Amy Beethe walked into a pre-operation room in January 2022 and was struck when she saw her patient: a small, underweight child in a hospital bed, covers pulled up to his chin.
The 4-year-old was scheduled for a heart catheterization. He did not have a parent or guardian with him. His eyes scanned the room, she said, wide and full of fear.
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“You could tell he was scared and nervous, and didn’t know anyone,” said Beethe, a pediatric cardiac anesthesiologist at Children’s Nebraska. “I don’t really see kids by themselves in pre-op.”
The child, named True, was born with congenital heart disease, a complex defect that meant the left side of his heart was underdeveloped. A few months earlier, in the fall of 2021, he underwent open-heart surgery, then faced months of complications.
What concerned Beethe most about True’s situation, though, was not his medical records. It was his home life. True was in foster care, and his caseworker – who would normally accompany him to medical appointments – had covid-19, so True was at the hospital for a multi-hour surgery alone.
“I was just so taken aback,” Beethe said.
She called True’s caseworker to ask about his situation and learned he had six siblings, five of whom were placed with their grandmother because of a domestic violence situation.
At home True had not been getting the medication or meals he needed, the caseworker told Beethe. And after his surgery months earlier, he rarely had visitors. As a result, he was sent to a rehab center to recover, and rehab staffers took him to the catheterization procedure, where he met Beethe.
The caseworker explained that it was a struggle to find a suitable home for True, given his specialized medical needs, and half-jokingly, asked Beethe: “Are you an option?”
In fact, she was.
Beethe and her husband, Ryan Beethe, became licensed foster parents in 2017 after having three biological children. They decided to do so, Amy Beethe said, after she saw the effects of child abuse in her work at the hospital.
“A little girl came in with a gunshot to her head, and she was the same age as my biological daughter. She looked like my daughter,” Beethe said. “The only difference between this girl and my daughter was who her parents are.”
Over the years, the Beethes had fostered and adopted three children. Taking in True at their home in Omaha felt like an obvious choice.
Beethe said she quickly saw True’s sense of humor and personality coming through. Just before the anesthesia fully kicked in, True tricked her, pretending to be asleep. He popped his eyes wide open and said: “Boo!”
“I thought, I love this kid. This kid is funny,” Beethe said. “This kid needs a break … he needs a better family.”
Ryan Beethe visited True in the hospital as he recovered, and they instantly hit it off.
“He was such an easy kid to love,” Ryan Beethe said. “It was meant to be.”
The Beethes brought True home in February 2022. True’s oldest brother has a different biological father than his siblings and was living with his father. True’s remaining five siblings were still living with their grandmother.
“True would always talk about his siblings,” Amy Beethe said.
Every week or two, the family would invite True’s biological siblings over for playdates. Through these visits, the Beethes learned more about their home life.
“I started talking to the caseworker, and I said, ‘I don’t think anybody is in a good spot in that home,’” Amy Beethe said. “I said, ‘Give me a minute to see what I can do.’”
The Beethes decided to take in True’s older sister Laney. They checked with family and friends to see if anyone was willing to foster the other four siblings. Amy Beethe’s sister and her husband took in one child, Ryan Beethe’s brother and his wife took in another child, and Beethe’s colleague – a fellow anesthesiologist at the hospital – took in the remaining two.
“The six all found homes,” Amy Beethe said.
The six children were adopted on the same day in August 2023.
“There was one big, huge adoption,” Amy Beethe said. “It’s a butterfly effect of kindness.”
Amy Beethe said her biological children have welcomed their adopted siblings with open arms.
“Everybody was on board with it and thought it was awesome,” Amy Beethe said. “They don’t know any different … it’s just like, this is who my family is.”
Amy and Ryan Beethe are each one of three children and didn’t expect to have eight kids.
“I never thought I would have this big of a family, but I’m very happy I did,” Amy Beethe said. “Everyone goes to bat for each other. It’s a loving house.”
True’s cardiologist emphasized the importance of a supportive home.
“I think he is alive today because of Amy and Ryan stepping up to the plate and taking him in,” said Jason Cole, the medical director of heart failure and transplant at Children’s Nebraska. “The home setting for kids as complex as True is vital to not only their survival but also their well-being.”
Cole said seeing another doctor become a parent to their patient has been extraordinary.
“I was there when he was in the hospital alone, by himself, and I watched Amy come along and never leave his bedside,” Cole said. “It’s exceptionally rare, and it’s amazing to actually see.”
True is being closely monitored and is stable for now. Eventually, Cole said, he will need a heart transplant, but there is no telling when that will be.
“It’s really a moment-by-moment, visit-by-visit decision with him,” Cole said.
To be a candidate for a heart transplant, he said, a person must have a strong support system to ensure they are well taken care of after the surgery.
“Before Amy and Ryan adopted him, he would not have been a candidate,” Cole said. Since his adoption, “he is medically in a place that allows him to have all the options available to him.”
True, now 9, said he is grateful for his mom and dad, and the chance they gave him and his siblings.
“I like having a big family,” he said. “I’m feeling good.”
True’s parents said he is thriving.
“You can just tell he’s in the right spot,” Ryan Beethe said. “He’s completed our family.”
The Beethes said they hope sharing True’s story, which was first reported by KETV in Omaha, will inspire others to consider taking in a foster child.
“They are like a little flower bud that just blossoms,” Amy Beethe said. “If more people would do it, it would change the world.”
Her husband added that their family is overflowing with love: “They help you just as much as you help them.”
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