Natalie N. has three kidneys, four siblings, and a deep, musical laugh that punctuates even the darkest of stories. From the first moment of our conversation, Natalie shows the gravitas that comes with being the oldest sibling—lovingly referred to as “sister mom” by her sisters and brothers after primarily raising them during hard times in their Northern Californian childhood—and as someone who’s seen the darkest of days, then pushed forth, towards a beautiful, shining dawn.
Born and raised in Northern California, Natalie considers herself a SoCal girl these days. She moved initially for school, studying to be an ultrasound tech, and now lives with one of her sisters. She excitedly shares about her recent travels to El Salvador, the first time she’s been out of the country. I ask how dialysis works while traveling, and Natalie proudly explains that she didn’t have to worry about it—she arranged for dialysis on the day she and her sister left for their trip, then for the day they came back. “I was restricting myself too much,” she muses, glad she took the chance to explore. And the trip was certainly worth it for the “beautiful experience, deepening perspective.”
At fourteen, Natalie was diagnosed with kidney failure. Her younger siblings acted as “little assistants, nurses,” helping carry the large bags filled with fluid for her nighttime dialysis and emptying waste into the bathroom the following morning. “They called my catheter a ‘caterpillar,’” she says with a laugh. Back then, Natalie, the aforementioned “sister mom,” was in charge most of the time. “The relationship was built in sh—t, trauma bonding. There were beautiful memories, but our family never had enough.” These days, Natalie shares that her siblings understand her diagnosis much better, and their individual relationships have moved in new directions. She’s back on dialysis after 11 years with a working kidney transplant that has recently failed. The experience has shifted the bond with her siblings in a new way. “Now they can be there for me,” she says. “I can let my guard down and let them in.” She’s gone from the oldest, always putting up a strong front in order to protect herself and her siblings, to learning how to show vulnerability and to say, “I love you.”
In spite of everything in her past, and in the recent year, Natalie maintains a positive, loving, creative outlook. She aspires to share her story—she’s a writer, keeping journals and writing poetry—and has been working with an excellent therapist. “I was afraid to put my thoughts on paper until this year,” she says. When she was young, Natalie’s mother found her journal with all of her private thoughts and disciplined her for it. “I stopped writing,” Natalie reflects, but reveals that during this past year she’s rediscovered the joy of journaling, reflection. Mindfulness and meditation have helped too. Just in talking to her, you can see that—Natalie’s open, with a curious energy. And there’s been much to reflect on in recent memory.
At the beginning of 2023, Natalie was able to attend the Renal Teen Prom as a guest for the third time, her second time in person. (She attended when the Prom was virtual, held over Zoom—she lovingly reflects on the experience during a “really hard time, with the world upside down,” and shares that they played games they were individually sent in the mail. “It was really fun”). During that 2023 Prom, however, Natalie’s life was falling apart behind the scenes. She had recently ended a three-year relationship that sent her into homelessness. “I was in a downward spiral, living in a hotel,” Natalie says. “Not having solid, safe housing was extremely triggering.” All of this happened as her transplant was failing and she was recovering from surviving COVID-19. Natalie reached out to Lori Hartwell, head of RSN and all things Renal Prom, and Lori acted as Fairy Godmother. She helped connect Natalie with people who could help and encouraged her to attend the Prom, despite all the chaos in her life. And Lori was right. “I felt the support, love, and appreciation that night,” Natalie says. “I took in all the good energy, positivity.” She harnessed that energy, which lasted all year. “I may not be where I thought I’d be, but I’m in a much better place now.” Natalie’s currently on dialysis and is actively seeking her next kidney transplant.
When Natalie first moved to SoCal back in 2019, she emailed RSN asking if she’d be able to go to the Prom for the first time even though she’d “aged out.” For years prior, she would register in hopes that she could go—but the drive south would be too much, and Natalie never ended up going. Then Lori got back to her, saying she could attend as a guest and Natalie went to one of the now-iconic Dress Shop fittings (then at Lori’s house). A whole new world opened up to her. Lori inspired her and continues to. “I hadn’t been around adults that had kidney failure, all the other experiences I saw were other teens. It’s life-changing to see an adult in control.” Natalie attended the prom with one of her sisters and had an incredible night being in a room where she “didn’t have to pretend,” around other people going through the same experiences.
When I ask her to go back in time to when she was a teenager experiencing kidney failure, Natalie doesn’t hesitate. Her strength flows out of her, very much indicating her older sibling status. Her family first discovered that she had kidney problems during a routine physical—Natalie had tried out for the school basketball team at age fourteen, and was required to do some bloodwork, labs. A few days later, the doctor reached out to her mother, saying that something was off, and they needed to come back, but Natalie’s mother wasn’t able to bring her back for another four, five months. By that time, Natalie’s kidney function had decreased by about 40%. She recalls sitting in the office as the doctor explained to her mother, “she’s going through renal failure,” and feeling a strange, sad moment of excitement: “at least now Mom will pay attention to me.” In order to cope, Natalie read as much as she could about what she was going through. She googled, she watched videos, read blogs. And at age sixteen, her mother got the call of a lifetime—there was a donor that matched Natalie’s needs, someone in Stanford, and yes there was one person in “line” ahead of her, but there was still a chance. As she moves through storytelling mode, Natalie’s voice softens. It’s clear she has love for her family, deep love, despite the following part of the journey. Natalie’s parents weren’t sure they wanted her to get the transplant. “Come on, come on!” the young Natalie pleaded, knowing time was of the essence—they only had a four-hour window, and they were two hours away from the hospital. But her parents were frozen.
Natalie was raised in an extremely religious household. Her parents had become very invested in their local church during the window of time between her diagnosis and the transplant opportunity and had been appointed leaders of said church. They were in charge of bible studies, religious events, and all of the free time Natalie and her siblings had was split between school activities and church ones. When the call came about the transplant, Natalie’s parents felt a surge of fear—wouldn’t God heal Natalie on His own? The surgery felt like a mark against their faith. They sat Natalie down and told her they didn’t know if they would take her to the transplant or not. Natalie already had her bag packed, her travel toothbrush at the ready. “This is my chance,” she pleaded, but her parents wouldn’t budge. Natalie called her uncle to try and get him to talk to her mother—and before she knew it, an entire congregation of extended family showed up to the house to convince her parents. Her grandparents, aunts, uncles all offered to drive—and Natalie went. Even as they approached the surgery, her mother was still praying that God would heal her. And whether it was with divine help or not, Natalie successfully received the transplant—which was put in alongside her two native kidneys. No more dialysis for eleven years to follow.
A great side effect of her religious upbringing was the love of music that blossomed in Natalie’s household. She and her siblings would play music for the congregation, Natalie on the “church piano,” her siblings on drums and singing the melodies. She taught herself how to play, the sign of a true artist. “The last time we played together was probably ten years ago,” Natalie says after I ask if the siblings ever do jam sessions, and she laughs joyously at the idea of them reconnecting as a little band. One of her sisters is a professional singer, now, she shares. And for Natalie, music helps her during dialysis sessions. She listens to high frequency tones, calming things. And in her free time, she loves R&B, Spanish music, 90s hip hop. The high frequency tones help her to stay grounded during her sessions. “When I feel stressed, I’m working to let it be there, no more dissociation,” Natalie says firmly.
We begin to wrap up our time together and I ask her about her current job. She’s on a leave of absence, as it’s difficult to manage dialysis with a full-time job. Natalie’s been working in the ultrasound field, and she misses it. “Sometimes I go onto campus, use the labs, practice.” Back when she was first diagnosed as a teen, Natalie became fascinated with the ultrasounds done on her own body. When she saw you could see through someone’s skin, she freaked out: “this is really cool!” But she didn’t think it was something she could do. “I thought, ‘this is for rich kids.’” Then at eighteen, when she was working, she remembered her dream of being an ultrasound tech. She got a job at an imaging facility, with no experience, only her endearing attitude, work ethic, and passion to champion her. They gave her the chance and encouraged her to follow her dreams which eventually led her to schooling so she would be able to move up in the career field. The shift reminded her of her own power, which she wields in many ways—as an artist, with her writing and her musicianship, as a sister with her deep care and bonds for her siblings (ever-changing, as she’s moved from caretaker to cared-for), and as a woman, moving beyond the challenges of difficult and threatening relationships, being unhoused, and returning to dialysis.
Natalie laughs cheekily when I ask her what words she’d use to describe herself. “Badass!” she says first, gleefully. Then she pauses. “Loving.” And lastly, almost to herself, “hopeful.” This year, 2024, holds much in store for her. Personal growth, evolution. And keeping that moniker, the Hopeful, Loving, Badass close to her heart.
Maxine Phoenix is a freelance writer and she also volunteers for RSN.
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