Dr Jane Aronson: Angelina Jolie's orphan docto

From The Times

December 12, 2009

Dr Jane Aronson: Angelina Jolie's orphan doctor

Angelina Jolie credits one woman with saving her daughter Zahara’s life – Dr Jane Aronson. As adoption medicine’s leading light, she treats children suffering with everything from TB to depression, and is a campaigning voice for orphans around the world

(Christopher Lane)

Janine di Giovanni

In a small, crowded basement office on the Upper East Side of Manhattan, situated between a button shop and an evangelical Church, Dr Jane Aronson is examining twin eight-year-old Chinese girls. Or rather, the girls, Gracie and Hannah, were born in China, adopted, and are now thoroughly American, complete with New York accents. They are here to get their flu jabs and a back-to-school checkup.

Aronson, who is sometimes called the Orphan Doctor, and calls herself “Doc” in e-mails and text messages, is a handsome woman of 58. Her role as paediatrician and adoption adviser to celebrities such as the Pitt-Jolies and Mary-Louise Parker has put her in the media limelight, and also turned her into a very public advocate and defender of adoption. She has enormous warmth, but press the wrong button, and she’s uncompromising. Once asked about the negative reaction of the press to Madonna’s adoption of a child from Malawi, her response was robust to say the least: “That woman spun jewellery off her tits for years and now she’s come back as a mature adult to do one goddamned good thing in her life that is unselfish.”

Yet, beyond all the stardust and celebrity endorsement, it is here in this humdrum office that her real work goes on, day in, day out, with families from a broad spectrum of American life. Aronson has wild grey hair, a slender, athletic build and wears oversized, Elton John-style pastel-coloured spectacles. She wears Levi’s, a tailored blazer and penny loafers with real pennies stuck in them. She has rather naughty blue eyes and she speaks in jokey kid language to her small patients, which makes them relax instantly. When she talks to children, she gets down to their level and makes herself small, too. In the 20 years she has practised adoption medicine, a new branch of paediatric medicine, Aronson reckons she has helped between 25,000 and 30,000 children.

“OK, what’s up?” she asks Gracie. “So how’s school this year?” Then to her mother: “And afterwards? Videos? TV? How many hours? Only on weekends? iPods? Violin lessons? Soy products? Respiratory issues?”

Nothing is left out; each subject takes time as the parents and child explain.

Finally, Aronson looks satisfied as Gracie beams. “Send in your sister. Beautiful. We’re in good shape.”

In adoption circles, Aronson is famous: partly a pathfinder in a burgeoning medical field, and partly an investigator for parents of adopted children suffering from mysterious illnesses that other paediatricians might not be able to diagnose. Among her patients are children who have had the toughest starts in some of the world’s harshest regions, and they can suffer from complaints such as rickets (sometimes mistaken for osteoporosis), TB and, in some cases, polio.

Born in Queens, New York, Aronson grew up the daughter of a retired schoolteacher and a grocer, a natural athlete and a “smart kid – 11th out of 310 in my high-school class”. She studied hard, compensating, she believes now, for a learning disability. From childhood, she loved kids. And she loved science. She was also influenced by stories of her great-uncle, Dr Joseph Aronson, who treated Native Americans suffering from TB. Perhaps as a tribute to him, when she did go to medical school in her mid-twenties (after a series of jobs which included carpentry, photography, bartending and teaching) she studied infectious diseases, and later worked with the Navajo Nation.

“But you know, really why I wanted to be a doctor was because as a kid, I loved my paediatrician,” she says. “He saved lives. He saved kids from having polio. I grew up thinking, ‘I want to do that.’?”

Her work starts with adoption from the earliest stages. She counsels parents preparing to adopt; guides them through the often gruelling referral process; then takes the baby or child – sometimes straight off the plane – into her medical care.

Angelina Jolie, who has become a close friend, credits her with saving her daughter Zahara’s life when she was found to be suffering from a bacterial infection. “My daughter is one of those children whom Jane helped have a chance to live, and I am for ever grateful,” she has said.

There are 145 million orphans in the world, and you get the sense that if Aronson, who works tirelessly, had her way, all of them would be in loving homes. “Every child,” she says gravely, “deserves a home.”

According to her patients, and what I witness over the course of a week trailing her through patient schedules and recruiting “Orphan Rangers” – healthcare officials who work overseas for her charity, Worldwide Orphans Foundation – she is one of the few doctors I know who always answers her phone. “Christmas, New Year’s Eve, she picks up the phone,” one parent told me.

“I can’t tell you how many times I called her in hysterics and she calmed me down.”

Tough love

Like a lot of extraordinary people, Aronson sleeps little. “I used to get 3-4 hours a night,” she tells me, “but now that I am nearing 60, I need a bit more.” And, God, does Aronson work hard. She makes me tired just watching her. Her office, which is cosy and painted in red and blue, is packed and has lots of toys and framed articles about her, plus letters and pictures drawn by children in her care.

A sweet woman named Helen answers phones, and takes payments, but Aronson draws the blood and gives the jabs and hands out the vials for urine specimens. Most visits last between 45 and 90 minutes.

“It can be intense,” she admits. “When parents bring in a newborn adopted baby, I spend a lot of time teaching them what to do.” I cannot imagine many other paediatricians teaching a parent how to change a nappy.

Aronson is also tough and to the point. “This is not Bloomingdale’s,” she reportedly once said to parents who gave her a “shopping list” of what they wanted in an adopted child. But she has a reason.

“Oh, you would be surprised,” she says, when I ask her if people have a certain kind of child in mind (blonde hair, blue eyes?). “People have very specific ideas.”

Aronson reckons there are about a dozen adoption medicine specialists in North America and perhaps a handful in Europe. The field is growing because adopted children have specific medical needs. But international adoption is certainly not new. It blossomed after the war in Korea in the early Fifties, and reached a zenith around 2000, when the international adoption rate nearly doubled from that ten years before.

During the past few years, there have been some problems with certain countries – such as China and Vietnam – making adoption procedures more complex, and imposing restrictions or quota systems. “It’s humiliating for a country to admit they cannot take care of their own children,” she says.

Other nations make it impossible for single parents to adopt. But Aronson always has some kind of answer. “You can adopt domestically in America if you are single,” she says. “You can adopt out of foster care. There are ways.”

When parents get the children home, the issues they encounter with them are diverse. Often, their birth mothers had no prenatal care. Some children (particularly from Eastern Europe and Russia) have foetal alcohol poisoning. They can have low birthweight. They can be malnourished or carry infectious diseases. Some may have HIV (although there are would-be parents who request children with HIV).

“The issues can be anything from sinus problems to the acquisition of language,” Aronson says. “But most of them are due to poor healthcare in the orphanage, and exposure to contaminated food and water.”

Orphans of the world

It was Aronson’s knowledge of the Dickensian conditions in many orphanages that led her to set up the Worldwide Orphans Foundation, which aims to improve standards of care around the world and to raise money to build new orphanages. Both Jolie and Mary-Louise Parker (the star of Weeds) work for the Foundation, which has a glitzy fundraiser once a year.

“The first time I saw an orphanage in Romania,” Aronson says, “I thought, ‘Holy cow. This is a tragedy. Unforgiving.’ There are institutions where children have been locked up their whole lives. And these were healthy children. I went everywhere. I saw everything. I grew a skill set. And I became an expert. I am now in it for the long term.”

I am in the office when someone comes in for an interview to work as an Orphan Ranger. The interviewee has recently lost her husband, but she is a skilled early childhood development worker, and she listens intently when Aronson explains the programmes in Ethiopia. “You’re breaking my heart!” Aronson exclaims to the woman. “Because I know you understand what we are doing.”

At the moment, the foundation is also very involved in Vietnam, running schools and trying to counter the stigma attached to children with HIV. Vietnam is special to Aronson. She grew up during the Vietnam War, watching images on television of the destroyed country, and it is where she and her partner, Diana Leos, a professional fundraiser whom Aronson met in 1999, found and adopted their son Ben, who is now 9.

Aronson loves being a mother. Leos once said that when Aronson adopted Ben, “she became a different kind of doctor”. (Aronson also has an 11-year old son from Ethiopia, Desaling, known as Dessi, and Diana has a daughter, now 20, whom she adopted in infancy.) “I’m a mother,” she says at some point during the week when I ask her a question about a patient. “So I do understand.”

The really satisfying part of Aronson’s work is that the foundation has probably helped 20,000 children over the years.

What Aronson calls the “painful part” is the children she does not reach. It is also the malnutrition and the depression she encounters in children who are hopelessly developmentally delayed.

“If they have been in foster care – usually in places like South Korea, Taiwan or Guatemala – chances are they have been well looked after.” She shakes her head. “But if they have been institutionalised, chances are there will be attachment issues.”

Aronson’s office is always packed with people who meet one another, make friends, connect. I see an African-American grandad with his Ethiopian granddaughter; a Dutch father with his 18-month-old Ethiopian baby (he has a Vietnamese son at home); a single mother with an adorable Chinese baby.

I see Ukrainian twins; American toddlers; older kids, all ages. I see a sweet five-year-old from Guatemala.

Although she has hundreds of patients, what strikes me about Aronson is that she knows all of them well. She remembers which of the twins, Gracie and Hannah, is highly strung, for example. She informs the girls’ parents that they may get their periods early. “I have to tell you that this is very common with adopted girls,” she says. “We don’t know why. It’s pretty much a mystery. But you should know it happens.” The parents look surprised. They ask questions, and spend nearly an hour with Aronson, despite the crowded waiting room and the sound of a child wailing nearby. But Aronson is utterly focused on what and who is in front of her.

Later on, there is baby Zoe, and Aronson remembers, without looking at notes, that Zoe gets frustrated because she is not talking properly. She counsels the mother that it will take time; Zoe has been institutionalised. She recommends various healthcare workers. She talks about developmental delays.

In suburbia

In her other life, Aronson is a mother and spouse. She lives in a leafy, quiet and very pretty suburb of New Jersey called Maplewood, 35 minutes outside Manhattan. Diana, a tall, graceful woman, is at home when we arrive on a Friday afternoon. On a wall near the front door is a framed document acknowledging the couple’s union and commitment to one another. Dessi is in the back yard, shooting hoops. Ben is working on a model downstairs.

In the welcoming, open-plan kitchen, Aronson sets to chopping garlic for a spaghetti sauce. She has had a full week, but she still has ferocious energy. Diana announces that she has to leave for a meeting about a gala fundraiser for the Worldwide Orphans Foundation.

As she prepares the evening meal, Aronson patiently answers my questions about the specific health problems that orphan children face. “There is the issue of tropical and infectious diseases,” she says, loading chopped meat into a frying pan, “but there is also the deeper issue of development. When children are institutionalised for a long time, there is inevitably damage. For every month they are institutionalised, they are usually three months’ delayed.”

Can it be reversed? She looks surprised. “They catch up. Of course, they can catch up.” But there are, she admits, exceptions. “In some cases, the kids have been so severely damaged by institutional life that they are dangerous to the families who adopt them,” she says quietly. “That is pretty rare. But when it happens, you can imagine the anguish it causes.”

It is only after dinner, when we sit and chat, and she goes over the week’s schedule with the kids, that I begin to notice the slight fatigue in her brow. Any other person would have keeled over by now, I reflect. But no, she won’t let me help with the dishes, and then she takes me to the train station.

As we drive, I ask if she ever gets discouraged. “Sometimes,” she says. But what keeps her going is the thought that somewhere there are children who are alone, hungry, unloved. And families who want to take care of them. Her job is to bring them together. “I just keep working. There’s a lot to be done. And I want to make a dent in it.”

For more information, visit wwo.org

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