Sacramento » Nancy

the immunosuppressants are reduced, so the risks get reduced, but they do not go away.

Death is something I already experience much more of since the hospital, and it will only get worse over the upcoming decades. I wonder if Amasa will ‘cancel’ me if I look too young?

“We would like you to go to Sacramento — for dialysis”

“That is a bit of a drive doctor. I can do it, but we are talking several hours of overhead”

“It should only be for a few weeks. And it would make the gods ecstatic “

I meet Nancy a few days later, and start helping her get home after the dialysis sessions.

SACRAMENTO » NANCY

January

I hate dialysis —truly and utterly. Over the two hours of a dialysis session I go from feeling one-hundred-percent (for my age) down to having no energy at all. I am lucky even: others do twice as long a session as me. I don’t know how someone like Mark seems so unaffected after four hours… it is almost like he gets stronger from the treatment.

I had a liver transplant last summer, but my kidneys never came back. They said they should: the transplant went well, and I recovered from surgery in a couple months. But the old kidneys don’t seem to like the new liver… why can’t they just get along? Why didn’t the doctors add a kidney at the same time they swapped in the new liver?

Now I have to wait again. And go through surgery again. And recover again.

I can only hope other senators don’t notice my second absence.

I come to dialysis as late as possible — in my afternoon session, so I can stay in the office or on the senate floor as long as possible. I know I have hurried a lot of work and bills through as 3pm approached, but I hope it is just a good kick in the pants to keep things moving. People just think I am very impatient, which is true… but now more than ever.

Because I come so late, I finish a bit after Mark. His session is longer, but he seems to arrive a bit after noon. His needles are pulled and he is dressed before my catheter is recapped. The first week he showed up, he was just another masked man. We never talked during dialysis. We are even in different sections because I need an RN for my catheter. I don’t think the needles are worth it, but at least he doesn’t have to protect his chest all the time. He can even take showers… sigh, that would be nice.

It was a strange coincidence — that turned a masked man into the living person named Mark. I take Hoyst to and from dialysis. I can’t drive after a session: both medically proscribed and I know realistically I would be a danger on the road. The catheter isn’t likely to open during the commute like the needle access holes could, but I have passed out on the trip home. I can’t risk plowing my convertible into whatever is on the road when I head for an abrupt exit or crash.

Last Monday, I launched Hoyst and inside the app a driver immediately offered to take me home. ETA: zero minutes. How can it be zero minutes? A Hoyst is waiting for passengers right next to a Voyager clinic?

No, a Hoyst driver was waiting for passengers in the Voyager parking lot

A grey SUV pulls up in front of the doors — but doesn’t have front plates, so I can’t match that to the app information. But the car is correct, and the eyes in the profile picture seem familiar. And the balding head.

After the driver door opens, Mark comes around the front of the vehicle and quietly says “your chariot awaits” as he slightly bows and

opens the rear passenger door with his right hand. He offers his right forearm for me to use to get inside. He is favoring his left arm, which is common for fistula patients. I hope he can drive me home safely.

The car is spacious, but not the size of the Escalade that I am sometimes transported in. The door thumps shut after I am comfortably in the seat. Hoysts have personality. Different drivers have personality in their vehicles, personality in what they think you want from their vehicle, and personality in their behavior. Mark’s SUV was very personalized. It had power cords designed for passengers to charge everything from an iPhone to a computer. It had a lap desk you could use for the computer (or maybe snacks) you might have. And it had dragons: stuffed black and white variations of the dragon from the movie ‘How To Train your Dragon’. Why Mark needs or wants dragons in his car may take a while to tease out of him.

When Mark asks me to dinner — I feel almost compelled to agree. I am not doing anything else, and I am a terrible cook. I mostly eat ready-to-eat dinners from Foodbox.

So we tend to have an early supper together right after dialysis, and he has a second meal when his wife gets home at 8:00 or so. Some people who have a failed kidney or liver burn a lot of calories just to stay alive, so Mark must be part of that group. When he weighs in his ‘wet weight’ — The weight before dialysis. After dialysis is the ‘dry weight’. Nurses and patients call out the weight to each other and everyone can hear — sounds pretty low. From all appearances he is definitely not retaining fluids, so he must have some amount of kidney function. I wonder why his dialysis session is so long if that is the case?