Dialysis and My Two Aunts
S.M. Arthur

      I had these two elderly aunts who were once Catholic nuns and were once teachers on Pine Ridge Indian reservation in South Dakota, and then retired and needed a little help getting around. 
      They were both named Margaret; one nicknamed Peg, and the other, Meg. So, they were united by name alliteration—Meg and Peg. The family had lots of fun with the names, and you hardly said one name singularly. It was always Meg and Peg and always in that particular order. 
      Meg held the title of my true aunt, and Peg was her lifelong friend. At times, because of Aunt Meg’s perpetual sour mood and demeanor, I sometimes claimed Peg as my true aunt instead. Peg was a largish Irish lady who grew up on the mean streets of lower downtown Denver in a time when it was an Irish ghetto and before it was refurbished to be LoDo with expensive condos and chic coffee houses and restaurants. In fact, they grew up opposite the dry ice factory, which later became the expensive Icehouse Condos on Wyncoop Street. 

      I found the two aunts fascinating from an early age. Meg was my mother’s youngest sister. She was a teacher and a nun and children were sometimes frightened by her abrupt manner, her seeming complete lack of sense of humor, and a way of cutting you to the quick with one curt remark. 
      My husband pointed out later that Meg did indeed have a sense of humor, but you had to watch her face carefully. She’d crack a curt remark or listen to a funny story and one corner of her mouth would curl up slightly and her eyes would sort of twinkle for a very short period of time. To my husband’s mind, this was her way of breaking into a guffaw of laughter. My Aunt’s demeanor proved harder to decipher. Usually, her comments were barbs and truly honest observations, mostly negative. The ones she dished out to me as a child were usually about standing up straight and that I really should eat more, as I looked like a toothpick with hair. 
      I liked this trait of hers, though, because unlike other adults in my life, I could count on her to tell the truth as she saw it and to point out things that I had not thought about. For instance, standing up straight and drinking water are universally good things to do. Nobody else seemed to notice.
      Her friend, Peg, whom Meg met at the young age of seventeen at the convent, was entirely different. She had a wonderful sense of humor and enough funny stories to keep the interest of a crowd of people. When I heard the statement “you complete me” for the first time, it reminded me of Meg and Peg, because certainly Meg was as reticent as Peg was outgoing. I couldn’t imagine one functioning in the world without the other, however, at one point one had no choice but to do exactly that.
       Nobody found Peg’s stories funnier than she, and her laugh alone was the real punch line. She produced from her round belly, a long almost-silent wheeze which heightened to a crescendo, accompanied by a few slaps on the knee. The leg receiving the slap on the knee would rise up and down slowly as if she were playing a piano or pumping an antique sewing machine. Peg did all the driving and I suspect, all the cooking and cleaning and shopping, until later in their lives when Peg’s health failed first.
      For the first ten years of my life, their visits were limited to once a year when they got paid vacations from the convent and were able to travel. They seemed like rich relatives to me when they visited, as they almost always came in a new car. They were respected and feared and revered, something like a man in uniform, only blessed by the Pope.
      The two aunts came to visit every so often at our old farmhouse in Western Colorado. Grand Junction is the city where the Colorado and Gunnison Rivers meet. Grand Junction is at once beautiful and awesome and dusty, dry and isolated. It is the place where the mountains of Colorado fade away into the desert of Utah, and one of those cities that teenagers vow to leave, and then vow to come back to someday. 
      There was a purported old Native American saying that if you take a mason jar full of ‘dobe badlands clay (the ‘dobe badlands being the barren silica and clay hills that surround Grand Junction), you would never come back. I later found out that the ‘dobe badlands are made of the exact stuff they use to make kitty litter. Or, do they make kitty litter of the ‘dobe badlands?. I never took the mason jar full of clay because I was sure I might return someday to live. 
      The two aunts would pull up to our old farmhouse in a different car every year. As it turned out the cars were rented, albeit paid for by the convent. They’d get out of the car with black habits flowing around them, their white wimples hiding the mystery that was their hair. 
      In my memory, they were always wearing their habits; long, black wool head-to-toe habits framed in white along the face. Heavy rosaries were their only accessory.
      I always looked for stray pieces of hair peeking out onto the faces swollen by the tight frame of their wimples, but it seemed they were designed to be watertight, like snorkel masks. I never knew their true hair color until they left the convent years later and arrived without their habits.
      They’d float up to the door as if on roller-blades and step up into the house. My brothers and sisters and I sat or stood in quiet awe, which must have been a blessing to my mother, for an hour or so listening to the grim (according to Meg) or hilarious (according to Peg) story of their journey from their convent in Montana.
      We knew by my parents’ demeanor and that of strangers, that these two deserved respect and that it had to do with the habits. We’d known nun before, of course, because we were Catholic, but had never known they had personal lives.
      I had never thought of them as eating scrambled eggs, bacon and toast with ravenous enthusiasm. I had never though of them as needing a bathroom to take a shower, or other earthly activities.
      Once the novelty wore off, we’d leave them to talk about adult things. We’d always have some kind of small road-trip, usually over the Colorado National Monument, and then have a lunch or dinner of some kind.
      It seemed to be not a bad life for them. They got certain perks. Both women had college degrees, compliments of the Catholic Church, who educated and prepared them for a life of teaching. Nobody in my parents’ families had college educations, so paid college tuition seemed to be a supreme perk. They talked of retiring, as people often do, and it seemed to be a retired nun was to be waited on and to travel and to leave the work to the younger nuns.
      Then, something changed and my mother got a mysterious late-night phone call and then left with our large green station wagon. When she got back the next day, the two aunts were with her, sans their habits. Gone were the wimples (although for a long time I thought I could make out the faint outlines of them on their faces) and the black flowing gowns. Their hair and arms and even their legs were now visible peeking out from polyester clothing, and I felt somehow disappointed by the dullish unstyled short hair.
      What happened to their dreams of retiring? What had happened to their “calling?”
      The single thing that had stood out for me from my Catholic education was one of the nuns repeating that becoming a nun or priest was a “special calling” and that you’d wait for the call and if it doesn’t come, then it isn’t for you. I wasn’t sure what the “calling” would be, but knew that it hadn’t come and so gave up on it.  
      I remember Peg declaring, “Glad to be free of the heavy wool habits because I’m was allergic to them and they caused hives.” Evidently polyester is much more comfortable and non-allergenic.
      Together they became independent in the true sense of the word. They taught in a Catholic school and then later became resident teachers on Pine Ridge Indian Reservation in South Dakota. They built lives together and still visited and attended yearly family reunions. After more than forty years of teaching, they retired. They bought a charming small house in Denver and retained that even while spending time in South Dakota teaching Native Americans and doing far more good than most of us do in a lifetime.
      Then, Peg’s health deteriorated. She developed and recovered from ovarian cancer, without complaining much at all. You would think she had a cold or something. She developed diabetes, and after a few years she needed kidney dialysis.  
      She resisted, and most people told her she should put if off if she could. She was deemed “borderline”
but the tests became worse and she was put on dialysis.
      Peg drove herself to dialysis for a few years. Sometimes the thought of it frightened me; she making the five-mile trip on a wing and a prayer, foot to gas peddle like there was no tomorrow. She never got into an accident or even a traffic ticket that I know of. Some days, she couldn’t drive and she tried the local bus handicapped ride. The concept was a good one; a wheelchair and handicapped accessible van would pick up the patients, and for a small fee, ferry them back and forth from dialysis and home.
      The concept was only as good as the drivers, however, and unfortunately, some of them didn’t appreciate spending their days with dialysis patients, who could “spring a leak” at any moment or pass out on the way home from the dialysis center. One in particular would park a block away and watch the door of the dialysis center. When the patient would run out of patience waiting for the ride, a relative or friend would invariably show up to fetch the tired victim.
      I began picking up Peg when the van didn’t show up, but would see the driver with the van he was symbolically shackled to parked a block away and wave. Soon, he was waving a greeting to me and then pulling off and leaving. A few days, he wouldn’t show up at all, and it seemed that no matter who was waiting inside to be picked up, he assumed that I was taking them home.
      I complained to the metro bus center, but it seemed these people didn’t matter too much. Maybe the volume wasn’t enough or the revenues enough. For whatever reason, they got the opposite of special treatment. Was it the lack of status that comes in America when one falls ill? Was it the loss of power and personal control that caused people to take advantage, or worse, not pay attention at all?
      You get used to walking into a dialysis facility, with its rows of vinyl reclining chairs and all the accessories needed to do dialysis; plastic tubing, monitors, scales, gloves, and the large dialysis machines which, when they’re in the process of cleaning someone’s blood, look like giant hearts with blood coming in one side, whirring around and coming out the other.
      I am thankful now for the job of driving Peg to and from dialysis, because she always had a good story for me. Some of the stories were repeated as her memory got worse, but I enjoyed the encore almost as much as the original story.
      Most of her stories were bittersweet, somewhat like her life. She grew up in a large Irish family that had emigrated first from Ireland to escape poverty and then from Canada to chase work. They ended up in the Irish ghetto in lower downtown Denver and like many Irish at the time, ended up in tenements, doing manual labor in the local ice factory. 
      She had happy memories of this time, like taking weekend drives to mountain springs to get fresh water and enjoying the scenery and stopping to play in the creeks and look for gold nuggets (and sometimes finding one). When she told me this particular story, she wondered aloud if the chemical fumes that emitted daily from the ice factory next to them could have caused not only her cancer, but also that of many of her brothers and sisters, most who died of various forms of cancer. She supposed she would never know because nobody had looked into it.
      She also told of how the family had to split up, some of the kids living with relatives because their parents could not feed and clothe them all. She considered herself fortunate, as some of their neighbors had to put their kids on “orphan trains”, which headed for the Midwest some nice farm family could adopt them. 
      I realized how her stories of poverty were not really about poverty, but about life, and about how people live their lives the best they can, even providing good memories for their children with very little money and sometimes little food.
      My favorite story she told was of her and Meg renting a Mustang convertible on a visit to San Diego and then drag racing a couple of teenagers in a souped-up car. She described how they must have looked, their veils trailing behind their wimpled heads like scarves blowing behind elegant movie stars. They won the race of course (so the story goes), and I realized that the kids in the other car would not dare to win, and they probably gained a good story out of it themselves.
      Peg always said she had a low pain thresh-hold, but her actions and perseverance belied that self-assessment. She was poked and prodded and drained and filled up with chemicals that made her ill. She usually took her treatments without benefit of numbing or painkillers because she was against using drugs. She must have been in pain and terribly tired most of the time.
      I took Peg to the hospital once when she needed one of her occasional blood transfusions to bring her blood count up. It happened with her all the time, the mysterious disappearing of red blood cells and I wondered where they went. Surly they weren’t left inside the dialysis machine or on the floor (although there was one man who seemed to “spring a leak and lose a couple of pints” after every dialysis session).
      Usually, we waited an intolerable amount of time for the doctor to see her and when he finally did, he read her chart as if for the first time. It was, in fact, the first time, as he was a relatively new doctor.
      This particular doctor was from India and spoke with a distinguished Indian accent. I waited for my sometimes prejudiced aunt to make a comment or to ask where he was from, but evidently the doctor’s white coat trumped any biased cell in her body because she fell into a cadence of “yes sirs and no sirs” to answer his questions. 
She shocked me by answering that yes, she had ovarian cancer a decade ago and also a remission and recurrence. It was the first I’d heard of the cancer. He also noticed she had been a teacher for forty years. 
      “We need more teachers,” he commented.
      “Well, I gave it a try,” she said.
      “Forty years is indeed a very good try,” he said. Then, he was off without commenting on her situation or condition and she seemed relieved that he didn’t have much to say about it.
      One regular at the dialysis clinic always made sure to say hello and goodbye to everybody. I’d sometimes see him before dialysis and he was a big strapping man, albeit a bit pale. But, when he came out of dialysis and sat waiting for his wife to pick him up, he’d look at me and say, “Takes the stuffing right out of you.” 
      Some days, he would say, “takes the starch out of your socks.” But, most days it was stuffing as opposed to starch.
      I could see that dialysis did take both the starch and the stuffing right out of him. He looked like the scarecrow that had lost his stuffing. He would be pale and seemingly smaller and shaky. His wife would arrive for him and would carry his large bag of supplies (usually a lunch, a blanket, a book, etc.) to the car and he’d kind of wave behind his head as he left.
      I told my husband this story one day and how it kind of haunted me, seeing the transition from Tin Man to Scarecrow all in one procedure. 
      My husband is interested in psychology and behavior. So, he suggested that the next time this man said, “takes the stuffing right out of you,” that I should follow with, “then, why don’t you put it back in?” this would somehow help him to heal.
      I kind of nodded, but in my head felt I could never say such a thing. But, the very next time I sat waiting for Aunt Peg, here came the “stuffing man” again. He sat down and looked at me and said, “takes the stuffing right out.” He used this shorthand with people he remembered.
Right then, his wife walked in the door and picked up his bag. 
      I said, “Looks like your wife has it right there, maybe she could stuff it back in.” They both laughed and I felt my face redden. From then on, he seemed to want me to say some variation of the “stuffing it back in.” 
      Dialysis patients exist in that netherworld of humans who don’t get looked in the eye too often, don’t get offered freebies because they might be wasted on someone with a short lifespan, don’t get taken to dinner or the movies even though they have plenty of time. Sometimes I felt people were afraid they’d be asked for a kidney if they got too close. I put myself in the same category, as the thought occurred to me, after all, I’ve got two good kidneys when I really only need one. Was I willing to give one up? She never asked and I never volunteered.
      Most of all dialysis patients as a rule don’t want to “put anybody out.” But, they want to live to see what happens next and to glean whatever good and enjoyable they can out of life like seeing a rainbow or smelling the rain or feeling the sun on their face. Sometimes they have unfinished business like writing a book or making it one more year to retirement or seeing a child graduate from college.  
      They don’t ask for much. They don’t ask for anything, really; a ride now and then, a cup of ice (crushed, not cubed), a few kind words. They ask to be noticed and to matter and to be remembered. Like everyone else, they need hope and time and a few kind words. 
      Every time I walked through the doors of the dialysis unit and saw the rows of white dialysis beds and the fragile souls lying in them, helplessly attached to the dialysis machine with tubing and tape (looking for so frail they could float away like balloons on strings if unthethered), I thought of all the priceless stories and all the incredible travels through life that led each of them to this place. All these stories and experiences would eventually float away with them. 
      Some of them, but not most, will get kidney transplants, some will come off dialysis as their kidneys improve, but most will die having spent the last months of their lives beholden to the machines that cleanse their blood. 
      One day in the future, these machines will look archaic, like the old iron lungs that were used on polio victims in the fifties. But for now, they extend lives and offer hope and make people’s lives miserable and give them one more day and then one more. 

(Peg McDougall passed away peacefully and painlessly October 22, 2005. Peg was recognized by the Bureau of Indian Affairs for her work and teaching on Pine Ridge Indian Reservation for over twenty years. Margaret Harding passed away 16 years later in 2021 of natural causes.)