A man of a different kidney

Seven weeks ago, Clive Sinclair wrote memorably here about illness, health morality, dialysis and the hope of a transplant. Here is his account of that transplant. Photograph by Michael Chambati-Woodhead
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The Independent Culture
The telephone is ringing. I look at the alarm clock. It is 5.50 on a Saturday morning, hardly a propitious time to be getting a call. I pick up the receiver, hoping against hope that it will be a wrong number. "Is that Clive Sinclair?" says a strange voice at the end of the line. I reluctantly agree that it is, and prepare for the worst. "This is St Mary's," continues the stranger (as I feared, a next of kin call), "we have a kidney for you." I can hardly believe my ears. Exactly a week after publishing an article in The Independent Magazine about dialysis and the possibility of receiving an organ from a pig in the indeterminate future, I am being offered a cadaveric kidney here and now. Inter alia I also boasted of my atheism. Is this God's response? If so I feel like St Augustine. Of course I want a transplant, but not just yet. Sensing hesitation the doctor points out that the kidney is a perfect match, a rare opportunity, not likely to occur again. "So I would be a fool to turn it down?" I ask. "Yes," replies the doctor. I am no fool.

By 8am, my affairs in order, I am at St Mary's in Paddington, west London. Or at least that is what the signs say. To tell the truth, I feel more like I have been abducted by aliens. In fact, the ward, on the ninth floor, bears an uncanny resemblance to the Starship Enterprise. The aliens, who man it, are obviously a thoughtful race; not wishing to scare me with their true appearance they have chosen to represent themselves as heroes from popular culture - my own heroes. So the Captain has the premature grey hair and humane gravitas of Jean-Luc Picard. His Number One, by his side, is none other than Tintin come to maturity (having found a better outlet for his skills than journalism). Another reminds me of Gary Cooper, as he was in High Noon. The remainder of the officers (whose insignia of rank seems to be the stethoscope) resemble the good guys from Bunter's Greyfriars. Head of communications is a dead-ringer for Uhuru.

I turn away from the bridge and explore the rest of the cabin. It is packed with cots, all of them filled with earthlings, most of whom are supine and attached to a variety of bottles and illuminated machines. At the far end is a wall of glass, which I identify as the viewing deck. The ship is apparently in stationary orbit, high above London, below is a panorama that stretches from Hampstead Heath to the Houses of Parliament and beyond.

Having allowed me time to acquaint myself with my new surroundings the Captain rises. "Welcome," he says. "Now, before we go any further, we need to be sure that your plasma contains no antibodies that will do in the donor kidney." At once fellow officers weigh me, take my temperature, measure my diastolic and systolic pressure, draw blood from my arm, and generally - like the God of Jeremiah - triest my heart and my kidneys. Finally, I am assigned to a bed in the acute area. It is clear to me that I am helpless in the hands of these strangers from outer space. My neighbours are asleep or, more likely, unconscious.

Before I can manage either merciful state, I am handed a Bic disposable razor and a canister of foam, and ordered to shave from my chest to my groin. This gives me pause for thought; how come such an advanced civilisation hasn't come up with a better way of removing unwanted body hair? I find a bathroom, unbutton my shirt, and spray foam all over my upper body and abdomen, until I look like a horse that has just won the Grand National. I try to scrape it off with the razor, but only succeed in dispersing the foam more widely and flattening the hairs. I return to my bed to wait... and watch.

However sophisticated these aliens are on the home planet they seem to have retained a definite class system on board their flying saucer, something resembling a master-slave relationship. While the officers sit at the bridge, processing reports or whatever, hyper-kinetic factotums, most of them female, rush from bed to bed performing protean duties; I observe that they are chambermaids, handmaidens, comforters, as well as being proficient medical orderlies. Whence comes this over-abundant energy? I can only guess. Perhaps it has something to do with that golden box on the bridge, from which they occasionally draw brown lozenges, which are carefully examined before being popped in the mouth.

One of them is even now approaching my berth, accompanied by John Lee Hooker. I look at the clock; it is exactly 12 hours since I first set foot in this place. The factotum holds my hand while the great bluesman begins to wheel my bed off the main deck and out into the long corridor. We enter a lift and descend to a lower level, where a woman in green overalls and a baker's hat awaits. She resembles the publicist from my first publishing house. I begin to wonder if my whole life is going to pass before my eyes in the next few moments. But there is no time. Before I know it, I am in the femme fatale's cabin and a mask has been placed over my nose and mouth. I am advised to breathe deeply. Without warning the doors of perception slam shut, and it's as black as a film noir. Everything has vanished, including consciousness and memory.

I seem to be back on the main deck, in my former berth, giving a fair impersonation of Frankenstein's monster. Instead of the famous bolt, I have a triple line protruding from my neck. Two polythene bags hanging from my side collect the blood that is draining from the wounds. A larger bag is draped over the side of the bed. It is full of urine, the colour of red wine, and is connected to my bladder via the catheter. One of the factotums places some pillows at the head of the bed and says, "Right, Clive, you've been on your back long enough, time to sit up." As I raise myself with my elbows I realise these outlandish women possess hitherto unsuspected powers. They are also shape-stealers, obviously with open access to my memory, for now I can see walking towards me across the deck the living image of my only son, whom I lovest. "Hi, dad," he says, "how are you feeling?" "Better than I look," I reply.

"You must go now," says a factotum to my son, "the Captain is making his rounds." We kiss. "Best boy," I say. "Best dad," he replies. And he vanishes. Within moments the Captain is moving from bed to bed, like a priest leading his acolytes in some sort of religious procession. Only on these occasions do the aliens converse in their own tongue, as they probe the abductee and browse through the case notes at the end of the cot. If you are lucky, one of the officers - perhaps Tintin - will look down upon you and say, "You are comfortable, yes?" However, when the examination is over, the officers relax and are even prepared to engage in conversation. After all, every abductee is also a learning experience.

But I too have a need to know; in particular, what happened to me after the lights went out. It seems that an especially skilled officer, whom I shall call Christian, effected the transplant. When he shows up to inspect his handiwork, I ask him if he would mind describing exactly how he did it. "With pleasure," replies Christian, sitting at the end of my bed. As he speaks I begin to feel like one of the credulous souls whose memory of alien abduction is retrieved by a hypnotherapist.

I see my body, as through a glass darkly. It is on a trolley under spotlights. It is indubitably my body but I see it as if it belonged to a third party. My gown has been removed and padding laid the length of both flanks, strategically placed to absorb any spills. A pipe has been forced down my throat to assist my breathing; a line implanted in my neck to facilitate the entry of drugs; a catheter inserted through my penis to drain off the urine. Someone then does a proper job of shaving my body, subsequently painting me with what looks like iodine.

A masked man draws near. He is holding a scalpel. Only his eyes are visible. He proceeds to the first incision, a lateral cut, which exposes my abdominal cavity, though the peritoneum within is spared. Instead of being punctured or penetrated, it is gently pushed aside, like an unnecessary ingredient at a banquet. All the major vessels are now exposed. Those running down the leg are carefully dissected. That accomplished, the masked man, like an Aztec priest running backwards, picks up the foreign kidney and places it in its new site, leaving my redundant kidneys undisturbed. The two renal arteries are connected to the iliac arteries that descend to the leg, and the renal vein to one of my veins. Whereupon the kidney pinks up and does what kidneys were made to do. It begins to pee. The thing is alive! Urine spurts from the ureter at its latter end. At once the room fills with spontaneous cheers, and I realise that my performance is being witnessed by the entire crew. By way of an encore the transplanted ureter is connected to my bladder, all other arteries reconnected, and my belly stapled together with a surgical gun.

"So I really am a man of a different kidney, whatever that may mean," I say to Christian. "It would seem so," he replies, patting me on the leg.

Later I feel well enough to read and unadvisedly choose Flaubert in Egypt from the flying saucer's infinite library. "The best was the second copulation with Kuchuk," boasts the Frenchman, before offering a vivid description, which ends with the words, "I felt like a tiger." Learn from my error. Do not read such stuff while attached to a catheter. The consequent erection nearly makes me levitate with pain. I look down and see that I have done better than Flaubert; I have come blood. If there is a hell, this will be the punishment reserved for fornicators; eternal attachment to a catheter. The damned souls will wonder aimlessly, clutching their little yellow attache cases, dreading memory and its consequences. I don't know if there is any causal connection, but within hours my testicles have expanded to the size of watermelons, and there is a hump on my penis worthy of a dromedary.

I reveal my affliction to Captain Picard. He has obviously learned the vernacular well. "You've got a swollen plonker," he observes. "It's almost certainly excess fluid, but there's an outside chance that urine is leaking somewhere in the system. We'd better have a look, just to be on the safe side." Shortly thereafter, John Lee Hooker turns up with a wheelchair and takes me to a distant chamber where I am laid flat, injected with a radioactive isotope, which is swept down to my new kidney. This is followed by a diuretic, which causes me to pee copiously. A strange predator-like machine records the progress of the luminous dye, as well as my involuntary micturition. The procedure (which uncovers no internal malfunction) takes about 40 minutes, giving me plenty of time to reflect upon my strange predicament.

I recall how, a couple of days previously, in an adjacent room, I had seen the kidney for myself on an ultra-sound screen. There it was pulsating in the depths of my abdomen, for all the world like one of those exotic jellyfish on display in a fashionable aquarium. The swishing of my blood sounded like the deepest of deep sea currents. The point is, it didn't look human. To be honest, I've never really considered my organs to be an integral part of the Sinclair body politic. On the contrary, I've always thought of them as bolshie agitators bent on overthrowing it. Consequently my own kidneys are as much strangers to me as the one I have just received from my unknown doppelganger.

Not that I am an ingrate, for I have some understanding of the feelings involved. It so happens there is someone walking about at this moment with my late wife's corneas. I regard that donation as Fran's last good deed, and certainly do not think of the recipient as part spouse. I am an old-fashioned Cartesian; cogito ergo sum has always been my motto, I think therefore I am. Now I have to consider the possibility that I feared my body because I was ill, even though I didn't recognise the fact until my forties. Who knows, if the transplant is a success, I may have to recast my credo; alter it to something like, I pee therefore I am.

Nine days after the early morning phone call, on 23 October, I am discharged and returned to terra firma. That evening I dine upon asparagus. Later, when I pee, the bathroom is suffused with a half-forgotten perfume. I sniff the air greedily. The next few months are uncertain, a lengthy game of snakes and ladders, as the doctors labour to outwit my body's natural desire to oust the alien organ, but tonight I am happy just to relish the unfamiliar aroma of asparagus arising from the toilet bowl

This article is dedicated to the doctors, nurses and staff of the Handfield Jones Ward, St Mary's, Paddington. Live long and prosper

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