A Gift Between Friends

As his kidney function declined and a growing list of friends and family members failed to be a match as an organ donor, Harold Engel was running out of options. Then, along came Angela.

Although Harold Engel had been diagnosed with polycystic kidney disease in his twenties, it wasn't until 2010 that his creatinine level was found to be dangerously high and the related decline in his kidney function began to take its toll. A New Jersey husband and father, and president of the advocacy group The Rights of the Child, which maintains orphanages in Thailand, Engel had always been an active person, who slept only four hours each night and traveled constantly. But as his kidney function worsened he started sleeping twenty hours each day and feeling physically drained and emotionally depressed. As the possibility of dialysis began looming larger, a string of relatives and friends—including his wife and sister—were tested as candidates to donate a kidney, but no one was a match.

“Then,” Engel remembers, “along came Angela.”

Angela Diaz, MD, MPH, Director of the Mount Sinai Adolescent Health Center, had done her pediatric residency at Mount Sinai with Engel's wife, Paula Elbirt, MD, and the two friends had remained close for over thirty years. As a result, Dr. Diaz had long been aware of Engel's declining health, and one night in the spring of 2012, during an ordinary phone call, she asked how he was doing.

“I knew he was going through a clearance for transplant so at the end of the conversation I asked where things were,” Dr. Diaz remembers. Upon hearing of Engels' dwindling options, Dr. Diaz responded with an amazing, spur-of-the-moment offer: “I said I would be tested and if I was a match, I would donate.”

"Engel was moved beyond words with gratitude and hope, and after subsequent conversations Dr. Diaz began the thorough process of being evaluated as a potential kidney donor. Unfortunately a very strong family history of diabetes—including her mother and a hemoglobin A1c at a level that made the surgical team uncomfortable about moving forward—meant that Dr. Diaz was an unsuitable candidate. When she shared this news with her then 30-year-old son, he replied that he would like to be considered as a possible donor. But Dr. Diaz was undeterred: She made lifestyle changes such as diet modifications and increased exercise to bring her levels within a healthier range, and re-testing a month later revealed that she was now able to donate. With the clearance official, arrangements moved very quickly, and the surgery date was set for July 24.

Asked why he thinks Dr. Diaz showed such tenacious follow-through in order to give him such a gift, Engel admits his inability to find words that would do justice to her kindness. “You don't ask ‘why' because there is no ‘why'—I have no way to express it,” he says. “Someone once told me the only reason God gave you two kidneys was to teach you to be generous. And I suppose that's true.”

The Turning Point

Engel vividly remembers arriving at Mount Sinai at the “ungodly hour” of 5:30 am on the morning of surgery. His wife and Dr. Diaz's three children and ex-husband also came and waited nervously through the pair of operations that were made longer due to complications from an underlying hernia condition that had been troubling Engel for years. But in the care of highly skilled surgeons, within five hours Dr. Diaz then Engel emerged from the OR after the successful completion of their procedures.

While Engel and Dr. Diaz were recovering in adjacent hospital rooms, their relieved families started ping-ponging back and forth between them sharing hugs, food, and updates. Then came one of the most joyous moments of Engel's journey: “About 48 hours after surgery, my creatinine level went from 8.1 to 1.8,” he says. “It's amazing how quickly the body cures itself.”

“Yes, that kidney was working right away,” Dr. Diaz adds. “It just took off.”

Dr. Diaz was feeling so well after her procedure, she was in the hospital for only one night and returned to work two days later—and on the way home from work she visited Engel in the hospital. Engel, dealing with significant pain from the hernia portion of his procedure, stayed for 8-9 days, but he is grateful for the staff that helped him through. “I had a great relationship with everyone at Mount Sinai,” he says. “It was a really wonderful experience.”

Looking Ahead

Dr. Diaz's generosity that year didn't end with the donation of her kidney. As director of the Mount Sinai Adolescent Health Center, which offers free care to young people between the ages of 10 and 24, she is tirelessly searching for money to provide services to the 12,000 patients they serve every year. Since 2010, she has been running the New York City Marathon to raise funds, and as soon as her surgeon cleared her after transplant surgery that August, she started training for the 2012 race. Although it was cancelled due to Hurricane Sandy, Dr. Diaz was pleased to run the 2013 marathon along with other team members from Mount Sinai and the community, and to raise almost $80,000.

Today Dr. Diaz continues to benefit from the healthy lifestyle changes she adopted in preparation for surgery, and she is very gratified by the transplantation experience itself. “It's just wonderful to see Harold the way he is now—he's doing well, he's traveling again, and he's full of life.” Plus, Dr. Diaz adds another observation. “It's interesting—he's a Jewish man from Europe, and I'm from the Caribbean, so our ancestry is quite diverse. But as it turned out, I was a closer match than even his sister. So I think it was very special to be able to do this.”

In return, Harold's gratitude is so enthusiastic that he surprised Dr. Diaz with a testament to her generosity at a holiday party: a tattoo on his hand of a heart with the initials “A” and “D” for the friend who saved his life.

“This entire experience has been phenomenal—better than any roller coaster ride you've ever been on,” Engel says. “And I wonder if everything worked out because life has a bigger purpose for me than it did in the past. I mean, Angela has devoted her life to the welfare of kids, and now I'm more devoted than ever to my work for children. And since the surgery we have such a bond—because now, every morning when I wake up, it's thanks to Angela.”