s extremely unpredictable because people assume that she will come to normal conclusions about basic things, but this isn’t always the case.

M continued to call us, we continued to visit her weekly. With time M got more comfortable with our family. We wondered what this child was like without medications. We studied different diets, different therapies. For whatever reason we hardly ever discussed removing ourselves from the picture. We felt like even at this distance we were in over our heads but when the team at the facility asked us to join their meetings we were always there on time.

After about two months the county and M started talking about M coming back into our home. I had just attended a meeting at the facility. One of the psychotherapists on staff said that M was doing so well that she would probably be able to leave in six months. Six months in the life of a child is a long time. There was zero talk about adjusting the medications.

Again, an odd thing happened. The regular therapist M met with was the main contact person for me. She noticed that M was showing strong signs of attachment to me and that I seemed to be able to handle M’s behaviors fairly well. She understood that if M was going to have a chance at belonging to a real family the time was running out for her.

Whenever I see one of those commercials on television about teens being adopted out of foster care with big smiles and college graduations, I hope the prospective parents realize that behind those smiles is a hell of a lot of excruciating work. We talk about losing trust in normal situations. Most of these kids have lost A LOT of trust.

Anyway, one day the therapist in conversation slipped out that the director of the program had spotted M playing with the other kids.

“Why is she still here?” he’d asked, because she was doing so well. To keep her any longer risked having her start to imitate worse behaviors.

This comment was never supposed to make it to me. The meeting about M staying six months (to milk Medicaid of every penny) had been a day or two before. I immediately called the county worker.

“Joy” had been on the case for a while now. M’s story was well known in the county, and everyone had a soft spot for M knowing all she had been through. They also knew that M was way past her “sell-by” date in the foster care world. They knew that if they didn’t act quickly M would be institutionalized forever.

Two weeks later M sat beside me, full of nerves and excitement. In the back seat were her meager belongings and a huge bag of medications:

(I list the side effects because there were no positive effects)

Perphazine: Parkinson-like symptoms, akathisia, tardive dyskinesia (tics and tremors possibly permanent), drowsiness, muscular weakness, dry mouth, blurred vision, weight gain, convulsive seizures, hyperactivity, blood clots, fast heart rate and much more

Lithium: Many of the symptoms are similar to the ones above with the added bonus: long term use can lead to hypothyroidism and kidney disease.

Zyprexa: asthenia, dizziness, drowsiness, extrapyramidal reaction, hyperkinetic muscle activity, akinesia, cogwheel rigidity, drug-induced Parkinson’s disease, dyspepsia, mask-like face, and xerostomia. Other side effects include: abnormal gait, back pain, constipation, fever, orthostatic hypotension, weight gain, myoclonus, and personality disorder. 

An important point is that with many of these medications a patient may actually develop the symptoms associated with what the meds are treating for. As M went from doctor to doctor, they perceived many more things wrong with her and treated her for those things!

Benadryl: to counteract some of the side effects and another medication I can’t remember that also worked to lessen the many side effects M was experiencing.

PREVIOUS POSTS IN THIS SERIES HERE