It was not an auspicious moment when I met Alain Meyrier. In December 1973, at 38 years of age, I was in Tenon Hospital and felt like hell. I had end-stage renal failure from polycystic kidneys, the same disease that had killed my mother at 51, and was being prepared for dialysis although I didn't yet know it. Things were not very clear to me in this state.
I was being followed by a Swiss resident aptly called Dessaigneux who rather obscurely told me "Il va falloir vous habituer aux piqûres". He never smiled, never explained anything. He was cold as a fish and I began having thoughts about transferring to Necker.
A fistula was made on my left arm and shortly I began dialysis in intensive care. At some point in all this I was visited by a young French doctor who spoke to me in rather affected British English. I thought he might be a fairy but he seemed pleasant enough. After two-, four-, six- and eight-hour dialyses I was told I could go home but to stop off at Dr. Meyrier's office on the way out. I felt very much alive again after the treatments but I was not looking forward to life with dialysis. I had been given sheets of instructions about dietary and liquid-intake restrictions and they sounded almost as bad as Dessaigneux.
I knocked on Meyrier's door and was told to come in and sit down. I was to start training for home dialysis. Looking at my analyses he said that since I was still urinating copiously at that time I could drink and eat what I wanted. I handed him the sheets of restrictions and said "But what about these?" He glanced at them, tore them in half and dropped them in the wastebasket. Then he offered me a cigar. "At least this won't hurt your kidneys." As he was lighting it for me I thought "Maybe this won't be so bad after all." He was the first good news since I entered the French hospital system.
Meyrier asked me who my regular doctor was. I had been seeing a urologist who, useless though he was, had had just enough sense to realize that something serious was wrong and sent me off to Bichat, thinking it might be liver trouble because I am a wine critic. I had told him from the start that I had polycystic kidneys but his only reply was "Nobody gets that before 50." At Bichat they made a laparoscopy, sewed me back up and sent me to Tenon. So in answer to Meyrier's question as to who my regular doctor was I said "I guess you are."
I won't go into all the ups and downs in 25 years of dialysis under Alain's supervision. I'll just mention septicemia from an infected needle site at a time when one was told to puncture the same hole time after time; ascites after a vacation with short dialyses using a portable Reddy generator in which the dialyser's sterilizing agent, ethylene oxide, was flushed into the recycled dialysate bath; a subsequent trial of another portable generator with the same recycled bath after which I had anaphylactic shock, fortunately in the presence of Alain who gave me the necessary antidotes; multiple recurrence of carpal tunnel syndrome in both hands; a double disk protusion in the lower back; et j'en passe.
Not one of these problems was detected by regular checkups prior to the actual event nor would any of them have been. For the first few years I was followed very closely but nothing ever showed up even after five days without dialysis. I began to skip monthly and six-monthly checkups. Alain continued to follow me à distance leaving me alone until I complained of some ailment. I am in general good health, I always take Kayexalate and Maalox, I do 10-hour home dialyses every three or four nights, at 62 I still work regularly as a wine critic and I live my life.
Isn't this what medicine is all about? To help someone with a medical problem to overcome it and live as normally as possible? Not to put the patient in jail and keep him there under a microscope. For Alain's having understood this is what I am most grateful for and why I consider him as much a close friend as my family doctor.