As I am led into the dialysis clinic, my temperature is taken and I begin breathing slowly in and out, counting to 10, and then shaping my breath into words: “The Lord is my shepherd, I shall not want.” Although I am not a Christian, I began to use this phrase in the early eighties and nineties while longlining for black cod and halibut in the Northern Pacific, the Gulf of Alaska, and the Bering Sea. After forty-some years of saying this phrase when I needed to get through moments when reality wants to eat me alive, the Lord, whatever that is, becomes breathing.
The door to the inner clinic opens, revealing all the dialyzers beeping and flashing beside patients hooked up to the machines: blood pink, clear plastic lines; one input, one output, stabbed or plugged into each patient in their lower arms, upper arms, or chests. All the machines voraciously pump blood for the cleansing of toxins and removal of fluids, the work the kidneys used to do. On the side of each machine are foot-long clear canisters, thinner in the middle and wider at the ends, about the size of small eight- to 10-pound exercise weights with fatter than normal middles.
I sit down in the brown faux leather easy chair and lay my elbow on the edge of the chair, preparing to stretch my arm out straight to give the tech a clear view of my arteriovenous, or AV, fistula that creates an artery out of a vein. I am in awe of this special vein. I often have trouble pronouncing multisyllabic medical words like “ar ter rio venous,” I say quietly under my mask. My long, steady breaths begin to stutter while I wait to be meat-stabbed by the huge, yet finely sharpened dialysis needles that will pierce two large, red, scared-up mounds on my fistula.
The tech, a mid-thirties, dark-haired, dark-eyed Native lady named Caroline, who I know is as smooth as butter on the stab, places a commonly used medical towel-like sheet (one side blue; the other side, a thick, absorbent white) on the armrest and a small metal table attached to the chair. I move the left arm to be immobile as possible, as I can feel the needles on the sides of my super vein when I move it to adjust the computer, or use the urinal, which is quite a challenge.
I have to get my mind to fly high, and away from here. It brings to mind my mother’s love for the song, “Somewhere over the Rainbow … Where troubles melt like lemon drops …” This song is in my soul too. I have not memorized all the words, but I work on remembering them to move me away from the immediacy of the four-hour plane ride to life.
After four hours that move slowly through cramping, like Crucifixion Spikes pounding into my lower legs, and the half-sleep dreams of places I may never see again, the tech pulls the needles out of my pounding vein. I hold the two bandages covering the two holes in my fistula for 10 minutes; then I stagger out, feeling like I’m walking on the deck of a boat on a breezy day, as the ground pitches and rolls. I steady myself in the moon-glow darkness. I’m careful with my fistula arm because I’ve had it start bleeding again if I work my arm too much. It’s a crisp winter night, the moon is rising above the mountains, dappling soft light on everything, as troubles melt like lemon drops.
I drive the eight minutes home, then sit on the couch between my two dogs, Ari and Ollie, my arms stretched across the soft fur of each one, and around their faces, ears, and chests as they curl into donut shapes, with noses against my thighs. Ari is a seventy-pound black lab with a kind of pit bull head, a big, black teddy bear. Ollie is a mix of beagle, English foxhound, and basset hound; his ears are the softest fur – shiny, and super snugly. When he wants something, he’ll look me straight in the eye with one paw up, with a face a gentle mixture of sadness and sweetness that is a dog’s way of saying please. I close my eyes with my arms on each dog; my left arm is still throbbing, like a pounding headache from the four-hour pull. My body is drained. I close my eyes. I say a soft prayer. I’m thankful for another day.
John Unger is a former college English teacher (College ESL; Adult transitional literacy), Navy Veteran, and former deckhand on commercial fishing boats in the northern Pacific, Gulf of Alaska, and Bering Sea. He now lives in Albuquerque, New Mexico with his two dogs, Aristotle and Oliver. He’s published several poems and a couple of short stories that end with poems in the Human Touch, Hippocampus Literary Magazine, and The Bangalore Review.
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