by Bonnie McCandless Ph.D.



Every Monday, Wednesday and Friday morning at 9:45 a.m. I enter a dialysis center and, after weighing in, make my way to my chair for treatment that consists of 3 and ¾ hours of being hooked to a machine which filters the toxins out of my blood, doing the job that my defective kidneys can no longer do for themselves. I say “my chair” because I am usually assigned to occupy the same chair every time, giving me a sense of belonging but also boredom with the same view and the same technicians sticking me, hooking me up and monitoring me for the duration.

Yesterday was different. It was Veteran’s Day, the auspicious 11-11-11 date, a Friday before a long weekend. As often happens on such days, I received a phone call at 7:30 a.m. asking me if I want to come in early and I always answer yes. So I arrived at the center at 8:30 and my usual chair was not ready for me, so I was given a different chair, which made all the difference that day.

As I made myself comfortable in the chair – feet up, blanket draped over my legs, blood pressure cuff on my right arm, left arm exposed and ready for sticking – I felt a warmth on my face and looked up to see a shimmer of gold across the room. “Wow!” I said to Jarrod, the tech at my side, “look at those trees out the window! They look like gold coins blowing in the wind!”

He followed my gaze and smiled, nodding. “Nice,” he murmured and then returned his attention to preparing my arm for the access to the machine. First the arteriol, then the venous. “This one down and this up?” he asked.

I nodded, still mesmerized by the shining trees. Then I looked at his fingers on my arm. “No, “ I said. “The arteriol is usually sideways.” “Like this?” “Yes.” “Ok.” “And don’t be afraid to go deep,” I urged him and returned my gaze to outside the window across the room.

The room was outlined on the left by chairs filled with dialysis patients like myself and on the right by nurse stations and back rooms where other staff came and went on an irregular basis. There was a steady undercurrent of beeping from the filtration machines and a blinking of lights, each with a specific message signaling a particular need or task to be filled by the steady stream of nurses and techs. But the activity in the room fell away to a blurred background and the gold shimmering trees moved into the foreground of my vision, almost as if they moved into the room itself to greet me.

In reality, the sunlight hit the leaves from the east and the wind blew the branches back and forth so they seemed disembodied from their roots and the leaves actually shook like gold coins dancing in mid air. I stared in awe at the shimmering gold which now nearly filled the room. This mystical moment was pierced by physical pain as the needle entered my arteriol access. I winced slightly but held my arm still for Jarrod to find the artery where my clean blood would flow back into my body. He poked around a bit, went a little deeper, I winced more, nearly crying “ouch” and then he stopped, satisfied that he had found the right spot. He propped up the needle shaft with rolled-up gauze and taped the entire operatus to my arm. I lost my distraction with the dralas and focused on the physical discomfort in my arm for a moment. Then the warmth from the golden shimmering leaves drew me back and I returned to the breath.

The venous entry was upwards, deep and clean. Nice draw. No pain. I closed my eyes and relaxed. When I opened them, the leaves were back outside the window and were turning red-brown-orange-yellow-green with bits of branches tying them together. The magical moment had passed and my blood was starting to process through the filtration process and return to the body, clean again.

I saw Jarrod glance across the room to the window and smile, and I knew the dralas had found him this morning too. Perhaps even the briefest moments of magical mystery can be transforming, even if we’re not trained to dwell in it? I was fortunate to have spent several years in Shambhala training in D.C. that built upon my chosen field of aesthetic education, but I don’t know if Jarrod has had such training. Anyway, it has been too many years now since I’ve been a regular student of the dralas. When we’re not “in training,” I guess we need to change chairs once in a while to capture a fresh view and reconnect mood with sense experience. The problem is that I don’t know how often my drala experiences are associated so much with pleasure as with pain, or with both together? And does it matter? What would Chogyam Trungpa say?

I have a grumpy old kidney doctor who visits once a month and comments on blood pressure or fluid weight gains and spouts archaic clichés about dialysis keeping us alive and we should get over our anger issues and get into a good book or play video games to pass the time. But the physical pain of needles being stuck in my arm and the mental boredom of four hours of viewing the travel channels or cooking shows, watching the clock tick away, only to go home and take a 90 minute nap and wake up with a headache sometimes pushes my endurance to the limit. I think of my father’s experience with dialysis and his comment that he was ready to end it all himself rather than go through the excruciating anguish of being tied to a machine and how “congestive heart failure” saved him from that drastic choice, ironically suffering a heart attack in a dialysis chair and being called “code blue” from the dialysis unit and taken directly to the hospital unit, then to the morgue.

But I’m not my father, I tell myself. He couldn’t stand to stay indoors during a blizzard; he had to go out for his morning coffee and newspaper. I’m not that ADHD, though I did inherit a good swath of his ocd tendencies. But I look at the faces of the patients around me – the blank stares, the open-mouthed sleepers, the readers, the tv viewers, the chatters, the game players – and I can’t help but think that if not for the dralas, each one of us is maybe a step or two away from pulling the trigger some days. Except for those who are brought in daily on a stretcher and often taken out in a code blue, like my father; they seem half dead already.

I wonder how the dralas enter our lives when there is so much closed heart? What if I hadn’t seen those gold leaves yesterday? What is the limit of our endurance to sit in the same chair day after day and see the same clock ticking away? I hear the tech Theresa giggle and it turns my head. That’s a drala speaking to me. On tv I watch a Vietnamese woman prepare a colorful steaming noodle soup in an open-air stall in Ho Chi Min City and can almost smell the scents that go along with the street noises. That’s a drala scene I am vicariously experiencing. The social worker smiles with drala insight as she brings me good news yesterday. I have been granted a spot in a dialysis unit near my son’s home on the Friday after Thanksgiving, so my travel plans could now be completed. I would be able to visit with my son’s family for those few precious days – joust with my grandson, hold my new granddaughter, share stories with my daughter-in-law and be shocked once again at how much my son reminds me of his father. I know this visit will give me a new chair’s view on a variety of drala experiences and let my moods flow again, one at a time, in and out, like my breath. The dralas don’t always appear as gold coins in the wind, but I’m grateful that I’ve learned to be open to them whenever and wherever they arrive.


Postscript, December 2012

A year later, I have developed a greater respect for dialysis as part of my life’s work, for better or worse, and am still working on ways to live with this restriction gracefully. After writing this piece “A New Chair,” I tried home peritoneal dialysis which allowed me to switch the clinic routine of three days a week for four hours each visit for a daily regimen of self-treatment at home through a catheter inserted in my abdomen. After three months I was able to use the cycler at night and do only two exchanges myself during the day. It was freedom from the pain of the hemodialysis needles and being tied to a machine for four hours but it tied me to a different kind of schedule at home and I’m not sure it was any better.

Ironically, the home isolation took the dralas from me as well. I realized that my dralas arrive most readily in the guise of people and nature, when I’m out and about. When I stay at home, I can experience the dralas in music or creative projects, but often the dralas have no space to appear because my daily routine closes them out. I need to be involved in life and with people, in order for them to want to show themselves.

Last year I developed an infection from the catheter – the dreaded peritonitis I had been warned about – and spent several weeks in the hospital and a month in rehab recovering from this illness. The doctors removed the catheter and I went back to hemodialysis -- a chance once again to experience my dralas through the visions and sensations of my lifelines at the clinic.

I also emerged from this experience, shaken by a depth of medical misery and a missed summer, awakened with a new resolve to finally complete unfinished projects and make my legacy meaningful in the time that remains. I traveled to be with family members who helped me reconnect with ancestral roots. I immersed myself in an unfinished creative project where the dralas accompanied my journey into reminiscence. I guess I need guidance positioning myself where the dralas can find me, and perhaps the dralas need encouragement too. It is a symbiosis that I am happy to embrace.


Written by Bonnie McCandless, Ph.D., Associate Professor of Writing at UMUC and creative mentor to three inspiring grandchildren, who all live in Virginia.

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