Medicine: The Second Transplant

An Ethiopian Jewish filmmaker was optimistic that the hard times were finally behind him. Then he was called on to sacrifice once more.

It was just before Passover 2003 when Avishai Mekonen, an Ethiopian Israeli filmmaker living in New York, called home to Tiberias to wish his mother and five brothers a happy holiday and heard the bad news: “Your brother Ariel is in the hospital.”

Ariel, an 11th grader, had come home from an outing with an insect bite on his leg and strange symptoms. No one in the family could tell Avishai what was wrong with his brother and he couldn’t get anyone in the local hospital, where the family was gathered, to explain it to him. When he called again four hours later, he was told that Ariel’s whole body had swollen and he was in intensive care. Finally, a doctor got on the phone and told Avishai that something was wrong with the single kidney Ariel had been born with, but he didn’t know what.

On subsequent calls, Avishai’s brothers told him Ariel was getting worse. No one knew how to calm Aviva Mekonen, their mother. Over the phone, Avishai heard someone screaming.

Eventually word came that Ariel would need a kidney transplant. “I was torn up,”? recalls Avishai. “I was in New York, newly married. I felt the people at [the hospital] didn’t know anything about this child, that he was born on the way to Israel, that his birth was a step along the way to the fulfillment of an ancient dream.”

Feeling helpless, Avishai wandered through the snowy streets of New York. On 58th Street he saw a sign with a familiar name: Hadassah. “I know what Hadassah is,” he remembers thinking, recalling treatment in Hadassah Hospital for an Army wound and his film studies at Hadassah College Jerusalem.

“I walked into the building,” he says. “I saw photos of Hadassah ladies. I said to myself, my God, someone is opening doors for me.”

An hour after he entered the building, Avishai left with what he believed would be the key to his brother’s recovery-the name of Dr. Michael Friedlaender, senior nephrologist at the Hadassah-Hebrew University Medical Center at Ein Kerem and Israel’s leading authority on kidney transplants. Through a series of e-mails and faxes, a friendship blossomed between the 32-year-old filmmaker in New York and the veteran physician in Jerusalem. Dr. Friedlaender arranged for Ariel to be transferred to Hadassah Hospital and to have him placed on a transplant list. Ariel underwent dialysis treatments. Meanwhile, family members were tested and it was determined that Avishai, the only one who lived outside Israel, was the best match as a donor for his little brother.

From the start, Dr. Friedlaender went beyond the family’s expectations. British-born and Oxford-trained, athletic and outgoing, he explained things to the Mekonens and comforted them. He also took care of all the paperwork, even though that wasn’t part of his job, Avishai says. He visited Ariel daily, spoke to the family on the phone, sometimes even at 10 P.M. “He kissed us like Ethiopians do,” Aviva says-at least three kisses on alternating cheeks.

Though Ariel’s treatment and the transplant were covered by Israel’s national health insurance, Avishai’s trip to Israel and his loss of income for the journey and two months of recovery were not. In New York, Avishai met with Jewish organizations and spoke in synagogues, trying to raise the money for his trip. He got help from the family of his wife, Shari Rothfarb Mekonen, a fellow filmmaker he had met in Israel. And not content with his other duties, Dr. Friedlaender also helped raise money for Avishai’s trip.

The surgery was easy-almost anticlimactic. Then, five days later, while Ariel and Avishai were still recuperating in the hospital, they heard more bad news. The evening before, Dr. Friedlaender had returned home from jogging and died of a sudden heart attack. He was 62.

“We laughed together yesterday at 5,” Aviva said, with tears in her eyes. “We wanted to give him an Ethiopian present, something handmade. He raised his hands-I remember his hands up in the air-and said, ‘I don’t want a present. Your smiles are enough for me’ Now I think he came yesterday to say good-bye.”

Avishai left his hospital bed so he could deliver one of the eulogies at Dr. Friedlaender’s funeral. After a coterie of doctors had praised their colleague for his humane approach to his patients and called him a “moral compass”? at Hadassah, Avishai slowly made his way to the front of the throng and spoke of Dr. Friedlaender as his family’s angel.

“I’m sorry I asked so many questions and didn’t ask, ‘What causes you to smile all the time?'”? Avishai said, capturing his essence.

The Mekonens’ experience perfectly exemplified Dr. Friedlaender’s all-too-short career. A column posted on the Hadassah Medical Organization’s Web site referred to him as the “total doctor”?: “He had scant regard for the political machinations of the health system and would streamroller his way to obtain the correct care for his patients,” the obituary said. “His office was always open for his patients and he was constantly answering their telephone queries.”

In retrospect, the idea of giving one of his kidneys to Ariel had seemed right to Avishai for many reasons, including some he could hardly verbalize. He was already a veteran of transplantation, albeit of another kind. The first, from Ethiopia to Israel, had been fraught with danger and brought traumas from which recovery would take years. He may have sensed that a new experience might help him close some painful chapters.

The Mekonens were originally from a small Jewish village near Ambover, in northern Ethiopia. As a boy, Avishai herded sheep while his father grew cotton and wove natalas, the large, white wrap that every Ethiopian owns, and his mother worked as a midwife. Aviva was pregnant with Ariel when, in 1984, the family left with 100 other Jews on their journey to Israel, which first involved walking to Sudan. Although only 11 on the trek out of Ethiopia, Avishai gave up his water rations for his mother and remembers standing in a circle of men to protect her when bandits attacked.

“During our three-week trek,” Avishai relates, “20 people died and four or five girls were kidnapped.” By the time they got to Sudan, Aviva was eight months pregnant. With diarrhea and malaria rampant and death all around, she began to lose weight. “I said to myself, I must save money,” Avishai remembers. He put on a keffiya, said his name was Mohammed and started selling ices. Leaving the refugee camp was forbidden, but Avishai decided rules were not the highest priority.

One day, he relates, “as I was selling ices, a truck stopped, five people got out-and the next thing I knew it was the next day and I found myself tied to a pole.”? Later he found himself in a carpeted room where he was told to walk around with other boys and girls, including many Ethiopian Jewish children. He understood that the children were being sold; he was not bought because he was too thin.

“I was taken out of the circle, given a room and told to forget my past,” he recalls. “My captors were Muslim and taught me to pray like them, but in my heart I prayed to our God.” He also began to feel weak and wondered if his captors were feeding him contaminated food.

It was six weeks before he had a chance to escape, and when he did he ran all the way to Gandaref, the nearest town where, in the city center, he encountered two men who asked who he was and argued with each other over whether he looked Jewish.

“They took me on their shoulders and found my family,” he says, “[but] at sunset, I started writhing from pain. I was taken…to a hospital where they operated on my stomach. I don’t know what they took out. I still have the scars.”

Three days later, the family was on a plane to Israel. “It was the first time I had ever seen a plane,” Avishai says. “I remembered my mother and father’s stories of how we would go to Jerusalem in a big bird…”

Though coming to Israel was the fulfillment of a dream, the Mekonen family has had its share of trouble. Aviva divorced her husband in 1996 and raised six sons by herself while working an evening factory shift. Her father and mother died within one month of each other around the time Ariel got sick.

For Avishai, it took years to shake his Sudanese captivity. “It’s like there’s a hole inside me,” he says.

In the Army, Avishai had sleep problems. Offered the chance to see a psychologist, he declined. Instead, he bought a blank notebook and began writing in it. “I talked with the page,” he says. “I had space there. I would turn the page and breathe deeply. The journal changed my life.”

Despite the problems, hope and gentleness pervade the atmosphere in the Mekonen home-a small apartment in a distressed neighborhood in Tiberias. And after all he had been through, Avishai felt that giving a kidney to Ariel would be easy. “Even before he was born, Ariel was very connected to me,” says Avishai. “Now I felt like I was giving him the ability to breathe. I’ll breathe half, and he’ll breathe half.”

Eight months after his surgery, Ariel travels from Tiberias once or twice a month for checkups at Hadassah Hospital and is returning to normal life.

He has a notebook in which he expresses his feelings through art, calligraphy and poetry with lines like, “We sing songs of praise/ to the pain of love, to the illness/ that doctors can’t cure/ the wound is a wound of passion.” And “I still have done nothing/ for God.”

He missed the last year of high school but is back on track. “Avishai didn’t give me his kidney so I would sit around the house,” he says. “He gave me life and wants me to get up and do something.”

Aviva is back at the Galtronics factory, where her coworkers had volunteered to give up their vacations to make up for the time she took off to be with her son. Avishai returned to New York, and he and his wife are working on a documentary film exploring racial and ethnic diversity in Judaism.

In March, Avishai and Shari Mekonen celebrated the birth of their first child, a boy. They named him Ariel.

Avishai and his brother have endured a great deal together and are more connected than ever. One gave up a kidney to save the other’s life. And perhaps Avishai’s second transplant journey will help heal the wounds left behind by the first.

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