A Christmas Day Miracle

A Christmas Day Miracle The True Story of One Man’s Yuletide Triumph Over Death

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Dean & Talya Rotbart

A Christmas Day Miracle: The True Story of One Man’s Yuletide Triumph Over Death Copyright © 2022 TJFR Press, Inc. All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission the the publisher.

First Edition ISBN: 978-1-956928-01-3 Library of Congress Control Number: 2021924099 Christmas / Inspirational / Health / Canadian Design: TimeInABottlePhotography.com Published by TJFR Press, Inc. ATTN: Dean and Talya Rotbart 200 Quebec Street Bldg. 300, Suite 111-26 Denver, CO 80230

A Christmas Day Miracle The True Story of One Man’s Yuletide Triumph Over Death

By Dean and Talya Rotbart

Introduction Miracles come in every variety.

Big or small, dramatic or subtle, they benefit adults and children in every corner of the planet.

It doesn’t matter what religion you belong to or even if you are a person of faith.

Blessings can and will find you. That is always true.

But when miracles occur on Christmas Day, they are extra special.

So it is that the family and friends of 59-year-old Riyaz Adat will always remember and retell the story of Christmas Day 2013 when the fates aligned to rescue Riyaz from the approaching hand of Malak ul Maut.

In the Islamic religion — into which Riyaz was born in Tanzania in 1954 — Malak ul Maut is the angel who reclaims souls and returns them to the Lord. In Western cultures, it is more commonly referred to as the Angel of Death.

Withering in a bed at Toronto General Hospital, his liver destroyed by a rare autoimmune disease and his body overcome with pain, it seemed unlikely that Riyaz would live to greet the New Year.

If he were to make it, Riyaz would need a miracle, the kind that Hollywood regularly produces but is far less common in real life.

At 5:00 a.m. on Christmas Day, snow lightly falling outdoors and temperatures a frosty 3° Fahrenheit, Riyaz’s primary physician spoke to his sickly patient.

“I hope you believe in Santa Claus,” the doctor smiled.

At that point, it was only candid to say that Riyaz did not.

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Improbable Lives The story of Riyaz and Margaret Adat is one of a young man and woman — from two distinctly separate cultures and regions of the world — who meet in a new land and together defy convention and overcome obstacles time and again.

Born in Dar es Salaam to parents of Indian descent, Riyaz and his family fled Tanzania for England in the wake of the East African country’s accelerating oppression of ethnic minorities. Eventually, in 1974, the Adats arrived as near-penniless immigrants in Canada.

Not long after his arrival, Riyaz met Margaret Moore — herself, her younger sister, and her parents, also recent immigrants to Canada.

Margaret grew up in Glasgow, Scotland — one of six daughters of a bus driver and a seamstress. For much of her early childhood, she and her family had no bathroom or hot water in their tiny, government-subsidized rental. The four Moores emigrated to Canada in search of economic advancement.

As improbable as it seemed to anyone who didn’t know Riyaz and Margaret well, theirs was a perfect match.

Forget their superficial differences. The couple shared core values, including unfailing dedication to family, the vital importance of education, gratitude for all of their advantages (without dwelling on what they lacked), and a solid commitment to helping others less fortunate than they.

Riyaz was Hollywood handsome. Think Omar Sharif, without the trademark mustache. Darkly complected, Riyaz had an engaging demeanor, complemented by a beaming smile and almond-shaped brown eyes that radiated an inner kindness.

Margaret had Maureen O’Hara-red hair, featuring bangs that flirted with her perfectly arched eyebrows. Paired with her sparkling blue eyes and petite frame, she, too, could have been mistaken for a silver screen star.

Riyaz and Margaret were married atop a waterfront hotel in downtown Toronto in June 1980.

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It has not been easy locating a minister willing to perform a non-denominational, interreligious ceremony. Such marriages were still uncommon in Canada — joining a Presbyterian (Margaret) with an Ismaili Muslim (Riyaz).

Fortunately, Riyaz and Margaret happened upon “The Marrying Minister,” an elderly clergyman who earned his moniker because of the numerous ceremonies he had officiated without regard to ethnicity or religion.

“Mixed marriages are a very good thing because they break down prejudice,” the minister preached. “Make your marriage a competition of who in your couple can give the most.”

To their credit, Riyaz and Margaret took his counsel to heart.

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Something Unexpected No one is so brave that he is not disturbed by something unexpected.

— Julius Caesar There are challenges in life that cannot be avoided. How we respond to them says a great deal about our grit, attitude, and character.

Whether our troubles relate to finances, health, relationships, or career, each carries with it the power to strengthen us as individuals — and bring us closer to our loved ones — or break us and sever the bonds of family and friendship.

The manner in which Riyaz and Margaret Adat responded when personal disaster arrived uninvited at their home is a master class on the ability to find the strength of spirit when one’s physical stamina is all but extinguished.

Riyaz’s journey to death’s door began more than 25 years before Christmas Day 2013 when he applied for a life insurance policy and was denied.

While he felt in good health, the required medical exam returned an unexpected result: He had elevated liver enzymes, the type doctors regularly encounter when testing heavy drinkers. Riyaz, however, only drank on the rarest of occasions.

Seeking an explanation, Riyaz bounced from one liver specialist to another. Margaret, for her part, couldn’t imagine there was any need to worry. After all, Riyaz looked and felt perfectly healthy.

They both reasoned that his elevated liver enzymes must be some benign anomaly. Time passed. Their first child, a son named Anil — a variant of the Hindu god of the wind, Vayu — was born in December 1982. Seth, their second son, was born in July 1984.

Raising their children, working, attending night school to further their careers, and helping out their parents occupied Riyaz and Margaret’s days. The mystery of the elevated enzymes — while ever-present — felt like anything but a pressing matter.

It took about three or four years from when Riyaz failed his insurance medical exam until he and Margaret finally discovered the root of the problem.

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“Thank God I Don’t Have Hepatitis” One of Riyaz’s many doctors speculated that he might have a lesser-known variety of hepatitis, a potentially life-threatening liver inflammation.

The physician advised Riyaz to visit with yet another specialist, a doctor who had been one of his medical school professors. She specialized in liver disease, especially the bile ducts, and a medical condition called primary biliary cirrhosis, now generally referred to as primary biliary cholangitis or PBC. “She is brilliant,” he assured Riyaz.

Almost as soon as Riyaz entered the specialist’s examination room and was seated, she told Riyaz — in a surprisingly strong British accent — that she knew the nature of his illness.

“Oh?” Riyaz uttered.

“Yes, I think you have PBC.” “Thank God I don’t have hepatitis,” he sighed out loud.

Riyaz had no clue whatsoever what PBC stood for, but at least it wasn’t hepatitis, and since he’d never heard of it, it couldn’t be so bad, could it?

What the specialist thought about Riyaz’s innocent — but badly mistaken — reasoning is unknown.

“Yeah, yeah,” was all she muttered at first.

“I’ll examine you to make sure it’s PBC,” she said.

“Is your skin itchy?”

Affirmative.

“Are you feeling tired?”

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Double affirmative.

Based on her questions, Riyaz realized that this doctor knew exactly what she was looking for — and looking at.

Finally, in her most matter-of-fact voice, the physician boomed — as if the higher decibel level would help penetrate the brain fog that she knew would follow, “Son, your liver is going to collapse. It’s going to go. You have ten to twelve years left.”

After a pregnant pause to allow her words to sink in, she added matter of factly, “Whatever you are doing, sell everything and consolidate.”

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She Must Be Mistaken Was this doctor telling him to put his affairs in order? This sounded like a line from a lousy soap opera. This couldn’t be true.

Riyaz was in shock. This was the last thing he had been prepared to hear from a doctor he had just met. She didn’t even know him.

Riyaz was not yet 40 years old, and she was handing him a death sentence without knowing a thing about him, his life, or his family.

He was Riyaz Adat, the adventurer who had made his way to Mt. Kilimanjaro as a kid by walking through the savanna and hopping on moving train cars with just the clothes on his back. He was Riyaz Adat, the teenage survivor who had been left on his own amid a socialist revolution in East Africa and managed to escape to join his family in England.

He had a beautiful wife and two young sons. Surely, men who fiercely love their wives and children aren’t handed this type of explosive news in an examination room roughly the size of a walk-in closet.

So his skin is itchy? So he is tired? Big deal!

No, this can’t be true. Ten years!

“God, where are you?” Riyaz thought. “Tell her she is mistaken.”

Cold sweat made its way down around his eyelids and revived him to the present.

“I want to see you in a few months and will do a biopsy to confirm the diagnosis,” the doctor was saying. “Don’t worry,” she added, “before your liver goes, we will give you another liver if you qualify.”

Had she really just said, “Don’t worry?”

Riyaz had enough worry at that instant to keep half of Toronto awake at night.

His first, overriding concern was how on earth to break the news to Margaret?

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The Moore Brigade Like her father and her grandfather, both battle-tested veterans, Margaret Moore Adat stood ready to defend her home front, be it in Scotland, on the battlefields of World War II, or in the examination rooms and medical centres of Toronto.

Like any good warrior, Margaret stepped to the fore. She’d show this PBC what Scots do to their enemies.

Her first skirmish would be with the statuesque, fiery red-haired diagnosing physician, Dr. Elizabeth Jane “Jenny” Heathcote, a graduate of the Royal Free Hospital School of Medicine in London.

Dr. Heathcote trained with Dame Professor Sheila Sherlock on the transmission of Hepatitis B and was then a professor of medicine at the University of Toronto.

An expert at University Health Network specializing in liver disease, Dr. Heathcote was already considered one of the world’s top ten liver specialists.

Margaret was a founding partner in a consumer accessory products company, Gentec International. Since its launch in September 1990, she had been instrumental in nurturing Gentec into one of Canada’s 50 best-managed companies.

As such, Margaret could see past Dr. Heathcote’s brusque bedside manner and relate to the highly capable physician as another rare female in a male-dominated profession.

All Margaret needed was a complete briefing on the nature of the enemy, its objective, and its strengths and weaknesses.

Margaret conducted her reconnaissance. She learned everything she could about this chronic autoimmune disease, PBC, that was slowly and aggressively striking at her husband. The more she learned, the more she came to hate it.

Margaret pledged to herself that her counter-offensive would be crushing, and PBC would be given no quarter. She stood ready to fight for Riyaz and with him until the enemy was vanquished.

It would prove to be a long, hard-fought battle.

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The Bilirubin Level The Adats’ relationship with Dr. Heathcote transcended the conventional physician-patient dynamic. Over time, the three developed a lasting personal friendship.

In the years to follow, whenever Dr. Heathcote was honored with an award for her pioneering work, she never failed to invite the Adats to the ceremony. Among her honors was the Distinguished Achievement Award from the American Association for the Study of Liver Diseases, and in 2015, two years after Dr. Heathcote’s formal retirement, the University Health Network Global Impact Award.

But those awards were well into the future.

This was 1994, and Riyaz — having been raised in Tanzania — didn’t fit the prevailing medical literature that described PBC as a ‘Western’ disease, one primarily afflicting women in the Northern Hemisphere.

Which made Riyaz’s case quite a puzzle.

Two months later, after the first meeting with Dr. Heathcote, a biopsy of Riyaz’s liver was performed. The results confirmed PBC and put the developmental stage of the disease at between one and two out of four.

The most critical liver enzyme that is measured for possible liver failure is bilirubin. A functioning liver helps clear the bilirubin from our blood. If the liver is diseased, the bilirubin levels steadily rise.

Riyaz’s initial bilirubin level came back at slightly over 20 out of a possible 100; 100 representing complete liver failure. Priority number one was to keep his bilirubin levels low. A new drug, Ursodiol (ursodeoxycholic acid, or UDCA), a derivative taken from bear bile, was on the market, and Riyaz was immediately started on it.

UDCA helps the liver quickly flush out daily food consumption. The upside of this particular drug was that it didn’t have side effects. Unfortunately, the medicine didn’t work well for Riyaz. Every year, after each blood test, his bilirubin level would drift up by two or three points.

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During this period, Riyaz experienced extreme fatigue and itching. The itch came from inside his body and was so debilitating that Riyaz lost the ability to sleep at night. He scratched his feet and hands for hours at a time. Margaret would wake up in the middle of the night to massage him with cream. Anything to try to reduce his suffering. Another drug was added in the mostly futile effort to relieve the itching.

There was nothing more that could be done, Riyaz and Margaret were told, other than to keep monitoring his bilirubin levels and take medicine in an effort to manage the symptoms.

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A Support Group is Born When Riyaz was diagnosed, there were no formal support groups in Canada for his particular illness. There was no one he could turn to and ask, “You have PBC, tell me about it.”

Being sick, with a potential death sentence dangling over his head, was one thing.

Knowing no one who was experiencing or had experienced the same trauma only made matters worse.

The Adats successfully located PBC support groups in the United States and England. Back in Scotland, one of Margaret’s older sisters, Joan, enlisted in the ‘Adat Brigade.’ Joan had the Moore fight in her, just like Margaret.

Joan located a woman in Edinburgh who headed up a PBC support group there.

The woman offered much-needed encouragement to the Adats.

Riyaz and Margaret flew to England with Anil and Seth to attend a seminar on PBC. The British support group met in a hotel and invited top English medical experts on PBC to come and speak. It was very informative.

The only other male patient in attendance in a room full of female PBC sufferers was Robbie Floydd. Globally, PBC afflicts women three times as often as it does men. The rarity of male sufferers made Robbie all the more special in Riyaz’s eyes, and the two became fast friends.

Before receiving a liver transplant, Robbie had worked for Scotland Yard. Afterward, he became a cab driver and continued to live beautifully for many years.

[Eventually, well into his seventies, Robbie’s health deteriorated, primarily from non-liver-related ailments.]

It was quite comforting and helpful finally to meet other people battling the same illness. “Wow, I can live with this,” Riyaz told himself.

The global epicentre for people affected with PBC was in Newcastle, England.

Doctors there had done a great deal of research trying to pinpoint the root of the illness but hadn’t come up with anything certain. Some researchers suggested that PBC resulted from environmental exposure since this area has been known, dat15

ing to Roman times, as a hub of coal mining (hence the expression — “carrying coals to Newcastle”).

Riyaz began to wonder if his youthful exposure to the pollution emanating from the Mwadui Diamond Mine complex on the outskirts of Shinyanga, Tanzania, was a contributing factor to his illness. As a child, Riyaz and his friends would catch a bus to the Mwadui campus and talk — more like beg — their way past the gate guards in order to frolic in the glistening, chlorinated, private swim club’s pool.

(The mystery of how and where Riyaz contracted PBC has never been solved.)

Back in Canada, Beverly Ritcey, a patient of Dr. Heathcote, expressed an interest in launching a local PBC support group, and the physician put her in contact with Riyaz. The process of obtaining all the necessary government approvals to establish a tax-exempt nonprofit was complicated. Riyaz, who was trained as an accountant, found that his background in recording and analyzing financial transactions came in handy. He completed all of the required paperwork and won all the necessary government approvals and permits.

In 2003, Riyaz, Beverly, and a third organizer, Barbara Badstober, became the founding members of the Canadian PBC Society, and Riyaz served as one of its first directors. As of this writing, the PBC Society serves more than 1,000 members throughout Canada, with regional groups comprised of patients, family members, and other concerned individuals.

Working strictly as volunteers, Riyaz, Beverly, and Barbara made it their mission to educate the public about PBC and connect Canadian sufferers with medical personnel. They created brochures, distributed them in medical offices, organized seminars, and set up a hotline for people who’d been diagnosed with PBC and didn’t know where to turn.

The three volunteers would talk to these panicked callers. At the end of the conversation, they were no longer strangers but part of a team and family.

Among those who phoned, Riyaz recalls most vividly, were women who had been mentally and sometimes physically abused by their husbands, who accused them of being lazy, when in fact they were experiencing the extreme fatigue and depres16

sion that often accompanies PBC. Most physicians didn’t know what these women were battling, and it took years to diagnose them accurately. Being able to share their ordeal with other sufferers offered these isolated women relief and validation.

Riyaz remained with the Canadian PBC Society for five years, then passed the leadership mantle to others.

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Canada’s Health Care System Riyaz didn’t want to tell anyone at work or in his local community that he was fighting a deadly disease.

The choice was intended to preserve normalcy in his life as long as possible, tinged with a bit of self-denial. Riyaz knew that once people became aware of his diagnosis, they would look at him and act differently in his presence.

He wanted none of it.

The only ones who were told early on about his illness, although not to its full extent, were Anil and Seth.

Riyaz and Margaret sat their sons down and explained in basic terms that Riyaz has PBC. “It is a slow, progressive disease that could lead to liver failure,” Margaret said, adding, reassuringly, that Dr. Heathcote told Riyaz that if his liver fails, she will get him another one.

It took almost a year after being diagnosed for Riyaz to share with extended family members and friends that he was fighting PBC. The news was received with shock and grief. No one in his close circle had ever heard of PBC, much less known someone with the diagnosis.

At the time, Riyaz was struggling to run his own company, Bosaro Biotech, which designed and manufactured a patented, fully adjustable, backcare seat support.

With the help of a team of experts and consultants, Riyaz produced a superior line of backrests that were being sold in Canada, the United States, Germany, Japan, Israel, South America, and the Caribbean.

It was Riyaz’s dream that the Bosaro line would one day be a household word globally. Only, it was not to be.

Riyaz went to work each day, and by the afternoon, exhaustion claimed his body.

Riyaz would shut himself in his office and sleep on the floor.

Struggle is not a foreign word for courageous business owners and entrepreneurs who face problems and annoyances daily, be they with employees, partners, cus18

tomers, or vendors. However, when one’s bodily defenses are down, the challenges can quickly become insurmountable.

It was hard for Riyaz to face the fact that he was beginning to have limitations and even harder to voice them. He finally confided in his best friend. Speaking to Margaret about his deteriorating physical condition brought clarity. “I can’t continue like this,” he admitted, “I am struggling with the business and partnership problems. In a normal time, I could do it, but now, it is taking so much out of me.”

Margaret was doing exceptionally well in her career at Gentec, and it brought Riyaz a certain peace of mind. What he was about to say was hard.

Riyaz was a self-made man, a fighter, and a dreamer. People often speak about the “American Dream,” but for Riyaz, it was the “Canadian Dream” that had been a propelling force.

A survivor, he had arrived in Canada with no tangible assets. But he was always prosperous when it came to the drive, instincts, diligence, courage, and intelligence that provided him priceless hope.

Moreover, Canada was a place, finally, he could call home.

Riyaz didn’t know how or when his end would come, but given how he was feeling during this period, he surmised that in his case, PCB’s ten-year survival rate might be overly optimistic. So, gathering the courage to face reality, he told Margaret he felt it would be best to fold his business.

Margaret was very supportive. She knew in her heart that the best chance that Riyaz had to fight PBC effectively was for him to take it easy and concentrate his remaining energies on managing his health. Letting go of Bosaro also meant that Riyaz would be at home, and having dad around could only be good for their two teenage sons.

As is often the case in life, when trouble rains, it pours. In this instance, Riyaz’s father, Abdul, fell gravely ill. Riyaz rallied around him and his mother, Roshan, to help in any way he could. He felt that taking care of his dad was a blessing. Giving of himself helped Riyaz take his focus off his own ailment and fears.

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Nonetheless, depression, an insidious pest in people affected by chronic and life-threatening diseases, grew quite bold. In Riyaz’s case, several developments converged to feed the beast. After all, he faced a life-altering illness with increasing physical limitations, having to let go of his business — a significant loss for a proud and self-reliant family man, and his father’s decline. It was an emotional freefall.

Riyaz became upset with God. “Why me? Why does God beat me at the prime of my life?”

Looking for answers, he started to read a variety of religious books. He went to the source, the Bible. He read every word of the Five Books of Moses, a.k.a. The Torah, which the Jewish people believe was given by God himself to Moses on Mount Sinai.

“Why me?”

He read the New Testament.

“Why me?”

He then turned to his copy of the Quran and read it and other Islamic texts from cover to cover. In one of the texts, he found a passage that states there is not one person in this world who doesn’t have a physical or mental issue, and that if they don’t, it’s because they haven’t yet been diagnosed.

All this reading took a long time to digest.

Still, Riyaz kept asking: “Why, why, why?”

He couldn’t or wouldn’t hear the answer.

He and Margaret traveled to Thailand and took classes there to understand Buddhist philosophy. Back home, he consulted psychiatrists. Riyaz was hard on himself and concluded that he had become lazy since he had no energy. He was angry at himself for falling asleep so frequently.

His general practitioner, Dr. Yitzchok Dukesz, based in nearby Newmarket, gen20

erously encouraged Riyaz to come at lunchtime once a week to talk. Dr. Dukesz taught Riyaz how to meditate, and meditation took on a big part of Riyaz’s life.

He started to look at his health and the world in a different light.

The answer to his question became clearer and louder, and played over and over in his head until he could accept it.

“Why me?” became, “Why not me?”

Simple, yet liberating. He even laughed about it, for, somewhere, in all the thousands of pages of religious texts that Riyaz had read, the answer had been waiting for him to find all along.

He graduated from being angry with God to “God is with me, I shall not fear.”

These words from the Hebrew Bible — Adonoi Le V-Lo Eerah — helped Riyaz control his fear of dying. Once again, he was free to proceed with life, free to try or do whatever he had always wanted. He relinquished any regrets.

“It is what it is,” he told himself.

During Riyaz’s long search for answers, Margaret made a concerted effort to keep her fears in check. When her emotions welled, she knew that she had to get over them quickly and turn her feelings into action.

Throughout Riyaz’s illness, Margaret drew from the experience of grieving during other family illnesses — including those that claimed her mother, father, and sister-in-law. It was extremely helpful to ask herself, “What can I do?” and then do it.

The question helped Margaret to shift her focus from feeling helpless to feeling empowered. At no point was she angry with God or felt the need to search for metaphysical answers. She didn’t and wouldn’t believe that the man she’d pledged to love and cherish “until death do us part” was going to die. Faith was her inner peace.

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PBC Progresses Once or twice a year following his initial diagnosis, Riyaz would meet with his doctors for a checkup. Every four years, a liver biopsy was performed because blood tests alone couldn’t accurately reflect how his liver was doing. Only a biopsy would provide reliable results.

First, the doctor would numb Riyaz’s skin around the area and then use a second anesthesia so that the muscle also became numb. A long needle was inserted between the ribs on Riyaz’s right side, near the liver.

Unfortunately, because the liver doesn’t get numb, Riyaz would feel the searing pain when the needle bit off a snippet and retrieved it. On each visit, the procedure had to be done twice because the doctors needed two pieces of the liver so that they could monitor different areas of the organ and measure the damage to the bile ducts. For a couple of days afterward, Riyaz would be sore.

One time the needle hit a nerve and Riyaz felt the shooting pain all the way to his head. “It’s not the end of the world,” he told himself. “It’s like going to the dentist.”

The next day, he was fine. Riyaz repeated these biopsies for more than a decade, his bilirubin level steadily inching higher at each reading.

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Grief, Loss, and Pre-Transplant In the summer of 2012, Riyaz’s sister Sabrina, a dentist, became very ill. In almost no time, she was transferred to a hospice care facility and remained there for seven months until her death from cancer.

Riyaz came to visit her almost every day. The stress of witnessing her slow degradation and knowing that Sabrina wouldn’t recover triggered his own downhill battle with PBC. While visiting his sister, he would have to rush to the bathroom six or seven times. Diarrhea can be an indication that the disease has progressed to its later stages. However, the new liver specialist who Riyaz went to see with this problem (Dr. Heathcoate had retired) felt that since Riyaz was in a hospital environment daily, he might have caught a bug.

“Riyaz, I don’t want to see you for the next two years; this has nothing to do with your liver,” the specialist reassured him. Riyaz would live — barely — to remember those mistaken words.

Things went from bad to worse. Sabrina passed away on February 3, 2013. In October of that year, Margaret took Riyaz to the Caribbean island of Barbados for a much-needed break. There wasn’t any time to grieve or rest properly because it became impossible for Riyaz to keep his food down. His eyes appeared jaundiced.

The Adats flew back to Toronto, and Margaret brought Riyaz to the hospital, where she insisted that he be seen by the liver specialist.

The doctor on call knew that something was very wrong and decided to test Riyaz’s bilirubin. The results came back and confirmed what the Adats feared.

The bilirubin levels had shot up.

The new doctor decided to monitor Riyaz every two weeks. She also changed his diet. The Adats asked about being put on a waitlist for a transplant, but the doctor explained that Riyaz was not eligible because his liver test results had not reached a critical number. She couldn’t refer him to a transplant clinic unless he hit that number.

Once he did, the transplant clinic would wait until he presented with yet an even higher number before putting him on a transplant list. Within a few weeks, Riyaz 23

reached the first critical reading. He now qualified to be seen by the transplant clinic doctors to be assessed.

The first day he and Margaret went to the clinic, they arrived on the ground floor.

There were two different routes to reach the office where they needed to go, one of which passed by the clinic’s gift shop. However, Riyaz knew an acquaintance who worked in the store and was reluctant to run into him.

Riyaz was not up to answering the many questions that were sure to be asked by this person. In another time and place, he would have been more than happy to chat. In his present deteriorating state, he opted to get to his appointment the other way.

So they took the alternate route.

As fate would have it, they bumped into Dr. Heathcote.

“Riyaz, what are you doing here?” she inquired in her trademark booming voice.

“You won’t believe it, but I have been referred to the transplant clinic.”

Dr. Heathcote reassured the Adats she would help them as much as possible.

“I am going to make a phone call and let the head of the clinic know that you are coming.”

In this dark hour, it felt reassuring for Riyaz to realize that he was not just a generic patient, that he, as a person, mattered to this brilliant doctor.

Sitting with the head of the liver clinic and a team of doctors, Riyaz and Margaret were told that while Riyaz qualified to be seen in the liver clinic, he still needed to qualify for the transplant list.

They examined him and brought up the possibility of finding a living donor, Toronto General Hospital being the largest living donor clinic in Canada. The Adats were briefed on everything they needed to know about the process.

After the meeting, Margaret called both her sons to share what she had learned.

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If Riyaz, or as was increasingly likely — when — Riyaz, qualified for a liver transplant, there would be two options. One would be to add his name to a list of those awaiting a transplant from a newly deceased patient. Such cadaver waitlists can sometimes grow very long — and there would be no guarantee that a liver would become available in time to save Riyaz’s life.

There was an alternative that could avoid the profound tension of waiting for an eligible donor to die and hoping to win the liver ‘lottery.’

“There is another option; it is the living donor,” Margaret told her sons.

“What’s a living donor?” each wanted to know.

As Margaret explained what it entailed — removing Riyaz’s diseased liver and replacing it with a portion of the living donor’s healthy liver — both Anil and Seth volunteered, without hesitation, to undergo the donation surgery.

Margaret couldn’t have been more proud. Or frightened.

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Swollen Legs the Size of Her Waist Finding a match from a living donor is a lengthy process.

Once a prospect has been successfully screened, a surgeon takes about 40% of the donor’s liver to transplant into the sick recipient. The extraordinary thing is that the liver of the donor grows back to normal size within three months. As for the recipient, the donated organ grows as well, but at a slower rate.

Riyaz still needed to undergo a battery of medical tests, assessing him for heart problems, diabetes, and other possible complications. He was put on an exercise regimen. In addition, the doctors wanted to know everything about his lifestyle that could be relevant.

Since the vetting of a living donor prospect is very expensive, the clinic only considers one donor candidate at a time until a match is found. Margaret immediately offered to be the donor, but the doctors rejected her out of hand due to her age. The liver of a younger person regenerates more quickly, they explained.

Moreover, Anil, Seth, and Riyaz’s niece Alisha — Sabrina’s daughter — each had volunteered, and all three were still under 30 years old.

The physicians selected Anil to test first as a possible donor. All along, Riyaz was adamant that he would not take his son’s liver. But Riyaz allowed the medical team to test Anil.

Riyaz hadn’t realized how much both Anil and Seth took after him in courage and resolve. They were very determined to contribute, despite the risks.

Meanwhile, Riyaz grew sicker and sicker.

He was in and out of the hospital — more in than out — and since it was challenging for Riyaz to undergo so many tests, Margaret — the ultimate advocate and dragonslayer — stormed the doctors’ offices to make sure that all the necessary tests were performed while Riyaz was still at the hospital, rather than requiring him to come back more than absolutely necessary.

Riyaz remained headstrong in his refusal to accept a part of Anil’s liver.

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The concept of putting Anil at risk was no pleasure for Margaret either, but if it meant saving Riyaz’s life — and considering that Anil was in good health and almost certain to recover quickly — Margaret turned to the one person who had Riyaz’s trust and likely could persuade him to change his mind — his general practitioner, Dr. Dukesz.

In an age when many physicians don’t remember most patients from one visit to the next, Dr. Dukesz had shown great compassion and care for Riyaz. Not only had Dr. Dukesz met regularly with Riyaz to teach him meditation, but the doctor also checked in on Riyaz when he was hospitalized.

“Dr. Dukesz,” Margaret implored, “Riyaz won’t take Anil’s liver, can you come and talk to him?”

One soul-searching conversation — at Southlake Regional Health Centre — is all it took for Dr. Dukesz to persuade Riyaz to accept his son’s liver donation if it turned out to be his best chance for survival.

Riyaz was increasingly miserable. He was unable to take pain medications at this point because his liver, which in a healthy individual could readily detoxify pain medications, was no longer able to perform that function.

One memorable Saturday morning, Margaret found Riyaz on the floor of their living room. His abdomen was bloated due to his non-functioning liver; his feet and ankles were swollen.

Margaret was horrified to observe that his legs were rounder than her waist.

“Margaret, I don’t know that I am going to make it through the day.”

To add to Margaret’s anxiety, Riyaz said that he was seeing black and was unable to focus his vision. “I just can’t handle it,” he gritted; even breathing required a focused effort.

Grabbing for her phone, she said, “I am going to dial 911.”

“Don’t! Listen!” he pleaded, “If you call 911, they are going to take me to Newmarket Hospital (about an 11-minute drive from their home), but my file is at 27

Toronto General Hospital (nearly an hour away by car).”

Toronto General is a university hospital affiliated with Princess Margaret Hospital and Toronto Western, where Dr. Heathcote had practiced. It was where the transplant was supposed to take place.

“I need to go there,” Riyaz beseeched.

Margaret was in no state to drive the nearly 100 kilometers to Toronto General herself.

Riyaz suggested she call Zahir ‘Zack’ Dhanani, a dear family friend, and ask him to transport the two of them. “I can handle that,” she replied, dialing with trembling fingers.

“Zahir, Riyaz is very sick. Can you drive us to Toronto General?” she sputtered into the phone.

Zahir must have flown to and from the Adat’s house, navigating traffic and arriving at the emergency room entrance as if he’d been driving an ‘ambulance’ all his life.

While Riyaz and Margaret waited to be seen by doctors, a young Indian man, roughly their sons’ age, walked confidently up to them. “Is your name Riyaz Adat?” the stranger asked. “Yes,” Riyaz answered, briefly wondering where this was going and how this man knew his name.

“You know my dad,” the stranger continued.

28

One In 1. 28 Billion Here it goes again, Riyaz thought, not feeling up to small talk. I am Indian like he is, and this young man starts assuming that I know his dad as if all of India’s 1.28 billion people know each other.

“Oh, really?” Riyaz managed politely while bending in pain in his uncomfortable chair.

“Yes,” the stranger insisted. “My father is Shamash Hirji,” he told Riyaz.

“Listen, I don’t know your dad. I am sorry.”

Just go away, Riyaz thought. Leave me be with my misery.

But the young man was unfazed. “You’ll know my mom then, Shaida Hirji,” he persisted.

There are limits, even for a kind soul such as Riyaz. Inhaling and exhaling through his mouth between waves of pain, Riyaz knew he was very near his limit.

“Oh, okay,” Riyaz responded weakly, looking up briefly from his bent position to maintain a polite demeanor. Upon hearing the name of this stranger’s mother, Riyaz drew a pained blank.

Riyaz briefly considered a white lie, acknowledging that he did indeed know the young man’s parents. Anything to be left alone.

“I am sorry, no, I don’t know your mother either,” he said, choosing to be truthful.

That should have brought a close to the conversation. But it didn’t.

Riyaz was stunned when the stranger pushed once more with hopeful energy.

“You’ll remember this then, were you in Mumbai, eight or nine years ago?”

“Yes,” Riyaz responded haltingly, as it began to dawn on him that perhaps he had crossed paths with this young man’s parents somewhere in the past after all.

29

“Do you remember getting sick one night?” the stranger continued.

“Yes,” Riyaz said, now intrigued by the unfolding riddle and momentarily distracted from his pain.

“Well,” the stranger proclaimed with a victorious smile, “the lady that nursed you was my mother. I am Alim Hirji, the transplant doctor at this hospital, and I am going to look after you, Riyaz,” he announced.

India is indeed a small country after all, Riyaz mused in wonder.

Dr. Hirji’s words transported Riyaz back in time to 2005, when he and Margaret had indeed traveled to Mumbai to celebrate their 25th wedding anniversary.

Zahir Dhanani, his friend and ‘ambulance driver,’ was also celebrating a wedding anniversary, and he and his wife, Aniz, joined the Adats on the trip.

Coincidentally, Shamash and Shaida Hirji, long-time friends of the Dhananis from Toronto, had arrived in India on holiday the previous day. All six Torontonians planned to dine together at one of Mumbai’s most famous restaurants.

It would have been a lovely evening, no doubt, only Riyaz’s PBC flared, and he fell ill. He reluctantly called Zahir to let him know that he and Margaret would have to remain at the hotel.

Shamash and Shaida were disappointed not to have the chance to meet the Adats.

When they learned that Riyaz was ill, they insisted that they all go to the hotel to check on him. “Let’s see what’s wrong, and then we’ll see what to do,” said Shaida, who happened to be a nurse. “Maybe I can help Riyaz feel better.”

When they arrived at Riyaz’s and Margaret’s room, Riyaz — not feeling the least bit sociable — was tempted to rebuff their goodwill gesture. Indeed, while he was close with Zahir and Aniz, he’d never met the Hirjis, and now was certainly not the opportune moment to do so.

But something about Shaida quickly put Riyaz at ease. She came across like a visiting angel as she tended to him all evening. The next day, feeling better, Riyaz and Margaret spent time with Shaida and Shamash and properly thanked them.

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It never came up in conversation that the Hirjis had a son in Canada who was a physician. Although all three couples lived in Toronto, neither Riyaz nor Margaret ever saw the Hirjis again.

Truthfully, the Adats couldn’t even remember their names. That is until the persistent stranger in the emergency waiting room reminded the Adats of his parents and their Mumbai encounter eight years earlier.

But still, this didn’t explain how on earth Dr. Hirji knew that Riyaz would be in the emergency room.

Riyaz would learn the whole story only much later. When he did, it made him wonder about the existence of angels and called to mind the vague feeling that he’d had, back in that hotel room in Mumbai, a divine guardian was tending to him.

Was it possible? A whole family of angels? How could it happen otherwise? How else could one possibly explain this unlikely series of events that had taken place years and worlds apart, only to converge and advance here in Toronto?

A family of angels, indeed, thought Riyaz as young Dr. Hirji saw to Riyaz as if he was caring for his own father.

As the story goes, while Zahir was picking up Riyaz and Margaret to drive them to the emergency room, the phone rang in Zahir’s home. Aniz answered. It was Shamash Hirji.

“Where is Zahir?” Shamash wondered.

Aniz, upset over Riyaz’s health crisis, began to cry.

“Why are you crying?” Shamash asked.

“Because something is seriously wrong with Riyaz’s liver,” she explained, reminding Shamash that he and Shaida had met the Adats back in 2005. Now Zahir was rushing Riyaz to the hospital.

“Which hospital?” he asked.

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Aniz didn’t know. She’d forgotten to ask Zahir where the Adats wanted to go. All she knew was that it was a facility in Toronto.

“Well, my son is a transplant doctor at Toronto General Hospital, and he is on duty today. Do you think that they are going there?”

Aniz, still teary, said she didn’t know.

Shamash promised Aniz that he’d text his son, Alim, and if Riyaz were indeed headed to Toronto General with Zahir and Margaret, Alim would see to Riyaz’s care.

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Christ Gets Involved Events were unfolding rapidly.

A transplant was scheduled for Riyaz at Toronto General Hospital on December 23rd, which coincidentally would be Riyaz’s 59th birthday.

Margaret hired a nurse assistant to stay with Riyaz all night. The young woman was from Nigeria. Her name was Chinwe (pronounced Chin We) Frank. Riyaz asked her why a 23 or 24-year-old woman would agree to the grueling duty of taking care of a dying man.

Chinwe said that she had dedicated her life to Jesus Christ and wanted to become a nurse in Canada.

“My mother is pastor of a congregation in Nigeria and has a television show on the weekend where she preaches nationally,” she told Riyaz. Chinwe was very proud of her mother. “She has a small medical clinic, and she takes care of a few patients as well.” Chinwe’s dream was to return to Nigeria as a nurse to help her mother in her work. She believed that Jesus would look after those who dedicated their lives to him. Being here with Riyaz was her way of giving back.

Riyaz was having difficulty sleeping and asked Chinwe if she would read the Bible to him. She was only too happy to oblige and did so for three nights before the transplant.

On one of these nights, as she was reading, Riyaz was in such physical pain, full of despair and anger, that he snapped.

“Stop it, stop reading the Bible to me! You know Chinwe, my God doesn’t give a f--k about me.”

Riyaz knew that he sounded crazed, but he was well beyond caring about appearances. Where was God, the Master of the Universe, when he needed Him? Why couldn’t God stop his pain? Was it too much to ask?

“No, no, no, please don’t say things like that,” Chinwe responded, a little horrified, and yet her sweet demeanor unfazed. “Jesus Christ is not like that.” She 33

continued at length about all the goodness of Christ until Riyaz told her to stop.

In pain and emotionally drained, Riyaz fell asleep. Chinwe could hardly believe that this was the same man who had been so nice to her for hours at a time. The same man who wanted to know about her life here and in Nigeria. The man who’d tell her to send his regards to her mother whenever she would call home. She was supposed to provide him care, but he was in so much pain, and now this?

She felt powerless.

Chinwe was so upset that she left Riyaz’s bedside and went downstairs to call her mother in Nigeria.

“Mom, do you remember my patient?” Chinwe recounted what had just occurred.

“Listen to me,” her mother said, “You tell Riyaz that Jesus Christ is healing him and that he is going to get a liver imminently. Tell him to stop worrying; Jesus Christ doesn’t like anybody to suffer.”

The next morning, as soon as Riyaz awoke, Chinwe related word-for-word what her mom had said. “So what do I have to do, take Jesus Christ’s word now?” Riyaz questioned.

“No, mother said that you don’t have to believe in him or anything. Jesus is telling you that this is what is going to happen.”

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“Get Well, and a Merry Christmas” When exactly Riyaz’s “angel” arrived in his hospital room, he can’t recall. In and out of consciousness, almost everything that took place in the days and hours leading up to his transplant is a blur.

Riyaz might well have imagined the stranger who materialized at his bedside — a delusional vision, perhaps — if not for the tangible evidence the man left behind.

As best as Riyaz can recollect through the fog of his hospitalization, the gentleman — White, in his fifties, and roughly 150-160 lbs — arrived out of nowhere and drew in close to Riyaz. “I wish you the best. Get well, and a Merry Christmas,” the visitor intoned. And then he was gone.

Did the man leave the glass angel ornament on Riyaz’s bedside table, or did he hand it to Riyaz? No matter. Crowned in gold with gilded wings, the ornament reflected and radiated the light of the room’s LED lamps, much like the sun’s rays bursting through the dawn clouds.

It would be an exaggeration to say that the little glass ornament pierced the many clouds that awaited Riyaz on the dangerous path ahead. But Riyaz grew deeply attached to the little angel, which has been the centerpiece atop the Adat Family’s annual Christmas tree ever since.

As the doctors prepared for the live-donor transplant, they examined Anil’s liver once more. Anil’s bile ducts were too close to an artery, they concluded, and at the last minute they refused to take a chance.

“We won’t take Anil’s liver,” was their final decision.

Margaret, for the first time, recognized death hovering over Riyaz’s hospital bed.

“He is dying,” she voiced her fear to her sons. “If he doesn’t get a liver quickly….”

Her voice broke off in terror.

Seth and Alisha had also signed up to be on the list of potential live donors. With Anil disqualified, the doctors fast-tracked both of them to be tested; only a skeletal staff remained in place during the Christmas and New Year’s Eve period.

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Riyaz was in his hospital bed, dying before their eyes, and Margaret knew that the tests were taking too long. “We are not testing anyone else,” one doctor said, “that’s it; those are the Ferraris,” he added, referring to the youth of Seth and Alisha.

As in all thrillers, a last-minute turn of events developed.

As Seth and Alisha were undergoing a multitude of tests, a man had died, and his body became available for organ donation.

The Adats would later learn that an organ from a recently deceased individual was always chosen one from a live donor.

The physician who broke the news at five in the morning on Christmas Day that Riyaz was second on the list to receive an organ from this newly deceased person was again none other than Dr. Hirji. The gentleman who was first on the list had once before received a liver transplant. It was now rapidly failing.

In a scene that could have been written for the American TV series, “Touched by an Angel,” Dr. Hirji simply said as he left, “I hope you believe in Santa Claus.”

A faceless committee of physicians would deliberate and then rule on who was going to receive the liver and who would have to wait — a possible death sentence for the “runner-up.” The doctors hadn’t made up their minds yet.

At the end of the meeting, it fell to Dr. Hirji to break the bad news.

“I’m so sorry,” he said, genuinely regretfully. But we will keep an eye open to get you another liver.”

Hope was all that Dr. Hirji had to offer.

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Christmas Day It was Riyaz who the transplant committee had selected. It was and would remain the best Christmas present he ever received.

Riyaz’s first recollection upon awakening after the seven-hour surgical procedure was that tubes were protruding from him everywhere.

It was Christmas Day, and Margaret’s sister Lynne, eleven years younger than Margaret, offered to have Margaret over for a Christmas Eve dinner. But Margaret, who never doubted that Riyaz would make it through the operation, refused to leave the hospital.

All that Riyaz remembered was being wheeled to the operating room around 6:30 on Christmas morning. A few doctors were there. One approached him and asked him if he had anything to say since they were about to begin.

Riyaz, in his ever-gracious way, responded: “First of all, I want to thank you all for being here on Christmas Day. You had a chance to stay at home but decided to come here and save my life. And secondly, I am so glad that all of you decided to take extra courses in the field of the liver so that you can save my life. Thank you so much. There was no need for that, but you guys did it. And thirdly, I don’t know the name of my donor, but I want to give him my heartfelt thanks.”

Riyaz was now ready. “Let’s start with it,” he added.

The anesthesiologist approached him and explained what he was about to do and that Riyaz would not feel a thing. “Okay,” was the last word that Riyaz uttered.

Before falling into oblivion, Riyaz later recalled, he not only smelled his new liver but saw and heard the sound of the organ that would save his life being cut in preparation for a life-saving operation.

Some patients might have been horrified by the sight, but to Riyaz, it was a reminder of the preciousness and fragility of life and of his desire to survive.

In the waiting room, the seven long hours that Riyaz was on the table proved 37

agonizing. Margaret, her sons and Lynne, along with her husband, Bill Fortnum, had been anxiously passing the time and supporting each other.

Another family sat nearby, waiting for an aunt also to come out of a kidney transplant surgery. Margaret guessed that these life-saving organs must have come from the same donor.

Sorrow and hope.

When the door opened, the first words they had all wished for finally resounded: The surgery went very well, the doctors said. Riyaz was resting. The physicians suggested that the Adat entourage all go home and get some much-needed rest.

Riyaz remained in intensive care for a week. His first operation in Canada had been for kidney stones, and at the time, he thought that was no picnic. The way he felt now made him wish that he had kidney stones instead.

He was moved to a different level in the hospital and, finally, to the transplant floor. When he saw Chinwe, he said, “You tell your mom that I am going to come to see her in Nigeria and go with her in front of the TV. I want her to tell the whole congregation what she said and what happened to me. This is truly a miracle.” Chinwe was overjoyed.

As time passed, Riyaz’s doctors felt that after such a prolonged period in the hospital, he should be moved to a rehabilitation center to rebuild his strength. Before he left, Riyaz had a chance to meet the person who had been selected initially to receive the liver that instead went to Riyaz at the last minute.

“You stole my liver,” said the man.

Riyaz worried that this stranger was serious. “I had nothing to do with it,” Riyaz replied defensively. “I don’t even know you!”

The man, as it turned out, had quite a sense of humor and was only teasing. The two liver recipients had a much-needed good laugh. Riyaz’s newfound friend was recuperating from the same surgery, having received a liver from another corpse.

Riyaz was heartened and relieved to know that his survival had not cost the second man his opportunity for a new liver.

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Battle for Survival While in rehab, Riyaz, at a most vulnerable stage of recovery, developed an infection caused by a staff member not washing his or her hands properly after coming into contact with bodily waste. The infection was highly contagious and had spread throughout the facility despite the staff ’s strenuous efforts to contain the bug.

Riyaz was infected, and it robbed him of what little progress he had made in regaining his strength. He was rushed back to the hospital with a fever. He was unable to keep down any food.

Although the hospital staff got the symptoms under control, the ordeal left Riyaz in a weakened condition. He couldn’t even reach for the food on his tray, much less cut it or feed himself. He required an around-the-clock aid that the family had retained to help him.

Some of the nurses were, nonetheless, disapproving.

“You are lazy,” they’d comment. “You’ll never get well if you do that.”

Perhaps it was “tough love,” but Riyaz didn’t appreciate it. “You’d think I was attending a military academy or something.”

Riyaz felt horrible.

He could hardly lift his hand without feeling drained by the effort. He was discouraged. The whole idea of going to rehab had been to rebuild his strength sufficiently to climb unaided the front two steps that led to his home. Before the infection, at the hospital, Riyaz had started to become stronger. If only he had not gone to rehab, he wouldn’t have caught this horrible virus.

Riyaz was finally released from the hospital once the infection was gone, but at home, his pain became excruciating. The doctors kept him on painkillers to no avail. Ten or fifteen days later, Riyaz finally saw the liver doctor at the hospital.

“On a scale of one to ten, ten being the worst, at which level is your pain?” the doctor asked. “It’s an eight,” Riyaz responded, “and I can’t take it anymore.”

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The doctor didn’t get far in his examination.

As soon as the physician touched the area of the liver, Riyaz jerked from the pain.

He couldn’t bear to be touched. Puzzled, the doctor called in another specialist, and they both admitted that they didn’t know what was wrong. They ran some tests, and the results came back a few days later.

Riyaz’s transplanted liver was infected with Epstein Barr Virus or EBV. This disease is more commonly known as mononucleosis or mono. The doctors put him on antiviral medication and thought it prudent to monitor him at the hospital.

Days turned into weeks. Complications arose, and Riyaz received blood transfusions. He kept being retested for EBV to see if the antiviral medicine he was on was working. The numbers showed that the medication was gradually producing the desired results.

Considering his pain and associated symptoms, Riyaz underwent more tests to see if other viruses were in play. To no avail. One doctor didn’t believe the negative EBV results. He was sure that something was wrong with the computation process of the test. As it turned out, he was right.

Further tests showed that the EBV numbers were elevated so high that they were not registering on the hospital’s device. Above a certain level, the machine would show 000.

Despite his doctors’ best efforts, the EBV virus was never entirely eliminated, and Riyaz still has flare-ups.

One of the possible complications of the Epstein Barr Virus infection is cancer.

Riyaz, who thought that he had finally put the worst behind him, was diagnosed with cancer a year later.

The diagnosis came as a shock, especially because he was finally feeling better.

Four rounds of treatment with immunotherapy drugs followed, successfully, at Princess Margaret Hospital.

How did Riyaz survive such a medical ordeal? He, himself, still wonders. Riyaz knew that the doctors were going to put him through hell. “They can do whatever 40

they want to me, and I will go through it,” he repeatedly told Margaret. And he was true to his word.

Riyaz simply refused to die.

“My time isn’t up,” he’d told Margaret. “I know one thing, God is not ready for me yet.”

As for Margaret, the fact that Riyaz was battling helped her survive the emotional rollercoaster. Neither Riyaz nor Margaret would quit.

Six months after the transplant, Margaret, in her typical spirit of gratitude for every aspect of life, organized a pool party to celebrate Riyaz’s recovery. It was summer, and she snapped a photo of a smiling Riyaz with two of his favorite nurses, Chinwe and Ginnette.

Ginnette was an operating room nurse from the Philippines who was studying to earn her accreditation in Canada. She had been in the country for less than a year when the Adats hired her to care for Sabrina. Margaret and Riyaz had screened a lot of agencies but discovered Ginnette on their own.

Ginnette was so admirable in her caring ways that when Riyaz fell seriously ill, Margaret approached her and said they needed her to take care of Riyaz. For Margaret, people like Ginnette had been her aides-de-camp; here to assist, protect, and report everything happening on the battlefield that was Riyaz’s hospital room.

Ginnette was at his side from the start of his ordeal. The Adats owned a small apartment building, and they gave Ginnette and her husband one unit to be nearby. Margaret went as far as finding a position at Gentec for Ginnette’s husband so that he could also work and live locally. He remained at the company for as long as Margaret was there.

There is no instruction manual or college class that teaches what Ginnette was able to do for Riyaz. Her efforts went well beyond the standard call of nursing: Personal assistant, nurse, companion, therapist, advocate, and loyal friend. Ginnette embodied all of it.

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She was attuned to Riyaz’s likes and dislikes. Anything that Riyaz needed or wanted, she would provide. Being sick, in pain, and miserable altered his usually affable nature, and Ginnette understood his moods. She would talk to Riyaz when she felt that he was up to it, and she had the rare quality of being a good listener.

To Margaret and Riyaz, she was a godsend from the minute they met her. Ginnette became the trusted nurse not only to Sabrina and Riyaz but also to Riyaz’s mother, Roshan, when she faced her final battle with cancer. Margaret and Riyaz were delighted when Ginnette finally received her Canadian nursing degree in 2017.

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Post-Recovery and Living a New Normal Riyaz had been at the hospital for four months, and for Margaret, a prominent executive and co-founder of a business, normal meant waking up every day at the Chelsea Inn at 33 West Gerrard Street.

It was located downtown, a half-kilometer walking distance from Toronto General Hospital, perfect for families or visiting patients who needed a convenient place to stay. The hotel kindly offered special hospital rates for extended-stay guests.

Margaret had set up her office at a small desk in her hotel room, but really, she wasn’t that functional. The preponderance of her attention was on Riyaz.

She would get dressed, visit with Riyaz and catch the doctors making their rounds early in the morning. She would listen to all that was said and of the plans being made for treatment that day.

Back at the hotel, Margaret would spend a few hours working, then return to the hospital to spend lunchtime with Riyaz. After lunch, she returned to the hotel for more work and then back to the hospital until bedtime.

During the late evening hours, Margaret would be on the phone, briefing family members and friends and receiving guidance. She would go to sleep when exhaustion claimed her. The next day would look the same, a good day because Riyaz was alive.

The time spent with Riyaz was emotionally draining more often than not in the days preceding the transplant. It was bruising to witness Riyaz in constant pain, in decline, and dangerously close to death. At times, Riyaz was confused and had memory issues. Much of it could be attributed to his prolonged hospital stay and the medicines he was taking.

Making their rounds, the doctors would routinely ask: “Do you know where you are?”

“In Bombay,” he would sometimes answer.

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Margaret’s heart would squeeze painfully just thinking about her erudite husband not only believing that he was in India but now very much unaware that Bombay had been called Mumbai since 1995.

“Okay,” the doctors continued, “can you tell us at which hospital you are then?”

“At Prince Aly Khan Hospital,” Riyaz would respond bemused, as if the doctors had lost their minds.

Leaving the room, the physicians, who couldn’t do anything about his confusion, would prescribe four or five daily laxatives to help him with something that could be remedied. The laxatives would leave Riyaz drained.

Both Margaret and Riyaz wished that someone would have told them what to expect in the last stages of the disease. It would have been helpful to Margaret beforehand to know that Riyaz would not be himself. All the toxins that would, in a healthy individual, be cleaned by the liver were building up in his brain. The Adats had not been prepared, and the element of surprise gave the enemy an advantage.

To make matters worse, Riyaz became volatile and paranoid. He was suspicious of Margaret and her motives for spending so much time with him and his doctors.

He never told Margaret about his darkest thoughts until he was better, but many times when Riyaz knew she was due to arrive, he would start shaking, fearing that his wife was coming to kill him.

In these moments of irrational paranoia, he could be rude to Margaret and anyone else who came in contact with him. Once, although he was bedridden and hardly able to move, he even went so far out of character as to strike Margaret, albeit weakly.

The resulting wound was purely emotional.

“My husband is kind, generous, and loving. This is not Riyaz. This is the ravages of PBC,” Margaret repeatedly reminded herself; yet, it was quite horrible to be subjected to Riyaz’s abusive behavior and even harder to witness.

Right after his operation, Riyaz was wheeled into intensive care. Margaret spent 44

time in the nearby waiting room with another woman whose husband had also been operated on for a liver transplant. Margaret casually asked this woman how she was holding up. Pretty soon, the woman was confiding a flood of emotions to Margaret.

“I don’t know what to do. My husband thinks that I am trying to kill him.”

Margaret was stunned to hear this. “You’re kidding me!” she uttered reflexively.

Margaret thought the woman’s experience was quite bizarre and quickly put it out of her mind until, once at home, Riyaz confessed his own dalliance with such irrational thinking.

Riyaz has no memory of most of his uncharacteristic words and deeds. When Margaret and others share their experiences, it’s as if he is hearing a story for the first time. Although everyone has reassured him many times over that they bear no grudges, nonetheless, to this day, he remains profoundly ashamed of his Jekylland-Hyde personality in the hospital.

It took Riyaz from his surgery on Christmas Day 2013 until the end of 2014 to start feeling ‘normal’ again.

Normal, of course, is a relative term. For Riyaz, normal life has included frequent blood tests, repeated biopsies, and endless visits with his liver, infectious disease, cancer, and general practice physicians.

Like the children’s game, Mother May I?, Riyaz’s life is commonly spent taking a few steps forward in his recovery and then encountering setbacks.

Yet, it is safe to say that Riyaz’s personality has made a total recovery.

Witness: As each year since his transplant passes, Riyaz dreams regularly about fresh travels and new adventures. He continually displays a wonderful sense of humor. And he is forever demonstrating his compassion and generosity toward others less fortunate than he.

Riyaz, of course, remains deeply devoted to Margaret and his sons. Anil found the love of his life, Sandra Oikawa, and the two were married in January 2014, 45

while Riyaz was still recovering. In July 2018, Riyaz received the most potent health boost of all, the birth of his and Margaret’s first grandchild, Kiyomi Sabrina Adat. Kiyomi, still a toddler, is a sweet, loving, precocious, and luminescent child who brightens the lives of everyone she encounters.

There can be no doubt, Riyaz Adat, affluent in family and friends, grateful each day to be alive, is a walking, breathing, Christmas Day miracle.

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Author’s Note A Christmas Day Miracle is adapted from our fuller biography of Margaret and Riyaz Adat, Improbable Lives: A Scot, A Tanzanian, and Their Canadian Love Story.

We first met the Adats in 2017 and immediately knew that their life stories were ones that would offer inspiration and hope to others who could relate to their humble beginnings, charitable souls, and ability to face down whatever challenges arose.

This book is the third “spin-off ” rooted in the actual events depicted in Improbable Lives.

Recalling Riyaz’s boundless spirit of curiosity and exploration as a child, Talya is the author of The Adventures of Riyaz, a semi-biographical series of children’s books that have been translated into more than a half-dozen languages, including Spanish, French, Chinese, Korean, and Swahili.

Together, the two of us published Perfectly Ordinary, Yet Extraordinary: Making a Meaningful Difference in the Lives of Others. The book recounts how Margaret and Riyaz, on their own, set about helping a woebegone school in far off Arusha, Tanzania, to improve the quality of school life for both the students and faculty.

Eventually, the Adats’ homegrown project was adopted as an undertaking of the Rotary Club of Willowdale (Ontario) and gained the worldwide attention of Rotary Club International.

Dean & Talya Rotbart

Denver, Colorado

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“A Christmas Day Miracle is an inspirational adult yuletide tale that offers hope to everyone — regardless of their religious beliefs — about the wonder and power of life’s unexpected blessings.”

About the Book This is the true story of Riyaz Adat, a happily married entrepreneur and the father of two. An Ismaili Muslim, Riyaz was born in Dar es Salaam, Tanzania, to parents of Indian descent. He and his family immigrated to Canada in the 1970s.

As Christmas 2013 approached, Riyaz was on death’s doorstep, withering away in excruciating pain in the transplant ward of Toronto General Hospital. Riyaz was second on the list to receive the liver of a man, a total stranger, who had recently died. Second, however, might not be enough to save Riyaz’s life.

On Christmas morning, snow was falling lightly and the temperature was a frosty 3° Fahrenheit.

Riyaz’s physician arrived at his bedside at 5:00 a.m.

“I hope you believe in Santa Claus,” the doctor smiled.

At that point, it was only candid to say that Riyaz did not.

As the title of this book signals, Riyaz and the Adat family were in for an unforgettable Christmas.

Big or small, dramatic or subtle, miracles benefit adults and children in every corner of the planet.

That is always true.

But when they occur on Christmas Day, miracles are extra special.

About the Authors Dean Rotbart is a Pulitzer Prize-nominated former reporter and columnist with The Wall Street Journal. He is the author of September Twelfth: An American Comeback Story.

Along with his wife, Talya, he is also the author of Improbable Lives: A Scot, A Tanzanian, and Their Canadian Love Story, a biography of Margaret and Riyaz Adat, and Perfectly Ordinary, Yet Extraordinary: Making a Meaningful Difference in the Lives of Others.

Since 2012, Dean has served as host and executive producer of Monday Morning Radio, a weekly business-to-business podcast. He is also chairman and editor-in-chief of the News Luminary Awards, which recognize outstanding achievements by journalists.

Talya Rotbart, a talented vocalist and painter, writes children’s books and is a romance novelist.

$12.25 ISBN 978-1-956928-01-3

Her book, The Boy Who Answered the Call of Kilimanjaro, has been translated into Spanish, French, Japanese, Korean, Hindi, Swahili, and Mandarin (Simple and Traditional).

9 781956 928013

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