Sabio’s Story, Part 2
“There is only one kind of shock worse than the totally unexpected: the expected for which one has refused to prepare.”
― Mary Renaul
Have you ever played a training or video game that is designed to show you how hard it is to make good choices when you’re poor, where you run out of money by the 10th of the month and your dead? Let me share with you by way of analogy the case managers’ complicated relationship with time. You might just glaze over if I just tell you there is not enough time in the day to complete the mandatory tasks of case management, let alone all this frivolous stuff disconnected designers add in.
With Sabio, I had to do the following things within 24 hours: Fill out seven-page placement packet (1 hour, minimum); submit and wait for a reply; keep Sabio with me and safe, calm, and cared for while we waited (9 hours); arrange and hold visitation with his mother and notify his father (90 minutes, minimum); research everything there was to know about the family in various government agency portals to “collect the record” (2 hours minimum); write the court report, revise the court report, submit the court report (4 hours minimum); take calls from skeptical foster parents (about 60 minutes); convince one (30 minutes); take calls from hysterical mother (one hour total); take calls from my supervisor (one hour total); meet with the permanency case manager (30 minutes, minimum); arrange for a Child and Family Team Meeting that would happen within 72 hours (including contacting a dozen participants—3 hours minimum); complete the long form Child and Adolescent Needs and Strengths Assessment (1 hour , minimum); and submit 5 or more referrals (15 minutes each, total of 1.5 hours minimum), wait for pick up (90 minutes, minimum). I also had to achieve my personal mission, which was connecting with this youth and easing his transition into care (uncountable hours). Finally, I had to reflect for testimony (unknown number of hours).
Try doing all that in a timed video game. You’d run out of time around “meet with permanency case manager.” This is every single removal in the state of Indiana. Every single one. Forget it if you’re removing 10 children at once with 8 different fathers, as I once did. I once knew a case manager who had five different removals accounting for some 17 children over an on-call weekend. I still don’t know how she didn’t just throw her hands up in the air and walk out. She got promoted to supervisor last I heard.
Link: Sabio’s Story, Part 1
With Sabio, getting him comfortable and his immediate needs met was my first concern. I fed him from the stash of snacks I kept in my drawer and gave him water and a soda. We talked casually about the questions he had about what would happen next. I was as transparent as I could be, given that placement was an unknown. He sat in the spare chair in my little cubicle for 9 hours while we waited for willing foster care placement. I had wanted to send him to an Emergency Youth Shelter (EYS) earlier so that we could thoughtfully plan out placement with the court. EYS was locked. Something was still not sitting right with me about this kid, but I wasn’t having any luck flushing it out with him, his mother, or through reflective supervision with my supervisor.
About an hour after we got to the office he asked if he could go to the bathroom. Though we were on the second floor, I still felt that he could run away at any moment and asked a male staff member to walk him over. It took a while, but when he got back we contacted his mom and arranged for her to come to the office to see him for about an hour. I had this court report to write, and two male supervisors were willing and able to provide supervision for the visitation.
When Sabio returned from visitation he was visibly agitated. His movements were a little quicker and his eyes roamed faster and farther than they had before. I was trying to write the court report tactfully while he sat in my cubicle, likely reading every word over my shoulder, which is exactly what I would have done. He said he needed to go the bathroom again. He went about 4 times over the next two hours. He was constantly being taken back and forth to the men’s restroom across from the elevators and each trip was lengthy. I worried that he was planning some kind of escape with his mother.
About an hour after his mother left, she called and asked to speak to him. They held a conversation for about 10 minutes, and it was very hard to read from where I was. He just kept saying Hmmmhmmm, m’kay, yeah. He kept saying, But Mom…
Near the end of the conversation, just before she hung up, he said it again, But Mom, am I going to be okay? Cartoonish, unintelligible speech came from the phone, followed by another, Mom, am I going to be okay? This continued until the noise from the phone was coming at the same time as Sabio’s question, Mom, am I going to be okay? He asked it four more times in a row. Mom, am I going to be okay? Mom, am I going to be okay? Mom, am I going to be okay? Mom! am I going to be okay? It was a weird cadence. It struck me and I put a mental pin in it to think about later. We went back to our short conversations amidst my multi-tasking.
At one point I looked back at him and he was covered in goosebumps, shivering and huddled up in the chair. I asked if he was cold, and he said he was. It was always cold in my cubicle. I retrieved a blanket from our unit stash and watched as he wrapped his whole body in it. His sneakers were parked outside my cubicle. I was intermittently trying to have conversations with him, using engagement techniques I had learned in my training and just a genuine desire to know more.
Sabio was very smart, and he learned a lot through observation. Soon he was using the techniques on me, asking me questions. I thought that it might help him to know that I had been through a similar process of initial removal and shared just a few basic things about having been in foster care myself. I shared that it was awful at first, but over time I was able to find my way and came to feel better about myself. I didn’t belabor it, and I didn’t go on and on. It was the first time I shared my lived experience with anyone but a few close colleagues. He seemed to think about this for a few minutes and then fell fast asleep in my chair while I finished up the report.
While he slept, I tried to convince my supervisor to put this boy in Emergency Youth Shelter, but she would not. Policy says that we have to go with the least restrictive placement first. That’s foster care. Well, policy didn’t know what I knew. It didn’t know what was in a kid that could make them run. I did.
I had been in a runaway before my stay in foster care and during my 5-year stay in foster care. I did not mess around with running away to party. I wasn’t looking to connect with people in the neighborhood. My neighborhood was dangerous. My family was not safe. I had been physically, emotionally, and sexually abused in it. I had been neglected so hard I landed in the hospital over it. I was running from something. I took to the national highways and crossed multiple state lines multiple times. My record includes 5 long-distance runaway trips. I started at age 13. I took my last trip at 16. I was almost murdered and that brought my recklessness to a screeching halt. But later it made me “The Runaway Whisperer,” as I would eventually come to be known by my colleagues. No one in our office could talk a kid back into care as quickly or as deftly as I could.
As a 42-year-old case manager with this lived experience eyeballing this newbie supervisor, I knew she was making the wrong call. I didn’t know what it was yet that was driving Sabio to want to flee, making him worry so hard if he would be okay, but I could recognize it because I’d felt it so many times before.
I returned to my desk to find Sabio curled up in a ball in my chair. He had to go again. He complained of a stomachache. His skin was slick with moisture despite being wrapped in the blanket. I thought he needed a doctor. I took him to the toilet myself this time and waited outside, the outer door cracked open. His bowels were cutting loose some kind of internal hell and I could hear his moans amidst the splashes.
When we returned to my desk, my supervisor had just gotten a call from a willing foster parent. She thought the foster parent could take him to the doctor. Sabio said he didn’t need a doctor. It was 9:00 at night and I had had this boy in my office since noon. My day had started at 8 am. I gave in to my supervisor’s guidance.
Because my cubicle was just below an air vent on the good side of the building (the part where the air worked well), I decided we would wait for the foster parent in the lobby, on the bad side where it was warmer. I gave Sabio a sweater and told him he could keep the blanket. He put on the sweater and wrapped the blanket around himself again. It was early September and the days were still hot. As we waited for the foster mom to arrive, I watched as more goosebumps appeared on Sabio’s face. I watched as he went into and out of sleep in the chair. I worried that this was the last time I would see him. But I didn’t see the most obvious thing and I wouldn’t until I woke up the next morning still thinking about him. It was so clear that I jolted awake with the truth of it. By that time Sabio was already gone.
What I realized in my reflections from that day and evening, leading to my morning revelation, was that Sabio had been experiencing the same opioid withdrawal symptoms I saw in his mom during her interview. The chills, the goosebumps, the stomachache, the moist, pallid skin. I had been witnessing Sabio go through opioid withdrawal, and I did not see it. I repeat, I did not see it when I needed to see it. My gut was wrenching as I made my way to the office.
As soon as I arrived my supervisor took me into her office and explained that Sabio had slipped out of the house sometime in the night. She had those damn shifty eyes. I told her what I had realized that morning. I told her that I might have seen it if I hadn’t had more than 50 assessments on my caseload and constant demands for revision from her. She cried because she knew it was true. I cried because the essential thing I was missing was the CAPACITY to know that a mother would do that to her own child. It ripped me wide open.
All at once I saw the futility of my job, of this whole system, for the first time (but not the last). You could not combat this with kumbaya Child and Family Team Meetings and LinkedIn Lifestyle memes, though there’s a place for that. Over 20 Case Managers had spent countless valuable hours on this family and hundreds of thousands of dollars had been spent over Sabio’s life. This was the result. This was what we got for that money and effort: A kid hooked on heroin at age 12 by his own mother, so she could keep him and love him. We bore some responsibility for that.
This is also what we got: Sabio’s face on milk cartons, placed there by the Center for Missing and Exploited Children. It was a photo I took. His face stayed on these milk cartons until he turned 18. Four years. I know. I checked each and every year.
You never forget in this field. Never.
It would have been easy for me to lay blame for this at mom’s feet alone, and I do hold her accountable for much of it. But I also know enough to understand that she was just doing what had been done to her. She was just mimicking what had been effective in her life. If she had known better, she likely could have done better. We didn’t take the time to show her better, and so we got what we got. And it’s like this all over America. Magnify Sabio’s challenges by 25,000 youth across this nation. Add in another 450,000 children and youth in foster care each year and their challenges and cases.
Can you see it yet? We keep the same system in place, doing the same thing year after year, hoping for different outcomes. We don’t get them. We get the same outcomes over and over and rising numbers, not diminishing numbers. Some outcomes are good. Most are harmful. We always leave scars and trails of broken hearts.
There must be a better way. I have ideas, which we will explore as I write these stories. I would encourage you to start thinking about what you can do in the meantime. If you work in Child Welfare, that reflection is critical. If you don’t reflect and change and aren’t willing to challenge others, you are part of making this system what it is.