The Things I Want Most (11 page)

But I had a completely different opinion of Harbour's second and backup procedure for using “resources,” i.e., outside counseling and some additional form of rewards-based behavior modification.

So far, we had been able to avoid hooking Mike up with a therapist. We didn't know very much about the profession. None of our children or our friends or family had ever been in counseling, and it seemed a little too mushy for us, particularly when a number of other parents we met at Harbours monthly meeting explained that, upon the advent of behavior which
might displace a child, Harbour would involve a therapist or counselor who would more often than not establish a daily checklist of required behavior and insist that parents record each and every deviation, The idea was that all the deviations for a day would be summed up, and the child's privileges would be reduced or increased according to an established formula. For example, a child might be allocated one hour of TV time daily, and each check mark for a bad word would result in the subtraction of five minutes from that time. Certain scores might cancel an outing or provide a reward.

Adding or subtracting five-minute increments of TV time? Whose life was long enough for something like that? Besides, the technique seemed to undermine parental authority. The child was, in a very important manner, singled out from the family group to be rewarded or punished separately from other children. What did that have to do with being a family? What did it have to do with the parent being the source of discipline and direction?

I didn't want to argue with Joanne or The Harbour Program about this. I just wanted to keep Mike and ourselves away from any system like that.

So when I coupled these factors in my mind with the fact that Harbour's gentle approach bore about as much similarity to the boot camp operating up in the karate school as a garden hoe did to a bulldozer, I couldn't see how we, or rather Sue, could possibly bridge the gap.

It was accomplished with insouciance. She downplayed the entire issue and instead presented the karate class as a logical extension of Mike's treatment plan. Then she flourished a filledout form from the karate school that listed short-term and longterm goals Mike had established for himself and written down under the instructor's supervision. They were grouped under various categories:

Joanne studied the little document. “Well, I'm impressed and touched. But still, there's the issue of schoolwork. Won't his karate schedule interfere?”

Sue played her best card. “No, Rich and I reached an agreement with the instructor, and he discussed it in a one-on-one with Mike. Mike will have to produce his report cards from school, and if his marks fall, he'll have to forgo karate for the next quarter. In other words, he'll be earning his reward.”

“I see.”

But then Sue overplayed it. “And besides, many people feel there's a strong correlation between martial arts and academic performance; also, that it helps with his social skills. And the improved muscle tone might even contribute to less bed-wetting and better digestion.”

Joanne looked Sue squarely in the eye. Sue knew, I knew, and
now Joanne knew that she was being conned. But then a curious phenomenon kicked in.

Since that discussion about Mike and karate, I've seen social workers suborn the system when they're confronted by adults who act with good motives as advocates for “system” children. It's as if, having seen so much abuse and neglect, they're ready to excuse almost any action that has as its purpose the good of the child—even if they believe the adults are seriously misdirected, or that important guidelines are being ignored.

The best guy I ever worked for called this “giving meat to eagles,” meaning that you break the rules in favor of somebody doing something, anything. But this wasn't manufacturing. It was social work. Social workers have more rules than anybody, and they're dealing with fragile lives. In the order of things, it takes a lot more guts.

I watched it happen as Joanne said, deep in thought, measuring the risks, “Before you do anything else like this on your own, you have to discuss it with us first.”

“Oh, sure,” Sue said quickly.

Afterward, I started to talk to Sue about the incident, but she quickly cut me off with, “Rich, karate is yesterday's news. We handled it. And that little tempest begs the real question of why Mike's acting the way he does now, and I never got out what I wanted to say to Joanne. There's a wrongness about Mike, and I don't mean emotionally. I mean he's out of focus or too focused.” When she said “too focused,” she smacked her hand on the table.

“I agree, I suppose. But we signed on the dotted line with Harbour—you agreed to play by their rules. Before we do anything else, we have to work it out with them.”

Then she cleared her throat and I started to worry.

“Sue, are you starting something else?”

Long silence. Then she said, “I just can't take any more abuse.
I refuse to be told any longer by some sawed-off eleven-year-old that I'm lying, so I called Dr. Reis.”

John Reis, a family practitioner, had been one of Sue's clients for a long time. Puzzled, I waited for what she was going to say next.

“When you feel the muscles in Mike's shoulder, they're as rigid as an iron bar. When you massage them, they loosen up and his facial tic disappears for a while. His voice tones down, too. He even loosens up a bit mentally and doesn't seem so argumentative.”

Then she bit her lip and cut to the nub. “Mike's been on medication ever since he arrived and for years before that. Who really knows at this point what it's doing to him or what it's done to him already? I read what he was taking to John, and he said that there shouldn't be any adverse side effects if he stopped, and that the tic, the tension in his muscles, and his extreme behavior could at least partially be a result of the meds. I can accept the fact that he doesn't really believe anything we say—I'm sure Joanne is right about the whys and wherefores of that—but I'm sure that's not the whole reason he's such a Tasmanian devil. Something else keeps him at that low threshold— perhaps the same something that kept him acting like a suicidal spastic in the children's home. Maybe it's the drugs; maybe it isn't. I think we should see.”

“Well, it's an interesting supposition,” I said. But then I understood what she was really telling me, and I put my hand over my face. “When,” I mumbled through my fingers, “did you stop his medication?”

Mike doesn't cry at night when the dogs are on his bed. When the whimpers begin, Teddy Bear or Pupsy nuzzles a snout under his arm, and he goes quiet.

I've seen it happen a dozen times by now, and it almost frightens me. It's as if the dogs know something we don't, or know how to do something we don't.

Sue said it one way when she was watching the three of them troop along outside her office window. “Somehow, they're on his page.”

But I think of it differently. I feel the little beast that's riding Mike's back has a certain degree of malignant intelligence. It knows it can't win an argument with dogs, so it doesn't try.

Mike never tries to correct them. Whatever they want him to do is okay in his book. When he's outside with them and calls them, if they saunter off in a different direction, he changes direction and follows along. If they come with him when he calls, that's okay, too.

“Drug-free in ninety-three,” Sue cracked as she dialed Joanne's office phone number.

“Sue,” I protested.

“Relax, I'm doing it your way We'll follow the rules, get a doctor to pull the medication.”

“After the fact?”

“We'll get a doctor to pull the medication,” she repeated.

Joanne answered the phone, and after about two minutes of chat, Sue told her she was worried about Mike's physical condition.

“He's not eating right.”

“No?” Joanne responded.

“No. The children's home wanted to get him to a nutritionist and I pooh-poohed the idea. But now I wonder if we shouldn't get him to see a doctor and see what he thinks.”

“Well, sure,” Joanne said doubtfully, “but he is scheduled to see Dr. Jacobsen.”

Dr. Jacobsen is the psychiatrist with the Mental Health Association.

“Yes,” said Sue, “but that's not for three weeks, and we do need a family doctor for him—someone we can call if he gets sick. No family doctor will see him on short notice unless he's already examined him. So maybe we should kill two birds with one stone—get him a family doctor and see if the practitioner wants to recommend a nutritionist.”

“Okay.”

With her token team effort out of the way, Sue shopped around for a family physician. Not so easy. If you're on Medicaid, it seems, the government's health care system wants you to go to a clinic in a city. At least that's what Sue came to believe when she found out most of the doctors in rural practice— those in Ulster County, for example—won't touch Medicaid.

But she did find three in the next county down. The first one was an aged, upright GP named O'Mara living way back in Pine Bush.

The morning of the appointment Sue laid out a silk blouse,
burgundy business suit, ivory jewelry, long black leather coat, and high heels. After all those years she spent in suits and dresses and high heels, Sue delights in dressing down, working away at her big executive desk in jeans and a sweatshirt, floppy old slippers, and a thick sweater. But today she wanted to make an impression.

Still, she didn't get off to a good start with this old fellow. Mike made an epic scene in the doctor's examining room, talking wildly and loudly about his real mother, his brother and sister who were living in a different family, shouting about Rockland State Psychiatric Hospital. And, of course, correcting everything the doctor had to say. Just generally acting like a nut.

And the way Sue was dressed had the opposite effect she intended.

The doctor almost sneered at her as he fingered the Medicaid card. “Miss Miniter, just how many children do you have?”

“Six others.”

“I don't suppose, of course, that Michael's father is still in the picture?”

“No,” said Sue, puzzled.

“I didn't think so. Now, are the rest of your children normal? Are there any other full siblings?”

“Huh?”

“How many different fathers did your children have?”

“What!”

“I asked, how many fathers?”

Sue exploded, “I heard what you said. I just can't believe you asked that—and it's
Mrs
, Miniter. I've been married twenty-seven years to the same man.
All
of my children have had the same father!”

Now the doctor looked confused and extremely embarrassed. “Then, what is Mike? He has a different last name.”

“Mike is a foster child. Who did you think he was?”

The doctor was taken aback. The only thing he could think
of to say was even more stupidly awkward. “You don't look like a foster mother.”

Sues eyes went blank and hard, her pupils little black arrowheads. “And just what does a foster mother look like?”

“Mrs. Miniter, Mike is severely disturbed. I don't know you—I've never seen you or Mike before. I thought he came from a badly confused family situation, and I wanted to see if there were any other full brothers or sisters who had any history of emotional problems.”

“Well, look,” Sue said, trying to calm down and remember what she was there for, “Mike's not having the best day. That's true. But what I want to know is, how is he physically?”

The doctor huffed a little bit. “I don't have his medical records, and I haven't done any workups, but he appears fine— maybe a little too thin. Is that why you're here—just that?”

“No,” said Sue, trying to force a smile. She extracted a form from her pocketbook. “He was released from the children's home close to two months ago, and the physician there had prescribed some medication.”

She handed over the page from Mike's file.

Dr. O'Mara read it and said, “Oh, yes, I see. You want a new prescription.”

“No,” said Sue again, “Dr. John Reis in Kingston suggested we wean him off; that perhaps a lot of his muscle tension and maybe his facial tic will ameliorate; that perhaps, at the least, we could establish a baseline for new dosages if we got him off it for a while.”

“Oh, I know John,” Dr. O'Mara said. Then he looked sharply at Sue. “Did Dr. Reis examine him?”

This was the crucial point of the talk, as far as Sue was concerned, but she was ready. “He consulted as a professional courtesy. But his practice doesn't take Medicaid patients, and Kingston is a long way He suggested we develop a relationship with a
local physician who'd be in a better position to keep an eye on things.”