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This one fell short of my expectations. I was expecting more of a medical nonfiction specifically about kidney transplantation. I would say this book is 50% love storey. In the title it states, A Kidney Doctor's Search for the Perfect Match which I'm thinking, now, refers to Vanessa Grubbs search for the perfect mate. Very little of this book regards finding a perfect kidney match, and touches lightly on donation of kidneys. Mostly, the book refers to Grubbs falling in love to a partner with CKD and donating her kidney to him, and her career trajectory to nephrologist. Her points aren't always clearly made, which left this reader confused at times. I guess I was hoping to learn more of the nitty gritty of kidney transplantation. It feels more like a memoir, at times. Hundreds of Interlaced Fingers is a reference to the filtering system of the glomerulus as well as to the hundreds of interlaced fingers involved in the complex process of kidney transplant.
I was mesmerized by the beauty in its design. The glomerulus was stripped of its cap and looked like a ball of tightly coiled yarn. Each strand like interlaced fingers. 160
Her opinions come across strongly as well. Some of that derives from being a new, younger, passionate doctor, perhaps. Grubbs suggests this herself, "She made a rookie mistake," a Black transplant nephrologist at another institution who was sympathetic of my predicament explained to a colleagure, 263
Vanessa Grubbs refers to the kidney in the feminine, which was distracting, while reading. For example: ...but we don't really see evidence that She can't keep up with her responsibilities until the estimted function drops below 12 teaspoons (60 milliliters) per minute. 194 I'm reading this scratching my head and wondering who she's referring to with this "She" and "Her" - it's the kidney she's referring to. Also, there are some awkward sentences, for example: As chronic kidney disease worsens over time, we try to replace the functions kidneys stop being able to do. 198 and Because once eventually comes, all that is left to do is to try to replace the kidneys with a transplant or dialysis, because we can't live without Her. 198
Overall, this book doesn't have a sharp focus, it's kind of here and there. It's hard to grasp exactly what the author was trying to convey. She does emphasize some interesting points, though.
Patients with end-stage kidney disease make up less than 1 percent of the Medicare population but consume about 7 percent of the Medicare budget. So I can't help but wonder, what price--in human effort and dollars--is too much to pay to maintain a life that is actively, repeatedly trying to destroy itself?....Many transplant centers require obese patients to lose weight and patients with drug or alcohol addiction to show they can get and stay clean and sober before they can be considered appropriate transplant candidates. Morbidly obese patients are required to lose significant weight prior to bariatric surgery to demonstrate commitment and improve continued success after surgery. It would seem logical to require patients with end-stage kidney disease and drug addiction to actively engage in drug rehab programs as a part of maintenance dialysis care for the individual's good and for society's good. 234- 235
