Patient “Forever”

One of the biggest frustrations with former foster children who have managed to make a life for themselves is the inability to give advice in an impactful manner.  Specifically, to give open, honest, direct and sometimes harsh advice to the people who need it – the social workers, the prospective foster parents.  I think I am starting to understand why.

First, the need for foster parents in this broken system is so extreme that most social workers who are in charge of foster parent training are probably worried about scaring off prospective foster parents. Bringing in a former foster child for a group conversation can backfire. Things come up and out of our mouths that can scare the shit of people.

Second, you have to think of DFCS as a business.  DFCS is the supplier of children, the foster parents are the customer. The foster child is not the product, but rather the patient.  We are the never ending patient.  We are “Patient Forever.”

Even when grown and successful, both the foster parents, non-foster parents and social service workers and court system see us as the patient who needs their guidance and direction and not so much in a good or bad way, but in a bit of a patronizing way.

Consider this…  A woman is raped.  A male psychologist counsels her.  Her husband comforts her.  He father comforts her.  And through the years, all of these men continue to treat her as if she is broken and needs their advice.  Patronizing? Man-splaining?

Or, consider all college courses on racial justice being taught only by white men, to only white people who are then charged with “fixing” racism. Those students then interface with the public and tell the public what they need to do.  Patronizing?

When foster survivors talk amongst ourselves there is often a puzzlement as to why we are not used more effectively to change the system.  And the answer I see now is that quite frankly, the system doesn’t see itself in need of change, it’s doing exactly what it was designed to do and it has nothing to do with reducing the incidence of foster care, simply to diagnose the case and refer “Patient Forever” to the next expert. We are the patient and our advice on improving the surgery and the hospital is quite frankly, not wanted.

We are supposed to talk about the disease we had, not the observation that maybe, there was no sickness at all.

We are supposed to talk about the doctor that helped diagnose the problem, not the ones who missed it.

We are supposed to say that we are OK and will continue to heal.

We are supposed to be polite, say thank you and go on our way, called upon sometimes to testify about the few people in the system who managed to help.

Those of us who follow that prescribed course get a pat on the back.

Imagine a hospital where everyday:

  • 100 people are admitted with abdominal pain, loss of appetite, dark stools, vomiting blood.
    • 10 are diagnosed with stomach cancer.
      • 3 of those 10 are cured.
      • The other 7 of those 10 die.
    • The remaining 90?
      • Referred to another hospital.

And then, ten years later:

  • Only the 3 of the 10 who were diagnosed correctly and were cured are invited to speak – not about how to prevent stomach cancer or diagnose various cancers and disorders – but about how great their doctor was.
  • The remaining 90 referred to another hospital?
    • 10 of those died within 6 months.
    • 40 more died within 5 years.
    • The other 40 didn’t have stomach cancer, but rather liver disease, IBS, or some other diagnosis.
      • None of these survivors are invited to the discussion on how to cure liver disease or how to correctly diagnose a patient.

Is this a problem?

It depends on your role.  

If you are the doctor and administrator then no, this is not a problem. You’re the expert, the person trained to do this work. The patient is usually too confused and sick to know what is going on.  You diagnosed the 10 who were obvious, sent the others to the next expert. The system is working as intended. You did your job.

If you are the family member who took any of those 100 people to the hospital or supported them, this might or might not be a problem.  After all, you didn’t know what to do either and you feared the worst case anyway. So….?  System working?  More or less. Maybe.

But if you are the patient – yeah, this is a big f’n problem!!   57 out of 100 of you are dead!  And an additional 40 out of 100 of you went through hell to get the right help.  So, 97 failures out of 100 – is that the definition of success we are willing to accept?

So who should be speaking to the public about the care they received? The 3 survivors of stomach cancer who were correctly diagnosed and attended to, or the other 43 survivors who went through hell and might have some solid advice on patient intake and diagnosis?

We are the forever patients. Always needing someone else’s advice and care. Even at 47 I have been told by social workers that I “need to heal more” – because I was willing to expose the 6 failures I experienced before the only successful placement in my foster care life.

Foster parents are NOT doctors. They are not equipped to diagnose and handle the patient they receive and the results of foster care in the U.S. expose the lie.

Yes, there are good cases here and there. But as with the stomach cancer example, it’s on the order of 3 out of 100.  Or, in my case, 1 out of 7.  That is not success.

On, I have presented a challenge in my answers to questions: Find one adult foster child who was placed in care after (about/apx.) age 5, who went through more than one foster home (let’s say 2+ homes) and did NOT receive abuse in one form or another. Just one example. So far, I have heard of no such example.

It should be difficult to become a foster parent of a stranger’s child.

It should be very, very difficult.  Really damned, f***ing difficult!!

But, it’s not difficult at all.

You should be trained, you should read a book, or ten!   You should have some understanding of the ACES study. You should spend time with foster care survivors.

That’s not the case today.

And you wonder why the overall outcomes aren’t changing.