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MillersBy KINZEY POSEN

Meet the Millers: husband Marshall and wife Na’ama, plus daughters Sami and Maya. In their house, they speak three languages fluently: English, Hebrew and “kidney”.

Kidney may not be a language as we know it, but  this family is conversant with everything that has to do with this important organ. Normally humans are born with two of them, whose job it is to eliminate waste, balance bodily fluids and produce urine among other functions. When they don’t, that’s when you begin to learn the language of kidney.
A few weeks back, I went to visit the Millers at their home in River Heights to talk about what they recently went through as a couple and family. Marshall, who is 53, a trained lawyer and musician, was diagnosed with kidney disease several years ago. That diagnosis changed their lives dramatically.
About a year ago, Marshall was told by his doctor that he had to go on dialysis in order to survive. His new routine consisted of going for dialysis three times a week for four and a half hours each visit. He’d be hooked up to a machine and have to lie still, surrounded by others suffering the same fate. As a result, he couldn’t work and his focus in life became the treatment. Ultimately, it meant he’d need a transplant. When he first found out about his failing kidneys, part of the procedure was getting family members tested to see if any of them were a potential match and, if someone was - a living donor so to speak, it would expedite the donation process. That meant he wouldn’t have to go on a waiting list.
Marshall’s siblings were tested and surprisingly, none were suitable. Normally, siblings have a 25% chance of being what’s called an “exact match.” Enter Marshall’s loving spouse Na’ama, a popular elementary teacher at the Gray Academy. She didn’t hesitate to have herself tested and thought she could be a donor in the National Living Donor Paired Exchange. Under this  program Na’ama would be able to donate her kidney for transplant in a suitable recipient and, in turn, Marshall could receive one from another suitable donor in the system. When I asked Na’ama what prompted her to donate, she said, “There was never a second thought or doubt, having lived and watched Marshall’s deep suffering, having experienced the impact on our family life, it was never an issue to go through all the unpleasant tests….a no brainer.”
Marshall was reluctant to have Na’ama go through the process of sacrificing an organ and one he certainly wouldn’t ask her to do. He was overwhelmed by her willingness to sacrifice for him. “I wanted to know how it would impact Na’ama,” he says. All of this was shared with their children. They saw how their dad was suffering and knew it was an operation that had to take place.
Through this ordeal, Marshall and Na’ama came to realize how blessed they were with their kids. For them, Sami and Maya were angels, showing compassion, support, love, endless energy and being there for them 24/7. They are so proud of how they stepped up.
Fast forward to the donor test results, where something highly unusual was about to happen. They got a call informing them that Na’ama, a non-blood relative, was literally a perfect match. As Marshall put it, “the chances of this happening are a million to one, a miracle!” The quality of the match meant Na’ama hit four of the six markers and, as one of the doctors later said, “It’s a beautiful match, this should last you forever!” For all of us who don’t speak kidney, this kind of an outcome is extremely rare.
In all the excitement of what was to come, they received a surprise when the original surgeon assigned to Marshall refused to do the surgery. The reason was Marshall’s high BMI (body mass index) which would have put him at risk. That’s when he had to start his dialysis and this surgeon put him on a list for bariatric (stomach reduction) surgery. When that doctor left the province, Marshall was directed to Dr. Josh Koulack who, after looking at his file, said, “I’ll throw a kidney in you.” This also meant Marshall didn’t have to have the bariatric surgery after all.
Months later, on Thursday, October 5th, the big day arrived. Marshall was admitted the night before so he could undergo one final dialysis treatment. Knowing what lay ahead, he was so thrilled to be able to say a bittersweet farewell to the dialysis team. Marshall couldn’t say enough about them and their loving care, but the main thing on his mind that night was worrying about his children. He knew Na’ama would be ok, but he thought about the risks involved and how it would affect Maya and Sami if it went badly. He thought that if his body rejected the kidney, all of this preparation and hope would be for naught, he’d have to return to the mind and body numbing drudgery of dialysis for five years and go on the kidney waiting list.
Na’ama and her girls arrived at 5:30 am on a Thursday and were met by her mother, sister and Marshall’s out-of-town siblings and brother-in-law. The laparoscopic surgery was scheduled for 7:30 am and it would last more than four hours. Na’ama smiled and recalled a comment from one of the nurses that morning. The nurse looked over at Marshall and said to Na’ama, “It’s so nice that you’re donating a kidney to your uncle.” After removal, the kidney was kept in the room, everything was sterilized and the surgical team took a break. Na’ama was taken to the recovery room, while Marshall was brought in. Once the kidney was removed, Dr. Rahul Bansal, Na’ama’s primary surgeon, came out to talk to the anxious family waiting outside. He told them exuberantly, “It’s a beautiful kidney!”

For the transplant, Marshall’s two kidneys were left in his body where, as non functioning organs, they would eventually shrivel up. The new one with all the plumbing was placed in a cavity in Marshall’s groin area. I asked Marshall, how it feels to physically have part of Na’ama in him. Besides making jokes of how he wants manicures and pedicures, the truth is, he says, “It’s a miracle; it has brought us closer together and I feel closer than ever before, after 27 years of marriage, I’m indebted in ways that can never be repaid.”
When Na’ama woke up, she was very groggy, extremely thirsty and was eventually brought to her room, where Maya and Sami awaited her - the same room to which Marshall would be brought to once he came out of recovery. After his two hour operation, he spent almost seven hours in recovery waiting to be brought to the room.
Thankfully, there were no complications and soon the couple was allowed to go home - first Na’ama, then Marshall, days later. At this point in the interview, both Marshall and Na’ama wanted to talk about what happened next. As soon as they got home - and even before, they felt the power of community.
Their family supported them at the highest level, but they weren’t prepared for the outpouring of love from friends and even people they didn’t know that well. Suddenly, they felt like the distribution centre for Skip the Dishes as meal after meal was brought to the house and put in the freezer. People wanted to know their complete Hebrew names so they could recite a “misha beirach” (prayer for the sick) at synagogues across the city. Na’ama found out that a teacher at her school added their names to her daily tefilah (prayer) and others would recite them at the kotel in Jerusalem. Na’ama’s students made videos for them. An emotional Marshall began to tear up as he expressed his awe at the depth of the support they have been receiving.

These days, recovery has taken on a certain routine. They tend to watch a lot of Netflix as they can’t lift heavy things and strain themselves in any way. There are twice weekly blood tests for Marshall and the results dictate the dosage of the anti-rejection drugs he must take for the rest of his life. “The prednisone can be a mood altering drug,” adds Marshall. “I might snap at the kids once or twice and at Na’ama five or six times, but that’s less than normal,” he jokes. For Na’ama, her blood pressure is monitored regularly. Also, spending a lot of time together - more than ever before, has led them to realize that their love for each other has truly moved them  to a new level.

I asked them both what the experience has taught them. After a thoughtful moment, Marshall responded with the power of love, friendship, the evils of diabetes, the dangers of not listening to his diabetic grandfather and mum. “You think you are impervious when you are young, but you pay for your mistakes made earlier in your life,” he says. Na’ama echoed Marshall’s comments and added, “We learned how truly blessed we are, to be really grateful for every day. You have to advocate for yourself in our medical system, nothing can be left to chance.” In fact, the medical staff told them, “You should be congratulated about speaking up for yourselves.” Na’ama recommends that people should be assertive, not aggressive, stay on top of medical appointments, and trust the professionals.
Throughout the interview, Marshall and Na’ama paid constant tribute to the medical staff on the front lines, from the nurses and doctors, to the orderlies and support staff. They couldn’t say enough about their compassion, professionalism and humanity. They are also in debt to the Kidney Foundation of Canada. Marshall calls their work truly remarkable, providing education and wide ranging support. He felt in very good hands with them and totally prepared.

By the way the next time you happen to be at HSC, drop by the main entrance on William and look for a special permanent exhibit called the Tree of Life. It’s there to honour all the people who have become living donors, as well as those who died and had their organs donated. It was first put there in 1997 and, after 20 years, was filled to capacity.
A new one created by Manitoba artists Audrey Hiebert and Beth Cage was recently installed. Thursdays are transplant days and every living donor gets their own flag that’s put up to honour that particular donor - just one more touching expression of gratitude from the people behind the scenes.
Besides the exhilaration of the whole procedure, Na’ama and Marshall have special mementos of what they went through to remind them of what they did. When leaving the hospital, they were both given very useful hand-sewn, small kidney-shaped pillows from the Kidney Foundation of Canada: the perfect gift for a couple who are a perfect match!