Kidney #3

On 5th May 2011, I was scheduled to have a live kidney transplant from my civil partner, Jayne. Below is an account of the events of 27th April, chronicling how I ended up with a kidney from someone else.

Wednesday 27th April 2011

Today is my last day at the office before I go on leave for the transplant. Several of my colleagues are already in when I arrive at 8.30am. I mumble ‘hello’ to them as I make my way to my desk and boot up my computer. My inbox contains a message telling me to phone someone called Richard Corbett urgently. I have never heard of him, but immediately dial the number in the email.

‘Hello Rachel.’ Richard Corbett has a soft voice that halts in unexpected places. ‘I’m one of the... renal registrars at Hammersmith Hospital. I’ve been leaving messages for you... everywhere. We’ve... got a perfectly matched cadaver kidney for you if you’d like to... come in.’

What?! I am pole-axed. I say ‘fuck’ about twenty times over the following sixty seconds, rather too loudly for an open-plan office. I sense curious eyes swivelling in my direction, but I am oblivious to the fact that people may be on the phone to clients. I am focusing on this new information and hoping that, like Aladdin’s open sesame, uttering the expletive will open the door to my brain and let it sink in. At the moment, it’s rolling off me in a wave of unreality. I didn’t even know I was on the transplant waiting list.

‘Can the kidney be offered to someone else?’ I ask. ‘Someone who doesn’t have a live donor?’
Dr Corbett parries with a politician’s reply: ‘It’s being offered to you – you’re the best match out of... everyone on the national waiting list’.

Cadaver kidneys need to be used quickly, so I have no time to prepare a thoughtful answer. ‘I’ll be with you as soon as I can,’ I say, and hang up.

I start sobbing. My team leader, Sam, comes to my desk and puts an arm around my shoulders. ‘Good news?’ he asks.

‘Yes,’ I reply. ‘Amazing.’ He smiles and hugs me closer. If I’m honest, though, it still feels dreamlike. There is also a part of me that is rather annoyed at this change of plan. Today was supposed to be a relaxing day of tidying, delegation and creating smug out-of-office messages. My adrenal glands weren’t meant to get this busy until at least Sunday night.

I frown at this ungrateful Rachel-imp until she is subdued.

‘Do you want us to call you a cab?’ Sam asks me.

‘Thank you, no,’ I reply, ‘I’ll get there quicker by Tube’.

Before leaving, I call Jayne. Lovely, lovely Jayne. I hated the thought of putting her through an operation and am elated that she is to be spared that ordeal. Still – I wonder how she will respond to the sudden change of strategy. She is big on planning. Actually, scratch that: she is huge on planning. I also know that she was really looking forward to having a legitimate reason to take three months off work.

From the silence that greets my news, I can tell that she, too, has an imp. ‘But I’m giving you a kidney,’ she says, somewhere between shocked, perplexed and indignant.

‘I know, sweetheart, but this is a perfect match and it’s been offered to me. I didn’t have long to make a decision. I’m off to the Hammersmith now. De Wardener ward.’

After a pause, she announces, ‘I’ll pack a bag for you and come to hospital.’

I cry openly as I say goodbye to my workmates and rush from the office.

It takes about twenty minutes on the Tube to get from Holborn to East Acton. In those twenty minutes, I occasionally tear up again. I am fairly sure that my eyes are red and swollen and I look around to see if any of my fellow passengers have noticed. I will one of them to look at me and ask what’s happened. I want to share my news with everyone.

No-one obliges. They look down, into books, fiddle with gadgetry. Of course they do – I forgot. Not only is this England, it is London – a city whose inhabitants are so averse to interacting with strangers that, had Jesus told the parable of The Good Samaritan here, he’d have been curtly informed that the story’s protagonist was an idiot who probably ended up taking out an injunction against the injured man after being subject to a year-long stalking campaign.

I decide to fiddle with one of my own gadgets and draft a text: ‘A perfectly matched cadaver kidney has been found for me so I’m off to hospital now!’

As soon as the central line goes above ground at White City station, I send the text to all my friends. I then call my parents in Sheffield. Mum answers.

‘Hi Mum, it’s Rachel.’

‘Hello love, how are you?’

I tell her I’m on my way to Hammersmith hospital to be transplanted.

‘That’s wonderful news,’ she says. ‘Dad and I are doing a coffee morning for charity on Saturday morning, so we’ll come after that.’

‘Lovely,’ I say. ‘Speak soon.’

It is only later, after my parents have changed their minds and are zooming down the M1, that I consider the implications of their deciding that putting on a coffee morning is more important than being around for their daughter when she’s undergoing major surgery.

The hospital is situated on Du Cane Road, an odd street in west London whose north side consists of a school, two hospitals and Wormwood Scrubs prison. To the north of that are Wormwood Scrubs park and the quickest route from East Acton Tube station to the renal unit. As I walk along the path beside the prison, my phone starts buzzing with replies to my text. Most of them are verbal bursts of happiness: ‘Congratulations!’, ‘Wow!’, ‘Fantastic!’

I also get one from a Christian friend, which says, ‘This is excellent news. David and I prayed for this to happen!’ I am touched that Hannah and her husband have been praying for me but, at the same time – and despite being an atheist – a little uncomfortable with the idea that God has killed someone for me.

My thoughts are interrupted by cawing to my left. I look up to see about twenty crows hopping around, pecking the grass; I recall that the collective noun for crows is a ‘murder’. If God does exist, He has one dark sense of humour.

My first impression of De Wardener ward is that it’s grey and that the air is filled with beeping. There is a grey seating area just inside the door. Beyond the seats is a grey corridor, with grey wards leading off on either side. The wards are the source of the beeping. The corridor broadens out in the middle: telephones, files and computers are scattered around this central section and a few staff members are milling around. I make my way there.

A youngish man with full pink lips and an incipient bald patch looks up and smiles at me. ‘Rachel?’ I nod. It is Dr Corbett.

He shakes my hand, then sends me back to the seating area with a junior doctor called Vikram, to complete my admission papers. This involves providing personal details and signing forms which absolve the hospital from any liability should my wedding ring or pancreas go missing during my stay.

‘Righty-ho,’ says Vikram, when we’ve completed the paperwork. ‘Got to get this into you, then take some blood’. He waves a cannula around. It occurs to me that, were it not for his ethnicity, Vikram would be perfectly cast as a young Bertie Wooster.

‘I have crap veins,’ I tell him. ‘I’m also left-handed, so if you could put it in my right arm, that’d be great’.

Vikram looks nervous, but gets the cannula into the back of my right hand on his first attempt. ‘Ha!’ he cries. ‘Now let’s get some blood.’ Unfortunately, the blood can’t be drawn from the cannula, so he has to inject my left arm. Again – and he smiles as though he has just been presented with an unexpected gift – he hits my vein first time and decants my blood into a number of coloured vials.
‘One last thing,’ says Vikram, preparing a syringe of saline. ‘Let’s flush that cannula.’ He unscrews the stopper on the cannula; blood trickles over my wrist and onto the floor.

‘Oopsie!’ he says, trying not to look too crestfallen. He injects the saline, then wanders off to find a cloth. I feel sorry for him, so when Dr Corbett comes over to ask how Vikram is performing, I beam, say ‘fine,’ and hover my foot over the blood spill so he doesn’t see it.

Vikram’s next task is to walk me through indistinguishable pale blue corridors to the imaging department, for a chest X-ray.

‘This is my first week in the renal department,’ he tells me, springing along.

Ah, I think. Makes sense. ‘But you’ve inserted cannulas before?’

‘Oh yes,’ he says. ‘Having that cannula put in will probably be the most painful part of your transplant.’

I raise an eyebrow at him. ‘I’ve already had two transplants,’ I say. ‘Believe me, cannulation is not the most painful part.’

He snorts. ‘Ha! Guess not. Silly thing to say, really.’

At least he has the decency to look sheepish. Hospital workers have a bizarre tendency to think that, because they’ve witnessed hundreds of people going through the same procedure, they know how it feels themselves. (Over the following ten days, I will be told by several healthy-looking nurses that my pain really isn’t that bad and that I only need a couple of paracetamol, as though I were suffering a mild headache and had not, a few days earlier, been sliced from solar plexus to crotch.)

By the time I return from my X-ray, Jayne has arrived. There are no beds free, so we are placed in a treatment room at the end of the ward.

As soon as we are alone, we embrace.

‘Are you okay, baby?’ I ask.

Jayne nods. ‘A bit in shock. More to the point, how are you?’

‘Same,’ I say. The change of plan has thrown us both. Ever since my morning conversation with Dr Corbett, I have felt like I am acting in a play that has gone seriously off-script. I am improvising as best I can, but am failing to connect with my character on anything but the most superficial level.
We hug again, holding onto each other, not wanting to let go.

When we finally pull apart, Jayne draws the blinds. I undress, put on the two hospital gowns left on the bed and swallow the pre-med tranquiliser the anaesthetist has prescribed for me.

At two o’clock, a nurse puts her head round the door. ‘They’re ready for you, Rachel.’

Jayne squeezes my hand. ‘See you later, sweetheart. Love you.’

‘Love you too,’ I whisper.

I walk barefoot towards the operating theatre. The nurse who called me walks behind me; in front of me is another nurse who is carrying a large white padded box. Halfway to theatre, I realise what is in that box.

I’m following my kidney. That thing in front of me is going to be inside my body in an hour. I can’t decide whether the surreal feeling this evokes is pleasant or horrifying.

General anaesthetics do strange things to time and it is only a second after a blonde anaesthetist tells me to imagine I’m relaxing on a beach (with a needle in my arm?) that I am opening my eyes in a large, almost empty room. By my side, watching over me, is Ivie, a middle-aged Nigerian nurse. She smiles often and speaks seldom.

There is pain in my abdomen and my mouth is dry. I have a drip in my right hand and some octopus-like drip, with about five tubes, dangling out of my neck. I move my hand over my body. Catheter – check. Tube coming out of my belly to drain fluid from the wound – check. Nasogastric tube: ooh, that’s a new one. If we were playing medical accessory bingo, I’d have a full house.

My favourite accessory is the dark brown button in my right hand, which delivers a shot of Fentanyl* to me whenever I press it. I am merrily pressing my button and moistening my mouth by munching ice-chips when Mr Hakim, my surgeon, appears at the foot of my bed. Mr Hakim, I have learnt, is an international superstar of the scalpel-wielding fraternity (though this doesn’t stop the nurses from referring to him as ‘Mr Hack-‘em-out-and-hack-‘em-in’). He is wearing a jumper and chinos and he smells fantastic: musky aftershave wafts up my one free nostril as he approaches.

‘Well, Rachel, we’re very pleased. Technically, the surgery was very difficult, but it’s a good kidney.’ He points at my stomach. ‘Shall we take a look?’ I nod.

He peels back the dressing that runs down my mid-line. Underneath, I have a long neat cut, held together by about forty staples. It looks like a zip. ‘Very nice,’ says Mr Hakim, rubbing his hands together.

‘Right, I shall leave you to it. Better get a nurse to put another dressing on.’ And off he walks, leaving me alone with Ivie.

I examine my other two transplant scars, on either side of the new cut. Together, the three wounds form an arrow pointing to my genitals. Nice. Perhaps, when I’m better, I should complete the look with some light vajazzling.

I suddenly realise that all that lying down unconscious has filled my lungs with phlegm.

‘I need to cough,’ I tell Ivie, who brings me a folded towel.

‘Press this to your stomach,’ she says. I obey and hack.

Holy crap. Fentanyl or no Fentanyl, that is bloody agonising. For the second time today, I fill a room with the word ‘fuck’. When I finally open my eyes, I am pleasantly surprised to see that I have not decorated Ivie with my entrails.

‘Sorry for my language,’ I croak.

‘Don’t worry about it,’ she says, laughing.

At 8pm, porters wheel me back to De Wardener. Jayne has left to travel back to Kent, but Mum and Dad have arrived and spend a short time checking on me before returning to their hospital flat. Alone, I read and listen to my iPod until lights out at 10pm.

Here I am in the ward, in the midst of the beeping. As an added extra, the man in the next bed has a snore that sounds like a horrific case of diarrhoea. These noises, together with the pain in my belly, combine to deprive me of proper sleep. I doze on and off all night.

By 9am the next morning, my creatinine** has come down from 250 to 75. Already, my kidney function is normal.

Postscript

At just over a month post-operation, the kidney is still performing excellently. I anticipate returning to work at the beginning of July.

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* An opioid, for pain relief
** Creatinine is a by-product of muscle metabolism. With normal kidney function, creatinine levels in the blood are between 60-120mmol/litre