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Long before anyone asked the Make America Great Again crowd to pinpoint exactly when America was great if you were Black, I heard a White stand-up comedian joke about how he could pretty much go back to any time in history and be ok, and acknowledged a Black person would not be ok. Hell, we’re still not ok.
But when I think about medicine, no one could go back in time and expect to be better off. And not just from the discovery of antibiotics or anesthesia perspective—from all the perspectives!
After recording my latest YouTube video for the fifty-leventh time before getting a usable version, I realized I didn’t answer the question posed by the inspiration email. In the video, I talk about how to bring up the notion of stopping dialysis to the nephrologist, but the writer was asking how to bring it up to their sister on dialysis. Anyone familiar with the vernacular “fifty-leventh” knows that means I did not have it in me to do even one more take. But I can address their question here.
“My sister won’t let me have anything I want to eat,” said Mr. G during his primary care clinic visit. In his late fifties, Mr. G had suffered a stroke that had taken a toll on his memory. His sister had stepped in to help.
“Like what?” I asked.
“Like burritos.”
“Why not?”
“Because of my kidney failure.”
I did a little what you talkin’ ‘bout Willis pout, as I didn’t remember him as having kidney failure.
Mr. Garcia was one of the lucky ones.
Not in the born-in-poverty or kidney-failure-by-30 sense. But lucky in the sense that by the time his kidneys failed completely, he was in California where Medicaid pays for undocumented folks get the same dialysis as the US-born and not in one of the 38 states that wait until undocumented people show up to their ERs damn near dead before they will give them a dialysis treatment or three before they send them back out to start the process again five or six days later—even though it is far more expensive than standard care. Because racism.
