A month ago the board of the eAJKD blog met to discuss plans for the blog. One topic, was what we wanted to do for World Kidney Day and decided that we should each write about what nephrology meant to each us. So for the last month I had been noodling about that and on World Kidney Eve I created the following video of my feelings.
I got into nephrology, like a lot of people get into it. I just went crazy for the chemistry. I loved fixing the numbers. I loved the inherent logical nature of nephrology. But as I have been doing it for a number of years my enjoyment of the field has matured and I now look at the field in a new way.
All of my life I have been an environmentalist. My very earliest childhood memories are populated by hiking and canoeing trips in the North Woods. Environmentalism has been an important part of my moral compass for as long as I can remember. I now see a connection between environmental awareness and appreciation of nephrology. When I look around, everywhere, I see examples of humans being poor stewards of the earth; however when I’m at work I see the kidneys, at least when they are functioning properly, being perfect stewards of their internal environment. Eternally maintaining a stable ecosystem for growth.
To a large extent I don’t blame humans. Our ability to affect the earth’s environment is so new, that we can’t see the consequences of our actions. We don’t have the benefit of a million generations of evolution that aid the kidney’s in there mission to establish and stabilize the internal environment. The kidneys have perfected their ability to maintain homeostasis. They maintain the body’s atmosphere and oceans in perfect balance.
The way the kidneys maintain this idyllic state is both simple and extraordinary. The kidneys simply track every atom that is absorbed and then make sure those same atoms are excreted. This happens in perfect balance. Atom in. Atom out. At the most fundamental level the kidneys are incredibly finely-tuned, atomic balancing-machines. And when I realized that this is what the kidneys were, I was just overwhelmed with their beauty and perfection.
I have to admit this is perhaps the most beautiful description of what kidneys do. I'm very sorry I didn't realize this as I was probably destroying my inner environment as My young adulthood began with hypertension and continued a overweight condition. Perhaps if I took better care of myself my kidneys would still be functioning. But now I have to continue living the best I could although my inner is not idyllic. That's why one of my personal mantras is that dialysis is not the end of life, but just a new beginning.
We must strive to provide the best dialysis therapy. We need to promote more frequent and longer dialysis. We need to promote more home dialysis and have centers which schedule therapy after 5:00 pm sp dialysis patients can continue working. We need to change the landscape of dialysis from a picture of devastation to something that more represents the idyllic picture healthy kidneys afford.
Thanks. I agree with you views on dialysis.