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Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on December 19, 2007, 09:32:35 PM
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Published: December 19, 2007 09:46 am
The Quill Box: Doctor learns from patient.
A patient does the healing
BY MICHAEL VANDERKOLK, M.D.
Special to the Record-Eagle
An Indian Quill Box is an odd sort of 10th anniversary present to get; yet that is what we received from my mother-in-law, Jean, for ours.
Perhaps Jean knew I was kind of odd and would appreciate it. I've always found boxes unique and have a little collection of them. There is something in the simple way they hold something, fulfilling a defined and specific purpose -- not too difficult, but efficiently done. I enjoy the craftsmanship that goes into making them and the attention to detail that a well-constructed box has.
As it was, we were given the Quill Box while staying at a summer cottage on Elk Lake. When packing to leave, I placed it on a shelf and forgot it. When I had to go back later to retrieve it, to my relief it was still there.
I didn't know much about Quill Boxes then -- only enough to know how intricate, special and expensive they are. Jean had bought this box in Peshawbestown, our local Indian reservation, during our family reunion at Elk Lake. It was a simple circular shape about four inches in diameter and two inches deep.
The cover was decorated with a quill design of three beautiful Lady's-Slippers, a wild flowering plant protected in the State of Michigan and somewhat rare in the woods. The inside was woven with SweetGrass and bark. The SweetGrass has a wonderful peaceful fragrance and for some reason reminds me of something pleasant back in my distant childhood. It is altogether a beautiful work of art. We placed it in our curio cabinet with other precious items and crystal, showing it to those we thought might be interested or appreciate the art work and craftsmanship.
It wasn't until years later in my practice as a general and vascular surgeon that I met Mrs. Baldwin. She was an elderly Native American with a slew of medical problems, not the least of which was renal failure. When dialysis was finally required, I placed her vascular access and later a fistula in her arm for dialysis. These are connections to the vascular system so that two needles can be inserted and connected to the dialysis machine three or four times a week for removal of toxins. The dialysis machine filters out waste products from blood removed by one needle and returned in the other needle. This process requires high flow rates and it is a continual challenge to keep these fistulas functioning in our patients. Mrs. Baldwin was no different, requiring several operations over the years.
During this period, I read an article about a Native American woman from Peshawbestown in the Record-Eagle. It told about Mrs. Catherine C. Baldwin and how her Quill Boxes were being displayed at the Smithsonian Institute. She was to demonstrate their construction and even presented then President Bill Clinton with a box. I was impressed, for I never would have suspected Mrs. Baldwin could do such intricate work. She always had appeared fairly ill from the renal failure, yet there was an inner calm, a peace and gentleness she exuded.
Renal failure is a truly ugly disease and accessing and maintaining a fistula for dialysis is a problem in itself. These patients undergo continual needle pokes and surgical revisions, and are never free from machines that require three to four hours of their time three to four days a week. I would revolt against such abuse, yet seldom do they -- and some, like Mrs. Baldwin, accept it all with a peace and serenity that is almost gracious.
I had the chance in the office one day to ask Mrs. Baldwin about her fame and described my Quill Box. Mine wasn't signed by the artist, but the workmanship was impeccable.
When I described it to Mrs. Baldwin, she smiled gently and explained the Lady's-Slipper was her trademark. She had made the box at an earlier time, when she didn't sign her work.
I was of course delighted and asked her if she could sign it if I brought it to her, which she agreed to do. I clipped and saved the newspaper article within the box and added traveling to Peshawbestown for Mrs. Baldwin to sign the box to my long mental list of things to do.
Before I got around to it, the renal failure got the best of Mrs. Baldwin and she passed away in kidney failure or one of the many associated complications of the disease.
I never got her signature, but it doesn't matter. She left more of a signature on me with how she lived her life and dealt with her disease. Even with all the adversity she faced, she was still able to make a simple box into an intricate object of art.
Reflecting on it now, I can see so many parallels between Mrs. Baldwin, the Quill Box and renal failure. The obvious one is the quill, which, like a needle, is hollow and very sharp. These sharp quills had to be collected from a porcupine, cleaned and stained and woven into her intricate designs.
I wonder how many times she stuck herself with the quills -- and how many times she was stuck by needles in dialysis. It's obvious the care she took in placing the quills in her box's patterns.
I wonder if such care was returned when needles were placed in her arm for dialysis. If I had been as precise as she when I created her fistulas, would she have required as many revisions? The human body isn't a Quill Box and precision is not obtainable with such variation, but I can't help wishing I had tried harder.
The gentle pattern of the Lady's-Slippers belies the harsh reality of the life Mrs. Baldwin had with renal failure. They mirror the peace, tranquility and beauty of how she appeared to live her life and deal with renal failure. The sweet smell of the SweetGrass, which still exudes from inside the box, is a sharp contrast to the acid smell of renal failure and the scents of alcohol and sterility in the dialysis unit. The simplicity of a box, complete unto itself, is the opposite of the complexity of the machines, drugs, tubes and dressings Mrs. Baldwin had to endure.
So the simple but unusual gift Jean gave us on our wedding anniversary turned into much more than a Quill Box. It turned into a small piece of life: beautiful and tragic -- a small vignette of how one person dealt with disease and decay, yet maintained her beauty while creating more beauty for others.
I thank Jean for this special gift and dedicate this short story to her now.
Michael VanderKolk, M.D. practices in Traverse City.
http://www.record-eagle.com/features/local_story_353094618.html?keyword=topstory
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:'( This story made me cry. Too bad the doctor couldn't be more help to Mrs. Baldwin.