Wednesday, July 9, 2008

The Worst Kind of Rejection

"Despair" by my mother

Rejection is tough. Who wants to learn you were passed over for a job because they preferred someone else to you? Or the guy you liked chose another. Or you didn't make the cut for the team or group you wanted to join.

But really, that rejection is easy.

The rejection I’m talking about is worse. Far worse.

More than five years ago, I was finally able to give my mother my kidney. She’d been on dialysis for two years. Two years too many.

It was a long journey. At first we were told I was not able to be a donor. But we got more tests and surmounted that hurdle. Then ten days before the scheduled transplant surgery, we had to hold off. I might no longer be a match, we were told. That was devastating. But we did it. Amazingly.

I think back now on how lucky we were, within, I should say, a pretty unlucky situation: My mother lost her kidney function in her 60s, seven years ago. I was pretty much her only hope since younger people on “the list” (ie, waiting for an organ to become available when, yes, sadly, someone dies) seem favored. Why? Organs are in short supply, especially kidneys in Michigan. It’s a five-year wait, unless you have a living donor.

Thankfully I could do this for her. But as one journey ended another began. My biggest fear waking from surgery? That the organ would be rejected.

These things happen.

But it took. And life, for the most part, resumed somewhat normally. My mother, no longer tethered to a daily dialysis therapy, felt better and became more like her old self.

But in the back of my mind, way back at least — always — was this: Keep working.

You see, rejection is the nemesis of any transplanted organ. That’s not my mother’s kidney in her lower right abdomen. It’s mine. Save for organ donation between identical twins, your body’s nature is to fight that foreigner. Anyone with a transplanted organ is on a steady cocktail of immunosuppressants for the rest of his or her life. Period. No cheating. You cheat on this regime and you cheat yourself.

Still.

Rejection can happen out of the blue. For no known reason. Sure, you can slack on your meds and in that case you can be sure you’ve just condemned that organ to death. Eventually. Once rejection sets in, I’m told, it’s a slow decline. A one-way ticket.

Still.

They say if they catch it early, they can manage it.

Today my mother lies in a hospital bed. Rejection. Moderate.

And it’s scary.

Her doctor says they can treat it and she can, hopefully, have the kidney a few more years. I hope that’s true. I hope it works.

* * * *

In the Hospital

So here my mother lies at a teaching hospital, where we try to digest devastating -- disappointing at the very least -- news. And we have to deal with so many questions: Whenever she’s wheeled around — from the ER to the ultrasound to the floor where she was admitted to for the next several days — everyone from nurses to med students asks her history. What meds is she on, what caused her kidney failure, what brought her here today? Did she smoke? How long? What other symptoms does she have? Do you have any pain here? How about here? Can I listen to your lungs? Do you have an advance medical directive? A living will?

It’s exhausting.

When her nephrologist came to tell us the picture was getting more “complicated” after seeing the results of the kidney biopsy, I started to feel sick. “On a scale of 1 to 3,” he began….

All I wanted to know: Does this mean she’s going back on dialysis?

Yes the news was disappointing but it could have been worse. You always — I mean always — look for the silver lining.

My father, a retired physician, once told me: “Medicine is more art than science.” That's good to know sometimes.

Still, yesterday was rough — being awakened before 6 a.m. to find my parents spent all night in the ER and now had to go to a major medical center and can I help drive in case they need help?

I was at my mother’s side until after 9 p.m. that day asking questions, digesting answers, making sense of terms I don’t know, reliving my mother’s medical history again. And again. And again. It's strangely comforting and depressing to look into kind and compassionate faces as they sympathize, saying how sweet my mother is to have to go through “all this.” It takes its toll.

By 4 p.m. I had to step outside while she had a procedure. I needed air. I longed to go sit on a the bench in a garden patio area where I spent time the day before when she had the kidney biopsy.

It was raining. It seemed a subtle slap in the face. I just wanted some sun after a full day behind windowless concrete walls.

As I stood in the small covered area outside the doors, I mostly just needed to cry. To purge my exhaustion and disappointment. I empathized with my mother, who often says god must hate her for all she’s been through. She’s been through a lot. Too much.

Later, as evening set, my mother settled into her room for the next few days, with new nurses, new faces. What did she have done? What meds does she take? As I told her nurse the story behind this newly-bandaged site on my mother’s abdomen above the kidney — where she now had a catheter placed — I paused as I leaned over my mother’s body, my right hand over the bandage.

“That’s my kidney,” I said suddenly, smiling, then catching myself, almost surprised.

My eyes welled up for an instant. It was a flicker of amazement. A flashback of all we’d gone through. Here was my organ, born from my mother to me, and now back with her.

And now it’s suffering.

That's the worst kind of rejection.

3 comments:

Cindy La Ferle said...

Ellen, this is a very powerful and moving story. I didn't know this about you. I am wondering how your mother is doing now, what's next for her?

I also admire the way you used the theme of rejection throughout the piece -- very effective. This really puts things into perspective for the rest of us who get wigged out over much smaller, less important rejections. Thank you for this piece.

Only the Half of It said...
This comment has been removed by the author.
Only the Half of It said...

Thanks Cindy. It's been rough. We just hang in there and hopefully treat the rejection and keep it from progressing. There are no symptoms so she's feeling fine and the kidney is working fine (you can do quite well with less than 25 percent function amazingly). But it's still damaged.
As for the piece itself, I think it could be tighter, etc. for an essay, but that is the beauty of blogs! :-) Thanks for chiming in.
PS: Did you notice that the art is a piece by my mother? Aprops, no?