Adopted child who repaid ailing father with a gift of life

Boaz could not sire a child, thus he assumed parenting of a son of his brother, who died of HIV/Aids. ILLUSTRATION| JOHN NYAGA

What you need to know:

  • Boaz could not sire a child, thus he assumed parenting of a son of his brother, who died of HIV/Aids.
  • Years later, this child was the only donor on Boaz’s kidney transplant list.

Every religion promotes the belief that if you do a good deed, you will be richly rewarded. They do so not only because it is true, but it also encourages Good Samaritans to continue doing good deeds. This theme comes out most vividly as I recall the case of Boaz, who came to see me because he could not sire a child. As usual, he was referred to me with his wife, Esther, by my gynaecological colleague, to rule out the cause of infertility in the male partner.

They were a pleasant couple, very much in love and deeply disappointed that their love could not culminate in an offspring. After examining Boaz for any abnormalities in his genitalia and finding none, I asked for a semen analysis, which showed no sperms.

When I told Boaz about it, he replied. “I never thought for a moment that I would be the guilty party.” Looking mischievously from the corners of his eyes at his wife, he added.” I always considered pregnancy and breast feeding as a woman’s problem and anything wrong with them as their responsibility.”

As Esther squirmed in her chair at such a gender sensitive statement, I took to her defence. “According to medical statistics, in one third of infertility cases, the man is the cause. Anyway, let us do further tests on you to verify if your testes are not producing sperms or there is a block between the testes and the urethra. If there is block we can unblock the passage by surgery.” I concluded.

The tests showed that there was no block, and biopsy on both testes showed no spermatogenesis. “I think you might benefit from tablets to boost your sperm population.” I advised doubting my own judgment because the tablets usually help oligospermia, a condition when there is paucity of sperms in the semen.

“And if that doesn’t work?” Asked Esther.

“We have other avenues.” I replied.

TABLETS DID NOT WORK

The tablets did not work as the subsequent analysis showed and so, Evelyne and I saw the couple jointly. “We have a few choices.” My gynaecological colleague started on a positive note. “Like insemination by a donor.”

Esther threw out the suggestion instantly. “I want our child, not my child with a foreign sperm.” She protested vehemently.

“That leaves us with adoption, where neither of you have footprints on the child.” Evelyne explained. While this reply sent the couple in a spin, she continued. “In our culture we usually adopt from our immediate or extended family. Can you think on these lines?”

Boaz was the first to take up the offer. “Certainly,” he replied. “My brother died last year, leaving a pregnant wife. She delivered a baby boy early this year and she unfortunately died soon after leaving an infant behind. We can adopt him,” He said side glancing at his wife.

She took the cue and said. “They both died of HIV Aids; so we must make sure that the toto is not suffering from it.”

“It would be nobler if we adopted the little boy despite him suffering from this terrible disease. Also, now with anti-retroviral, he can lead a normal life.” Boaz remarked.

“We don’t have to decide right now.” Having been impressed by Boaz’s benevolent spirit, I intervened to prevent an argument between husband and wife. Just as well, because examination of medical records traced by Evelyne and me proved that the wife died of surgical complications following a Caesarean Section and the husband was on anti-retroviral drugs after being diagnosed positive for HIV/Aids. Above all, the toto, named Mark, was negative on repeated testing ordered by me on Esther’s insistence.

MAKE ADOPTION OFFICIAL

Once all these matters had been resolved, Evelyne and I were witnesses in signing various papers to make the adoption official as desired by Esther & Boaz. “We don’t want any matata in the future,” the couple said.

Once all these formalities were completed, we two specialists had no medical reason to not see the happy couple or their adopted son leave. Hence their files went into my archives until Boaz’s file needed retrieving, when a couple of years back I went to the Dialysis Unit to see a patient referred to me by my nephrologist colleague, Prof Adam. His patient had developed an abscess, which according to him needed lancing. Next to his bed, I saw a familiar face on a kidney machine. “What are you doing here?” I asked him.

“Both my kidneys are failing and I can’t get rid of my waste products.” Boaz replied, using a layman’s jargon. I decided to obtain his medical facts from my professional colleague. By a pleasant coincidence, he arrived in his Unit just then and I remarked. “Think of the devil and he is there!”

Prof Adam was a competent kidney specialist, but lacked a sense of humour, and he solemnly asked. “What can I do for you?”

I gave him my opinion on the patient he had referred to me and added. “I wonder if you can give me some information on your other patient, Boaz, because a few years ago he was under the joint care of our mutual gynaecological friend and me.”

“Sure,” he replied. “In the last few years, he developed high blood pressure and diabetes, which took a toll on his kidneys, in spite of them being treated adequately. Recently, both his kidneys packed up and he needs dialysis three times a week.” Then pre-empting my next question, he went on. “The cost of frequent dialysis and the inconvenience of three hospital admissions every week are taxing him a great deal.

“So he is a candidate for kidney transplant but we are having great difficulty in finding a suitable donor.”

“I suppose you have tried both his immediate and extended family.” I chipped in hesitatingly, knowing well that no specialist worth his salt wants to be told how to do his job.

“Yes,” replied Prof Adam, “and we have drawn a blank. Boaz does not have any siblings. He had a brother who died of HIV/Aids some years back and the couple has no biological children.”

“But they have an adopted son.” I informed him.

“Being adopted, he is unlikely to have any genetic resemblance,” Prof Adam gave his reasons.” Furthermore, Esther is not very keen on the idea. She says if anything goes wrong with the transplant surgery, she will lose her only son and her husband too.”

“That is a very fatalistic attitude.” I said.

“But Esther staunchly believes it,” the good professor said.

“Then we must disabuse her of the erroneous notion.” I replied. Looking at the disbelief on the professor’s face, I added. “I am happy to try and change her mind.”

Accordingly, I saw the couple in my office after Boaz had finished with his dialysis as a day case and went home. After a lot of good-natured arguing, my final point, mainly addressed to Esther, won the day. “In all the years I have witnessed kidney transplants on my patients, both here and abroad, I have never seen a scenario that you have conjured up.” Seeing their complying faces, I continued. “I am happy to see Mark.”

“Oh, he is very keen to donate a kidney to his dad.” Esther replied. “It is me who is holding him back.”

The stage was set to put Mark through the tests that a kidney donor has to undergo.

ELABORATE TESTS

Prof Adam started with blood, which include HIV test and ended with some elaborate tests, all of which showed that Mark was an ideal donor. I was not surprised because being the brother’s son, he had the genetic imprint. After counselling Mark because after all, here was a healthy young man prepared to donate one of his two kidneys and undergoing major surgery, not to overcome an illness, but entirely out of an altruistic motive, a trend universally accepted, the date of the transplant was fixed.

Once again, I was in the twin operating theatre where Mark’s left kidney was harvested by the ‘Donor’ surgeon and transplanted into the right groin of Boaz by the ‘Recipient’ team.

 It is always the left kidney which is taken from the donor since it is technically easier because of the vascular connections on the left side, which are different on the right side and more hazardous. It will interest my readers to know that the harvested kidney is transplanted in the groin without removing the diseased kidney. There is no need to do it and the time spent on removing it makes the procedure long and fraught with danger. All the connections of the diseased kidney, vein, artery and ureter, the tube which conducts the urine to the bladder are connected to the transplanted kidney.

I was very pleased to see blood-stained urine coming out of the catheter temporarily put in the bladder for that purpose. After all, I had put my reputation on line, having assured Esther, Boaz and Mark that nothing would go wrong. From the operating theatre, Mark went to the men’s surgical ward while Boaz was taken to Intensive Care for a couple of days for close observation. Mark went home a week later and Boaz was discharged 10 days after the surgery.

Currently, Boaz is on regular drugs to prevent rejection of his transplanted kidney, while Mark is in a state of euphoria at having donated his kidney to his dad. I want to end this remarkable experience of mine with a quote from Mark, when I asked how he felt about it. ”After all, he picked me up from the gutter so I am so glad that I could repay my dad with the gift of life!” He quipped.