i hear you

I had been seeing Josephine Ocampo in my clinic roughly every other month for nearly 2 years. But it wasn’t until she said, “I’m going to the Philippines tomorrow to bury my mother,” that I noticed the maiden name on her chart—Nisnisan. The very old woman’s last name was Nisnisan. “Oh, I helped take care of your mother!” I said. “I’m so sorry for your loss.”

She nodded a half-smile. Like she appreciated my words.

Every time I saw her over the last nearly 2 years I explained her blood test results. Where her kidney function was at the time, compared to where it had been over the last several months. Each time she would nod her understanding of the information. That day was no different.

She nodded with flat eyes. Like she understood my words.

About 4 months and 2 visits later, again she sat in the exam room. Again I explained her blood test results.

“Your kidney function is about the same as last time—19%. The last 2 times we checked it was 20%,” I said matter-of-factly. Her kidney function was drifting down, from about 28% when I met her, to where it was now. As I told her it would.

She nodded as usual.

But then a flicker came across her eyes. Like she heard my words. For the first time. In nearly 2 years.

And then she started to cry.

She cried all the way down to her shoulders. They shook uncontrollably. Inconsolably. The tears streamed down her face.

I handed her tissues from the small yellow box that sat at the corner of the computer desk nearest her, like it was anticipating moments like this. I looked at her with my brows furrowed, surprised at her reaction. Because I hadn't said anything new. Because I thought I was giving her pretty good news—her kidney function was stable.

She cried and cried so long that my own tears began to fall. I reached out my arms to her. She fell forward into them like a little girl who lost her favorite doll. I held her until she could stop her shoulders from shaking.

“You mean I have what my mother had? You mean I am going to die?”

“You do have chronic kidney disease, but you are not your mother,” I said, staring into her eyes.

I went on to explain how her mother’s life, almost a century long, would not have been extended by dialysis. How dialysis would extend hers by many years. How transplant was an option for her. How her kidney function had been about the same for the last 6 months. How another year or more would probably pass before her body would probably need dialysis.

She nodded with eyes looking at me, but distant. Like she was only seeing her mother. And not hearing me.