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Rich and Carrie Greenberg knew there was room for more in the Holladay home they’d built with their two children, Zach and Samantha.

A physician who works in pediatric emergency medicine at  and also teaches at the �㽶��Ƶ of Utah School of Medicine, Rich has seen his share of tough cases, including children placed into foster care because of difficult circumstances at home. Empathy for kids in need of a caring family and a desire to bring a new sibling into the lives of their own children, ages 7 and 9, prompted the Greenbergs to sign up to become foster parents through the Utah Foster Care Foundation.

The family never realized, however, just how life would change the day they met Marla Rae, a 1-year-old who stole their hearts from the moment they met her.

Foster care workers had contacted the Greenbergs after Marla was admitted to Primary Children’s Medical Center more than a year ago with several medical problems. With Rich’s medical background, social workers thought the family could be the perfect fit for tiny Marla, who had been severely neglected by her biological family.

It didn’t take long for the Greenbergs to decide to bring Marla home. But the decision came with a set of challenging medical conditions and the need to adapt to everyday life with a medically fragile child.

Marla had been classified as “failure to thrive,” meaning that she’d lost a significant amount of weight. Doctors had inserted a nasogastric or NG tube to feed the girl, who was unable to eat on her own because she’d developed an oral aversion.

The Greenbergs learned that Marla had been born prematurely and received her first NG tube at birth. She later transitioned to a bottle, but her biological family didn’t understand how to care for the girl’s needs. Marla suffered from severe reflux and spit up constantly. She wasn’t given the opportunity to properly eat and drink when she was being supplemented with the NG tube while in the care of her biological family, who didn’t realize they were causing trauma by taking the girl’s NG tube in and out every time she ate.

By the time Marla arrived at Primary Children’s Medical Center and was placed into foster care, she was terrified to let anyone touch her face, because of the trauma she'd previously suffered.

The Greenbergs weren’t daunted by their new foster daughter’s challenges. They saw a chance to make a difference in the little girl’s life and brought her home, giving her affection that at first seemed like a foreign concept to the toddler.

“If you put your hand on her cheek, if you went to give her a kiss, if you did anything … she’d have a screaming fit,” Rich recalls. “She’d bat her hands and wouldn’t let you near her face because she was traumatized.”

The family noticed other worrisome behavior that pointed to neglect. When they put Marla in her crib for the night or to take a nap, as an 18-month-old, she didn’t protest.

“She didn’t play, she didn’t say a word. She closed her eyes, laid still like a statue and went to sleep,” says Rich. “Initially we thought, ‘Oh, what a great sleeper. And then we began to realize ‘this is not normal.’”

Day by day, Marla began to trust her new family. The Greenbergs stood by her as she underwent a hip surgery and alterations to her NG tube. Doctors also determined that Marla would need a surgical procedure called Nissen fundoplication to treat her gastroesophageal reflux disease wrapping her stomach around her esophagus.

The procedures were successful and the Greenbergs tended to Marla as she recovered in a spica cast, which kept her stabilized from her chest to her ankles. After a month in the cast, she moved into a brace for 2 to 3 months and soon began a regimen of physical, occupational and speech therapy.

Today, it’s been more than a year since the Greenbergs first took in Marla as a foster child, but the girl is now a permanent part of their family. The opportunity to adopt Marla arose, and the family was thrilled to bring her into their family for good. The adoption was finalized this month.

The family knows that some outsiders who hear their story may wonder why they took on the complications of adopting a medically fragile child. The Greenbergs say they can’t imagine life without Marla.

“I know it sounds like ‘Oh my gosh, what a train wreck,’” says Rich, recounting the medical journey Marla has taken the family on. “ But she is the light of all our our lives. She is amazing. She is so much fun.”

“People tell us ‘What a lucky child. She went to the right family.’ But we feel like we’re the lucky ones. We’re so blessed to have her.’”

Caring for Marla will continue to have its challenges, the family acknowledges. She can’t yet walk, but is cruising around furniture. She can say about 30 words, including “mom, dad, potty and hi.” She receives the majority of her nutrition from a feeding pump that she’s hooked up to for about 15 hours a day – a routine that is likely to continue for several more years.

Still, the family celebrates the developmental progress Marla has made while in their care and is enjoying the person she is becoming.

“She loves to dance, she loves music. She loves water and her bathtub. She has the most amazing smile,” says Rich. “She’s gone from a neglected child to the opposite end of the spectrum.”​

Foster Families Needed

The Utah Foster Care Foundation is searching for families to care for children with special medical needs. The organization is asking those in Utah’s medical community – including �㽶��Ƶ of Utah Health Care employees – to consider lending a helping hand.

About 2,700 children in Utah are in foster care at any given time, including approximately 750 kids in Salt Lake County.

There are children with a variety of medical needs who need to find good homes. Those needs can be as simple as helping a child diagnosed with diabetes to regulate his or her diet and monitor insulin. Other cases include caring for children prone to seizures, tending to kids who have disabilities because they’ve been shaken as a baby or were born addicted to drugs from a mother’s drug use.

Statewide Facts: Children in Foster Care

• In Utah, most children are in foster care for about 12 months; though some children may stay in foster care for much longer. The length of time a child is in foster care varies depending on their family’s individual circumstances.
• 40 percent of children who enter foster care return to live with their birth parents. Foster families have the opportunity to mentor and support parents who are working to have their children returned to them.
• Many children are adopted from foster care. Last year (FY12), 525 children were adopted from foster care in Utah. Most children adopted from foster care are adopted by their foster parents.
• Children in foster care are between the ages of 0-19. There is a particular need for families who are able and willing to care for children over age 8.
• Many children enter foster care with brothers and sisters and need foster families who can help them stay together.
• Foster parents can be married or single. They can own or rent their homes. It takes 32 hours of training and the ability to pass a criminal background check to become a foster parent in Utah. The Utah Foster Care Foundation and Division of Child and Family Services provide ongoing training to foster and adoptive parents throughout the state.

For more information visit www.utahfostercare.org or call (877) 505-KIDS (5437).​