Chapter 7- Another Dialysis Machine

Annabel Biruete, NSMC intern summarizes chapter7

Another Dialysis Machine

After some post-transplant complications, the doctors were trying to figure out why Robert’s kidney was not working properly. They discovered that Robert had hydronephrosis, meaning that urine was not flowing from the kidney to the bladder. A new transplant surgeon joined the team and after a second surgical intervention, the surgeon was able to correct the problem by redirecting Vanessa’s ureter to Robert’s bladder. Once Robert woke up from the surgery, he was disappointed to find himself again connected to a dialysis machine, which could have meant that the newly transplanted kidney had failed. Luckily, he was relieved after the nurses told him that the new kidney was working properly and this time dialysis was used only to remove some of the extra fluid he gained the past few days, while his transplanted kidney was not functioning properly. The chapter ends with a marriage proposal, once Robert feels he can plan for the future with his new kidney.

In this chapter, the topic of race disparities in healthcare is highlighted. Even though at first Vanessa thought that the reason of the kidney transplant complication could have been laziness from the surgeon, Vanessa’s mentor brought up that perhaps subconsciously she believed it was a matter of race or implicit bias. This made her think that the surgery complications could have been prevented and that perhaps the surgeon would have done a little extra work if he had a personal connection with the patient (or if the patient was the same race as the surgeon). However, she did not want to feel that the complications were a matter of race.

This chapter, as the whole book, was eye-opening and let me realize--as a health professional working with hemodialysis patients-- the emotional ups and downs kidney transplant patients and their families go through. Not only the process of waiting for a kidney, which in a lot of cases may never happen, but the unforeseen complications after the transplant and organ rejection. Similarly, the psychological effects after a transplant, such as  anxiety and stress, just by thinking about “wasting” the kidney of a person we love, which seemed to be Robert’s biggest concern. Finally, this chapter made me realize how planning for the future may be avoided by some dialysis patients. This may be in part because the routine of an end-stage kidney disease patient is centered around dialysis: time to get to and from a dialysis center, treatment time, symptoms post-treatment, diet, medications, etc. Once a patient receives a kidney transplant, they will be trying to adjust to normal life, again.