30 Years Ago, Romania Deprived Thousands of Babies of Human Contact

Image above: Izidor Ruckel near his home outside Denver

For his first three years of life, Izidor lived at the hospital.

The dark-eyed, black-haired boy, born June 20, 1980, had been abandoned when he was a few weeks old. The reason was obvious to anyone who bothered to look: His right leg was a bit deformed. After a bout of illness (probably polio), he had been tossed into a sea of abandoned infants in the Socialist Republic of Romania.

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In films of the period documenting orphan care, you see nurses like assembly-line workers swaddling newborns out of a seemingly endless supply; with muscled arms and casual indifference, they sling each one onto a square of cloth, expertly knot it into a tidy package, and stick it at the end of a row of silent, worried-looking papooses. The women don’t coo or sing to the babies. You see the small faces trying to fathom what’s happening as their heads whip by during the wrapping maneuvers.

In his hospital, in the Southern Carpathian mountain town of Sighetu Marmaţiei, Izidor would have been fed by a bottle stuck into his mouth and propped against the bars of a crib. Well past the age when children in the outside world began tasting solid food and then feeding themselves, he and his age-mates remained on their backs, sucking from bottles with widened openings to allow the passage of a watery gruel. Without proper care or physical therapy, the baby’s leg muscles wasted. At 3, he was deemed “deficient” and transferred across town to a Cămin Spital Pentru Copii Deficienţi, a Home Hospital for Irrecoverable Children.

The cement fortress emitted no sounds of children playing, though as many as 500 lived inside at one time. It stood mournfully aloof from the cobblestone streets and sparkling river of the town where Elie Wiesel had been born, in 1928, and enjoyed a happy childhood before the Nazi deportations.

The windows on Izidor’s third-floor ward had been fitted with prison bars. In boyhood, he stood there often, gazing down on an empty mud yard enclosed by a barbed-wire fence. Through bare branches in winter, Izidor got a look at another hospital that sat right in front of his own and concealed it from the street. Real children, children wearing shoes and coats, children holding their parents’ hands, came and went from that hospital. No one from Izidor’s Cămin Spital was ever taken there, no matter how sick, not even if they were dying.

Like all the boys and girls who lived in the hospital for “irrecoverables,” Izidor was served nearly inedible, watered-down food at long tables where naked children on benches banged their tin bowls. He grew up in overcrowded rooms where his fellow orphans endlessly rocked, or punched themselves in the face, or shrieked. Out-of-control children were dosed with adult tranquilizers, administered through unsterilized needles, while many who fell ill received transfusions of unscreened blood. Hepatitis B and HIV/AIDS ravaged the Romanian orphanages.

Izidor was destined to spend the rest of his childhood in this building, to exit the gates only at 18, at which time, if he were thoroughly incapacitated, he’d be transferred to a home for old men; if he turned out to be minimally functional, he’d be evicted to make his way on the streets. Odds were high that he wouldn’t survive that long, that the boy with the shriveled leg would die in childhood, malnourished, shivering, unloved.

This past Christmas Day was the 30th anniversary of the public execution by firing squad of Romania’s last Communist dictator, Nicolae Ceaușescu, who’d ruled for 24 years. In 1990, the outside world discovered his network of “child gulags,” in which an estimated 170,000 abandoned infants, children, and teens were being raised. Believing that a larger population would beef up Romania’s economy, Ceaușescu had curtailed contraception and abortion, imposed tax penalties on people who were childless, and celebrated as “heroine mothers” women who gave birth to 10 or more. Parents who couldn’t possibly handle another baby might call their new arrival “Ceauşescu’s child,” as in “Let him raise it.”

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To house a generation of unwanted or unaffordable children, Ceauşescu ordered the construction or conversion of hundreds of structures around the country. Signs displayed the slogan: the state can take better care of your child than you can.

At age 3, abandoned children were sorted. Future workers would get clothes, shoes, food, and some schooling in Case de copii—“children’s homes”—while “deficient” children wouldn’t get much of anything in their Cămine Spitale. The Soviet “science of defectology” viewed disabilities in infants as intrinsic and uncurable. Even children with treatable issues—perhaps they were cross-eyed or anemic, or had a cleft lip—were classified as “unsalvageable.”

After the Romanian revolution, children in unspeakable conditions—skeletal, splashing in urine on the floor, caked with feces—were discovered and filmed by foreign news programs, including ABC’s 20/20, which broadcast “Shame of a Nation” in 1990. Like the liberators of Auschwitz 45 years before, early visitors to the institutions have been haunted all their lives by what they saw. “We flew in by helicopter over the snow to Siret, landing after midnight, subzero weather, accompanied by Romanian bodyguards carrying Uzis,” Jane Aronson tells me. A Manhattan-based pediatrician and adoption-medicine specialist, she was part of one of the first pediatric teams summoned to Romania by the new government. “We walk into a pitch-black, freezing-cold building and discover there are youngsters lurking about—they’re tiny, but older, something weird, like trolls, filthy, stinking. They’re chanting in a dronelike way, gibberish. We open a door and find a population of ‘cretins’—now it’s known as congenital iodine deficiency syndrome; untreated hypothyroidism stunts growth and brain development. I don’t know how old they were, three feet tall, could have been in their 20s. In other rooms we see teenagers the size of 6- and 7-year-olds, with no secondary sexual characteristics. There were children with underlying genetic disorders lying in cages. You start almost to disassociate.”

“I walked into an institution in Bucharest one afternoon, and there was a small child standing there sobbing,” recalls Charles A. Nelson III, a professor of pediatrics and neuroscience at Harvard Medical School and Boston Children’s Hospital. “He was heartbroken and had wet his pants. I asked, ‘What’s going on with that child?’ A worker said, ‘Well, his mother abandoned him this morning and he’s been like that all day.’ That was it. No one comforted the little boy or picked him up. That was my introduction.”

The Romanian orphans were not the first devastatingly neglected children to be seen by psychologists in the 20th century. Unresponsive World War II orphans, as well as children kept isolated for long periods in hospitals, had deeply concerned mid-century child-development giants such as René Spitz and John Bowlby. In an era devoted to fighting malnutrition, injury, and infection, the idea that adequately fed and medically stable children could waste away because they missed their parents was hard to believe. Their research led to the then-bold notion, advanced especially by Bowlby, that simply lacking an “attachment figure,” a parent or caregiver, could wreak a lifetime of havoc on mental and physical health.

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Neuroscientists tended to view “attachment theory” as suggestive and thought-provoking work within the “soft science” of psychology. It largely relied on case studies or correlational evidence or animal research. In the psychologist Harry Harlow’s infamous “maternal deprivation” experiments, he caged baby rhesus monkeys alone, offering them only maternal facsimiles made of wire and wood, or foam and terry cloth.

In 1998, at a small scientific meeting, animal research presented back-to-back with images from Romanian orphanages changed the course of the study of attachment. First the University of Minnesota neonatal-pediatrics professor Dana Johnson shared photos and videos that he’d collected in Romania of rooms teeming with children engaged in “motor stereotypies”: rocking, banging their heads, squawking. He was followed by a speaker who showed videos of her work with motherless primate infants like the ones Harlow had produced—swaying, twirling, self-mutilating. The audience was shocked by the parallels. “We were all in tears,” Nelson told me.

In the decade after the fall of Ceaușescu, the new Romanian government welcomed Western child-development experts to simultaneously help and study the tens of thousands of children still warehoused in state care. Researchers hoped to answer some long-standing questions: Are there sensitive periods in neural development, after which the brain of a deprived child cannot make full use of the mental, emotional, and physical stimulation later offered? Can the effects of “maternal deprivation” or “caregiver absence” be documented with modern neuroimaging techniques? Finally, if an institutionalized child is transferred into a family setting, can he or she recoup undeveloped capacities? Implicitly, poignantly: Can a person unloved in childhood learn to love?

Tract developments fan out from the Denver airport like playing cards on a table. The Great Plains have been ground down to almost nothing here, to wind and dirt and trash on the shoulder of the highway, to Walgreens and Arby’s and AutoZone. In a rental car, I drive slowly around the semicircles and cul-de-sacs of Izidor’s subdivision until I see him step out of the shadow of a 4,500-square-foot McMansion with a polite half-wave. He sublets a room here, as do others, including some families—an exurban commune in a single-family residence built for Goliaths. At 39, Izidor is an elegant, wiry man with mournful eyes. His manner is alert and tentative. A general manager for a KFC, he works 60-to-65-hour weeks.

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“Welcome to Romania,” he announces, opening his bedroom door. It’s an entryway into another time, another place. From every visit to his home country, Izidor has brought back folk art and souvenirs—hand-painted glazed plates and teacups, embroidered tea towels, Romanian flags, shot glasses, wood figurines, cut-glass flasks of plum brandy, and CDs of Romanian folk music, heavy on the violins. He could stock a gift shop. There are thick wine-colored rugs, blankets, and wall hangings. The ambient light is maroon, the curtains closed against the high-altitude sunshine. Ten miles southwest of the Denver airport, Izidor is living in an ersatz Romanian cottage.

“Everyone in Maramureş lives like this,” he tells me, referring to the cultural region in northern Romania where he was born.

I’m thinking, Do they, though?

“You will see that many people there have these things in their homes,” he clarifies.

That sounds more accurate. People like knickknacks. “Do you sound like a Romanian when you visit?” I ask.

“No,” he says. “When I start to speak, they ask, ‘Where are you from?’ I tell them: ‘From Maramureş!’ ” No one believes him, because of his accent, so he has to explain: “Technically, if you want to be logical about it, I am Romanian, but I’ve lived in America for more than 20 years.”

“When you meet new people, do you talk about your history?”

“No, I try not to. I want to experience Romania as a normal human being. I don’t want to be known everywhere as ‘the Orphan.’ ”

His precise English makes even casual phrases sound formal. In his room, Izidor has captured the Romanian folk aesthetic, but something else stirs beneath the surface. I’m reminded of the book he self-published at age 22, titled Abandoned for Life. It’s a grim tale, but once, when he was about 8, Izidor had a happy day.

A kind nanny had started working at the hospital. “Onisa was a young lady, a bit chubby, with long black hair and round rosy cheeks,” Izidor writes in his memoir. “She loved to sing and often taught us some of her music.” One day, Onisa intervened when another nanny was striking Izidor with a broomstick. Like a few others before her, Onisa had spotted his intelligence. On the ward of semi-ambulatory (some crawled or creeped), slightly verbal (some just made noises) children, Izidor was the go-to kid if an adult had questions, like what was that one’s name or when had that one died. The director would occasionally peek in and ask Izidor if he and the other children were being hit; to avoid retribution, Izidor always said no.

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On that day, to cheer him up after his beating, Onisa promised that someday she’d take him home with her for an overnight visit. Skeptical that such an extraordinary event would ever happen, Izidor thanked her for the nice idea.

A few weeks later, on a snowy winter day, Onisa dressed Izidor in warm clothes and shoes she’d brought from home, took him by the hand, and led him out the front door and through the orphanage gate. Walking slowly, she took the small boy, who swayed on uneven legs with a deep, tilting limp, down the lane past the public hospital and into the town. Cold, fresh air brushed his cheeks, and snow squeaked under his shoes; the wind rattled the branches; a bird stood on a chimney. “It was my first time ever going out into the world,” he tells me now. He looked in astonishment at the cars and houses and shops. He tried to absorb and memorize everything to report back to the kids on his ward.

“When I stepped into Onisa’s apartment,” he writes, “I could not believe how beautiful it was; the walls were covered with dark rugs and there was a picture of the Last Supper on one of them. The carpets on the floor were red.” Neighborhood children knocked on Onisa’s door to see if the strange boy from the orphanage wanted to come out and play, and he did. Onisa’s children arrived home from school, and Izidor learned that it was the start of their Christmas holiday. He feasted alongside Onisa’s family at their friends’ dinner table that night, tasting Romanian specialties for the first time, including sarmale (stuffed cabbage), potato goulash with thick noodles, and sweet yellow sponge cake with cream filling. He remembers every bite. On the living-room floor after dinner, the child of that household let Izidor play with his toys. Izidor followed the boy’s lead and drove little trains across the rug. Back at Onisa’s, he slept in his first-ever soft, clean bed.

The next morning, Onisa asked Izidor if he wanted to go to work with her or to stay with her children. Here he made a mistake so terrible that, 31 years later, he still remembers it with grief.

“I want to go to work with you!” he called. He was deep into a fantasy that Onisa was his mother, and he didn’t want to be parted from her. “I got dressed as fast as I could, and we headed out the door,” he remembers. “When we were near her work, I realized that her work was at the hospital, my hospital, and I began to cry … It had only been 24 hours but somehow I thought I was going to be part of Onisa’s family now. It didn’t occur to me that her work was actually at the hospital until we were at the gate again. I felt so shocked when we turned into the yard it was like I’d forgotten I came from there.”

He tried to turn back but wasn’t permitted. He’d found the most wonderful spot on Earth—Onisa’s apartment—and, through his own stupidity, had let it slip away. He sobbed like a newcomer until the other nannies threatened to slap him.

Today Izidor lives 6,000 miles from Romania. He leads a solitary life. But in his bedroom in a subdivision on a paved-over prairie, he has re-created the setting from the happiest night in his childhood.

“That night at Onisa’s,” I ask, “do you think you sensed that there were family relationships and emotions happening there that you’d never seen or felt before?”

“No, I was too young to perceive that.”

“But you did notice the beautiful furnishings?”

“Yes! You see this?” Izidor says, picking up a tapestry woven with burgundy roses on a dark, leafy background. “This is almost identical to Onisa’s. I bought it in Romania for that reason!”

“All these things …” I gesture.

“Yes.”

“But not because they signify ‘family’ to you?”

“No, but they signify ‘peace’ to me. It was the first time I slept in a real home. For many years I thought, Why can’t I have a home like that? ”

Now he does. But he knows there are missing parts—no matter how many shot glasses he collects.

In the early 1990s, Danny and Marlys Ruckel lived with their three young daughters in a San Diego condo. They thought it would be nice to add a boy to the mix, and heard about a local independent filmmaker, John Upton, who was arranging adoptions of Romanian orphans. Marlys called and told him they wanted to adopt a baby boy. “There’s thousands of kids there,” Upton replied. “That’ll be easy.”

Marlys laughs. “Not much of that was accurate!” she tells me. We’re seated in the living room of a white-stucco house in the Southern California wine-country town of Temecula. Kids and dogs bang in and out of the dazzling hot day (the Ruckels have adopted five children from foster care in recent years). Marlys, now a job coach for adults with special needs, is like a Diane Keaton character, shyly retreating behind large glasses and a fall of long hair, but occasionally making brave outbursts. Danny, a programmer, is an easygoing guy. Marlys describes herself as a homebody, but then there was that time she moved to Romania for two months to try to adopt a boy she saw on a video.

Undone by “Shame of a Nation,” Upton had flown to Romania four days after the broadcast, and made his way to the worst place on the show, the Home Hospital for Irrecoverable Children in Sighetu Marmaţiei. He went back a few times. On one visit, he gathered a bunch of kids in an empty room to film them for prospective adoptive parents. His video would not show children packed together naked “like little reptiles in an aquarium,” as he’d described them, but as people, wearing clothes and speaking.

By then, donations had started to come in from charities around the world. Little reached the children, because the staff skimmed the best items, but on that day, in deference to the American, nannies put donated sweaters on the kids. Though the children seemed excited to be the center of attention, Upton and his Romanian assistant found it slow-going. Some didn’t speak at all, and others were unable to stand up or to stand still. When the filmmakers asked for the children’s names and ages, the nannies shrugged.

At the end of a wooden bench sat a boy the size of a 6-year-old—at age 10, Izidor weighed about 50 pounds. Upton was the first American he’d ever seen. Izidor knew about Americans from the TV show Dallas. A donated television had arrived one day, and he had lobbied for this one thing to stay at the hospital. The director had assented. On Sunday nights at 8 o’clock, ambulatory kids, nannies, and workers from other floors gathered to watch Dallas together. When rumors flew up the stairs that day that an American had arrived, the reaction inside the orphanage was, Almighty God, someone from the land of the giant houses!

Izidor knew the information the nannies didn’t. He tells me: “John Upton would ask a kid, ‘How old are you?,’ and the kid would say, ‘I don’t know,’ and the nanny would say, ‘I don’t know,’ and I’d yell, ‘He’s 14!’ He’d ask about another kid, ‘What’s his last name?,’ and I’d yell, ‘Dumka!’ ”

“Izidor knows the children here better than the staff,” Upton grouses in one of the tapes. Before wrapping up the session, he lifts Izidor into his lap and asks if he’d like to go to America. Izidor says that he would.

Back in San Diego, Upton told the Ruckels about the bright boy of about 7 who hoped to come to the United States. “We’d wanted to adopt a baby,” Marlys says. “Then we saw John’s video and fell in love with Izidor.”

In May 1991, Marlys flew to Romania to meet the child and try to bring him home. Just before traveling, she learned that Izidor was almost 11, but she was undaunted. She traveled with a new friend, Debbie Principe, who had also been matched with a child by Upton. In the director’s office, Marlys waited to meet Izidor, and Debbie waited to meet a little blond live wire named Ciprian.

“When Izidor entered,” Marlys says, “all I saw was him, like everything else was fuzzy. He was as beautiful as I’d imagined. Our translator asked him which of the visitors in the office he hoped would be his new mother, and he pointed to me!”

Izidor had a question for the translator: “Where will I live? Is it like Dallas?”

“Well … no, we live in a condo, like an apartment,” Marlys said. “But you’ll have three sisters. You’ll love them.”

This did not strike Izidor as an interesting trade-off. He dryly replied to the translator: “We will see.”

That night, Marlys rejoiced about what an angel Izidor was.

Debbie laughed. “He struck me more like a cool operator, a savvy politician type,” she told Marlys. “He was much more on top of things than Chippy.” Ciprian had spent the time in the office rummaging wildly through everything, including desk drawers and the pockets of everyone in the room.

“No, he’s an innocent. He’s adorable,” Marlys said. “Did you see him pick me to be his mother?”

Years later, in his memoir, Izidor explained that moment:

Marlys was the tall American and Debbie was the short American … “Roxana, which one is going to be my new mother?” I asked [the translator].

“Which one do you want to have as your mother?”

“Which one is my mother?” I begged to know.

“The tall American,” she replied.

“Then that’s who I want to have as my mother,” I said.

When I picked Marlys, she began to cry, filled with joy that I had picked her.

The pediatric neuroscientist Charles Nelson is famously gregarious and kind, with wavy, graying blond hair and a mustache like Captain Kangaroo’s. In the fall of 2000, he, along with his colleagues Nathan A. Fox, a human-development professor at the University of Maryland, and Charles H. Zeanah, a child-psychiatry professor at the Tulane University School of Medicine, launched the Bucharest Early Intervention Project. They had permission to work with 136 children, ages six months to 2.5 years, from six Bucharest leagãne, baby institutions. None was a Home Hospital for Irrecoverable Children, like Izidor’s; they were somewhat better supplied and staffed.

By design, 68 of the children would continue to receive “care as usual,” while the other 68 would be placed with foster families recruited and trained by BEIP. (Romania didn’t have a tradition of foster care; officials believed orphanages were safer for children.) Local kids whose parents volunteered to participate made up a third group. The BEIP study would become the first-ever randomized controlled trial to measure the impact of early institutionalization on brain and behavioral development and to examine high-quality foster care as an alternative.

To start, the researchers employed Mary Ainsworth’s classic “strange situation” procedure to assess the quality of the attachment relationships between the children and their caregivers or parents. In a typical setup, a baby between nine and 18 months old enters an unfamiliar playroom with her “attachment figure” and experiences some increasingly unsettling events, including the arrival of a stranger and the departure of her grown-up, as researchers code the baby’s behavior from behind a one-way mirror. “Our coders, unaware of any child’s background, assessed 100 percent of the community kids as having fully developed attachment relationships with their mothers,” Zeanah told me. “That was true of 3 percent of the institutionalized kids.”

Nearly two-thirds of the children were coded as “disorganized,” meaning they displayed contradictory, jerky behaviors, perhaps freezing in place or suddenly reversing direction after starting to approach the adult. This pattern is the one most closely related to later psychopathology. Even more disturbing, Zeanah told me, 13 percent were deemed “unclassified,” meaning they displayed no attachment behaviors at all. “Ainsworth and John Bowlby believed infants would attach to an adult even if the adult were abusive,” he said. “They hadn’t considered the possibility of infants without attachments.”

Until the Bucharest project, Zeanah said, he hadn’t realized that seeking comfort for distress is a learned behavior. “These children had no idea that an adult could make them feel better,” he told me. “Imagine how that must feel—to be miserable and not even know that another human being could help.”

In October 1991, Izidor and Ciprian flew with Romanian escorts to San Diego. The boys’ new families waited at the airport to greet them, along with Upton and previously adopted Romanian children—a small crowd holding balloons and signs, cheering and waving. Izidor gazed around the terminal with satisfaction. “Where is my bedroom?” he asked. When Marlys told him they were in an airport, not his new home, Izidor was taken aback. Though she’d explained that the Ruckels did not live like the Ewings in Dallas, he hadn’t believed her. Now he’d mistaken the arrivals area for his new living room.

A 17-year-old from the orphanage, Izabela, was part of the airport welcoming committee. Born with hydrocephalus and unable to walk after being left all her life in a crib, she was in a wheelchair, dressed up and looking pretty. Rescued by Upton on an earlier trip, she’d been admitted to the U.S. on a humanitarian medical basis and was being fostered by the Ruckels.

Izidor was startled to see Izabela: “Who is your mother?”

“My mother is your mother, Izidor.”

“I didn’t like the sound of that,” he remembers. To make sure he’d heard correctly, he asked again: “Who is your mother here in America?”

“Izidor, you and I have the same mother,” she said, pointing at Marlys.

So now he had to get used to four sisters.

In the car, when Danny tried to click a seat belt across Izidor’s waist, he bucked and yelled, fearing he was being straitjacketed.

Marlys homeschooled the girls, but Izidor insisted on starting fourth grade in the local school, where he quickly learned English. His canny ability to read the room put him in good stead with the teachers, but at home, he seemed constantly irritated. Suddenly insulted, he’d storm off to his room and tear things apart. “He shredded books, posters, family pictures,” Marlys tells me, “and then stood on the balcony to sprinkle the pieces onto the yard. If I had to leave for an hour, by the time I got home, everyone would be upset: ‘He did this; he did that.’ He didn’t like the girls.”

Marlys and Danny had hoped to expand the family fun and happiness by bringing in another child. But the newest family member almost never laughed. He didn’t like to be touched. He was vigilant, hurt, proud. “By about 14, he was angry about everything,” she tells me. “He decided he’d grow up and become the American president. When he found out that wouldn’t be possible because of his foreign birth, he said, ‘Fine, I’ll go back to Romania.’ That’s when that started—his goal of returning to Romania. We thought it was a good thing for him to have a goal, so we said, ‘Sure, get a job, save your money, and when you’re 18, you can move back to Romania.’ ” Izidor worked every day after school at a fast-food restaurant.

“Those were rough years. I was walking on eggshells, trying not to set him off. The girls were so over it. It was me they were mad at. Not for bringing Izidor into the family but for being so … so whipped by him. They’d say, ‘Mom, all you do is try to fix him!’ I was so focused on helping him adjust, I lost sight of the fact that the other children were scraping by with a fraction of my time.

“Danny and I tried taking him to therapy, but he refused to go back. He said, ‘I don’t need therapy. You two need therapy. Why don’t you go?’ So we did.

“He’d say: ‘I’m fine when nobody’s in the house.’

“We’d say: ‘But Izidor, it’s our house.’ ”

As early as 2003, it was evident to the BEIP scientists and their Romanian research partners that the foster-care children were making progress. Glimmering through the data was a sensitive period of 24 months during which it was crucial for a child to establish an attachment relationship with a caregiver, Zeanah says. Children taken out of orphanages before their second birthday were benefiting from being with families far more than those who stayed longer. “When you’re doing a trial and your preliminary evidence is that the intervention is effective, you have to ask, ‘Do we stop now and make the drug available to everyone?’ ” he told me. “For us, the ‘effective drug’ happened to be foster care, and we weren’t capable of creating a national foster-care system.” Instead, the researchers announced their results publicly, and the next year, the Romanian government banned the institutionalization of children under the age of 2. Since then, it has raised the minimum age to 7, and government-sponsored foster care has expanded dramatically.

Meanwhile, the study continued. When the children were reassessed in a “strange situation” playroom at age 3.5, the portion who displayed secure attachments climbed from the baseline of 3 percent to nearly 50 percent among the foster-care kids, but to only 18 percent among those who remained institutionalized—and, again, the children moved before their second birthday did best. “Timing is critical,” the researchers wrote. Brain plasticity wasn’t “unlimited,” they warned. “Earlier is better.”

The benefits for children who’d achieved secure attachments accrued as time went on. At age 4.5, they had significantly lower rates of depression and anxiety and fewer “callous unemotional traits” (limited empathy, lack of guilt, shallow affect) than their peers still in institutions. About 40 percent of teenagers in the study who’d ever been in orphanages, in fact, were eventually diagnosed with a major psychiatric condition. Their growth was stunted, and their motor skills and language development stalled. MRI studies revealed that the brain volume of the still-institutionalized children was below that of the never institutionalized, and EEGs showed profoundly less brain activity. “If you think of the brain as a light bulb,” Charles Nelson has said, “it’s as though there was a dimmer that had reduced them from a 100-watt bulb to 30 watts.”

One purpose of a baby attaching to just a small number of adults, according to evolutionary theory, is that it’s the most efficient way to get help. “If there were many attachment figures and danger emerged, the infant wouldn’t know to whom to direct the signal,” explains Martha Pott, a senior lecturer in child development at Tufts. Unattached children see threats everywhere, an idea borne out in the brain studies. Flooded with stress hormones like cortisol and adrenaline, the amygdala—the main part of the brain dealing with fear and emotion—seemingly worked overtime in the still-institutionalized children.

Comparing data from orphanages worldwide shows the profound impact institutionalization has on social-emotional development even in the best cases. “In England’s residential nurseries in the 1960s, there was a reasonable number of caregivers, and the children were materially well provided for. Their IQs, though lower than those of children in families, were well within the average range, up in the 90s,” Zeanah told me. “More recently, the caregiver-child ratio in Greek orphanages was not as good, nor were they as materially well equipped; those kids had IQs in the low-average range. Then, in Romania, you have our kids with really major-league deficits. But here’s the remarkable thing: Across all those settings, the attachment impairments are similar.”

When the children in the Bucharest study were 8, the researchers set up playdates, hoping to learn how early attachment impairments might inhibit a child’s later ability to interact with peers. In a video I watched, two boys, strangers to each other, enter a playroom. Within seconds, things go off the rails. One boy, wearing a white turtleneck, eagerly seizes the other boy’s hand and gnaws on it. That boy, in a striped pullover, yanks back his hand and checks for teeth marks. The researcher offers a toy, but the boy in white is busy trying to hold hands with the other kid, or grab him by the wrists, or hug him, as if he were trying to carry a giant teddy bear. He tries to overturn the table. The other boy makes a feeble effort to save the table, then lets it fall. He’s weird, you can imagine him thinking. Can I go home now?

The boy in the white turtleneck lived in an institution; the boy in the striped pullover was a neighborhood kid.

Nelson cautions that the door doesn’t “slam shut” for children left in institutions beyond 24 months of age. “But the longer you wait to get children into a family,” he says, “the harder it is to get them back on an even keel.”

“Every time we got into another fight,” Izidor remembers, “I wanted one of them to say: ‘Izidor, we wish we had never adopted you and we are going to send you back to the hospital.’ But they didn’t say it.”

Unable to process his family’s affection, he just wanted to know where he stood. It was simpler in the orphanage, where either you were being beaten or you weren’t. “I responded better to being smacked around,” Izidor tells me. “In America, they had ‘rules’ and ‘consequences.’ So much talk. I hated ‘Let’s talk about this.’ As a child, I’d never heard words like ‘You are special’ or ‘You’re our kid.’ Later, if your adoption parents tell you words like that, you feel, Okay, whatever, thanks. I don’t even know what you’re talking about. I don’t know what you want from me, or what I’m supposed to do for you.” When banished to his room, for rudeness or cursing or being mean to the girls, Izidor would stomp up the stairs and blast Romanian music or bang on his door from the inside with his fists or a shoe.

Marlys blamed herself. “He said he wanted to go back to his first mother, a woman who hadn’t even wanted him, a woman he didn’t remember. When I took him to the bank to set up his savings account, the bank official filling out the form asked Izidor, ‘What’s your mother’s maiden name?’ I opened my mouth to answer, but he immediately said ‘Maria.’ That’s his birth mother’s name. I know it was probably dumb to feel hurt by that.”

One night when Izidor was 16, Marlys and Danny felt so scared by Izidor’s outburst that they called the police. “I’m going to kill you!” he’d screamed at them. After an officer escorted Izidor to the police car, he insisted that his parents “abused” him.

“Oh, for Christ’s sake,” Danny said when informed of his son’s accusation.

“Great,” said Marlys. “Did he happen to mention how we abuse him?”

Back in the car, the officer asked: “How do your parents abuse you?”

“I work and they take all my money,” Izidor hollered. In the house, the officer searched Izidor’s room, and found his savings-account book.

“We can’t take him,” the officer told the Ruckels. “He’s mad, but there’s nothing wrong here. I’d suggest you lock your bedroom doors tonight.”

Again, they had the thought: But it’s our house.

The next morning Marlys and Danny offered Izidor a ride to school and then drove him straight to a psychiatric hospital instead. “We couldn’t afford it, but we took a tour and it scared him,” Marlys tells me. “He said, ‘Don’t leave me here! I’ll follow your rules. Don’t make me go here!’ Back in the car, we said: ‘Listen, Izidor, you don’t have to love us, but you have to be safe and we have to be safe. You can live at home, work, and go to school until you’re 18. We love you.’ But, you know, the sappy stuff didn’t work with him.”

Living by the rules didn’t last long. One night Izidor stayed out until 2 a.m., and found the house locked. He banged on the door. Marlys opened it a crack. “Your things are in the garage,” she told him.

Izidor would never again live at home. He moved in with some guys he knew; their indifference suited him. “He’d get drunk in the middle of the night and call us, and his friends would get on the line to say vulgar things about our daughters,” Marlys says. “Admittedly, it was finally peaceful in our house, but I worried about him.”

On Izidor’s 18th birthday, Marlys baked a cake and wrapped his gift, a photo album documenting their life together: his first day in America, his first dental appointment, his first job, his first shave. She took the presents to the house where she’d heard her son was staying. The person who answered the door agreed to deliver them when Izidor got back. “In the middle of the night,” Marlys says, “we heard a car squealing around the cul-de-sac, then a loud thud against the front door and the car squealing away. I went down and opened the door. It was the photo album.”

At 20, in 2001, Izidor felt an urgent desire to return to Romania. Short on cash, he wrote letters to TV shows, pitching the exclusive story of a Romanian orphan making his first trip back to his home country. 20/20 took him up on it, and on March 25, 2001, a film crew met him at the Los Angeles airport. So did the Ruckels.

“I thought, This is it. I’ll never see him again,” Marlys says. “I hugged and kissed him whether he wanted me to or not. I told him, ‘You’ll always be our son and we’ll always love you.’ ”

Izidor showed the Ruckels his wallet, in which he’d stuck two family photographs. “In case I do decide to stay there, I’ll have something to remember you by,” he said. Though he meant it kindly, Marlys was chilled by the ease with which Izidor seemed to be exiting their lives.

From the September 1998 issue: Robert D. Kaplan on Romania, the fulcrum of Europe

In Romania, the 20/20 producers took Izidor to visit his old orphanage, where he was feted like a returning prince, and then they revealed, on camera, that they’d found his birth family outside a farming village three hours away. They drove through a snowy landscape and pulled over in a field. A one-room shack sat on a treeless expanse of mud. Wearing a white button-down, a tie, and dress pants, Izidor limped across the soggy, uneven ground. He was shaking. A narrow-faced man emerged from the hut and strode across the field toward him. Oddly, they passed each other like two strangers on a sidewalk. “Ce mai faci?”—How are you?—the man mumbled as he walked by.

“Bun,” Izidor muttered. Good.

That was Izidor’s father, after whom he’d been named. Two young women then hurried from the hut and greeted Izidor with kisses on each cheek; these were his sisters. Finally a short, black-haired woman not yet 50 identified herself as Maria—his mother—and reached out to hug him. Suddenly angry, Izidor swerved past her. How can I greet someone I barely know?, he remembers thinking. She crossed her hands on her chest and began to wail, “Fiul meu! Fiul meu! ” My son! My son!

The house had a dirt floor, and an oil lamp glowed dimly. There was no electricity or plumbing. The family offered Izidor the best seat in the house, a stool. “Why was I put in the hospital in the first place?” he asked.

“You were six weeks old when you got sick,” Maria said. “We took you to the doctor to see what was wrong. Your grandparents checked on you a few weeks later, but then there was something wrong with your right leg. We asked the doctor to fix your leg, but no one would help us. So we took you to a hospital in Sighetu Marmaţiei, and that’s where we left you.”

“Why did no one visit me for 11 years? I was stuck there, and no one ever told me I had parents.”

“Your father was out of work. I was taking care of the other children. We couldn’t afford to come see you.”

“Do you know that living in the Cămin Spital was like living in hell?”

“My heart,” cried Maria. “You must understand that we’re poor people; we were moving from one place to another.”

Agitated, almost unable to catch his breath, Izidor got up and went outside. His Romanian family invited him to look at a few pictures of his older siblings who’d left home, and he presented them with his photo album: Here was a sunlit, grinning Izidor poolside, wearing medals from a swimming competition; here were the Ruckels at the beach in Oceanside; here they were at a picnic table in a verdant park. The Romanians turned the shiny pages wordlessly. When the TV cameras were turned off, Izidor tells me, Maria asked whether the Ruckels had hurt him or taught him to beg. He assured her neither was true.

“You look thin,” Maria went on. “Maybe your American mother doesn’t feed you enough. Move in with us. I will take care of you.” She then pressed him for details about his jobs and wages in America and asked if he’d like to build the family a new house. After three hours, Izidor was exhausted and eager to leave. “He called me from Bucharest,” Marlys says, “and said, ‘I have to come home. Get me out of here. These people are awful.’ ”

“My birth family scared me, especially Maria,” Izidor says. “I had a feeling I could get trapped there.”

A few weeks later he was back in Temecula, working in a fast-food restaurant. But suddenly, he found himself longing for Romania again. It would become a pattern, restless relocation in search of somewhere that felt like home.

Friends told him there were jobs in Denver, so he decided to move to Colorado. Danny and Marlys visit him there and have gone on trips to Romania with him. It’s harder for him to come home to California, Marlys says. “Thanksgiving, Christmas—they’re too much for him. Even when he lived on his own nearby, he was bad at holidays. He always made an excuse, like ‘I have to make the pizza dough.’ When our whole family is here and someone asks, ‘Is Izidor coming?,’ someone will say, ‘Nope, he’s making the pizza dough.’ ”

The neuropsychologist Ron Federici was another of the first wave of child-development experts to visit the institutions for the “unsalvageables,” and he has become one of the world’s top specialists caring for post-institutionalized children adopted into Western homes. “In the early years, everybody had starry eyes,” Federici says. “They thought loving, caring families could heal these kids. I warned them: These kids are going to push you to the breaking point. Get trained to work with special-needs children. Keep their bedrooms spare and simple. Instead of ‘I love you,’ just tell them, ‘You are safe.’ ” But most new or prospective parents couldn’t bear to hear it, and the adoption agencies that set up shop overnight in Romania weren’t in the business of delivering such dire messages. “I got a lot of hate mail,” says Federici, who is fast-talking and blunt, with a long face and a thatch of shiny black hair. “ ‘You’re cold! They need love! They’ve got to be hugged.’ ” But the former marine, once widely accused of being too pessimistic about the kids’ futures, is now considered prescient.

Federici and his wife adopted eight children from brutal institutions themselves: three from Russia and five from Romania, including a trio of brothers, ages 8, 10, and 12. The two oldest weighed 30 pounds each and were dying from untreated hemophilia and hepatitis C when he carried them out the front door of their orphanage; it took the couple two years to locate the boys’ younger brother in another institution. Since then, in his clinical practice in Northern Virginia, Federici has seen 9,000 young people, close to a third of them from Romania. Tracking his patients across the decades, he has found that 25 percent require round-the-clock care, another 55 percent have “significant” challenges that can be managed with adult-support services, and about 20 percent are able to live independently.

The most successful parents, he believes, were able to focus on imparting basic living skills and appropriate behaviors. “The Ruckels are a good example—they hung on, and he’s doing okay. But I just had a family today. I knew this girl from Romania forever, first saw her when she was a little girl with the whole post-traumatic stress picture: fear, anxiety, uncertainty, depression. She’s 22 now. The parents said, ‘We’re done. She’s into drugs, alcohol, self-injury. She’s on the streets.’ I said, ‘Let’s get you back on a family program.’ They said, ‘No, we’re exhausted, we can’t afford more treatment—it’s time to focus on our other kids.’ ”

Within his own family, Federici and his wife have become the permanent legal guardians for four of his Romanian children, who are now all adults. Two of them work, under supervision, for a foundation he established in Bucharest; the other two live with their parents in Virginia. (The fifth is a stirring example of the fortunate 20 percent—he’s an ER physician in Wisconsin.) Both of his adult sons who haven’t left home are cognitively impaired, but they have jobs and are pleasant to be around, according to Federici. “They’re happy!” he exclaims. “Are they 100 percent attached to us? Hell no. Are they content with the family? Yes. Can they function in the world, around other people? Absolutely. They’ve figured out ways, not to overcome what happened to them—you can’t really overcome—but to adapt to it and not take other people hostage.”

When a baby was born into the family nine years ago—the family’s only biological child—the doctor began to see new behaviors in his older kids. “The little one is a rock star to them,” he says. “The big brothers at home are so protective of him. In public, in restaurants, God forbid anyone would hurt him or touch a hair on his head. It’s an interesting dynamic: No one watched out for them in their childhoods, but they’ve appointed themselves his bodyguards. He’s their little brother. He’s been to Romania with them. Is this love? It’s whatever. They’re more attached to him than to us, which is absolutely fine.”

By any measure, Izidor—living independently—is a success story among the survivors of Ceauşescu’s institutions. “Do you imagine ever having a family?” I ask. We’re in his room in the giant house outside Denver.

“You mean of my own? No. I have known since I was 15 that I would not have a family. Seeing all my friends in dumb relationships, with jealousy and control and depression—I thought, Really? All that for a relationship? No. The way I see myself is that there would be no human being who would ever want to get close to me. Someone might say that’s false, but that’s how I see myself. If someone tries to get close, I get away. I’m used to it. It’s called a celibacy life.”

He says he doesn’t miss what he never knew, what he doesn’t even perceive. Perhaps it’s like color blindness. Do people with color blindness miss green? He focuses on the tasks before him and does his best to act the way humans expect other humans to act.

“You can be the smartest orphan in the hospital. But you are missing things,” Izidor says. “I’m not a person who can be intimate. It’s hard on a person’s parents, because they show you love and you can’t return it.”

Though Izidor says he wants to live like a “normal” human, he still regularly consents to donning the mantle of former orphan to give talks around the U.S. and Romania about what institutionalization does to little kids. He’s working with a screenwriter on a miniseries about his life, believing that if people could be made to understand what it’s like to live behind fences, inside cages, they’d stop putting children there. He’s keenly aware that up to 8 million children around the world are institutionalized, including those at America’s southern border. Izidor’s dream is to buy a house in Romania and create a group home for his own former wardmates—those who were transferred to nursing homes or put out on the streets. A group home for his fellow post-institutionalized adults is as close to the idea of family as Izidor can get.

Neural pathways thrive in the brain of a baby showered with loving attention; the pathways multiply, intersect, and loop through remote regions of the brain like a national highway system under construction. But in the brain of a neglected baby—a baby lying alone and unwanted every week, every year—fewer connections get built. The baby’s wet diaper isn’t changed. The baby’s smiles aren’t answered. The baby falls silent. The door is closing, but a sliver of light shines around the frame.

People once in a while paid attention to the baby with the twisted leg. Nannies thought he was appealing, and quick-witted. The director talked to him. One brilliant winter afternoon, Onisa took him out of the orphanage, and he walked down a street.

Sometimes, Izidor has feelings.

Two years after the Ruckels kicked him out, Izidor was getting a haircut from a stylist who knew the family. “Did you hear what happened to your family?” she asked. “Your mom and sisters got in a terrible car accident yesterday. They’re in the hospital.”

Izidor tore out of there, took the day off from work, bought three dozen red roses, and showed up at the hospital.

“We were in the truck coming out of Costco,” Marlys recalls, “and a guy hit us really hard—it was a five-car crash. After a few hours at the hospital, we were released. I didn’t call Izidor to tell him. We weren’t speaking. But he found out, and I guess at the hospital he said, ‘I’m here to see the Ruckel family,’ and they said, ‘They’re not here anymore,’ which he took to mean ‘They’re dead.’ ”

Izidor raced from the hospital to the house—the house he’d been boycotting, the family he hated.

Danny Ruckel wasn’t going to let him in without a negotiation. “What are your intentions?” he would ask. “Do you promise to be decent to us?” Izidor would promise. Danny would allow Izidor to enter the living room and face everyone, to stand there with his arms full of flowers and his eyes wet with tears. Before leaving that day, Izidor would lay the flowers in his mother’s arms and say, with a greater attempt at earnestness than they’d ever heard before, “These are for all of you. I love you.” It would mark a turning point. From that day on, something would be softer in him, regarding the Ruckel family.

But first Izidor was obliged to approach the heavy wooden door, the door against which he’d hurled the photo album Marlys made for his birthday, the door he’d slammed behind him a hundred times, the door he’d battered and kicked when he was locked out. He knocked and stood on the front step, head hanging, heart pounding, unsure whether he’d be admitted. I abandoned them, I neglected them, I put them through hell, he thought. The prickly stems of burgundy-red roses wrapped in dark leaves and plastic bristled in his arms.

And then they opened the door.

Lily Samuel contributed research to this article. It appears in the July/August 2020 print edition with the headline “Can an Unloved Child Learn to Love?”