21) We Are All On Stage

June 17, 2006

It seems like kidney donation is "in the news" lately. There¹s the article
in Texas Monthly, TV stories on Alonzo Mourning¹s transplant* and playng in the NBA finals, and an article in the current AARP Bulletin** (Winning the Waiting Game) . Maybe I just notice all these things because I¹m in the market for a healthy pink kidney, or maybe its just like having a maroon Toyota T-100 and noticing all the other T-100s on the roads. 'In the News¹ these days is a move (by UNOS***) to increase kidney donation by developing a registry for people who want to donate to a person but aren¹t a match. People on the registry could swap one of their donors for a donor who does match. However, this registry will take action by Congress to be approved. As quoted from Bustler and Hudnall¹s article in the AARP Bulletin, "[In the United States,] we could do as many as 2,000 more kidney transplants a year by swapping donors," says Robert Montgomery, M.D., chief of transplantation at the Johns Hopkins Hospital in Baltimore and the lead author of a recent study that reported on the method's success." UNOS was created under a law that will have to be amended to clarify a swap program ("exchanges between paired donors and patients do not involve money and thus would encourage other transplant centers to create their own paired donation programs.") The bipartisan bill to amend the law is "languishing in a Senate committee, and no one has come forward to sponsor such a bill in the House." And UNOS can¹t begin the registry without such a change to the law.

Although the swap amendment is not yet a reality, many people in search of a kidney turn to their network of friends and the internet to find prospective donors (my Blog is an example). Some officials and experts consider open kidney searching as an unethical approach, suggesting that people who are advertising their need for a kidney are "cheating". I plan to write a summary and opinion on the ethical questions surrounding 'advertising¹ for a kidney in an upcoming post, so keep tuned in for that.

El Milagro: Eloy cannulated me today, doing a smooth poke. As he is working on me, the new guy shows up, seemingly late for work. He is explaining to Herman (the Nursing Administrator) and Herman is showing no emotions nor nodding is head in agree
ment. He is stone-faced. I mention to Eloy something like, "This new guy seems to be a bit of a problem" to which Eloy chuckles and replies, "You are observant, aren¹t you?". After I settle in, I¹m watching Ghana beat the Czek Republic in a rousing upset. Having the World Cup on TV is a definite benefit of being on dialysis right now, since the games are all over the TV and most of the people at the center are interested in them. Its like being in a strange sports bar.

I have noticed them before: the computer-printed signs on 8 1/2 x 11 paper that say "On Stage". Today I ask Eloy about them, and Herman is within earshot and adds some to Eloy¹s answer. These signs are reminders to the staff that they are being watched, Eloy reports. They are "on stage" and the patients are the audience. The administrators are the watchers. Herman adds that the idea is that everyone is here to 'perform¹ for the patients and that the patients are watching too. We are all watching later as the USA and Italy play to a tie, even though the refereeing was horrible (we watched). USA was lucky because Italy contributed to the tie by scoring the USA¹s only score. Just as the game is over I am done with today¹s session.

Notes: In at 72.5 Kg, and out at 70.5 Kg.

*Barbara Basler and Chad Hudnall, (2006) Winning the waiting game. available online at the AARP Website:
** Conrad, C.R. (2006) Say it ain¹t so, Zo. Available online at the Star IQ Website: http://www.stariq.com/Main/Articles/P0001675.HTM
*** United Network for Organ Sharing, on the web at www.unos.org

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