Make Me Whole
MARGOLIS, RICHARD J.
States of the Union MAKE ME WHOLE BY RICHARD J. MARGOLIS The recorded female voice at the Baxter Healthcare Corporation's "800" number has the inflections of an airlineattendant:...
...I'll try to keep that in mind...
...Kolff's bathtub helped launch the organ transplant era...
...It wasn't until the labors of Dr...
...If all goes well, one fine day in the not too distant future Dr...
...The upto-date version, I trust, has our sisters sharing the credit with our brothers...
...The hemodialysis user, moreover, tends to feel pinned down by the tyrannies of technology, as the following poem demonstrates...
...And it beats dying...
...Help us to be among those who...
...Above me old men, dying of coronaries...
...He called the process dialysis, after the Greek word for separation...
...Home brew dialysis, my kind, made a comeback in the '70s (a story to be told in a later column), but the hemo- variety remains the therapy of choice for thousands of kidney patients, even though it's timeconsuming and usually has to be done in a hospital or clinic...
...Somewhat remote as a parent but larger than life as a rabbinical presence, my father occupied a special pulpit in my heart...
...Too much risk of infection...
...Meanwhile, I continue to wait through the silence...
...To borrow from the old Passover song, I would give my last two zuzim for an only kidney...
...One of ourrepresentatives will be with you shortly...
...Some said they were praying for me...
...I was barely 16 at the time...
...too many cases of peritonitis...
...Numberless gifts and blessings have been laid in our cradles as our birthright...
...The Travenol salesman wears glasses and a dark suit: "Do you Take this machine In sickness and in health Till Death do you part...
...Uncle Albert endured a lot of pain...
...The good doctor had no way of comprehending my sudden fit of laughter...
...and Susan's career ("I'm lobbying for a promotion...
...How much we owe to the labors of our brothers...
...Waiting through silence was what got me into this jam in the first place...
...Let us then, ? Lord, be just and great-hearted in our dealings with our fellowmen...
...I rushed to the public library and started thumbing through a copy of Carrel's Man and the Unknown, published in 1936...
...Four times a day I pour a concoction of dextrose, or sugar water, into my peritoneum, a thin double membrane that lies just beneath myskin...
...just plastic bags, tubes, clamps and valves, and the force of gravity to empty and fill...
...Willem J. Kolff, during World War II, that the term "dialysis" assumed medical significance...
...Paul Ramsey, has written wryly concerning the hubris of his profession, "the triumphalist temptation to slash and suture our way to eternal life...
...Marks to give me a thumbnail history of transplant technology...
...Uncle Albert did not hesitate...
...Actually, he was interviewing me, hoping to learn whether I was a suitable candidate for a transplant...
...There was a passion in many of the prayers, fueled as they were by both the heat of humanism and deeper fission of the Old Testament...
...The donor will bebothdead and anonymous, yet another sister or brother to whom I shall surely address a nonprayer of appreciation...
...Others, like my friend Alice, waxed wistfully agnostic...
...If Peter and I were the praying sort, shewrote, "we would certainly send up a prayer on your behalf...
...Well, I am quite prepared to let the doctors slash away...
...I do Reclining On the nausea-green hospital chair Below me children, playing in the street...
...Unsound medical advice, I think to myself...
...His fingers were as thick as sausages...
...About once a month I ring up Baxter in Deerfield, Illinois and ask Susan, my "representative," to send me more sugar water...
...Then it says, "Please wait through the silence...
...The phone call is a social occasion...
...The liquid runs through a blue, white and yellow plastic tube (vivid childhood colors) that Yale nephrologists have thoughtfully inserted into the left side of my stomach...
...dare to be bearers of light in the dark loneliness of stricken lives...
...He did not hesitate...
...Coils, alarms, twisted tubing turning scarlet Deep within the machine dark blood Mixing with fluid, cellophane-separated, plugged in and Turned on...
...After the War Kolff emigrated to the United States, continuing his research in Ohio at the Cleveland Clinic...
...Graham did not have the foggiest idea how his discovery might be put to use...
...It began," he said, "with a French physiologist who won the Nobel Prize in 1912 for his transplant research...
...As it happens, my childhood rang with a certain kind of prayer, the kind one finds in Reform Jewry's Union Prayerbook...
...Instead, throughout the '50s and '60s nephrologists relied on hemodialysis, an exchange of the patient's blood two or three times a week...
...Working under extremely difficult conditions in Nazi-occupied Holland, Kolff invented a primitive artificial kidney—in effect, aperitoneal dialysis machine—using a tub from a Westinghouse ringer washing machine for the chamber...
...Uncle Albert," I asked, sitting opposite him in his brown, dusty study, "how does one prove the existence of God...
...Dear technological age, make me whole...
...A Seattle transplant surgeon, Dr...
...he was simply digging for some truths...
...Not only did Kolff's creation extend the lives of thousands of people," notesGutkind, "butit offered the secure knowledge that patients could usually be returned to dialysis if the transplant didn't take...
...With home brew dialysis there are no machines...
...He was indeed avuncular —large and jowly and affectionate...
...There the dextrose works its alchemy, separating, flushing, filtering—doing some of the things my kidneys should be doing but can't...
...Peritoneal dialysis is not the most convenient of treatments, but it is painless...
...According to my doctors I am a victim of "silent prostatism, " a condition that sounds like a religious reformation but is in fact a malady...
...I am The final essence of the technological age, Flesh conjoined with plastic, vessels with steel...
...And the discussion was over...
...Make sure you pray on the night before you die, the Talmud instructs (as usual, raising more questions than it answers...
...It went something like this: "It's hard to be a good Christian when your glands are diseased...
...Travenol was the name of the machine manufacturer...
...The other day I was talking with Dr...
...Doctors at my HMO discovered the wreckage on Pearl Harbor Day, and I have been on dialysis ever since...
...I could even appreciate the hypothetical prayer that got stuck in her throat...
...The exchange was accomplished via a pump and a shunt, one end of which penetrated the patient's neck...
...Readingthemnow, and breathing in their steamy lyricism, I can almost forget they were written by a committee...
...Dear God Purify me...
...Read Alexis Carrel," he pronounced...
...He was all the theology I thought I would ever need...
...Marks in his office at Yale...
...But peritoneal dialysis gradually fell from favor...
...Mine failed last December...
...Hesuffered from a chronic and incurable form of elephantiasis...
...It bothered me, that summer of his death, that my faith, like a toy balloon, had been so easily burst...
...For openers, there was the Scottish chemist Thomas Graham, who in 1852 discovered that certain substances pass through a membrane more slowly than do others and can thus be separated—sugar from starch, for example...
...Of course," he added, "hardly anyone remembers him now...
...It was written in 1971 by M. Sapperstein, a hemodialysis patient, and printed in a newsletter published back then by the National Association of Hemodialysis Patients...
...For me God had died with my father, who was also my rabbi...
...My particular form of therapy—peritoneal dialysis, it's called—turns out to be a cottage industry, a home brew I can imbibe while in my study...
...Carrel, it turned out, was a French physiologist who dabbled in metaphysics...
...Near the close of our interview I asked Dr...
...Marks and his colleagues will provide me with a relatively fresh kidney with all its working parts in order...
...Still and all, I am feeling entirely too mortal these days to wholly reject the efficacy of prayer...
...Nowadays I find such prayers all too pertinent...
...we discuss the weather, baseball ("Oh, those Cubs...
...Secular in its rhythms, socially uplifting in its message, those JewishAmerican petitions and apostrophes have haunted me all my years, and probably ruined my prose style...
...But I did stumble on a sentence that may have had a powerful effect on Uncle Albert...
...All our lines are temporarily in use," it says...
...Day by day they dig far away from the sun that we may be warm...
...Sneaky and largely asymptomatic, silent prostatism can gradually destroy one's kidneys...
...an only kidney...
...for as Lee Gutkind points out in Many Sleepless Nights: The World of Organ Transplantation (1988), the availability of dialysis encouraged surgeons to experiment with kidney transplants...
...In my perplexity I sought advice from my father's closest friend, his colleague across the river in Minneapolis, Rabbi Albert Minda, a man I had addressed all my life as "Uncle Albert...
...Skimming and skipping, I found nothing in his treatise to rebuild my Humpty-Dumpty faith...
...While I languished in the hospital last December, friends and relations sent me notes of sympathy...
...Some of those dimly remembered diggers, for instance, struck pay dirt that would one day translate for me into a gift of continuing life...
...Last I heard, he was teaching at the University of Utah...
...I could understand her hesitations...
...I am quoting from my own copy of the Union Prayerbook [# 1], which my parents gave me on Shavuoth, my confirmation day, in 1943...
...His name was Alexis Carrel...
...States of the Union MAKE ME WHOLE BY RICHARD J. MARGOLIS The recorded female voice at the Baxter Healthcare Corporation's "800" number has the inflections of an airlineattendant: Verbs are italicized...
Vol. 73 • August 1990 • No. 10
