Another Perspective

Waiting

Three years is a long time to go without a kidney.

By 2.14.08

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On my favorite Rolling Stones album, Aftermath, the LP, the song that comes just before the well-known "Under My Thumb" is "I Am Waiting."

I am waiting
I am waiting
Oh yeah, oh yeah
I am waiting
I am waiting
Oh, yeah, oh yeah
Waiting for someone to come out from somewhere

The song bears the unmistakable Elizabethan cast of the late Brian Jones, the Stones' rhythm guitarist and multi-instrumentalist of the sixties. Like many another song of the era, it doesn't seem to be about much of anything, while, at the same time, it evokes a great deal.

"Escalation fears," the lyric says at one point, employing a word freighted with meaning at the time -- of an increased military commitment in Vietnam. "Oh, yes, we will find out."

I GOT MY FIRST kidney transplant in 1981. I had been on dialysis by that time for six years. Thank heavens I was young and strong when I started that ordeal. I saw people wither and die under the slow torture of the kidney machine.

Every group of doctors has a culture. How those doctors behave, what treatments they pursue, all grow out of their culture, their belief system. The doctors I had fallen in with believed in dialysis, and did not push transplants.

Doctors' cultural leanings dominate their practice to this very day. I have recently left the nephrology and transplant practice of one of Boston's large teaching hospitals. I came to see this large teaching institution as hidebound by process, unfocused on results.

With my wife's help, I found another transplant center in New England where I have now enrolled and transferred my waiting time. I'm back on dialysis again. That first kidney failed after 21 years. Another transplant, from my sister, never really kicked in, and failed after two years. That was three years ago.

I AM WAITING. I have signed all the papers, gone through all the tests, and I am waiting. I probably won't wait too long. At my new transplant center, my blood type typically gets a transplant in about three years. I have been on dialysis three years now.

As part of the intake process, a transplant candidate gets interviewed by a social worker. The social worker asks you about your "support systems" (sounds like an Erector set) and such, and always inquires if you are suffering from depression or anxiety.

What I said this last time, having been through this before, was that I was in tough physical shape, and that I sometimes felt down about it, but that I regarded that feeling as a rational response to circumstances, not as depression.

The days go by, all very much the same. Five times a day, I hang a two-liter bag of dialysis fluid (sugar water, basically) on an IV pole, attach it to my belly via a catheter, and let the fluid pour into my peritoneal cavity. About three hours later, I drain the two liters out, finding it has been augmented by 500-800 ccs of body waste (it's pale yellow), and add a fresh bag.

THAT IS WHAT is called continuous ambulatory peritoneal dialysis (CAPD), a far more merciful procedure than hemodialysis, the old kidney machine, which pulls your blood out and squeezes it through a filter and then gives it back to you, round and round, for three hours every two days.

CAPD imposes some limits on what I can do, but it lets me read, watch TV, work at the computer, or even, if pressed, get my boy fed and dressed in the morning and off to school, feed the dog, eat a bowl of cereal, have a cup of coffee.

But today is one of those days when the hard physical circumstances have gotten to me. Yes, it is a rational response to circumstance. But there it is. I am waiting.

Oh, yeah, oh yeah.

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About the Author

Lawrence Henry writes every week from North Andover, Massachusetts.