Lindsay Terrell, MD is a Duke Child Abuse and Neglect Fellow. She is mentored in her role by Aditee Narayan, MD, MPH, Duke Child Abuse and Neglect Fellowship Program Director
Seven years ago in medical school, on my rotation through the emergency room, I met a teenage boy in foster care. He had been through many foster homes over the past several years. I remember how he talked about his “homes” – all were discussed in a matter-of-fact way; in the same way he would have told me about his school options. This was not how a child should ever describe his home. Now at Duke where I see children in our Foster Care Clinic, I wish I could tell that teenager how he inspired the direction of my career. My career goal is to improve the medical care of children in foster care. I want these children, when all else may feel impermanent, to have consistent and complete medical care.
To this day I still enjoy my conversations with children in foster care because, like my conversation with that teenage boy, they challenge how I provide care. I have learned to ask simple questions, such as “what do you like or not like?” Or “what else can I do to help you?” Recently, one teenage girl answered that she would like me to tell her foster mother she wants to spend more time with her – to bond. What a simple, yet insightful request. By listening to these children opportunities arise to impact their lives beyond standard medical practice.
I have so enjoyed these simple conversations that I now ask foster parents personal questions, such as “what inspired your interest in becoming a foster parent?” One woman told the story of a newspaper article she came across twenty years ago. I was so fascinated that I attempted to find the article, in part because I know I will never be able to track down the teenager that inspired me. To my surprise I found an article published in 1996 that meets her descriptions. I was amazed that an ordinary article inspired such a change in her life. Another woman answered that she saw the “need to be a ministry to children and birth families.” Learning the inspiration behind fostering has made me more appreciative of others in our community that recognize and attempt to serve this enormous need.
I also ask how these parents do what they do. Most credit patience, love, and support of a spouse, extended family, and community. One woman noted: “it really does take time, energy, sweat, and tears but… seeing a child progress and change what their future can hold when someone invests time and energy in them, gives me hope.” The hardest part? Foster parents talk about time management, communicating effectively with all people involved, keeping safe boundaries, and of course “seeing my children when they have to leave.”
Foster parents are not alone. Any pediatrician who has cared for a child in foster care knows that it requires community support, time, energy, occasional tears, boundaries, etc. In many ways the task is simple; as one foster mother said, “just jump in… care deeply for these children.” Both nationally and locally, changes are being made to improve the care of these children. In 2006, the AAP prioritized the health needs of youth in foster care. A taskforce was charged with increasing awareness, knowledge, and skills of pediatricians in the treatment of foster children. Locally, the North Carolina Pediatric Society’s Fostering Health NC initiative is working to make measurable improvements in health outcomes for NC’s foster population.
Do you feel inspired? Want to make a difference in your area? I encourage you to educate yourself, utilize available resources from the AAP and the NC Pediatric Society. You can have an impact on your local foster children. While the challenges are many, I can assure you of this truth articulated to me recently from a foster mother: “You will get out of it more than you will give.”