Parenting

04.30.13

Dr. Jane Aronson on the Early Challenges of Adopting

World-famous ‘orphan doctor’ Dr. Jane Aronson on how a New Yorker article almost ruined her plans to adopt a child from Vietnam—and on the unexpected roadblocks many adoptive parents face.

Before we met Ben, there was a hitch in our adoption plans, something that explains part of the eagerness with which I ran into the orphanage that day when we were finally able to travel to Vietnam to bring him home. In July of 2000, five weeks before we were scheduled to travel, an article about international adoption, “The Orphan Ranger,” written by Melissa Fay Greene (who graciously contributed the essay “The Science of Happiness” in this book), appeared in The New Yorker. I knew the gist of what Melissa would write, based on her many interviews with me over the course of the prior year. Wishing not to appear academic, scientific, and one-dimensional, I had phoned her one day to say that I wanted to be open about my sexuality in the article. I was tired of being a doctor without a real life. With impending parenthood, I wanted to be as open and honest with readers of the magazine as I planned to be with my child.

I received a call from the social worker from my adoption agency in late July. My dossier to Vietnam was being held in D.C. by the Vietnamese consul. They were questioning something in the application. The social worker was evasive. She then got to the point of her call. “You know that article in The New Yorker? Well, it might have been better if you had talked to us beforehand.” I could hear the disapproval in her voice. In this moment, I had the terrible realization that something bad could happen in our adoption process and that we might not get Ben. I heard the social worker say, “We will respond to the inquiry about your dossier and get back to you.” She said that they needed a character letter or something like that. I never found out who they contacted or what this person ultimately said or wrote on my behalf, but about 10 days later I was cleared and we set off in August to get our son.

On our way home, at the U. S. consulate in Saigon, the last stop in the long process to finalize the adoption, I carried Ben to the Plexiglas window to answer some final questions. The three officials on the other side of the window stared at Ben and me for a few moments. Suddenly one of them held up a copy of The New Yorker and all three of them smiled and gave us the thumbs-up. What a moment! With tears streaming down my face, I jubilantly acknowledged this vindication from these Vietnamese officials of our integrity as parents who had come to take our child home. But the New Yorker episode was just one of many challenges we would face as a new family that had crossed oceans to come together.

I called the early intervention group that I had used for many of my adoptive families in Manhattan. The therapists came one after another to evaluate the developmental milestones of this now butterball baby boy. He couldn’t keep his head up straight, he still held his hands in fists, and he wasn’t able to turn over. He qualified for services with an occupational therapist and a physical therapist because his delays were 33 1/3 percent in each domain of development, that is, gross motor and fine motor.

I didn’t know what to expect, even with all of my experience with adopted kids. Still, we settled into our family life. This was my kid and there was no map or predetermined plan. We just hoped that with all this work, he would be OK, whatever that meant.

Ben had six hours of physical and occupational therapy a week, but then, at 10 months, he let out his first belly laugh and we came running to witness it. His neck had straightened over the months with a lot of manipulation, massage, and hard work on his part. He was happy in his Boppy pillow, able to see the world around him. He finally walked at 15 months with a great sense of pride in himself. But his thumbs hardly ever came away from his palms. He grabbed everything with his fingers alone. The therapists frankly were baffled and finally suggested little braces, which were useless.

What was most encouraging was his ability to communicate. He vocalized constantly right from the beginning so those parts of his brain appeared to be very active and intact. And language came swiftly for him. While his body failed him in some ways, he was content and so were we. He could enjoy intimacy and social connections because he could understand us and make himself understood. As I see it, Ben had a gift for communicating. Many of the kids I see in my office struggle for years to communicate and are terribly frustrated.

After five years of occupational therapy and handwriting tutoring, Ben had his thumbs back and was able to write letters and numbers indistinguishable from other children his age; in fact, he was quite adept and became a Lego master, a cello player (with a kid-size cello, of course), and he now plays the piano. Today Ben is a very happy and healthy boy, and both Diana and I think his fingers are very pretty and magical when he plays the piano.

As an adoption medicine specialist, I have traveled all over the world visiting orphanages and learning about the many facets of “orphanage society.” I wanted to know why the children who arrived in my office from institutions abroad looked through me and didn’t shed a tear as I drew their blood and administered vaccines; I wanted to know why some of these sweet little ones often appeared limp and lifeless when offered intimacy or closeness. And I wanted to know why dear babies who were alert didn’t attempt to vocalize. As I examined newly adopted children in my pediatric office, I observed children staring at their hands and lifting their legs into the air as if they had never realized that they could move these appendages; I realized that they were truly unaware of their physical place in the world. They had no understanding of their bodies and they knew nothing about what they could do physically.

As infants, many orphans around the world lie in cribs soiled and vanquished. Often they lie on their backs with bottles propped for their feeding, missing out on the experience of intimacy with a primary caretaker who holds, touches, and talks to them—the building blocks for attachment. As toddlers, they stand along railings, rocking side to side, cruising unsteadily along the railings of their large pens in soundless rooms. Nevertheless, children are amazingly resilient and—with the support of loving parents who are able to accept that the process can be very gradual and full of uncertainty—they eventually adapt and stabilize in their new home environments. As the testimonies in this section of the book reveal, the creation of a family through adoption can involve many challenges, but love and permanence are powerfully healing forces.

Excerpted from Carried in Our Hearts: the Gift of Adoption; Inspiring Stories of Families Created Across Continents by Dr. Jane Aronson with the permission of Tarcher/Penguin. Copyright Jane Aronson 2013.