For nurse Liz Smith, caring for a sickly baby became more than a job – it was the beginning of a life-changing experience.

For Liz Smith, a role as senior director of nursing at a children’s hospital in Brighton, MA, meant a rewarding work life spending long days caring for her vulnerable patients. However, a young girl named Gisele who arrived at Franciscan Children’s Hospital in October 2016 was to have a profound impact upon Smith’s life.

Smith’s job at Franciscan Children’s Hospital was the completion of a cycle that had seen her volunteer at the facility two decades previously as a newly qualified nurse. After leaving Villanova University in 1996, the nurse had embarked upon a career that had seen her complete a master’s at Boston University and subsequently start her own medical facility in Richmond, Virginia.

Professionally, then, Smith’s life was rich. “Since I was a little girl, I always wanted to be a nurse,” she later told the TODAY show. But privately, the Massachusetts native felt that there was something missing. She dreamed of becoming a mom and, although it still hadn’t happened at that point, Smith remained optimistic.

“It just seemed natural that I would go to college, get my nursing degree, meet a guy, get married and have children,” Smith told TODAY. “Becoming a nurse was easy, but becoming a mum was not.” Her options still weren’t exhausted, though, and Smith’s sister recommended that she look to have kids by herself. “She said, ‘I’ll be right by your side.’ We went to see an infertility specialist,” Smith recalled. “She was very positive, said, ‘You’re healthy. You have the ovaries of a 30-year-old, this is gonna be good.’”

Unfortunately for Smith, however, it wasn’t to be. Despite the initial optimism, subsequent tests and false starts were to result in the nurse being told that IVF wasn’t an option. Understandably, she was heartbroken. “I put it in the back of my mind [and] got busy with work, as I always do,” Smith explained.

It seemed Smith would have to settle for her life as a nurse and gain fulfillment from her role as aunt to an incredible number of nephews and nieces. Smith’s sister and brother had 13 kids between them, in fact. Nonetheless, the news that she would never have a child of her own was upsetting. “When that door closed quickly and suddenly, it was a bad day,” Smith told the Franciscan Children’s Hospital website.

Image: Ashley Puzzuti via Franciscan Children’s

But fate was to offer up another possibility to Smith, even if it was one that she’d initially rejected. “I wasn’t considering adoption at all,” she admitted to Yahoo! Lifestyle. That was to change, though, when Smith was transferred to a different department within the Franciscan Children’s Hospital. It was there that she met a little girl who was to transform her life.

“I came out of the medical unit one day, and in the stroller was this beautiful little girl,” Smith told TODAY. “And I said to the nurse, Megan, ‘Who is this beautiful little angel?’ and she said, ‘This is Gisele.’ And that was it.” Smith was immediately drawn to this infant girl, in fact. But as the nurse began to learn about Gisele’s background and current medical needs, it became clear that this was a complex situation.

Image: Ashley Pizzuti via Franciscan Children’s

Gisele was just eight months old when Smith first encountered her, but the little girl had actually been at the Franciscans Children’s Hospital since October 2016. She’d come into the world at another hospital just three months prior to that. Furthermore, shortly after Gisele’s arrival at her new medical facility, she’d become a ward of the state.

The infant had endured a tough start to life, then. Indeed, she’d been brought into the world 11 weeks premature and on delivery had weighed only 1 pound and 14 ounces. And Gisele was also burdened with neonatal absence syndrome (NAS). This condition is caused by a baby’s withdrawal from the drug(s) the mother has taken during pregnancy. Unfortunately, the symptoms can be wide-reaching and disastrous for a child’s health.

The Washington Post reported that Gisele’s mother had been a user of methadone, cocaine and heroin while she was pregnant. As a result, the little girl relied upon a feeding tube and was placed under supervision for a lung defect. She was subsequently transferred to the Franciscan Children’s Hospital to have this care administered. The infant had also come under the custody of the state, which was trying to place her with a foster family at the time.

“After spending almost three months in the NICU on ventilator support [Gisele] developed an oral aversion,” an article on the Franciscan Children’s Hospital website explains. “This reluctance to eat is common in premature babies who’ve never experienced pleasure from feeding.” Hence the feeding tube. So, Gisele was a little girl who was battling her way through the early months of life.

Smith told Yahoo! Lifestyle that both Gisele’s parents struggled with addiction. When Smith finally came across the child in the following March, Gisele’s mother and father had attended the hospital on a couple of supervised trips, but that was the full extent of the child’s visitors. Fortunately for Gisele, though, it didn’t take long for someone to fall for her. “I went to see her every day,” Smith recalled. “It was kind of my reward after a long workday.”

Image: Franciscan Children’s Hospital via Yahoo Lifestyle

Now eight months old, however, Gisele required more than the care that was being delivered to her at the children’s hospital. As part of her developmental process, she needed to sit up, move about if possible and start exploring the world around her. “Bringing her home felt urgent because, for most of her life, Gisele lay in a crib, so she had to get moving and meet her milestones,” Smith explained. “She was barely sitting up on her own.”

Image: Franciscan Children’s Hospital via YAHOO

As a result, a little over a month after first meeting Gisele, Smith was allowed to foster the child she’d been so committed to visiting. “Since the moment I met her, there was something behind her striking blue eyes capturing my attention. I felt that I needed to love this child and keep her safe,” Smith told The Washington Post. And the care couldn’t wait, either. “She was behind developmentally, and I wanted to get her out of the hospital and get her thriving.”

Thankfully, Smith was in a prime position to foster Gisele. Her work as a nurse and familiarity with the child’s medical needs would ensure she could provide the specialist care any foster parent would be required to deliver. Therefore, after receiving the full backing of family and colleagues, Smith brought Gisele home.

However, fostering was always intended to be a temporary solution. The ultimate objective was still to return Gisele to her parents once they were in a position to care for her. It’s typical in such situations, in fact, that all efforts are made to return a child to the birth parents. As a result, Smith knew it could be a short-lived arrangement.

Smith’s colleagues were nonetheless keen to mark the occasion and consequently arranged a baby shower for the nurse. They also assisted her in erecting a crib at her home. However, it was a bittersweet time for Smith. “I had mixed feelings, because Gisele needed some basic items and I wanted to enjoy the moment,” she informed Yahoo! Lifestyle. “But her parents were still trying to win custody. There was a lot of stress.”

The aim was still to reunite Gisele with her parents, in fact, and weekly supervised visits were arranged by the Department of Children & Family Services. Unfortunately, though, these visits didn’t go well. They proved difficult for all concerned to manage, not least Smith who now had an emotional attachment to the child in her care. “During her first visit, I sat in my parked car outside Whole Foods for 45 minutes and thought, ‘Does she know where I am? Is she scared?’“ Smith recalled.

Ultimately, however, no bond began to form between the birth parents and Gisele, and the weekly visits began to dry up. Furthermore, doubts were raised about the mom and dad’s ability to care for their child. The parents’ rights were eventually terminated as a result. In addition, there were no other blood relatives deemed suitable or willing to take care of Gisele. So, the path had been laid clear for Smith to pursue another avenue.

“There was no bond between Gisele and her parents, though they genuinely believed they could care for her,” Smith said. “Eventually, they disengaged and their connection faded away. I don’t think they realized what her medical needs required.”

At the same time, Smith herself was also struggling emotionally with the situation. “I remember certain nights, one in particular, when she was hooked up to the feed and I was walking by the mirror. And the thought went into my head of losing her,” Smith recalled. “I had to go there in my mind, because it was still a reality. But it made me sick to my stomach. You can’t just love a certain percentage. You have to give it your all.”

With the state having terminated Gisele’s parents’ right to take care of her, it was up to her mum and dad to appeal the decision – but they didn’t. Smith was consequently presented with the opportunity to become the little girl’s permanent guardian. The nurse’s long-held desire to become a mother could now potentially become a reality. And more than that, this was a little girl who was desperately in need of security and dedicated care, too.

It’s revealing of Smith’s nature that in this happiest of moments for her personally, her empathy still stretched to the parents of the little girl who was in her care. “When I got the call that the parents’ rights were terminated, I imagined that it would be a day of relief,” she admitted when talking to the Franciscans Children’s Hospital website. “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.”

“My gain was another’s loss. It’s a feeling difficult to describe when you are experiencing this life-changing moment that someone else is as well, in the opposite way,” Smith continued. “The bottom line is: it’s devastating for another family.” Despite the bittersweet feelings, though, it was clear that little Gisele was going to get the care, commitment and love that every child deserves with Smith as her new mother.

However, there were still official matters to tie up before Smith could legally call herself Gisele’s mother. Indeed, Smith remained anxious until the moment she finally received the big news. “The day I got the phone call with the adoption date was the day that I was jumping up and down,” she recalled. “They said, ‘October 18.’ And it’s my grandmother’s birthday, and I just started crying.”

And so, on that emotional day in mid-October, all of Smith’s wishes finally became a reality. Surrounded by relatives, friends and colleagues, the judge made a ruling that would change the lives of two people who seemingly were destined for each other.

It was there, in a Brockton, MA, courtroom that a judge approved all documents making Smith Gisele’s legal guardian under the terms of adoption law. This was a momentous day for the newly certified mother and Gisele, who was by this point two years old. Indeed, it had been 18 months since the pair had first met in Franciscan Children’s Hospital.

The Brockton judge was effusive in their praise for Smith. “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,” they said, according to the Franciscans Children’s Hospital website. “A birthing day is a miracle. But adopting a child from miles away is destiny. That’s what brought you two together.”

Smith’s brother, Phil, was also full of praise for his sister and her relationship with Gisele. “This is the mother-daughter relationship my sister has waited a long time for,” he told The Washington Post. “It’s plain to see that they have brought a completeness to each other.” As for Smith, there was a particular moment when it all began to feel real: when the judge referred to her as Gisele’s “mom.” “I think that’s where I realized I was a parent,” Smith informed TODAY.

Despite the stability of her new home and the happiness she shares with her new mom, though, Gisele still faces challenges due to her difficult birth. The young girl’s still using a feeding tube, for example. That said, improvements are being observed all the time. “She’s doing great. She continues to amaze me with her strength and resilience every single day,” Smith stated.

While the feeding issues may continue, Gisele’s appetite nonetheless continues to grow. Indeed, her palate is developing constantly and becoming more akin to the average two-year-old’s. “If you told me a year ago she would be asking for pizza, I would not have believed you. It’s just slow progression, but in the right direction,” Smith explained.

The feeding tube is only supplementary now – a big change from when Smith first met Gisele at the Franciscan Children’s Hospital. Indeed, back then, the tiny infant was fitted with a gastronomy tube and was receiving her nourishment via this device for up to 16 hours per day. In contrast, cheese and avocados are now on the menu.

However, it’s not just her feeding habits that indicate Gisele is a happy and content two-year-old. The toddler also expresses joy through dancing and singing, for example. “Her new favorite song is ‘You Are My Sunshine.’ And every time she sings it, I think to myself, ‘You have no idea,’” Smith told The Washington Post.

Looking ahead, Gisele’s new mom feels she has a lot to teach her daughter and of course wants only the best for Gisele’s future. High up the list is a good education that will hopefully lead to a good career. The ability to make healthy life choices is also important for Smith, as she feels that, personally, she hasn’t always managed to do this in her own life.

Smith told the Boston Globe, ““The one wish I have as a mom is that she grows up happy. 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,” Smith continued. “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.”

The story of Liz Smith and Gisele is a tale of battling against the odds. Needless to say, it’s all been worth it, as can be seen in Smith’s remarks about her adopted daughter; “The things that made her giggle and laugh randomly, the times that she’ll notice that I’m sad and come up to me and give me a hug just out of the blue, or seeing her running to me from daycare. Those are the moments I love,” Smith explained to the Franciscan Children’s Hospital’s website.

Those periods of struggle now seem a long time ago for Smith, although she’ll never forget the battles that both she and Gisele have fought to be where they are today. “I remember some of the painful pieces at times, but when I look at her I’m so happy I can’t believe I was ever so upset,” Smith said. “I can’t remember the hard times because she makes me so happy.”

And Smith has a powerful message that she wants to communicate to others as a result of their journey. “I want to tell people to be open to things that they may not have planned for, because otherwise you could miss something right in front of you and the power of fostering and see how it transforms a child’s life and how they can transform yours,” she stated. “I would, just, really if you want to become a mom or dad or parent, then look at fostering and adoption.”