Insight of the Week

Sometimes someone says something that just resonates in your very soul as the truth and you can't stop thinking about it. This is what happened this past Saturday at the Kidney Beings (cute, huh!) support group meeting.

I voiced my frustration and anger about the miscommunication, withholding of information, and insufficient training I have experienced with the PD clinic. One long-time support group member said she thought I had been treated shabbily and had been inadequately trained in PD therapy, but then added, "Just remember this, Heidi: Long after you are dead, everyone at the PD clinic will still have a job."

Boy, there are so many ways one can take what she said! In its tamest form, it means: Don't get yourself worked up about things you can't change. You're dealing with an entrenched system that is sometimes dysfunctional, but it is too big of a job to try to reform it. All you need be concerned about is your care, not changing the way an inefficient and faulty system operates because 20 years from now, it's probably still going to be operating in the same dysfunctional way.

A harsher way of viewing her comment is most likely also true: So many kidney patients die within a few years of beginning dialysis. In fact, the average life expectancy on dialysis is only five years. So, during the course of a career as a PD nurse or a nephrologist, one is apt to see many, many patients die. So perhaps they figure that inconsistent instructions or no instructions or the wrong doses of medications are no big deal, that if it's not this that kills a patient, something else will. So in other words, sloppiness is not something that needs to be prevented because there's so much that can go wrong with a kidney patient that some slip-ups could never be tracked back to a single cause.

Also, as in any profession, for most people, it's just a job, something to pay the bills. It's not a life calling or a mission or a labor of love. If I die or if 40 percent of the patients die in any given year, so what, we still get a check!

I am so grateful for Debbie's comment. It puts everything in perspective. Her comment makes it clear that I can't assume that the nurses and doctors are focused on their job. They could very well be like the grocery store clerks who, when you tell them you don't need a bag, they look right at you, say "OK," and put your purchase into a bag.

The bottom line is that I have to watch out for myself because no one else may be doing that. I have always been an ask-questions patient, an informed purveyor of medical services, but now I will have to increase my vigilance. Because that's MY job!