One of my favorite essays is titled “You May Want to Marry my Husband,” and it inspired these reflections as I prepare to leave my job as a Social Worker in a dialysis center in Richmond, Virginia.
You may want to work at a dialysis center, I know I have enjoyed these last five years serving dialysis patients and their families. Prior to working here, like many, I didn’t realize Chronic Kidney Disease affects approximately 1 in 7 U.S. adults. The final stage of kidney disease can only be treated with dialysis or a transplant leaving many people asking “What will I do if my body outlives my kidneys?”
In many ways we are lucky, the kidney is the only organ that has a form of life support that isn’t needed continuously. Most dialysis patients simply come in for dialysis treatments three times a week for about 3-4 hours each time. Imagine if patients with severe lung disease could exist for years only using a ventilator 12-16 hours a week? Dialysis patients typically live an additional 5-10 years after beginning dialysis. Those extra years give patients time to watch their children or grandchildren grow up, continue working, take up a hobby, or whatever else they enjoy. I will never forget a patient’s daughter who told me, “Mom would have never saw her grandchildren get married or meet her 4 great-grandchildren if she didn’t start dialysis. We are so grateful she made this sacrifice for us.”
Sacrifice it is- many patients describe dialysis as feeling like a part-time job which unfortunately is neither paid nor comes with time off! Between getting to treatments, the actual dialysis, and waiting for sites to stop bleeding, the whole endeavor usually takes 4-6 hours. Not to mention most feel tired and take a nap when they get home.
Of course, you can’t talk about the sacrifices of dialysis patients without mentioning the insane diet which includes limiting all fluid consumption to 32 oz daily, avoiding phosphorus which is in about every delicious thing you can imagine: cheese, nuts, chocolate, dark sodas, etc., and foods high in potassium such as French fries and bananas.
But, I said you may want to work at a dialysis center so surely there must be more to it and there is. There is something incredibly special about supporting a group of people who could have died, but got another chance at life through dialysis.
Many patients talk about their “dialysis family” which includes fellow patients, the loved ones or staff who drive them to treatments, and caring staff members. Especially during the first year of the COVID-19 pandemic, many patients saw their dialysis family far more often than their own family and friends. Patients do special things for each other like bring each other snacks, yell across the treatment floor about last night’s game, and ask about their families. During both my pregnancies, I essentially had 50 honorary grandparents who asked how I was feeling, commented as baby grew, and cheered me on when I got back to work. Especially after my oldest daughter was born, many patients would rush through my assessments so they could hear what mattered most to them—“How is the baby doing?!”
None of my grandparents are still living, and I really treasured the support my patients showed me. I will never forget the patient who said “Soon you will understand why the expression ‘slept like a baby’ makes absolutely no sense. Babies wake up every hour crying.”
Like any family, we celebrated the little things like making it to Friday and the big things like a patient getting transplanted. In November I often helped patients create a gratitude board and it always humbled me to see how many people were simply grateful to be alive and have family in their lives. I will also
never forget the man who lived in a nursing home who was so excited about his “Big TV” a family member gave him that year. He loved watching jeopardy and his “stories.”
Of course, the hardest part of working at a dialysis center is facing death, although even those situations reveal the beauty of a life well lived. Sometimes patients decide to stop dialysis and begin hospice services. That often is a hard choice after steady or fast decline often brought on by other health complications. I will never forget the conversations with patients facing this choice but wondering “Would I be killing myself? Can I still go to heaven?” Holding hands and sometimes with tears I would look in their eyes and say, “You would just be allowing a natural death to occur. My faith says that is okay.”
One patient decided to stop dialysis after a series of hospitalizations spanning several months including a foot amputation. His wife was prepared that her husband might die just a few days after stopping dialysis so she got the family together to celebrate his birthday a little early. I called him after the party and he loved it—his siblings, children and grandchildren all came and brought his favorite foods. In some miracle he lived several more weeks and got to see his actual birthday and enjoyed the little things like coffee, donuts, and visiting with family. When he passed away, it seemed like he and his family had found peace and that was a beautiful thing to witness.
To end things on a happier note, I will say that there is some sort of magic that happens when a person has nowhere to go for the next three hours and there is a willing listener. I have heard stories of childhoods spent in the county picking cherries, fishing, and sleeping on the porch to escape the summer heat. Stories of the blatant racism in our city’s past (e.g. closing the pool at Byrd Park in lieu of integrating). Stories from a former IT person who stayed at work overnight with the threat of Y2K only to realize nothing happened after midnight. In our busy lives, it’s easy to forget how special it is to sit down and listen to someone share a story.
So maybe you should work at a dialysis center or at least find the chance to sit down and listen to somone’s life story. You will be changed in the most beautiful way.







































































































































