Her first nursing degree was conferred upon her by her mother, a nurse herself who must have spotted something nurturing in Liz Smith, even when she was still a little girl in pigtails.
“My mom framed for me a certificate from the Hasbro School of Nursing,’’ Smith said, recalling the toy company’s fanciful degree that would foreshadow her real-life career. “I knew I wanted to take care of people.’’
Smith, now 45, collected her nursing degree from Villanova University in 1996. In 2007, she received a master’s degree in business from Boston University.
Her professional journey has wound through MetroWest Medical Center in Framingham to St. Elizabeth’s Medical Center in Brighton. By the time she found herself at Franciscan Children’s hospital, where she is now director of nursing, she knew two things: She loved taking care of children. She wanted a child of her own.
“I was constantly around kids,’’ she told me the other day in her office. “I think I’m going to graduate college, meet a guy, and have kids. That was the game plan. I now realize you can’t plan. And, actually, if you don’t, better things happen. It took me a long time to get there.’’
And a long time to get to Giselle, an impossibly cute 2-year-old with pink sneakers and long eyelashes who squirmed lovingly in the lap of her mother as a wan winter sun danced across the floor of Smith’s Brighton office.
There was satisfaction in that embrace that belied the heartbreaking journey that preceded it.
There was a long-term relationship that once held the promise of marriage and children. There were tears when a nurse practitioner told her, as she approached her 40th birthday, to focus on her career, not motherhood.
There were soulful conversations with her sister, who encouraged her to have a child on her own — advice that led to sperm donor selections and, ultimately, to in vitro fertilization that briefly promised to bear fruit.
“When that door closed quickly and suddenly,” Smith said, “it was a bad day.’’
Then she saw Giselle.
Smith was coming out of Franciscan’s Unit 2, when she saw a nurse pushing a stroller, and — as she often does — stopped to see one of the littlest patients, a quiet 8-month-old baby who was unusually inexpressive.
“I said, ‘Who is that beautiful little angel?’ And the nurse said, ‘This is Giselle.’ And that was it. Literally every day after that I went to see her. I would wait until after work. It was my reward.’’
Giselle was born at 29 weeks. She weighed 1 pound, 14 ounces, born with neonatal abstinence syndrome, a consequence of her birth mother’s drug use. The baby was withdrawing from methadone, heroin, and cocaine.
Smith knew the baby had spent almost 90 days on a ventilator. She knew her neurological prognosis was uncertain. She knew Giselle was underdeveloped.
And Liz Smith knew this: The little girl had opened a little door into her heart.
“She was at a critical point where if she did not get out of the hospital she may not catch up developmentally,’’ Smith said.
The state had taken custody of Giselle in October 2016, shortly after her arrival at Franciscan. The infant had almost no visitors. She needed a foster mother. Liz Smith raised her hand.
Her hospital colleagues rejoiced, showering her with presents, transforming the apartment of a single woman. A crib was set up in Liz Smith’s bedroom, where she could closely watch the baby with a feeding tube, the little girl who was sick. Vomiting frequently. Still a ward of the state.
“I remember one night I was walking by a mirror and I was holding her, and I remember thinking, ‘I could lose her,’ ’’ Smith said. “I would talk to [the state agency] about it. And they said, ‘We’re not going to come and take her in the middle of the night. It’ll be a planned event.’ Any time we had those conversations, I wanted to get sick.
“You can’t just love a certain percentage. You can’t. You have to give it your all.’’
And that’s precisely what Liz Smith did.
She also held her breath.
There were processes to be followed. The baby’s birth parents were notified and had weekly supervised visits with Giselle. Talk of reunification flickered briefly and then faded. And then Liz Smith marched toward formal adoption.
Tears rolled down her cheeks as she told me about it.
“When I got the call that the parents’ rights were terminated, I imagined that it would be a day of relief,’’ Smith said. “And it was a day I was really sad. I was really happy. But I was really sad for them. I was gaining her but they were losing her. And to try to battle addiction and being a mom, that’s impossible.’’
Giselle wore a Navy blue dress and patent leather shoes last Oct. 18 , Liz Smith’s grandmother’s birthday.
Her whole family assembled at a Brockton courthouse. The judge summoned Smith into her chambers. She presented the woman on the threshold of motherhood with a photo album to commemorate the big day.
In the courtroom, “the judge stood up and said, ‘When a judge walks in the room, everyone stands out of respect. But today I stand in respect for you, Liz, because you deserve the respect from this room.’
“Then everybody started crying. She said, ‘A birthing day is a miracle. But adopting a child from miles away is destiny. That’s what brought you two together.’ ’’
Smith was presented with an official document, certifying her motherhood. Someone took a photo of Giselle with the judge’s gavel. There were cheers. And a great family celebration.
And then Liz Smith went home with the baby she had wanted since she was a little girl.
Life is different from dreams, she knows now. Being a single mom with a demanding career requires stamina and balance. And love.
“I can’t wait to wake up in the morning to say good morning to her. To pick her up at day care. To have her run to me and ask for food now that she’s eating. Every milestone is so different. You just saw that when I cry, she knows to console me. I never imagined that I could have a best friend who is 2.’’
She wants what all mothers want.
She wants Giselle to get a good education. She wants her to make good life choices. She wants her life to have purpose and value.
For the little girl with the feeding tube, she wants good health. Giselle is already exceeding developmental goals.
“The one wish I have as a mom is that she grows up happy,’’ Liz Smith said. “I want her to get everything out of life that she wants to. For so long I felt pressure. I need to find someone. I need to get married. I need to have children. What’s wrong with me? I’m not married yet.
“I put so much pressure on myself to have a child. I think that was taking away from finding a partner. Of course, that’s still something I want in my life and I’ve had in my life since I met Giselle. But it’s a totally different experience now because I’m settled. This is my life.’’
It’s a life where little things matter.
Like the other night when mother and daughter had pizza together, a TV dinner like the ones a little Liz Smith occasionally would enjoy as a kid.
“She was beside herself. Sitting there having a piece of pizza. It was one of the happiest moments that I’ve had with her.
“It’s those little things that you don’t expect. It’s just so fun. I couldn’t be happier. I just could not love her more.’’
And as little Giselle nuzzled against her mother, it was clear that the feeling is mutual.
Thomas Farragher is a Globe columnist. He can be reached at email@example.com.