Four years ago, 7-year-old best friends Mai Frandsen and Mae Rainey were adopted from a southern Chinese orphanage into families on opposite sides of the U.S. Now 11 years old, the girls both received treatment at the UCSF Benioff Children’s Hospital in Oakland, California for a genetic blood disease.

The girls share thalassemia, a genetic blood disease that inhibits the body’s ability to produce oxygen-carrying hemoglobin. Without blood transfusions, patients with the disease will become severely anemic and may die.

“If they don’t get transfusions, children will die in the first few years of life,” said Dr. Ash Lal. Lal runs the thalassemia clinical program at the Benioff Children’s Hospital.

The girls’ health improved with their new families, as obtaining adequate blood transfusions in China for orphans can be difficult. Many adopted children with the disease who didn’t received treatment have additional problems such as organ damage or growth impairment. The Oakland hospital opened a special clinic for adopted Chinese children with the genetic disease to help them recover.

After Mae was adopted in November of 2011 by the Rainey family in Charlotte, N.C., she mentioned life in foster care and the orphanage frequently, especially her friend “Sing-Sing.”

“For 3½ years, she would say to us, ‘Do you think we’ll ever find Sing-Sing?’” said Bryan Rainey, Mae’s father.

Rainey and his wife Robin didn’t know who Sing-Sing was, whether that was her real name, or if she would even keep the same name if she was adopted.

Mai was adopted in May of 2013. Both of the girls were given new names upon adoption; the fact that they were given the same name is a coincidence.

Mae eventually required a bone marrow transplant to cure her disease. In the process of finding a donor match, her family found Mai on the same list. The parents exchanged photos and the girls recognized each other immediately.

“Mae said that’s her. That’s her best friend,” Bryan Rainey said.

When the girls first talked over the computer, they were shy and quiet. Their parents realized they would both be at the Oakland hospital and decided to meet there.

The meeting was awkward at first and both girls were nervous, later calling their meeting “weird.”

“At first you don’t know what to say. This is a stranger to you,” said Mae. But by the next morning, it was as though they’d never been apart, and they said they’ll be friends forever.

“They were both really nervous,” said Heather Frandsen, Mai’s mother. “I don’t know if my Mai really believed it was going to happen. But when we got back to the room that night, after they met, her whole demeanor changed. I think when Mae left the orphanage, that was really traumatic for my Mai. I think Mae was her person. You know, that one person who means everything.”

As for the girls, they never thought they’d see each other again and are thrilled to be together.

“It’s just crazy,” Mae said. “You know, in Chinese, mei-mei means sister.”

Besides writing, R. McKinley loves reading (especially historical fiction and science books), playing piano and flute, being involved in politics and community, working out, enjoying nature, and hanging out with four wonderful cats.