on April 14th 2005 I was a primary care physician walking through a hospital
physician walking through a hospital
physician walking through a hospital hall like I had done many times before
hall like I had done many times before
hall like I had done many times before but this day was different because I was
but this day was different because I was
but this day was different because I was about to be the patient I was about to
about to be the patient I was about to
about to be the patient I was about to give my left kidney to Robert Phillips a
give my left kidney to Robert Phillips a
give my left kidney to Robert Phillips a man who had been on dialysis for several
man who had been on dialysis for several
man who had been on dialysis for several years and who I have started dating less
years and who I have started dating less
years and who I have started dating less than a year prior now how I got to this
than a year prior now how I got to this
than a year prior now how I got to this point I think can best be summed up by
point I think can best be summed up by
point I think can best be summed up by part of a quote from Maya Angelou when
part of a quote from Maya Angelou when
part of a quote from Maya Angelou when you know better do better and I say this
you know better do better and I say this
you know better do better and I say this because when I was a resident physician
because when I was a resident physician
because when I was a resident physician and training I took care of lots of
and training I took care of lots of
and training I took care of lots of patients in the hospital who are on
patients in the hospital who are on
patients in the hospital who are on dialysis but then I was usually
dialysis but then I was usually
dialysis but then I was usually sleep-deprived and always eager to get
sleep-deprived and always eager to get
sleep-deprived and always eager to get on to the next patient
on to the next patient
on to the next patient I paid careful attention to the dialysis
I paid careful attention to the dialysis
I paid careful attention to the dialysis orders and the blood test results but
orders and the blood test results but
orders and the blood test results but sadly not so much to the person living
sadly not so much to the person living
sadly not so much to the person living with a serious illness all that changed
with a serious illness all that changed
with a serious illness all that changed when I became Roberts girlfriend as
when I became Roberts girlfriend as
when I became Roberts girlfriend as Roberts girlfriend I wasn’t in a rush
Roberts girlfriend I wasn’t in a rush
Roberts girlfriend I wasn’t in a rush anymore I wanted to be with him at
anymore I wanted to be with him at
anymore I wanted to be with him at dialysis as often as possible to help
dialysis as often as possible to help
dialysis as often as possible to help him pass the time for hours three times
him pass the time for hours three times
him pass the time for hours three times a week trying hard not to move his left
a week trying hard not to move his left
a week trying hard not to move his left arm too much and dislodged the needles
arm too much and dislodged the needles
arm too much and dislodged the needles that were connecting him to the dialysis
that were connecting him to the dialysis
that were connecting him to the dialysis machine as girlfriend I watched him
machine as girlfriend I watched him
machine as girlfriend I watched him struggle to not drink too much liquid in
struggle to not drink too much liquid in
struggle to not drink too much liquid in between Dallas’s treatments even though
between Dallas’s treatments even though
between Dallas’s treatments even though he was thirsty all the time because if
he was thirsty all the time because if
he was thirsty all the time because if he did because his kidneys couldn’t pee
he did because his kidneys couldn’t pee
he did because his kidneys couldn’t pee it out he would pay for it with swelling
it out he would pay for it with swelling
it out he would pay for it with swelling and cramping and feeling short of breath
and cramping and feeling short of breath
and cramping and feeling short of breath I went with him to his transplant
I went with him to his transplant
I went with him to his transplant evaluation appointment and there I saw a
evaluation appointment and there I saw a
evaluation appointment and there I saw a sight of medicine that I couldn’t see as
sight of medicine that I couldn’t see as
sight of medicine that I couldn’t see as a primary care doctor it was a sigh that
a primary care doctor it was a sigh that
a primary care doctor it was a sigh that felt like it was stacked against him
felt like it was stacked against him
felt like it was stacked against him because it was part of a system in which
because it was part of a system in which
because it was part of a system in which blacks waited nearly two years longer to
blacks waited nearly two years longer to
blacks waited nearly two years longer to get a kidney transplant than whites so
get a kidney transplant than whites so
get a kidney transplant than whites so it was that day that I decided I was
it was that day that I decided I was
it was that day that I decided I was gonna give him one of my kidneys because
gonna give him one of my kidneys because
gonna give him one of my kidneys because I knew what he was going through because
I knew what he was going through because
I knew what he was going through because I knew better and because I knew better
I knew better and because I knew better
I knew better and because I knew better I also went on to become a nephrologist
I also went on to become a nephrologist
I also went on to become a nephrologist a kidney doctor so my goal today is to
a kidney doctor so my goal today is to
a kidney doctor so my goal today is to tell you about three patients that I’ve
tell you about three patients that I’ve
tell you about three patients that I’ve encountered since becoming a
encountered since becoming a
encountered since becoming a nephrologist that I say demonstrate how
nephrologist that I say demonstrate how
nephrologist that I say demonstrate how we can all do better
we can all do better
we can all do better the first is Chris when I met Chris he
the first is Chris when I met Chris he
the first is Chris when I met Chris he was this 25 year old fresh-faced
was this 25 year old fresh-faced
was this 25 year old fresh-faced strawberry blonde head at young man who
strawberry blonde head at young man who
strawberry blonde head at young man who should have been able to just focus on
should have been able to just focus on
should have been able to just focus on his future but instead he was facing
his future but instead he was facing
his future but instead he was facing kidney failure his kidneys were failing
kidney failure his kidneys were failing
kidney failure his kidneys were failing because of an autoimmune disease called
because of an autoimmune disease called
because of an autoimmune disease called IgA nephropathy and he needed to start
IgA nephropathy and he needed to start
IgA nephropathy and he needed to start dialysis less than a year later now I
dialysis less than a year later now I
dialysis less than a year later now I don’t know how many of you noticed this
don’t know how many of you noticed this
don’t know how many of you noticed this little guy at the bottom of the picture
little guy at the bottom of the picture
little guy at the bottom of the picture having tea with Chris but this is his
having tea with Chris but this is his
having tea with Chris but this is his dialysis catheter surgically implanted
dialysis catheter surgically implanted
dialysis catheter surgically implanted into his belly and this is the way Chris
into his belly and this is the way Chris
into his belly and this is the way Chris coped with his illness take the little
coped with his illness take the little
coped with his illness take the little face on it named it called it his
face on it named it called it his
face on it named it called it his closest newest friend Chris also had two
closest newest friend Chris also had two
closest newest friend Chris also had two older brothers both healthy but both
older brothers both healthy but both
older brothers both healthy but both said no to giving baby brother a kidney
said no to giving baby brother a kidney
said no to giving baby brother a kidney they figured he’s on the waiting list to
they figured he’s on the waiting list to
they figured he’s on the waiting list to get a kidney from somebody who’s passed
get a kidney from somebody who’s passed
get a kidney from somebody who’s passed away and he can just do dialysis until
away and he can just do dialysis until
away and he can just do dialysis until then now the problem with that logic is
then now the problem with that logic is
then now the problem with that logic is that it can take up to nine years to get
that it can take up to nine years to get
that it can take up to nine years to get a deceased donor kidney transplant
a deceased donor kidney transplant
a deceased donor kidney transplant depending on your blood type and where
depending on your blood type and where
depending on your blood type and where you live and every year there are
you live and every year there are
you live and every year there are another hundred thousand people on that
another hundred thousand people on that
another hundred thousand people on that same list but we only do about 12,000
same list but we only do about 12,000
same list but we only do about 12,000 deceased donor kidney transplants each
deceased donor kidney transplants each
deceased donor kidney transplants each year and another 5,000 roughly living
year and another 5,000 roughly living
year and another 5,000 roughly living donor transplants so that’s how we end
donor transplants so that’s how we end
donor transplants so that’s how we end up with thirteen people dying
up with thirteen people dying
up with thirteen people dying every day waiting for a kidney
every day waiting for a kidney
every day waiting for a kidney transplant one of the brothers came to
transplant one of the brothers came to
transplant one of the brothers came to visit Chris for the first time since he
visit Chris for the first time since he
visit Chris for the first time since he started Dallas’s and he saw how Chris
started Dallas’s and he saw how Chris
started Dallas’s and he saw how Chris had to connect himself every night to a
had to connect himself every night to a
had to connect himself every night to a Dallas’s machine that pushed and pulled
Dallas’s machine that pushed and pulled
Dallas’s machine that pushed and pulled fluid in and out of the space between
fluid in and out of the space between
fluid in and out of the space between his skin and his abdominal organs all
his skin and his abdominal organs all
his skin and his abdominal organs all night long and Chris just hoped it he
night long and Chris just hoped it he
night long and Chris just hoped it he could get through the night before the
could get through the night before the
could get through the night before the alarm would be beeping are accidentally
alarm would be beeping are accidentally
alarm would be beeping are accidentally tugging on his catheter and that’s all
tugging on his catheter and that’s all
tugging on his catheter and that’s all it took to make the brother change his
it took to make the brother change his
it took to make the brother change his mind
mind
mind and he decided to give Chris one of his
and he decided to give Chris one of his
and he decided to give Chris one of his kidneys
kidneys
kidneys now his donation gave Chris the best
now his donation gave Chris the best
now his donation gave Chris the best chance for a longer and better quality
chance for a longer and better quality
chance for a longer and better quality of life better than a deceased donor
of life better than a deceased donor
of life better than a deceased donor kidney could way better than the Alice’s
kidney could way better than the Alice’s
kidney could way better than the Alice’s could after five years two-thirds of all
could after five years two-thirds of all
could after five years two-thirds of all kidney transplants are going strong at
kidney transplants are going strong at
kidney transplants are going strong at five years but only about a third of
five years but only about a third of
five years but only about a third of Dallas’s patients are even alive now
Dallas’s patients are even alive now
Dallas’s patients are even alive now four months after surgery Robert became
four months after surgery Robert became
four months after surgery Robert became my husband I know he kind of had to
my husband I know he kind of had to
my husband I know he kind of had to marry me
but he has had my kidney for 12 years
but he has had my kidney for 12 years and Counting and the longest living
and Counting and the longest living
and Counting and the longest living kidney lasted for 54 years
kidney lasted for 54 years
kidney lasted for 54 years in a man who died when he was 88 years
in a man who died when he was 88 years
in a man who died when he was 88 years old now this man happened to be named
old now this man happened to be named
old now this man happened to be named Robert Phillips – you know at my core I
Robert Phillips – you know at my core I
Robert Phillips – you know at my core I am a superstitious country girl so I
am a superstitious country girl so I
am a superstitious country girl so I take that as a very good sign so if now
take that as a very good sign so if now
take that as a very good sign so if now that you know what people with kidney
that you know what people with kidney
that you know what people with kidney failure are facing if you know if
failure are facing if you know if
failure are facing if you know if there’s somebody in your life who is in
there’s somebody in your life who is in
there’s somebody in your life who is in need of a kidney transplant and you’re
need of a kidney transplant and you’re
need of a kidney transplant and you’re healthy enough to give one I hope you’ll
healthy enough to give one I hope you’ll
healthy enough to give one I hope you’ll consider it I get that it’s a bit
consider it I get that it’s a bit
consider it I get that it’s a bit daunting I had all kinds of butterflies
daunting I had all kinds of butterflies
daunting I had all kinds of butterflies in my stomach the morning of surgery
in my stomach the morning of surgery
in my stomach the morning of surgery but when I woke up and I saw this bag at
but when I woke up and I saw this bag at
but when I woke up and I saw this bag at the foot of Roberts bed in recovery just
the foot of Roberts bed in recovery just
the foot of Roberts bed in recovery just filling up with lots of pale yellow
filling up with lots of pale yellow
filling up with lots of pale yellow urine I was like that’s my kidney doing
urine I was like that’s my kidney doing
urine I was like that’s my kidney doing that
and I was just so happy because I knew
and I was just so happy because I knew that soon he won’t be able to drink as
that soon he won’t be able to drink as
that soon he won’t be able to drink as much ice-cold beverages his thirst
much ice-cold beverages his thirst
much ice-cold beverages his thirst desired and if I could go back in time I
desired and if I could go back in time I
desired and if I could go back in time I would do it again and to be a donor you
would do it again and to be a donor you
would do it again and to be a donor you don’t need to be related and the only
don’t need to be related and the only
don’t need to be related and the only race that matters is the human race you
race that matters is the human race you
race that matters is the human race you don’t even have to be a perfect match in
don’t even have to be a perfect match in
don’t even have to be a perfect match in fact Robert and I only had 1 out of 6
fact Robert and I only had 1 out of 6
fact Robert and I only had 1 out of 6 genetic markers felt important at the
genetic markers felt important at the
genetic markers felt important at the time and common at the very least I hope
time and common at the very least I hope
time and common at the very least I hope you will consider registering as a organ
you will consider registering as a organ
you will consider registering as a organ donor with the DMV and let your family
donor with the DMV and let your family
donor with the DMV and let your family know that you did so that after you’re
know that you did so that after you’re
know that you did so that after you’re gone
gone
gone they will uphold your wishes and all
they will uphold your wishes and all
they will uphold your wishes and all your healthy parts will go to make the
your healthy parts will go to make the
your healthy parts will go to make the lives of others longer and better now if
lives of others longer and better now if
lives of others longer and better now if you’re one of the 26 million adults in
you’re one of the 26 million adults in
you’re one of the 26 million adults in this country with chronic kidney disease
this country with chronic kidney disease
this country with chronic kidney disease the story of my next patient who I’ll
the story of my next patient who I’ll
the story of my next patient who I’ll call miss a photo is for you miss a
call miss a photo is for you miss a
call miss a photo is for you miss a photo was almost 50 years old when I met
photo was almost 50 years old when I met
photo was almost 50 years old when I met her she had this smooth brown Samoan
her she had this smooth brown Samoan
her she had this smooth brown Samoan skin but her kidneys were shrunken and
skin but her kidneys were shrunken and
skin but her kidneys were shrunken and shriveled hardly functioning because of
shriveled hardly functioning because of
shriveled hardly functioning because of years and years of uncontrolled diabetes
years and years of uncontrolled diabetes
years and years of uncontrolled diabetes and high blood pressure which caused
and high blood pressure which caused
and high blood pressure which caused two-thirds of chronic kidney disease in
two-thirds of chronic kidney disease in
two-thirds of chronic kidney disease in this country but even though she has
this country but even though she has
this country but even though she has such advanced disease she tried to run
such advanced disease she tried to run
such advanced disease she tried to run away from it she wouldn’t believe me
away from it she wouldn’t believe me
away from it she wouldn’t believe me when I told her that her kidneys would
when I told her that her kidneys would
when I told her that her kidneys would soon fell and that she needed to prepare
soon fell and that she needed to prepare
soon fell and that she needed to prepare for analysis she said things like you
for analysis she said things like you
for analysis she said things like you know the swelling in my legs that’s
know the swelling in my legs that’s
know the swelling in my legs that’s that’s because I’ve been on my feet all
that’s because I’ve been on my feet all
that’s because I’ve been on my feet all day and this metallic taste that’s
day and this metallic taste that’s
day and this metallic taste that’s because of the pills that you tell me to
because of the pills that you tell me to
because of the pills that you tell me to take not because of kidney failure truth
take not because of kidney failure truth
take not because of kidney failure truth is there is no outrunning kidney failure
is there is no outrunning kidney failure
is there is no outrunning kidney failure unless something else gets you first
unless something else gets you first
unless something else gets you first like you get hit by a bus or your heart
like you get hit by a bus or your heart
like you get hit by a bus or your heart stops beating kidney failure will catch
stops beating kidney failure will catch
stops beating kidney failure will catch you and I know she was hoping for a
you and I know she was hoping for a
you and I know she was hoping for a miracle but in truth the only miracle
miracle but in truth the only miracle
miracle but in truth the only miracle that was really in her near future was
that was really in her near future was
that was really in her near future was dialysis because 60 years ago
dialysis because 60 years ago
dialysis because 60 years ago Dallas’s didn’t exist and everybody with
Dallas’s didn’t exist and everybody with
Dallas’s didn’t exist and everybody with kidney failure just passed away so
kidney failure just passed away so
kidney failure just passed away so because miss of futa could not face the
because miss of futa could not face the
because miss of futa could not face the reality she ended up with a lot of
reality she ended up with a lot of
reality she ended up with a lot of avoidable things like the trauma of
avoidable things like the trauma of
avoidable things like the trauma of feeling like you’re about to die and
feeling like you’re about to die and
feeling like you’re about to die and having to call 9-1-1 13 hours in the
having to call 9-1-1 13 hours in the
having to call 9-1-1 13 hours in the emergency room a plastic Dallas’s
emergency room a plastic Dallas’s
emergency room a plastic Dallas’s catheter in her chest a hospital
catheter in her chest a hospital
catheter in her chest a hospital admission she was looking at dialysis as
admission she was looking at dialysis as
admission she was looking at dialysis as if it would be the end of her life when
if it would be the end of her life when
if it would be the end of her life when in truth it would just make her life
in truth it would just make her life
in truth it would just make her life different no it wouldn’t be perfect or
different no it wouldn’t be perfect or
different no it wouldn’t be perfect or take away all the issues that come with
take away all the issues that come with
take away all the issues that come with a vital organ dying yes it would have
a vital organ dying yes it would have
a vital organ dying yes it would have his frustrations and take time but the
his frustrations and take time but the
his frustrations and take time but the time in between could be filled with
time in between could be filled with
time in between could be filled with life and all the things that she wanted
life and all the things that she wanted
life and all the things that she wanted to keep doing with Dallas’s she could
to keep doing with Dallas’s she could
to keep doing with Dallas’s she could expect to live for many years without it
expect to live for many years without it
expect to live for many years without it once her kidneys fail completely
once her kidneys fail completely
once her kidneys fail completely she get a week maybe two now roughly 80%
she get a week maybe two now roughly 80%
she get a week maybe two now roughly 80% of adults in this country have
of adults in this country have
of adults in this country have significant chronic kidney disease and
significant chronic kidney disease and
significant chronic kidney disease and don’t even know it so if you might be a
don’t even know it so if you might be a
don’t even know it so if you might be a patient for example you have diabetes or
patient for example you have diabetes or
patient for example you have diabetes or high blood pressure or even if it just
high blood pressure or even if it just
high blood pressure or even if it just runs in your family
runs in your family
runs in your family get tested a simple blood and urine test
get tested a simple blood and urine test
get tested a simple blood and urine test can detect kidney disease long before
can detect kidney disease long before
can detect kidney disease long before you’ll ever feel anything and knowing is
you’ll ever feel anything and knowing is
you’ll ever feel anything and knowing is doing better for yourself and your
doing better for yourself and your
doing better for yourself and your family if you already know you’re a
family if you already know you’re a
family if you already know you’re a patient then don’t let fear get in the
patient then don’t let fear get in the
patient then don’t let fear get in the way of you accepting reality so that you
way of you accepting reality so that you
way of you accepting reality so that you can do
can do
can do how many of you saw this movie The Book
how many of you saw this movie The Book
how many of you saw this movie The Book of Eli starring Denzel Washington yeah
of Eli starring Denzel Washington yeah
of Eli starring Denzel Washington yeah not many so the next patient that I’ll
not many so the next patient that I’ll
not many so the next patient that I’ll tell you about looks exactly like Denzel
tell you about looks exactly like Denzel
tell you about looks exactly like Denzel in this movie now I know what some of
in this movie now I know what some of
in this movie now I know what some of you are probably thinking but I have
you are probably thinking but I have
you are probably thinking but I have never been among the multitudes of women
never been among the multitudes of women
never been among the multitudes of women who would just wriggle out of her
who would just wriggle out of her
who would just wriggle out of her panties and throw them on any stage that
panties and throw them on any stage that
panties and throw them on any stage that Denzel stands on I just saw my patient
Denzel stands on I just saw my patient
Denzel stands on I just saw my patient who I will call because Eli as a
who I will call because Eli as a
who I will call because Eli as a good-looking brother who had a chronic
good-looking brother who had a chronic
good-looking brother who had a chronic kidney problem now when I met Book of
kidney problem now when I met Book of
kidney problem now when I met Book of Eli
Eli
Eli he was very muscular I needed a large
he was very muscular I needed a large
he was very muscular I needed a large extra-large blood pressure cuff to take
extra-large blood pressure cuff to take
extra-large blood pressure cuff to take his blood pressure but five years later
his blood pressure but five years later
his blood pressure but five years later as his kidney disease declined from a
as his kidney disease declined from a
as his kidney disease declined from a disease called membranous nephropathy
disease called membranous nephropathy
disease called membranous nephropathy his muscles had wasted away too and so a
his muscles had wasted away too and so a
his muscles had wasted away too and so a regular blood pressure cuff would do at
regular blood pressure cuff would do at
regular blood pressure cuff would do at every visit I would tell him about all
every visit I would tell him about all
every visit I would tell him about all of his test results and cout including
of his test results and cout including
of his test results and cout including creatinine the blood tests that we used
creatinine the blood tests that we used
creatinine the blood tests that we used to find out about kidney function in
to find out about kidney function in
to find out about kidney function in 1999 a group of researchers publish a
1999 a group of researchers publish a
1999 a group of researchers publish a study of 1,600 adults who they examined
study of 1,600 adults who they examined
study of 1,600 adults who they examined to find out equations that we could use
to find out equations that we could use
to find out equations that we could use to estimate kidney function using
to estimate kidney function using
to estimate kidney function using creatinine now because creatinine is a
creatinine now because creatinine is a
creatinine now because creatinine is a breakdown product of our muscles
breakdown product of our muscles
breakdown product of our muscles released at a fairly constant rate all
released at a fairly constant rate all
released at a fairly constant rate all day the equations that they came up with
day the equations that they came up with
day the equations that they came up with also include age and gender because as
also include age and gender because as
also include age and gender because as we get older we tend to lose muscle mass
we get older we tend to lose muscle mass
we get older we tend to lose muscle mass and men tend to have higher muscle mass
and men tend to have higher muscle mass
and men tend to have higher muscle mass the women but if the patient is black
the women but if the patient is black
the women but if the patient is black they suggested that we also need to
they suggested that we also need to
they suggested that we also need to multiply by 1.2 because what they found
multiply by 1.2 because what they found
multiply by 1.2 because what they found is that blacks in their study generally
is that blacks in their study generally
is that blacks in their study generally had a higher muscle mass than the white
had a higher muscle mass than the white
had a higher muscle mass than the white folks did
folks did
folks did so these equations got applied to the
so these equations got applied to the
so these equations got applied to the entire population everybody even though
entire population everybody even though
entire population everybody even though that original study only included about
that original study only included about
that original study only included about 200 black people and no American Samoans
200 black people and no American Samoans
200 black people and no American Samoans no Native Americans no Asians no Latinos
no Native Americans no Asians no Latinos
no Native Americans no Asians no Latinos and these groups have very different
and these groups have very different
and these groups have very different body frames but in our equations they’re
body frames but in our equations they’re
body frames but in our equations they’re just not black so the implication then
just not black so the implication then
just not black so the implication then only black people are different and the
only black people are different and the
only black people are different and the problem with generalizations at least
problem with generalizations at least
problem with generalizations at least one of them is that sometimes they’re
one of them is that sometimes they’re
one of them is that sometimes they’re not true but in medicine we tend to not
not true but in medicine we tend to not
not true but in medicine we tend to not challenge these things particularly when
challenge these things particularly when
challenge these things particularly when they are in line with our underlying
they are in line with our underlying
they are in line with our underlying assumptions and beliefs like the belief
assumptions and beliefs like the belief
assumptions and beliefs like the belief that our social construct of race is the
that our social construct of race is the
that our social construct of race is the same as a real biological science even
same as a real biological science even
same as a real biological science even though the human genome project
though the human genome project
though the human genome project completed sequencing the entire human
completed sequencing the entire human
completed sequencing the entire human DNA into in 2003 and found that we
DNA into in 2003 and found that we
DNA into in 2003 and found that we humans are 99.9% identical and that
humans are 99.9% identical and that
humans are 99.9% identical and that point 1% difference does not fit into
point 1% difference does not fit into
point 1% difference does not fit into our made-up race categories now I wonder
our made-up race categories now I wonder
our made-up race categories now I wonder how many health care providers when
how many health care providers when
how many health care providers when they’re sitting in front of their
they’re sitting in front of their
they’re sitting in front of their patients interpreting lab results and
patients interpreting lab results and
patients interpreting lab results and deciding what they will do or not about
deciding what they will do or not about
deciding what they will do or not about them how many remember or even know that
them how many remember or even know that
them how many remember or even know that this race adjustment is really supposed
this race adjustment is really supposed
this race adjustment is really supposed to be about muscle mass a proxy for
to be about muscle mass a proxy for
to be about muscle mass a proxy for muscle mass or are they just focusing on
muscle mass or are they just focusing on
muscle mass or are they just focusing on the race or the person in front of them
and which one of these people they would
and which one of these people they would quote the race adjusted kidney function
quote the race adjusted kidney function
quote the race adjusted kidney function estimate to the skinny black woman or
estimate to the skinny black woman or
estimate to the skinny black woman or the white male bodybuilder these
the white male bodybuilder these
the white male bodybuilder these shortcuts can have significant negative
shortcuts can have significant negative
shortcuts can have significant negative consequences for black people who need a
consequences for black people who need a
consequences for black people who need a kidney transplant
kidney transplant
kidney transplant and happen to have lower muscle mass
and happen to have lower muscle mass
and happen to have lower muscle mass like my patient Book of Eli so I
like my patient Book of Eli so I
like my patient Book of Eli so I explained all of this to him and I asked
explained all of this to him and I asked
explained all of this to him and I asked him to collect his urine for a full 24
him to collect his urine for a full 24
him to collect his urine for a full 24 hours and get a blood test so that we
hours and get a blood test so that we
hours and get a blood test so that we could get a more accurate measure of how
could get a more accurate measure of how
could get a more accurate measure of how well his kidneys were filtering blood
what we call a glomerular filtration
what we call a glomerular filtration rate our GFR now this more accurate
rate our GFR now this more accurate
rate our GFR now this more accurate estimate showed that his GFR was 20 and
estimate showed that his GFR was 20 and
estimate showed that his GFR was 20 and that was the same as the shortcut
that was the same as the shortcut
that was the same as the shortcut equation GFR but not racist at one at 20
equation GFR but not racist at one at 20
equation GFR but not racist at one at 20 at a GFR 20 people can be placed on the
at a GFR 20 people can be placed on the
at a GFR 20 people can be placed on the waitlist for kidney transplant Book of
waitlist for kidney transplant Book of
waitlist for kidney transplant Book of Eli would have had to wait an additional
Eli would have had to wait an additional
Eli would have had to wait an additional year had I waited for his race adjusted
year had I waited for his race adjusted
year had I waited for his race adjusted estimate which was 24 at the time to
estimate which was 24 at the time to
estimate which was 24 at the time to fall to 20 and this matters because time
fall to 20 and this matters because time
fall to 20 and this matters because time on the waitlist is one of the most
on the waitlist is one of the most
on the waitlist is one of the most important determinants of when a person
important determinants of when a person
important determinants of when a person gets a kidney transplant so by using a
gets a kidney transplant so by using a
gets a kidney transplant so by using a more accurate estimate Book of Eli got
more accurate estimate Book of Eli got
more accurate estimate Book of Eli got more time on the list and for patients
more time on the list and for patients
more time on the list and for patients dealing with kidney failure time is life
so today I’ve told you about Robert and
so today I’ve told you about Robert and Chris so that you would know at least
Chris so that you would know at least
Chris so that you would know at least some of what people with kidney failure
some of what people with kidney failure
some of what people with kidney failure are going through I told you about Ms o
are going through I told you about Ms o
are going through I told you about Ms o futa so you would know what happens when
futa so you would know what happens when
futa so you would know what happens when we let fear paralyze us and I told you
we let fear paralyze us and I told you
we let fear paralyze us and I told you about Book of Eli so you wouldn’t know
about Book of Eli so you wouldn’t know
about Book of Eli so you wouldn’t know how when we make assumptions about race
how when we make assumptions about race
how when we make assumptions about race it can blur the lines of real science so
it can blur the lines of real science so
it can blur the lines of real science so now that you know better what would you
now that you know better what would you
now that you know better what would you do
do
do thank you
thank you
thank you you
”
Be First to Comment