Perspective

I am just over a week into my new job, and I'm happy to report that I'm loving it!! For the first few days it was like any other job - training, training and more training. Lots of reading, online modules, and being thrown into two hour meetings so I can "get the feel for things" even though I have NO clue what they're talking about. Much of the terminology flies right over my head - I guess I need to pull out the old endocrinology and physiology books....

By last Thursday, though, the uniqueness of this field and the people in it started to shine through. I have gone on 3 "roundings" with the doc or nurse practitioner, who are both incredible teachers. They know that I am starting this job with no dialysis background, and my basic A&P and medical terminology is extremely rusty. They take the time to explain patient histories, medication lists, and the "why's", not just the "what's".

The most eye opening part of this job thus far has been my interaction with patients during rounds. Having absolutely no knowledge about chronic kidney disease, I really had no way of knowing what I was getting myself into. I'll give an example: One computer program that we'll be using during a study is set up to allow for 88 medical history entries per patient. EIGHTY EIGHT...who in the world has 88 individual medical occurrences?? Even I, the girl who vowed to "keep the surgery number up with the age!" (kidding, of course), don't have 88 individual medical occurrences worthy enough of being described during a medical history. The head of research protested when she heard how many fields existed in the program - "Only 88? No, no, that's not enough. These patients will go far beyond 88 by the time we get it all down". WHAT?! But it's true. After 2 days of rounds with the doc and nurse practitioner, it has become painfully evident that this population is the sickest - sicker than cancer patients, even. Diabetes, hypertension, amputations, osteoporosis, congestive heart failure...you name it, they have it. And most of the issues can be tied back to their kidney disease.

These patients are war vets, past physicians, one was even a cultural attache. 3 days a week, 4 hours a day, these patients come in for dialysis. Some have been dialyzing for 15 years. I think the most shocking bit of reality was how few of the patients ever get on the transplant list, and that even fewer actually get a transplant that works. And even in the face of these horrible odds, they don't give up. Dialysis is a huge life interruption, but I haven't heard a single complaint out of any of these patients. I suppose when it comes down to it, dialysis isn't an option...but I'm pretty sure if I had to plop my butt in a chair and have needles stuck in my arm every other day for hours at a time, I wouldn't be silent about it. These patients and the families that support them and the spouses or children or caregivers that come with them and sit by their side are so much stronger than I will ever be. I sometimes feel guilty when they casually ask me how I am when I walk by their chair....is it even OK to ask how they are in that every day conversational sense? I mean, clearly they're in pain and have so many hurdles every day....it's like a slap in the face to ask how they are. But really, I think most of them just appreciate the chance to talk about something else besides their illness. It's all very humbling...At the end of the day, I bitch about my feet hurting, my head pounding, the long drive home in traffic, not knowing what to do for dinner....when I really just need to shut up and be thankful that I'm not in that dialysis chair.