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.

 


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Saturday, August 29, 2015

Between a Rock and a Hard Place



A Rock and a Hard Place, attribution unknown


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."



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Friday, August 21, 2015

A Little Shop of Horrors






I title this post "A Little Shop of Horrors" in honor of a PET scan. Actually, a PET scan is a thing of surprising beauty, from a scientific and visual standpoint. It's only when it belongs to someone you know, care about or love, that you have a problem. But more on that later.

So here I am, writing again. It's like I drank some real Nepenthe and forgot this blog, right? Only not so much. It's partly that I had nothing positive to say, about the world, about child welfare, about so many things, that I thought, hey, fallow is good, fallow is fine. So now, by virtue of not posting for two years, it's like my own private diary, right?

You'll notice the delphinium flowers above. (Don't you have problems with delphinum/delphinia?) They're to honor my Mom, the lady that can grow officially Zone 8a plants in Zone 10b. That's my Mom. Growing things. Hey, she even grew me, though, for a while there, she sure didn't water me much. That long stretch between 13 and 24? Yeah, that was no man's land. DNRs were signed, grandparents died, muggings, breakups, rape, yeah, there was bad shit during that time. But in the end she showed up. She's been around on quarter time or so, since. But the early years, in between trying to commit suicide when I was 3 and when I was 13, those are the golden years. The books! The music! The theater! Oh, the enrichment of those years! They were the truly formative ones for me. So much of who I am, especially intellectually, owes to those years, in spite of the fact that pretty much everyone says I am my father's child, rather than hers.

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.




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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.

"Three months before the remains were found, DCF had received a report that Dontrell Melvin (see below) had long been missing. But no one at the time — not his parents, not police and not DCF — went looking for the infant, who disappeared when he was about 5 months old.

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."

"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. 




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Sunday, June 23, 2013

Palate Cleanser: Placeholder Version


Sounds of the Sea by Karl Gussow


Yeah, yeah, yeah, I've been listening to you people.

So, I have been turning over the idea of continuing to blog. I quit, in part, because I felt there was nothing positive to say. (At least based on what was going on around me...) I was weary of the negativity. But lately, I've started wondering again whether talking about what is messed up isn't actually a positive. After all, so many people ignore what's messed up, for various reasons. I guess I wanted to try to find a positive spin on negative things. I'm not sure I'm there yet. But maybe I can get there iteratively. We'll see.

Skål, à bientôt, and bis später.

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Wednesday, October 10, 2012

Uppity Woman (Child) #21: A Profile in Courage



From the Muslim Times, Veronique De Viguerie / Getty Images, file


From dictionary.com- 

Uppity: rebelliously self-assertive; not inclined to be tractable or deferential.

I know of no person who better embodies the spirit of the amazing women on my list of "Uppity Women" than Malala Yousafzai. Yet Malala is a child of only 14. She is "uppity" because she dared to blog, under a pseudonym, about the atrocities committed by the Tehrik-i-Taliban in Swat Valley for the BBC, that bastion of apostasy, in 2009, at the amazing age of 11. Her blog espoused both her desire and firm belief in her right to an education, and her outrage at the destruction of schools and the violence visited on peaceful Pakistanis who wanted their daughters to be educated or those who wanted to educate all children. The Taliban in the Swat Valley are clearly very threatened by the idea of educated females, and by Malala in particular, because yesterday two of their thugs proudly got on her school bus in Mingora, Swat and after asking which girl was Malala, shot her in the head and neck, then shot two other education righteous-thinking girls for good measure. Malala has survived the shooting, although just barely. Reports still insist the bullet did not penetrate her brain.

Malala, who was nominated for the International Children's Peace Prize in 2011,  won the Pakistani National Peace Prize in December, 2011. The Government School for Girls was renamed the Malala Yousafzai School earlier this year. Her attempted assassination, for certainly she was a well-known and charismatic figure, has brought immense sorrow, anger and embarrassment in various circles in Pakistan. But among the Tehrik-i-Taliban there is only the consternation that she is the girl who lived, albeit precariously so at this point. Their leader, Ihsanullah Ihsan has said tersely, "Let this be a lesson," and promised they will try to kill her again for the obscenity of her desire for her rights and Western-tainted values. 

The Pakistani National Airline has said they are ready to fly her to any facility in the world for further medical care but she is evidently not stable enough to be moved. Meanwhile, demonstrators flooded the streets, as evidenced by the many photos on Al Jazeera and other Islamic news outlets. This morning the government of Pakistan offered a 10 Million Rupee bounty for the men that shot Malala and her friends, an extraordinary sum. Roads are barricaded, streets bear signs decrying the shooting and Pakistani PM Pervez Ashraf said of the attack, "She is our daughter." Journalist Nadeem F. Paracha said in a positively brutal tweet on Twitter, "Come on brothers, be REAL MEN. Kill a schoolgirl." Yet, the Karachi-based Paracha's column in today's Dawn lays the blame for Malala's suffering not just on the Taliban but on Pakistanis themselves, who he paints in stark contrast, due to their apathy, to brave souls like Malala.

A friend asked me this morning about whether Malala couldn't get asylum in the West. I guess the US or the UK would be able to grant her asylum. Surely there is ample cause. But imagine uprooting your entire family and struggling to rebuild their lives so far from home. Why should she, or they, have to seek asylum, is my thought. Why can't a 14 year old girl be safe on a school bus or in her government school? Why should she or her friends live in fear? Why should any of the lessons she's learning have to do with grown men shooting children? Why can't she study as long as she wants to, and whatever she wishes to? 

Malala, who was named after a Pashtun poet and warrior woman, clearly saw the risks of opposing the Taliban, based on her direct experience and as detailed in her blogging. And yet, she was a child and children never internalize risks as adults do. Perhaps her courage will galvanize her elder compatriots and make them see, yet again, that the very future of their country is being brutalized and terrorized. Demonstrators in Benghazi, Libya took matters into their own hands, striking against, and routing, the Ansar-al-Sharia who killed Ambassador Chris Stevens. Maybe the people of Swat Valley need to make their voices, and their will, clearer to the Tehrik-i-Taliban? Maybe the bravery of "their daughter" will be the catalyst for the change that Malala believes in

The world, excepting a pack of barbarians, wishes this child a full recovery.


Demonstrators protesting Malala's shooting in Peshawar.

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Friday, August 31, 2012

Child Welfare: Present Line of Thought



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Monday, August 20, 2012

No Honor Here...






I guess I must just be on a tear with Pakistani treatment of women and children. Lest we think the Taliban is the only problem facing Pakistani women, or the sole factor in the mindset that women are mere chattel, we need only consider the case of Shafilea Ahmed. This honor killing, which occurred in 2003 and is finally facing justice, took place in England. About a week ago, her parents were finally convicted of Shafilea's grisly murder, on the basis of her younger sister's testimony against her parents. Her parents had been living in the UK for more than a decade by the time they killed their 17 year old daughter for being too Westernized.


Shafilea Ahmed's teachers deserve kudos for trying, albeit unsuccessfully, to help this child. Just like recent killings in Canada however, the child welfare system seems to find it difficult to safeguard young women in these difficult situations. You can watch the CNN video report on the welfare failure here:





And meanwhile, I encourage anyone who wants to spend a bit more of their time *headdesk*-ing to check out the comments on the Pakistan Express Tribune's Facebook posting of their article on Rifta Masih, the poor 11 year old Down's syndrome child who is charged with blasphemy (punishable by death) for burning pages of the Koran. As it turns out, her mother was with her when she was jailed. But of course, the rest of the family had run off and abandoned the mother who stood by her child. The police now deny the mother and child were "tortured." Since a later Pakistan Express Tribune article opens with the statement that the child was severely beaten, I'm wondering exactly what the police mean by "not tortured." A later article still says that Islamabad police have registered a case against the Muslim cleric in Rifta's village for encouraging a village mob to set the child on fire. Reportedly, the police intervened before that could occur.





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