Compassion Trumps Judgment: A Lesson from Dialysis Patients

As a clinical social worker, I work with very ill people with chronic conditions, amputations, and a physical attachment to a machine that performs the tasks their organs have failed to do. These people are often stigmatized because of the history which led them to this place. Many have diabetes and high blood pressure- conditions which can be controlled with diet and medication compliance. Along the way in life there were distractions, children, financial strains and, honestly, pure denial. These individuals trying to make it through life ended up as patients on a dialysis machine. The reality of their situation is harsh. Not only are they on more restrictions, medications, and diets than their original condition called for, but now they are judged for being sick. I get it; I see where these people failed to make good choices and care for their health. I also so happen to get to know these individuals as just that- real, human, people who love, laugh, care, and survive despite their inherited genetic condition or self-induced disease. In either situation there is suffering, and it is undeniable. Is it ever an appropriate response to someone else’s suffering to say, “Well that’s what you get for [fill in the blank of something you may be guilty of as well]?” It's surely not the most loving response.

I could guarantee the decrease in distanced judgment via direct observation and interaction with the patients (the people) I work with every day. These people are funny and kind and some are doctors and nurses.  There are people on hemodialysis working full time jobs and making it to every four hour treatment three times a week (something I'm not sure I could do myself). They are worthy of education and quality care. You could be attached to a dialysis machine too and self-willing your kidneys to work properly could not keep you from it. Kidney disease happens, sometimes slowly, sometimes suddenly, sometimes not at all- and that does not make one superior- it makes one a human with functioning kidneys. Everyone has weakness; I’ve never met someone who is perfectly strong in everything. I don’t think humans come in that model. 

I have battled my own judgments and frustration transitioning into the world of nephrology. My goal as their social worker is for the patients to have a good quality of life and that often equates to behavior change. Sometimes this does not happen the way I would like, and sometimes patients die because of their choices. The individual with the malady is capable of changing everything or unable to escape the heavy-load of their life, but they surely deserve a helping hand along the way. The patients are the ones who suffer most, and I am now able to recognize the internal pain of dependence on others, of which they are so often blamed.  

My hope personally is to be changed by the love of these people who have lived a unique life story, made mistakes, received forgiveness, survived another day and yet care enough to talk to me. My hope for the world is to embrace education on prevention, love the person-not the disease, and find a cure! A doctor told me recently that artificial kidneys will be in use within our lifetime. How wonderful it is to know that all the patients attached to a dialysis machine could someday walk away with their own new kidney and live free from the constraints of constant healthcare, chemicals and fellow man’s downward eye.  It is always a sobering dose of reality when a former patient walks through the door of the dialysis center post-transplant. They become just another person with functioning kidneys making their way through life with all the potential in the world, just like you and just like me.