It would not have been too much to ask of Fate for a quiet winding-down of a chap’s affairs after retirement – restore the Lotus 7, build that model of the Mary Rose, visit grand-children…… Like most of my predictions, I got it wrong: the “phoney” retirement evaporated and we’ve had such a white-knuckle, exciting and demanding decade since our 50th class anniversary.
Our good
news has come from family - the two sons
in regular employment, a profusion of amazing grandchildren – some cousins have
produced only girls so the family’s future is guaranteed straight, narrow and
unswervingly de-prejudiced – and Paula created a thoroughbred racing Syndicate from
which herd two flat-racer mares, Welsh Sunrise and Welsh Moonlight got 5 wins
and 4 second between them. But sadly my
alpaca herd failed when the cost of spinning primary fleece rose to £50/kg (we
provided 70 kg/ year).
Then came
fun, shrouded in disaster’s clothes: In
2018 I developed end-stage renal failure
(allergic nephritis due to Lansoprazole* sensitivity). Some of you may recall that my main interest
after Monteverdi was (is still, vide infra) renal and pancreas
transplantation, so you will appreciate my astonishment that I should become a
patient, diagnosed with a disease for which
I had been “dishing it out” to thousands of other people over 41 years . I’ve not yet found another transplant surgeon
whom Fate has chosen for such a familiar and interesting diagnosis. Urgent advice was obtained from my very old
friend, nephrologist, guru and “skin-graft brother”, Stewart Cameron**. Whilst on peritoneal dialysis I waited
patiently for the Liverpool MDC verdict on a transplant for this 81 -year-old
chronic bronchitic. The 50:50 vote on
whether Paula’s left kidney should be transplanted in me created a suspicion
that some members felt uncomfortable that they might be on call on the night
that the old Unit Director turned up his toes with post-op pneumonitis. The casting vote in favour came from my old
friend and director Abdul Hamad. The
real heroine, Paula, with radiologically normal kidneys, stepped forward and
the day before her birthday gave me her left kidney, Abdul officiating. 3 years later my renal function is normal and
Paula is very fit. We had never needed
or desired to demonstrate our
compatibility. But disturbingly, the HLA mismatch showed complete
incompatibility. The clinical risk of
rejection was substantially reduced by a tiny dose of the monoclonal CamPath,
which has effectively reduced my blood lymphocyte count to the occasional
effete, fugitive cell seen on high power microscopy, once in a blue moon.
Then there
was…. But I’ve talked too much.. See you
all Saturday and I look forward to it.
Best, Robert.
*Half the
Western world takes Lansoprazole; rarely, sensitivity to the drug causes renal
failure in the young, according to the somewhat equivocal literature. Evidently youth is not an essential requirement…
** Guy’s Immunologist
Prof Richard Batchelor (whom you will all remember) was a pioneer investigator
in the effect of HLA mismatching on the prognosis after a renal
transplant. To do this , Richard
recruited volunteers in whom anti- HLA antibodies, potentially useful for
tissue-typing, were evoked by exchanging 2 skin grafts, 2 months apart. Stewart and I each have the scars to prove
it. Stewart developed a useful
antibody; I did not.
No comments:
Post a Comment