the New York Times

September 18, 2021

Empty Nests Are Overrated

Our grown sons had long since moved out when my husband and I took in two foster daughters. We all took a chance on trust.

My younger foster daughter stormed out of the living room where we’d been doing battle.

“You knew what you were getting into when you signed up for me!” she screamed, the crash of the front door shattering my heart.

But the truth was I didn’t know what I was getting into when I became a foster parent. My husband, Saul, and I had had Janine and her sister Mariah as foster children for almost four years by then. I had known the girls since they were small. I was their pediatrician. I met them on the day their mother, Linda, dragged them into my office with no appointment — they were not even my patients yet — and announced that Mariah was sick.

“She’s not well!” Linda bawled. “You have to help her!”

Indeed, she was not well. She had a fever of 105, was shaking, sweaty and pale. She had just come from the emergency room across the street where they’d drawn blood, diagnosed her with pneumonia, and sent her home with a prescription for antibiotics. But instead of going to the pharmacy, Linda had come to my office, unannounced, demanding more.

Linda was a mentally ill alcoholic, but her maternal instincts were spot on. I gave Mariah a shot of a potent antibiotic and hospitalized her. Sure enough, the next day her blood cultures turned positive. She was septic. And Linda had known. Or at least she had known that Mariah needed more.

As it turned out, both girls would need more. Their father would die of recurrent bladder cancer the day after Mariah turned 11. Their mother would start drinking heavily again, becoming violent with the girls. The Department of Children and Families would place them in foster care. Both girls would turn to self-destructive behaviors to cope with their rapidly disintegrating world. Mariah would begin cutting herself, bringing her pain into sharper focus. Janine would develop severe anorexia, shrinking her crumbling world into one manageable bite.

They were placed in 11 different homes and programs each over the next five years. Through it all, I tried to keep track of them. But Janine’s social worker stopped returning my calls after she was placed in her third residential treatment program. I heard through Mariah’s court-appointed special advocate that she was so unhappy in her latest placement that although she’d been there for three weeks, she wouldn’t even unpack her bags.

I had to do something. As a doctor, I knew a bit about eating disorders and I knew about teens who cut. Maybe I could provide that extra level of care and skill these girls needed. Maybe I could become their foster mother. Maybe I could give them that something more.

I told Saul the whole story.

“Empty nests are overrated,” I joked, even though this was no laughing matter.

Our nest had been empty for a while. Our sons Dan and Neil were by then in their 30s. They both lived on their own with significant others, Dan in Maine working in the family restaurant supply business and Neil in New Hampshire, pursuing his Ph.D. in mathematics education. I asked if they minded. They both laughed and said, “Why would we?” But giving away their rooms felt like a “no-going-back” kind of move, even though they hadn’t spend a night in those rooms in years.

We got Mariah first. Her last foster mother had recently summoned the police when Mariah had stayed out too late, resulting in an unpleasant scene with chairs thrown and names called. She arrived at my office with her social worker on a cold dark January afternoon. We transferred her belongings into my car. Plastic hampers full of balled-up clothes. A white oversize pocketbook with school texts and notebooks spilling out. Two torn black plastic trash bags filled with who knew what. She told me she had recently gotten her learner’s permit. When we finished loading her stuff into my car, I handed her my keys.

“Really?” she asked me, wide-eyed and squeaky-voiced.

“Sure,” I said. I wanted to show her I had confidence in her. Believed in her. Trusted her.

On the way home, we stopped at the grocery store. I told her to pick out whatever she wanted. She told me she made a mean guacamole. I told her I did, too.

“Sounds like a guac-off,” she said, throwing avocados and limes into the cart.

It would be another six months before we would get her sister home. We attended family therapy sessions at the eating disorder program where Janine lived, learning about her mental illness and how best to help her. We took her home on passes, first for a few hours, then for meals, finally for overnights and whole weekends home.

In one of our last therapy sessions before Janine’s discharge, her therapist Alex wrote “I Overcame …” on a sheet of construction paper and affixed it to the top of one of the walls in his office. Then he had Janine write on colored pieces of paper all the challenges, traumas and obstacles she could think of that she had risen above in her young life. “My father’s death” she wrote on one sheet of paper. “My mother’s alcoholism” on another. “Living without my sister” on a third.

On a fourth square of paper, Janine wrote, “Being afraid to make a mistake.”

“What does that mean?” I asked.

“In foster care, you always feel like if you do something wrong, you can be taken away at any moment. Sent somewhere else to live.”

My heart cracked.

The point Alex was trying to make with his construction paper and markers, with his wall of overcome obstacles, was about attachment. These girls had been abandoned — in one way or another, intentionally or not — by almost everyone in their lives. But with all of the trauma and loss, they were still willing to take another chance on us.

Before that moment, I had really only thought about my own gamble. Trading away a life of near-retirement for an uncertain future with two new and needy teens.

But I finally understood that it was these girls — these brave, beautiful girls — who were taking the bigger gamble. Risking further pain and fresh abandonment by starting over with us. With all they had been through, they were still willing to trust. To walk into our home. To fall into our open arms with no guarantee.

Janine was wrong that day we argued in the living room. We didn’t know what we were getting into when we took them in as foster children. But they didn’t know what they were getting into with us either. We were all gambling on each other. Doubling down on love. And holding out for more.

Carolyn Roy-Bornstein is a pediatrician who has completed a memoir about taking chances, making commitments and redefining love.