Читать книгу Cruel to Be Kind: Part 2 of 3: Saying no can save a child’s life - Cathy Glass, Cathy Glass - Страница 8

That afternoon Jill phoned to ask how the weekend had gone and I updated her, including that I had seen Max’s teacher on Friday, the hospital visits, Max playing in the tent, our trip to the park, Max’s concerns about sports day, and Jo’s call and the complaints from Caz. Had Jill not telephoned me I would have phoned her before the end of the day. Jill tutted when I told her of Jo’s response to the complaints, although I knew she was too professional to criticize another social worker.

‘At least Jo is dealing with the complaints, so they are unlikely to go any further,’ Jill pointed out. ‘I suppose she feels that as Max will only be with you for a short while, there’s no point in making big changes. It would be different if he was with you long term.’

‘Yes, I understand.’

‘But generally Max is settling in well?’ she asked.

‘Yes. Which was why I was surprised to receive these complaints.’

‘I doubt they’ve come from Max, but obviously don’t question him.’

‘No, I wouldn’t.’

‘You dealt with the matter of sports day well,’ Jill added. She always found something positive to say. ‘I’m sure he’ll feel he can go and participate once his teacher has spoken to him.’

‘Yes, I hope so.’

‘Has Caz got a discharge date yet?’

‘Not as far as I know, although when I gave Summer a lift home she said her mother was having to walk more in preparation for going home.’

‘I’ll ask Jo next time I speak to her, and well done. Thanks for all you are doing for Max. It’s much appreciated.’ And those few words of thanks were enough to lift my spirits and renew my confidence, allowing me to move forward and once again concentrate on doing my best for Max while he was with us, which is what fostering is all about.

That afternoon, when I collected Adrian from school, he handed me a letter that informed all parents that the children needed to stay late on Friday, as it was a full dress rehearsal for the school’s end-of-year show. Adrian was excited to be in the production – based on Joseph and the Amazing Technicolor Dreamcoat – as were all the children. Adrian’s costume – an ancient Egyptian – was already in school, hanging on his peg, having been checked and okayed by his teacher. That Adrian had to stay late on Friday would help me, as Max’s sports day was the same afternoon and wasn’t due to finish until four o’clock. Paula and I would be watching, so it meant I would now have enough time to leave there and meet Adrian when his rehearsal finished.

When I collected Max from after-school club that afternoon I quietly asked him if Mrs Marshall had spoken to him about sports day. He nodded. ‘How do you feel about going now?’ I asked.

‘I think it will be a challenge, but one I can overcome,’ he said proudly.

‘Well done,’ I said, patting him on the shoulder. And well done, Mrs Marshall, I thought, for clearly these were her words and they seemed to have done the trick.

Before we left for the hospital that evening I handed Max the bag of sweets I’d bought. ‘Wow!’ he said, his eyes lighting up, as did Adrian’s and Paula’s.

‘They are for you to share with your mother and sisters,’ I said to Max. ‘And you two can have something in the café,’ I told Adrian and Paula so they wouldn’t feel left out.

‘Thank you. That is kind,’ Max said, looking at the bag and genuinely surprised.

Judging from his reaction, I thought (as Jill had done) that the request to bring in sweets hadn’t come from him but his mother. Caz could easily have asked me. Indeed, much of what she’d complained about to Jo she could have mentioned to me, rather than making an issue of it. I hoped that before long she would drop her hostility and start to try to interact with me – for Max’s sake. But when we arrived at the hospital that evening I realized it wasn’t going to be any time soon. Empowered by the complaints she’d made to Jo and having them acted on, she was ready with more. Upright on her pillows, surrounded by her entourage and clutching the bag of sweets Max had given to her, she glared at me. ‘You need to bring his inhaler in with him. It’s irresponsible not to. He’s got asthma.’

‘Absolutely,’ I agreed. ‘I take it everywhere with us.’ Opening my bag I took out the inhaler and placed it on the bed beside her. ‘I’ll leave it with you for safekeeping. And here’s a few grapes I thought you might all enjoy.’ I set the bag beside the inhaler.

‘Oh, I love grapes,’ Kelly said, immediately dipping her hand into the bag. Caz scowled at her as if she was letting down their side.

‘They’ve been washed,’ I said. ‘I’ll see you later. Have a nice evening.’ I turned and left. It was quiet as I walked away, no laughing, although I could feel Caz looking daggers at me.

Upstairs in the café Adrian and Paula chose a chocolate biscuit each to have with their drinks and we settled at our usual table, close to the play area.

‘Why doesn’t Max’s mother like you?’ Adrian asked. I guessed he’d read her body language, for I doubted he or Paula could have heard what she’d said from where they’d been waiting by the ward door.

‘She’s angry because Max had to go into care.’

‘But it’s not your fault,’ Adrian said, with a shrug.

‘I know. Don’t worry, I’m sure things will improve. Max is happy, so that’s the main thing.’

‘Do his sisters like us?’ Paula asked.

‘I’m sure they do,’ I replied.

She shrugged just as Adrian had done.

‘Copycat,’ he said.

‘You’re a copycat,’ Paula retaliated.

‘There you are, you’ve done it again. Copycat.’ He grinned provocatively.

‘No, I’m not.’

‘Yes, you are.’

‘Enough,’ I said. ‘Adrian, have you brought your homework with you to do?’

‘We haven’t got any.’ Homework was tailing off with the end of term approaching.

‘OK, so find something to do.’

With a small sigh he took his book from his bag. ‘I’ll read for a bit, but it’s boring here. I could be at home in the garden.’

‘I know. It shouldn’t be for much longer,’ I sympathized. I felt it too. Although we kept ourselves occupied, all our evenings had vanished, taken up with the hospital visiting when there were so many more productive things we could be doing.

When we returned to the ward Adrian and Paula waited in their usual place by the door while I went over to Caz’s bed. All four bags of sweets were empty and so too was the bag of grapes, the empty bags and sweet wrappers scattered across the bed. I resisted the temptation to start clearing them up.

‘Did Max ask you about sports day?’ I said to Caz.

‘Yes, but clearly I won’t be going,’ she rebuffed.

‘But I wondered if the girls or Max’s father might like to go. Anyway, he’s told you the details – Friday at one o’clock.’

Ignoring me, she pointedly turned her head and began talking to her daughters. Max seemed to accept her behaviour as normal, and again I was reminded of Mrs Marshall’s comparison with Roald Dahl’s Matilda. Max was so different to his family.

From that evening on, as well as buying Max sweets to take into hospital I also bought some fruit, washing it first: grapes, strawberries, blueberries, tangerines and apples, which I sliced. No one said thank you, but according to Max they all enjoyed them, including his mother. I felt my small olive branch of friendship had been partially accepted.

The letter advising me of the appointment for Max’s medical arrived the following morning. It had been arranged for 2 p.m. on Thursday at the local health centre. I didn’t think it was appropriate to take Paula, and Adrian might need collecting from school if it overran, so I telephoned my parents and asked them if they were free to help. Mum said they were and they’d be delighted to come. I suggested they stay for dinner and Mum said she’d make a pudding and bring it with her. They lived about an hour’s drive away and had helped me out before. Indeed, since my husband had left they’d been a great support and my father was a fine male role model for Adrian, who missed his father more than he admitted. I mentioned to Mum that Max was considerably overweight so that she and Dad were prepared. This would be the first time they met him, and while they’d never comment, they may have had to hide their surprise or shock, and children pick up non-verbal signs just as adults do. Similarly, when I fostered a child with very challenging behaviour I always warned my parents in advance so they were prepared. Fostering involves the whole family, which often includes grandparents, aunts and uncles. While I would never divulge confidential information to them, some things they need to know so that family get-togethers run smoothly and are pleasant for everyone.

Jo’s instructions to give Max whatever he wanted to eat had created a double standard for me. I encouraged Adrian and Paula (and all the other children I’d fostered) to eat healthily and I wasn’t about to change that. Neither was I going to restock my cupboards with bottles of fizzy drinks, packets of biscuits, cakes, bags of sweets and so on, but I recognized I had to make some concessions. I still intended to offer Max the healthy option by, for example, putting vegetables on his plate, which he could leave if he didn’t want them, as he had been doing. We’d drink water with our meals, although I did say that as Nana and Grandpa were coming to dinner on Thursday it was a special occasion, so I’d buy some fizzy drinks. I asked the children what they’d like. Max chose cola and Adrian and Paula lemonade. I felt this was a reasonable compromise and one evening of fizzy drinks wasn’t going to rot their teeth. Similarly, if Max really didn’t want to walk somewhere, we could take the car if practical. As Jill had said, Max wouldn’t be with me for very long, so there was little point in ‘making big changes’.

On Thursday my parents arrived in good time for me to collect Max from school for his medical and made a huge fuss of Paula as they always did. Dad gave me a bunch of flowers and then Mum produced a wonderful homemade fruit trifle and a pot of cream from a cooler bag for dessert. I thanked her, resisted the temptation to try it, and put the trifle and cream in the fridge, then made them a cup of tea, which they had in the garden. Before I left I reminded them to help themselves to whatever they wanted, and the time Adrian needed to be collected if I wasn’t back. It was another warm, sunny day and I left the three of them in the garden, Paula in her element at having the complete attention of her beloved nana and grandpa.

I’d informed Max’s school that morning that I’d need to collect him at 1.30 p.m. to take him to have a medical, and when I arrived he was already sitting in reception with his school bag. ‘Good boy,’ I said, and I signed us out.

‘Is a medical like when I go to my doctor’s?’ he asked a little anxiously as we left the building.

‘Similar, but the clinic is in a different building to the doctor you go to. Don’t worry, I’ve taken children to have medicals before and it is fine.’

‘Will I have to have an injection?’ he asked.

‘No. The doctor just wants to check you over to make sure you are fit and well.’

I’d already explained to Max what a medical involved, but understandably he was anxious. He was quiet in the car and I reassured him again that there was nothing to worry about. Once we were in the health centre and he saw the other children, babies and toddlers waiting – a number of different clinics ran in the same building – he relaxed. Having given his name at reception, we were told to take a seat. Some of the children were playing with the toys provided at one end of the room, but Max just wanted to sit beside me. We chatted about school and the book he was reading. Shortly after our appointment time Max’s name flashed on the digital display screen together with a recorded voice telling us to go to consulting room three. He slipped his hand into mine and we crossed the waiting area and then went down a short corridor until we came to a door marked Room 3. I knocked on the door and a female voice said, ‘Come in.’

As we entered a young woman doctor rose from her chair behind her desk and greeted us with a warm smile. ‘Hello, lovely to meet you. I’m Doctor Seema Jhaveri.’

‘Cathy Glass,’ I said, returning her smile. ‘And this is Max.’

‘Hello, take a seat.’ I saw her look Max up and down and then frown.

We sat in the two chairs at right angles to her desk and she opened the file in front of her and read what looked like a letter of referral. ‘You are his foster carer?’

‘Yes.’

‘And Max is six.’

‘Yes.’

‘He’s badly overweight,’ she said, looking up – first at Max and then at me.

‘I know.’ I suddenly saw an ally. ‘He won’t be with me for long, so I’ve been told not to do anything about it.’

‘Why ever not?’ she asked, shocked.

I glanced at Max. I didn’t like talking about a child in front of them but there was no choice, so I phrased it as best I could. ‘His mother doesn’t see there is a problem and his social worker doesn’t want her upset.’

‘But that’s ridiculous. The child is obese and probably has been all his life. He should be on a diet and exercise programme. It’s cruel for him not to be.’

‘Thank you,’ I said, relieved. ‘I feel like I’ve been fighting a lone battle. I wanted to make changes to his diet but I’ve been stopped.’

She frowned again. ‘That’s not good. Does he eat a lot of sweet and fatty foods?’

‘Usually, yes.’

‘I see from here’, she said, referring to another page in the folder, ‘that he has already had four teeth extracted due to decay. And there are two more that might need to come out. That’s appalling for a young child.’ I nodded in agreement. ‘Does he have a lot of fizzy drinks, squashes and juices? You know the acidity in fruit juice is as bad for teeth as sugary drinks.’

‘Yes, I know. He was used to having fizzy drinks, but I mainly give him water with the occasional glass of juice. We only have fizzy drinks as an occasional treat.’

‘That’s all right. But a lot of the damage will already have been done, as I’m sure the dentist would have told Max’s mother. And he has asthma,’ she said, reading on.

‘It’s been diagnosed, but he’s only needed his inhaler once since he’s been with me – when he first arrived.’

‘He was probably stressed. Have you heard him wheezing?’

‘No. He gets out of breath easily, but there’s no wheezing.’

‘He would get out of breath, carrying all that extra weight around. It puts a huge strain on the cardiovascular and respiratory system. To overfeed a child to this extent is a form of abuse.’

I glanced at Max again. I felt uncomfortable that he had to hear all of this, but it was the truth, after all. ‘He’s only been with me a short while,’ I said, feeling culpable.

‘Does he exercise?’ Dr Jhaveri asked.

‘Not a lot. He joins in PE at school, but he doesn’t like walking.’

‘That’s because it’s uncomfortable for him, but walking is a good form of exercise. Incorporate it into his daily routine.’ I nodded. ‘So what has his social worker told you to do?’ She looked at me.

‘To keep everything as it has been and leave it to his mother to deal with once he’s home.’

‘Clearly his mother hasn’t been dealing with it so far,’ Dr Jhaveri said firmly. ‘What makes her think it will be different in the future?’

‘I don’t know.’

‘Is his mother badly overweight too?’

‘Yes.’

‘Any siblings?’

‘Three older sisters.’

‘All obese?’

I nodded.

‘I’m really shocked that no one has been advising the mother on her children’s health, especially when the social services are involved. I see families here. We have a clinic that offers advice and support, and a weekly weigh-in. Obesity is a massive problem in the Western world and we are storing up huge health problems for the next generation. Is his mother in good health?’

I shook my head. ‘She’s in hospital now, that’s why Max came to me.’

‘What’s the matter with her?’

‘She had two toes amputated – I understand it’s a result of type 2 diabetes.’

She let out a heartfelt sigh. ‘Yet she’s allowed her son to go the same way.’ Dr Jhaveri was clearly a conscientious paediatrician whose outspokenness was a result of her concern for Max. ‘I’ll speak to his social worker. Perhaps she’s not aware of the help available. I have her contact details on the letter of referral.’ She then turned to Max. ‘Hi, Max. How are you today?’

‘OK,’ he said quietly, obviously chastened by what he’d heard.

‘Pleased to have the afternoon off school?’ she asked, being friendly.

Max wasn’t sure what to say.

‘He likes school,’ I said. ‘He’s doing very well and he loves reading.’

‘That’s good. My children like reading too. So do I. Now, I’m going to examine you. I expect you had an examination at your doctor’s when he prescribed the inhaler.’ Max nodded. ‘We’ll start by looking in your ears. Can you hear all right?’

‘Yes,’ Max said.

She took an otoscope from the top drawer of her desk and looked first in one of Max’s ears and then the other. ‘That’s fine,’ she said. Returning the otoscope to the drawer, she took a wooden tongue depressor from a sealed packet and then asked Max to open his mouth wide so she could look in. ‘Thank you,’ she said. Throwing the used spatula into the bin, she picked up the ophthalmoscope from where it lay on her desk and looked in his eyes. ‘Do you have glasses for reading?’ she asked. Max shook his head.

‘And you can see the board the teacher writes on?’

‘Yes.’

‘Good. Can you read the letters on that chart?’ she asked him, referring to the Snellen wall chart. Max read all the letters without any problem.

‘Excellent.’ She returned the ophthalmoscope to the desk and, looping her stethoscope around her neck, listened to his chest and then his back. ‘His chest is clear,’ she said and made a note on the form for the medical that Jo had sent. ‘Now, let’s measure you,’ she said to Max. ‘Can you take off your shoes and stand just here for me?’ She took the few steps to the height recorder as Max leaned forward and began struggling to take off his shoes. It wasn’t that he lacked the motor skills to undo the Velcro and pull off his shoes, but the fat around his middle stopped him from leaning far enough forward. I helped him and he padded across to the doctor. She gently placed him in front of the height bar and then lowered the ruler so it was just touching his head. ‘Three feet, eleven inches,’ she said. ‘That’s average for his age.’ She went to her desk, made a note on the form and then returned to Max. ‘Now, let’s weigh you. Stand on here, please.’ Max stood on the scales. I watched and waited. I knew he was overweight, but I had no idea by how much. It came as a huge shock. ‘One hundred and nineteen pounds,’ she read out. ‘That’s eight and a half stone – more than twice the weight he should be.’ Then, as she walked to the desk to record the figure, she frowned. ‘Do you realize that’s the weight of the average fourteen-year-old? Perhaps the social worker will do something now.’