Thread by @TheRealDoctorT

“And I don’t want a never-ending life.
I just want to be alive,
while I’m here...”

- “Spirits,” The Strumbellas.

(Thread below.)

“This room is filled with dead people!”

The nephrologist seems proud as he gestures to the dialysis unit he is showing me.

“Every person in here should be dead! Saved by the miracle of dialysis!”

He sounds like P.T. Barnum.

I wince at the deeply troubling words. 1/

It’s early in my career. I’m interviewing for different job opportunities. This nephrologist runs a big city practice and seems eager to take me under his wing.

He has asked me to tag along on his dialysis rounds before a lunchtime interview.

I said I’d be delighted to. 2/

As we see each patient, he makes smalltalk with lots of theatrical gestures. The patients seem annoyed, and I realize the show and tell is all to impress me.

Now I’m getting annoyed too.

He tells a patient he needs to increase his dialysis time to four and a half hours. 3/

The patient looks at him, incredulous. “Doc, have you ever sat in a chair for four and a half hours, three times a WEEK?”

The nephrologist brushes aside his question with a bevy of well-rehearsed phrases.

And we are on to the next patient. A 92-year old gentleman. 4/

The nephrologist leans close to me and whispers, conspiratorially, “This poor man has no quality of life. Just sits with his dog every day. But he won’t quit his dialysis!”

I look at the patient. He’s reading a newspaper contentedly.

I ponder his quality of life... 5/

And so on, and on.

I’m dragged from one patient to another, until the nephrologist wraps up with another canned bit of self-promotion as his charge nurse dutifully recites his praises and how thankful she is to work with him.

Her eyes tell a different story. Subtly. 6/

“You see Sayed? A room of miracles!”

He says it triumphantly, but I sense no triumph here...

Later that evening, I’m back in my hotel room. Sleeping at night has always been problematic for me. I am wide awake.

I have nothing better to do so I decide to try something. 7/

I’m going to sit in a recliner for four and a half hours. Just to try it. To see what it feels like.

Within 15 minutes I’m staring fixedly at the clock, trying to make it go faster.

I flick through the different TV stations. Nothing’s worth watching.

Damn. 8/

I grab a book I’ve been reading from a nearby sidetable. “Freakonomics.”

It’s a great book, but it barely distracts me from the reality of how much time I’ve got left to go.

Two hours into it and my back is bothering me. My legs feel weirdly sore. I need to pee. 9/

I force myself to still my mind and calm my thoughts.

I think of the 92 year-old with “no quality of life.” Who decides what an acceptable quality of life is?

Maybe all he wants is to be able to sit with his dog and to read the newspaper every day.

Maybe that’s enough. 10/

By the time it’s four hours, I’ve finished my book and am watching late-night informercials. Every muscle in my legs and lower back is painfully uncomfortable.

The time has passed at a snail’s pace.

And I still have 30 minutes to go.

I can’t imagine this thrice weekly... 11/

What bothered me most about the nephrologist was the lack of empathy.

This thought occurs to me as I start getting ready for bed, aching from the recliner.

Empathy would have led to different interactions with almost every single patient we saw that day. 12/

I think of empathy as a function of distance. When you empathize with someone, you connect with them, and you close that distance.

When you empathize completely, that distance is close to zero, and it’s almost like you’re in that person’s shoes, sharing their experiences. 13/

As I fall asleep that night I have a vivid nightmare.

The nephrologist is once again taking me on a tour of a dialysis unit, but I can’t see any patients.

It’s empty.

“This room is filled with dead people!”

He leers at me, and I realize the truth.

We are the dead people. 14/

I wake up with a jolt, sweating, and rubbing my eyes.

Squinting at the sickly green glow of the digital clock, I sigh as I realize it’s barely 2AM.

The dream was a warning.

Empathy can die. And without it, something more crucial can die too.

I can’t let it.

I am alive.

(Note: Just because I sat in a chair for four hours doesn’t mean I understand what it’s like to be on dialysis.

Just because you think you’re empathizing with someone doesn’t mean you are, or that you understand them, or that you share anything at all.

But it’s worth trying.)