Tuesday, August 30, 2011

Trust and Ugly Truths

When I was growing up, my mom had this maxim that she repeated many a time. She said it just the other day when we were on our way to get her new (rescued) kitty, Ashley. She was talking about congress and the debt and such but she said it, with her usual emphasis.

"I'd rather have an ugly truth than a beautiful lie."

Having lived virtually my entire life in the lap of the luxury of a warm and loving family, never really wanting for much in particular other than things like world peace, an end to hunger and for my kids to stop bickering with their dad at the dinner table, I guess I never really gave it much thought about just how hard it might be to offer up the "ugly truth" to someone I didn't think had a vested interest in caring about me no matter what. Or maybe none of my truths were ugly enough to ever have me worried. Maybe I've led that fortunate a life.


In one of my current GAL cases, in the past year the assigned case manager for the youth has changed five times because of instability with his foster care management agency's staff. His present case manager, a not too competent but seemingly well-meaning young woman, has been on his case since shortly (read just days) before his judicial review in late February, 2011. At that hearing, which was before a citizen's review panel called Foster Care Review, she was like a deer in the headlights. But I was hopeful for this one. She used to play ball. Professionally, I mean. She looks really fit and has some fairly interesting tattoos. She has an edge about her, and I was hopeful that maybe that would be enough to bridge the gap a bit with my young man. But here we are at the end of August and, as she admitted to me at the end of July, at her second semi-annual judicial review for his case, he tells her nothing. She didn't know his sister got her kids back in upstate NY. She didn't know he still calls his deported dad in Suriname on my dime or that I pay half his school lunch money and her agency was picking up the other half because the young man got himself into a swanky magnet program at a school that doesn't provide free school lunches. She didn't know his cousins had been down here for a bit but went back to PA and that one of them had an arrest history for possession that I found in our Criminal Justice Information System. She didn't even know there were cousins because his case dates back to 1994 and even just since 2005 he's been in four different homes, had so many case managers it's dizzying and there are reams of reports in his five part file. He's been in the last home, a fabulous home (like the best foster home other than my home) for the past four years. The foster mom and I are the ones that tell his case manager the stuff that's really going on with him. When I asked this young man, who I've known since February of 2005, why he doesn't talk to her, his answer was brutally honest.

"Why should I? She doesn't know anything about me and she's not going to be around long enough to make it worth my while."

And there, in a nice, articulate nutshell, is the leading problem for children and youth in dependency.

On one of my now closed cases, a gifted 16 year old girl told me she wasn't going to be talking to therapists anymore. Over nine months of the case being in the system she had had three therapists. Her sister, age 13, was in the same boat. But the older young woman, seeing the opportunity to get it out there about what it was like being the oldest of five when your mom was so sick and addicted but really loved her kids and was having trouble taking care of them, really wanted to work with the first therapist. And she did. She talked, she made some progress processing her feelings of both anger and relief at not having to keep it all together anymore after the five kids were removed and their mom was in rehab. But the private agency providing therapy reassigned the therapist after three months, breaking the therapeutic bond abruptly when the therapist showed up and told her she was going to have to do a termination session. (That's where the therapist explains that they can't work with you anymore, why, and wishes you well and hopes you keep seeking treatment with your new therapist.) So the 16 year old started over with a new therapist. She was more guarded, but she tried. A couple of months later, you guessed it. That second therapist quit. She left the agency and then the agency assigned a new therapist. Now the 16 year old had nothing to say. She'd sit in her school's conference room or walk around the block with the therapist barely even speaking or just observing meaningless pleasantries. She had learned not to talk to a therapist. The system of care taught her how. 

This is not, by any stretch, the first time this has happened with one of my GAL kids, either. It happened in the DCF days and it still happens far too frequently in privatized care.

The young man I described above is lucky on the therapy issue, though. He has had, through his foster care management agency, consistency in therapeutic services when he's needed therapy. His therapist is marvelous and would keep in touch with him by cellphone if he needed to touch base. It got him through a rough time when his mom died of HIV. But that is such a rarity in the foster care system. In fact, I'd probably pretty much say it was that therapist being there for him. She went out of her way for him.

Instability and loss of continuity in case management and therapy give rise to serious problems in my experience as a GAL. Not at all surprisingly, youths, especially, become unwilling to trust, to invest feelings and effort, into what is a fundamental therapeutic bond- that with their social worker and/or therapist- if it is continually being broken. Most of the kids in the system, if they've been in the system for any length of time, have been bandied from pillar to post, have seen a revolving door of case managers, therapists, attorneys and in some instances, even judges. I've wondered, more than once, about what this teaches children and youth in longterm care about interpersonal relationships. That they're fleeting and not worth investing a lot of yourself?

I asked my youngest, the one who's adopted, and who's now been in my home for seven years, during which time he's had the same therapist week in, week out, (even as I type this he's still in therapy because of what all happened way back when, for seven whole years, yes, really, and I think it's done him a world of good) what he would do if he had to change therapists and start from scratch all over again.

"I wouldn't. Do that, I mean. I wouldn't do that. Talk to someone else about all that stuff? No. No way."

I think it has to be pretty much typical, really. It worries me for him though, since his therapist is near 70 and not in great health. So much trust and shared information is vested in that therapeutic bond. It's simply irreplaceable.

Further evidence for the idea that it's damaging to have a loss of therapeutic or social worker continuity is that after countless therapists, case managers, targeted case managers, independent living case managers and support coordinators and such, my friend Keyoncé had not told his present case manager (who knew hardly anything about his past, not even that his sister was also their client) that he was making ends meet by engaging in prostitution. She was simply dumbfounded and it took most of my morning and finally several three way calls with a very angry and feeling violated Keyoncé to convince her that this was true. Leaving aside the conflict I feel about having shared his private info with her in order to try to keep him safe and out of the clutches of what I can only view as someone preying on him, I'm left with the lingering, almost plaintive remarks she made to me when he was off the line. She didn't know why he hadn't told her, why he was covering things up, why he didn't tell her about all his traffic charges, the sugar daddy who paid them off, the fact that he wasn't really living with the person he said he was anymore, why he didn't mention the lack of electricity and water there as part of why he left, why, why, why? Keyoncé told he me didn't want anybody else "in his business" and now he's mad that I got him to admit it to her, even though I do think he knows how worried about him I am. But why did he tell me? "You know me. You know all about me. I can tell you that stuff."

Would you tell a veritable stranger your life story for the umpteenth time? What if it was a really sordid and ugly story filled with drugs, prostitution, and things people who are supposed to be helping you might want to judge you for? I mean, really, if you were prostituting yourself, would you talk about it easily to the nice lady you just met who doesn't know a damn thing about you, not even that you have a sister you barely know who is the same agency's client? Would you talk about the things that you had done that got you in trouble? About all your ugly truths? 

Well, whether you or I would is not the point.

Without continuity and stability, they don't.

© Bright Nepenthe, 2011

Monday, August 29, 2011

Happy Returns

Ouroboros Design by Good Winter 

The Ouroboros is a symbol that, as Carl Jung said, has great significance in the human psyche. It originated in Ancient Egypt, in the Books of the Netherworld and the Dead but has found resonance in many cultures from the Greeks and Romans to the Celts to the Vikings. Clearly, the Egyptians had that scoping problem (taking the wide view versus the narrow view) down pat. Ouroboros represents the endless cycle. You know, something starting anew as soon as it is complete? As I begin my fifth decade, I'm seriously thinking of getting this thing tattooed on myself, somewhere I can easily see it, as a reminder of what this reality is all about. Only, I like the one above, rather than the regular Ouroboros, which is just a serpent in a circle. See, the one above is more realistic. It's in knots and it will regenerate or renew in more knots. That's so perfect, isn't it? Not. Sorry. That's almost a pun or something. Let me begin again. Maybe I'm just out of practice...

Last week, in between convincing some family of part of my family, who is now like family to me, that she really needed to high-tail it out of the Bahamas well in advance of Hurricane Irene, and taking my Mom to four hour doctor's appointments starting at 8 am on my birthday, I had to get my driver's license renewed. I had actually tried to get my license renewed two weeks before but fell short of the documentation I needed to do so in my state, my wonderful, wonderful state. Yeah, I had my old license, my passport, my social security card. I had my two copies of two different utility company bills bearing my residential address and my name (because if it wasn't in my name, I'd have to get my husband to certify that I resided at that billing address, of course). Nope, I was missing a certified copy of my marriage license, to prove I was really married. This, in spite of the fact that my driver's license, passport and social security card all bore my hyphenated legal married name. Nope, they needed that certified copy. I had to make a new appointment all over again, and because my license would expire on my birthday, I had to make one at an office way, way down south from me. Like 30 miles away, almost at the other end of the county. Down in [Redacted to Protect the Disaffected], where migrant workers stand by the roadside hoping for the day's backbreaking, pesticide-filled work in sweltering hot fields cooled only by thunderstorms, picking my locally grown organic fruits and vegetables. So a scant 24 hours before my license expired I drove down there, promptly got lost, got misdirected by both Google Maps and a well-intended gas station attendant. I finally got there but not before pulling into the wrong parking lot and when trying to exit the parking lot getting smacked broadside by a young woman who backed, really hard, into my 2006 Prius. Dented two panels of the car- driver's door and left front fender onto the wheel well area. She was promptly hysterical and started imploring me in Spanish not to call the police over the sobbing screams of her toddler in the back seat of her mid-1980's Honda Civic. I waived her off, not wanting to be the cause of her cheerful deportation experience with her possibly or not American-born baby. I just couldn't face the idea of calling the police and worrying about what might happen to her. Besides, I had my appointment for my license to keep.

Inside the license agency I saw the most disaffected public servant I have met in years. When I replied to her "How are you today?" with a simple, "Fine, and how are you?", I got an earful. She replied, "This job is killing me..." and from there told me about her less than $26,000 USD job and trying to manage raising two teenage girls on that salary, that she can't even use her state government-provided health insurance because she can't afford her co-pays, that the Courts won't go after her ex-husband for support effectively because she won't do stuff like apply for Section 8 housing and food stamps because she doesn't want her daughters to think in the future that the government (any- state, federal, whatever) are going to be offering them a helping hand. Why should she have to apply for federal or state aid in order to get enforced what the state decreed in her divorce judgment, she wondered? She talked briskly about the fact that all this documentation ("Why did they tell you that you needed the certified marriage license if your license, passport and social security card are already in your married name?") was needed because it was a money making racket for local government and clerk's offices to make you get all these certified copies of this, that and the other thing and ("Oh, the utilities are still in your maiden name? Gimme that marriage license after all...") that she is so tired of her long hours sitting on her butt, watching people go nuts because they don't have all the newly required documents and that in general she is tired of the entire State of Florida, and its hoodlum governor who costs tax payers dollars defending his arbitrary but obviously unconstitutional decisions on things like not allowing any state organizations to make new rules without His Royal Governorship's permission. She went on about how she knows only one person that voted for him and wondered how on earth he even got into office in the first place and will the recall movement eventually gain traction? All the while, she dutifully and efficiently scanned all my documents, tested my vision, verified my contact lens usage, confirmed I was still an organ donor (does anyone really want these things? Sheesh!) and wham, bam, thank you mam, I had my shiny new license so I could legally take Mom to the hours long appointment in which we learned about the chronic and badass viral syndromes affecting her (our?) immune systems and making them crazy, stupid bad. 

Oh My Quantum Field it's a license and I didn't need my husband's permission to get it!

Seriously, last week was... well if there is a better word-fit than draining or enervating, I hope to find the energy later to look for it. Still, it was made better by sweet friends, and friends of the blog like Uzza

But I got my license, the not quite but sorta family was safe and went back to Vegas, I had a quiet belated birthday dinner on Saturday with my friend who shares my birthday and was finally having my outrage/anger/plot to destroy the world just in order to no longer have to deal with some of my GAL case problems return to mere fury. But then there was yesterday into today.

Yesterday, Keyoncé, whom readers will remember from a previous blog post, turned 21. I had made some progress by contacting his Independent Living Case Manager about his reported problems with his SSI Disability Check and his Medicaid. We got that all worked out, but Keyoncé missed three successive appointments with me to go to the Public Health Department to test for his problem that keeps on giving, which is now in its secondary stage and therefore much harder to explain to him as to its seriousness. He finally didn't answer his phone for two weeks and then he called me late last week saying he'd lost his phone and had to "earn enough money to get a new one". So here he was calling me a few scant days before his 21st birthday and he said he was depressed and didn't want to live. I calmed him down and told him he forgot my birthday and got him all distracted about the hurricane and had he heard from the little girl he called his cousin, who wasn't but who was one of my other GAL kids, and who went back to Jamaica to live with her mom. Then I talked to him yesterday, on his birthday,  and we had this loose plan to meet at Dadeland, a big mall here in Miami, and that I'd give him some money for his birthday and he could buy some clothes. He ended up not being able to do it, for a variety of reasons some of which appeared to involve being very hung over or something. He called me about 20 minutes before he was supposed to meet me and said he hadn't left his North Miami living area, and it's at least a 40 minute ride on a bus and Metrorail from there. So we did it today.

We met in a far less posh location, not too far away from his North Miami "room". There was a flea market and a bunch of low cost shops where he can likely get more clothes for the money. Even a Rainbow in case he wanted to get something girly and shiny. (He does like such finery.) Keyoncé was, in childlike fashion, almost as delighted that I gave him a birthday card with a photo of a polar bear on it as he was with the cash. He hugged me and told me yesterday he just stayed in the house he was living in and felt sad. I don't know if it's true or not but he did seem sad and seemed lonely. He then proceeded to ask me about going to Citrus Health Network to go back on medication (a conversation we have had no less than a million times, I swear it, I do) and would I take him. All I wanted to talk about was his not showing up when I was supposed to take him somewhere, like to that appointment to get him treated for his now likely secondary syphilis infection and omigosh would you PLEASE go with me to the Little Haiti Health Department Clinic tomorrow I beg of you...  and of course, yeah, if you make a morning appointment to go to Citrus to see your psychiatrist, I will attempt, yet again, to take you.

Then came the part of the conversation that blew my mind and left me feeling like I should just come home and lie in fetal position rocking myself, as my head explodes. After talking at the end of last month to Keyoncé's IL Case Manager and getting things all straightened out, he's supposed to start getting his SSI check again on Sept 1. Yay! It's only for about $350 USD, but hey, that's $350 he isn't earning doing 'you know what' while potentially spreading 'you know what'! I asked him where he's going to cash it, or deposit it (been through two checking accounts now and can't do the balancing if he tried, what with the limited reading and paucity of math he can do...). 

Quoth Keyoncé, "The lady is my payee."

"What Lady?" I ask, worriedly.

"The lady who lets me stay in her house."

"What do you get for giving her that money?"

"What do you mean?"

"Well, the room and what else? Does she give you food?"


"So it's just for rent for the room?"

"No, she uses it to pay for my hotel room."

[Marzie does double take thinking to herself, no, no, NO, NO]

"Um, your hotel room where you see your johns?"

He looks away and says shyly,

"Yeah, at the [Redacted] on Biscayne Boulevard."

"Keyoncé, is she prostituting you?" I gasp.

"What that mean?"

"If you do something with a john, do you have to give her some of the money?"

"Well, I'm staying in her house."

"So she's a pimp?"

"No, she sells marijauna and that stuff like Mrs. Reed did. You know, those rock things. Crack. She sells that stuff. She was a friend of Mrs. Reed's."

Well SHIT! Say I, internally, having long thought these past 6 years that about the only reason I can think of that it would be a good thing if there really was a hell was that surely I could beat the heck out of Mrs. Reed in it, when I land there for not believing in anything other than a quantum field filled with a happy little sea of swirling quarks and gluons. (You remember I'm damned right? I'm a damned non-believer.)

"She's a friend of Mrs. Reed's? Why did you make a friend of Mrs. Reed's your payee on your SSI check?"

"She let me stay in my room."

And there you have it.

Your writer has successfully restored $350+ USD a month to a pimp and drug dealer payee of a mentally disabled aged-out foster youth who is making his primary living as a cross-dressing prostitute and who also, btw, has untreated secondary syphilis. [curtsies]

Keyoncé asked me if I could be his payee instead when he heard about how things work for Marina and Stacy (Stacy is my other aged out youth of whom I'm becoming permanent legal guardian).

"You might need to leave that lady's house if you do that Keyoncé," I said. "And really, I think you need to go back to being in an Agency for Persons with Disabilities home. You can't live with that lady. She's a drug dealer! What if the house is raided? Remember what happened to you at Mrs. Reed's house when they raided it? It was really scary and they put a gun to your head?"

"If I went to an APD home, would they let me have my own room and go out at night whenever I wanted? I didn't like those other homes. They wouldn't let me go out when I needed to. But I'd trust you to keep my money. Maybe I could just work more and the lady would let me stay, and then you could give me all my Disability money and I could buy stuff?"

Sigh. Crack. Ugh! goes my heart yet again.

Fix a problem, Look! It's a problem!!!

I just love my State. Love it! We have prepared this foster youth for his aging out and have protected him from his disabilities so very, very well.*

Anybody know a good tattoo artist in Miami?

*Might I mention that at several points in time that the State of Florida placed Keyoncé in the lovely Mrs. Reed's custody? After doing homestudies!!!!! 

© Bright Nepenthe, 2011

Tuesday, August 2, 2011

A Special Kind of Hell

If there is a hell, there must be a special one for the members of the Shabab Islamist insurgency, who are keeping people, keeping children, like the one above, from fleeing Southern Somalia or receiving aid outside the Shabab territory. That's terrorism, in that picture. Just the slow motion kind. From the Times:

"People from those areas who were interviewed in Mogadishu say Shabab fighters are blocking rivers to steal water from impoverished villagers and divert it to commercial farmers who pay them taxes. The Shabab are intercepting displaced people who are trying to reach Mogadishu and forcing them to stay in a Shabab-run camp about 25 miles outside the city. The camp now holds several thousand people and receives only a trickle of food...
A few years ago, the Shabab began banning immunizations, deeming them a Western plot to kill Somali children. Now countless unvaccinated children are dying from measles and cholera as tens of thousands of malnourished, immunity-suppressed people flee the drought areas and pack into filthy, crowded camps."

Shabab leaders counter the claims of locals who've escaped and NGO/aid organizations: the people in the internment camps are attracted to them! Because of “this sense of serenity and security.” Yeah, right. Sure they are. They're attracted to your guns and violence, too, I bet.

Somehow, seeing this article at lunch distracted me from the possibility of the US credit rating dipping to AA or from the truly miraculous recovery of Gabrielle Giffords. It totally distracted me from eating, too.

“This is worse than 1992,” said Dr. Lul Mohamed, Banadir’s head of pediatrics, referring to Somalia’s last famine. “Back then, at least we had some help.” ~ from the New York Times

Giving lie to the phrase 'the more things change, the more they stay the same...', as my stepmom and I were noting just yesterday, the world is getting to be an even uglier place.

How can half a million children be on the brink of starvation in one small country

I was looking at the total population as of 2010 on Wikipedia. The irony of the Somali national anthem is simply breathtaking. Could serve the whole world, with equal irony, of course.

I don't know when I'm ever going to get that image of that poor child above out of my head.

Maybe I shouldn't?

© Bright Nepenthe, 2011