Happy Birthday Dr. Scribner

Cross posted from my blog

Happy Birthday Dr. Scribner

By Bill Peckham

Today would have been Dr. Scribner's 88th birthday if we hadn't lost him that gray Thursday in 2003. The New York Times' two page obituary contains a couple Scribner stories. I've heard a number of Scribner stories over the years. As the Times piece notes he famously got into some legal trouble over wine (Washington State still restricts the sale of liquor in unique and unexpected ways; in the 60's the laws were stricter). The Scribner wine incident hullabaloo is rightly credited with giving us access to a better selection of wines in the state. It's a minor achievement in the scheme of things but it should be remembered. Of more consequence is Scribner dreaming up a way to sustain the lives of people with CKD. In the Nephrology Oral History Project's Sherrard interview, Sherrard gives one version of the Scribner shunt story, that it was in response to a dream, the NYT gives another version, I've heard elements of both; it would have been interesting to hear Blagg tell it. The Nephrology Oral History Project interviews are full of Scribner references, the industry is still debating the Scribner approach to dialysis and patient care.

I have my own Scribner story. (It is times like this that I wish I kept a journal, I don't remember the date specifically but I think it would have been early 2001, before I started dialyzing at home, before Scribner published his last paper (on the HemoDialysis Product (pdf link)) and before he got the(Lasker.)

Scribner invited me to his houseboat home to discuss patient travel, this was in the period of my regular trips abroad (1995-2006) and he was writing a book that was going to include a bit about travel while on dialysis. I was excited to visit with Scribner. At the time I knew less about the history of dialysis than I do today but I had met Scribner several times through the NKC board and anyone Googling dialysis to find the available papers on optimal dialysis would know and admire his work. I was excited to talk dialysis with him but I remember also being excited to visit a houseboat, which are iconic Seattle homes (in over 20 years of Seattle living, the only one I've been in is Scribner's).

Here's how I remember it. I found the address and walked down the dock where I found Mrs. Scribner watering plants. I introduced myself and was invited on board to find Dr. Scribner sitting happily in the front room, surrounded by papers. It was a large room with stuff everywhere to look at, on the walls and shelves, oars and photos, many photos - and hanging from the ceiling a radio controlled single engine plane. I had flown a Cessna 150s, I remember thinking it looked like a Cessna 172. We shook hands but before I had time to ask about the plane he asked me what my blood pressure was ... ahh, umm ... and if he could take it, which he proceeded to do.

I felt like I was back in school taking a pop quiz and I hadn't studied. I knew that Scribner considered blood pressure control central to successfully treating CKD with dialysis and I knew my BP could bounce around seemingly at random, from moment to moment. And I knew I wasn't on BP meds which Scribner ascertained while donning his stethoscope. Thankfully, I passed the quiz. On that day I had a perfectly acceptable 120/80 something. He asked how I controlled my BP sans medication. I, being a brown noser, pointed to salt control.

I'm not sure what would have happened if my blood pressure had been high that day, I have a feeling my nephrologist, a former fellow of Dr. Scribner's, would have gotten a phone call. Seattle is Scribner country. Here we believe in the importance of controlling blood pressure through fluid control. Something that Scribner believed to be inherent to optimal dialysis.

Happy Birthday Doctor Scribner, you were right.