Richard Freimark has something in common with approximately 96,000 other Americans.

He needs a kidney.

Kidney disease is an unfortunately common story. What’s perhaps less common is that, despite the incidence of kidney disease being no more frequent in Jewish populations than the rest of the country, the Jewish community has responded to the issue in an organized and meaningful way.

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Freimark’s journey with kidney problems began when he was a teen; while delivering holiday baskets for his father’s bakery, he handed one to its recipient, a doctor, and noticed a pain in his wrist. The doctor examined him, took a sample of fluid from the noticeably swollen wrist, and found uric acid crystals in the fluid. Further testing revealed that the concentration was in the hundreds on a scale where, Freimark explained, “anything over 10 is problematic.”

Freimark was put on a high dose of a medication which reduces the concentration of uric acid in the blood and told, he recalled, “by the time you get to 50 or 60, you’ll have kidney failure.”

While Freimark wasn’t one of those 96,000 -yet- he joined another club that day. Approximately 35 million Americans have some form of kidney disease. It’s a club that’s gotten larger since Freimark joined it.

“The incidence is higher because, you can see the rate of obesity is higher,” Dr. Karen Douek, a retired nephrologist living in Portland, explained “Type2 diabetes, which is related to obesity, high blood pressure. Look at the way Americans live in general.”

While many instances of kidney disease are related to lifestyle factors, many cases are due to genetics. Freimark falls into the latter camp; his father and grandfather both suffered from less severe kidney-related diseases, and while the Holocaust wiped out any medical records going farther back than that, one of his sisters and his son also have kidney issues. As soon as he was diagnosed, Freimark became diligent about keeping those lifestyle factors from aggravating the situation.

“I stopped eating red meat. I never drank any alcohol. I did a very careful life structure,” Freimark said, to hold off the disease’s progression. He’s also very physically active.

It was that activity that let Freimark know that last summer, at age 71, he’d finally ended up where his doctor from his teens said he would. It was while he and his partner were driving to visit Canada. They’d stopped to see a friend in Bellingham, and Freimark felt noticeably fatigued, though he chalked it up to the 95-degree weather. The lethargy didn’t go away.

“The whole vacation, I was just really tired,” he said.

The first thing he did when he got home was go to the hospital. The levels of creatine and other toxins in his blood suggested he’d had a heart attack. He was admitted on the spot.

“That was on a Wednesday night,” Freimark said. “And then Thursday morning they put the port in, and Friday I had my first dialysis.”

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Dialysis is the reason that there are far more people living with kidney failure than with most other types of organ failure; there’s no stopgap measure for liver failure, for example. But dialysis is just that – a stopgap measure, and there are some drawbacks.

“Most people can’t work, they’re exhausted. It’s a terrible experience tethered to a machine,” Rabbi Josh Sturm, the Director of Outreach at Renewal, explained. “Besides all of that, the long-term survivor rate on dialysis is not very good.”

Because dialysis only manages 10 to 15 percent of what a healthy kidney can do, Rabbi Sturm explained, the average survival time on dialysis hovers around five years – unfortunately, this is also the typical waiting time for someone entering the back of that 96,000-person line for a kidney.

“There’s a potential solution that’s called kidney donation,” Rabbi Sturm said.

Renewal is here to help make that happen. Founded in Brooklyn by Mendy Reiner in 2006, Renewal exists for the same reason that JCCs, Jewish family service agencies and other similar organizations exist – when the Jewish community needs something, it tends to be the case that the Jewish community builds it. So, when Jewish people need kidneys, Jewish people respond. The Talmud, in Tractate Shevuot, puts it more succinctly: “Kol Yisrael arevim zeh bazeh.” (All of Israel are responsible for one another)

“I think what motivates the Jewish community in a strong way is that there’s a very, very strong sense of community. We identify with each other. And even if we’re not exactly alike, but we identify as one people, as one nation, and therefore, I don’t know you, but you’re still my brother,” Rabbi Sturm said. “There’s a very, very strong sense of that communal bond.”

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Some of those communal bonds are stronger than others.

Marshal Spector came to Portland in 1990 and joined Congregation Shaarie Torah, where he quickly connected with the synagogue’s cantor, David Rosenberg, z”l. It turned out that Rosenberg’s adoptive father, a world-renowned cantor, had studied with Spector’s great-grandfather in Europe in the 1930s. The two men’s children became friends, and they shared an affinity for Judaism and hockey.

“David became sick in the late 1990s and the early 2000s; he had various health issues over time,” Spector recalled. “At some point, his kidneys began to fail.”

Due to his adoption, Rosenberg was not in touch with any of his biological family, Spector said, and turned to his community in search of a potential donor kidney. Several individuals volunteered to be tested for a match; Spector’s tests came back positive, and he agreed to donate a kidney. It was not a decision, or a process he took on lightly. Spector embarked on a holistic process to prepare himself for the procedure.

“I picked up my exercise quite a bit. I saw a therapist to help with mental health,” he recalled. “I looked at alternative medicine and I saw an acupuncturist and a naturopath because I wanted to not only bring the wisdom and experience and proficiency of Western medicine, which was going to be the actual donation part, but I believed in also bringing in anything I could in terms of my mental health, my physical health, and everything else.”

That included diving further into his Jewish learning to understand the halacha (Jewish law) and teachings of Jewish sages around the subject.

“We are not supposed to desecrate our bodies, but we are also obligated to help people, to help preserve life,” Spector recounted. “There has been a whole body of Jewish law, especially as these types of things became medically possible, about whether it is forbidden for someone to be a donor, whether it is required for someone to be a donor, or whether it’s just permitted. My understanding of Jewish law is that it is neither required nor is it forbidden, but it is permitted to do this.”

Spector, a father of three who’s children were aged 16, 14 and 12 at the time of his donation, also included his family in the process, having his doctors speak with them and soliciting their input.

“My younger son, who has a great sense of humor, asked the surgeon if they could remove the Blackberry (mobile phone) from me along with the kidney,” Spector recalled. “My older son, who was 16 and was very thoughtful about it, he well understood the risks that I was taking, said, ‘Dad, if you ever need a kidney, I’ve got your back.’”

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Family can provide more than support in these situations – they’re usually the first place people turn in search of a kidney. While Rosenberg did not have that option, Carol Danish did when she was diagnosed with polycystic kidney disease in 1999. Just after the turn of the millennium, she received a kidney from her daughter, Debbie Plawner; it was the third kidney transplant surgery performed at Legacy Good Samaritan Hospital in Portland.

“I knew where it came from and I knew she took good care of it,” Danish said of Plawner’s kidney.

Plawner, one of whose sisters is Rosenberg’s wife, Kim, has gone on to help friends like former Jewish Federation of Greater Portland professional Jen Feldman find kidneys and co-organize local events for Renewal along with Spector and Devorah Wilhelm, whose husband, Rabbi Moshe Wilhelm, received a kidney donation.

“Everyone that I know that’s donated a kidney, the reward has been the person and the moments. My mother holding my babies, my mother going to their high school graduations, my mother celebrating their college graduations. That’s the reward,” Plawner said. “Someone who does it for a stranger takes that reward in a different way than I do, but they take that reward and that’s still the same reward. It’s the awareness that person lives. It’s a big one.”

Plawner’s kidney spent 16 years in Danish – an average run for a live donor kidney, Rabbi Sturm of Renewal said – before it stopped working. Danish then received a second kidney transplant, this one from a deceased donor.

“I was in dialysis and the person who was in charge of the dialysis unit was on a portable phone and I saw him walking toward me and motioning with his finger, ‘this is for you.’ I got so frightened because I thought somebody was in an accident or something like that,” she recalled. Instead, the woman on the other end of the call asked “What are you doing at 5:30 tomorrow morning? We’ve got a kidney waiting for you and we want you to come in so you can have a transplant.”

Danish was Number One on the transplant list – “you were sicker than you thought you were,” she recalled a doctor telling her – and a deceased 7-year-old’s parents had agreed to donate their child’s organs.

“I’m keeping it for the seven-year old,” Danish said of her kidney. “He’s now 17.”

Of the approximately 21,000 kidney transplants done in the United States last year, about 15,000 involved organs from deceased donors.

“The problem is that it didn’t move our waiting list at all,” Rabbi Sturm noted “We’re adding more and more people to the waiting list, and we’re not lowering those numbers despite how many transplants that we’re doing a year. That is the difficult reality that we face, and that’s why this idea of kidney donation has become something that’s been talked about more and more.”

Each one, however, is special. Just ask Danish.

“The grass is greener to me, and the sky is bluer. I’ve been totally optimistic since this surgery because I realize that I’ve been given a gift of life, and it still surprises me the length of time not only that I’ve had, but also the simchas, the joys in my family that I have seen,” she said. “I’m a grandmother, I’m a great-grandmother, and my family is very close and very supportive of me. It’s a blessing.”

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Giving someone that kind of joy starts out very simply. Renewal’s Rabbi Sturm explains how simple the initial testing process is for someone who is interested in donating.

“We mail them a kit, which is literally just two Q-tips. They swab the right cheek, they swab the left cheek, completely painless, and they put it back in the envelope and mail it back to us,” he said. “I tell people if you could brush your teeth, you could swab.”

If a potential match is identified, there’s more testing to confirm it – the better the match, the lower the risk of the recipient’s body rejecting the donated organ.

“We worked with the hospitals and hospitals have become a lot better, many of them at least, of treating this donor like the hero that they are,” Rabbi Sturm said. “We’ve had a hospital that kept their lab open after hours so that the potential donor could come in after work and they don’t have to take off a day from work to go for a lab.”

All procedures related to donations are typically covered by the donor’s insurance or the facility performing the transplant. The surgery is more invasive for the donor than the recipient, but advances in laparoscopic surgical techniques have made the process smoother than before.

“The physical recovery was actually better than I was told it might be and better than I anticipated,” Spector recalled of his donation. “I was walking and eating and sleeping comfortably within a few days.”

He was back to work in a couple weeks. Three months later, he was ready to play in BB Camp’s annual Men’s Camp basketball tournament – he joked that, though it was not a concern, he told opponents they couldn’t elbow him.

“I think that one of the best rewards of even entering into the process of being considered to be a kidney donor is that you are put through all of the tests to evaluate both if your kidney is healthy and if you are strong,” Plawner said. ” The result is that if someone says yes to you, that’s because you’re really healthy.”

Make no mistake: it’s a significant procedure, but it’s not debilitating.

“I’ve heard people on the street tell me that, ‘oh yeah, kidney donors, they’re going to be out of work for like 6 months, right?’ Or ‘kidney donors, they have to take medication for the rest of their life.’” Rabbi Sturm related. “Both of those are completely false.”

Plawner explained that, with a single kidney, she’s very careful about staying hydrated. Spector said he no longer uses Advil (its active ingredient, ibuprofen, puts stress on kidneys) and has quit white-water kayaking following his donation.

They’d both do it all over again.

“You do anything for them,” Plawner said of her family. “If I could give another kidney, I would have given another kidney.”

“In some ways, this was one of the easiest decisions of my life, knowing that while there was some risk to me because I would be undergoing surgery while I was totally healthy and giving up a kidney,” Spector said, “it was one of the easiest decisions because I was able to do something to save a friend’s life.”

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A friend. A family member. Or a complete stranger. The last of those is the life Dr. Douek, the retired nephrologist, saved with her kidney donation.

“I always knew I was going to do it,” she said. “As a nephrologist, I know I only need one.”

She had a friend who needed a kidney, but they weren’t the same blood type. A paired exchange was arranged, where a donor and a recipient who know each other are linked with another donor/recipient combo, but before the surgery happened, Douek was in a bicycle accident and sustained a severe concussion.

“Around the same time, I read this article about a firefighter,” she said.

The firefighter, who had been assigned to a station near Beaverton-Hillsdale Highway that sent other personnel to Douek’s crash, shared Douek’s blood type, she found, and she knew the reporter who had written the piece from a swimming group a decade prior. Douek got connected, the arrangements were made, and Douek donated her kidney in 2025.

Though she’d known she wanted to donate at some point, Douek explained that the aftermath of Oct. 7 ended up spurring her on.

“I think October 7th, honestly, made it really important to me. I’ve been hurting so much. I’m a secular Jew, but my parents are from the Middle East, exiled Jews,” she explained. “I only heal by giving. That’s the type of person I am. [Donating has] actually made a huge difference for me. Just that act of giving, like it’s a gift, but that gift was really to me. It’s a gift I gave myself.”

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It was a gift that kept on giving for Spector.

“People offered to help drive my kids or take my kids places. People gave tzedakah (literally “justice’ in Hebrew but usually translated to “charity”) to all types of places in honor of this,” Spector said. “It created a feeling of goodwill in the community that people learned about what was going on.”

A lot of people learned, thanks to a piece in The Oregonian (“Timeless faith, renewed life,” Sept. 16, 2007, re-published Dec. 20, 2014), including someone in Lake Oswego who knew a woman at their church who needed a kidney. Inspired by the Oregonian piece, an appeal was made to the congregation for a kidney donation. From that church, a donor was found who saved their fellow parishioner’s life just the way Spector saved Rosenberg’s.

“You never know, when you do a mitzvah, what the effect might be for others and how one mitzvah can lead to another,” Spector said.

Spector has performed plenty more mitzvot following his donation, even as people joked to him that the donation would mean he’d never need to attend synagogue again.

“One of the beautiful things when you do things for others, that it encourages people to find deeper meaning in things,” Spector said. “It helped me find deeper meanings to things in my life, to try to become a better person, to try to become a better parent, to try to become more active in the community.”

Spector often reflects on two pieces of Jewish wisdom in regard to his donation. One is a famous idea from the Talmud, most notably paraphrased in “Schindler’s List” as “whoever saves one life, saves the world entire.” The second was from a piece written by Shaarie Torah’s then-rabbi in the congregational bulletin just after Spector’s donation.

“His message at the time was that while my donation of my kidney added days to David’s life, it added life to my days,” Spector recalled. “It really has.”

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Those days are what Freimark is hoping for. Next month will be his 12th on dialysis. Three days a week, five hours at a time, with each session beginning at 4 am. He’s doing his best to get ready for the kidney he’s looking for.

“I’m very active, I walk a lot, I have a trainer,” he said.

He’d started exercising more and cut out the small amount of alcohol in his diet four years ago when he and his kidney-disease-afflicted son-in-law both committed to a more kidney-friendly regimen; Freimark had already cut out red meat, pork and shellfish long ago.

Unfortunately, no one in his family is a match.

“My oldest sister has cysts on both her liver and her kidney; she’s four years older than me. My middle sister, who’s 14 months older than me, only has one kidney and my other sister, who is two years younger than me, she has kidney disease as well,” he said. “My daughter is not a match at all for me, but she’s a perfect match for her husband. who has kidney disease, whose father died from kidney disease. Until you get in this arena, you don’t realize how many people have kidney disease.”

Thus, he has been forced to go looking for a kidney – that’s where Renewal has come in.

“I wish we were, but we’re not an organization where we have a refrigerator full of kidneys and you just walk in and we say, ‘what make and model would you like?’” Rabbi Sturm said. “I wish it worked that way. The reality is it doesn’t. So, what we do is we help to strategize with that recipient the best ways of bringing in their own donor through these different outreach methods, and what we’re really good at is assisting the donor throughout the process.”

Freimark, already amongst the club of 96,000 Americans who need kidneys, hopes to transition to the smaller club – more than 1,500 members, at this point – of people who Renewal has helped secure kidney transplants for.

Spector frames it differently – there’s just the one club.

“The human body doesn’t care about gender, about sexual orientation, about race, about religion. about economic status, about nationality and, certainly these days, about any political leanings,” he said. “Being a match to save a life, to donate a kidney, is basically about the biological merging of one human to another; the club here is just a human club.”

If you or someone you know is interested in potentially donating a kidney to Freimark, contact Oregon Health and Science University’s Living Donation Program at 503-494-8500 or at livingdonation@ohsu.edu. Learn more about kidney donation at renewal.org.

PHOTO: Richard Freimark leads a bread-baking class at The Shuk Sunday, June 21, at the Eastside Jewish Commons. (Rockne Roll/Jewish Review file)