American Journal of Kidney Diseases

Lighthouses of Constancy

Published:November 04, 2022DOI:
      One patient (Mr Lynch),one intern (myself),four settings (clinic, ICU, wards, ED),three constants (Tuesday, Thursday, and Saturday).
      Each episode was unique,(different indications and pathologies,various seasons and specialties)and yet each had a striking similarity.
      In each, the four letters of his life (ESRD),were revealed to me in dialysis and dry weights,in nutrients and volumetric numbers,in electrolytes and eccentricities.
      In each, he surrendered himself unto our care,trusting us to guide him through the valley of his shadow,to shepherd him back to the still and predictable watersof his thrice-weekly existence.
      Upon retrospection, these encounters(these formative experiences in my medical education,these acute exacerbations of his unavoidable chronicity)unveil a cruel and perverse juxtaposition:
      my year of growth and progression washis year of setbacks and complications,my tangential encounters with the world of ESRDwere for him a lifestyle, a lifeline, a lifetime.
      His present and his future, his life and his livelihood,were anchored to the pillars of filtration,buoyed, (I’d like to think) in some part by the earnest work of a medical intern and their collective hope.
      Tuesday, Thursday, and Saturday:the lighthouses of constancyin the storm of his tenuous vitality,his reasons for living and the reason he lives.