Five Years Later

Miss Stevens, the caseworker I met the day my mom died, tried her best to find family members who were willing to take me in, but there just wasn’t much information for her to work with. My mom hadn’t listed anyone as my father on my birth certificate, confirming what she’d told me growing up; she just didn’t know for sure. That left me with only one option...the grandparents I had never met because they kicked my mom out of their house when they found out she was pregnant with me. It wasn’t a surprise when they refused to take me into their home even though I had nowhere else to go. They’d washed their hands of me before I was born and had no desire to change their minds twelve years later.

I didn’t have high expectations of other people, and my outlook served me well in the foster system. The kids who were soft had it the hardest because the transition was rougher for them. The absolute worst were the ones whose entire world had changed in the blink of an eye. The parents who had loved them were gone, and nobody was left to take them in, so they were tossed into the system with us throw-away kids. They weren’t just soft, they were sad. Unfortunately, there wasn’t anyone around to give a damn or help them adjust to life without their family so they had to figure it out for themselves.

The only constant in my life was Miss Stevens. Even when they tried to transfer me over to someone else, she insisted on keeping me as one of her “kids” as she liked to call us. She was always on my case about giving my foster parents a chance. “They’re good people who just want to help you,” she would say any time I got kicked out of one and sent to another, usually because I kept to myself so much it made people wonder if I had a personality disorder or something.

Maybe there really were good foster parents out there who did it for the love of kids, but I hadn’t been lucky enough to meet any of them yet. And honestly, as nice as she was, what did she know about it anyway? In my experience, foster parents put on a good show when one of our caseworkers did a visit, but it was just temporary. Once it was over, we were back to our regular programming of disinterest and sometimes flat-out neglect.

It was the latter of the two which landed me in the hospital. When I first got sick, I thought it was just a sore throat and didn’t worry much about it. By the time I could barely swallow and complained to my foster mother about it, her real child was sick too. Of course, she took him to the doctor right away and didn’t even think that maybe I should go along since I’d been the first to catch whatever was starting to spread through the house. The doctor diagnosed him with strep throat; a highly contagious disease that any reasonable person would guess to also be the cause of my illness since our symptoms were identical. But since I was the brat who had infected her precious boy, my foster mother wasn’t in a hurry to seek medical help for me. Almost a week later, when two of the other foster children got sick, she finally bothered to take me to an urgent care clinic. But the damage had already been done.

About a week later, I started having weird symptoms. It began with some swelling in my feet and I figured it was just from the insanely hot weather we were having. Then it moved to my belly, which could easily be blamed on my period since it was supposed to start soon. When my face started looking puffy, I finally wondered what might be wrong with me. An online search at the school library gave me a huge list of things that could be the cause of the swelling. Anything from my period to all the salty food my foster mother fed us. Deciding either of those were the most likely culprit, I told myself not to worry too much about it.

When my fingers, wrists, and elbows started to ache, I figured it was from the swelling. Then my pee turned an odd color, but I thought it was probably from some of the candy I had eaten at lunch when a classmate shared it with me. But the next morning, when I found blood on the toilet paper after I went to the bathroom, I couldn’t explain it away. My period hadn’t started yet so it was enough to freak me the hell out. I didn’t trust my foster mother enough to take me to see a good doctor, and I was scared that maybe I was dying or something. So I called Miss Stevens to ask for her help. It was the first time I’d ever reached out to her, and I think she was too stunned to do anything but agree to take me.

I met her at the curb when she came to pick me up because I didn’t want anyone to ask questions about what was going on. Offering her a weak smile, I climbed into the car and quickly buckled up so we could get out of there before one of the other kids saw me. “Thanks,” I whispered.

“You’re welcome,” she replied before an awkward silence filled the vehicle. She tried to strike up a conversation a few minutes later, but I was even more uncommunicative than usual. I was less than a year away from aging out of the system and didn’t know what would happen to me if I was really sick.

Although it was only half an hour later, I felt like I’d waited hours before I was sitting across from the doctor and he was doing the physical examination. “I’ll need to run some tests to make sure, but I think it’s post-streptococcal glomerulonephritis,” he said when he was finished. “It’s a kidney disorder that sometimes occurs after infection with certain strains of Streptococcus bacteria.”

“Like the strep throat I had a couple of weeks ago?” I asked.

Instead of answering right away, he clicked the mouse on his laptop a couple times and peered at the monitor. “I don’t see anything in your chart about strep. Were you treated for it here?”

Sneaking a glance at Miss Stevens, I knew she was going to be angry I hadn’t talked to her about this sooner. “No, my foster mom took me to the urgent care clinic, along with a couple of the other kids who had it too.”

“I’ll give them a call to get your records transferred over here. It’s pretty rare for a case of strep that’s been treated in someone your age to cause post-strep GM.”

“Maybe we should have the other kids brought in to be checked over too,” Miss Stevens suggested. “Since all of you caught it at the same time, they might be at risk too.”

“I had it longer than everyone else,” I whispered.

“How much longer?” the doctor asked.

Miss Stevens leaned over and took my hand in hers when I hesitated. “Faith, when did you get sick?”

“Maybe a week and a half before we went to the clinic,” I answered softly.

She gasped at my response and turned to the doctor. “Could the delay in her care be responsible for her being ill now?”

“Yes,” he confirmed. “Letting strep go untreated can lead to further complications.”

“Oh, Faith,” she sighed. “I’m so sorry.”

“It’s okay,” I reassured her. “You didn’t know.”

“But your foster mom did, didn’t she?” she asked.

“Yeah,” I admitted. “I got sick before Adam did.”

“Did she get medical care for him right away?”

I looked down at my hands as I twisted them together in my lap. “Yes.”

“Oh my goodness,” she breathed. “Are you telling me your foster mother knew you were sick with the same symptoms as her son, ignored your illness even though she took him to the doctor, and then bothered to get you treatment only when the other kids came down with it too?”

In the face of her mounting anger, I just nodded my head. At my confirmation, she jumped out of her chair and began to pace the room. The doctor and I watched her for a moment before he interrupted her as she mumbled under her breath.

“I know there’s a lot going on here, but we need to discuss Faith’s medical needs sooner rather than later.”

“What kind of medical needs?” I asked as Miss Stevens came to sit beside me again.

“I’d like to run some blood work to look for the antibodies to a substance produced by the bacterium that caused your bout of strep throat, check some of your levels, and do a urinalysis,” he explained.

“Okay,” I replied since that didn’t sound too bad even though I didn’t understand it all.

“You’ll also need a couple of medications. An antibiotic to make sure we get all the infection out of your system, and I want to put you on a diuretic to help with the edema as well as a blood pressure medication since yours is high,” he continued.

“Oh,” I sighed. That sounded like a lot of different pills for me to keep track of.

“I’ll make sure she gets the prescriptions filled and we have a plan in place to make sure she gets anything else she needs,” Miss Stevens said. “Is there anything else we need to do?”

“Limit her salt intake and call me immediately if she has decreased urine output or any new symptoms develop.”

Although my head was spinning, I didn’t miss the mention of new symptoms. “Like what?”

“At this point, I want you to call me with anything unusual,” he answered vaguely. “And I have to admit that I’m leaning towards hospitalizing her.”

“Hospitalizing me?” I repeated.

“Usually post-strep GM can be cleared up in several weeks to a few months,” he clarified. “But that’s only if you receive the proper care for it. Considering the circumstances that brought you here today, I have some serious concerns about the type of support you’ll receive at home.”

“I’ve been taking care of myself for a long time, Doc,” I joked weakly.

“I don’t want to scare you any more than you already are, but you need to fully understand your condition,” he said, taking a deep breath before looking at me with resignation in his eyes. “In a small number of patients, post-strep GM may get worse and lead to chronic kidney failure. Sometimes it can progress to end-stage kidney disease, which would require dialysis and a kidney transplant.”

I’d spent years convinced I lived without hope. It took hearing those words to understand I wasn’t as hopeless as I thought I had been. Or at least I hadn’t been. Until that very moment, I was more similar to other teenagers than I ever would have admitted in that I thought I would have a long and fairly healthy life. I didn’t smoke, drink, or do drugs—not after the way I had watched my mom destroy herself. Apparently, none of that mattered because a common childhood illness that could be easily treated with antibiotics had managed to become a possible death sentence for me.

In the following weeks, I discovered how low I could fall as my condition didn’t improve. It didn’t matter that Miss Stevens had all the kids pulled from the foster home where I had been staying or that she finally found one of the few nice ones for me to go to with a foster mother who really acted like a mom and treated me as though I was her own. She cared for me as the swelling got worse, my blood pressure shot through the roof, and my appetite disappeared.

When the time came for me to be admitted to the hospital, she visited almost daily for the first few weeks until there was another foster child who needed her to be home so she could properly care for them. Saying goodbye to her was one of the hardest things I had ever done because I’d come to care for her. It was impossible not to when she’d shown me such compassion, but I knew there were others who needed her more than I did since I had nurses and personal care attendants watching over me around the clock.

Kids came and went through the pediatric unit. Some of them even tried to befriend me before I got a reputation for being a loner. But with everything going on, I was even more closed off than usual. Trying to focus on anything but how sick I had gotten, I threw myself into my online courses in the hope that I’d be able to keep up with my studies so that I wouldn’t have to repeat my senior year. As my condition continued to worsen, I worked even harder on my classes because I was suddenly obsessed with the idea that I wanted to at least graduate high school before I died.

They monitored everything about me on a regular basis, and I felt like studying was the only thing over which I had control right now. I couldn’t eat what or how much I wanted because the doctors wanted to reduce the buildup of toxins that my kidneys would normally remove. My fluid intake was closely monitored so that I only drank the same amount I could pee. They brought me pills and took my vitals around the clock. But study time? That was all me. I could even turn on the laptop they’d provided and read to my heart’s content. Nobody ever tried to tell me I couldn’t...probably because they all knew I was on my way towards death’s door.

When they first put me on dialysis, I felt better and started to think I could beat this thing. It was only supposed to be used for the short-term, but I was one of the unlucky ones because my kidney damage was so great that they thought dialysis may be permanently needed. That’s when they started talking about a transplant. If I had any family who gave a damn, they would have tried to do a live donation. My rare blood type made me a difficult match, and being a foster kid only complicated it further.

I became obsessed with making the UNOS waiting list, even though there wasn’t a damn thing I could do to influence their decision to list me. Or to put me high enough up that I even had a remote chance of getting the kidney I so desperately needed. When the day finally came and I was told I made the list, it hit me. In order for me to live, someone else must first die.

Although a part of me celebrated the fact that my chances of survival had at least slightly improved that day, I felt morbid. It was like I was wishing death upon another person. As though I was hoping to swap fates with them, even though I’d never want anyone else to have the crap luck I’d lived with all my life.

Then it was just a waiting game, watching my place on the list rise and fall depending on the results of my newest labs. Each of us were ranked by UNOS using a point system. It also took a number of other factors into consideration, including the degree of match between us and the donor and the length of time we had been on the waiting list. My place never went high enough for me to get my hopes up, though. The doctors knew I was a bad bet since I had no support system in place to help me after the transplant, and so did I.

The dialysis continued, but I knew I was getting worse and the day was drawing closer when I was going to run out of options. It was painfully obvious to everyone that I was starting to accept my fate, starting to believe the call would never come. Not for me. That’s when the nurses started up the faith jokes—to try and raise my spirits and get me focused on staying as healthy as I could while I waited. And waited. And waited some more.

During all that time, I knuckled down and plowed through my school work like it was the one thing that could save my life. Although I knew I wasn’t going to be able to return to school to finish my senior year, I wasn’t willing to completely give up until I finished all my courses and knew I had accomplished something my mother had not. I worked towards my graduation with a desperation that meant I finished months before the school year ended. When I clicked the mouse to shut out the program, all my tests finished and papers completed, I finally felt like I could let go.

That was the day my luck changed. Somehow, a miracle happened. I was given a second chance. One I promised myself I wouldn’t waste.