A Slot in Dialysis

Guillermo Garcia-Garcia is a nephrologist based in Mexico and he is sharing his experience with kidney disease. He describes the emotional story of a father struggling to get a slot in hemodialysis for his son and the difficulty for those in need to have access to treatment. 

One of many days, by the morning, I’m sitting in my improvised office at the crowded hemodialysis unit: 8 dialysis stations in a place designed to hold 4!

There is movement all around. The patients lay in their chairs; some are sleeping, some are watching television. The dialysis nurses keep busy; some are checking the sound of the alarms, some are talking to the patients. A group of young students pays close attention to the instructions given by one dialysis nurse. At far, a patient lies on a stretcher, with a tube in his throat, fighting the respirator: “until when are we going to stop improvising?”, I ask myself.

The doorbell rings incessantly, over and over again. “Can I open the door?, shouts one nurse. No, I’m disconnecting a patient!, shouts the other”. The doorbell rings once again. “When are we going to have a reception area?” I ask my secretary. “Never!” she replies with a smile.

“Doctor, a patient would like to see you”, says a nurse. Without asking why, I guessed what it was all about.
Please, let the patient in, I say. A patient in a wheelchair comes to my doorstep. He looks pale, no expression in his eyes, in his fifties, about my age, I think; his swollen face and legs are clearly evident; behind him, pushing the wheelchair, I see an elderly man, close to his eighties, I guess. Suddenly, I see myself in their place. I, sitting in the wheelchair, and my father behind me, pushing me.

“Good morning! What can I do for you?”,  I ask my visitors. The elderly man replies: “my son was on peritoneal dialysis; he had an infection and lost his abdomen. We were told his last chance is hemodialysis. His doctor sent us home, he did not have a place for him. We’ve been searching for days in different hospitals to find a slot in hemodialysis. It is too expensive; we can’t afford it; we don’t have money, no social security; we’ve spent all we’ve got; we don’t have any other place to go”, he tells me.

“Do we have a space available?” I ask the nurse. “Yes we do, tomorrow, on the first shift, the one we keep for emergencies”, she replies. “Well,” I say, “we are all set. We’ll see you tomorrow, at seven o’clock sharp, or if you prefer, your son can stay in the hospital.”

“It’s not necessary”, replies the father. “We’ll be back tomorrow morning”. They both look satisfied. “You don’t know how grateful we are”, he says, as they leave my office, smiling, looking as if they were born again.

The next morning I arrive at the hospital at the usual time. At a distance, sitting outside the unit, I recognize the patient’s father. “Good morning!”, I greet him. “Is your son on dialysis?”, I ask. “Doctor”, he quietly replies. “I only came to say thank you. My son died last night, in his sleep, with the peace of knowing that he finally had his slot in hemodialysis.”