When Love Isn't Enough - The Musser Family Tragedy - Part Four

The adage "the road to Hell is paved with good intentions" has been repeating in my mind since I started looking into Tommy Musser's death.  Susanna and Joe Musser had the best of intentions when they started down the road of adopting Tommy.  Their intentions, while good, have landed their entire family in hell.

Tommy Musser died.

 His mother made a mistake.  Not a malicious mistake or egregious neglect like Tommy had known in the past, but still a mistake that lead to his death.

Joseph, Daniel, Joshua, Laura, Jane, Katie, John Michael, Peter, James,  Stephen, Verity and Benjamin Musser lost a brother.

I feel a great deal of empathy and sadness for Tommy's twelve surviving siblings because I know what a sudden, unexpected death of a child can do to a family.

One example to start with:

When you are a kid, a common question people ask you is "How many siblings do you have?"  Seems like a harmless question, doesn't it?

I hated that question.  I still hate that question.

Should I tell them the truth: "I'm one of four kids, but my brother David died when he was almost a year old."?

From personal experience, I'll let you in on a secret: most people do NOT respond well to that answer.  Between asking detailed questions about how he died to looking shell-shocked and frantically changing the subject, I've received a whole slew of responses that make me want to hide under a bed until the person leaves.

Should I lie: "I'm one of three kids."?  Bluntly, I've found the lie gets easier over time.  Most people don't really want to know the truth during small talk and the people who really matter will find out when the time is right.

A wonderful therapist pointed out to me that when I spoke of grieving for David, I was actually mourning two losses: the loss of my brother and the loss of what my family was like before David died. Because when David died, my entire family changed over night.

Youth is not a protection.  I was four when David died - right between Stephen and Verity.  Young children grieve and lack some of the coping skills that older people have.

Being unborn or not adopted yet isn't a protection.  My youngest brother, Mike, was born a few months after David died.  He grew up in a family who was grieving for a person he had never met and that did have an effect on him.

Each of the Musser children will be affected by Tommy's death in a real, life-changing and personal way.

Susanna and Joe Musser will spend the rest of their lives knowing their choices lead to their son's death.

To quote my mom: "They've started on a journey that I wouldn't wish on my worst enemy."  I can't imagine the amount of guilt, remorse, pain and anger that Susanna and Joe are facing.

The part I have the hardest time wrapping my head around is that they had other options available besides adopting Tommy right now.  The Mussers had brought a lot of attention to Pleven when they showed people in Bulgaria how much Katie had grown in the year after she was adopted.  She went from being the size of a badly underfed toddler to about the size of a 3 or 4 year old.  That's a huge developmental leap - and brought a lot of needed attention to the neglect going on at the orphanage.

Susanna mentioned how horrified the local doctors were when they saw Katie.  Why not contact those doctors again?  Set up an oversight committee of local health professionals and other interested community members.  Since they are in the country, they would be much more able to wield effective pressure for change.

Where do we go from here? (Mel's Two-Cents)

• Starting on July 14th of 2014, agencies who are involved with international adoptions will need to be accredited through the Council of Accreditation (good!) or supervised by an agency that is accredited (that worries me...) to get in compliance with the Hague Adoption Convention.

• A huge hole that I see is there seems to be no required accreditation for home study providers.  This is what allowed the Musser family to shop around to find a home study provider who didn't see a problem adding a third special-needs child into a family that would have 12 children.

• I think the minimum requirement of a yearly income of at least 125% of the Federal Poverty Guidelines is a good starting place for non-relative adoptions.  However:
• the income should be demonstrated over a time period of at least 3 years.  
• primary residences and vehicles should NOT be counted as income.  (Ok, did I really have to write that sentence? It seems so obvious that my house is NOT income.  And yet, I've been proven wrong....)
• if a family owns their primary residence outright without any liens or mortgages., then a waiver could be written to increase their income by the amount of a similar rental in their neighborhood minus the property taxes if needed.  (In plain English, pretend my husband and I own our house outright.  The agency could document our ownership of the house, determine market rental for a similar house (say $700 per month or $8,400 per year) and subtract property taxes ($500 per year).  In this case, since we don't pay a mortgage or rent, our income should be increased by $7,900 per year.)

• I'm still curious what - exactly - the Musser's church community did to determine the family was ready to take on Tommy on top of 11 other children.  Did someone sit at their house for 24 hours a day for a week?  Did they arrange to bring over another special needs child - similar to Tommy's projected needs - for a week or so to see how the family coped?  Did any of the people making the recommendation have experience with special-needs children, adoptions, or both?  If you need to ask your church if adopting another kid is a good idea, the answer is no. 

When Love Isn't Enough - The Musser Family Tragedy - Part Three

The Musser daughter behind the bride is the same as Katie
 who Susanna is holding. Tommy is the same age as the son
between the groom and Tommy in the back row.

(Ed. Note: As I've been reading Susanna's blog, I realized that their family has especially poignant reminders of how much as been taken from Katie and Tommy.   Katie is the same age as one of their biological daughters.  Tommy was born in the same month as one of their sons.  Verity is a wonderful example of how early intervention can help children with disabilities thrive and the youngest infant son, Benjamin, is already moving beyond Tommy in areas of social development.)

Even before Tommy's death, the Musser family was grieving.  When a family lives with a child who has a disability, the parents go through cycles of grief involving denial, anxiety, fear, guilt, depression and anger.
Susanna often alludes to guilt or anger, but always minimizes the feeling by explaining how lucky their family really is.

In addition to a grueling schedule of therapists and daily care for 4 children with developmental ages under 4, normal care and home-schooling for four children with developmental ages between 5 and 8, and normal care and (possible) home-schooling for four teenagers between 11 and 18, Susanna was dealing with waves of emotions from both Tommy and Katie's years of neglect and how that neglect destroyed their bodies and minds.

By September of 2013, doctors had had enough time to run tests on Tommy to better evaluate his medical and long-term prognosis.

Susanna explains "The more we learn about Tommy, the more it looks like his original disability was low muscle tone in conjunction with some chromosomal irregularity or other that would have caused some developmental delays similar to Down syndrome.

Almost all of Tommy’s medical problems can be explained by low muscle tone plus fifteen years of severe neglect and underfeeding. 

Some of his issues can be explained by the neglect alone."

What the doctors found out about Tommy:

• He does not have hypotonic cerebral palsy, autism, or a seizure disorder as was indicated by the orphanage when he was adopted.

• From the unspecified disorder that Tommy was born with, Tommy has a high arched palate which means the roof of his mouth is unusually higher than most people and moderate hearing loss.

• From years of malnutrition, isolation and medical neglect, Tommy developed
• Severe osteoporosis caused by chronic malnutrition.
•  (His score was at the -8.6 deviations on a bell curve.  A -2 score means that the bone density is less than 97% of tested asymptomatic people his age and the cut-off for osteoporosis.  A score of  -3 means his bone density is found naturally in less than .5% of asymptomatic people.  His adopted sister Katie initially tested at a -15 deviations.)
• Atrophic gut caused by chronic malnutrition.
• Tommy's intestines are unable to absorb high-quality nutrients.
• Near the end of the summer, Tommy has a gastric feeding tube placed since it is highly unlikely his digestive system will ever be able to manage traditional feeding methods.
• Mild scoliosis due to years of laying down - which weakened his core muscles - then having him sit up without having strengthened his core muscles.
• Feet malformations due to not being moved enough while in the orphanage.
• His adult teeth are rotted due to lack of nutrition and hygiene.
• Because of the severity, the local dentist expected that Tommy would need at least 2 sessions under general anesthesia with a dental surgeon to clean and determine of course of treatment.  The ongoing problem the family ran in to was that because Tommy had such severe osteoporosis, the oral surgeons were afraid that any work on Tommy's teeth would cause severe jaw fractures.  I don't think the family were ever able to find a dental surgeon who could complete the work.
• Tommy's tongue was thrust out of his mouth because he was fed for years flat on his back with a propped up bottle with a huge hole cut in the nipple.  This meant he simply needed to keep his tongue out of the way and gulp the liquid food.
• Tommy's brain was severely underdeveloped as result of years of low protein, low carbohydrate food and nearly no interaction with others or objects.

• As Susanna explains  "In the photo below, he may appear to be a typical child focusing on the picture on this flash card, but we can’t detect any evidence that he recognizes two-dimensional objects.  I had to tap on the card to get him to look, captured his extremely brief glance at it, and praised him enthusiastically!  “Good job looking, Tommy!” 

Later, Susanna explains "So many times unexpected hot tears have come to my eyes.  Sudden fierce grief and anger has risen within me at the dignity that was stripped from him, the potential that was stolen from his life.  He is clueless as an infant to so much of the world around him.  He is oblivious to his own vulnerability to the scorn of others.

I grieve for him because he cannot do it for himself.

I’ve stuffed it away without examining it, and kept moving.

But I wouldn’t be able to count how many times I’ve gazed into his face and wondered.

Who would Tommy have been, what would he be able to enjoy learning and knowing and seeing and doing if he had not had so much stolen from him?

He has no idea how to play appropriately with toys.  He completely missed that part of his childhood.  Without hand over hand assistance, he either shakes, taps, or drops toys to see whether they make noise. If he likes a toy, he’ll hold it up high, look at it, shake it, and shriek. If he doesn’t like a toy, he’ll drop it.

What he didn’t get is all the more painfully obvious to me as I care for him alongside Benjamin. 

One small and surface-level example–

Ben tries to make eye contact with us when he wants our attention.  He begins to vocalize more and more as he gets sleepy, and if we don’t respond to his more polite requests, he eventually cries.  We meet most of his needs before he even has to ask for them, and we always respond gently and affectionately when he does ask.  Even if we know he’s just being cranky, we tell him reassuringly, “It’s okay, Ben!  You’re okay!”

When Tommy was a tiny baby like Benjamin, he asked, too, just like Ben asks.

But nobody responded.

If he was sad, nobody responded.

If he was cold, nobody responded.

If he was lonely, nobody responded.

If he was hungry, nobody responded.

If he was hurting, nobody responded.

If he had a dirty diaper, nobody responded.

If he was just feeling fussy, nobody responded.

Before too long, baby Tommy stopped asking.  For sixteen years, there was no point in asking for anything.

But even as soon as September, Tommy was showing progress. In Susanna's words:

"Tommy is getting stronger, more energetic, more curious and motivated to move, more engaged in his environment, more vocal, more expressive of his emotions, opinions, and preferences.

He now asks.

He reaches out for affection and interaction.

We’ve learned to scan his surroundings for items he shouldn’t have, like doors that he will grab onto and bang over and over again, bowls full of food that he would grab and fling to the floor, or other people’s earrings!  We put couch pillows around the floor lamp so he can’t pull it over.  We brought our play yard out of storage to make a safe play space for him when and where it’s necessary.

When he’s sitting, he can swivel himself in a circle but not much else.  If he wants to move, he’ll go from sitting to lying down and then scoot along the floor fairly quickly on his back.  Recently, when on his back, he’s much more likely to go over to his side and try hard to pull himself up to a sitting position, especially when attempting to grab something that’s up just out of his reach.

A little over a month before Tommy's death:

It’s a Sunday morning, tranquil and lit with a cool winter sunshine.

Ben is upstairs napping.

I rise wearily from the floor where I had been sitting with Katie, both of us still in our pajamas.

I’ve shed many tears lately.

Tommy is in his feeding chair, receiving a tube feeding.  I stop at his side.

Because he is well hydrated now, drool is often dripping down his chin.

Because of his tongue thrust, a crust of dried drool is often forming on his tongue and upper lip.

Because of the decay present in his mouth, both the drool and the crust are as foul-smelling as his breath.

For the dozenth time that day, I use a damp cloth to wipe the drool from his chin and work at the crust clinging to his skin.

I gaze mutely downward into the chocolate brown eyes of my son and he gazes mutely back up into mine.

Now my tears are streaming.

This task I have performed countless times without thinking is a holy privilege, as though my wounded Savior is allowing me to look into His eyes and wipe the crusted blood and stinking sweat from His face.

I wipe my tears on my shoulder and look downward into the chocolate brown eyes of my son, and he looks back into mine.

A strange joy mingles with the deep grief in my heart.

Welcome, Lord Jesus.

Susanna playing with Tommy, Benjamin and Katie

When Love Isn't Enough - The Musser Family Tragedy - Part 2

Before Tommy arrived, Susanna was already exhausted: "Get up half an hour earlier because Daniel will be working with his dad and grandpa all day.  Katie and Verity are still dry; take them to their potties right away.  Have Peter fill the humidifiers.  Need to eat.  Make sure to fit in phonics flashcards with the little boys and catch up on our history reading.  Sit down and breathe in the sweet scent of clean heads. Ask John Michael to do his “cleaning the glass” chore before the therapist gets here.  Ask Laura to write baby bath on the grocery list before I forget again.  Have Joshua scrub up some sweet potatoes and put them into the oven to eat with our supper.Need to make that phone call before office hours are over.  Must choose photos for Katie’s twelve month post-placement report.  Take a few more “Photos of our Family and Home” for Tommy’s country. Jot a note to ask Daniel for a complete inventory of what’s in our two refrigerators and five freezers so I can finish reorganizing the meal planning and freezer cooking.  Must fold and put away the little girls’ laundry and lay out tomorrow’s clothes.  Answer a few more emails before the lapse of time grows to downright insulting lengths.  Need to keep my eyes open a little longer to be a sounding board for a teenager.  

Plan and prepare for three birthday parties this month.  Plan and prepare for a couple of field trips.  Have leisure time on field trips; take plenty of photos. Plan and prepare for company for supper again this week.  Just two therapy sessions this week.  Compensate for one of our household helpers being on vacation.  Do all this and much, much more…with washing machine broken down, slow cooker broken down, and sick children.  Verity cries every time someone coughs, sneezes, or blows their nose.  I am left sweating and exhausted every time I work with Katie to transition her to her new adaptive toilet seat.

And trying to pre-plan as best as possible:

"But the best part about this storm for our family happened after the therapists called to cancel this week’s therapy sessions.  Since the beginning of September, knowing that 2013 may well be the most challenging year our family has ever experienced, I’ve been systematically targeting every area of our household that shows signs of loose ends, and working like mad to bring it back under dominion, from our kitchen cabinets to our Sunday morning schedule.  It’s been pretty slow going, since there’s not a lot of extra time left after home schooling.  By this past Monday morning, as the bone-chilling rains fell and winds blew, and therapies began to be re-scheduled, I had been working for weeks on completely re-thinking and re-organizing our menu plan.  The break this week has been such a welcome gift of extra TIME from God to us.  Just rain rain rain, snuggling up together to read aloud, some delicious homemade meals from a friend, and TIME to finish the menu project and begin the ongoing task of putting homemade mixes and other foods into the freezers.  And beginning to reclaim the next territory.  Because God is growing our family, and we want to be ready!"

And not sleeping much : 

"A pregnant mama needs more than the four or five hours of sleep I’ve been getting during this time."

"Confession:  Did you know that since I began blogging more than three years ago, I’ve pulled overnighters four times, and that all four of those times occurred within the past six months?  The upcoming Musser family update may help you visualize why my writing time is dwindling fast.  <grin>"

After Tommy came home, Susanna continued to ask for help from friends and family - who stepped up to the plate.

What were some of the issues the family was facing?

Since Tommy couldn't eat solid foods, Susanna prepared pureed meals for him.  (This means that Tommy was seeing a speech pathologist for food training and an occupational therapist for small motor skills in his hands)

 

Katie was still working on feeding herself due to coordination issues. (Katie probably saw an occupational therapist)

Tommy and Katie were working towards independent walking (Cue two more therapist visits for physical therapy)

 

Verity and Benjamin continued to grow. (Verity likely saw some combination of rehabilitation therapists including speech and OT; Benjamin just needed all the things a young baby often needs.)

 

In short, Susanna was balancing at least 7 separate therapist visits per week for Tommy and Katie plus however many visits Verity needed and the needs of a small baby.

(My mom talks about how hard it was when my twin sister and I were small and they had no other children.  We both needed physical therapy and Rachel needed speech therapy.  Balancing those visits along with trying to keep a schedule for two infant/toddler girls was a full-time job in and of it's self.  I cannot imagine how much harder it would get with three children and a baby.)

Plus, each child would have at-home activities to do from each therapist.

Speech for Verity

OT and cognitive for Katie

PT for Tommy

Speech and tactile for Katie

OT and colors for Verity

Four children who were not toilet trained lead to some rough days:

Okay, that’s only part of the truth.  The rest of the truth involves spectacular displays of revolting, uncontrolled bodily substances and multiple diaper fails.

How many nights were like this one?

12:00 am:

 <stre-e-e-e-etch>  It’s midnight.  I didn’t accomplish all I’d hoped to, but I can’t focus my eyes on my work any more.  It’s past time to wrap up my Planning Night.  Just need to wash my face and brush my teeth, and I can snuggle in bed for Ben’s dreamfeed and then sleep.

Ah, blessed sleep.

Walking through the hallway, the air rushing past my face on its way up to the attic fan feels refreshingly cool.  I detour through the boys’ room.  When I bend down to look at my newest boy, I’m surprised to see bright eyes shining back at me through the darkness.

“Hi Tommy!  What’s keeping you awake in the middle of the night?”  He grins in response to my smile, my teasing whisper and pat on his belly.

Maybe he’s chilly in his shorts and short sleeves.  And I can give him a dry diaper at the same time. 

“Come here, buddy; come to mama.  Let’s go get you some warmer clothes.”

Huh.  Good thing I checked on him; he’s wet through already.

12:15 am:  I lay Tommy on the bathroom floor and flip on the overhead light.

Oh my.

Repulsive black goo is oozing generously from around his waistband, front and back.  He flaps his arms and legs and shrieks with glee.  I hastily clear the area of anything within his contaminated reach.  He giggles, immediately jerking his body, twisting and reaching for the objects I moved and scooting on his back toward them, leaving a black smeary trail.

I wash my hands with anti-bacterial soap and scoop all movable items out of the lower half of the bath and shower area, then lift him into the bathtub.  I wash my hands again and clean the floor.

He grows more and more delighted about this unprecedented middle-of-the-night social occasion and begins to shriek happily over and over again, flapping his hands and feet, slapping them onto the front of himself.  As he flaps and slaps, little black splatters appear all around him on the tub, walls and shower curtain liner.  Black ooze spreads all the way up to his shoulder blades and down one sleeve and arm.

Quickly gathering his clean diapers and clothing, I flip on the light to examine his bed.  By some miracle, there is not one sign of the latest explosion.  How can that possibly be?  His bed isn’t even damp; it smells just as clean and fresh as when the Amish girl changed sheets that afternoon.

<whew>

12:30 am: Explain the untimely shenanigans to a bleary-eyed Joseph. 

Smile at Tommy and chat about what I’m doing as I commence to peel the repulsive garments from his body and wash him amid enthused splashings and shriekings. Help a warm, stiff and slippery little person out onto a thick towel and drop his soiled clothes into the tub.  Dry him briskly.  Fasten the inner diaper (size 6) snugly.  Fasten the outer diaper (youth size XL) snugly, holding everything in place with two tapes on each side.  Help him to a sitting position and pull the clean, long-sleeved shirt over his head.  Help him lie down again and pull the elastic waistband of his sweat pants up firmly, making sure his shirt is well tucked in.

“There now, Tommy-boy, doesn’t that feel better?”

12:50 am:  Wrap my arms around my little boy and sing “Jesus loves Tommy,” rocking him back and forth as I perch on the edge of the bathtub.  He smiles into my eyes, giggles, and pulls the snap clip out of my hair.  Carry him back to his bed and give him extra squeezes and kisses.  He accepts his pillow and hugs it to himself gladly.

“Goodnight, sweet boy.”

1 am:  Rinse disgusting garments in cold water; wring them out well and stain treat them.  Spray anti-bacterial bathroom cleaner thoroughly over entire bathtub and shower curtain liner.  Scrub and rinse.  Scrub my arms and hands with anti-bacterial soap and put on fresh pajamas.

Wash my face and brush my teeth.

1:25 am:  As I re-enter my room, I remember–oh yes, the dreamfeed.  Ben gets a dry diaper and then instead of snuggling in bed, I grab the Boppy pillow and nurse baby boy while typing this post.

2:05 am:  Ben burps on my shoulder, then suddenly fills his diaper while gushing sour curdled liquid down the front of my pajamas.

I change his diaper, swaddle him, and place him back in his wee trundle bed with many kisses on his little soft face.

Then change to fresh pajamas once again.

2:15 am:  All is clean and peaceful once more.

[Now I'm wide awake and hungry.

Good thing, because next came Stephen, knocking at the door with a fever and a tale of a biting spider and pincer bug in his bed, "so that's why I have to sleep in here." I finally fell asleep just past 4:30 am, to be wakened by Ben at 5:30.  Did you know that four can fit in a full-sized bed? Heh heh.]

In a later post, Susanna explains that "What you do not see in the photos is Tommy’s countless diaper explosions and all the many ramifications of said explosions to his ever-shrinking wardrobe, our schedule, our carpet, my decisions to take him in public." (Ed. Note: "decisions to take him in public" should not be taken to mean she was embarrassed of  Tommy; imagine trying to clean up the diaper explosion that she described at night in a McDonald's or at a festival.....)

If that isn't hard enough, Susanna had 4 teenagers and 4 school-aged children at home that she was home-schooling.  The exhaustion must have been grueling.

When Love Isn't Enough: The Musser Family Tragedy- Part 1

Sixteen years ago, a baby was born in Bulgaria. At four months old, he was placed in an orphanage.   The orphanage young Tommy was placed at was hell on Earth.  The director "modified" the foods fed to the children to prevent them from growing normally.  By doing this, the director kept the children permanently in the youngest/weakest group of the orphanage where the orphanage received the most funds for the children.  Tommy was listed at age 15 as "Male child at 15 years of age, with the following diagnoses: Infantile Cerebral Palsy – Hypotonic form; Severe lagging behind in the physical and neuro-psychical development; Severe protein-caloric malnutrition – unspecified; Ectopic [undescended] testicle – condition after surgery for correction."  Tommy was slowly dying - and time was running out.  If he was not adopted by the time he turned sixteen in the spring of 2013, he would be considered an adult in his home country, moved to an adult institution, and be ineligible for adoption domestically or internationally.



Meanwhile in the United States:

Joe and Susanna Musser had nine biological children.  Their tenth child, a little girl named Verity, was born with Down Syndrome in 2010.  As the family watched Verity grow and develop, they began to consider adopting more children with special needs.  They saw a video about children who were barely surviving in a Bulgarian orphanage.  After completing the multiple steps required to adopt, the Musser family brought home Katie in October of 2011.  From the unconscionable neglect she had suffered at the orphanage, Katie was diagnosed with  "scurvy, severe anemia, atrophic skin, muscle wasting, severe osteoporosis, and multiple spinal compression fractures due to the severe protein-energy malnutrition she had suffered all her life. "



Verity, on the left, is 17 months old.  Katie, on the right, is nine YEARS old.


With proper nutrition and intensive therapy, Katie has thrived and is much healthier, although her body and intellectual development have been permanently damaged from the years of neglect.
 
A year later, Katie, now 10, had out-grown Verity who is around 3.

Now, to adopt Katie, the Musser family went through the steps required of any adoptive family.  A home study was conducted.  Family finances were studied.  Background checks and medical examinations of the parents were completed.  To adopt a child, a family must make at least 125% of the Federal Poverty Guidelines.  Since their family was so large, you add $5,075 for each additional person to reach the family size including the adopted child.  In a domestic adoption, families need to produce three years worth of financial evidence showing income at or above the 125% guideline.  For reasons that are never explained, the agency that the Musser family used either only used income verification for one year which was a higher than average year.

While the Mussers' home-schooled most of their family, they sensibly recognized that Katie needed more than they alone could provide and sent her to a good program in the local school system and acted as healthy advocates for her.


Meanwhile, Susanna found out about Tommy before June 15, 2012.  Orignally, they hoped to adopt Tommy, but would not make the financial requirements that year. In her words, "  Our income last year was significantly lower than the stated income requirement for a family of our size.  Not even within sight of that golden number".  Since Tommy's situation was critical, Susanna used her blog to publicize Tommy's plight since he was going to age out of adoption in less than one year.

  In the meantime, she worked with the agency and the government to see if there was any way the Musser family could adopt Tommy.

• The government agency suggested applying the value of their home, cars, savings and investments to boost their "income" to the required levels.
•  They asked their church leaders and friends for input on if the family was taking on too much by adopting Tommy.  Their community gave their blessing.  
• The agency with whom they were working for this adoption did not require the same level of pre-screening as the previous agency ("(no psychologist visit, letter of employment, or local police clearance, for instance), and our home study doesn’t have to be written from scratch for Tommy") (The agency that handled Tommy's adoption is About a Child)

She also adapted her family's way of life.

• She hired "mother's helpers" to assist her in housework and became comfortable with home visits from therapists.

 On June 29,2012, Susanna was able to announce that they would be able to adopt Tommy.

• The family reached out to a social worker who came from a large family with multiple special needs adopted children who completed their home study.  The family had needed to do two home studies to adopt Katie since one agency refused to approve them due to family size.
• Their medical and mental competence was assured by their family doctor.

 While in the process of adopting Tommy, Susanna found out she was pregnant again.  She asked the agency if that would be a problem and was assured that it would not interrupt the adoption.

• Susanna traveled overseas to fulfill the requirements of Tommy's home country while very pregnant and with a severely sprained ankle. 
• She and a physical therapist friend assess Tommy's actual level of development and teach the staff safer ways to lift children with fragile bones, how to use a gait trainer and bring lots of badly needed supplies.

A family picture was taken in March 2013 with a caption of the ages of their children so far:

This picture was taken at the end of March, 2013.   Back, left to right-Joseph, 19, holding Katie, 11, Joshua, 16, Joe, holding Stephen, 4 1/2, Susanna, holding Verity, 2 1/2, Daniel, 17 1/2, and Laura, 13 1/2

Middle-Jane, 11

Front, left to right-John Michael, 7 1/2, James, 6, and Peter, 6 

Tommy's adoption went through on April 9th, 2013 becoming their twelfth child and their third child with developmental delays.

Their 13th son, Benjamin was born on or around April 29th, 2013.

Tommy arrived home on June 17, 2013.

To visualize the ages of the children more easily at the time Benjamin was born (chronologically)

• Joseph (19)
•  Daniel (17.5)
• Joshua (16)
• Tommy (16 - developmentally delayed to toddlerhood; has a seizure disorder)
• Laura (13)
• Jane (11)
•  Katie (11 - developmentally delayed to around age 2)
•  John Michael (7.5),
• James (6)
• Peter (6)
• Stephen (4.5)
• Verity (2.5 - minor developmental delays)
• Benjamin (newborn)

Or to quote Susanna "We have four booster seats and four car seats in our big van. That’s eight little people who are developmentally age seven and under."

A year later, Susanna was left alone with eight little ones who were at the developmental age of eight or below.  Somehow, Tommy was left unattended for a period of time while he was in the bathtub.  Tommy drowned. With Tommy's developmental age and seizure disorder, he was at high risk for drowning in a very short period time in a small amount of water.

In my next post, I'll look at the level of stress and exhaustion Susanna Musser was under prior to Tommy's accidental death.