March 24, 2006 -- People who know Lansana say he is magical — like a boy who landed on Mars from a distant, troubled place.
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Wendy Cohen remembered one of her first encounters with Lansana after he was brought to the United States from his war-ravaged native country, Sierra Leone. "He put his arms around my neck, and he said, 'I can't lose you. I can't die. I don't know you yet.'"
Cohen was swept into Lansana's life by proxy, just as she was ending a relationship with Ian Zlotolow.
Zlotolow is a well-known doctor, the former chief of dental service andmaxillofacial prosthetics at Memorial Sloan-Kettering Cancer Center in New York. He can quote Bob Dylan lyrics from memory. He is the one who found Lansana in the heart of darkness -- the reason that he, Cohen and Lansana now share a kind of power over each others' lives.
"Somebody had to do something," Zlotolow said. "And isn't this all just a simple twist of fate?"
Civil War in Sierra Leone
The cause that brought their fates together was the civil war that began in 1991 in Sierra Leone in West Africa. Seeded both by government corruption and forces recruited by Liberian warlord Charles Taylor, who sought to destabilize Sierra Leone as he plundered resources there and in his own country, the civil war set tribal faction against tribal faction, revolutionaries against government troops. It was worsened by vicious battles for control of the country's alluvial diamond fields.
Atrocities were committed by all sides, sometimes acting in concert with each other to enrich themselves. In a world where limbs were hacked off; where children were kidnapped, stoked with drugs, and placed on the front lines of battle to draw enemy fire; where among the ways that human beings can damage and destroy each other, few methods were overlooked -- in one regard, Lansana was lucky. As a young boy of 5 or 6, after chasing a soccer ball into the bush, he was bitten by a snake.
"He was taken to the village doctor who bloodlet him," Zlotolow said. "Apparently, he was very traumatized."
An uncle abandoned Lansana at a hospital in Bo, Sierra Leone. Lansana's father was missing. His mother was dead. How she died hasn't been determined.
Lansana walked with crutches as the infection from the snake bite worsened. "He had osteomyelitis, and it spread up his [right] leg," Zlotolow said. Osteomyelitis causes bone tissue to die.
Of his time in the hospital, Lansana remembers "just being in a lot of pain, lying in the same old bed. I remember this one guy who died next to me. I just turned around, and he was facing toward me. It was kind of scary."
Late in 2001, Zlotolow arrived at the hospital as a medical volunteer on leave from Sloan-Kettering. Zlotolow specializes in creating prosthetic parts for facial wounds and deformities. Among other things, he made replacements for ears that had been hacked off by machete-wielding soldiers.
"All the ear prostheses that I made … were all for young men," Zlotolow said. "I don't know what side they were on. But it didn't matter then."
When Zlotolow encountered Lansana lying on a hospital bed, he asked Lansana to smile, hoping to estimate the boy's age from the condition of his teeth. By that time, Lansana had been in the hospital for nearly two years, and was 7 or 8 years old.
"He had this dynamic smile," Zlotolow said. "And he was with some other little kids. He wore pajama bottoms, and he had these wooden crutches with no rubber tips, and they were broken."
Doctors recommended that Lansana's leg be amputated. Zlotolow thought that a specialist might be able to reconstruct the mangled leg, despite the destruction of the bone between Lansana's right knee and ankle.
But even more importantly, through an interpreter, Lansana said to Zlotolow: "I want to go where you are from."
The words were perfectly aimed at a man described by acquaintances as a doctor with a heart of gold. "All of a sudden, something came to me," Zlotolow said. "The people I knew from Sloan-Kettering came to mind, my father, my family. You do the right thing. And I knew that I would have all this support, and I guess I just said, 'This kid, he needs help. He won't make it here.'"
As he prepared to return to New York from the horrors of Sierra Leone's refugee camps, Zlotolow struggled to find a way to get Lansana out, too. Among the references Zlotolow listed in his paperwork on behalf of Lansana was Muhammed Ali, a childhood friend from Louisville, Ky. A Methodist missionary couple offered to help get a visa for Lansana.
In New York, Cohen got a telephone call as Zlotolow passed through London on his way back to Manhattan. Cohen had told Zlotolow just before he had left for Sierra Leone that she thought it was time for them to end their live-in relationship. But Zlotolow wanted to enlist her in his new mission.
Cohen was taken aback by the conversation. "He said, 'Well, there is this little boy and we are going to try to get him out of the country, and he needs an operation for a leg.' And that was really it. Then he said, 'I'll be home tomorrow.'"
They were hardly the words of a dissolving relationship.
Early in 2002, in Greenwich Village, the spiritual home of one of Zlotolow's idols, Bob Dylan, Lansana was roaming the streets with Zlotolow. Lansana had arrived by airplane in New York after his visa had been approved. Cohen agreed to help with the boy's adjustment to America. "The closest I could come to [describing his situation] would be like my landing on Mars and trying to find my way. And he was this little boy who landed in Manhattan."
"The first night that I put him to bed, he just was staring at me. And I realized he probably had never slept alone in a room before. As I was making the bed, I said, 'Do you want me to lie down?' And he nodded, and I lay down next to him. And he put his arms around me and passed out, just fell asleep. And I realized he was terrified. He was just this sweet little boy who was terrified."
Zlotolow sought treatment for the boy's leg, adamant that it be saved from amputation if possible. On the recommendation of other doctors, he took Lansana to Dr. Robert Rozbruch, director of the Institute for Limb Lengthening and Reconstruction at New York's Hospital for Special Surgery.
"His leg was probably about six inches short," Rozbruch said. "And it was about 45 degrees angled inward. And then the X-ray showed that he was missing the bottom half of his tibia, or leg bone, that is also the top part of the ankle. So, he had lost his ankle in the process as well."
Saving, Lengthening Lansana's Leg
Saving the leg involved a series of procedures that required Lansana to wear a heavy brace -- first, to correct the deformity and then to undergo surgeries that were designed to lengthen the remaining healthy bone.
"We gradually pulled that piece of bone downward, towards the ankle, to fill in the defect," Rozbruch said. "And in that way, we [were able to] grow him new bone and essentially reconstruct his ankle, and attach what was left of his leg to his foot."
In stages, the bone was lengthened by nearly eight inches. Though his right leg is still shorter than the left, Lansana is able to walk without crutches and play soccer and basketball.
His emotional adjustment also was proceeding well, with help from Zlotolow and Cohen. "He was trying to figure out who we were, and were we going to be there for him," Cohen said. "Were we going to disappear?"
Zlotolow had a grown son and Cohen, a grown daughter. Their initial plans were to place Lansana with a young family. They took Lansana to an interview with an interested couple. But they soon realized they couldn't give up what they had started. In the process of breaking up, Zlotolow and Cohen had become more involved than ever in Lansana's life. Their commitment was dramatically illustrated by a decision that Zlotolow made. At the height of his career, he gave up his position at Sloan-Kettering Hospital.
"My job at Sloan-Kettering was the best," Zlotolow said. "I was the most privileged person in my specialty in the United States. But my job required 14 hours a day. I was in the operating room three, four days a week. And, you know, I just made this decision that it would be too hard to balance with raising this child and giving him the things that he needed."
Both Zlotolow and Cohen moved to where they previously had lived before working in New York -- Oakland, Calif. There, they reasoned, Lansana could have space, a house, and a yard to play in.
Zlotolow and Cohen didn't get back together as a couple. They live in separate houses, about a mile apart. In the two households where Lansana divides his time, he is involved in constant banter with his parents, who both work to help him catch up on years of missed schooling.
"Ian's more like the messy house, like a boy's house, and [Wendy] likes to clean house and keep everything organized," he laughed.
He also has learned the art of diplomacy. When asked which path he would follow when he grew up, he said, "I might split up the house -- messy in one corner, clean in the other corner."
The wartime traumas Lansana experienced still lurk beneath the surface of his emotions. He sees a therapist that Cohen calls the "worry doctor." There also are moments when he seems to be lost in the past, although they are becoming less frequent.
"There was one time we were driving down the highway, in silence, and there were tears coming down his eyes," said Zlotolow. "And I am sure there are times when he must be thinking of his family in Sierra Leone, and he gets quiet."
One more enormous adjustment remained, and came suddenly. In 2003, After Ian and Wendy had started the complicated paperwork to adopt Lansana, Lansana's father showed up at the hospital where the boy had been abandoned three years before and inquired after his son. Ian and Wendy arranged a phone call with the father, then told Lansana.
"And I think he was stunned," said Cohen. "He started to cry. And then he got on the phone, and he spilled tears. And the thing was, he couldn't remember the language, to speak to them."
"I was shocked," said Lansana of the conversation with his father. "I couldn't understand him. So, I couldn't really say anything back. I just kept saying, 'Yes.'"
Lansana wants to stay in the United States; and his father in Sierra Leone offered his blessings for Lansana's adoption in America, happy that the child would be the first in his family to be educated. In an extraordinary ceremony on May 17, 2005 -- with Ian's grown son and Wendy's grown daughter in attendance -- the two people who couldn't stay together as a couple legally became Lansana's mother and father.
"He took special pride in that day," said Zlotolow. "He knew that he belonged. He had a family. And that family is for life. And you could just see it in his eyes and in his heart."
When their relationship with Lansana was described by an interviewer as "joint custody without a marriage or divorce," Cohen said, "The good news is, there is no ax to grind. There is no animosity. There is no fighting. There is a conscious commitment that this is a very special human being that's come into our lives, and we love him very, very much. And we want to do this. So legally, this poor child's name is 'Lansana Cohen Zlotolow Lapia,' which is really a mouthful. So it's 'Lansana Lapia,' for everyday stuff. But for the legal stuff, he has got us there, forever."
Zlotolow and Cohen keep photos of Lansana's father displayed in their houses. Zlotolow sends money to the family in Sierra Leone (siblings also have been located); and someday, Lansana will go back and see them. He says his memories of what happened there are vague.
"I'm not sure if it's a dream or not," said Lansana. "But I remember running off or something like that, like a war going on -- my parents getting apart. I'm not sure if it's a dream or not. But I remember that, and it always stays in my head," he said.
Today, said Lansana, "I don't have any more dreams of that kind. I just have American dreams."
Ian Zlotolow still plans to travel to places where he is needed, through the foundation he started, the International Society of Maxillofacial Rehabilitation. He's holding down two jobs, and still volunteering his time to help those in need at San Francisco's Laguna Honda Hospital.
Wendy works in magazine publishing. Lansana isn't sure yet what he wants to do as an adult. Through his father, he finally found out how old he is. The boy with the magical smile who has lived in through so many crises -- and who has changed a few lives -- will turn 13 in May.
"He has something to offer the world," said Zlotolow. "If everyone had his outlook on life, we wouldn't have wars. And I have been given this opportunity. And we have all just gone with it. And maybe I didn't give up anything. Maybe I just gained."