Special Report

On Dialysis

In less litigious times, one didn't have to dialyze alone.

By 7.1.05

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When my kidney transplant failed this past March, I went into the hospital for an eight-day stay. During that time, surgeons implanted two catheters, one for home peritoneal dialysis in my abdomen, and one near my right shoulder in a vein for hemodialysis, the commonly referred-to "kidney machine." I would have to use hemodialysis for at least a month while the PD catheter healed. After several dialysis treatments in the hospital, I was discharged, and sent to a dialysis unit in Brookline for thrice-weekly treatments.

As I sat in the dialysis unit waiting room for the first time, it all came back to me. I had spent almost six years on dialysis from 1975 to 1981 in California. There were the patients of every age, of every ethnic background, from every walk of life -- kidney disease is very democratic. There was the ready good will among patients, a willingness to acknowledge that we were all in this together. There was the griping about schedules. There were the very ill, in wheelchairs, or using walkers. There were the blind and the amputees, victims of diabetes, which can cause kidney failure. There was the raucous, busy, no-nonsense staff.

But things are different nowadays, too.

Medical privacy legislation and the fear of lawsuits have raised barriers between patients and staff, barriers that were almost non-existent back in the 1970s. I made friends with my dialysis nurses. When torrential rains flooded Pacific Coast Highway, where I lived, I stayed in Santa Monica nearer the dialysis unit with one of the nurses. I didn't realize he was gay till I got there and encountered his live-in partner. It didn't make any difference. I dated one of the nurses, who I told unabashedly on her first day of work, "You're my kind of girl." One of my fellow patients, who became a friend, carried on a months-long affair with the head nurse, who was married.

We smoked on treatment. We ate. There were no television sets, so we talked with one another. When I finally got a transplant, one of my fellow patients, a black man from Louisiana, brought me back a country ham to celebrate the occasion.

WE HAD PARTIES, AND we had fun. The unit sponsored Christmas and Thanksgiving dinners, lovingly cooked to conform to our dietary requirements, with rock and roll bands and thimbles of champagne. On Halloween, Carl, one of the gay nurses, came to work wearing a nurse's tight white dress, with a name placard declaring him "Nurse Diesel." The Fedex man came, mumbling and dozing through his rounds, made a delivery, and held out a clipboard for Carl to sign. Only then did he notice that this tight-bodied nurse had a black beard. He fled while we all howled.

It was so much more casual in so many ways. I sold a rifle to the husband of one of my nurses. I brought the rifle in and leaned it against my chair while I got plugged in. The husband came in to see it, measured its comb and drop against his arm, worked the bolt, checked the trigger pull, and paid me for it.

We took casualties like an infantry platoon. Julie, who sat across from me during treatment, went in for a transplant. It didn't work. She returned to the unit with some kind of sepsis. She could no longer walk. She died. We had a terrible accident one day on the shift opposite mine. Instead of dialysate running through all the machines from a shared reservoir, someone threw a valve wrong and pumped water in. The water, in the kidney machine filters, burst blood cells in a series of patients, the worst nearest the reservoir. Burst blood cells release potassium, a poison. The three patients nearest the reservoir died. The next three had to be hospitalized with convulsions.

Maria, a dignified old Russian woman, died, not unexpectedly. I put on a yarmulke and went to her funeral. I still see her gorgeous twin daughters in television commercials.

Kathy, my kind of girl, had problems, I knew that. But I didn't know how bad they were. Shortly after my successful transplant, I came back for a visit and found out she had committed suicide.

Joanne, the new head nurse, who was Kathy's friend, told me, "She had apparently been planning it for months. She bought tickets for a tennis match in Las Vegas, because she wanted to see John McEnroe play tennis. As soon as she came home, she injected herself with insulin. Covered her face up with a towel."

THESE PEOPLE WERE kind to me. Two tough nurses browbeat me out of an addiction to prescription painkillers. Three of my pals among the staff, young women from Chile, used to take European trips together, and they would bring me presents. I am still friends with one of my former fellow patients. We shared bylines on a dozen or more stories together; he's a writer, too.

All these memories make me think. I dialyze at home now, and no longer have that social connection with treatment. But last week, while I was running an errand at the hospital, I met a fellow peritoneal dialysis patient who lives in the town next door. I really should get in touch. We bonded instantly, and he likes to play golf too.

Lawrence Henry writes every week from North Andover, Massachusetts.

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Lawrence Henry writes every week from North Andover, Massachusetts.