Medical Kidnap Files 1-6, page 140
Malachi looked in her direction, so she knew that he had heard her, but he didn’t give any indication that he was interested in something to eat.
“Come on. I have cookies. Do you want some cookies?”
Malachi looked at her again, longer this time, his eyes measuring her. Wondering if she really did have cookies? Adela dug into her backpack and pulled out a pouch of tiny chocolate chip cookies.
“See? You want some of those?”
He kept watching her, which Adela took as a yes. If he had looked away and continued to play, she would know that he wasn’t going to be persuaded. She tore the corner from the pouch and rattled it a little to encourage Malachi to come over to her.
“You shouldn’t be feeding him junk food,” one of the other mothers in the waiting room disapproved. “There are a lot of things you can give him as a healthy snack. Fruits or veggies. A teething biscuit. Those cookies are just pure sugar and refined flour. Those are like feeding him poison!”
Adela ignored her, pretending she hadn’t even heard. Malachi pulled himself to his feet using one of the waiting room chairs, then cruised along the row of chairs using them for balance until he reached her.
“Good job!” Adela praised. “You’re going to be walking on your own before long. Here. One for each hand.” She put one of the mini cookies in each of his hands. Malachi sucked on his fist at first, but eventually got the idea and pushed one of the cookies into his mouth, with the other following shortly. He was getting better at independent eating, though he still seemed to expect Adela to feed him at the table. “Mmm, those are good, huh? Do you want another one?”
“Dood,” Malachi echoed.
“That’s right!” She encouraged him to take a couple more cookies, ignoring the other mother tsking away beside her.
At long last, the nurse called Adela in for her appointment, taking her to a room that was more like an administrator’s office than an examination room. Malachi was succumbing to his exhaustion by this time, cuddling against her and trying to go to sleep. He whined and fussed as Adela had to get up and walk to the doctor’s office, but quickly settled again once she was sitting down.
The doctor didn’t keep her waiting, but swept into the office behind her before the nurse had had a chance to ask any questions or assure Adela that he would be right with her. “Thank you, Nurse Cooper,” he told her briskly, and moved behind the big dark desk, fussing with his flapping white lab jacket when it caught on a corner. He got it straightened away and sat down in a large chair with plenty of padding under the black leather.
“Mrs. Glass. Nice to see you. How is this little fellow doing?”
Adela shrugged. “He seems to be doing fine. I’m hoping you can tell me something I don’t already know.”
“There isn’t much to report yet. We’ve done the basic bloods, urine, stool, cystic fibrosis, all that kind of thing. Nothing that strays too far from the norm at this point. No parasitic infection or metabolic illness. Celiac disease screening was negative. Cystic fibrosis negative.”
“That’s all good. But nothing to point to a reason for his weight faltering?”
The doctor tapped a few keystrokes into his computer and paged through the results, though he undoubtedly knew the answer to her question without verifying it on the screen. “I would like to see a more comprehensive family history. Both parents. Their own growth charts if they have them, other cases of Failure to Thrive in the extended family. Any diseases that run in the family and could result in stunted growth or faltering weight. Whether we just happen to have a family with ‘short genes.’”
“Unfortunately… we don’t have that. As you know, he is a foster child. I don’t know if the father is even known. Malachi’s medical records give his own history since birth, but even that is sparse. Mother was also in foster care, was possibly drug-addicted when Malachi was born, an impoverished single mom. I can ask the social worker if we can try to get more of Mom’s family history, but I’m not sure we would get anywhere.”
“That’s really a deficiency in the evaluation. It’s hard to say whether a child is underweight or just happens to come from a family that is typically smaller or slower to develop. There’s nothing wrong with slow growth by itself. But it is often an indicator of disease, which is why we pay attention to it. Without that information, it’s hard to say what’s going on with Malachi.”
“Does that mean you’ve hit a wall, or do you plan to do more? Is there other testing we could do?”
“There is, but you start to get into the realm of the obscure. If he had other disease symptoms, I would be more inclined to pursue it. But you aren’t concerned about anything else?”
“No, not particularly. He sleeps a lot,” Adela nodded down at Malachi, snoozing in her arms. “But that may be nothing. He might just be a kid who needs more sleep.”
“Other milestones? Any stomach issues? Throwing up?”
“His developmental milestones are at the lower end of normal, but when you adjust for his prematurity…” Adela shrugged. “Then he’s pretty much where he should be. He does seem to have a bit more of a sensitive tummy. You don’t expect to see spitting up in a child this old, but he does spit up daily, or almost daily.”
“Especially after large meals?”
“I’ve never seen him have a large meal. He doesn’t have a big appetite. I try to feed him frequent snacks because at a meal, even when he should be quite hungry, say first thing in the morning when he’s been eight hours without anything to eat, he still only has a very small amount.”
“It’s not that unusual in a child his age, if you adjust for prematurity. But with his lack of weight gain and appetite, it might be worth trying something for reflux. It may just be immaturity of his lower esophageal sphincter that will eventually resolve on its own, but if we can make him more comfortable, it might help increase his intake.”
Adela nodded. “I’d be willing to try that. A kid who has negative associations with food, like if he hurts or feels nauseated when he eats, can become very resistant to feeding.”
“Of course. Even adults develop strong aversions to foods that have made them sick in the past. Or even that they just happened to eat before coming down with a stomach bug. The more comfortable we can make mealtimes for him, the better the chances that he will eat more and start putting on some weight.”
“That sounds good.”
“Keep feeding him small meals and snacks wherever you can. You have our handouts on increasing calorie contents of the foods he will eat?”
“Of course. And some tricks of my own.”
“I’m sure you do. You could probably teach a class on the subject.” The doctor sat back in his comfortable chair, making the springs squeak. “Unless you see any other symptoms or something changes drastically, I’m reluctant to put him through any more testing. We could do a hospital evaluation, weighing and measuring everything he’ll eat over a few days, but I think that would be counterproductive and you will be able to do more at home. A hospital environment will just be stressful for him. If he is happy and active when he’s awake, I don’t see the point of disrupting things.”
“He doesn’t act sick. Maybe he has reflux, but he’s not sickly. He seems very bright and alert. Normal, other than being small.”
“Let’s schedule a follow up in a month. I’ll prescribe something for reflux and we’ll see if it makes a difference. In the meantime, if you see anything that concerns you—blood or bile, choking, bouts of diarrhea and constipation—then bring him in and we’ll get into some more invasive testing. Maybe scope him out. But if not… I’ll see you in a month. Hopefully, we will see some weight gain by then.”
CHAPTER FORTY
Kiara paced anxiously. She couldn’t believe that she was finally going to see Malachi again. She knew in her head that it had only been a couple of weeks, but it seemed like forever. Children grew and changed so fast at that age. She was afraid he would forget her if she didn’t get to see him very often. And she knew that the longer he was away from her, the harder it would be to get social services to return him. They would become less and less concerned about reuniting them, knowing that he was forgetting her and bonding with a new family. And lots of the couples who fostered babies did it because they wanted to adopt. DCFS told them that they could foster to adopt babies. Babies that weren’t available yet, but that DCFS would work to free up later. Whoever had Malachi now might be thinking that she’d be able to take him forever. Raise him as her own. And she couldn’t. Kiara hadn’t done anything wrong, and she was going to do whatever it took to get him back. As quickly as possible.
Mrs. Lewis was late getting there. That didn’t necessarily mean anything. She might have been held up because of a traffic accident. Or the foster mom might not have had Malachi ready to go when she got there. There could be a lot of reasons she was late. It didn’t necessarily mean that she wasn’t coming.
But she knew how many times visits had been called off at the last minute when Kiara was the child waiting to see her mother. They would be waiting on the doorstep, or actually en route in the car to see her mother, and then would get the call saying that it wasn’t going to work out. Kiara knew how hard her mother had been working to get them back, so she knew she wasn’t the one who had canceled those meetings. It had all been social services. It had been Mrs. Lewis.
She muttered swears to herself under her breath. If she couldn’t calm herself down, people were going to be looking at her, thinking she was having a psychotic break. Or Mrs. Lewis would get there, just to have Kiara blow up in her face because she couldn’t hold back all of the built-up tension.
She’d be there. She said she would be there and hadn’t called to cancel, so it was still on. She just hadn’t bothered to call to explain why it was taking so long. She wasn’t showing Kiara respect. But if she brought Malachi, Kiara wouldn’t say anything. She would just let it go because that was the only thing that was important.
Finally, she saw Mrs. Lewis walking down the tiled floor of the mall toward Kiara. Pushing a stroller. That meant that she hadn’t gone all of that way just to tell Kiara that there wasn’t going to be any visit with Malachi. It meant that Kiara got what she had been begging the universe for. A chance to see and hold Malachi again.
Kiara walked quickly toward them, not willing to waste seconds waiting to see her baby again.
“Malachi! Malachi! It’s Mommy, look, Mommy is here!”
She saw Mrs. Lewis’s look of disapproval. Over what? Over Kiara calling herself Mommy? Unless the foster mother had been calling herself Mommy, Malachi wouldn’t be confused by the names.
Malachi was sitting up in the stroller, looking around with interested eyes. He looked at Kiara blankly at first, and her heart sank that a baby’s memory was so short that he had forgotten her in that length of time. But he kept looking away and then looking back at her face. Maybe something was catching his attention. Something made him keep looking back to see if he recognized her. Something about her must have been familiar. When they got within a few feet, then Malachi put up his arms for her.
“Ma, ma, ma, ma…”
“Yes, Mommy is here. Come here, you precious boy.” Kiara bent over to unbuckle the stroller seat belt to free him and then swung him up in her arms.
“You probably shouldn’t be lifting him,” Mrs. Lewis warned.
“I’m not an invalid,” Kiara snapped. “Just pregnant! I’m allowed to pick up my own baby.”
But in straightening up with Malachi, she had a head rush, dizziness swamping her for a moment, but she kept a hand on the stroller and tried not to look obvious about it. After she was steady once more, she let go of the stroller and looked at Malachi.
“Oh, you are such a sight for sore eyes!” She kissed him on both cheeks, his forehead, and his nose. Malachi laughed and slapped at her face.
Kiara touched the corner of Malachi’s head lightly. There was a large purple bump with a cut across the top. “What happened here? Did he fall?”
“Just an accident like all toddlers have,” Mrs. Lewis said. “Learning to get around on their own, they bump into furniture, roughhouse with other kids, run into walls.” She shrugged, unconcerned.
Kiara figured she would have shown a lot more concern if Malachi had gotten a bump and cut like that while he was in her care. They probably would have burned her at the stake for not watching him closely enough.
“I want to know how it happened.”
“It isn’t anything to be worried about, Kiara.”
“I’m his mom. I’m the one to judge that.”
“No. I’m his social worker, which means that I am the one evaluating his care and wellness. Not you.”
Kiara shook her head at this. How superior could the woman get? Nobody replaced Kiara in her position as Malachi’s mother and the one most concerned with his welfare. Not a foster mom. Not a social worker. Not even a judge. Kiara was the one who would always care the most about Malachi.
“So, I can go where I want to as long as I stay in the mall and you’re around to supervise?” she suggested.
Kiara wanted her freedom. To be able to go shopping with Malachi, or take him to the little toddler’s play area, or whatever she felt like.
Mrs. Lewis shook her head. “I would like to talk to you as well. Why don’t we go there?” She motioned to the restaurant she had told Kiara to meet her in front of. “We can sit down and talk. Malachi can sit in a highchair and color or play with whatever you brought with you.”
Kiara hadn’t even thought of bringing toys with her. There might be one or two tucked into her diaper bag. She hadn’t even been sure whether to bring that, but figured that at some point, Malachi would need to be changed, and she’d better look like she was ready for it instead of being surprised that what went in one end actually came out the other.
CHAPTER FORTY-ONE
She walked toward the restaurant. It was a family restaurant, but didn’t really have anywhere for children to play. As Mrs. Lewis said, Malachi would have to sit in the highchair. Or in her lap. And he was going to get bored with that before they got anything to eat. Maybe Mrs. Lewis just intended for them to get coffee. Something to keep them occupied while they talked about other arrangements to be made in the future. Kiara was going to stay on top of them for visits. She wasn’t going to let weeks and months go by without being able to see her baby.
That wouldn’t happen to her.
As they sat down and the waitress gave Kiara a coloring page for Malachi, which served as the kids’ menu, she realized why Mrs. Lewis had suggested they go into the sit-down restaurant for the visit.
Because she wanted to see Kiara feeding Malachi.
Was that the way it was going to be whenever they had a visit? Even after Malachi was returned to her? Every time Mrs. Lewis made a visit, she was going to want to watch Kiara feeding Malachi? Was she going to want to weigh and measure him at every appointment too? Kiara had visions of Mrs. Lewis demanding to know how much Malachi weighed when he was fifteen, sixteen, or seventeen. Still in Kiara’s life. Still watching Malachi eat and demanding to know his measurements down to the ounce.
Kiara looked over the kids’ menu while Malachi hit the table with a spoon. Something that he would eat more than one bite of. Was Kiara responsible for paying for it? Or was it a DCFS bill? Kiara couldn’t remember her mother taking them anywhere to eat for supervised visits.
“I guess… I’ll get him a macaroni and cheese,” Kiara said, moving the menu closer and farther from her eyes. The print was blurry no matter where she held it. They’d obviously had a problem with their printer. She couldn’t quite make out the price, couldn’t tell the difference between sixes and eights.
Mrs. Lewis nodded at this. “I’ve eaten, but wouldn’t mind a coffee. How about you? Have you been taking care of yourself?”
She eyed Kiara, eyes calculating. Trying to figure out how much weight she’d gained with the pregnancy? Whether it was enough or too much? Was she gaining too much weight and putting herself at risk for diabetes or high blood pressure? Endangering the baby with her negligence? Or was she not gaining enough weight, too skinny from amphetamine abuse?
“I take good care of myself and the baby,” Kiara told her. “I go to all of my doctor appointments, and he’s monitoring my weight and blood pressure and all of that. He says I’m doing everything right.”
She could tell the doctor to release her medical records to DCFS if Mrs. Lewis doubted it. They would see how careful she had been to do everything right and to take care of herself and the baby. Maybe that would help them understand that she had been the one to express concern with the doctor about Malachi not gaining weight quickly enough, not the other way around.
“That’s good. No problems with this pregnancy like you had with Malachi?”
Kiara didn’t know how much of that situation she was aware of. She hadn’t told Mrs. Lewis much about it, but did she know anyway from looking at Malachi’s birth records? They would show that she hadn’t been doing anything risky. She hadn’t been eating junk food or taking illegal drugs. Sometimes, problems just developed and babies came early, or had to be taken early.
“No. He says that everything has been right on target.”
“Good to hear.”
The waitress returned to take their orders. Kiara made a point of squinting at the kids’ menu so that she would see how blurry it was. Then she gave it to Malachi to color the pictures and puzzles on it. He was happy with a couple of crayons.
Kiara took out her phone and took a couple of pictures of him. Not just because he was so cute or he was growing up too much away from her. She wanted a record of the bump on his head. And it didn’t look to her like he had gained any weight at all in the two weeks he had been in foster care. He seemed smaller than she remembered. Was it possible that he had lost weight?
“Has he put on any weight?” she asked Mrs. Lewis.
