This review was reprinted with permission by Dr. Christopher Blagg.
The world is full of caregivers, many of whom are not professionals but rather are family members or close friends. While many care for the old or the disabled with various chronic problems there are now some 350,000 patients in the United States on some form of artificial kidney treatment because of irreversible kidney failure. Each has family members and others who are impacted by the disease and the need for repeated dialysis treatments. A small proportion of these patients treat themselves or are treated in the home with even more involvement of family and friends.
Poignant Moments . . . A Caregiver’s Perspective by John Francis Wissler is a remarkable account of the life and death of a dialysis patient as seen over the years by her friend, lover and caregiver. It covers twelve years of Lois’ life, the complications of her kidney failure, and the last seven years when she was treated by hemodialysis in a center and then treated herself by peritoneal dialysis, and finally with home hemodialysis.
When we first started using home hemodialysis in Seattle more than 40 years ago, it very soon became obvious that whether a family member or friend was actively involved in the treatments or merely stood by, they came under pressure from the repetitive nature of the treatment. Three times a week for hemodialysis and every day with peritoneal dialysis.
We also realized the importance, as with any chronic disease, of the patient becoming as knowledgeable as possible about their illness and its treatment and becoming responsible for doing as much for themselves as possible. Even so, the pressures on the family member or friend are considerable.
This book describes in detail the ups and downs of the life of one particular dialysis patient. Not all patients have so many trials and tribulations on dialysis, and some will get a kidney transplant. For the others, as the book suggests, treatment at home is better in many ways provided the patient has a home and someone to support them and wishes to do this treatment at home. Perhaps Lois would have done better today as the even greater benefits of doing hemodialysis almost every day are becoming obvious.
This book is an account of how two ordinary people coped with adversity for a number of years and the effects this had on them. Both Lois and John, the book’s author, have a lot to tell us all. It is great, excellent, and very touching.
Christopher R. Blagg MD FRCP
Professor Emeritus of Medicine, University of Washington
Executive Director Emeritus, Northwest Kidney Centers, Seattle