This is Brave. This is a Life.

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Things I remember about donating a kidney.

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This is brave.

This is a life.

I want you to see the world.
We learnt the difference between haemodialysis and peritoneal dialysis.
The best way to stack medical supplies in a crowded house. What to cook for someone on a
renal diet.
How not to stare at your distended stomach.
It’s not supposed to happen like this. You’re not supposed to be hooked up to machines at
twenty-four.
I want you to see the world. The only place you’ve ever flown to is Australia, back when we
were kids.
Australia doesn’t even count.
There’s blood in your brother’s urine.
It doesn’t make sense to me, how the body turns on itself sometimes. How that very thing
that is supposed to protect you, your immune system, starts attacking you from the inside.
Who can we trust if not our own insides?
Not the doctors, who got it wrong several times. Not the gods who let these things happen.
Ward 24 is full of older men, grey-haired and frail. Some of them confused. You look
misplaced, a letter arrived at the wrong address. The bloke over there coughs nonstop, you
tell us. And the other one threw a glass of water across the room in the middle of the night.
But even Ward 24 is better than the cardiac ward. He has kidney problems, I want to
say, why are you worried about his heart? It’s electrolyte imbalances leading to
arrhythmia. It’s the chemicals stuck in your system when your kidneys don’t work.
I can see that quivering heart on the screen. All ups and downs, peaks and troughs. This is a
life, it beeps.
But all your life has drained down to is survival.
You make jokes about the medicine you’re taking, the one that contains cells from
genetically engineered Chinese hamsters. It helps with haemoglobin. Isn’t it amazing what
science has figured out?
Let us laugh and marvel and distract ourselves from survival and life expectancy.

When people ask me, what’s wrong with your brother? I find it hard to explain. IgA
nephropathy. You know Jonah Lomu? It’s kind of like what he had.
Oh, they say. Jonah Lomu.
I remember getting home from school one day, fighting over who got to use the family
computer first that afternoon. You found a folder of my emo, angsty teen poetry. Why don’t
you just kill yourself, you said.
Not all siblings are close and sometimes the silence is uncomfortable but I love you like
anything and nothing and everything.
I want you to see the world.
The donor’s remaining kidney grows in size to compensate for the removed organ.

Heavy Humidity
It wasn’t the nicest of summer days, but it was warm enough. And although the sky was
congested with clouds the sun broke through every so often, dissolving some of the
awkwardness between my mother and me. I had an appointment to see a doctor at
Auckland Hospital.
There was a gentle breeze, dancing off the harbour and up the city streets. A man sitting at
a wooden table outside some Bohemian café lost his paper to a small gust. I picked it up and
handed it to him, and he smiled at me over his coffee and I smiled back.
We wandered across Grafton Bridge. There were curved glass screens protruding from the
concrete walls, up and over the top of the footpath. My mother said it was to stop suicides.
The statement hung between us like a heavy humid day. I thought about falling, about
shattering sadness and the time I swallowed too many pills in Wellington. I thought about
the humiliating trip to the emergency department and the cold shoulders of the medical
staff and the way my parents didn’t drive an hour and forty-five minutes to visit me when
my desperate pleas for help were burning my oesophagus.
Our route took us along Karangahape Road, through Auckland’s run-down red light district.
Despite not minding sex shops and strip clubs, a familiar sense of guilt edged its way into my
mind. It was mid-afternoon but the doors to Calendar Girls were wide open and I could see
straight inside to the shiny poles lit up with spotlights like shafts from heaven. My mother
pretended not to notice, as she does with most things that make her uncomfortable.
I wondered if she had ever examined life outside of the air-tight wrongs and rights she’d
boxed us up in.
At the hospital one of the forms I had to fill in asked me to state my religion. I hovered my
pen over the blank space for a while, until my mother asked why I was taking so long to read
the question. I said I wasn’t, that I was thinking about what I wanted to put. She
said Catholic, and I hesitated for a moment before saying that I didn’t know if I was Catholic
anymore. I felt her soul sink with disappointment as she realised that the safety glass she’d
carefully constructed around my life was shattering, and I nearly wrote the letters in
anyway, just to please her, as I have been trying to do my whole life.
On our way back to the airport we came across some sort of art installation, a blackboard
fence running along the footpath. The words Before I die I want to… had been written
hundreds of times, each one with a blank space next to it. People had chalked in their
answers: travel the world, visit my sister in Canada, have two kids, fall in love, record a song,
fuck Hayley C. We spent a while wandering up and down the length of the wall, reading.

There was a man making notes, jotting down some of the answers people had given. He
dropped his pen and I bent down to pick it up, and he smiled and said thanks and I smiled
back and told him he was welcome.
As we walked away I joked to my mother that Aucklanders drop things a lot, and she
laughed and said it must be because seeing me makes them fumble.
It was the first time I remember my mother ever calling me beautiful.

Disfiguring Scars
The psychologist who is assessing my donor potential pulls out her notepad, poises her pen,
looks up at me and says, “So. Why do you want to have life endangering, major surgery that
will leave you with disfiguring scars?”
Scare tactics.
I open my mouth to answer but she cuts in “–And don’t just say it’s because you love your
brother.”
I close my mouth. I open it again, frown, close it again. Eventually I repeat, simply and
stupidly, “It’s because I love my brother.”
I don’t think there’s anything more to it, really.
Earlier in the assessment, when my brother had also been present, the psychologist had
observed us together. She asked him questions about our family, his history, what he’d do
with his new kidney.
Now I say, “You heard him talk about his dreams, what he wants out of life. I want him to be
able to do those things.”
She nods and notes something down. “I can tell the two of you aren’t close. Are you giving
him your kidney in an attempt to fix your relationship?”
I must look a little startled because she adds, “People do it. They almost always end up
disappointed.”
“We’ve never been close,” I shrug. “But that’s just what it’s like with us. We can sit in a
room together and not feel the need to make conversation. It’s comfortable. It doesn’t need
fixing.”
There’s a pause while she writes that down. Then she says, “Your brother mentioned that
your family is Catholic. Are you donating out of Catholic guilt?”
“No,” I laugh. There’s a lot of things I do out of Catholic guilt, but this isn’t one. “I’m not
really Catholic anymore,” I explain.
Her next question is one I’d been expecting. “Is there anything you’re worried about?”
“There are three things. The first is the possibility that the transplant could fail; then it will
all have been for nothing. The second is about how having one kidney will impact any future

pregnancies. The third is - and I’m embarrassed to say this, because it seems trivial - the
third is the scars I’ll have.”
“You’re a young woman,” they psychologist says kindly. “It is completely understandable
that the scars worry you. Do you have a partner?”
I shake my head.
“What will you do if you’re with someone in the future and they find the scars unsightly?”
“If a man finds the scars gross even after I’ve told him what they’re from, then he isn’t
someone worth being with,” I say assertively.
I say it, but I know that if I found myself in that situation, exposed and vulnerable in front of
a lover who found my body disgusting, it would break my heart.
Four weeks later, “psychologically sound” and lying on a gurney before the surgery, a
theatre nurse ran through the potential risks and complications of donor nephrectomy one
last time. I signed consent. I wasn’t scared of dying. I had one hand resting on the smooth
skin of my stomach, a last caress of the bullied body that had taken me 22 years to learn to
love, and which I would come to hate all over again. The only thing that had caused me to
think twice about donating was the fact that I would be scarred for life. I thought about
summer and not being able to wear a bikini. I imagined a lover kissing his way down my
body and not being able to feel his lips below my navel; the nerve endings severed. I
pictured my abdomen carved up like a wedding cake. A fucking wedding cake. A wedding
cake I might never get to cut because what if no one ever finds me attractive again? I was
embarrassed over these hyperbolic, jumbled feelings piling up inside me. I was angry over
the way media distorts beauty; My disfigured perceptions. I felt vain and stupid and selfish.
I thought, what does it say about the world we live in when I’m more afraid of scars on my
skin than of dying during surgery?

The first time I called myself a writer and meant it.
It felt weird because I could walk.
I could walk but they were wheeling me up to the operating theatre on a gurney, so I spent
my last moments of uncompromised health lying in bed watching the ceiling slide by. It was
just past eight in the morning. I was wearing a pale green gown with “HOSPITAL PROPERTY”
printed all over it.
In the pre-op room I met the theatre nurse who was going to be looking after me. She was
wearing red lipstick. I liked her immediately. She opened a folder and ran through a series of
questions. She told me the likelihood of serious complication. She told me the likelihood of
death.
I signed consent.
She asked if I wanted them to save me a tissue sample, a little piece of my insides returned
to me post-surgery. I said I thought I’d be alright.
Her lipstick was the exact shade I’d wear on a Saturday night. Her smile was all the theatre
lights turned on bright. She said that transplants are her favourite sort of surgery to do.
My mother asked her if she got to assist during both operations – the donor and the
recipient. She grinned and said, yes, sometimes. She said she might be doing my brother’s
surgery that afternoon.
She said transplants were her favourite because she liked a good story.
I like a good story.
Everyone likes a good story, and they like them even more in hospitals because hospitals are
so full of sickness and death.
There were more nurses but I forgot all their names. How weird that the people who change
your life can remain anonymous. At 8:14 they took me into theatre. We must have gone
through three or four sets of doors. They opened them by kicking these little buttons on the
wall at floor level.
I wondered why scrubs are always blue or green.
“Here we are,” the nurse with the red lipstick announced, as we rounded a final corner. She
said it like we were arriving at a holiday destination or a friend’s house or a good restaurant
someone had told us about. “Theatre 4. The best operating theatre in the hospital.”

It was nothing like what I thought it would be like. I’d imagined the operating table to be a
stainless steel slab of sorts, but reality was more like a dentist’s chair: narrow, black and
smooth and padded, with separate segments for head, torso, legs. They wheeled my gurney
up beside it and told me to move over when I was ready. “Take your time,” they said kindly.
I nearly laughed because it all felt so weird. I don’t imagine there are many patients who
climb onto the operating table by themselves.
Once I was lying down again they swung pieces of the table out on each side, like wings. I
rested my arms on them. Everything started to happen very quickly. I tried to count how
many people were in the room. There were at least eight. I found it strange that there were
windows. Or maybe there weren’t. To my right, the anaesthetist prepared a line. I focused
on the needle sliding into my skin. On my left someone checked my patient identification
bracelet. I recited my full name and date of birth. She gently turned my wrist over to check
my national health number and noticed my tattoo. “Hey, what’s your tattoo mean?” she
asked with interest.
“I like to write,” I said. And then, after a moment, I corrected myself. “I’m a writer.”
It’s the last thing I remember before they put me under.

Bravery.
I never thought I’d feel depressed about saving a life.
“Your health will be exactly the same after the donation as it was before,” they said.
They lied. I grieved for the hole inside of me.
The doctor placing the adhesive electrodes onto my skin thought I was being brave. “I don’t
feel brave,” I wanted to say.
They strapped a blood pressure cuff around my left arm and a monitor across my chest. I
wore the machine for 24 hours, let it strangle a reading out of me every ten minutes. I
collected urine for two days. Gave 14 vials of blood in one go. Tests, procedures. A camera
shoved up my arse. An MRI of my kidneys, complete with contrast dye that made me feel
like I’d pissed myself in front of a team of professionals. A psych report.
I’m so good at saying what they want to hear.
And after the surgery: nausea, nausea, nausea. Vomiting, constipation, diarrhoea. A
catheter, inserted under anaesthesia, removed the following day, inserted again on a bed in
a ward with a mere curtain for privacy, by two nurses who spent ten minutes trying to figure
out where to put it, all the while apologising to me, lying in agony with my legs in the air.
There is nothing brave about all this.
Morning rounds: the surgeon, the transplant specialist, the registrant, the nurses, the ‘pain
team’. My parents. A gaggle of people staring at me. The wound so low I couldn’t wear
underwear. So high on morphine I just let them pull back the sheets and expose everything.
The surgeon, so proud of his work that he wanted to photograph my scar for a conference
he was giving.
The medical students who paid me a visit in order to observe my emphysema. Me under
scrutiny like an abnormality. I lifted my gown and let them press on the air beneath my skin.
Felt it crackle like rice bubbles.
Let them learn from my bravery.
The stranger in the bed next to mine who gave me flowers and a teddy bear after I spent the
first night scratching myself raw. I must have been talking in my sleep about how scared I
was. I cried because I didn’t think anyone had ever been so kind. Her husband said, “You’re
unbelievably brave.”
They were gone the next day.
And then I was gone too. Released from hospital. Spent two nights floating in and out of
consciousness, trying not to empty my insides onto the hotel floor. Readmitted in a different
ward.
Feeling so incredibly sorry for myself.

And then, remembering –
My sister doing her nursing degree. Writing an essay on chronic illness. Her subject: end
stage renal failure. Our brother attempting to tell her how it feels to think you’re going to
die. To think, this is it. Time’s up.
This is all you get in life.
And after all that he’s been through…
Seeing him smile. Watching his waxy skin gain some colour. Hear him make a joke. Charm
the nurses. Walk the corridors.
Laugh.
Look after the dog. Go to concerts. Get a job again. Play football. Book a flight.
See a future.

I understand now,

This is brave.

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