Of course, as you can imagine, the technology of the machinery had to be absolutely correct. Absolutely everything had to be done within strict sterile precautions. It was all new and, looking back through all the years, I can feel the tension that existed in the Unit, and fully understand it. Everyone was on trial. From my perspective, I was fascinated by the process, happy to accept the training, and overjoyed when finally I was allowed to replace (or at least assist the registrar replace) tubes if they got clogged in the middle of the night. I did not know that Vic Parsons and the unit were on trial. At that stage you have no idea of the politics and machinations, and the history-making side of what we were doing was never really explained to me. Ultimately it was to be successful, and the whole circus was moved into bigger quarters with extended facilities. Fascinating to have been there, even if I never really felt part of the program; simply a junior doctor who would move on to other things in a matter of months, and would not find out the importance of the whole thing until researching a life story almost 50 years later.
Of course not everyone was suitable for peritoneal dialysis. In addition, the process in the early days had strict time limits to avoid infection and internal abdominal scarring. There was a reticence to repeat the process too often, even if someone was at death’s door. There was one patient who stands out in my mind. He had been a senior physician in Sri Lanka for many years. He had travelled to the UK and King’s as a last resort to stave off renal failure. He had a series of peritoneal dialysis treatments, but it was never enough, and he had been taken off the program. The use of renal transplants, tissue typing, and medications to prevent rejection were still in their infancy. He knew his renal status was terminal, and chose to stay on the ward for his last weeks, often surrounded by family and former colleagues.
He was a charming and urbane man, and had endless stories from his early days in medicine. So whenever I could, often after visitors had left, I would sit with him while he reminisced, often for half an hour or so. I felt an immense sadness that this man’s experience and skill would all be lost as he faded. But it was more than that. I felt an affinity; I was just drawn to him. Perhaps I recognised that one day this might be happening to me; but looking back, that was far too philosophical for my younger self. I had not experienced the coming of death at such close quarters, but I don’t think that was the fascination. I just enjoyed being with him. I have a sense that he taught me some humility. I was deeply saddened coming in one morning to a ward round to be told he had passed away in the night. I did not weep, but I did feel an immense sense of loss.
Some months later, a rather large and very heavy box arrived at our flat from an unknown sender. Jan and I opened it to discover the most exquisite dinner service of hand-painted china. It is robust, and still in use 50 years down the track, not a piece broken through endless cycles in dishwashers. There was a card simply noting thanks from his family for my care, explaining how much my time spent with him had meant. I was, and remain, bemused by this kindness. I somehow felt that I was the one who had gained from the experience. He had been somehow a haven in the midst of the ward turmoil. And I believe it was he who taught me not to fear death, a lifelong and very special gift.