RED BLOOD CELLS

Three days later we pulled into a darkly shaded parking lot under the entrance for a large brown office building where we would meet the nephrologist. We circled around a few times, waiting to find a spot. Being in the city of New Haven, I knew it would take a while. I knew it would be difficult. I breathed in deep, enjoying the air conditioning that softly bristled against my bare legs. We finally found a car backing out of a nearby spot and pulled in. I waited impatiently as my mom backed her car up, only to pull it in again, adjusting the oversized tan Buick ‘just right’. She was famous for backing in and out a few times before getting out of the car. That just seemed like too much effort to me. I opened the car door inhaling the muggy summer air that felt heavy on my lungs and began to look for a sign that would tell us where to go. We made our way down a grey hallway and entered an old wooden elevator. Its doors creaked open as we got on. We made our way up to the fourth floor toward a blue sign that read “Metabolism Associates”. I thought that was a strange name for a nephrology office. It sounded more like a weight loss clinic to me. I wondered what kind of patients would be on the other side of that door. I tried to envision what I might encounter in hopes of preparing myself, but my mind felt empty. We entered the waiting room, as we had so many others. I immediately noticed the aged brown carpet covering the floors and yellowish lighting that shown down over several rows of tan chairs. I caught a glimpse of a solemn African American male with a large protruding abdomen and dry skin sitting against the wall. I then saw an older Caucasian male with frail arms and legs and sunken in eyelids look up at us from across the room. I was disheartened to see another waiting room, another room full of ‘old’ people. And me.

I looked out the large picture window and wondered how I would fit in this world. Everything seemed to be telling me I was different. Everywhere we went I was reminded. I wondered what my friends from New York were doing. I quietly sighed.

Five minutes later a door opened and a tall woman in royal purple scrubs called my name. We quickly got up and followed her down a long narrow hall with many rooms. I noted a large microscope hanging off the wall at the end of the hall. I watched as an Indian woman with a white coat and a focused gaze walked by. We entered the last room on the left and I shivered, hearing the white paper crinkle as I sat down on the exam table. I was immediately asked to take a small cup into the room across the hall and leave a urine sample. I did my best to fill the cup, wiping off the sides carefully and pretending I hadn’t just gotten it everywhere. I was sure I wasn’t the only one to play this game. I neatly placed my sample with the others in the silver box on the wall. I carefully washed my hands and met my own eyes in the mirror. I rolled my eyes, annoyed by what I saw. I heard myself take a deep breath as I opened the door, making my way across the hall. For a moment I stopped, secretly hoping my sample wouldn’t show anything. I hoped Dr. Arnold was wrong. I hoped there would be no red blood cells found. At that moment I tried to “will” my kidneys to work. I knew it didn’t make sense. But I also couldn’t help but secretly hope that maybe they were wrong. And that just maybe everything would be okay.

A few moments later a middle aged woman with unkempt brown hair and glasses dressed in an oversized black shirt and black pants walked in. She introduced herself with an excited smile, telling me her name was “Joni Hansson”. I knew she was the doctor but she didn’t look like one to me. I noticed a small leather strap draped across her chest from her right shoulder to her left hip which supported her small leather bag. I wondered if she had forgotten to take her purse off.  Maybe she was rushed that morning? I hoped she wouldn’t forget other things. Other important things. I thought about telling her she was still wearing her purse. Instead I decided to pretend not to notice.

She began to tell me she had viewed my urine sample under a microscope and had seen red blood cells in my urine. She went on to say this was concerning for damage to my kidneys. I had trouble believing her. Although she confirmed Dr. Arnold’s findings, I hadn’t seen any blood. I had no lower abdominal pain. I had no flank pain. How was this possible? She went on to say that I needed a kidney biopsy. She went further, telling me she needed to assess my kidneys and determine what level of damage had occurred due to the lupus.

I swallowed hard. A wave of fear came over me, as I pictured her taking a chunk of my kidney out for sampling. How far down would she have to go? Would I be awake for this? I knew more pain was in my future. I hated that. I hated the unexpected surprise. Could we just skip this part? I hated that that we couldn’t. I hated knowing this was another something I would have to get through. I had done my share of reading on that dreadful purple page. I knew there were many lupus patients who had kidney involvement. I knew there were many lupus patients who went into kidney failure. I knew many required dialysis. I pictured my kidneys for a moment and wondered what they were doing. I wondered what was happening with this body that I couldn’t  trust. This body that had so betrayed me over the past months. This body that I had been left with.