Thursday, November 29, 2012

Recovery

I did a dumb thing last week. I was playing at my kids' school with them and banged my right foot really badly wearing Wellies. I am too embarrassed to tell you what I did exactly, but it was a bad connection between foot and metal. I limped home slowly and seriously thought I'd broken my right big toe. I broke my left big toe when I was 18, and it felt remarkably similar. I knew my injury was my fault, and I felt stupid. But there wasn't much I could do about it at that point (my family was having too much fun laughing at me to beat myself up any further). Broken or fractured or bruised, oh well. Ice the toe, take Advil, and suck it up. I had good range of motion, so I knew it wasn't worth darkening my MD's door.

It hurt. It was swollen. It got worse, then better-ish. But it was hot and red. Never a good sign.

On Sunday, I worked. It wasn't awesome to have to hustle in the hallways, but I survived. Then Monday morning, when I was watching The Walking Dead  and drinking my coffee, I noticed that the swelling wasn't inflammation swelling: it was abscess swelling. Double gross.

I am a nurse. I prepared my sterile field and lanced the grossness. It was gratifyingly full bacterial effluvia. Problem was that there was involvement of the nail and atrophy of the tissue behind the nail. I knew that the nail had to go, just not when or how. I knew it should probably go soon to prevent more bacterial growth. I was keeping the wound clean and irrigating it with normal saline; I checked in with my ED nurse and MD friends. I had a nightmare about gangrene. I spiked a temp of 100 degrees.

Wednesday morning I called my MD and made an appointment; my regular MD wasn't there, but I was able to see the new physician in the practice, who is wonderful. She read my complicated history and said, on coming into the room, "You've really been through a lot!" I appreciated that. Then she looked at my gross toe, immediately wrote me a prescription for Bactrim to take orally, and declined to take my nail off. She said she'd never done it before, and that I should see a podiatrist ASAP.

The receptionist referred me to a podiatrist (outside of UCSF); I drove home and called the podiatrist's office, explaining my problem and the urgency. I was offered an appointment on December 7th! I said that I needed an appointment sooner, and she said it wasn't possible. I asked her what I should do, then. Go to the ER? She said I should take the December 7th appointment. I asked if she'd ever heard of sepsis. I asked her if she could refer me to another office. She did.

Best thing.

The next office was the most fabulous place! They fit me in immediately, were kind and compassionate, and understood what an abscess was. I checked out the DPM on yelp and she is covered in love. I can add to that.

Anyway, I showed up at my appointment today, and she giggled that the primary care MD didn't want to take off the toenail. It took her 15 seconds, after she numbed me up with lidocaine and put on an awesome makeshift tourniquet made from an exam glove. She showed me where the nerves are in the toe, where best to numb them, and described rookie mistakes in numbing. She teased me about how as an RN I could be masochistic enough to lance myself but not take off the nail. I said that I don't have my own private stash of lidocaine, and we laughed. She was nerdy and excellent! It was all surprisingly anticlimactic.

It felt great until the lidocaine wore off. And now it hurts, but I am sure as the nail bed dries I will feel much better. I will wait a year for my nail to grow back, and in the meantime marvel at my nail-less toe. The human body never ceases to fascinate me.

Far from the Tree has arrived, as well, and I am deep into the first chapter. It is written so engagingly that I hope I can put it down and not read all night.


Wednesday, November 28, 2012

Unhappy Families

Anna Karenina famously begins, "All happy families are alike; each unhappy family is unhappy in its own way."

I was reading Julie Myerson's review of Andrew Solomon's Far from the Tree in last Sunday's Times (that book seems inescapable at the moment), and Myerson wrote that Solomon came to an "'anti-Tolstoyan' conclusion that 'the unhappy families who reject their variant children have much in common, while the happy ones who strive to accept them are happy in a multitude of ways.'"

This is fascinating; what makes rejection inevitable and the rejecting families unhappy, while the happy families can accept difference? I have been thinking about my long history of being a variant. I believe that variants do strike fear into the hearts of those who try hard to fit in and not be different from those around them. Those whose goal in life it is not to stick out, not one little bit. Our (variants') being around, and talking about who we are, can be an enormous threat to the balance that some work so hard to achieve and pass off as effortless. But variants aren't figments of people's imaginations; we are real. And running away from us doesn't make us go away, except in a physical sense. As do those who have to live with/around/near us: this is a 700+ page book that talks about the real (emotional/physical/financial) difficulties of living with those with horizontal identity. I get it. We're not easy, either. Perhaps in some cases, relationships are broken and never mended, or are broken and then mended (as in the case of Tiffanie DiDonato I wrote about a few days ago).

In her review in the Times, Myerson indicates that Solomon writes perceptively about the challenges of figuring out who we are: "[Solomon] knows about the humiliations involved in the search for (in his case, sexual) identity. He knows what it is to feel like a freak." And as a fellow freak, apparently he writes without judgment. I thank him for that. It sounds like he is wonderfully empathetic and intelligent and probing, having compiled 40,000 transcript pages from interviews with many families and distilled his findings into this book.

A reviewer on amazon.com said that she got caught up by some great sentences on page 2 of Far from the Tree, which certainly resonate with me, both as an adoptee and as a parent:

"Parenthood abruptly catapults us into a permanent relationship with a stranger, and the more alien the stranger, the stronger the whiff of negativity." 

"From the beginning, we tempt them into imitation of us and long for what may be life's most profound compliment: their choosing to live according to our own system of values. Though many of us take pride in how different we are from our parents, we are endlessly sad at how different our children are from us."

I am incredibly excited to read this book (my copy on order is taking TOO long), and I cannot believe (well, yes I can) that adoption wasn't included as an example of horizontal identity. Perhaps it's an invisible example?


Tuesday, November 27, 2012

Diversity

I am an adoptee, and in that sense I belong to a social minority. I was asked today to think about diversity. My life has been immeasurably enriched by friends who belong to groups very different from mine: genders, social classes, ethnicities, cultures, and so on.

How do we definite diversity?
According to Merriam-Webster:
di•ver•si•ty:
1. the condition of having or being composed of different elements; VARIETY; especially, the inclusion of different types people (as in people of different races or cultures) in a group or organization diversity
in schools>2. an instance of being composed of differing elements or qualities: an instance of being diverse diversity
of opinion>
The first definition is about how a group of people looks, perhaps, or define themselves; their families, abilities, or ethnicities. The second definition isn't necessarily about ideas, but the example they chose is interesting in that it does.

We absolutely have a diversity of opinion in adoptoland, although that diversity not always welcomed or praised. We also have a diversity of adoptees, and of adoptee experiences (and of course, of first parent and adoptive parent experiences, too). Some of us adoptees are older than others; some of us are infant adoptees; some of us are international adoptees; some of us are foster adoptees; some of us are in reunion; some of us are not. Some of us spend hours thinking about what adoption has meant; some of us don't think much about it at all. Some of us have written books about adoption; some of us have written about other topics. Some of us are artists; some of us are comedians; some of us are professional chefs; some of us have moved home to the countries of our births. Some of us are activists; some of us care more about our clothes than about our bloodlines. Some of us are depressed; some of us are unquenchably happy. To quote Kurt Vonnegut, "So it goes."

And all of it is okay.

Today I send out love to all of my adoptee comrades, wherever you are, whoever you are. Pax. We are in this together.

Diversity is what makes us strong. I have learned more--the most, perhaps--from the people living lives most divergent from mine. Those were the people who encouraged me to look hard, and carefully, at myself, to scrutinize my unearned privilege, to look at the unspoken things that I can take for granted. Things that many other people cannot, just by virtue of who they were born, and where they were born, and the why of their births. Inequalities don't come from nowhere.

I know I have posted this beautiful, heartbreaking essay before, by my wonderful friend who has seen me through thick and thin and taught me more about diversity and justice and what my role in changing things needs to be, and why, than anyone else. But I want to honor him today by posting it again.


Monday, November 26, 2012

Small Shelf

I always love getting The Times around the holidays, when it is brimming with suggestions of great books to give as gifts. One book sounds interesting, less for its contents than as an idea. Thessaly La Force has collected a list of 100 famous people's favorite books, asking them to imagine what books (the amount that would populate a small shelf) would best describe them. The book, titled, My Ideal Bookshelf is also sunnily illustrated by Jane Mount. I would be interested in seeing what appears most commonly on the lists (apparently it's not George Eliot), and perhaps there would be some little gem that I would not otherwise have known. I am certain I will thumb through this and have a look.

I was trying to think which books I would choose, and was realizing that rather oddly, I would begin with a stack of things that I read in high school, and that I read quite concentratedly in junior year. My English teacher, Mr. Bayer, and I have similar taste, I suppose. He knew how to choose good books!

Thomas Mann's Death in Venice; Franz Kafka's The Metamorphosis; Euripides' Medea; Anton Chekhov's The Steppe. Good old Macbeth.

And then things I discovered on my own: Virginia Woolf's Mrs. Dalloway and all her short stories; Elizabeth Bowen's short stories; Katherine Mansfield's short stories; Emily Bronte's Wuthering Heights (forget Charlotte and her insufferable Jane Eyre); Jane Austen's Northanger Abbey: Leo Tolstoy's Anna Karenina; Henry James's Portrait of a Lady; Harold Bloom's Stories and Poems for Extremely Intelligent Children of All Ages; John Guy, ed., Wonder of the Age: Master Painters of India, 1100-1900; K. Lange and M. Hirmer, Egypt; C. Baldick, ed. The Oxford Book of Gothic Tales. The Tempest (if not the RSC's William Shakespeare Complete Works); Homer's Odyssey.

My small shelf is full, I believe. I am sure if you asked me tomorrow, there would be a few small differences. but probably nothing major. Wow, am I Eurocentric. And pretty predictable. I really love my classics, morose Germans/Austrians and Russians, and early 20th-century women. But I am a European-American woman obsessed with the past, so perhaps it's not all that surprising that these are the books that describe me.

What would be on your shelf?

Sunday, November 25, 2012

More about Horizontal Identity

After I wrote about horizontal identities week before last (and I still mean to read Andrew Solomon's book, Far from the Tree), I ran across an article about a woman, Tiffanie DiDonato, with dwarfism, that referenced Solomon's book. The article I found was in Allure, but still. It gave pause. DiDonato is strong and admirable as hell. But the fact that her grandmother and her father wanted her mother to give her up for adoption: horrifying! The article (by Judith Newman) isn't available online, but I wanted to quote a paragraph from it below (December 2012, p. 132).

When Tiffanie Lorraine DiDonato was born in Worcester, Massachusetts, to parents of normal stature in 1980, her father, Gerry, was advised by his own mother to give his child up for adoption. He told his wife, Robin, to choose between him and the baby. She chose her baby and left him. Tiffanie's father spent the next six months unable to eat or sleep, and the couple divorced, but six months after that they got back together. Gerry has spent the rest of Tiffanie's life making up for that initial bad decision. (It appears to have worked; he and Tiffanie adore one another.)

Talk about triggering; all's well, I suppose. DiDonato is healthy, married, and has a son of her own. She has taken charge of her life, and is happy in her body, which is more than many of us can say.

More power to Tiffanie DiDonato and her family, and to her mother, who stood strong in the face of what must have been overwhelming pressures to relinquish.




Saturday, November 24, 2012

Personal History

In as much as I love history on the page, and I love history in general, it has developed a new lustre for me through my natural family. I have written before about Dad's family in Norway, and how cool they are, but how that's not my history. And how I love Mom's family in all their Ohio and Minnesota glory, red hair and all. But yet when they sit around with the family tree, it's not my family tree (even though I am penciled in--LOL, and I love people on it).

I have a new respect and love for U.S. history now I feel that I have a part in it. I have been told by various members of my natural family that they don't care about genealogy, and that everything I've told them has been news to them, from our being distant cousins of James McReynolds, the crotchety Supreme Court Justice who gave FDR such a rough time (yes, I am a liberal, so that's my read of it) to our having relatives who fought and died in the Revolutionary and Civil Wars. Not that they don't like learning about it, but they hadn't felt a huge inner drive to do much about it on their own. I was very glad to share the great work that my awesome friend Zack has done for me in the genealogy arena with them--love you, Zack!

All this to say that when I saw Steven Spielberg's new film Lincoln today, all I could think about were some documents that Zack had e-mailed me related to my great-great-great-grandfather Russel/Russell (?) Showers, who was killed fighting for the Union, in the 80th Indiana Volunteer Infantry, in 1864 in the Battle of Resaca, as part of Sherman's March to the Sea.


I was crying throughout the film, not only because the script was amazing and the story is fantastic; and the acting is some of the best I've seen in years; and the topic is pertinent to us today in how far (and how little) we have come in terms of human relations; but because I am incontrovertibly tied to real people who died in that war, a heartbreaking war that split families apart, quite literally. I can name someone from that war whose blood runs in my veins, just like my husband can name his grandfather when talking about WWI. It's part of that experience, as another adoptee said to me once, of becoming "a real girl."

I only wish I were as eloquent as Abraham Lincoln was. I wonder what my great-great-great-great grandfather sounded like, and if he ever had the chance to hear the President speak.






Friday, November 23, 2012

Coping and Forgiveness

I was thinking about forgiveness along with thanks yesterday, and talking it over with friends at the dinner I attended. I was talking about being adopted, and before long, one of the guests at the other end of the table piped in with "You were chosen! How lucky you are. Not many of us can say this. We get saddled with the family we're born into, but your parents picked you, just you, out of a roomful of babies and that love is perfect."

Which is, of course, bunk. I wasn't chosen. I was matched with my parents, probably because they were older and had good health insurance. That's what Dad says, anyway. And as I said before, they did have a right to refuse me, but given they'd been wanting and waiting, it was highly unlikely they'd have done so. My dad particularly wanted a girl, and there I was: a female infant, 10 weeks old. If it hadn't been me, it would have been the next available baby. I hold no illusions.

I really like the friend of the host who came out with the social fairytale about my story. She meant well, to be certain. But in telling it, she took over my story and made some pretty huge assumptions. Because, you know, that's what the world is like: it is easier to handle us if we all follow the "chosen baby" story; people can, as I have said before, project all kinds of their own hopes and dreams and wishes onto us. We're receptacles in an odd way, for the way people want the world to be.

I forgive her. I also didn't bother to correct her or to say anything else. I just shut up and asked her about her trip to see Obama's first inauguration, which was quite a journey, apparently. There's nothing quite as safe as deflection (except maybe not talking about oneself at all).

I read a fascinating, heartbreaking blog post at neverforgottenisfound about one adult international adoptee's attempts to come to terms abandonment within the contexts of Korean culture and familial expectations. It is complicated, so complicated. In her place, I don't know that I'd be able to forgive. Perhaps.

I have also been thinking about whether I am too rigid and unforgiving. I know I used to be, but at the same time, one can only forgive the same mistake from the same person so many times before wondering if what they're doing is intentional and not a mistake, if there's an underlying message about how they feel about one that they're trying to share in an indirect way. I know that life is messy, people change, circumstances call for elasticity. I can ask for change, and if it doesn't come, I learn from that lack of change (while being honest with myself about what I am asking of the other person). I can also forgive trespasses while not exactly wanting to put myself in the firing line again, knowing that other people's behavior patterns are not going to change. That means changing my expectations about relationships, and that's okay, as well.

I tend to want to be direct when I am invested in a relationship, and to speak directly about what is upsetting me, or what I hope can change. I run into huge problems when dealing with people who greatly dislike talking directly about feelings or problems. It's not easy, for sure; I often feel guilty about asking for what I need. But I am trying hard to change that.

I definitely have an easier time forgiving others than forgiving myself; as I have blogged about before, I am highly skilled in self-flagellation and wear guilt like fine jewelry. I am a Catholic in my soul, I know it. But I also try to deal with the oppressive weight of my guilt by being realistic, not pretending that what I did never happened. And I also try my best not to hurt that person in the same way again, especially when I love and respect that person. "Sorry" is an underused word, IMO, but it has to come tempered with desire for change. It can be an incredibly empty word, too.

How do you cope with forgiveness?








Thursday, November 22, 2012

Thanksgiving

Happy Thanksgiving to all my fellow Americans!

Don't Let that Horse


Don't let that horse
                            eat that violin

  cried Chagall's mother

                                     But he
                  kept right on
                                     painting

And became famous

And kept on painting
                                 The Horse With Violin In Mouth
And when he finally finished it
he jumped up upon the horse
                                             and rode away
           waving the violin

And then with a low bow gave it 
to the first naked nude he ran across

And there were no strings 
                                        attached

--Lawrence Ferlinghetti

Wednesday, November 21, 2012

Strengths

I am the "art docent" or parent art teacher for my sons' classes. The district cut funding for art teachers years ago and expect the parents to pick up the slack and teach art. Despite myself (I function much better with adults than with children, usually), I enjoy the teaching and have found ways to present material in a way that is accessible and even perhaps interesting to the kids. When they see me on campus, they'll run over and say, "Hey! Tobey's/Callum's mom! I had so much fun in art and have been doing painting on my own, thinking about the Fauves/Picasso/Baroque portraits/Rothko/Malevich!" Whatever lesson it was. I am glad to introduce them to art history and to affirm their art-making. Some day, if they ever choose to go to a museum, maybe they'll have a vague memory of what I taught them, or they'll seek out what they like. At least they have some vocabulary for talking about art.

I did a project with Tobey's first grade class last week, focused on early 20th century art and abstraction as a mode of artistic thinking vs. representational art. The students were excited and full of questions. I told them that I wanted them to paint me something abstract, using gouache. Although they were hesitant at first, they quickly became absorbed into the task I had set them. The end products were gorgeous! One of the other moms is a designer for the North Face; she took the paintings to work to mount them. She said the other designers were incredibly excited by what the children had done and asked permission to Xerox some of the children's work for inspiration. Then the other two first grade teachers came to me and asked me to lead the same session in their classrooms, guiding their parent art docents. It felt good to be of use and to put my art history training to work. Especially when I sometimes dread sitting in front of a classroom of six- and seven-year-olds.

I love sitting quietly my art books, losing myself in good reproductions (even better to be in a museum, but I don't often have the time I'd like for that). I have been hatching a plan to go to the Getty Villa to see the two-thousand year old monumental sculpture of a lion attacking a horse. Probably Hellenistic, taken to Rome as part of spolia during the Empire.




The theme of the lion attacking a horse/deer is older still than the Hellenistic period, and common in the Near East (Mesopotamia, etc.) from the third millenium BCE. There was much borrowing of ideas, cross-pollination, in the ancient Mediterranean; this process of borrowing, or seeing strands of imagination across cultures and periods continues to this day, and perhaps is even more intense, in this period of globalization. (The lion attacking a horse/deer  can also be seen as a strand picked up at times in Islamic art, unsurprisingly).

The sculpture on view at the Getty Villa was restored (to Renaissance taste) by a student of Michelangelo, who gave it the horse's head and both animals' limbs and tails. So as we see it, it is a complex work of art having different layers of artistic contribution. And it also influenced other artists, including painters such as George Stubbs, who painted the subject several times.


Stubb's version of 1770 seems to be more about the horse's pain and death, perhaps, than the triumph of an imperial/royal lion. The horse, in white, is boxed into a corner, shown on what appears to be a ledge. The portentous clouds and darkness and apparent lack of means of escape foreground the fear of the attack. We don't see the lion much at all, but the scream of the horse and the taut muscles and sense of the prey's fight for life, instead. The browns of the lion tend to blend into the background, although the effect appears more stark in reproduction.

This painting, in most art history circles, (besides being considered marginal and British) is labeled as hackneyed. Overwrought. Too emotional. It's the painting on the cover of my thick copy of English Romantic Verse. Too much Shelley in it, maybe?

And yet when I look at the painting as owing something to a long history of a theme, I see something more. I find it eerie and disconcerting, yes. But what about its DNA in relation to the history of art? So many people I trained with at Berkeley wouldn't know the monumental piece from the Capitoline if it bit them in the metaphorical ass. "I don't need to know antiquity," they'd sneer. "I'm studying Picasso." Lame.

Since childhood, I have found more of a home in ideas than people (unless you count portraits, as I have mentioned before, and a handful of other oddballs, like me). I love thinking about esoteric, weird things. It's just who I am. Why did I memorize the Egyptian dynasties when I was eight years old? Why did I specialize in Near Eastern art as an undergraduate? When my parents took me to the Louvre when I was 10, all I wanted to do was haunt the Egyptian and Near Eastern galleries. I told them to go see the Mona Lisa and all the modern stuff without me. I was busy.

I don't know where my fascination for antiquity and art comes from. It's not anyone's but my own, as far as I can tell. But who knows? I may be a throwback, or perhaps I am just "special". LOL

I share my interest in medicine with my brother, the physician. That was affirming to discover. He is intelligent and driven and publishes his research, important research, all the time. He mentors his residents. I admire him for his commitment to his field.

I wonder sometimes what I would have done or been had I followed my desire to be physician. What kind of physician would I have been? If I had chosen that path at 18, I would (likely) have missed out on my world travels and my chance to immerse myself in nothing but books for the 10 years of graduate school. Some of my happiest hours were researching until the British Museum and the National Art Library closed and I was kicked out. I honestly hated handing back rare books and letters and going home to my flat. I was holding a letter of Oscar Wilde's in my hands!

Until about five years ago, I would denigrate myself for being different: for living off the beaten track of my community. As I have written before, parts of my adolescence were torture because I internalized the messages that people around me would share about my being "odd." These were the same people who would argue about whether I had lived in "London" or in "England." And I let them put me down? Unbelievable. It was sad that it took me so long to say to myself, "Why do you care what these people think?" How sad that I was living my life to please people who didn't give me a second thought, except to be jerks. I believe my my self-hatred/self-doubt was part of my being adopted. People-pleasing sucks, but it was what I thought I had to do at the expense of myself (although it's truly impossible to please others all the time: the goalposts are always moving).

Everyone has strengths, and those are to be lauded and loved. As a people-pleaser, I developed mad skills of talking to people about themselves and what they are interested in and love. Who doesn't enjoy an enthusiastic audience when talking about themselves? Easiest conversations ever; I can blend into the background and smile broadly and be known as the "nicest person." I do notice, however, that it's harder to find people to cross the road to talk to me; more recently I believe it's because I have boundaries now and don't put up with certain things. I can think of a couple of examples from nursing school when apparently I terrorized people who overstepped their boundaries with me. Better than being a doormat, I say.

Cynicism aside, I celebrate difference in people; we all have things to learn from each other, which I do on a daily basis, especially at work. And interestingly enough, some of my patients who have the most challenging lives--and the fewest resources--have the most compassion and are the kindest people imaginable.

A good life, in my opinion, is all about having respect for one another, which can be a very hard thing to do. And in the meantime, I will be thinking of the lion and horse, and wondering which one I am feeling like today.






Tuesday, November 20, 2012

Caring, Compassion, Community, Courage

I was on the strike line today. We still do not have a contract. Management claims that we are unwilling to negotiate, which isn't true. They want us to accept an insulting "last, best, and final offer" from their side, which is the act of dictatorship, not negotiation. At other hospitals, Sutter has taken to implementing the changes they want, circumventing the rules of the National Labor Relations Board. Sutter thinks it is above the law.

I am proud to stand with my fellow nurses, who asked that we think of our being together in the union as an act of "caring, compassion, community, and courage." I strike because I care about safe care for my patients. The changes that Sutter wants makes safe care a crap shoot. I have worked with unsafe staffing, and it's scary. Sutter needs to value nurses, not demean them.

An RN working at one of our facilities, fearing reprisal, wrote an anonymous letter and sent it to the local media. I am sharing it below. Her message is important. Think about the work that RNs do, and support us, if you are able!


Dear Readers,

It is with great sadness that I read articles in our local newspapers, disparaging nurses, our work as nurses, our profession and our work colleagues. It is on those days that I wish you could walk a day in my shoes.

Because when I walk into the Sutter Intensive Care Unit where I work, I do so with the strength, purpose, and character to do the very best job I can to take care of my patients. And my patients are the sickest of the sick, coming to the hospital with an extensive list of illnesses and medical conditions, in a medical crisis.

On my shift I most often take care of two patients on life support who have machines breathing for them. And because they cannot do anything for themselves, I clean the runny snotty secretions from their nose, mouth and throat. I wash and bathe their sweaty, soiled bodies, and when they have a loose bowel movement on themselves, I clean their bottom and replace their hospital gowns and bed linen. I feed them their nutrition, and when their doctor visits, I ensure they get the treatment, medications, and therapies that will help them make progress and improve so that they can get better and rejoin their families at home.

And when a patient’s heart stops, I am part of the team of nurses that works tirelessly to save a life, or when blood pressure falls dangerously low, I work to get the medications and treatments to pump blood to their vital organs. If a patient stops breathing, the team is there to ensure that they the life support ventilation they need immediately. And when the time comes for my patient to leave this world, and their family members are too scared to be with them, or cannot be there, I am there to hold my patient's hand, to comfort them and their families with the kindness and words they need at a time when they need it most.

My job is not glamorous, but every day I treat every one of my patients as if they were my mom or dad or husband or child because every one of my patients deserves the very best treatment we can give them, often times on holidays when I dearly wish both they and I could be at home with our families.

At my job I am often yelled at by overworked doctors or by tired family members who are stressed out because their family member is so ill, or because they feel scared or guilty that they couldn't do things differently. I am often screamed at because I cannot come to the phone to answer it fast enough when I am taking great care of my patients and our management has cut our secretarial staff. I am yelled at because I have to wait longer and call more often to get medications from our pharmacy because management has cut our pharmacy staff. I have to make do with fewer wash cloths and towels because we don't have resources. I have to do without my lunch breaks and chart instead because our staffing has been cut. We have nobody to take care of our patients if we step away to get lunch, and we are not allowed to file overtime. I can't take or make calls to my family or doctor's office, and I'm lucky if I get a bathroom break before I am desperate.  And when our nurses talk to our managers about our safety concerns about short staffing, it is important that you know our concerns fall on deaf ears.

And so I wonder how you as a reader and member of the community wants to take care of the person who saves your life or your loved one's life: that nurse who is there for you when you need comfort or care the most. Would you want us to go without healthcare insurance, sick time or lunch breaks? Would you want us to have so many patients that we cannot do our jobs safely? Would you be upset if we did not have the support and supplies to allow us to take the best care of your loved one? And if we injure ourselves on the job moving a patient or contract some illness from our patients, would you want us to come to work anyway and have it interfere with how we care for you?

Should we be compensated like our executives Pat Fry, CEO, $4,788,548, Martin Brotman, Sutter West Bay, $4,287.671, Sara Krevans, Sutter Sacramento Sierra Region, $2.094,933 and Ed Berdick, Sutter East Bay Hospitals, $2,015,930? We are asking for the same wages we make now, not a raise. The very same contract, without cuts. 

Newspaper journalists and Sutter Health report to you that we make exorbitant salaries and have "Cadillac health plans."  I think it is important that your hear from the nurses that take care of you in your community if you are very Ill. I will not make a six-figure salary working a full-time job this year, and my colleague, who just retired after 35 years of service to her community as a Registered Nurse, will make less than $12,000 dollars per year in retirement--not the $84,000 dollars/year reported by Sutter Health. I will retire with NO HEALTH BENEFITS, and if I fall injured on the job as many of my colleagues have, it will be "tough luck" for me from Sutter Health. 

If Sutter implements the changes they propose, your nursing staff will have to come to work to take care of you if they are sick. You will receive less time from your nurses when you are in the hospital, and your nurses will no longer be able to advocate for your care. Your nurse will be placed in unsafe working conditions, and your safety may be compromised. I am surprised that it raised no flags or concerns with our community that a hospital representative and MD would describe a Sutter Health nurse's health insurance plan a "Cadillac health plan" and wants to compromise your health care. When you are priced out of your healthcare, know that your nurses were fighting for you.

In closing I ask you to ask questions of your nurses; find out why they are fighting as they strike for you, their community, and for themselves. When Sutter Health tells you we are asking for too much, know that we are not asking for anything new, and we are out on the line to help maintain the quality of health care for everyone in our community. Please support us as we do. 
 
Sincerely
Registered Nurse, ICU at a Sutter Health Hospital
Posted anonymously, due to fear of being reprimanded by my employer

Monday, November 19, 2012

Adoptee Stories

I live adoption, and these days often don't want to take the time to read about it as well, except in the blogosphere.

I did my share of reading adoption-related books in the mid-90's, as I have mentioned before. It was illuminating to see how people connected--or didn't--when I had no hope of connecting on my own. Other people's stories in those pre-Internet days gave me hope and permission to continue my journey, slowly. Betty Jean Lifton was especially influential and I enjoyed her books, and then her personal support in my darkest times. Her death was a tremendous loss to the world.

More than once I have thought about writing some version (fictional? creative?) of my story, strange as it is. I enjoy writing; I am a good writer. It's probably one of my best talents. Many people have said they're surprised I have not ended up employed as a writer (hell, it's not like I didn't try, and I am published in peer-reviewed journals). But somehow when it comes to doing more than journaling about my messy life, I can venture no further. I am tripped up by that important writer's adage, "show, don't tell." I am not, perhaps, the most elegant of storytellers; I enjoy the tell too much. Maybe I would be better if I tried; I am not averse to editing and criticism. Of course, if I don't take myself seriously in this arena, no one else will.

On the positive side, I have had repeated glimmers of beginnings, especially driving over the Bay Bridge at night, the hum of the engine sending me back into my memory to particularly interesting or funny or difficult moments in the tale. I have some fabulous possible first lines to go with the chapter titles Thomenon suggested to me two years ago. I hesitate, however, to tell a story that isn't only mine. There are so many other people involved, and I don't necessarily want to paint them in a light that isn't flattering. I know I would hate to have my privacy exposed, just so. I am extremely protective of people I love, and while some of the weirdnesses I've lived might be wildly entertaining/enthralling/shocking to a wider audience, I don't want to put others on the line any more than I've done already. My ongoing readers, moreover, know exactly what I think of expurgated versions of things. On the other hand, I could write this story only for myself, and see what happens. Maybe start small?

What did Anne Lamott's father say? "Bird by bird?"




Sunday, November 18, 2012

Thoughtfulness

A friend pointed me to Karl Stenske's recent essay over on Adoption Voices, "What Can a Tiny Baby Know?"

There was nothing in the essay I hadn't heard before, and while I agreed with most of it, there was some I couldn't back 100%. And that's fine. I did scroll to the comments a number of different times, expecting there to have been an explosion of anti-woundie rhetoric, because we all know how shitty it is for people to say their experiences as babies might have long lasting effects. It's so traumatic for some people--you know who you are--to read such things, that you spend hours crafting nasty prose just to be assholes in return. I was pleasantly surprised not to see any real rancor, or "There's no data, dumbass," or "Until a baby can talk, we'll never know." Maybe a happy adoptee or two, but that's fine. We are all entitled to our experiences. I didn't chime in because I have no desire to rejoin any PW battle of any shape.

That said, I was thinking about some conversations about my experience as a neonate I've had recently with my psychiatrist friend and some OB-Gyns at work. They've been supportive, and although medical science doesn't, at this time, engage in double-blind studies on fetuses, they are willing to believe that there is merit to my argument that my mother's stress level during pregnancy, as well as the genes she passed along to me, combined with the NICU stay with no caregiver and the phenobarbitol and the sleeping 12 hours straight by 10 weeks and intense anxiety are all part of a complicated set of circumstances that made me who I am. It's not voodoo science, it's trying to make sense of what happened to me, taking into account as many variables as I am aware of. And I care because it informs who I am now. I wish I could simply turn off the anxiety and depression switches, but there are no such things.

I remember reading a couple of years ago, maybe in a review of one of Oliver Sacks's books in The New Yorker, about how fetal/neonatal stress can cause rewiring of the amygdala that can present as/exacerbate existing predispositions for mental illness as the individual grows. I Googled some things and stumbled across the writings of an extremely intelligent psychiatrist, Kevin Turnquist, practicing in Minnesota. I spent most of yesterday devouring different essays of his, which are nuanced and insightful. I could see myself in some of what he wrote. I wished that he lived closer; I would be fascinated to get his take on my mental illness.

I almost fell in love with him when I read:


Another way that the care of the child becomes reflected in its brain development involves stress responses. When babies come into the world they have "raw" nervous systems. Their brain cells have not yet developed their full coat of insulating myelin. Intrauterine life has not prepared them for dealing with any sorts of stress or frustration. In a very real way, humans are born without the capacity to soothe themselves. We must count on others to provide that vital function initially, and to eventually help us to acquire it for ourselves.

When babies don't have that attuned caretaker to sense their distress and comfort them the painful feelings continue to mount. Eventually what has been referred to as a "catanoid reaction" occurs. The baby's nervous system essentially shuts down in an attempt to manage the negative feelings. If that process happens often enough there will be fundamental changes in the way that the brain's emotional apparatus develops.


That was me! The catanoid reaction. I shut down, and my ability to cope was hindered by lack of consistent, attentive caregiver over those first few months. Even though my parents are wonderful and picked right up, I was damaged. Telling me that I am making it all up in hindsight is not only wrong, it's more about the insecurities/power issues of the people saying such bogus bullshit than it is at all related to me, my experience, and what actually happened. And what my parents told me, moreover, about their experiences with me as a preverbal infant. Back in 1969, before Verrier, before any "taint" of "voodoo scholarship" could have clouded their perceptions.

I was ruminating at length about what Dr. Turnquist says about escaping into the past. I am so guilty of escaping into my head, into books, into the past to fuel endogenous opioid release. Anything, anything other than feeling what I am living. It's a coping mechanism; at least I am not drinking, abusing drugs, or sleeping with anything that walks by. But it is very sad, in some ways, to lead a life based on paper. I was thinking about how unwilling I am to let go of my books. I need the paper in my hands, and I remember when and where and why I bought most of my books. Sometimes I feel my books love me/understand me more than people do. And maybe that's just another tragedy I have to live with.


An important but often overlooked facet of human behavior is our capacity for generating comforting thoughts. From the very first time that we learn to soothe ourselves with the thought that "Mommy will come back" we utilize thoughts that are designed to bring us hope and ease our anxieties. Each of us has our own repertoire of thoughts and memories that we can turn to in an effort to feel better. Fantasies of romantic conquests, wealth, being admired, and high ranking in our social groups are common themes in the thoughts that we rely upon to produce positive emotions within our own brains.

The problem is that this unique human ability to generate thoughts that make us feel good is reinforced by brain chemicals that have an addictive quality. The more we turn to thoughts and memories to feel good, the stronger is our tendency to live in our inner worlds. This tendency to keep attaching positive emotions to images of ourselves also opens us up to despair. Humans can't help but compare current representations of ourselves to underlying idealized images of how good we think we should be.

The greater the disparity between the genuine image of our self and the idealized version, the more severe are our feelings of depression and existential pain.


I am drawing these quotations from one particular essay of his, "Implications of the Emerging Model," that discusses the state of how we think about mental illness in the United States and the problems inherent in current models of treatment. He talks about how difficult it is to listen and hear people who walk different paths than we do; how we expect what is to clear to us to be clear to them, or for them at least to be receptive to what we're saying. Sadly, they're not. I loved how he closed his essay, and I encourage everyone to think about their part in this, in dealing with people with mental illness (and you could substitute "adoptee" for mentally ill person--not that I am saying that all adoptees are mentally ill). It's just what he says makes sense, and we as rational, thinking people should work together, not belittle one another. How can we apply this to working together so that we call have our OBCs?


A natural tendency among humans is to believe that people who are different than us are somehow less human than we are. Without the power of this mental mechanism we'd have a hard time killing other humans that are seen as enemies, much less their innocent children.

When someone on a local editorial page suggested that we've come to view people in the Middle East as being less human than Americans another writer responded by angrily asserting that those people are less human than we are. Perhaps that gentleman should travel more. An inescapable conclusion when people visit other cultures is that humans are pretty much alike everywhere. They may have different languages or religious beliefs but as we go about our day to day lives the differences are pretty minimal.

The unfortunate result for mentally ill people is that we also extend these types of beliefs to them. Because they seem different from us we may conclude that they're less human than people who don't have suffer from mental illness. And when we conclude that any group is less human than ourselves all sorts of terrible treatment can be "justified."

Compounding matters is a tendency on the part of mentally ill people to be consumed with self-loathing and to believe that they somehow deserve to be treated badly. As Nietzsche pointed out, "terrible experiences make one wonder whether he who experiences them is not something terrible."


and


The rationale for change

It's always tempting to advance moral arguments in favor of the types of changes that have been suggested here. When a person has been around poor and disadvantaged people for a long enough time those ethical points of view can be extremely compelling. And these moral arguments work well on other people that have similar backgrounds and experiences as us so it's natural to assume that they'll make sense to everyone else.

But our understanding of, and sentiments towards, people that seem different than us are, ultimately, impossible to separate from our feelings about ourselves. And those are very hard to change. People that, at their very cores, don't believe that their own lives are worthwhile or meaningful will not be touched by arguments that are based on ethical assumptions about the value of the lives of mentally ill people.

The more persuasive arguments for change that arise from the emerging model of mental illness must be based on a realistic appraisal of human nature. When we more fully understand what it means to be mentally ill and appreciate the kinds of things that the people suffering from these disorders need to function more independently it will make sense to redefine the basic safety net that our society provides for its most disadvantaged and marginalized citizens.

The arguments in favor of efficiency and cost-effectiveness will prove most convincing over the long haul. It will be much cheaper in the end to provide a true safety net that will catch everybody than to maintain one that's full of holes, then keep spending lots of money on the people that the net didn't catch. And people need to know how far they'll drop before the net will catch them. When everyone can count on receiving the basic essentials necessary for a decent quality of life the decrease in those stress hormones will be almost palpable.

The real implication of the model of mental illness that is now emerging is that we're going to have a great many mentally ill people in our society whether we like it or not. They aren't going to go away when some new and better medication comes along. Mental illness is in our genome and may be increasing because of ways that our society is evolving.

Recovery from these disorders will not come in the form of a capsule alone. Even when the medications work at their best there will still be residual problems that many of these people won't be able to negotiate on their own.

Creating safe and humane living environments for the adults that suffer from these disorders - environments that provide actual opportunities and incentives to function as independently as possible - will be more effective than continuing a system that promotes dependency and dysfunction. Providing a "good enough" environment for our children as they develop their brains will reduce the number of people that will eventually depend on society to support them.

Is there any part of the political spectrum that's opposed to these outcomes?





Saturday, November 17, 2012

Disappointment

On the rainy afternoon that was yesterday, I took the train into the city to see Joe Wright's new adaptation of Anna Karenina. I had to see it on opening day, being a lover of the novel and having had many of my own disappointments in love. The novel resonates with me on many levels.

I was excited to see what Tom Stoppard, that brilliant playwright, had made of the screenplay, and I had heard that there was some artifice involved in the way Wright conceived of the film. And even better, Matthew Macfadyen was in it (playing Oblonsky, it turned out). The picture below isn't from the film; just some gratuitous MM.



I walked upstairs in the theater, and looked out over Yerba Buena Gardens, gazing at SFMOMA through the huge windows, over the grass, in the grey light. I thought about my past, being an art historian (I had coincidentally run into one of my thesis advisers in Berkeley earlier) and living abroad and reading Anna Karenina in London in the fall of 1995. My friend S had been worried about my mental state at the time, knowing me, wondering if I was reading tragedy to feed some inner hunger for self-immolation. I wasn't, actually. I remember reading Anna Karenina when I was 18 and not really understanding much of it, thinking back. I admired the writing and the descriptions and feeling sad when Frou-Frou died, and wondering why Anna had to kill herself at all at the end. I did not understand passion or the social conventions that damned her, really. Then when I reread it in my 20's, I thought I understood, but at most I was getting at it from Kitty's point of view. I can now read it and understand it on many levels, and sympathize with many characters. In crueler moments, some of my friends call my husband Karenin. They do have some character traits in common, to be sure.

I last read the novel in the fever of uncertainty and sadness. I think I will reread it now, at peace, although I cannot be sure that it will not stir certain memories for me. I used to be envious of the Russian majors who would read Tolstoy as their senior thesis. Sometimes I think I should have continued and been a Russian major; one of our Russian professors was charming and sexy and fabulously brilliant. His Chekhov class in translation was always packed. He was an emigre from the USSR and people would follow him and around and become majors just to spend time with him. When my brother was in Afghanistan, I found a translation of Chekhov's stories by dear George Pahomov to send to him; I was so proud!

But back to Anna K. I wanted to love this film, I did. I cannot count the times I have watched Wright's Pride and Prejudice, faults and all. I appreciate how Wright doesn't want to do pure literary adaptation; that he respects the medium of film, and that he wants to be innovative. I appreciate that he wanted to point out the theatricality in the book in a quite literal way, as well as foreground that theatricality in the film. But somehow, despite some bravura performances, I could not connect with the characters in the way I wanted. The emotions were too distant, too clean.

I had thought the dramatics of the production were the result of the collaboration between Stoppard and Wright, but reviews such as this suggest otherwise. It was a brilliant stroke of genius, and brilliantly carried out, but somehow did not work to convey the depths necessary. Stylization (what was up with the dancing?) happens at the cost of something, and for me it was authenticity of feeling. That isn't to say I didn't believe what the actors were conveying; it's just that the vehicle bounded their expressions in a way that the book didn't, in my opinion.

I adore Jude Law, and for the first time I felt sympathy for Karenin, as he portrayed him, strain and forgiveness and all. Maybe that is an unexpected gain.






Friday, November 16, 2012

Horizontal Identities

I was reading a review of a book by Andrew Solomon, Far from the Tree, in the November 19 issue of The New Yorker, that describes identities that separate children from their parents. [In full disclosure, I did not read the book yet, only Nathan Heller's review.]

Shared experience in families, says Solomon [via Heller] "flows naturally down the generations" via "vertical identity." I guess we could say this is tied to genetics and socialization. It is more likely, but not inevitable, that you will find mathematicians in a family of mathematicians, musicians in a family of musicians, writers in a family of writers, or at least you will find some people in a branch of the family with certain talents that will be recognized and encouraged. As Heller says, "It's a conduit through which the benefits of shared experience--empathy, hindsight, a sense of who you are--can travel." This is what is cut off, via adoption, is it not? Shared experience, mirroring?

"Horizontal identity" is specific difference. Solomon talks about deafness in a family of hearing people, for example. Or little people/dwarves (sorry if I am not using politically correct terminology here) in a family of people of otherwise unremarkable height. There is a list that Solomon apparently discusses in his book: "Down syndrome, autism, schizophrenia, multiple severe disability, early genius, conception through rape, criminal behavior, transgender life." In each circumstance, Solomon looks at families and how difference/horizontal identity affects the families' ability to cope and function, while also thinking philosophically about "difference" and how it is handled in families and in society at large.

Although Solomon wasn't specifically talking about adoptees, this "horizontal identity" immediately sounded like something that applies to adoption. Indeed, in one case, a couple gave up a child with horizontal identity for adoption, saying, "I'm not the right mother for this child." Which seems a little backward, because in giving up a child for adoption, you're creating another situation of horizontal identity, at least in cutting the child off from her roots.

I find it telling that adoption is so normalized that it doesn't figure as "difference" to the writers of book and the review, and that a parent gave up on her own child, as different, saying that another family could do better, as though adoption solved a problem by providing better families. Except that there's no guarantee of anything "better," as the news tragically tells us on a daily basis.

I was fortunate, perhaps, in that I was placed with a family whose vertical identity was not at odds with me in some aspects: love of travel, history, education, etc. While I don't share their genes, obviously, my aparents told me I could do whatever I wanted, achieve what I wanted, be whoever I wanted to be. I know, however, that having a good match is like winning the lottery, and when you lose, there can be tragic outcomes. And before anyone feels the need to tell me, I am well aware that there can be enormous differences of identity in biological families, as well (Solomon's book is based on biological families, after all).

Why is, or isn't, adoption an aspect of "horizontal identity" in your opinion? Or more important, have you read Solomon's book?

Thursday, November 15, 2012

Ides of November

It seems that the move is off, and while I am a little disappointed in the end, I am also relieved. I have come to know and love the bay, and I adore those mornings when I can take the boys and the skinny dog with no tail to Crissy Field, where we walk on the beach in the shadow of the Golden Gate Bridge. It's joyous to have such natural beauty easily accessible. And the climate here is 100x better for me. I am a fragile Northern European flower who does not do well in extreme heat.


There will be other adventures ahead, no doubt.

In the meantime, I have decided that I need to improve my French; reading Nerval was a comeuppance. I bought a book titled Correct Your French Blunders. I have much to do in terms of remembering. Maybe I can even find a Francophone patient to bear with me today at work!




Wednesday, November 14, 2012

What People Say

I feel that I have said quite enough recently, and even before, about the negative things that people say regarding adoption. I have pondered my own place and what I expected and what I wanted, and how nothing came to pass the way I thought it would in my wildest dreams. I expended immense amounts of energy, physical and psychological, trying to fit, either into one box or another, or into places I thought I should fit. I wanted things so tremendously much that I had to give up. And in giving them up (dreams/expectations), I have found peace.

I was reading around the Adoption Interview Project today; interviews have been posted. Some of the match ups have made me raise eyebrows, for certain, but it's been enlightening and interesting.

In particular, Megan, over at Earth Stains, said something in her interview that resonated with me profoundly.

“Personally, adoption gives me a serene sense of beyondness. There is no destiny except what I choose.” 

I had struggled for decades with feeling alone, unique, different: not fitting in. I wanted to belong, so badly, somewhere, somehow. I thought I could belong, would belong one way, then another, then another. It turns out that the serene sense of beyondness I have now is not as frightening as I had always thought it would be. The margins are peaceful. They're mine. I like being here. The less I struggle, the more comfortable I feel. The less I depend on others, the less I ask, the more self-reliant I am, the more I love myself and take myself seriously, the better. And who says they're margins, anyway? It all depends on your point of reference. From where I am, it's a center of exciting things.

There are people in this world I love immensely; always have, always will. I am sure I will meet others whom I will love unconditionally. But adoption has made me different; I am very different from many people, on many counts. I am my own island, and I rather like it. I love it when my friends visit me on my island, especially the friends who understand and lead parallel lives of relative freakiness, beyondness, if you will. I like the path and the friends I have chosen, and even if the circle of people who understands and accepts it is small, I am at peace that with that, as well.

I have found that sometimes what I want isn't necessarily what is best for me, or what I get. And what I find is even better, if I can let go of my expectations.

In terms of the interviews, I also found I am's insistence on parental honesty spot on.

He said:

The only way to raise a child yourself or place a child with others, is to do it with integrity and honesty. Living with the kind of integrity that doesn’t permit any falsehood is a lot tougher than it sounds. In my experience it is the only way to face your child without regret.

This call for difficult, necessary honesty helped make a difference for me on a day when I shook with anger to read about another mother and father who decided to place their fourth baby and keep that baby a secret (initially) from their own older children and also from their extended family (that secret is ongoing). It made me ill to think of the continuing culture of lies, and another adoptee denied down the road, another sacrificed individual. That kind of parenting is not "heroic," not one bit. I wish that poor young adoptee Godspeed, and I am so glad that I am not she.








Tuesday, November 13, 2012

Liberate the OBCs!

I do not have my OBC because I was born in the State of Missouri. See its laws below. They are quite draconian (and infantilizing), and as a state that produces Todd Akin would witness, Missouri is not a place very open to liberal progressive rational thinking. Change? CHANGE? You have to be kidding.

I frankly miss my Ted Drewes, I know my St. Louis high schools (first question you will be asked if you are a St. Louisan, by a St. Louisan, "Where did you go to high school?"), I love the Mississippi, but these days, I do not identify as a Show Me State woman. When people ask me where I am from, I don't say Missouri, and they don't guess that I am Midwestern anymore. Problem is, that's where I was born, and I have zero control over that. My OBC is languishing in a file, somewhere in Jefferson City. I hope it has friends and knows that I am on my way to liberate it from its airless orphanage, where it has been since 1970. I am sure it hasn't seen the light of day in over four decades.

Truth: I am embarrassed that I am not doing more to change the laws in Missouri (and in all states where OBCs are sealed away). I need to give of my money and time, as I did to the cause to defeat Todd Akin. (Note to self: you deserve to win this battle as much as Claire McCaskill did!)

Hereby witness my goal for 2013: make advocating for OBC access a personal priority. I have already committed to attending the Adoptee Rights Protest in Georgia next summer. I am an adoptee; it's been more than two years since attending my last protest; and I feel that I am letting my side down. If we don't work together, no one will work with us.

For more information about the specific types of hurdles faced by adult adoptees in the United States wanting access to their OBCs (and other information), see the excellent summary/introduction published by the Child Welfare Information Gateway at http://www.childwelfare.gov/systemwide/laws_policies/statutes/infoaccessapall.pdf (It is slightly outdated, as it was published in 2009, but it still provides a good overview.) 


Missouri


Who May Access Information

Citation: Ann. Stat. § 453.121
Nonidentifying information is available to: 
• The adoptive parents.

• The child’s legal guardians.
• The adult adopted person.
Identifying information is available to the adopted adult.

Access to Nonidentifying Information
Citation: Ann. Stat. § 453.121
Nonidentifying information, if known, concerning undisclosed birth parents or siblings shall be provided upon written request. Nonidentifying information can include the physical description, nationality, religious background, and medical history of the birth parents or siblings.

Mutual Access to Identifying Information
Citation: Ann. Stat. § 453.121
An adopted adult may make a written request for information identifying his or her biological parents. If the biological parents have consented to the release of identifying information or if they are proven to be deceased, the court shall disclose the identifying information. If the biological  parents have not consented, the court shall notify in writing, within 10 days of receipt of the request, the child placing agency or court personnel having access to the information. If the agency or court is unable to notify the biological parent within 3 months, the identifying information shall not be disclosed to the adopted adult. If an affidavit executed by a birth parent authorizing the release of information is filed with the court, the court shall disclose the identifying information.

An adopted adult may request identifying information about an adult sibling. Identifying information pertaining exclusively to the adult sibling shall be released only upon consent of that adult sibling. The department shall maintain a registry for birth parents, adult siblings, and adoptive adults to indicate their desire to be contacted by each other. At the time of registration, a birth parent or adult sibling may consent in writing to the release of identifying information to an adopted adult. If such consent has not been executed and the division believes that a match has occurred, the division shall make confidential contact with the birth parents or adult siblings and with the adopted adult. The birth parent, adult sibling, or adopted adult may refuse to go forward with any further contact between the parties when contacted by the division.


Access to Original Birth Certificate

Citation: Ann. Stat. § 193.125
The original birth certificate is available only upon order of the court.

Where the Information Can Be Located
Missouri Division of Family Services, Adoption Information Registry

Sources: http://www.gsadoptionregistry.com/missouri/missouriadoptionlaws.html and http://www.childwelfare.gov/systemwide/laws_policies/statutes/infoaccessapall.pdf