Who Lives?

Yesterday afternoon I attended a matinee performance of "Who Lives?" at the Pico Playhouse with friends Susie and Alexi. This play had been recommended to me by a social worker, and Alexi knew about it because the playwright had been her short story-writing teacher. It's based on the 1960s review board that decided who would receive dialysis and who would not. The number of machines available at that time was limited, so only a very few kidney patients were given the chance to live. Without dialysis, they died of uremia in which the body becomes overloaded with toxins, resulting in nausea, fluid overload, and retching. An unpleasant way to go. A way that I had just a few months ago contemplated.

As a dialysis patient, I wished that all the nurses, doctors, and support personnel from the PD clinic I attend would have seen this play. Though all are proficient at the administration of their medical tasks, and most are generally cheery, they could all use a lot of help in how they deal with the emotional, social, and psychospiritual aspects of dialysis.

Perhaps I've written this before, but during my darkest days in January and February, I broached the subjects of hopelessness, a sense of imprisonment, and a weariness with all of this on four occasions with four staff members--a doctor, a nurse, the dietician, and the social worker.

The doctor was the most poised, but told me things happen in life, and I just had to adapt. True, if this were an intellectual discussion, but the topic was emotions.

The nurse quickly pointed out that cancer patients have it worse than me. I told him that may be true, but his is a silly game because I could easily counter with, "Yes, but a whole lot of people have it a whole lot better than me too."

The dietician said her husband was experiencing back pain, and that he, too, is upset about not being able to do the things he once was able to do. I could tell she was worn out with his complaining and was putting me in the same category as him.

The social worker also brushed off my despair, saying it wasn't that bad.

So, instead of listening as one human being to another, they all gave "shut up" messages. They were outside their comfort zone and wanted desperately to return to the practical and logistical aspects of dialysis.

In an after-performance discussion of "Who Lives?" with the playwright, producer, director, and cast members, an older lady who identified herself as a nurse said some things I wish the entire PD staff could have heard. Actually, I wish every healthcare professional in the entire nation could have heard. I can't quote her, but I will put the following in her voice nonetheless, as this was the gist of her message: "It's so rare that we think of the patient as a human being like us. We get so caught up in administering this treatment or giving this pill that we don't stop and realize how what we're saying and doing is affecting this person. I thank the playright and the actors for making this so clear. Patients are people with feelings and with a life that we need to respect." Granted, this is a paraphrase, but it's what she conveyed, tears close at hand. I got the impression that her entire career had been focused on medicine and not on healing, which necessitates a human-to-human bond.

The producer said that a few physicians had attended previous performances. I sure wish this play success elsewhere--and a deeper inroad into the community of nephrologists and dialysis nurses. Just think if every performance would result in at least one epiphany. And that transformed doctor or nurse would affect the practice of his or her colleagues. This could radically alter healthcare in this country.