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Our Stories :: In the News :: "Betrayal of Body & Soul: A Tribute to Ben", from The New York Times Relative Choices Blog

November 28, 2007

By Dr. Jane Aronson

Nguyen, Nam Van A or B (Ben)

I loved him from the minute I saw his photos. I loved the idea of him for sure. My partner and others who saw the first photos saw his sadness. I did, too. I loved him when I met him on that very hot day in August 2000. I flew through the doors of the orphanage and almost demanded to know where he was; his name was Nam Van Nguyen and there were two children with this name: one was “A” and the other was “B.” Bobo, the facilitator for the adoption agency found him. I scooped him up in my arms and held him tightly. He stared blankly with his head turned to one side. I was mesmerized. He was 18 weeks old.

My partner, Diana, and I took Ben (named by Diana for my brother, Barry), back to the hotel. He was wearing a “onesy” from Sears, most likely donated by an American family who had come through for their adoption. We undressed him and changed his diaper, all the while talking and smiling at him, trying to make him happy. In the taxi on the way to the hotel, Diana made him smile. On the videotape I made of him in those early hours, Diana says out loud while talking to him in a high pitched voice, he “needed to smile.”

He worked very hard at everything. It was sad and yet I don’t recall feeling sad at the time. I was so crazy for this boy that nothing was going to take that away (I admit, a sort of denial). That he didn’t smile and that hands were balled into fists didn’t matter to me. That he was in most ways depressed and uncomfortable with himself hadn’t fully registered. I look at him now, seven years later, and he is in some ways that same inward looking little fellow, just not sad and depressed as he was when we met him.

The author and her son, Ben, at his seventh birthday party in 2007. (Photos courtesy of the author)

He was seated on my lap at a local Hanoi café (frequented by Catherine Deneuve when she filmed “Indochine”); his leg had a tremor and the skin appeared mottled. I repositioned him and these unusual symptoms subsided. I pointed it out to Diana. Even with all my experience treating children from orphanages, we both were puzzled. We took him to the clinic on Ha Ba Trung in Hanoi for a check-up. He had some fungus (thrush) in his mouth and the doctor saw the mottling and the tremor, but had no explanation. The doctor also diagnosed Ben’s acquired torticollis, a shortening of the neck muscles that caused his head to tilt.

He slept through the night and ate well. He napped diligently as we ate lunch and dinner, spread out on his little blanket on two chairs in restaurants in Hanoi and Ho Chi Minh City. Ben was in most ways a very easy baby.

He seemed to enjoy our frivolity and eagerness. And we enjoyed the day in and day out tasks of making him comfortable. After three weeks in Vietnam, we took him home to New York to start our lives as a family.

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

A Bump in the Road

Before any of these wonderful things happened, there was a hitch in our plans – something that explains part of the eagerness with which I went into the orphanage. Just before we were to travel to Vietnam, an article about international adoption, “The Orphan Ranger,” written by Melissa Fay Greene, appeared in The New Yorker. I knew the flavor of what the author had written and the parts about me somehow seemed sterile. I appeared stiff and not real, not alive. Something was missing. I decided on my own to be open about my sexuality in the article. I was never pressured to be out. I was tired of being this doctor character without passion about love and relationships. And with impending parenthood, I wanted to be open and honest as would be expected of any parent with their child.

I received a call from the social worker from my agency in late July. My dossier to Vietnam was being held in D.C. by the Vietnamese Consul. They were questioning something in the application. The social worker was evasive. She then got to the point of her call. “You know that article in The New Yorker? Well, it might have been better if you had talked to us beforehand.” I could hear the disapproval in her voice.

I had a moment when I realized that something bad could happen to our adoption process — that I might not get Ben. And at that moment, I could hear her say, “We will respond to the inquiry about your dossier and get back to you.” She said that they needed a character letter or something like that. I never found out who they contacted or what they said or wrote in my behalf, but about 10 days later I was cleared and traveled in August to get my son.

On our way home, at the U.S. Consulate in Saigon, the last stop in the long process to finalize the adoption, I brought Ben to the plexiglass window to engage in some question and answer. Suddenly there were three officials on the other side looking at me and Ben. One of them had a copy of the New Yorker. They held it up for me and all smiled at once with their thumbs up. What a moment — chills, tears, affirmation of what was right and the jubilance and vindication of honesty and integrity right there in Vietnam. And Ben was part of it.

Blighted Potentials, Eclipsed Lives, Silenced

Over the last 16 years, as an adoption medicine specialist, I have traveled all over the world visiting orphanages and learning about the facets of “orphanage society.” I wanted to know why the children who arrived in my office from institutions abroad looked through me and didn’t cry as I drew their blood and administered vaccines; I wanted to know why these sweet ones were limp and lifeless and apparently poor students of intimacy and closeness. And I wanted to know why dear babies who were alert didn’t understand conversation and didn’t vocalize.

As I examined newly adopted children in my pediatric office, I observed children staring at their hands and lifting their legs into the air as if they had never realized that they could move these appendages; I realized that they were truly unaware of their physical place in the world. They had no understanding of their bodies and they knew nothing about what they could do physically.

As infants, orphans lie in cribs soiled and vanquished. As toddlers, they stand along railings, rocking side to side, cruising unsteadily along the railings of their large pens in soundless rooms. The smell of unchanged clothes saturated with stool and urine pervade the room; those smells are missing from the hundreds of videos of these scenes that are stacked on my shelves. (I use the videos to help prospective parents evaluate the health and well-being of the children in orphanages). While the conditions and care in some orphanages is clearly better than in others, this is essentially the state of millions of children all over the world living in orphanages.

In orphanages, children lie on their backs with bottles propped for their feeding. They do not experience the normal intimacy of a primary caretaker who would be holding, touching, talking to them, creating a model of reciprocal communication. In nurturing situations, the adult looks endearingly at the baby; the baby looks back transfixed and connected. The adult speaks in high pitched musical tones and the baby mimics almost immediately. This is repeated over and over again, consolidating the millions of stimuli in the baby’s brain. The baby experiences sensations: I feel good. I feel bad. I am hungry. I am tired. And these feelings are then greeted with the best guesses of the parent or caretaker. Those simple pathways are at the heart of attachment and intimacy. And they are missing for orphans, a deficit that can lead them down a path to poor self-regulation, language delays, and attachment issues.

Back to Ben

So we settled into our family life as parents. Ben had 6 hours of physical and occupational therapy a week and gradually evolved into a healthy and happy baby — but it took years. I didn’t know what to expect, even with all of my experience with adopted kids. This was my kid and there was no map or pre-determined plan. We just hoped that with all this work, he would be O.K. — whatever that meant.

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

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

After five years of occupational therapy and handwriting tutoring, Ben had his thumbs back and was able to write letters and numbers indistinguishable from other children his age; in fact he was quite adept and became a Lego master and now plays the cello (kid-sized, of course). Both Diana and I think his fingers are pretty and magical when we watch him play that lovely instrument.

Ben in Hoi An on the South China Sea in Viet Nam, June 2007

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  This page last updated March 5, 2008 5:15 PM EST