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Our Stories :: In the News :: "A Doctor's Tale", from Telegraph Magazine

As written by Charles Lawrence for Telegraph Magazine

"Look! Look at you! It's a miracle!" In a narrow, basement-level surgery in New York's medical ghetto of the Upper East Side, a small space from which any residue of urban gloom has been banished with happy nursery colours, Dr Jane Aronson is poking a finger at the chest of an infant girl. She leans in close, head cocked to one side in the attentive, birdlike fashion of the doctor at work. The little girl raises her arms in the instinctive greeting of the very young child, and almost smiles, and at this Aronson chuckles with delight.

Zoya Hardikova, one year old on December 9th, has just arrived. She was born in Kursk, Russia, to a woman who was almost certainly a prostitute. She has a fetching round face, wispy blond hair, and a Slavic tilt to her encouragingly bright and inquiring eyes. From now on, she will be Julia Rose Lee. And within a few weeks, depending on how speedily the vast wheels of America's Immigration and Naturalisation Service happen to be spinning, she will trade Russian for United States citizenship. Little Julia Rose is the latest child to be found in an old Eastern Bloc orphanage and accepted for adoption in the West. Her parents are now Jim and Stacey Lee, and they all got back from Moscow two days ago. Jim is a plumber and Stacey an office manager for stockbrokers Merryl Lynch, and they decided on adoption, rather than the complexities of surgery and surrogacy, soon after learning that Stacey was infertile.

Tens of thousands of babies have made the journey from one world to the other since the first pathetic, pale and lethargic children were found lying in hard iron cribs in state care in Romania, in 1989. The Berlin Wall had just fallen, the West had won the Cold War, and the old Soviet-sponsored dictators were being hounded from office in places like Romania. The kids became a kind of symbol of the dreadful residue of communism, of futures perverted and abandoned to cold and hunger by false ideology. They were also very quickly seen as an exciting new source of white babies, babies who "look like us", for which there was a terrific, pent-up demand in America and Western Europe. For years, there had been a growing shortage of candidates for adoption, and a rising demand from couples afflicted by infertility, and desperate to make families. Last year, America alone imported 16,000 abandoned babies from Eastern Europe, Russia and China too.

But to Aronson, each child is simply a miracle. Now 49, with a shock of salt-and-pepper hair and lean Jewish features regularly split and creased by a raucous laugh, she was in her 30s when the traffic began and, after a late start in the medical profession, newly established as a pediatric doctor. She found herself drawn by instinct to the orphans: to the often-troubled babies themselves, and to the parents who wanted them. "In adoption I see people trying to put together a family" she says. "And that combines the science and psychology of medicine perfectly.'

She has become known as the Orphan Ranger, a doctor in a white hat on a rescue mission. And to Aronson, the idea is very much to rescue the child: she once warned a would-be parent that "this isn't a supermarket, you know", and returned the fees paid by another, a high-powered female lawyer, who demanded her assessment of a child on a will-he-make-it-to-Harvard sort of scale from one to ten. "She said she was paying me as an expert witness, and demanded to know. That was not a nice person," says Aronson. "I am here to think of the children. Who are they? What do they need? What can we do to make them well, and happy, and safe?"

In 1993, Aronson formed the International Adoption Medical Consultation Services and has become an expert on the difficult issues involved in both selecting and dealing with an adopted child. As parents and adoption agencies found themselves struggling with medical and emotional problems in infants from blighted and very foreign orphanages, she developed a technique to "screen" orphans that involves the study of video films or still photographs as well as whatever medical records may be available.

The wobbly, homemade videos are shot in the orphanages and sent to Aronson by parents who have to make up their minds whether or not to accept an available child. It is an inexact science: Aronson looks for evidence of serious defect, but also for signs that recovery is possible with proper care and committed love.

Aronson, whose clinic is one of about a dozen in America, has seen more than 300 newly adopted kids come through her surgery, and she has snapped cassettes into her video player to screen at least 2000 more. Parents who adopt children from abroad, most of them with minimal medical records or details of family background, are inevitably taking a risk. Aronson has categories for "average risk" and "extreme risk", but none for "no risk". The greatest fears for parents are of incurable illness, and of a condition of emotional damage familiar to most of us only since the Romanian babies first arrived, and known as reactive attachment disorder. These are the children who will not stop screaming on the aeroplane home, who will not sit still, and who never seem to learn to do as they are told.

The theory is that institutional neglect will leave some children unable to form any kind of bond with their new parents. Not only will they never be affectionate or loyal to a new family, they will be out of control and out of reach of the discipline needed for "structure" and socialisation. There have even been warnings that these children are doomed to become sociopathic criminals, human predators from the nightmare pages of sociology. These ideas have in turn led to a proliferation of "new age" therapies: the "holding" therapy of the Evergreen Clinic in Colorado, for one, and the "rebirthing" that led to tragedy and the death of a 10 year-old girl at the neighbouring clinic of therapist Connell Watkins, on trial in Golden, Colorado, with three of her assistants next spring.

"I just do not go along with this," says Aronson. " Everyone knows of reactive attachment disorder because there have been some very sad stories in the media, but in my opinion it is a lot less common than it is made out to be. Most of the time, it is the parents(itals) who fail to bond, who fail to understand and love the child. And when you look carefully at these therapies, it is the grown-ups who have the problems."

A decade of work has made Aronson into one of America's most respected "adoption doctors", and these days she rarely treats any child who has not been adopted. This year, she has been profiled in The New Yorker magazine, and has been the star speaker at the annual conference of the Adoptive Parents Committee. But her drive has always remained intensely personal.

"When I was a child," she says, "my favourite television show was the Lone Ranger. I just loved the whole idea of him and I suppose in some way we identify a need we have like that." She is the sort of woman who will ask everyone how they are feeling, and then quip, "Don't worry! I'm a Doctor! I'll look after you!" Three years ago, she started her own foundation to send young medical students abroad to study conditions at foreign orphanages, and to try to introduce better ways of nurturing their charges, and she called them The Orphan Rangers. The foundation has grown - she has students studying family etiquette and rejected children in Ecuador, and introducing the idea of art therapy in Russia - but the name stuck to her.

And although it took her years to realise it, her work was ultimately inspired by her own need for a family. As a girl growing up in a clan of New York Jewish intellectuals and high-achievers, she had always boasted of wanting to be a doctor, and having five of her own children, living in one of the city's big Brownstone townhouses. But adolescence and the 1960s left such ideas in the dust of confusion: she left college to become a photographer, and abandoned her family's ambitious paths to "find myself".

Aronson found herself a lesbian, and a perfectionist who could never be quite happy at anything, and quickly concluded that she would make a hopeless parent. For a start, she could not stand the thought of being pregnant. Instead, for ten years before returning to medical school, she worked as a teacher. At least she was with children. "And then I derived tremendous satisfaction from my work with my adoptive kids," she says. "But there was something missing. When I went abroad to see the orphanages myself, I felt the most incredible draw towards these babies. I wanted my own."

There were very few who knew that the Orphan Ranger who was becoming a beloved prop to a burgeoning community of adoptive parents was going home broken-hearted at night. "I had been in a steady relationship for 18 years," she says," and the trouble was that my partner simply didn't want to have children." A year or so ago, Aronson screwed up her courage, ended her relationship, and made a telephone call to a local adoption agency for which she acts as consultant. This time, she was looking for a child for herself.

Aronson found him in an orphanage in Vietnam, and his name is now Ben. As if to prove that this was meant to be, Aronson met a new partner within weeks of starting the adoption process. Diana Leo, 52, a development officer at New York University Law School, had been married, had a teenage daughter and, to Aronson's amazement, volunteered the idea that if they were going to be a couple, they should have a child.

They went to Vietnam together, and spent 17 days just looking at Ben. Aronson was helping to feed and clothe him, falling in love just like any woman longing for a child, and just like one who had never been to medical school. "I was instantly besotted," she says."He is mine. I know what it feels like now". She forgot to measure his head circumference, but believes she learned more than she ever knew about the hopes and needs and feelings of newborn babies.

In August, when Ben was four months old, she brought him home, and now there is a framed photograph of Aronson and her boy in her surgery, looking on as she begins her work with Julia Rose and her hopeful Mom and Dad. The videotape, Aronson tells me, had shown a pretty baby, but one who was clearly very small and about in the middle of the risk factor. Had she been very premature? Had her mother been on drugs? Or infected with sexually transmitted diseases? "Nice, tiny, with a big voice," she quips, slipping into unsentimental doctoring.

The little girl turns out to be in the bottom one per cent in size for her age, and to show signs of having suffered severe nappy rash - a classic for a Russian orphanage short of both staff and money. Her mental development - speech, hearing, and so on - seems to be around 9 months, which is encouraging for a 12 month old from an orphanage. Her fine motor skills measured at about the same age range, but the good news was that "gross motor skills", her ability to pull herself to her feet and teeter at the very edge of walking, were bang on target.

The Lees, exhausted by their trip to the strange world of Moscow and Kursk and Russian courts where adoption papers are stamped, begin to smile. "We knew she was ours right away," says Stacey," and it's an overwhelming feeling when you go all that way and see her for the first time. We were worried about her size, but what we were really afraid of was whether she would be all withdrawn and unable to love. You hear all these horror stories. But right away she put her arms up for me and wanted to hold me. I cried at that, believe me."

But Aronson does find one warning sign: Julia shows a sort of quivering tension to her muscle tone, and an excitable tendency to rush from one object of interest to another, and this is a standard sign of orphanage neglect. It comes, literally, from the baby spending too much lying around, understimulated, and is a bit like the stiff muscles of an adult after a long sleep. Aronson organises "early intervention" treatment from a physio-therapist and psychologist. Then she reduces her surgery to Bedlam with a range of hyperdermic needles: the diseases of Russian orphanages range from diptheria to syphilis.

It is now two o'clock in the afternoon and the Orphan Ranger is bolting down an egg sandwich and a glass of orange juice at the neighbourhood diner before hurrying home to Ben and the joys of motherhood. We find him on the sofa, on his nanny's lap, a little pink in the cheeks and complaining about the imminent arrival of his first tooth. He is six months now, a little late in learning to sit up, but recognising Mom with a big dribbly smile. He is trying to crawl, and has reached the stage of getting his bottom in the air, and going backwards.

All anyone knows about Ben is that he was about three weeks old when a young woman walked into the casualty ward of a local hospital and put him down on Bed Number 7. A group of old women saw her do it, and they exchanged polite smiles. When they realised that the baby had been abandoned, they called a doctor.

"When we went to find Ben, I realised just how fragile a child's life is in the orphanage," says Aronson. "I had thought that in those first few months, surely not much can happen to damage a child. Ben was only 4 months old, but I could see how it effected the way he saw the world. He was so sad, and withdrawn. Our first mission was just to make him laugh."

She succeeded. She has him rolling around on the floor now, chuckling and purring. "Ooooh," she teases, " you're the fun boy now, you have a couple of grey-haired old ladies to look after you!" Aronson is already planning to bring home a second child from an orphanage somewhere in the world, on the grounds that two is company, and is digging me in the ribs and pointing out that the search for volunteers for male role models is on.

Then it is time to settle for an afternoon bottle, and a nap. Ben, as round as a baby Buddha, snuggles into the boney shoulder of his unlikely new Mom, and they stare into each others eyes. "Who are you?" Aronson whispers, "Who are you?" It is, perhaps, the most intimate question in the process of adoption, and it is one that may never be completely answered.

Aronson looks up and as the little boy begins to doze, she says that she and Diana sometimes wonder about the girl who must have given birth to Ben, and fret over the knowledge that she is lost forever. "We would just love," she says," to be able to tell her that Ben really is going to be all right now."

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  This page last updated March 5, 2008 5:03 PM EST