Doctors » Dr. A

DOCTORS » DR. A

“We could do a marketing campaign — to get kidney donors” proposes Doctor X.

Y. “We could convert people further from death” proposes Doctor

“Run the existing vampires for longer? Somehow make it so their bodies can process more waste?”

“Harvest genetically modified kidneys from pigs”

“Switch everyone to peritoneal dialysis”

“Prioritize dialysis patients.”

I wrote each of these proposals on the white board, both to have an agenda and to help anyone brainstorm a new idea. Doctors X and Y were the most vocal, but many of their suggests were murmured by other doctors in the room.

There were twelve of us: like a jury that needs to determine the sentence… the fate… of more than thirty thousand dialysis patients. They were already convicted by whatever caused their kidneys to fail. The obvious sentence was simply death. But hemodialysis can prevent that, if we have enough resources for it. How do we return to the same level of dialysis resources now that thousands of vampires went on strike?

“Let’s walk through these one-by-one — and describe their details and characteristics. Starting with ‘donors’ ” I begin for the group. Again Doctors X and Y tend to vocalize what others in the room murmur… their accents were similar enough it was even hard to tell them apart with my back turned to write, so I started to think of everyone as just ‘the room’.

- 153 -

“Donors: Massive marketing campaign to get people to provide one of their two kidneys. Start transplanting kidneys into the pool of dialysis patients. An advantage is we know all this technology. A disadvantage is we only do a few thousand living donor transplants a year. This would be a massive increase in that double donor-torecipient surgery procedure. For thirty thousand patients the cost would be about five billion dollars. It would take years to successfully transplant all of them, assuming a mass willingness of the public to donate. And we might have to explain to the public why the sudden mass request.” Responds the room.

“I think the last one could simply be a heavier promotion of normal marketing: «people can live longer and better lives with one of your two kidneys… help them with minimal risk to yourself»”

“But that has never worked. We are years behind in kidneys: a dozen people die every day while waiting for a kidney. With the reduced dialysis capacity that could double, and time will solve the problem”

“OK, that is very pessimistic, but I believe I captured all of that on the board. Next, ‘conversion’. Can you explain that Doctor?”

“Hypothetically — there may be ways we could increase the pool of candidates for vampiric conversion. Let us call this ‘overconversion’. There would be no fiscal cost to enlarging this pool, so the only cost would be the vampire conversion itself. What are our current vampire conversion costs?”

“It costs about the same as a liver transplant, so about a million dollars. It is worth it because the revenue of hemodialysis is more than a half-a-million dollars a year per vampire. Over the ‘lifetime’ of the vampire, it is a huge return on that million dollar investment”

“OK. So each vampire costs a million dollars but is worth more like three million dollars as a revenue stream. “

- 154 -

“Except we already had that revenue stream with the current striking vampires” Chimes in Dr. X.

“Right, so we are just recouping a loss. In any case, it is a million per vampire, so it will cost a few billion dollars to do a mass conversion to vampires. And I glossed over the risk of exposure from over-conversion. And any costs we want to consider around morality.”

- 155 -

- 156 -