Aug 182010
 

“There are no concerns.”

I stared at the paper, but the words didn’t change.  “There are no concerns.”  There it was, my handwriting in black ink on the medical chart.  In medical language, it means that the patient isn’t sick.  They don’t feel bad.  There is nothing wrong.  Normally that is a good thing.  But this time, as I sat filling out yet another medical form for yet another child entering the emergency foster shelter, I found myself overtaken with emotion.

                                               Anger.  Disgust.  Frustration.  Sadness.  Worry. 

I wrote that there were no concerns.  But that isn’t true.  I have concerns.  I have lots of concerns.  Concerns about these children.  About what they will think about and what they will feel when the lights go out at night and the shelter is quiet.  About where they will live next, and whether the family who takes them in will treat them as their own or merely as transients.  About whether their social worker will get to know them as human beings or just by a case number.  About when they will see their family again, and whether that reunion will be filled with joy or anger or fear. 

We should be concerned.  And may that concern fuel our actions.  May it compel us to get out of our comfortable lives where most of our concern is for ourselves, and to be concerned for someone else for a change.

Mar 252010
 

He was a cute, freckle-faced little kid, not yet 4 feet tall. The foosball champ of the foster shelter, or so he told me. Hmm, we’ll see about that, or so I told him. He gave up video game time for a chance to play against me – even recruited a friend for his team. I scored first, but then they caught up. Back and forth, neck and neck. Until the final goal rolled in. Then a shout of joy!!

By two freckle-faced little kids. Who beat me 4-3.

Time matters – spend yours well today.

Feb 152010
 

Loss is a common part of the human experience. Some days it is closer to us than others, and this week it has been uncomfortably close. Two friends grieving – one over a life fully lived and another barely begun – both abruptly lost.  In the quiet darkness of the early morning, as I think about my friends, my mind drifts where it often does – to foster kids.  Physical death in children is thankfully rare, even among such a high risk group, but I have come to realize that there is more than one way to die. 

She was 15, the eldest of four siblings.  Life had not been kind – her parents had died unexpectedly when she was 12, and after living with a couple of  different relatives, her aunt had reluctantly taken them in.  The basics were provided – food, shelter, education – but there wasn’t much emotional connection, so at such a young age she took on the responsibility of “mothering” her younger siblings. 

I remember the first day I met her – she had just arrived at the shelter and was very upbeat and smiling.  Seemed strange.  When I inquired why she was there, her eyes got more serious.  Her aunt had gone on a trip and left them alone.  She had tried very hard to get her brothers and sister up in the morning, fed, dressed and off to school, then had met them in the afternoon, prepared supper, helped with homework and tucked them in bed.  But they were beginning to run out of food in the house.  She was worried, and asked their neighbor for help – the neighbor provided them some food, but also contacted the authorities and the kids were picked up. 

She was OK with being at the shelter – OK with not having to stress about providing for her siblings.  She was hopeful about the future – she wanted to be a pediatrician and hammered me with lots of questions about college, med school, and what it was like to work with sick children.  It was impossible not to fall in love with her spunk and her hopefulness. 

She came frequently to the clinic while I was there – at first just to hang out and talk, which we both seemed to enjoy.  Then with some minor complaints – an occasional headache or stomachache.  Then more serious ones.  Weight loss.  Sleeplessness. Depression.  Her siblings left the shelter, one by one, each to a relative. 

But no one wanted her.  And her soul died.  Her hope died.  Right in front of me.

We cry when the body dies.  But who cries when the soul dies?  Who cries for foster kids?  Who cries for her?

Feb 022010
 

The door swung open abruptly.  “What are you doing right now?”  I was a chief resident, a young pediatrician who had just completed my own medical training, and was now responsible for administrating the training of other residents.  I was working on the resident schedule at the time.  He stomped impatiently and waved to me.  “Come on, let’s go.”  I followed him, after all, he was going to be my boss in a few weeks.  I had no idea where we were going, and he didn’t offer an explanation.  We got into his Jeep and drove a few miles from the hospital, stopping at a low brick building with no sign.  “This is the foster shelter.  I want you to think about being the doctor here,” he announced.  The shelter?  Come to think of it, I had heard the social workers at the hospital talk about kids from the shelter,  but I had no concept of what it might be like, or why kids would even be there.

We took the tour.  Offices.  Dorm-style bedrooms with 2 plain beds and a small dresser.  A half-court gym that reminded me of my own gradeschool.  A common area with books, games, and a television.  As buildings go, it wasn’t too bad – a little institutional, but not too bad.

Then I saw them – children.  Everywhere. 

Babies.  Toddlers.  Kids.  Teenagers.  Moving in small groups through the halls and rooms, led by direct care staff from lunch to naps, school to free time.  A few days ago they were at home with their families.  Now, because of what their families have done or neglected to do, now they are homeless.  Sure, they have food and shelter.  But this was no home.  There were no homes – no relatives or foster parents waiting to hold them, to comfort them, to encourage them. 

I was horrified.  I didn’t sleep for days.  And I knew without a doubt that I was going to be the shelter doctor.