My Dialysis Calendar
by James A. Michener
April 24, 1997
When nephritis hit me some years ago I knew nothing about dialysis
and had barely heard the term. But in the intervening years --
now four or five -- I learned a lot, thanks to the help of the
doctors and nurses with whom I worked in Austin. They were superb
teachers and were patient in teaching me the rules.
Once I began treatment, I quickly adapted to an obligatory Dialysis
Calendar. Monday, Wednesday and Friday became days sacred to the
dialysis system. I never was late in reporting; I never missed
a day. Even to think of shortchanging the requirements of dialysis
sends a shudder through me.
When I finish each three-and-a-half hour assignment on the dialysis
machine, I come home exhausted and must take a recuperative nap.
This means that I must conduct my normal life, including such
social occasions as develop, on Tuesday, Thursday and the weekend.
It is amazing how many people want to see me to talk about various
aspects of my life, but it is obligatory that their visits occur
on my days away from dialysis. In a dozen or so very important
meetings, such as those with my longtime agent Owen Laster, or
my editor at Random House, or dear friends like Stan Musial, the
great All-American baseball player or Ed Piszek, a Philadelphia
business man who has joined me on many projects, I am able to
see them briefly right after my dialysis session, especially on
Friday with a carry-over to Saturday or Sunday. I treasure these
meetings and end them exhausted. But since I recuperate quickly,
the next day I am in pretty good shape.
So Tuesday and Thursday are precious days. I reserve them for
the people who work with me or for special visitors like Lady
Bird Johnson or Hall of Fame pitcher Robin Roberts. I tend to
end my Tuesday and Thursday sessions at about 3 p.m., after which
I take a nap. This Calendar, rigidly but willingly adhered to,
is the basis of a fairly satisfactory overall life.
I do not go to my dialysis on Monday, Wednesday and Friday with
any reluctance. I have enormous respect for the doctors, nurses
and assistants who care for me and for the some 60 other patients
coming to dialysis these days. They make up a splendid group.
I have an affectionate regard for the wonderful way in which they
treat me. But fundamental to everything is my gratitude that I
lived into the period when dialysis chairs were numerous and well-attended.
I have heard many tales of the period here in Austin some years
ago, when there were only one or two chairs and when the Death
Squad met to allocate them among the many claimants who needed
them. In those evil days when the Squad, composed of caring doctors
and wonderful nurses, finished their work, it meant that patients
A, B and C would get use of the chairs, while the unfortunate
patients D, E and F were sentenced to death.
I have felt convinced since my first days of dialysis that sometime
around the year A.D. 2010, some radical new system of dialysis
would be invented. Recent miracles with cloning, as performed
in Scotland, could mean an unlimited supply of healthy kidneys.
Or the brilliance of our medical explorers could very well come
up with some new system that I cannot visualize. The bottom line
of my personal reaction is that even under the rigid dictates
of the present system, a reasonably happy life can be achieved
if one is willing to meet the system halfway.
But I am always mindful of the mournful young man I met during
my first weeks in dialysis. He was 32 years old and a handsome
young fellow. But he had not yet learned to live by the Dialysis
Calendar and his spirits flagged. When I saw that he was reporting
late for his sessions and leaving early I remonstrated with him,
reminding that the system -- unpleasant though it might be to
him -- did keep him alive and that he could, if he wished, work
out a satisfactory life.
He looked at me almost in contempt and asked: 'How old are you
And I said: 'Eighty-seven.'
He burst into a derisive laugh: 'Sir, I'm 32. You've had your
life and can adjust your remaining days to a new regime. More
power to you. I'm just starting my life and the thought that it's
going to be lived like this terrifies me.'
Shortly, he appeared later and later and left earlier. And then,
he stopped coming altogether, which every dialysis patient is
free to do. Three weeks later, I heard that he was dead.
James A. Michener