Legacy of a Mother’s Drinking : Fetal Alcohol Syndrome’s a Lifelong Scourge for Adopted Son of Author Michael Dorris

The minute he laid eyes on the toddler in a red snow suit, Michael Dorris fell in love. As the little boy played with toy trucks on the floor of a welfare office, he smiled at the tall, dark-haired man who had come to adopt him and said, “Hi, Daddy.” Then he went back to his toys.

It was a joyous time for Dorris, then a 25-year-old anthropologist and American Indian scholar at a small New England college. He was one of the first American men known to have adopted a child on his own, and Dorris relished the role of bachelor father. Like any parent, he began making big plans for his son, who had been born on a South Dakota Indian reservation.

But none of them would come to pass. Unknown to Dorris, the boy he adopted in 1971 was doomed to a life of mental and physical disability because his biological mother drank heavily during pregnancy. Like thousands of other American children, he would be a victim of fetal alcohol syndrome, the third leading cause of mental retardation and a growing health menace.

Today, Adam Dorris, 21, is an affectionate, gentle person who has little understanding of time, money, the changing seasons or the concept of death. He has to be reminded to change his clothes and needs frequent supervision. Lost in a world of his own, he works as a dishwasher at a truck stop and has an IQ of less than 80.

“You can’t undo the past, you can’t unwish someone’s life, and that’s the real tragedy here,” says Dorris, 44, who now has written “The Broken Cord,” a moving account of his family’s struggle to understand and cope with fetal alcohol syndrome. To protect the boy’s privacy, Dorris gave him a fictitious first name.

“It was years before we accepted the fact that Adam was not going to change. You never want to accept that about a child, but he was always the little engine that couldn’t get over the mountain, no matter how hard he tried.”

Book Is a Family Product

As he sits in the living room of his rustic, two-story farmhouse, deep in the New Hampshire countryside, Dorris emphasizes that the book is truly a family product. His wife, author Louise Erdich, wrote a poignant introduction about the responsibilities of women who drink. And Adam, who learned how to peck away at a manual typewriter, concludes the book with a rambling but deeply affecting autobiography that took him six years to write.

“We tried to tell our story as honestly as we could,” says Dorris, who previously wrote “A Yellow Raft in Blue Water,” a lyrical, much-praised novel about three generations of American Indian women. “So it seemed only right that the three of us take part in the book.”

But “The Broken Cord” is more than a personal tale. Dorris, who is part Indian, shows how fetal alcohol syndrome (FAS) threatens American Indians and the nation as a whole. An estimated 50,000 children are born each year with some form of impairment as a result of maternal drinking, according to numerous studies. Despite public education campaigns warning women about alcohol and pregnancy, the number of afflicted children continues to grow.

Originally, Dorris set out to write a dispassionate, academic book about the disease. But as he interviewed parents of FAS children, he felt it was hypocritical to pretend the issue did not affect him personally. Dropping any pretense of objectivity, Dorris wrote “The Broken Cord” in the first person, and the book is filled with wrenching passages in which he confronts some of the unhappiest moments of his life.

“If I had it to do again, I would have tried to be a better parent to Adam, so I wouldn’t have pushed him so hard,” says Dorris, a handsome, intense man who is also a professor of anthropology at Dartmouth College. “You want so much for children, you want them to succeed. That’s something I have to live with.”

The author, who now has three young girls of his own with his wife, rises slowly from a rocking chair and lays an old photograph of his son on a table. In the distance, a car chugs up the winding mountain road where Adam played for hours as a little boy.

“If I could change anything, I would have stopped his biological mother from drinking,” he says softly. “That’s what eventually killed her, and it scarred my son for life.”

In the beginning, 18 years ago, there was nothing but hope.

After months of trying to adopt a child, Dorris was elated when Catholic Charities officials agreed to help him. On a cloudy afternoon, he flew to South Dakota to adopt a frail, 3-year-old boy who had been living with state-appointed guardians and in hospitals.

Dorris was told that the Sioux Indian child was malnourished, possibly retarded and showed signs of physical abuse. He also was informed that the mother had been a heavy drinker, and died from cirrhosis of the liver. But the young father-to-be brushed aside these warnings.

“I didn’t even want to think about that, because all I knew was that I had a wonderful son,” he says. “For me it was complete euphoria. No parent at that point is prepared to believe the worst about a child.”

To Dorris, the decision to adopt a baby was not unusual. An only child whose father died when he was 2, he was part Modoc Indian, a tribe from the Pacific Northwest. Raised by his mother and other relatives, he resolved as a high school student that one day he would adopt Indian children, whether he was married or not.

“I had known many Native American youngsters who had lost their parents, and who faced a bleak future,” he says. “I thought I could offer them something, because of my heritage.”

At first, Adam didn’t seem too different from other children his age. Although he was not toilet-trained, Dorris was patient with the boy. While Adam’s speech patterns were slower to develop than other children’s, the father was not worried. What mattered most, it seemed, was that Adam was unusually affectionate, always ready with a big hug, even for strangers.

That illusion of normalcy was shattered on a winter night in 1972, when Adam suffered a seizure and Dorris discovered him unconscious in bed. Doctors were baffled, because the only signs of abnormality were that Adam was small for his age and seemed to develop slower than other children. They suggested a range of maladies, such as encephalitis or meningitis, but not too convincingly.

“It’s a puzzler,” one physician said. “He may have some kind of flu,” another concluded.

Adam continued to have seizures, and doctors finally prescribed medication to control them. They ran a full battery of tests on the boy, but still had no clue what was wrong.

By the time Adam was 5, Dorris realized that his son was lagging badly behind other children. He couldn’t distinguish one color from another, he had difficulty counting and telling time, he couldn’t run easily, and he still wasn’t toilet-trained.

Still, the father insisted that there was nothing fundamentally wrong with his son, only that he had gotten a “late start” in life. Looking back, Dorris admits he was in a full-blown state of denial.

He rejected any thought, for example, that Adam’s biological mother was responsible for his retarded development. As an American Indian, Dorris felt strongly that a dominant white culture was responsible for nearly all the ills befalling Indians.

“If I thought about alcohol at all, it was that she was a victim, and that Adam was a victim to a second degree,” he said. “Not because her alcohol had caused his problems, but because it prevented her from raising him in an ideal family setting.”

Trouble in School

Meanwhile, Adam was doing poorly in school. Although he progressed from one grade to another, he had trouble reading maps, could not remember what country he lived in, and had difficulty with basic mathematics. Teachers found him to be friendly and affectionate, but concluded that he had a severe learning disability.

As a concerned parent, Dorris fought them every inch of the way. By 1981 he had married Erdich, who was part Chippewa Indian, and she, too, expressed concern over the boy’s slow academic development.

“I must have been a formidable force for Adam’s teachers to deal with,” Dorris wrote. “I talked more than I listened, demanded reports of ‘progress,’ and vigorously protested any opinions that seemed to limit Adam’s chances. To what extent was Adam’s steady progress from one grade to another due to my bluster?”

The breakthrough came in 1982, when Dorris visited South Dakota Indian reservations on a research trip. One day, while visiting a family crisis center, he was stunned when several boys--all distinctly resembling his son--rushed into a room and began watching television.

Small for Their Age

They all had Adam’s slouch, the same dull look in their eyes, the same tendency to relax all other muscles when concentrating on one physical activity. Like Adam, they were small for their age. When Dorris asked about the children and produced a photo of his son that looked like them, a family counselor took him aside. For the first time, he learned about fetal alcohol syndrome.

No longer would Dorris search for answers in cultural arguments, or blame teachers for their ignorance. From now on, he would seek explanations for Adam’s troubles in his mother’s alcoholic bingeing--especially during the nine months she carried him in her womb.

The idea that American Indians are plagued by alcohol abuse was nothing new to Dorris, who had spent much of his life living or doing research on Indian reservations. From the time he was a teen-ager, there were pressures on him to drink heavily, for purely social reasons.

“No matter who or what you might otherwise be, you were still a helpless idiot like everyone else when it came to booze,” he wrote. Dorris finally decided to quit drinking because of the damage he saw it doing to others, and because it made him physically sick.

It had been that way for hundreds of years--ever since European traders introduced American Indians to alcohol and swindled them out of land in exchange for bottles of fiery liquor. In 1971, a federal commission concluded that alcoholic abuse is “the most severe and widespread health problem among Indians today.”

Not all American Indian tribes are plagued to the same degree, and some have worked diligently to purge themselves of alcohol abuse. But of those tribes affected, as many as 50% of the members surveyed have family problems because of drinking, Dorris found in his research. Among American Indians, alcohol-related deaths are occurring at 6 1/2 times the national rate.

In 1968, the year Adam was born, even more troubling data surfaced. French scientists reported that mothers who drank during pregnancy ran the risk of damaging their unborn children, in some cases exposing them to the risk of mental retardation.

When scientists at the University of Washington reached the same conclusions in 1973, the term fetal alcohol syndrome was born. Researchers also coined the term fetal alcohol effect (FAE), referring to patients who had less severe forms of alcohol-related impairment.

Fetus Also Gets Drunk

In a nutshell, scientists found that most of the alcohol a pregnant mother drinks eventually passes through her placenta and is distributed in the amniotic fluid surrounding the embryonic child. If the mother gets drunk, so does her fetus, and repeated exposure to ethanol, the active ingredient, can cause long-term damage to an unborn child.

Doctors cannot test for FAS or FAE like they can for other forms of mental retardation, such as Down’s syndrome, but there are telltale signs of the impairment. Affected babies are often premature, and continue to be much smaller than other children their age.

Many FAS children have a small head circumference, a flat nasal bridge, a small midface and shortened eyelids. They also are characterized by shortened attention spans, learning disabilities, memory problems and hyperactivity. In particular, they often show a lack of basic judgment, an inability to predict consequences for their behavior.

Although it can be years before doctors make a proper diagnosis, some babies show signs of inebriation at birth, lapsing into delirium tremens after the umbilical cord is cut. In extreme cases, Dorris writes, FAS babies “enter the world tainted with stale wine. Their amniotic fluid literally reeks of Thunderbird or Ripple, and the whole operating theater stinks like the scene of a three-day party. . . . Nurses close their eyes at the memory.”

Estimates are imprecise, but Dr. Ernest L. Abel at the Research Institute on Alcoholism in Buffalo, N.Y., and other scientists suggest that more than 7,400 FAS children are born each year. Dr. Ann Streissguth at the University of Washington, one of the nation’s leading experts on the problem, says that five or six times that many FAE cases are born annually.

On Indian reservations, Dorris found that as many as 30%-40% of newborn babies show signs of fetal impairment because of maternal drinking. More ominously, many of these children themselves grow up to be alcoholics, and give birth to similarly impaired children.

Disorder Can Be Prevented

The irony, Streissguth wrote in 1988, is that “this tragic disorder could be entirely prevented if women refrained from the use and abuse of alcohol during pregnancy.”

Much research remains to be done on FAS. It is not clear, for example, why some women can drink heavily during pregnancy and not endanger their children, while others who drink moderately put their unborn babies at risk. Scientists also are evaluating data that suggests physical damage to the fetus can result from drinking in the first and second trimesters of pregnancy, with emotional and learning damage caused by drinking in the third trimester.

For all these reasons, the U.S. surgeon general and the American Medican Assn. have stated recently that there is no safe level of alcoholic consumption for women during pregnancy. Meanwhile, the number of FAS and FAE births continues to grow.

“Who is going to take responsibility for all these children?” Dorris asks. “Are we going to have an entire nation of people like Adam, who cannot in the most fundamental sense take care of themselves?”

In the years since they learned about FAS, Dorris and his wife have accepted that Adam will be retarded forever. Today, he lives in a group house near his parents and sees them once a week. Counselors make sure he socializes with other residents, and help him manage his money.

A few weeks ago, Adam called his father and asked what season it was. Dorris says if he had told him it was winter, his son would have believed him and asked if there was snow on the ground. It is a conversation the two have had many times.

Through it all, Adam has remained a loyal and affectionate member of the family, especially with his three young sisters. In one sense he is the perfect playmate, Dorris notes, because he can focus on only one thing at a time, and delights in playing the same game over and over.

But there are times when Adam displays flashes of the generous and responsible adult he might have become. In these moments, Erdich says, the full tragedy of FAS becomes clear.

Adam’s Autobiography

When Dorris asked him to help clear away plants that were growing around their house, for example, Adam took the job seriously. He wrote about it in his 14-page autobiography that concludes “The Broken Cord.” The passage is reproduced exactly as he wrote it:

“It was a real pain in the neck digging up more and more burlocks each time but it had to be done anyway. I diden,t mind doing the job for my father . If I haden,t done that job for my father we would of ended up having all the burlocks growing around our house . And that would of been a catastrofe .”

The re-reading of that passage brings a long silence to the living room. Erdich’s eyes moisten with tears, and she says it shows that, despite everything, Adam is a caring, gentle person.

After a pause, Dorris steers the conversation toward the battle against fetal alcohol syndrome. He and his wife say there is a need for a massive public education campaign, because the problem will grow until the dangers of drinking during pregnancy are common knowledge.

Beyond that, Dorris says funds are needed to develop special educational programs for FAS and FAE children. Most public school systems classify these children as “learning disabled,” which does not really address their needs. Such children need basic lessons in how to take care of themselves, rather than standard classroom instruction, he explains.

Finally, Erdich says women need to be warned more directly about the dangers of drinking during pregnancy. Although liquor companies will be required by the federal government to put warning labels on bottles starting this November, she does not believe that is enough.

“I don’t believe any bar should serve liquor to a pregnant woman,” she says. “It might be hard to determine who is pregnant, but still it would be an important statement to make.”

And if that doesn’t work? Erdich pauses before answering.

Responsibility to Baby

“I’m pro-choice, and I believe in a woman’s right to choose whether to have an abortion,” she says. “But once a woman decides to carry a child to full term, she has a responsibility not to abuse that baby. If she does, society has a right to make her stop that abuse.”

Specifically, Erdich points to several Indian reservations that now are considering policies that would allow them to incarcerate pregnant mothers who insist on drinking.

“The reason we talk about incarceration is the desperation with which Indian communities face this problem,” she says. “We’re talking about completely besieged people. People who do not have halfway houses or detoxification centers where they can go, even if they desperately wanted these facilities.”

Support From Family

Despite his affliction, Adam has been fortunate, Dorris says. Unlike thousands of FAS children living in poverty, he had the benefit of physicians, neurologists, psychologists and educators who took a special interest in his case. Most important, he had a family that stood by him.

“This isn’t a sad story,” Dorris says. “Adam’s is not a sad story because he’s a very lucky kid. He landed in the best possible place after this initial horrible luck.”

Still, despite all he has learned, there are fleeting moments when Dorris hopes that his son will be cured--that the legacy of his mother’s drinking will be magically erased.

“I think that, in our heart of hearts, we still expect that there’s going to be this key turned in Adam’s brain that opens the door to what’s in the world, or who he is, or who we are,” he says.

“But intellectually I know that’s not going to happen. It can’t happen. His mother drank when she was pregnant, and the damage was done.”