4) Of Mr. Animado & Infiltration

Thursday

El Milagro: This place isn’t very popular this afternoon… 4 chairs with people in the section I can see. Today I’m in a chair in the back-to-back row separating the two rectangles, so I can see out the windows and watch traffic on the freeway slow to a crawl through the rush hour. This as a background visual is like the opposite of one of those speeded up films of clouds, sky, and sunset.

I had a long conversation with nurse Phyllis about Davita and the other dialysis centers in Austin. She ball-parks that there are about 2500 people on dialysis in Austin. Davita has about four centers in Austin (one in San Marcos) and who knows how many nationwide. Doctors who are medical directors of the units (like Moritz) have the option to buy in as a partner, thus increasing their income from a contracted annual amount to a percentage of the profit. Three of the doctors from Moritz’s practice are medical directors of three of the Davita units. I guess this paragraph is for those of you who are interested in the organizational info.

The place is not empty today because everyone died. I was pleased to hear that. Phyllis reported that the population decrease has to do with a few people being hospitalized for various reasons, a few switching times, and a few of the crowd last time being visitors. And one person on this shift hasn’t shown up yet. As I write this, he walks in. He is a Hispanic guy who always bounds in laughing and saying hello to all the Hispanic patients, going to each of their chairs and giving them a personal greeting and some sort of touch on the knee or shoulder. He is the most cheerful person on my shift. He’s always kidding with the staff and shouting to one of the two other Hispanic guys who are here. All three of them seem to be younger than I, and look to be gritty workers who come in directly from their worksites. Two of them are fairly quiet and seem “sicker”, but Mr. Animado really brightens the place up. Another person I met, Amanda, when we introduced ourselves, said “Sorry to have to meet you this way.” She too, looks younger than me.

There are some folks here that are older than me and generally they look much worse for the wear. A few of them come and go in wheelchairs and a few are slow shufflers. Watching these older folks makes me wonder how they reflect and contemplate on this experience. Do they see it as a necessary labor to stay alive and stave off death? Do they come in here all business and weak looking, but brighten up at home with their families? Have they given up and are just letting their relatives push them along to this necessary life-extending process? Maybe when I get more acclimated into the system here I’ll interview a few of the older people and explore how they perceive this experience.

‘Charlie’ Moritz stopped by this evening, in a black with green hibiscus Hawaiian shirt and matching black pants. He grinned a “Hello, how ya doing?” and I asked him if my insurance was getting charged for a office visit every time he stops by and spends a minute or two checking on me. He answered that it’s more like a hospital rate, where the individual stop-bys don’t count individually. He said I’ll still be coming by the office twice a year and he’ll get my insurance money then. He added that he doesn’t only come to see patients (of which about 4 seem to be his), but also to do ‘director’ work.

Note: It’s two hours into this and my legs are getting fidgety…. I keep readjusting them from cross-legged to straight out to folded right over left to folded left over right to underneath my butt and back to cross-legged. And this cycle occurs about every 4 minutes and I have to do it carefully to ensure I don’t move my left arm*.

*(Added later) I learned on my second visit here that it is not a good idea to move your arm. I moved it that time and got what they call “infiltrated”. That means the needle coming back into my vein poked through the vein and shoved blood into my arm. Yowzaaa that hurt! I can finally talk rationally about that experience now, 2 weeks later. Fortunately the machine beeped and a tech came to my rescue. Blood shot into my muscle and whatever else is in there that is not the proper place for the blood to shoot for less than a minute. My arm swelled up and the pain was pretty smart. They stopped the dialysis 20 minutes early and taped me up. My “Popeye” arm (named by John) became a topic of interest at our Passover seder the next night. I took a picture of the bruising and will put it up here when I find the connecter from the camera to the computer.

That’s it for tonight. Now I’m gonna watch Survivor.