The Ring

HEMODIEALYSIS

Nancy marked the end of several things — Not of using my abilities, but of some wavering I was having around them. Nancy was a nice person, and just doing her job (representing her constituents) as best as she could. The bill we just shot down would have enabled more of her constituents to have dialysis, at a risk of medical complications. Deciding amongst those tradeoffs should be done in a public forum, and not in the smoke-filled (metaphorically) Lyft trips with Nancy. It is true that the bill put us vampires at a premium (more dialysis… more needed vampires), but I believe that could have been addressed in other ways if Stanford had not decided to crush the bill.

Based on the Nancy assignment by Stanford, I decided to change a number of things. First, I stopped telling Dr. A about any new abilities. Second, I standardized on ‘Only use on ass****s’ principle: I try to actively avoid influencing or harming anyone that is not an ‘ass****’. Especially if I don’t consent to the goal, or just can find an alternative approach. Third, I started my v-wan (vampire widearea-network) project.

As Dr. A and I discussed, — there are tens of thousands of vampires / slaves. But I know less than a dozen. How is that possible? My guess is that the hospitals and clinics do not want us to know each other. It could be we are too valuable and they don’t want us negotiating a better contract or getting poached. As it is now, I make Stanford happy or I don’t exist. I have no idea how to contact someone at the Mayo Clinic or Cedar Sinai to get into their ‘V5’ equivalent program. The hospitals may even have formal relationships barring poaching. Google, Apple, and others conspired with each other to prevent competitive wages… until they were caught and paid several hundred million to avoid going to trial.

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We vampires are like employees who have life-long non-compete clauses. Or possibly more descriptively, well-treated slaves.

The V-Wan project — started as a virtual meetup: just a Meetup listing containing Zoom-based get togethers. The meetup was titled Hemodiealysis, where the misspelling was intentional. But otherwise, the details sounded normal. It was for patients in hemodialysis to discuss their physical and emotional problems and needs. [[todo]]

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FIVE HUNDRED

The thought came to me — during one of my sessions. I watched the pump of the dialysis machine spinning as it pushed my blood through the tubes, into the membrane, and then back to my body. Spin spin. Pump pump. Flow flow. The machine would do this for four hours and an amount of blood equivalent to two-times the amount of water in the patient’s body would be processed. The blood picks up new ‘dirty’ water from the body each time it cycles through. At least that is the theory around hemodialysis.

But that is not what is really happening. My blood (cleansed of undesirables) is put through a switchable manifold into the proper line to go to one of the twelve different patients I am supporting. Essentially, this is just a fancy way to do a two-way blood transfusion between me and that patient. Why do we need the middle men and machines?

The next piece of the puzzle — was to understand that pump: how do you buy or make a ‘roller pump’ (formally a ‘peristaltic pump’) since that pump seems to be necessary for the transfusion? A quick google search and some conversations with a college friend made it clear this was not an issue: I could easily get a ‘patient pump’ capable of the 500mL/minute maximum flow rate. To support a vampires flow rate would require a pump capable of 6L/minute, but that is only about twice as expensive. And the concept I was working on does not require that rate to begin with: it could easily be a oneto-one speed of transfer. The patient gives me their blood and I send it directly back — after wandering through the nooks and crannies of my cardiovascular system — with the blood moving at that 500mL/minute flow rate.

In less than four hours, a single patient and I would have

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exchanged blood. The patient would get kidney-clean blood to enable them to live and I would get… what? Payment? It would need to be at least a half-liter (a pint) of their blood for me to live also.

Who would pay — for dialysis with their blood instead of with cash? The answer seemed quite obvious: anyone that is not wellinsured or incredibly wealthy. Each dialysis treatment-session costs about $500. Over a year (150 sessions) that is $75K. The median salary in the US is less than that, so the cost of dialysis is more than the patient “is worth”. And this gap will likely be for the rest of their life, or until they come up to the front of the transplant list and can pay $1M for the privilege of not spending $75K in perpetuity.

So at least half of the dialysis patients at my clinic can’t afford to be doing dialysis except by the favors of the government, employment, insurance, or other unreliable sources. On any given day they could walk into the clinic and be asked “Pay your tab or leave” .

My basic concept — is offering to pay dialysis patients $500 for a half-liter of blood. Or even more simply: I am offering them their lives for a half-liter of their blood. The medical system is offering the same reward (brokering me) for $500 per session and a half-liter of their blood. I do get a cut of that $500 in my stipend, but definitely not a significant portion of the million dollars that the twelve patients gave the system.

The patient could sell their plasma (where legal) for maybe $50 per session, but they would still be down $450 to get their treatment. And I am not sure whether dialysis patients are allowed to donate plasma.

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