Originally published 2021-11-23.
Liz Smith, a senior director of nursing at Franciscan Children's in Boston, became the foster mother and later the adoptive mother of Gisele, a baby born very prematurely who had spent months in the hospital while her birth family's visits dwindled and stopped. The adoption was finalised when Gisele was two years old, 533 days after the two first met. CBS News reported the story in April 2019, and it has been shared widely ever since.
It is a warm story, but not a simple one. It involves a child with serious medical needs, a birth mother struggling with addiction, a state child-welfare system, and a nurse who had never planned to foster. Here is how it unfolded, and what it shows about medical foster care.
A premature baby with nobody coming
Gisele was born at 29 weeks, about eleven weeks early, weighing 1 pound 14 ounces (roughly 850 grams). Her birth mother was addicted to drugs and was not able to care for her, and the state took custody. Gisele had complex medical needs and developmental delays, and she ended up at Franciscan Children's, a Boston hospital that specialises in children with long-term and complex conditions.
Babies like Gisele often need weeks or months of specialised care, and they do best with a steady adult who visits, holds them and learns their routines. At first, relatives came to see her. Over time, the visits became less frequent and then stopped. Retellings of the story have described her as spending around five months without a single visitor, and some later versions said she was eight months old when Smith decided to foster her; CBS described the two as first meeting when Gisele was a newborn. What is clear is that, for a long stretch, the people caring for her most consistently were hospital staff.
How a nursing director became a foster mother
Smith did not go looking for a child. She had always wanted to be a mother, but by her late thirties she had learned that IVF was not going to be an option for her, and she had not considered fostering or adoption. Then a few nurses at the hospital asked whether she had met Gisele.
She told CBS Boston that the moment was immediate: Gisele crossed my path in a stroller and we locked eyes and that was it.
About a week after the nurses first raised the idea, Smith was getting to know the baby, visiting her every day after work. Gisele needed what is called a medical foster home, a placement with someone able to manage feeding equipment, medications and frequent appointments. A senior nurse was unusually well suited.
Smith went through the state's foster care process and brought Gisele home. She has described sleepless nights, including one when Gisele was hooked up to a feeding pump and the fear of losing her suddenly hit. Her approach was to hold nothing back: You can't just love a certain percentage. You have to give it your all.
From fostering to adoption
Foster care in the United States is designed, first and foremost, to be temporary. When a child enters care, the usual goal is reunification: helping the birth parents address the problems that led to removal so that the child can safely go home. Foster parents agree to care for a child knowing that he or she may leave.
That was the plan for Gisele too. Her birth parents had supervised visits, but these became less frequent and eventually stopped, and the official goal shifted to adoption. Before an adoption can happen, a court must terminate the birth parents' legal rights. In Gisele's case, the parents did not appeal that decision, and no biological relatives were able to adopt her.
The legal process took time. The adoption was finally made official in court when Gisele was two, and she marked the occasion by banging the judge's gavel.
Joy on one side, loss on the other
What makes Smith's account stand out is that she never pretended the story had only one side. She spoke openly about the grief of the birth family, and about how impossible it is to fight addiction and raise a fragile newborn at the same time. As she put it: I was gaining her but they were losing her.
That honesty matters. Adoption from foster care always begins with a loss. Birth parents who struggle with substance use are often dealing with poverty, trauma or mental illness, and many of them love their children deeply. Stories that cast them simply as people who "abandoned" a baby miss the reality of addiction. They can also make it harder for other parents to seek help.
It is also worth being careful about Gisele herself. She was a toddler when her story first went public, and her life now belongs to her and her family. The reporting captures a moment, not her whole history.
What medical foster care involves
Children with serious medical needs are among the hardest to place in foster care. They may need tube feeding, oxygen, medication schedules, therapy sessions and frequent specialist visits. Many states and agencies run specific programmes, sometimes called medical or specialised foster care, that offer extra training and support to the families who take them in.
You do not have to be a nurse to do this work, although healthcare experience helps. Agencies typically look for:
- a stable home and time to attend appointments and therapies;
- willingness to complete training on the child's specific needs;
- a support network of family or friends who can help;
- openness to working with birth families when reunification is the goal.
If you are curious, the best first step is to contact your local or state child welfare agency or a licensed foster care agency and ask about information sessions. Even if fostering is not right for you, hospitals and agencies often welcome volunteers, donations and respite carers who give foster families a break.
Why the story still resonates
Hospitals are full of children who spend long stretches with too few visitors, and staff often form deep bonds with them. Most of those bonds end when the child goes home or moves to a placement. In Gisele's case, one of those relationships became a permanent family.
Smith's experience is a reminder that the most life-changing decisions sometimes begin with a simple question from a colleague. It also shows that a good outcome for one child can sit alongside sadness for others, and that both deserve to be told.
Sources: CBS News: Nurse adopts baby whose parents didn't visit her in the hospital for five months (April 2019). Photo and video: Franciscan Children's / Liz Smith, as published in news coverage.
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