How Many Children Live with Their Grandparents? A 6-year-old
female came to clinic who was well-known to the practice for a
fever and earache for 1 day. She previously had rhinorrhea for 3
days, and was otherwise well. The past medical history was non-
contributory. The pertinent physical exam showed a healthy
female with temperature of 39.4°C with other vital signs and
growth parameters normal. She had copious clear rhinorrhea,
slightly erythematous pharynx and a left ear with erythema, pus
and immobile tympanic membrane. The right ear had a splayed
light reflex and opaque fluid behind the tympanic membrane with
a fluid level. The diagnosis of left otitis media was made. The
grandmother remarked that she was now happier because she had
recently gained legal custody of the girl and her 8 year old
brother. She now could make decisions for them without seeking
permission through the foster care system. She said she felt
relieved because “now my babies are legal and well taken care
of.” She denied any significant