Never can say goodbye . . .

Even though the pain and heartache

Seems to follow me wherever I go

Though I try and try to hide my feelings

They always seem to show

Then you try to say you're leaving me

And I always have to say no...

Tell me why

Is it so

That I

Never can say goodbye

No no no no, I

Never can say goodbye

This is one of Elizabeth's favorite songs. She loves the Jackson Five and she sings along loudly with this song. I found myself singing it as I left Butner for what I hope is the last time for a while. It was hard for me to leave too.

Goodbye laundromat. Goodbye Credit Union with your nice tellers. Goodbye Bob's pie. Goodbye Butmoor with all your fast food. Goodbye Stem. Goodbye this chunk of my life.

On Friday night when I visited her, she cried about going to the new school. She wanted to go home to me, to her sister, to her cats. She was sure we didn't love her. She was sure she wouldn't live with us until she was 18. I held her in my lap like I did when she was little and rocked. She wasn't pacified by talk of ponies, the campus cat, the pool, the climbing walls. She wanted to go home. And if she couldn't go home, she wanted to go back to Wright School. And if she couldn't go there, she wanted to stay at Central Regional Hospital. Elizabeth is a big fan of "better the devil you know than the devil you don't." Truth be told, I was scared too. Goodbyes are so hard.

I had to fly to Atlanta on Saturday morning for a family funeral and then back on Sunday. On Monday, CRH would take her to the new school, where Claire and I would meet her. I explained the plan over and over again. She was still anxious. She had learned the CRH jargon and routine and was looking at having to learn it all over again.

Goodbye overhead assistance calls. Goodbye courtyard ball games. Goodbye high acuity unit. Goodbye visiting rooms. Goodbye nice nurses who braided her hair. Goodbye Ms Cox and Dr. Gazzola. Goodbye long halls and shuffling men with vacant eyes.

I am grateful for her stay in CRH. Butner has always been a nightmarish place to me—so much pain there, with the prisons, and substance abuse rehab, and the state mental hospital, and myriad other institutions. But I've found the pain is balanced by a great deal of caring. After our first night, I can say we received some of the finest care we've ever gotten. Part of it was that the staff had the time to be intrigued. Her psychiatrist had a caseload of six; her social worker, four. Value Options, North Carolina's Medicaid gatekeeper, wasn't on their backs to kick her out after ten days. Six weeks let them do a lot of testing and we left with diagnoses that feel right to me and have some hope attached.

Her primary diagnosis is Disruptive Behavior Disorder, a little worse than ADHD but not quite so bad as conduct disorder. She also has anxiety disorder, nos. That means it doesn't look like most people's anxiety. And complicating it all is a brand new diagnosis of severe receptive-expressive language disorder. I've been diagnosing something similar to this for years, but have always been poo-pooed. When people talk, Elizabeth drowns in an ocean of words. Kids with this disorder have a very hard time in classrooms because teachers talk so dang much. You know how the adults in Charlie Brown videos sound? That's how she hears language. She loves lists and worksheets because she can take in language at her own pace.

Today she and Ms Mary, one of her favorite nurses, arrived in Winston about the same time I did. She didn't seem particularly glad to see me. But she was very upset about Ms Mary leaving and stood at the window and silently sulked as she left. We will probably never see Ms Mary again and Elizabeth knows that. She has a hard time with people who are in her life for a short time and then disappear. It's a painful fact that object permanence doesn't seem to work with people. I've never liked that fact either.

We walked down to her cottage. This is a brand new program in a 102 year old institution. They work with kids from ages six to twelve for four to twelve months. Elizabeth is one of the first two kids, both of whom start today. The staff is excited and ready to get going. I feel confident that they will make this placement go well, both for Elizabeth's sake and for the program. We went through her clothes and put them away. The other new kid arrived and we went out to greet him. She had her physical and then we said our goodbyes and left.

Goodbye . . .