Tuesday, 15 March 2011

Donate Life Organ and Tissue Donation Blog (sm)

Donate Life Organ and Tissue Donation Blog (sm)

This, other than being very interesting for research, just made me realise something I should have realised soooooooo long ago;

If I'm trying to get an audience to care a little bit about how my characters have to spend a substantial amount of time focussing on the ridiculous practicalities of dialysis, how they can't miss even a little bit of treatment because of the grave ramifications of lack of treatment, I can't just lead into that with how bad total kidney failure is - I have to include a character who just dies! Not really developed, just really body-shape changingly sick, and then just dies.

Of kidney failure I mean. Not of being set on fire, not shot, not run down by an angry mob, just the organs going kaput on their own. I know this sounds probably a tiny bit abstract, but other than abstract a little bit obvious. But really, it had not occurred to me that I couldn't just frame what the death would be like in conversations, charts, photos, I HAVE to show it to fully and efficiently make plausible the lengths to which the characters will go to keep focussing on it.

This is a clear cut example of someone being so close to what they're writing that they don't see the most important thing right in front of them. To me, how bad a kidney failure death would be is ingrained in my mind, because when I was put in hospital I was ten days from being dead, and I remember very clearly how bad I felt. It wasn't just easy for me to gauge incrementally how much worse I would be two days from then, five days, then the tenth day. The swift progress of feeling a bit ill to feeling like what I was (being, basically, poisoned by my own body) was incrementally obvious to me over the month before, so I had a pretty good sense that the last ten days must be pretty horrifying.

But an audience doesn't know any of that. No conversation could ever make you really picture what that's like. You have to show it. Obviously, showing it doesn't make anyone know what it's like either, but seeing something horrible is the closest thing we get to feeling like we know it's horrible, and being really glad we aren't feeling that. Seeing and hearing the infamous lil bit in 127 Hours is most definitely nothing like actually going through it but it's the best we got.

I better start finding out from the hospital quite what the worst death from kidney failure can be, and the combination of organ problems that come from it...


  1. Actually,dieing from kidney failure has been called the 'peaceful death'. The worse part I would think are the hallucinations that one experiences as the kidneys shut down. The body fills with fluid and you drift into a coma. I saw my dad go through it and it took 2 weeks for him to pass. I am waiting for a kidney transplant now. Been on the list for a year.

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  3. I understand your point - I was told if it had gone undiagnosed another week I would have likely died 'in my sleep', if the 3 stone of extra fluid didn't tip me towards heart implosion first. However I have to differ with you on my perception of the lead in; when I was admitted I'd been doing all the usual (full time job, going to the gym four or five times a week, shopping, cleaning, all that jazz) and I felt terrible, and it was not peaceful. The medical team said if I'd kept it up a few more days I would have felt exponentially worse each day in line with how much sicker I was, and personally that translates to me as I wouldn't have felt very peaceful until the time comes that you are totally out of it. Apparently I came in with approx 2800 creatinine level, which they claimed meant I shouldn't have been able to stand let alone go to work, the gym, write scripts and shop for food and clean my house. They said it was an unusual case; they hadn't met anyone stupid enough to carry on that long, so that made me feel special. :p I'd be interested to know your own experience, to get a different perceptive.

    My point being, everyone's different; it all depends on the individual situation.

    I don't say this to deride your personal experiences. My point in fact is that an area of illness such as kidney failure is so broad it defies having blanket assumptions made about patient experience, when there is such a variety of issues involved. In the case my script, it requires communicating the stakes can be varied, both high and low, to justify why some characters go to some extreme lengths to avoid their death. It is oversimplified and poor motivation for the audience if they think every death is peaceful and quite nice. I'm sure you are right about your father, but people experience kidney failure because of so many things; as a result of autoimmune conditions, dying because of the totality of their bodily problems. Some people die after dialysis has taken a toll on their heart, some heart issues arise because patients have a particular problem controlling their potassium, or hypertension and then of course you have the most common condition of all, and it's varying degrees of cyst severity. For me personally the description that 'dying from kidney failure is the 'peaceful death' is an inaccurate use of words, since it only applies to specific parts of the process, specific patients and specific combinations of problems. And it contributes to the popular belief amongst the unfamiliar that kidney illness is not all that bad. Which I'm personally against, though it's something that has to be accepted as part of the nature of society, there are very few illnesses or areas of general illness that everyone in society is familiar with. There are thousands I would have a simplified view of if I met a patient. But I'm generally against the simplification. For me, it was and is surprising how many misconceptions are believed. In my case I most noticed several things, such as that most people joked that I had been getting drunk too much, and post transplant almost everyone thinks that it's a miracle cure that requires no upkeep.

    I'm sure you know your own and your father's experience better than I'll ever imagine, and I know many people who stay comfortable during the whole experience, but for the script I'm trying to cover a solid spectrum across 6 – 10 characters, including those staying healthy and post transplant, those awaiting their second transplant doing well on dialysis, and those doing poorly...

    More importantly, I'm sorry to hear about your father, and I send my best wishes to you for your transplant, when it's scheduled; if you haven't been put off by my sheer intensity (it's nothing personal, to me this is normal; friends either get used to it or eventually tell me to fuck off) would love to hear more about how things are going for you and your family x


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