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Two sisters desperate for liver transplants. A father who could donate to only one. The incredible journey of Phuoc and Binh Wagner—and how their family's battle saved other children too.

By Michael Friscolanti

The twin girls were lying side by side on a wooden change table, close enough that one tiny head touched the other. Together, as always. Their dark eyes, oblivious to the moment, glanced around the room while two workers from the orphanage picked out some baby clothes and slid them on. For Binh, a pink and white dress with flowers all around. For Phuoc, a yellow top with thin, green trim.

“Please come on in,” one woman said, as a camera filmed the scene. “There they are.”

On the verge of tears, Johanne Wagner covered her mouth as she glimpsed her new daughters for the first time. Michael, her soldier husband, leaned over and kissed her temple. His expression could not have been more blank. “I had that look on my face that I was looking for another exit,” he says now, after seeing the video so many times. “ ‘Am I sure I am in the right place?’ ”

He was. Ho Chi Minh City, Vietnam. Nov. 3, 2012.

For 10 months, the Wagners had waited for that Saturday morning introduction—with eyes wide open. They understood that the twins they chose to adopt from the other side of the globe were gravely ill and severely malnourished, the diagnosis not yet clear. They’d seen photos of the girls’ toothpick legs and jaundiced skin. And they knew their weight (barely four kilograms each) came nowhere close to matching their age (18 months). But no amount of research, no stack of pictures, could have fully prepared them for that first encounter.

“I was devastated,” Johanne recalls, sitting at her kitchen table in Kingston, Ont. “I remember thinking: ‘Wow.’ They were smaller than my newborn babies.”

“They looked polluted,” Michael says. “It was overwhelming. I didn’t realize how sick these young girls were.”

Johanne reached for Binh and pecked her cheek. Michael picked up Phuoc and cradled her in his arms, staring at her fragile face as the camera zoomed in. “Everything will be fine,” said Johanne, rubbing Binh’s tummy. “I promise you, everything will be fine.”

In truth, the Wagners feared the worst. Later that afternoon, they walked through a Vietnamese market and purchased two cup-sized containers: both red and black, painted with dragonflies. “To lay their ashes in,” Johanne says. “We thought that’s where it was heading. All they might need is to hold our hand and have known the love of a family for a short while. If that’s all we can give them, that’s what we were going to give them.”

Today, those would-be urns are on display in the Wagners’ living room, a constant reminder of what should have been—if not for the sheer will of one unique, fiercely determined family, and the breathtaking generosity of so many selfless strangers.

What happened instead, two years later, triggered headlines around the world: identical twin sisters desperate for liver transplants, and an adoptive father whose organ, a perfect match, could save only one. An “unspeakable dilemma,” one article proclaimed. “Impossible choice,” said another. Agonizing. Heartbreaking. Some news reports went so far as to compare the Wagners’ predicament to the Oscar-winning film Sophie’s Choice, in which Meryl Streep’s character is forced to decide which of her two children would be gassed by the Nazis.

The reality was not quite so dramatic. From the moment the twins landed on the transplant list last December, their parents were tenacious about spreading the word, hoping a grassroots social media campaign would compel potential donors to come forward. In the meantime, Michael put his own name in the hat—and when doctors confirmed he fit the criteria, the Wagners were ecstatic, not devastated. One liver down, one to go. “We knew from the beginning that the two of them would not receive [a transplant] at the same time,” Johanne says. “We never, ever had to make a choice, and I want people to understand that we didn’t pick—and we never felt we had to pick.” That decision was left to the experts at Toronto’s Hospital for Sick Children. And in the end, the choice was quite obvious: Phuoc (pronounced Phook, like hook) was clearly the sister in more dire need. (Even their parents were not surprised by the selection. “I always suspected Phuoc was going to go first because she was more symptomatic,” Johanne says. “She was more miserable, more burdened. I was kind of relieved.”)

But the Wagners’ story, heart-wrenching all the same, went absolutely viral. Journalists from New York to Sydney to Paris reported on the couple’s relentless pursuit of a second donor, with emphasis on their apparently impossible choice. In a matter of days, the world was introduced to not only the twins and their tireless parents, but to the seven other Wagner children: five biological and two others adopted from Vietnam, for a total of nine. A “beautiful rainbow family,” as Johanne describes them.

“I thought my phone was going to kill itself,” Michael says. “Both my wife and I said: ‘We’ve got to ride this while we can.’ I think at one point each of us was doing four interviews a day.” Binh still needed a healthy liver, after all, and any publicity is good publicity.

Their strategy worked, better than anyone could have imagined. Moved by the girls’ plight, nearly 600 strangers came forward, offering to donate a portion of their livers to save the second twin. The volunteers emerged from everywhere. British Columbia. New Zealand. Brazil. Wyoming. “I’ve never seen a response like this,” says Dr. Gary Levy, director of the living-donor liver program at Toronto General Hospital UHN, which works in tandem with SickKids. “One person I spoke to said: ‘I refuse to take no for an answer, and if you don’t accept my candidacy I’m going to come to Toronto and picket in front of your hospital.’ ”

For Binh, the unprecedented response ensured she would receive the same precious gift as her sister: a future. In fact, doctors had the rare luxury of sifting through the wave of applicants and assembling an A-list of four prime candidates—a list that was recently narrowed down to one, when nurses wheeled Binh into surgery for a transplant that would unleash yet another round of headlines.

But in a story that has tugged at countless hearts, the most inspiring twist is the one that continues to unfold far away from the media’s glare. Of those 600 potential donors, nearly 50 have passed the initial screening tests—and some have told Levy they are willing to help any patient stuck on the liver waiting list. Two of those anonymous volunteers have already gone under the knife, saving two Canadian children whose names and faces never made the news.

All because of Binh and Phuoc, two sick, tiny orphans who don’t yet realize the astronomical odds they’ve overcome. Or the huge difference they’ve made.

An early photo from the Wagners' Facebook page. The twins have Alagille syndrome, a genetic disorder


When Binh and Phuoc were added to the transplant list in December, their parents launched a Facebook page,hoping to compel potential live liver donors to come forward.

Walk inside the Wagners’ front door, and the coat rack screwed to the wall is impossible to miss. Each hook is labelled, reserved for a particular child’s jacket. On the opposite side of the foyer is a wooden shelving unit stacked with black totes, each bin (like the hooks) assigned to a sibling. When 11 people live under the same roof, disorder is not an option.

“People ask me what they are like because they seem freakish in their circumstance,” says Begoña Pereira, a close friend who lives two doors down. “They are normal. That is what I love about them. It’s not that there’s a religious calling for them to parent or anything like that. They just make a good household for children, so why stop when they can absorb more?”

They met at a bar. Johanne, originally from Quebec City, was teaching in Ottawa. Michael, then a Halifax Army reservist, was on vacation in the capital, crashing at a buddy’s place. “I got in a taxi and said: ‘Where does everyone go out here?’ ” Michael recalls. “The taxi driver took me to Hull. He said: ‘Cheap beer and lots of girls.’ ”

Johanne noticed him first, sitting alone and looking handsome. Both were 24 (born two days apart, as they would soon discover). “I was with a friend and I said: ‘Oh, look at that nice-looking guy,’ ” she says. “I remember making a comment to myself: ‘I’m going to marry that guy.’ ”

Although they exchanged phone numbers and kept in touch, their relationship really took off two years later, when Michael was sent to Kingston in advance of a 1996 deployment to Zaire. He hadn’t left Canada before, and was understandably nervous. Hearing the anxiety in his voice, Johanne hung up the phone and drove the two hours to see him. The Zaire mission never did materialize, but by the time Michael shipped out to Bosnia instead, he and Johanne had fallen in love. He proposed during a mid-tour leave. “He is my anchor, the one who keeps me grounded,” says Johanne, who, like her husband, is now 45. “He made me a better person, helped me get focused. I think I could have been a much more selfish individual.”

The newlyweds never set out to have nine children, or even half that many. Both grew up with only one sibling. In a perfect world, Michael hoped for four kids. “Four?” Johanne thought, when they first talked about children. “Are you out of your mind?”

Rose arrived first. When Fiona was born, Michael jumped from the reserves to the regular force, which meant increased job stability but also months of officer training away from home—and subsequent moves to Ottawa, Quebec City and Montreal. A third daughter, Grace, came next, followed by Noah, their first boy. Four kids. Dad’s ideal number.

The Wagners' "beautiful rainbow family" of nine children

But Johanne, once floored by her husband’s “crazy” suggestion, was now a full-time mom, and in her eyes the family felt incomplete. “She always had adoption on her heart, especially international adoption,” says close friend Véronique Bergeron, who first met Johanne when their husbands were stationed together in Ottawa. “It seemed like a pipe dream for a long time; they were having children on their own and were busy with the little kids. But she always felt a strong calling to adopt.”

A logistics officer, Michael deployed to Afghanistan in 2005 to help set up the Canadian battle group in Kandahar; he shipped out again in 2007. It was during that second tour, while speaking to his wife on a satellite phone, that Johanne first broached the idea of overseas adoption. Look into it, he told her. “Sure enough, I did,” she says. “He came back from Afghanistan and he had a stack of papers to go through and sign.” (“There are no half measures with Johanne,” Bergeron says. “She is a 100 per cent person. She goes all in, whatever she does.”

Like any Canadian hoping to adopt from abroad, the Wagners weaved through a sea of bureaucracy on two continents. Between police checks and immigration applications, the process stretched on for more than a year. In the meantime, Johanne gave birth to the couple’s fifth child: another son, Liam. Finally, on Thanksgiving weekend 2008, the Wagners received a picture of a baby boy living in an orphanage in Vũng Táu, on the southern shore of Vietnam. “The connection was instant,” Michael recalls. “As soon as I saw the photo, the question was answered: ‘That’s my son.’ ” He flew to Asia that December to pick up Logan Hoang and bring him home.

Weeks later, Michael was on a flight back to Kandahar for a third tour in Afghanistan. When he returned to Canada, the family uprooted yet again, this time for a posting in Kingston. They bought a modest, two-storey home in a relatively new subdivision: four bedrooms upstairs, a row kitchen, and a dining area just big enough to fit their wide, wooden table from Ikea—a table that was about to squeeze in a seventh sibling. Toan (pronounced Toe-ann) was born in the same Vietnamese province as Logan, his soon-to-be brother. Orphanage staff suspected he might suffer from cerebral palsy, but that only made Michael and Johanne more determined to bring him to Canada. If Toan needed a wheelchair, they figured, they could always buy a bungalow. What’s one more move?

In May 2011, Johanne launched a blog (One More Potato in the Pot) to chronicle her journey to meet Toan and unite him with the family. “I never thought our life was that interesting to justify writing about it,” she wrote in her inaugural post. “We are very ordinary people and we do not intend to show off in any way through this media of communication. However, as things tend to get very busy around here, I thought this would be the best way for me to keep you all informed on what is happening with our newest adventure, the adoption of our seventh wonder.” That June, when Johanne laid eyes on Toan for the first time, he was asleep in a crib. “What a gift!” she later wrote. “I really can see where the suspicion of cerebral palsy comes from and that’s ok, everything will be just fine. I already love him.”


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Binh (in green) and Phuoc were quite ill when the Wagners first brought them back to Canada

Looking back, Johanne likes to say “the girls found us.” In January 2012, barely six months after she returned to Kingston with Toan, a photo landed in her inbox, emailed from a contact in Vietnam. “From the moment we heard about the twins, they were ours,” she says. “You can’t turn your back on them and say: ‘Oh, I’m just going to forget you exist.’ They had reached out to us.”

They were born on May 14, 2011: Binh first, Phuoc five minutes later. Their mother left them at the hospital. When Dr. Jonathan Halevy first examined their frail bodies, the girls were living in the orphanage, approaching their first birthday. “It’s very hard to forget a couple of babies in their condition,” says Halevy, over the phone from his Ho Chi Minh clinic. “It was amazing that they managed to survive at all.”

Jaundiced and dangerously underweight, the twins seemed to be suffering from some form of liver disease. Although the precise diagnosis wasn’t clear, the prime suspect was Alagille syndrome: a genetic disorder that attacks one in every 70,000 newborns, triggering a buildup of bile in the liver and limiting its ability to remove waste from the bloodstream. “It appeared that both of them would need a liver transplant,” says Halevy, an Israeli pediatrician who has practised in Vietnam for nearly a decade. “And there wasn’t any chance that they would get it here.” They should have died, in other words.

Although the Wagners were instantly convinced they should adopt the twins, convincing the Ontario Ministry of Children and Youth Services was another matter. The provincial bureaucracy, which must approve all international adoptions, had some pressing, sometimes uncomfortable, questions for Michael and Johanne. Why another adoption, so soon after the last one? Why twins? Why twins who are so obviously sick? “We never had to justify ourselves so much before in our lives,” Johanne blogged. “But they have a job to do and in retrospect, I am happy to see they challenged us. Each additional question from them solidified our position and made us realize that that was really what we wanted to do.”

What truly stung was the reaction of some friends and relatives. A few disagreed with the couple’s decision to adopt again, and let them know. “We realize that we are subject to the judgments of others and that’s fine,” Johanne wrote in another blog post. “As long as we are comfortable with what we are doing, as long as we are certain that the other children will not suffer from this adoption, as long as we go to bed at night with the certainty that we are doing what is right, I can fight anyone. I have stated before that my children might never have had breakfast with Mickey Mouse, but they are offered the chance to open their heart to others in need and THAT is priceless.”

Awaiting final approval, Johanne and Michael pored through the girls’ medical files and clicked on countless links about Alagille syndrome. The information was dizzying, to the point of uselessness. “They found that doing a lot of research was overwhelming,” says Bergeron, their Ottawa friend. “They knew they would be getting those girls, they knew it would be very demanding, and so at some point they had to stop reading about all the worst-case scenarios and just get the girls.”

They left for Vietnam, together this time, in late October 2012. Snapshots from the trip show the smiling couple standing outside, their new daughters swaddled in slings. The official adoption ceremony occurred on Nov. 5, two days after that emotional first encounter. “We would like to say we are certain of the outcome, but it would be foolish of us not to consider that time with them could be short,” Johanne blogged. “To be frank, these girls are sick.”

Watch as Johanne and Michael Wagner meet their twin daughters for the first time

But as prepared as they were for palliative care—the urns packed in their luggage—the twins’ new parents were certainly not resigned to it. “I remember promising them: ‘I’ll do everything in my power to make sure you are well. Don’t worry, we’ve got you now,’ ” Michael says. “We promised both those girls we would do everything we could for them, and that’s what my wife and I did.”

It was well after dark when the foursome landed at Toronto’s Pearson International Airport. One of Michael’s military colleagues, Capt. Krystal Turner, picked them up at the terminal. “The girls were very, very small, and they looked extremely fragile,” Turner recalls. “Jo had to rummage through a bag so she handed one of the girls to me. For the life of me, I didn’t want to move because I thought she might actually break.” (When Pereira, the neighbour, first met the girls, they were sprawled on blankets in the Wagners’ living room; Phuoc seemed especially dazed and distant, as if her eyes were looking right through the others in the room. “I remember thinking I was looking at someone who was dying,” she says. “It just felt that way.”)

The twins spent their first two months as Canadian citizens in and out of Kingston General Hospital, with specialists trying to pinpoint both the root cause of their symptoms and the right treatments. Their bones were ultra-thin, and no matter how much food they seemed to eat, the weight just wouldn’t stick. Michael took particular pride in his homemade soup recipe—a “super fatty” mixture of coconut oil, cream cheese, butter and broth—but even that didn’t work. At one point, the girls were actually shedding weight.


As November blended into December, the girls were back in the hospital, with Michael clocking night shifts at the ward and day shifts at work. A military padre finally told him: If you don’t request a compassionate leave until after Christmas, I’m going to do it for you. Maj. Wagner caved. As hard as it was to concede, the hectic pace, the swirling uncertainty, was too much. “Both Johanne and I are having difficulty with this situation,” he wrote in a rare entry on his wife’s blog. “This being said, I would not turn back time and I would walk the same road again. It is hard not to become depressed and lost in your own emotions. Not to sound like some superhero but we can’t afford to do this. We need to focus. We made this beautiful mess and it is our fault we are here so we must carry on.”

By January 2013, genetic testing confirmed what everyone suspected: Alagille syndrome. An inherited disorder that mimics other forms of prolonged liver disease, it essentially inhibits the body from absorbing the necessary nutrients in food. Symptoms include poor growth, incessant itching, and red, bubbly skin rashes triggered by cholesterol deposits. The syndrome can also affect other parts of the body, including the heart and kidney. In up to 30 per cent of patients, the liver eventually fails to function altogether, requiring transplantation (if, of course, an organ is available). “There,” Johanne wrote. “Now we know who the enemy to fight is.”

Back home, the Wagner clan adjusted to their “new normal.” Doctors prescribed a regimen of vitamin supplements and anti-itch medications, to the point where each twin was swallowing up to 20 syringe-fuls a day. Both were also equipped with nasogastric (NG) tubes, a finicky feeding system that pumped special formula through their noses, past their throats and into their stomachs. Their shared IV pole quickly became just another piece of furniture (like the two cribs crammed into Mom and Dad’s bedroom).

“You know what got me the most?” Michael says now. “Just how well my other kids adapted. There was a bit of fear: ‘Are they going to get ticked off?’ But they were not resentful.” If anything, they were anxious to help their new little sisters. “Our children are very resilient and have big, big, big hearts,” Johanne says. “I’ve often compared our family to a bunch of pencils. If you take one pencil and try to break it, it is quick and easy. Take a lot of them, tie them together with a knot and try to break them, you’re going to have a hard time. That is our family dynamic.”

Day by day, the girls slowly improved. They started to giggle. Roll around. Clap their hands. By their second birthday, six months after arriving in Canada, their weight had more than doubled, to nearly 10 kg each. Doctors were confident enough to replace the NG-tubes with G-tubes, gastric feeding lines inserted directly through the abdomen and into the stomach. When not hooked up to the feeders, the girls’ belly holes are literally plugged with buttons, like a cork.


In the years before their surgery, the twins received nutritional supplements



Dr. Gary Levy has a short, grey beard, and as he speaks, his glasses rest on the tip of his nose. A green ribbon, the symbol of organ donation awareness, is pinned to the left lapel of his white physician’s coat. “Being a liver doctor before transplantation was a very bad job,” he says, sitting in his office at Toronto General Hospital. “I can remember many people sitting where you’re sitting right now, and I had to tell them there was nothing we could do for them. And they died.”

Three decades later, Levy has helped build what is now the largest program of its kind in Canada, performing more than 500 annual organ transplants, including lung, kidney, heart and (his area of expertise) liver. “When liver transplantation started, you saw people literally rise from the dead,” he says. “It was like the Phoenix rising from the ashes. People would go into the operating room and they knew that if this wasn’t successful, that was the end. But they also knew without this, they had no hope whatsoever.”

In a perfect scenario, donated organs come from the dead: people who take the time to register their wishes in advance. But across Canada, most don’t bother. In Ontario, which boasts some of the best figures, only 26 per cent of eligible donors—3.1 million of 11.8 million—have signed up to share their organs, after death, with someone in need. “We are not a selfish society, that’s for sure, but we are a complacent society,” says Ronnie Gavsie, president of Trillium Gift of Life Network, Ontario’s organ and tissue donation agency. “The major barrier is procrastination. People feel: ‘Yes, I believe in it. Yes, if I needed a transplant I would take an organ to save my life. But it’s not going to affect me today.’ ”

Right now, nearly 1,600 people in the province are waiting for an organ, including 211 hoping for a new liver. Last year, 64 of those liver patients did not survive the wait.

There may come a time when researchers are able to grow organs in a petri dish. Until then, the only alternative to deceased donation is live donation—and because the human liver can completely regenerate itself, it is the ideal organ for such a procedure.

Toronto General performed its first live liver transplant in the mid-1990s, and has since completed more than 680 others. It is major surgery with inherent risks (doctors remove between 10 and 70 per cent of the liver; the younger the recipient, the less they need), but to date not a single donor has died on the operating table at Toronto General. Levy’s team works with doctors at SickKids—directly across the street—meeting twice a week to discuss patient files and timelines. “We beat to the drum of the recipient,” Levy says. “We work together to save lives.” In an average year, 20 dying children receive new livers from living donors, thanks to that close collaboration between hospitals. Not surprisingly, almost all of those 20 donors are moms and dads. A small few, however, are complete strangers: anonymous volunteers willing to endure unnecessary surgery, and weeks of painful recovery, to help someone they’ve never met.

It is Levy’s job, among so much else, to screen those volunteers. His office, the first meeting point, is decorated with old newspaper clippings about the program’s success, and his desk is littered with confidential folders. (Levy makes sure to move the paperwork before the interview begins, careful not to breach the hospital’s strict rules around donor anonymity.) Hanging on one of his walls is a homemade sign, the work of a grateful child. “Noun: a person who is admired for courage, outstanding achievements, and noble qualities,” it reads. “Pronoun: Dr. Gary Levy.”

“Most of the people I talk to are remarkable,” he says. “They want to save a life because they see the problem that exists.”

A live liver donor must share a compatible blood group with the recipient (not necessarily the same blood type) and be in generally good health. But the entire screening process is far more rigorous. Candidates are scrutinized by surgeons, psychiatrists and social workers—even doctors independent of the program, just to ensure they’re not being coerced. They also undergo an MRI, a CT scan, and if necessary, a liver biopsy. “This is an amazingly arduous process,” Levy says. “They are seen by more doctors than they have probably ever seen in their life.” Post-surgery, a typical donor can expect a week-long stay in hospital, and up to three more months of at-home recovery while the liver grows back to original size.

At all times, donor safety is Levy’s paramount concern. If doctors suspect, at any point, that a candidate is no longer a good match, surgery is aborted. Approved donors also have the freedom to back out, even at the last possible moment. “They have the opportunity to change their mind,” Levy says, “right up until the time they are being wheeled into the operating room.”

Listen to Dr. Levy discuss the people who donate: "They want to save a life"



The twins celebrated their third birthday on May 14, 2014, with G-tubes still snaking into their bellies. They had learned to walk, even climb the stairs, and were talking more and more. “Mom.” “Dad.” “Elsa.” (They go crazy for Disney’s Frozen.) Considering where it all began, the girls were thriving.

By the fall, however, doctors at SickKids were convinced that Binh and Phuoc would need to be added to Ontario’s liver waiting list. The medical team wanted to hold off a little longer, try every possible drug, but the next battle was inevitable: to survive, both twins would need a transplant.

In limbo once again, the Wagner house churned along as it always does. School buses. Family dinners. Swimming lessons. Karate. Laundry. Bedtime rounds, kissing all nine kids goodnight. “Johanne and Michael, man they are symbiotic,” says Pereira, the neighbour. “The two of them are such a good team.” Amid all that uncertainty, they even found time for one more task: to plan Pereira’s wedding.

She and her husband-to-be kept putting off the big day—until September, when Johanne forced her in the car and drove her to a venue. The manager told them the next available date was Dec. 20; they booked it on the spot. While Johanne helped pick the dress, the logistics officer organized the rest, from itinerary to seating arrangements. “My husband and I did nothing but show up,” says Pereira, a fundraiser at Queen’s University. “The next morning, the whole Wagner gang was there at the crack of dawn, cleaning up. By the time we got down, the boys were pushing brooms around and the girls were busing tables. That is just the way the Wagners do things.”

By the wedding day, Michael and Johanne had received official word: the girls were placed on the transplant list, effective Dec. 3. Their next plan—finding two willing, compatible donors—would be their most ambitious yet. “A big percentage of people on the transplant list end up dying before they get an organ, and we decided that wasn’t going to happen,” Johanne says. As her husband vowed: “We’re changing the odds.” Their Facebook site—“Liver Transplants for our Vietnamese Twin Girls”—went up first, featuring a homepage photo of adoption day and information how to become a living donor. “With the New Year coming, let’s think about those who are sick, and especially those who are waiting for the Gift of Life on a transplant list,” it said. “This is the case for our beautiful daughters, Binh and Phuoc.”

At best, the Wagners hoped for some local publicity, maybe a mention on Kingston’s newscast. When the Facebook page hit 100 likes, a pittance in hindsight, the family celebrated. On Jan. 9, the Kingston Whig-Standard published the first article: “Liver donors sought for twins.” CBC came next. Then another local paper. On Jan. 20, Michael appeared on CTV’s Canada AM. “Not to sound altruistic,” he told the viewers, in typical understatement. “But from the moment we saw them they were our kids.”

Michael was actually in Toronto that week to meet Levy’s team, to see if his liver might be a match. When informed of the good news, he immediately phoned his wife. “I guess it’s a go,” he told her. Johanne’s next Facebook post, Jan. 21, left little doubt about the family’s elation. “WE HAVE A DONOR for one of the girls!!!” she typed. “We need one more!”

For a brief moment, Michael did struggle with mixed emotions. “It bothered me a bit that I couldn’t do both,” he says now. “In a perfect world, I would love to be able to wait six weeks, regrow a bit of the liver and say: ‘All right, do it again guys.’ ” Deep down, he knew that was wishful thinking (medically speaking, live liver donation is a one-time deal). He also realized how blessed he was: the finish line was suddenly halfway closer.

But the inevitable question—Which daughter would Dad save?—made for instant headlines, generating clicks on news sites all over the world. The Facebook page lit up, hitting 10,000 likes and counting, while Johanne’s blog, barely an Internet blip until then, exploded with page views (at last count, more than 157,000). Michael started hearing from old friends he hadn’t spoken to in years. Is that you, Mike?

When reporters asked, Michael and Johanne always provided the same response: the doctors will decide who goes first, based on need. But as far as the Internet was concerned, they were the distraught Canadian parents facing an “impossible choice.” “Any coverage is good coverage, and we can’t control the editor,” says Michael, whose focus remained the same throughout: finding a second donor. “We invite you guys in; it’s up to you whatever angle or story you go with.”

Johanne Wagner talks about the family's so-called impossible choice

Whatever the spin, the story’s impact was tangible. Potential live donors must submit a 12-page health history downloaded from Toronto General’s website, and the questionnaires started flooding in—by the hundreds. For privacy reasons, the hospital is adamant about protecting the identity of its anonymous applicants, even from recipients. But their generous hearts touched even Levy, a man who has met so many inspirational people throughout the years.

One volunteer offered to fly in from B.C. Another from Buenos Aires. One is a paramedic working in Ontario. “He said his business is saving lives,” Levy says. “He has two young children, and he said he goes to bed every night and he thanks God for the fact that his children are healthy. He just couldn’t live with himself if this child dies.”

The first transplant: Watch as Michael and Phuoc Wagner undergo surgery

In early February, as the headlines kept multiplying, the hospital phoned: Phuoc, not Binh, would be getting Dad’s liver. “I’ve never seen this exact predicament before, where a parent has two children in need and can only give to one,” says Dr. Steven Paraskevas, a Montreal surgeon and president of the Canadian Society of Transplantation. “There are no true guidelines because it’s such an extremely rare occurrence. If a distinction on medical grounds cannot be made, there’s almost no precedence on how to make that call.”

In this case, the distinction was apparent. Dr. Binita Kamath, a staff hepatologist at SickKids, would later explain that there were “slight differences” in the girls’ blood work, symptoms, and overall quality of life—and that Phuoc’s condition was clearly more severe than her sister’s. “We don’t burden the family with that discussion,” Kamath said. “That decision, it’s ultimately our decision.”

The Wagners were neither surprised nor conflicted. They’ve had nothing but praise for the medical professionals who have cared for the girls since their arrival, and had no reason to second-guess the experts this time. Their real worry was the same fear every family faces when confronted with major surgery: Will there be complications? Two Wagners, not one, were about to go under the knife at the same time, increasing the chances, however slim, that something could go wrong. “That was going through the kids’ minds,” Johanne says. “We fell back on the statistics: that they’ve never lost a donor, that they have a perfect record. We fell back on the logic.”

Never the type to sugarcoat, Michael sat his kids down. “Dad is going to do it,” he told them. “I would do it for anybody here.” As always, the Wagners organized a detailed game plan. Michael’s mother, Mary, would fly in from Halifax to watch the older children. A neighbour across the street offered to help the boys with their after-school homework. Fellow soldiers from Michael’s unit were a phone call away, 24/7, for whatever Grammy needed. On Feb. 8, a Sunday, Johanne, Michael and the twins said goodbye to the others and boarded a westbound train to Toronto. The transplant was scheduled for Feb. 10, first thing Tuesday morning.

They spent Sunday night at Ronald McDonald House, in the heart of downtown’s hospital district, before checking Phuoc into SickKids the next day. She met a bubble-blowing clown, who made her laugh. That Monday, Krystal Turner arrived. Because Johanne would be busy with the twins (one in hospital, one out), Michael had asked his friend, a fellow Maritimer, to be the point person during his surgery. Now stationed in Ottawa, the captain received permission from her chain of command to stay by Michael’s side. Turner was at the airport when the twins first landed in Canada; she would now witness the operation aimed at saving one of their lives.

She bought Michael a sub for supper. Binh, still in need of her nightly G-tube feedings, was at Ronald McDonald House with them, while Johanne stayed at SickKids with Phuoc. Finished her sandwich, Turner walked to a nearby hotel that Michael had booked for her. Their plan was to meet early the next morning, 5:45 sharp, outside Toronto General.

The sun was still down when Michael climbed out of bed. It was frigid, another winter day well below zero. By complete chance, another Canadian Forces member, whose daughter also suffers from Alagille syndrome, was staying in a room down the hall. Michael asked if his neighbour would mind keeping on eye on Binh until later that morning, when Phuoc went into surgery and Johanne returned.

Asleep on a cot in Phuoc’s hospital room, Johanne felt an embrace. Michael had stopped by for one more visit, carrying a morning Starbucks for his wife (double milk, as usual). They went for a short walk, saying little. At that point, what’s left to say? At 5:30 a.m., Michael kissed Johanne, then turned to leave. She watched her husband disappear down the hallway. “That was harder than when I had to let him go for Afghanistan,” she recalls, holding back tears.

Downstairs, Michael crossed Gerrard Street West. He met Turner out front of Toronto General Hospital at quarter-to-six, right on time. Upstairs, a nurse put a bracelet on Michael’s arm and handed him a light blue gown. He was getting changed when his three eldest daughters—Rose, 14; Fiona, 13; and Grace, 11—sprinted into the room. (A family friend was supposed to drive them to Toronto, but her car broke down; they caught an overnight bus instead, arriving just in time to see their dad.) “It was emotional for each of the girls, and Mike,” recalls Turner, 35. “They were scared. They understood that surgery doesn’t always go according to plan.”

Ever the practical joker, Michael tried to keep things light. He and Turner poked fun at the tight compression socks that went up to his thighs, designed to keep blood flowing to his extremities during surgery. “Sexy legs.” And they laughed about other procedures the doctors should consider, since he was going to be in the operating room anyway. A brain upgrade? Brad Pitt’s abs?

Did he ever contemplate, even for a moment, that he might not wake up? “You know what? I did,” he admits. “But then I thought: ‘These guys have never lost a patient. Why would I be the first?’ I’m going to use a military term: these guys have their s--t wired tight. I felt very confident where I was going.”

As nurses wheeled his gurney toward the operating room, the clock approaching 9 a.m., a videographer recorded the scene. (Well aware of the massive media interest, both hospitals wanted footage to release to the press.) Michael was lying underneath a white blanket, his feet sticking out the bottom. What looked like a blue shower cap covered his military buzz cut. He spoke to some of the doctors. One initialled his belly, standard procedure. One peppered him with questions about Afghanistan. The last thing Michael remembers is thinking about his children.

Phuoc and Johanne Wagner before Phuoc's liver transplant

Across the road at SickKids, Johanne held Phuoc in her arms, squeezing hard as she swayed from side to side. She had promised her daughters, way back at the orphanage, that she and Michael would do everything—anything—to keep them alive. But at that moment, letting go was utterly excruciating. Trying not to cry, Johanne kissed her daughter one more time before handing her to a nurse. “Me giving Phuoc to the medical team was fulfilling my promise,” she says now, choking up at the memory. “I had done it—everything—and if she wasn’t going to come back, at least I knew I had done everything.”

Surgeons opened up Michael first, slicing a 15 per cent chunk from his liver’s left lobe. The machines monitoring his vital signs beeped in the background as the medical team, faces masked, hunched over his chest. The doctor doing the cutting did not use a scalpel, but a high-frequency Waterpik that cauterizes the surface. If done properly, it is a completely bloodless procedure.

Flushed with fluid and bagged in ice, Michael’s gift was packaged in a red cooler and walked, via underground tunnel, to Phuoc’s operating room at the Hospital for Sick Children. The videographer followed behind. At its destination, a separate team of doctors huddled around Phuoc, working to remove her near-useless organ. Shaped like a butterfly, the liver came out of her body almost pitch black, like a smoker’s lung. Doctors carefully installed the replacement, meticulously sewing Phuoc’s veins and arteries to what was, just moments earlier, a piece of her father. All told, Michael was in surgery for six hours, Phuoc for seven.


The next morning, Phuoc was awake in the intensive care unit, calling for Mommy but unable to get up. Johanne was not allowed to hug her. Not yet. Begoña Pereira had travelled to Toronto to support her friend, to be a second set of eyes and ears. She started to cry—not because Phuoc was upset, but because the enormity of it all had sunk in. “That is the moment I thought: ‘This is unbelievable science, that they can do this.’ ”

Take a dad’s vital organ and save his child.

At Toronto General, Michael felt like a splattered bowl of Jell-O. He could barely move, let alone step out of bed. Fading in and out of sleep, he was lucid enough to wonder about all the tubes sticking out of his body, especially the one piercing his neck. He asked Turner if Phuoc was all right. He tried wiggling his toes. When the pain was especially harsh, he thumbed the tiny button on his morphine drip.

Pitching in from Ottawa, Véronique Bergeron took control of the Facebook page, posting whatever updates she could as her friend bounced from room to room to room. “I felt myself pulled in four different directions,” Johanne recalls. “My husband was at Toronto General, Phu-Phu at SickKids, I had Binh with a caregiver at Ronald McDonald House, and my other kids in Kingston with Grammy. I felt like people were pulling on my arms and my legs, and my heart was just aching to know where to go.”

She was also dodging journalists. One tried phoning Michael’s hospital room. “Please be aware that Johanne is not returning calls or messages because she is at her daughter’s bedside in intensive care,” Bergeron wrote on the Facebook page. “Michael is not returning calls because he is recovering from major surgery whereby he had his abdomen opened up to remove part of a vital organ and stitched back up. Phuoc is not returning calls because she’s 3 . . . and intubated.”

The next morning, Feb. 12, the hospitals convened a joint press conference with Johanne at the centre of the table, exhausted but appreciative. As she spoke, nearly a dozen cameras zoomed in. “I would like to thank everyone who has chosen to support us in this journey—worldwide,” she said. “It was quite a surprise to see how viral our story went, and it’s a great thing to raise awareness, first of all for Alagille syndrome, which is often unknown, and also awareness for organ donation. I would like also to give a very special thank you to my partner in crime, my best friend, my hero, the best person, the best man I know out there: my husband. Thank you, Michael, for offering the best present ever to our daughter. There is no price to that.”

Knowing full well why so many reporters were in the room—the choice—Dr. Kamath answered the question before anyone could ask it. “This was a complex decision taken by the team together based on medical data, but also included the family,” she said. Even Johanne made a point to downplay the misconception that she and Michael had to somehow pick one daughter over the other.

Asked about Binh, Levy told the cameras he and his staff were busy assessing the wave of applicants (by then, more than 400) and that a timeline for surgery will depend on the little girl’s condition. “Although Binh most definitely needs this liver transplant, she’s not in a life-threatening stage right now,” Kamath added. “She is stable, so that is a fortunate situation to be in: we can wait, let our colleagues at Toronto General find an ideal donor, and do this in a very planned action.” How long could she conceivably wait? “I’d be comfortable with her waiting for months,” she replied.

Someone asked Levy what would happen to those hundreds of volunteers who came forward to help Binh, but aren’t selected. Could their livers be used to save someone else? “It’s an excellent question,” he replied. “We anticipate that several of these individuals will want to step forward [to donate to another patient]. If it’s deemed safe, we will give them the opportunity to do so.”

Another journalist asked Johanne what was going through her mind, knowing both her twin daughters may soon be healthy. “I might end up being, you know, bored,” she smiled. “Life may be actually quiet, I don’t know. I’m used to go, go, go all the time with nine children, and special needs children.”

“Is nine enough?” a TV reporter asked.

“I think nine is enough,” she replied, still smiling.

A few minutes later, the same reporter came back again. “Nine children is a lot,” he said, more statement than question.

“I don’t think nine children is much.”

“It’s almost two basketball teams.”

“Is it?” Johanne replied. “We need a basketball court, I guess.”


Johanne can hear the shovel outside, scraping yet another snowfall off the driveway. Without looking, she knows exactly who’s out there: John Beddows, an Army major who works alongside her husband at the directorate of Army doctrine. (Michael’s current job is writing how-to manuals for other soldiers.) Like many, Beddows has been checking on the Wagners every day since the surgeries. “Mike is one of those guys you want to help, even if he wasn’t doing something so blindly courageous,” he says.

Standing inside the front door, beside the name-tagged coat rack, Johanne thanks him for the shovelling. “I will give you a call later,” Beddows says. “À la prochaine.”

It is Feb. 25, a Wednesday afternoon: 15 days since the transplant, 13 since the press conference. Michael has been discharged from hospital but remains in Toronto with Phuoc, whose new liver continues to be closely monitored. In Kingston, meanwhile, Johanne and Binh are home, hoping to recapture some semblance of routine with the other seven children as they wait for the next surgery.

The Wagners’ house, warm and inviting, is an organizational triumph. Chaos controlled, as opposed to controlled chaos. In the basement, the eldest two have their own bedrooms. The other nine family members sleep on the top floor, split between four more rooms: Grace in one; Noah beside her; Logan, Liam and Toan bunked in another; and Binh and Phuoc with Mom and Dad. “In the long term, we’re thinking we might make a dorm,” Johanne says. “Give our room to the four boys, move into Noah’s—because all we need is a bed—and give the other room to the twins.” The main level is open concept, centred around the large dining table that so many have seen on the news. For a few more minutes, the adjacent living room will remain what it rarely is: quiet. Binh, missing her sister terribly, is at daycare, enjoying some interaction with friends. The others are in school.

Johanne has done her best to lie low the past couple weeks, careful not to reopen the media floodgates; as grateful as she is for all the publicity, the attention has been a double-edged sword, almost suffocating. But she also knows her daughters’ improbable story is helping to save other deserving children, and she wants to keep that momentum going. “We knew we had a good story,” Johanne says, sipping a coffee at the table. “Let’s face it: two little babies adopted from an orphanage far away, it’s a sappy story. But the other people on the list are just as worthy as Binh and Phuoc. They just don’t have the story to get the media attention.”

Johanne says she and her husband are proud of what they’ve accomplished. (“Michael and I can do anything.”) She is overwhelmed by the support they’ve received—from strangers, from the military, from Canada’s Vietnamese community. She is confident her kids are digesting the life lessons that truly matter: what it means to be generous, to offer a hand to someone in need. And if given a second chance, they wouldn’t change a thing.

Watch as Michael Wagner talks about Phuoc's transformation


While Phuoc and Michael were in the hospital in Toronto, Binh and Johanne were home in Kingston

Though eternally positive, Johanne is not naive. She has skimmed through a few of the online comments below the articles, and she knows some readers are critical. Why adopt such sick children from another country? Why should Canadians have to cover the girls’ health care costs? Sadly, she’s heard it all before. “I have lost dear people around me over [the twins],” she says. “People who have never understood why we did that, and got out of our life. They just stopped talking to us.”

Asked how she would respond to that small minority of critics, Johanne doesn’t hesitate. “It’s sad to be you,” she replies. “I know what I did is right. I pity you.”

Rose comes home from school first. Toan, 4, follows through the front door a few minutes later, dropped off by his daily taxi. “He is still too small to take the school bus,” Johanne says, leaning down to hug him. He kisses her on the lips. It turns out Toan does not suffer from cerebral palsy, as originally thought; he has Noonan syndrome, a genetic disorder that prevents typical development in various parts of the body. Doctors also suspect an autism spectrum disorder, Asperger’s perhaps. “On Friday, we are going to the gland specialist,” his mom says. “They are going to start him on growth hormones.”

Fiona and Grace arrive home next. An air cadet, Fiona is learning to play the drums and guitar. The other boys are across the road, still doing their homework at the neighbours’ while Michael is away. “I’m going to get Binh at daycare with Fiona, because she needs shoe polish for her boots,” Johanne tells Rose. “When I come back with Binh I’m going to give her a bath and then we’re going to have supper. Mexican meatloaf.” The family car, parked in the freshly shovelled driveway, is a white, 15-seat passenger van, the kind sports teams typically rent for out-of-town tournaments. As Johanne walks to the vehicle, a text message lands on her phone. It’s from Michael in Toronto. “I love you.”

“My parents have taught me to keep going until you get what you want,” says Rose, standing in the kitchen. “My mom is the perfect example of that. She doesn’t stop until she gets what she thinks is best for the kids. As soon as we heard the girls were on the transplant list, she was: ‘OK, Facebook page. Can we do anything else?’ ”

Asked what life is like as the oldest of nine, Rose grins. “It’s great,” she says. “Having a big family sometimes has its downsides, I have to say. But there’s a lot that gives back. I love them all so much. I don’t know what I would have done if I were an only child or had only one sibling.”

When Johanne returns home with Binh (and the shoe polish), she quarterbacks an early round of baths for the younger kids. The boys, finished their homework, go first. When it’s Binh’s turn, she starts to cry. “Would you like a drink of water?” her mother asks, trying to soothe her tears.

“No,” Binh whimpers.

“She misses her sister,” Johanne says. A few days ago, they tried facetiming: Phuoc from the hospital, Binh from home. But that only upset them both, unable to understand why they could see each other, but not touch.

In the bath, the crying continues. “She is itchy,” Johanne says, wrapping Binh in a green towel and lying her on the floor of the master bedroom. “She is scratching all the time.” While drying off, Johanne points to the cholesterol deposits on her daughter’s knuckles, yet another symptom of the syndrome. “At this point, there is nothing that helps.”

Before zipping up Binh’s pink pajamas, Johanne makes sure to replace the circular bandage on her stomach, which wraps firmly around the G-tube button. It needs to be changed once a day, if not twice. “Those things never healed and they’re still not healed,” she says. “I’m going to do the dance of joy the day they remove the G-tubes.”

For a few minutes, Binh cuddles with her mom on a rocking chair, a surefire remedy for the tears. When Toan wanders into the bedroom, he joins their snuggle.

“I’m going to be five,” he says.

“Are you going to be five?” his mom replies. “Can I eat your nose?”

“Yes,” Toan answers.

“OK, give it to me,” Johanne says, pretending to chomp. “Can I eat it with ketchup or mustard?”

“Hmmm,” he thinks. “Mustard!” Binh smiles.

“I wouldn’t talk because you have a cute nose too,” Johanne says, turning to her daughter. “Can I eat it?”

When they head downstairs for dinner, Binh is able to navigate the steps on her own. In the living room, Fiona strums her acoustic guitar. Rose is at the table, doing her Latin homework. The others are gathered around the television, watching the cartoon Arthur. Binh squeezes into a chair with her brother Liam, who makes room. The microwave beeps. The Mexican meatloaf, cooked in advance over the weekend with Rose’s help, is ready. Johanne puts salsa and nacho chips on the big table. “Grace, can you sit please,” she says. “Logan, can you sit please.”

There is no prayer before supper, a deliberate choice Johanne makes sure to point out.

As the children eat their meatloaf, the conversation turns to the family’s sudden brush with fame. When Rose took Binh to the grocery store the other day, a lady in line recognized the little girl. Noah, the 8-year-old, says his whole class saw him on TV.

“Why did they pick Phu-Phu, by the way?” Noah asks, wondering why Phuoc, not Binh, had her transplant first.

“She was more miserable,” Mom answers.

“Maybe she was more eager to get a new liver,” he jokes. “Maybe she was like this for a new liver: ‘Back away, it’s mine, Binh!’ ”

His older sisters chuckle.


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Binh is comforted by Johanne as she waits for her surgery

If the military life has taught Michael anything, it is patience. Hurry up and wait. With Phuoc at SickKids—and Daddy by her side, hour after hour—that virtue is being put to the ultimate test. “Both of us get a bit of cabin fever after a while, but we’re trying to make the best of a bad situation,” he says, speaking on his cellphone from Phuoc’s hospital room. “I’m not going to have too many days where I just get to hang out with one of my kids, eat macaroni on the floor and play Lego. That’s what we’re going to do today.”

Sixteen days removed from surgery, Michael is able to walk on his own two feet, but remains in significantly more pain than he anticipated. Bending down is still a chore. “I felt like hell,” he says. “Honestly, I felt like a blob.”

Michael didn’t climb out of bed for more than a day, and may not have tried if Capt. Turner hadn’t been there to encourage him. He watched his wife’s press conference that Thursday—and told her afterwards what a great job she did—but has no memory of doing either. Later that week, when his commanding officer dropped by to visit, he fell asleep mid-conversation. “It wasn’t until Saturday that I actually have real memories,” he says. “I had to ask my wife: ‘Where did the chocolates come from? Who brought the magazines?’ ”

Phuoc has made it through the critical first few days, when the odds of organ rejection are highest, and doctors are encouraged by her daily blood readings. Simply put, the new liver appears to be settling in—so well, in fact, that there’s talk of her being discharged on Monday, March 2, less than three weeks since the transplant. The original estimate was up to two months in hospital. “You should see her,” Michael says. “She is walking around this room like nothing. Right now, she’s got her apple juice, she’s got a little bench, and she is sitting and colouring.”

The whites of Phuoc’s eyes, almost orange pre-operation, are actually white. Sleep time is suddenly peaceful, and her huge appetite is unrecognizable. “We are now starting to see her true personality that is not clouded by liver disease,” Michael says. “I am looking at her and I’m thinking: ‘You’re back.’ ”

Two years ago, he held Phuoc for the first time, wondering if she would live much longer. “Now you have a piece of me inside of you, and it’s making you better,” Michael says. “I don’t know if it’s pride, but it’s: ‘Wow, I’m so happy I could do it for her.’ I understand in some way why people are interested, because you can’t make this stuff up.”

Sometimes, Michael finds himself wondering how he got to this point—not the hospital room, but to the life he now leads. He can’t pinpoint exactly what motivated him and his wife to adopt special-needs children; it was more a feeling than a well-laid plan. He’s also the first to admit the logistics aren’t always easy, especially for a family living on one military income. A single adoption from Vietnam can cost thousands of dollars. “If I didn’t adopt these kids, my mortgage would be paid and I’d have bigger retirement savings,” he says over the phone. “Do I regret it? No. There are a lot of things, financially, that bringing in these kids has impacted. But one of the things it has taught my wife and I is how to live well on less, and what truly is important.”

As Michael talks, Phuoc calls for Dad. Done colouring, she wants to watch a cartoon.

“You’ve seen my house, and we are nowhere near poverty,” he continues. “To be really honest with you, it takes a lot for me to complain anymore. When somebody says: ‘Oh my Lord, I can’t believe that we’ve got to wait three hours in the emerg to get something stitched up,’ I’ll gladly wait three hours to do that. You realize you’re complaining with your mouth full.”

Back home: Phuoc, post-surgery, and Binh

Dr. Levy’s staff has phoned back every volunteer donor—close to 600 people, at last count. Levy himself has personally dialled some of the numbers, just to say thank you. “Many of them have stories,” he says. The man from Wyoming was especially memorable. He was adamant about travelling to Toronto to help the second twin, but Levy convinced him to redirect his good intentions. “I said: ‘I have a better idea. There is a transplant centre in Washington, tell them you spoke to me, and tell them you’re interested in live donation.’ So I think this is a story that is going to have an impact all across North America, and all around the world.”

Again, Binh’s eventual donor must be blood-group compatible, but gender is irrelevant. When doctors have a choice, they prefer someone less than 40; the younger the person, the better the liver’s regenerative capacity. When doctors really have a choice—from 600 applicants, for instance—Levy’s team seeks out the fittest of the fit, people with the strength and stamina to withstand what Michael knows all too well. At first, the team identified between 75 and 80 candidates from the initial wave, then whittled that list to eight (all from Ontario). From there, staff selected the ideal four. “They are very mature, very insightful, they have a history of altruistic behaviour—whether it’s giving blood or helping people through community service—and they are healthy,” Levy says. “And I mean healthy. You and I should be so healthy.” All of the final four also boast strong support networks, critical for post-op care and recovery.

On the morning of the transplant, Levy suspects that two of the four will be asked to come to the hospital. But he tells Maclean’s the preferred donor has already been selected, barring any unforeseen circumstances. Although he can’t reveal personal details, Levy says the entire team agreed on the top choice. “Everybody this person met is blown away by this person,” he says. “We believe this is the best candidate.”

Bottom line: Binh will have her turn. The only question left is how many others will, too, thanks to the twins.

Of those 600 who came forward to help the Wagners, Levy says nearly 50 have expressed an interest in donating to any patient in need. Never has the doctor possessed so many file folders full of potential anonymous donors. “Is the number shocking to us? Yes it is,” Levy says. “I wouldn’t have predicted that this many would have stepped forward and said: ‘Just use my organ for anyone.’ ”

Two of those volunteers have already undergone surgery—in both cases, saving critically ill children who were less than two years old. Another two volunteers have completed every necessary test, and are ready for when the moment comes to donate.

For various reasons, Levy doesn’t expect all 50 interested candidates to reach the operating room. He’s confident, though, that as many as 10 could turn out to be donors—which may not sound like a lot, but is actually astounding. In a typical year, Toronto General performs six to eight anonymous live liver transplants; one story, Binh and Phuoc’s, is poised to double that output.

If nothing else, advocates hope the Wagners’ story inspires people to do what so many still don’t: take the time to register as deceased organ donors. The process takes barely a few minutes, and carries zero risk. “What we try to make people understand is: For every person you see on the news, or somehow making their story known, there are many others you don’t hear about,” says Paraskevas, of the Canadian Society of Transplantation. “The Wagners give it a human story and a face, and you realize the plight of this family is the plight of many families.”

Consider these stats: on a typical day, Ontario’s organ donation website ( processes 80 to 100 online registrations. On Feb. 12, the day of Johanne’s press conference, 162 people clicked on the site to sign up. But even that temporary boost was a mere drop in the bucket. To increase the number of eligible donors by just one percentage point (to 27 per cent from its current 26 per cent) would require 125,000 new sign-ups.

“Michael Wagner put his health and his safety at risk,” says Gavsie, Trillium’s president. “Would we choose to put the father of nine at risk if we had an alternative? We do have an alternative. There is no cost, there is no pain, there is no risk, to donating at the end of your life.”

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Phuoc was not released that Monday, as doctors had hoped. She picked up a touch of stomach flu over the weekend, forcing her and Dad to stay at SickKids a little while longer. She was finally discharged on March 6, the following Friday—3½ weeks after transplant. Still way too winded to get behind a wheel, Michael asked some Army friends to drive in from Kingston and pick them up.

“You could tell Phuoc was excited just to get out of the hospital,” he says. “As we started to get closer, she started to recognize: ‘I think I know where I am.’ When we got in front of the house she wanted out of that van—pulling against the harness of her car seat. The door opened and everyone was screaming and yelling.” A clip of her emotional homecoming, posted on the Facebook page, has topped 3,500 views.

One week later, Michael and Johanne are sitting at the dining room table, the afternoon sun shining through the windows that overlook the backyard. The twins are beside them, one in each highchair, chewing their lunch: shepherd’s pie, compliments of a local restaurant. “We are so lucky,” Johanne says. So many have done so much, from delivering home-cooked meals to driving the other kids to their various lessons and appointments. Dozens have also donated to an online fundraising campaign that has collected nearly $15,000 (to help offset some of the Wagners’ transplant-related expenses, such as travel costs and extra caregiver fees).

“My energy level is just not back to where it was, and I feel that,” says Michael, eating some leftover pasta. “I think the most I can lift is maybe 10 lb.” Still on medical leave, he has dropped in to visit his colleagues—who asked, inevitably, to see the scar on his stomach. “That’s it?” they joked. “You’re still off work for that?” (Michael politely declines to show the scar to Maclean’s. Despite his family’s very public story, some things are still private.)

Phuoc’s scar is shaped like a wishbone, beginning in the middle of her chest and splitting in two directions as it winds down each side of her stomach. When Binh first saw the incision marks, she immediately turned away. “She doesn’t like to see it,” Michael says. “Even in the bathtub, she really finds it odd to see her sister’s scar.”

Phuoc’s physical transformation is truly astonishing. Watching the twins eat their shepherd’s pie, side by side, is like looking at a makeover ad: before and after. On the right, Binh’s skin is still yellow and itchy, the tension ever present in her eyes. Phuoc, on the left, looks pale by comparison, the jaundice completely gone. “I just see it in Phu’s face,” Michael says. “That sense of: ‘I’m not itchy, I’m not bothered, things are good.’ ”

“I never thought she would recover so quickly,” Johanne adds. “You would never tell by looking at how she moves and acts that she went through such a big ordeal.”

That ordeal, of course, is far from over. The Wagners’ kitchen counter is full of new prescriptions, including anti-rejection meds—and anti-anti-rejection meds. Still getting comfortable with the updated routine, Michael and Johanne keep a detailed chart of times and dosages. Once a day, a homecare nurse drops by to check Phuoc’s blood levels and administer intravenous drugs.

Then there’s the Binh question, hovering over everything. The Wagners still don’t know a date for her transplant, or even how much advance notice they’ll receive from the hospital. But they try not to focus on things they can’t control, confident, as they’ve been from the beginning, that both girls will get their turn. “It’s going to come when it comes,” Johanne says. “I’m not stressed out. I’m actually happy that it’s taking a bit of time because by the time she gets called and I have to go with her, Michael will only be stronger.”

Michael’s outlook is trademark Michael: “We could sit and watch the water boil, which isn’t going to make the water boil any faster.”

Finished lunch, the girls romp around the living room, building towers with coloured blocks. Frozen, nearly finished, is playing on the television. “We just hope that they can have as normal a life as they can,” Michael says. “They can go to school, learn to ride a bike: all the things that we’ve all done.”

“And without any big expectations,” Johanne says. “Just live and be happy.”

As naptime approaches, Michael starts picking some blocks off the floor. For now, at least, the girls’ toys are among the few things he does have the strength to lift.

“Are we ever going to be able to find out how many people will have directly benefited from this story?” Johanne says, sitting on the couch. “I don’t think we will, but I know some will. And just that—knowing we’ve helped, or will help people on the list—is great.”

When the movie credits start to roll, the twins join their mom on the couch. Binh rests her head on a brown pillow and curls up underneath a plaid blanket. Phuoc climbs onto Johanne’s lap, snuggling into her chest. Within minutes, both are fast asleep.


Phuoc (left), after surgery, back home playing with Binh


Watch the Wagners tell of Phuoc's homecoming

The news arrived, without warning, in an early morning Facebook update. “BINH RECEIVED HER GIFT!!!” Johanne wrote on Monday, April 20, just before 6:00 a.m. She went on to post multiple photos, including a short video of Binh taking her first steps post-transplant. Clearly, the little girl had received her new liver at least a week—if not more—before her mother’s surprise announcement. “There are not enough words to thank the amazing and so unselfish donor,” Johanne continued. “And in order to respect the anonymity of this wonderful person, please do not ask or try to find out when the transplant took place: this is irrelevant. After all, what really counts here is the gesture and the great result.”

Within hours, the twins’ adorable faces were all over the news once again—the happy ending so many had hoped for.

Phuoc with her parents after Binh's liver transplant was made public

The next morning, April 21, a row of television cameras is waiting for another press conference to begin. When Michael and Johanne enter the room, a special guest follows along: Phuoc, just 10 weeks removed from her own life-saving transplant, looking healthier than ever in a grey shirt with blue polka dots. Photographers click away as she walks toward a long table lined with microphones. Grinning wide, she plops into her father’s lap.

“I am pleased to tell you that the procedure took place several weeks ago,” Dr. Levy tells the reporters. “We kept it under wraps.”

The mystery donor has already returned home and is doing extremely well, he says. Before the press conference, Levy spoke on the phone with the person, who made a point of passing along their love and best wishes to the Wagners. “The donor is a very generous individual and has made a remarkable gift with no expectations,” Levy continues. “The repayment, for lack of a better term, comes from within. Their thanks is that the child is doing well. That’s the thanks they want.”

When it’s Michael’s turn to speak, he can barely do so. “I’m going to cry,” he says.

“That’s OK,” his wife assures him.

“I’d like to thank the donor,” he says, stopping again to wipe the tears under his glasses. Sitting to his right, Johanne starts to cry, too.

“They put their life on the line for someone they’ve never met, and changed our lives forever.”

Though careful not to disclose any timelines, Johanne says that on the day of the transplant, she thought of the anonymous donor as much as her daughter. “Walking in front of the hospital, that whole time I suspected you were in there,” she tells the cameras. “I could look up at the window where my husband used to be, suspecting maybe that’s where you were. I was sending you my positive vibes and positive thoughts every single day, several times a day. Thank you for your unselfishness, for what you’ve done for Binh. There is no other word than thank you.”

Binh remains at the Hospital for Sick Children, and while doing relatively well, her recovery hasn’t been as speedy as her sister’s. Her breathing was strained in the days following the operation, and she needs to eat more on her own before doctors will consider sending her home. “She has had a few issues, which we are currently dealing with,” says Dr. Kamath, the SickKids hepatologist. “But with close, continued medical and nursing attention, we are anticipating an excellent recovery for her.”

For the Wagners, it’s hard to imagine a better outcome. The twins will turn four in May (itself an amazing feat), and doctors expect both to eventually rely on only one or two immunosuppressant drugs to maintain their new livers. In time, the feeding tubes will also come out, no longer necessary. Throw in the unexpected ripple effect—that the girls’ story saved two other children, with more transplants expected—and it’s no wonder Levy says everyone at the table is “absolutely thrilled.” (“Aren’t you thrilled?” he asks Phuoc at one point, looking down at her smiling face.)

But as the Wagners have said many times before, they know their daughters weren’t the only two in need. Thousands of Canadians are waiting for organ transplants, and many will die waiting because the majority of eligible people don’t register to donate after death. (News of Binh’s transplant actually broke in the middle of National Organ and Tissue Donation Awareness Week.) “It should be Organ Donation Day every day,” Johanne says. “Please keep on spreading the word. It saves lives. It works.”

Thirty minutes into the news conference, Phuoc is starting to fall asleep in Michael’s arms, the same arms that held her for the first time that Saturday morning three years ago. A reporter asks what the Wagners will remember most about the twins’ most unlikely journey. “The conviction that we did the right thing,” Johanne replies. “Those four children from Vietnam were always meant to be with us. They reached out in some way to come to us, and the last three, who are special needs, needed us—and we needed them. Yes, they might grow up to be thankful, but we are immensely grateful to them that they came into our lives and shaped it into the way it has become.”

And the way it will soon be, with all nine children back under the same roof. Back at the kitchen table.

One doctor who wasn’t at the press conference was Jonathan Halevy, the pediatrician who treated the twins back in Ho Chi Minh City. He has watched the news unfold from afar, still stunned that such a story could be true. “It was amazing that they managed to get adopted, to find such a wonderful family, and now they’re getting liver transplants,” he says. “It’s a miracle. It’s once in a lifetime, I think.”


Binh is recovering from her transplant


After Binh's transplant, Phuoc (left) greets her at Ronald McDonald House

For more information on organ donation, please click on the province or territory where you reside.

Writer: Michael Friscolanti Editor: Dianna Symonds 
Designer and developer: Amanda Shendruk 
 Photographers: Cole Garside and Christopher Wahl Videographers: Cole Garside and David Zelikovitz Video editor: David Zelikovitz Photo editors: Natalie Castellino and Liz Sullivan