Charles

"C'mon, Daddy," Julie said, her voice a shade away from a whine. "Tonight's a dialysis night." She stood there in her cut-off jeans and long-sleeved Opus the Penguin T-shirt, holding the glass out to him. "Let me have some more. I'm thirsty."

"How many ounces have you had already?" Charles asked.

"Six."

"Only two more."

"Four! Please!" She hung her tongue out of her mouth and made a choking sound.

"All right! All right!"

He filled her eight-ounce tumbler halfway to the top, but restrained her arm as she lifted the glass.

"Use it to wash down your last three Amphojels."

She made a face but popped them in her mouth and began chewing one the twenty-eight pills Julie had to take a day— the calcium, the activated vitamin D, the iron, the water-soluble vitamins—she hated her aluminum hydroxide tablets the most.

When she had finished gulping down the juice, he pointed toward the back end of the apartment.

Julie slumped her shoulders and pouted. "Can't it wait?"

"Toddle on, and no more lolly-gagging. It's after six already."

He followed her into the back room where she plopped herself into the recliner, rolled up her sleeve, and placed her bared forearm on the arm of the chair.

Charles had the dialyzer all warmed up and ready to go. He seated himself next to his daughter and inspected her forearm. The fistula was still in excellent shape after five years. The thickened, ropy veins about as big around as his little finger bulged up under her skin. A few years ago one of the kids at school had seen her fistula and given her the name "wormy arms." She had worn long sleeves ever since— even in the summer.

After cleaning the area with Betadine and alcohol, he made the skin punctures and cannulated the arterial and venous ends. He hooked her up to the dialyzer and watched the blood begin to flow toward the machine.

"You want the telly?"

She shook her head. "Maybe later. I want to read this first." She held up the latest Bloom County collection. The comic strip was her current favorite and Opus the Penguin her latest fave.

Charles placed the remote control for the tv next to her on the seat, then stood over the dialyzer—which came up to his chest—and watched it do its thing, drawing the red blood and the clear dialysate past each other on different sides of the membrane, then sending the freshened blood, relieved of most of its toxins, back to Julie's vein while it stored away the tainted dialysate. Charles was happy with this particular hollow-fiber dialyzer. There was seldom trouble with the transmembrane pressures, and Julie had got shocky only twice so far this year—a pretty good record.

He sank into the couch across the room from her.

How does she do it? he wondered for the thousandth time as he watched her smile and occasionally giggle as she paged through the book. How does she keep from going crazy?

How much longer did this have to go on? Something had to break soon. He couldn't see how she could put up with this for the rest of her life. It was living hell…

… three hours on the machine three times a week. He always timed it as the last event of the day because it exhausted her. All those pills… the ones that didn't nauseate her made her constipated. She had to measure every bloody ounce of fluid that passed her lips so as not to overload her vascular system. And the diet—rigidly restricted sodium, protein, and phosphorus, which meant no pizza, no milk shakes, no ice cream, no pickles, no cold cuts, or anything else that kids like. She was constantly anemic and tired, so she couldn't get into any school activities that required exertion.

That was no life for a kid.

But that wasn't the worst of it. Typical of a kid on long-term hemodialysis, she wasn't growing or developing at a normal rate. As they became teenagers, they didn't… become teenagers. They stayed small; they didn't develop much in the way of secondary sexual characteristics, and that took a terrible emotional toll after a while. Julie wasn't to that stage as yet, but she would be before too long. And she was already small for her age.

Charles studied Julie, with her big brown eyes and raven hair. So beautiful. Just like her mother. Lucky for her that was the only thing she had inherited from the bloody bitch. He felt his teeth grinding and banished his ex-wife from his mind. Every time he thought of her, or someone even mentioned her name, he felt himself edged toward violence.

She didn't have to leave. It was hard living with a child in chronic renal failure, but lots of parents lived with lots worse. And Jesus, look at Sylvia—she'd gone out and adopted a bloody autistic boy! If only his ex had been like Sylvia—what a life they could have had!

But no use gnawing on that subject. He'd chewed it to death over the years. There were more important concerns to be dealt with in the here and now.

Like the call from Julie's nephrologist just an hour ago. Her circulating levels of cytotoxic antibodies were still high, years after her body had rejected the kidney he'd donated to her. She hadn't been a good transplant candidate in the first place, and until those antibody levels came down, she was no candidate at all.

So she went on day by day, producing her ounce or so of urine per week, feeling tired most of the time, and getting her thrice-weekly hemodialysis treatments here in this room. An unimaginable existence for Charles, but the only life Julie had ever known.

He watched television for a while, and when he glanced her way at 8:30, she was asleep. He waited until her dialysis was done, then he disconnected her from the machine, bandaged up her arm, and carried her into her bedroom, where he changed her into her pajamas and slipped her under the sheet.

As he sat there for a moment stroking her hair and looking at that innocent little face, she stirred and raised her head.

"I forgot to say my prayers."

"That's okay, Love," he said soothingly and she went back to sleep immediately.

There's nobody listening anyway.

It never ceased to amaze him how people could believe in a provident God when so many children in this world suffered from the day they were born.

There was no God for him. There was only Julie and this world and today—and, hopefully, tomorrow.

He kissed her on the forehead and turned out the light.


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