Great Foster Mom
Alison Holmes, MD, MPH, pediatric hospitalist, Concord Hospital, Concord, N.H., and assistant professor of Community and Family Medicine, Dartmouth Medical School, contributed two stories.
When I was a resident, there was one chronically ill baby who was born at 34 weeks and had significant cyanotic heart disease. He would need a number of high-risk cardiac surgeries, and he also had a portion of his small intestine removed for necrotizing enterocolitis [caused by] his prematurity. After that it can be hard to absorb [nutrients] and grow. The baby had a lot of trouble with diarrhea and dehydration. We put him on the GI service, and the fluid overload from rehydration caused him to go into heart failure, and nobody could ever get the balance right.
He’d go back and forth between the GI service and the cardiology service. All the residents knew him, and he was in a horrible social situation. His mother was a drug user, and after his birth she never visited; we didn’t know anything about the father. The baby was this high-risk infant who basically had laid in the hospital with the TV on for the first five months of his life. Nobody paid attention to him, and I remember thinking, “This is horrible. He’s not going to get any love or nurturing. He’s not going to be normal, because nobody picks him up and holds him and talks to him.”
He was discharged into foster care, and I became his primary doctor. He just had the greatest foster mother in the world. She didn’t care that he had these medical problems; she was so glad to have a baby. She had been a foster parent for a while and had cared for troubled older children and had had enough of that, and she had her own 11-year-old. She was so thrilled to have this baby, and she just loved him and loved him and loved him.
I watched over the next year as he regained normal development despite all his early setbacks—both medical and social. Eventually his father did get involved; he went back into the father’s care, and the father rallied his whole family. The foster mother stays in touch with the family and is the child’s godmother.
By the time I finished residency, he was about three and a half years old, had been through three major cardiac surgeries, and was completely developmentally normal. I’ll never forget that no matter what we do medically, it’s people like that foster mother who make a difference for children.
Doing Wonders
I cared for a growth-retarded baby whose mother was in her late 30s. She was a drug user, and she had lost custody of her three prior children. Here she was with a fourth child, without any supports. She had used cocaine until about the fifth month of her pregnancy, when she decided to get some help.
I thought, “What are this baby’s chances?” But [the mom] did it. She did not go back to using drugs. She stayed clean and reconciled with the father. Life wasn’t always so kind to her. She couldn’t always hold down the same job, but at least she always had a job. She did wonders for this little girl, and she was able to turn her own life around.