Tuesday, September 29, 2015
The Things That Keep Me Up At Night...
Thursday, September 24, 2015
Boundaries and Balance
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| Artist Unknown but boy does it capture the feeling of a balanced heart... |
So you know, in the last few months, I have had all kinds of challenge to my intention to do good and stay sane and unfatigued, compassion-wise.
There was the foster parent who told me that she was disappointed that I didn't get the foster youth placed with her and didn't try hard enough, when the youth and her placement agency wanted to place her elsewhere, and oh, by the way, I was trying to stay in touch while my terminally ill mother was getting her PET scan only she didn't because she didn't adhere to the instructions and I was trying to reschedule it. My bad for not picking up the phone. Yeah, that one really sticks in my craw. Personality disordered much?
There are the group or EFC (Extended Foster Care) home providers who seem to think I am a taxi service and that I'm failing in my transportation duties. (Let's just forget all commitments to other youth and to my own family, because, hey, let's just.)
There's the group home provider that won't even give you the courtesy of a hello or eye contact, because your GAL youth is a difficult youth. Hey, you're right. It's all my fault. I just love it when you won't reply to a text message or only call me to rant.
There is the judiciary, kind of forgetting they're talking in front of a person's 12, 15 and 16 year olds about how terrible their parent (who still has custody for 2 of 3) is and how long their criminal history (back before 1990) is. Kids just love to hear their parents called bad apples. Love. It.
There are all the bashing emails. The ones where you reply trying to point out all the good things the case manager did. The ones where the one thing that went wrong today is all everyone's fault, evidently. Every. One's.
There are the aged out teenage kids, who sometimes resemble leeches until you realize that you are the only one that picks up the phone call. That helps them move from one placement to another. The only one that will give them the money for the spontaneous GED test or the daycare they need for their child if they have any hope of getting that GED. And maybe they aren't leeches as much as desperate, because for sure they are not getting that from anyone else in the system.
There's the fact that I haven't had time to see my mom this week. Not since Sunday. Wow is that messed up.
How do we maintain the boundaries that keep people from draining us dry, and still have heart enough to truly care?
A tough one, this question.
© Bright Nepenthe, 2015
Sunday, August 30, 2015
Palate Cleanser La Petite Comtesse Version
Un cadeau de La Petite Comtesse, la Fée Fuchsia, m'a envoyé hier. Qu'est-ce que une fille douce, non?
Source Unknown, but looks a lot like the Apple Dahlia.
I'm really hoping that this next week is an improvement over the past week, which we just won't review, for the sake of sanity. Pretty flowers are a fine start. As was the 10 hour night's sleep.
Saturday, August 29, 2015
Between a Rock and a Hard Place
This brief post is about what it's like to be a case manager. It is a pastiche of actual comments from some of the truly wonderful case managers I've known. And I've known more good ones than bad ones.
"I feel horrible. I'm taking care of everybody else's neglected children and feel like I'm neglecting my own children."
"One day I came home from work, like usual, after 8 pm, and my daughter asked me why she never saw me anymore, why I never went to any of her extracurriculars. I had to quit doing case management. I couldn't bear it."
"So I do all this work, get a master's degree, hardly sleep, really care about each and every child in my case load, spend my own money buying them things my agency won't, and then this judge, who thinks that parents can do no wrong and practically own those kids, sends them home to get beaten with a belt? I have to get out of here. Maybe I can go into medical social work or something. I just can't stand this anymore."
"I missed his first words, his first steps, his first morning at pre-K. I can't miss any more."
"You're on your own out there. Your supervisor won't raise a finger to help and will only tell you what you did wrong. Your administrator's door is always closed. I'm up there facing a judge and there's nobody that has my back."
"At my agency they have all these layers. I'm supposed to have someone else do all the referrals for me. But if they don't get made or services don't get started, it's my fault, and you can bet I'm going to get blamed for it. But, if I do them myself, then I'm accused of not following their structure, and of being inefficient with my time. I just can't win."
"Overwhelmed? I was overwhelmed last year. This year, I'm almost drowned. I don't know where I can go. This is the third agency I tried. This system is broken, and while I want to try to keep these kids safe, no one's really helping me do it. Some judges give them right back and others don't want to even give their parents a chance. Staffing after staffing of what I'm supposed to be doing that I haven't done yet for this case or that. No money to do it with, all these insurance snags or limitations, no way to do anything nice for these kids, foster parents that you don't like, and program managers talking about money, money, money. I don't want to quit caring about these kids, but I have to get out of here, or I will. I am almost too tired to care about myself."
"I feel so terrible about leaving her case, because she has such abandonment issues. But my whole unit was reassigned. I just don't know why they do this. I'm so sorry. If I give you my personal cell number, you could call me with her, when you visit. I don't want her to feel like I just disappeared and forgot about her, like her family did."
Friday, August 21, 2015
A Little Shop of Horrors
from Wikimedia Commons
So on Monday, I'm going to be 54, and the following Tuesday, Mom will be a frail 77. I have contemplated our age difference a lot recently, thinking about how unformed I was at 23, how wounded at 24, and then reflecting on how my Mom had me, at barely 23. I was, to say the least, a challenging child. I can't imagine. Especially, I can't imagine my Mom and my Dad and how they ever managed the quantum entanglement that resulted in a hurtful marriage and me. I can kind of understand, knowing both of them, what led my mom afoul when I was 3 (hey, long before post-partum depression was understood, and regular depression is still such a taboo... A failure of will, what a lack of discipline, pull yourself up by your bootstraps and just get on with it, no matter how many times you get knocked down!) and how my parents circled one another like a they were like bowling balls, or twin stars, on a gravitational track into a black hole. Swish, swish as they swirl around each other, both to be extinguished, crushed and then, the quanta exit to form new worlds.
Wow, that got side-tracked... So anyway, after years of diffident and sometimes hostile-avoidant interaction, here I am worried about my Mom. The same Mom I overtly blamed, in a sadly seen by her diary, at age 16, for the ruination of my "family" (not that it had been all that awesome, mind you) by her refusal to try anti-depressants, and for her lack of "participation" in my life. (Yeah, that thing about not showing up at all for anything in school still burns. Award ceremonies (senior year got 5, but friend's parents were the one's clapping for me). Parent Night (I was a guide, showing everyone's parents around but mine), College graduation (all she cared about was that Phi Beta Kappa pin but she didn't go to the ceremony, even for that...), So yeah, she watches Fox News now (incessantly and thinks Bill O'Reilly is awesome and that Bobby Jindal is soooo smart) and I watch BBC and Al Jazeera. Oil and water, my mom and me, the mostly my father's active, go-getter child, on a social justice crusade because, hey, ya gotta do more than fill your time gardening. (Oops, I do garden, come to think of it...) And yet, she influenced who I am, my intellectual curiosity, my interest in music, art, literature, more than my Dad ever did. My dad was never around much and then he left. Such common wounds, these. Yet bridged, or bandaged, by urgency, by foreseeing a future with so little time.
About 5 years ago, my mom lost 30 pounds. It seemed gradual, but one day, as leaving after a visit, I hugged her and I realized that there was just too little of her to be right. Enter the aggressive pursuit of fixing my Mom. After a 1.5 hour wait and total indifference from her then GP, I ditched him on her behalf and after asking the Provost of UM (connections, man!) for a recommendation, got to an autoimmunologist (old school) and a really good geriatrician. Aggressive pursuit of reasons for weight loss and a slew of other things (platelet aggregation disorder? Hematologist! Refractory celiac? Diverticulosis? diverticulitis? GI! Nodules in the lungs? Pulmonologist!) led eventually, five years later, to now. Ah. Let me talk about now.
At the last geriatrician appointment, my frail mom, who used to be 5' 4.5" was measured as barely 5' 1" ("Stand up straight, dear!" said the kind nurse with the Caribbean accent) and 119 lbs, up from 118 lbs (and way up from 107 lbs!), but I know it's only because she didn't take her sweater off. This was the appointment where we found out that the cancer in her lungs maybe probably came from elsewhere only we spoke in code because the language my mom speaks is "Don't touch me, I'm tired and I am tired especially of all this." Later, I read the PET scan report and found out that what we had been told was primary lung cancer and early stage 4 was actually primary colon cancer and waaaay stage 4. Like lungs, adrenal glands and colon. Oh, my! Three colonoscopies over the past three fifteen years, capped by a virtual colonoscopy in May of this year, and none of them showed... the clearly visible on PET scan massive lesion with more than half the maximum uptake of the radionuclide-tagged glucose (8.1 on a maximum scale of 15)!
Today, I saw the actual scan, with a good friend of my mom's who is her acupuncturist and a modest practitioner of Chinese Medicine. My mom, who naively but firmly stated to me that her friend had both seen the scan and understood how to read it, doesn't know that her friend Mary and I sat down and I basically interpreted a little shop of horrors for her. About the best I can say is that it hasn't made it to her brain. The lesion in her colon is so large that in comparison to her frail frame and narrow hips, it took my breath away. A lesion missed by so many exams, a lesion that will consume her.
In recent weeks we have made end of life preparations- Advanced Directives, Living Will, Designation of Healthcare Surrogate, Trusts. so much planning. Yet all I can remember of this, right now, is a narrow pelvis and a colon cancer the size of Texas, in my mind. I've had other friends who have battled cancer- some lost, many won, with all the modern techniques and treatments. But this is somehow different. Both the painfully accurate five years long conviction that something is really wrong with her, and heartrending reality that it's too late to do anything now that we finally, finally figured out what was wrong. And the unrelenting reality that she is being eaten alive from the inside out and there is nothing I can do, or anyone can do, now, to fix it. Did I mention how strained my Mom and I have been? Or that I would do anything to "fix" her? To buy her more time? To buy her no pain?
When we were working on the trust, the deed for her house will be tied to her trust, of course. I was so absorbed thinking of what will become not of the house, but of her garden, her life's work and the one thing that makes her happy. An ecosystem for cats, for birds, for squirrels, opossums, raccoons and at one time some sort of exotic fowl that I still can't confidently identify (cruelly killed by some predator, crushing my mom). No one will be able to maintain that garden, and as my husband says, with maybe too much gusto, no one is going to want that garden... Something inside me just quails at this. It was the one thing, in 54 years on this earth, that I knew made her happy. She, the one who grew camelias in Miami, delphinia, and so many other northern plants I love, the creator of magic, reader of stories with voices, the offerer of wonderful books, art, music, is dying. Somewhere, the intersection between PET scans and gardens spells disaster. I can drop a Google Maps pin and show you where.
There is this garden. It's a slice of magic. And it's gonna die. Just like her.
It hurts.
It hurts so bad.
Garden as a metaphor for a person? Hey, why not.
Garden as a metaphor for a person? Hey, why not.
Monday, July 8, 2013
Simple Mistakes
I am still tasting bitter disgust from an article I read over the weekend. It was written by Mike Clary, a reporter I both respect, and whom, coincidentally, I used to live next to in Coral Gables. His article ran in the Sun-Sentinel and the Miami Herald over the weekend. Let me cut to the chase for you. I'm sure you'll see precisely where my problems began and where they are fixated still.
Sierra and Melvin have been jailed, charged with felony child
neglect. Though Dontrell's death was ruled a killing, no
homicide-related charges have been filed in the case.
Both Miles (Dennis Miles, DCF's southeast regional managing director) and Benitez (Emilio Benitez, CEO of ChildNet, the private agency contracted by the
state's Department of Children and Families to oversee foster care in
Broward and Palm Beach counties) said a high-profile case, such as Dontrell's, may influence investigators' decisions on removals.
'They see that from a simple mistake they may get prosecuted," Benitez
said. "That sends a chill down your spine. It sends a chill across the
whole system."
Child-abuse investigators are required to remove a child from a home
when the child is in imminent danger. The case is then to go before a
dependency court judge for a shelter hearing within 24 hours."
This is Dontrell Melvin. I don't know about you, but to me he doesn't look like the victim of a simple mistake.
He looks like a CHILD. One who is now forever gone from this earth.
This child was murdered by his parents, who were supposedly investigated by the Department of Children and Families. He is one of six children I know of who have suffered the same fate in my state thus far this year. You can read about them, in brief, in various Florida news outlets: Ezra Raphael, Antwan Hope, Fernando Barahona, Bryan Osceola, Dontrell Melvin and Emma Morrison. A few days before Mike's article ran, the Miami Herald ran an OpEd aptly titled "DCF Fails Vulnerable Children."
You can see how "affecting" to some child welfare sector management the public outcry has been when you hear tone-deaf responses like that of Mr. Benitez, CEO of ChildNet, an organization managing child welfare case management services in not one but two counties. Failure to remove this child was "a simple mistake," and that, oh, boohoo, child protective investigators have been "chilled" by the fact that they'll get at a minimum a lot of notoriety, and a at a maximum, charged if the children they investigate are further harmed and/or killed.
I'll tell you what's chilling and it has nothing to do to with whether PIs are removing more children because they're afraid if they don't that they'll be.... oooooooh! cue the Twilight Zone theme.... in the public eye.
I've said it before and I won't quit saying it:
Where is the WELFARE in my state?
We need an army of Mike Clarys and Carol Marbin Millers in my state and we need to give them megaphones and a large bandwidth to make the stories of these children heard and most of all, to prevent similar stories. We need a rising tide of outrage to crest in change. It should be chilling that any child is unsafe when under the watchful eye of the Department of Children and Families!
From Rilya Wilson to Nubia Barahona to Dontrell Melvin and onwards, we have too many dead children, too many excuses, too much handwringing. We have no real change in my state.
It's a cruel irony that children's protective services doesn't even come into play until after a child has suffered harm. But to allow that harm to accrue? To ignore it? To turn a blind eye and then cry crocodile tears when that child dies? To call these compounded failures "simple mistakes?"
These are not "simple mistakes."
No mistake that involves the death of a child ever will be.
These are shameful failures. They represent the utter failure of the system of care. They represent no meaningful caring at all.
The bottom line is that, in my state, saving money is more important than saving children's lives.
Sunday, June 23, 2013
Palate Cleanser: Placeholder Version
Sounds of the Sea by Karl Gussow
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