What's the Deal with Dialysis?

Navigating the Waters of Dialysis A Convergence of Science and Compassion

Maurice Carlisle and Ira McAliley Season 1 Episode 2

Water, often termed the essence of life, takes on a life-saving role in the world of dialysis – a truth that resonated deeply with me as my sister courageously navigates her path to a kidney transplant. With Maurice Carlisle and Paul Terry by my side, two titans in the dialysis arena, we unravel the intricate dance between life-giving technology and the human touch that forms the cornerstone of patient care. Our dialogue ventures into the complexities of water chemistry and its profound implications for safety, drawing from a wellspring of personal experiences and industry expertise to enlighten those touched by the reality of dialysis. Maurice's insights, coupled with the broadened horizon Paul discovered in his leap from technician to the biomedical field, illuminate the paramount importance of meticulous management in this delicate process.

As your host, I weave through the conversation's threads, we confront the challenging equilibrium between compassion and cutting-edge technology. We probe into how the industry's pulse sometimes seems to skip a beat in maintaining empathy among its technical advances. The generational shift in attitudes among technicians emerges as a focal point, sparking debate over its influence on the quality of empathetic care. This exploration underscores the undying necessity of a moral compass in healthcare, particularly for professionals like Maurice and Paul, whose everyday decisions leave indelible impressions on human lives. Join us for a heart-to-heart on the essence of humanity amidst the march of medical machinery – a dialogue that promises to inspire, educate, and reaffirm the human connection at the core of healthcare.

A conversation about the kidneys and what happens when they fail.

Speaker 2:

What's up, beautiful people, here we are once again for another installment of what's the deal with dialysis. We are back here, my dude, maurice Carlisle, who's in Ohio, technician, the brain behind this whole concept, and this is his heart child. And back with Paul Terry, who he's been doing dialysis for a long time in various aspects. So we're just going to have another conversation for some education and for some inspiration. So how's that fellas?

Speaker 3:

Good morning. Good morning, good morning.

Speaker 4:

Yes, it is Me and Paul, full disclosure. Me and Paul go back to college man UCSD in San Diego well, la Jolla, let me get that right. And so we go all the way back there and we ended up in the same industry. We've been discussing this for about the last 15, 20 years. Me and Paul go back to the beginning of this, so we've been just like feeding off each other. So it was just a natural progression for him to come into what's the deal with dialysis and talk about what he does every day.

Speaker 2:

And so, just to start off, what our intentions are to educate folks who are either on dialysis, who have loved ones on dialysis, and myself being a filmmaker and in the entertainment industry in Hollywood Like I didn't know anything about dialysis when we started the conversation with Maurice Ways back, I've now learned much. I know I have a lot more to learn, but my sister has been on dialysis for several years and actually good news she just got qualified to be on the transplant list and may actually already have a donor. So that's a celebration. But just in general, there's some things in the industry that Maurice was talking about and we're just like let's just expose, not to tear people down but to build people up and just make it a better experience for all those involved. And so if you're here for the first time, that is what this is about.

Speaker 4:

So Absolutely, and Paul knows far too well. Paul was actually a I'll let Paul tell you, but he was a technician and then when it's the bio Medfield. So it was an interesting pathway to this industry.

Speaker 3:

Thank you, this is true, you know it's a trip. It's just you make mention of that, Reese, because I remember, I remember my early days in the past. It was, it still is, a female dominated career path. It wasn't a lot of males involved on the clinical side of dialysis, A lot of the males involved with that's on the technical side, biomedical side, administrative side. But and so it was interesting part of my introduction during my early days how people were.

Speaker 3:

People were not used to black men, especially in certain settings where the patient, the patient population may have been predominantly Caucasian, European and they would see me coming. Sometimes it'd be like I'm not letting that big dude put stick me right, I've been dialysis for 32 years, so and they didn't mean to harm they, just they were genuinely, sincerely afraid sometimes and I remember those days. Just to add to what you said, man, it's been 32 years, learned a lot, learned a great deal, especially chair side. I think my and I'm about to admit now but I really I credit my time being a technician as the time that I was I gained the most wisdom from patient population sitting chair side and listening to their stories and them sharing their lives with you. That was probably the best part of it. I'm on the technical side now.

Speaker 3:

So I can actually impact more people on the technical side, because it is my job to make sure that technicality and that things are at the part and they are as they should be in dialysis, because it's serious. Dialysis is serious and I-.

Speaker 4:

Paul talk a little bit about how important water is in dialysis, because I don't think people really even know that much.

Speaker 3:

Well, like most of us, the first time we saw it, the first time we walk into a dialysis clinic facility, that was the first time we'd ever seen or heard anything about it. It's still a remote type of practice. You know what I mean If you don't know about dialysis, or nobody, when on dialysis, generally speaking, you are oblivious to dialysis. Water, just like in your body, water is everything, and dialysis it's all about the chemistry which is the part, a very integral part, of the biomedical technician, biomedical engineers. That's job description, Because if your water is not right, I'm gonna give you an example. You remember the gradient flow? You remember seeing the commercialist say listen, if you have a friend or family member on dialysis and we were using gradient flow, you have the potential for a lawsuit called this number. Do you remember those? Do you remember those? I remember those. I know Ever since you were in the hospital.

Speaker 3:

You do or you do not, I do not, okay. Well, what happened was I'll give you an example of the chemistry part of dialysis, the importance of it what happens when the manufacturer's formulated one of the solutions that we combined for the chemistry of dialysis? They formulated it over the long term to save money, so it was to provide more buffer for the exchange that occurs during a patient's treatment. But if the bio man wasn't versed or didn't have a fundamental understanding of biology or chemistry and he was not proportioning the dialysis correctly, that would lead to a person receiving too much of this buffer and it actually becoming dangerous to them, specifically their heart. And so there were some issues with patient safety and they wanted to blame it on the solution that was formulated, when in reality, the problem resided with the bio meds, who were not educated in that regard. And because your bio med is your job, to educate your physicians, your staff, on what's going on with changes in dialysis, because it's all chemistry. That's how important water is in dialysis.

Speaker 4:

It is everything. And let's be clear people died. That's what he's talking about. That's why they were saying you might have a lawsuit. Let's be clear, because many, many people died because of that error, and so those are family members and kids and see they wanted to go after.

Speaker 3:

They wanted to go after the manufacturer who formulated this particular solution, but they're still making that product, which basically is a testament to the fact that it wasn't the manufacturer's problem. It was lack of understanding on the part of the dial med. It was interesting because people, when we were using one of my clinics, still uses it. One of my others does not. I have a couple of clinics that use citrate, as you're familiar with that, where it's just more bio-compatible. It's more bio-compatible. You know what I mean.

Speaker 3:

And you have less remarkable adverse effects when you're using something that's more bio-compatible, meaning it's more compatible with the blood, with the patient's blood makeup or your blood chemistry, the pH in your body and so on and so forth. The dialysis water, dialysis, chemistry is everything. So I recommend that a person either has a biology background or has been a technician for we'll call it a lengthy period of time minimum two years so that you understand what's going on before you come to the Biomemet Department. It's more than repairing machines and maintaining water treatment systems, steve.

Speaker 2:

That's all I mean. What I hear you guys talking. You guys are talking about the kind of technical side mixed with, but you also talked about the human side and that is kind of the in-between from a technician to me, from a technician's perspective, and it is merging the go-between between, you know, the business, industrial, technical side and just human beings whose lives have been changed. You know what I mean. Like that is, you know, that's kind of what this whole thing is about is kind of trying to find the ways to, you know, have the technical industrial side be a little more compassionate about the human side, right, and have you know you guys understand the people.

Speaker 2:

Like you said, you sat down next to the people and that influences how you take care of your machines, because you know it's about saving a person's life, not just checking off the box, that you did your job for your employer. You know what I mean. I think that is, I think that's an important aspect, you know. And how do we, how do you bring that understanding into the bio-med side, into the technician side of things?

Speaker 3:

You're asking hard questions, don't? Didn't? I like your interview, that's probably what you're saying bro, come on, you know what?

Speaker 3:

And basically you guys and again myself, maurice and Ira, we've dabbled in conversation, we've made, we have put, put us together them primarily, and that is interesting because one of the points that Maurice and myself like to emphasize is the fact that it just doesn't seem like compassionate is as prevalent as it once was, especially when we were at our early years in dialysis, as clinicians, as dialysis technicians, which requires a state certification and, some instances, a national certification. But it is very interesting that you bring that up because it seems as if that part is diminishing as time goes on. And I don't wanna blame it on a generation, I don't wanna say this generation of technicians coming in are not or do not possess the compassion or the moral compass that we, that I think that we possess, but it just seems to be the case. But I think a part of it is the industry itself has changed.