2. Medical Shows Need to Get a Goddamn Consult
A Critique of B Positive Episode 2 “Die Alysis”
As promised, I — a kidney donor, nephrologist (kidney doctor) and writer/author — am back to critique B Positive, a popular and highly rated sitcom about Drew, a newly divorced father of a 12-year-old girl with kidney failure and Gina, the ditzy “train wreck” high school acquaintance who offers to give him one of her kidneys. Last week I published a commentary on Episode 1 “Pilot.” In that episode, Drew finds out he has kidney failure and starts looking for donors. Today I’ll discuss Episode 2 “Die Alysis.” Let’s get into it — the top inaccuracies/absurdities in order of appearance explained and rated on level of eye rolling induced for me:
1. The episode title: Die Alysis. What’s wrong with this?: I get that this is a play on the word “dialysis,” a treatment for kidney failure and it feeds into a common misconception that dialysis kills people. The truth? Untreated kidney failure kills people. Dialysis provides some replacement of kidney function that gives most more time to live than they would have without it. Is it perfect? Not even close. But it’s the best we got for everybody who can’t get a transplant. Rating: 🙄 🙄 🙄 🙄 🙄
2. The episode opens with Drew praying when he receives a call from his nephrologist, letting him know that he needs to start dialysis, to which Drew responds, “I thought you said I could avoid this with a donor,” but agrees to go. What’s wrong with this?: It’s hard for me to believe that any nephrologist would not have given a patient a sense of timing, much less just break this news over the phone. Rating: 🙄 (just one eye roll because, sadly, a lot of us doctors are assholes and don’t know how to communicate with patients, so maybe this could happen)
3. Drew shows up to dialysis the next day for his first dialysis treatment. He’s connected to the dialysis machine through needles in his arm. What’s wrong with this?: Dialysis can’t be done through regular blood vessels in the arm. It requires a surgically created fistula or graft (synthetic tube that mimics a fistula, but a fistula is better to have). It takes at least two months for a fistula to be created and ready to use. They did the same absurd shit in Going In Style, a movie in which Morgan Freeman was on dialysis. 🙄 🙄 🙄 🙄 🙄 😒 (off the eye roll chart)
4. Samantha, one of the other patients at the dialysis unit and an impeccably dressed executive, tells Gideon, the dialysis nurse, that she wants to leave early because she has meeting. Gideon says sassily, “Is it with God? You keep skipping dialysis, that’s the only meeting you’re going to!” [cue laugh track] What’s wrong with this?: Not to promote bad behavior, but ending a treatment a little early occasionally isn’t gonna kill anybody. A person with not even a tiny amount of kidney function left who skips two treatments in a row? — they might die. Rating: 🙄 🙄 🙄 (for promoting excessive fear for a laugh)
Now for what they got right, in order of appearance and rated for how much it pleased me:
1. Drew is very concerned when he learns that Gina drives a motorcycle. What’s right about this?: I tend to think of motorcyclists as organ donors waiting to happen because if they get in an accident, they are highly unlikely to survive. Some might wonder if it is in Drew’s best interest that Gina does ride a motorcycle, but I don’t think the system is organized enough to hold a kidney for Drew. It would probably go to the next person on deceased donor waiting list. Rating: 🙂 🙂 🙂 (because if Drew was wishing for Gina to crash, that would make him a selfish asshole, in my humble opinion)
2. The other patients at the dialysis unit school Drew for second-guessing accepting Gina’s kidney because of her reckless lifestyle. Eli, a retired NFL player, shares that his brother offered a kidney but was told he had to lose 40 pounds before surgery and a year later he had gained 8 pounds. Jerry, a dentist, shares that his cousin backed out of donating because the girlfriend didn’t want him to have a scar. And Samantha’s best friend backs out because she might have a child that needs a kidney someday. Best friend is 46 years old. What’s right about this?: This is real. Folks are rejected as donors and back out of being a donor for all kinds of reasons. Some of the reasons people back out may seem small or selfish or ridiculous — and, I think, all rooted in fear, which is also real. And allowed. Even so, all are heartbreaking for the person who needs a kidney. When I donated, my son was 5 years old. Someone actually asked me if I had considered that my son might need a kidney someday. My response, “All I knew was that somebody I loved needed one now. I couldn’t consider what might, but probably wouldn’t, happen someday, even for my son.” Rating: 🙂 🙂 🙂
3. All of the dialysis patients look under age 50, healthy, and upper- to upper-middle class. What’s right about this?: I’m on the fence about this one. I’ve been in quite a few dialysis clinics and my husband, who traveled frequently during his first 3 years on dialysis, has been in many more. And we ain’t never, never ever, seen a dialysis clinic in which people are so young, so healthy, and, frankly, so White. (Only Eli is Black). In truth, most dialysis patients are over 50 and there are 3.5 times more Black than White people on dialysis in the US. And poverty is generally not good for one’s health, so…. All that said, I do like the depiction of dialysis patients as something other than at death’s door — who seem to be the only ones patients visiting a dialysis clinic (as part of treatment options education) seem to see, even if they do look more like Eli. Rating: 🙂(just one because this was a missed opportunity to call out the real inequities around who gets kidney failure and why.
That’s all for now. Critique on episode 3 soon. Screenwriters and producers: please get a medical consult from someone who knows what they’re talking about. I’m available.
