#24. A different sort of relationship - Dec 2011

When I met with the transplant nephrologist, he started by explaining that our relationship was very different than most relationships he has with patients. He has nothing to give me; I am not sick, I have not come for treatment for anything. He stated his bias; he sees a lot of really sick people, and he knows he can help them if he can find kidneys to transplant into them. So he is obviously pro-transplant. But that his first priority with me is to see that my health would allow me to safely donate a kidney.

In response to my question, the doctor explained that the majority of people with kidney disease aren’t candidates for transplants. They may have gotten kidney disease very late in life, or they have other complicating factors that do not allow them to undergo an operation like that.   But if they are a candidate for a kidney transplant, and they can get a kidney in time, their health will be significantly improved.

People sign their donor cards, which is good, but there are only a small number of people who die in such a way that their kidneys can be used for someone else.  Kidneys from live donors have a far greater success rate than from deceased donors.

Something he said at the end of the appointment sticks with me. He said, “Imagine if we could cure cancer by transplanting…”  I never thought of it that way before; everyone is searching so hard for a cure to cancer, people are running and biking and raising tens of millions of dollars to find that cure. For people with kidney disease, they are dying too. And some people can be cured of kidney disease. It’s just that there aren’t enough kidneys to go around.

The doctor told me the story of a young man he had seen earlier in the day. He had had a kidney transplant, but it failed, and now he is back on dialysis. They want to give him another kidney, but he keeps having antibodies against every kidney that they test for him. So it’s a very frustrating and long wait time for him…

Somehow I got the sense that being this doctor is both very rewarding and also excruciating. Rewarding because you can give people really good news, and help them get a new kidney so they can live long and healthy lives. But excruciating because there are people you want to help, but you can't because you can't create a kidney out of nothing, you have to wait until one becomes available. Until someone dies, or a donor is found that matches. And sometimes you can't find a match in time, and the person dies. I think it would be a very intense job to have.