The craziest nephrology fellow assignment

In 1971, Congress was debating adding a dialysis benefit to Medicare, and extending that benefit to all Americans. As part of his testimony to the House Ways and Means Committee, Shep Glazer was dialyzed in front of the committee. The process only lasted a few minutes but the event is considered to be the moment where Congress became committed to providing the benefit.

Glazer's testified the following:

I am 43 years old, married for 20 years, with two children ages 14 and 10. I was a salesman until a couple of months ago until it became necessary for me to supplement my income to pay for the dialysis supplies. I tried to sell a noncompetitive line, was found out, and was fired. Gentlemen, what should I do? End it all and die? Sell my house for which I worked so hard, and go on welfare? Should I go into the hospital under my hospitalization policy, then I cannot work? Please tell me. If your kidneys failed tomorrow, wouldn't you want the opportunity to live? Wouldn't you want to see your children grow up?

The part of the story I never knew was that George Schreiner, the Chief of Nephrology and head of the National Kidney Foundation was the primary architect involved in lobbying congress for the dialysis benefit. He provided the dialysis machine but the National Kidney Foundation did not want to lend dignity to what they considered a risky stunt and barred Schreiner from attending.

So Schreiner sent his fellow to attend the procedure.

Can you imagine getting that page from your attending. "Hey, listen Topf, I've been barred from the hearing, but here's what we're going to do: You are going to take that dialysis machine, in that truck, to Capital Hill and then set it up. Just like I taught you. Yeah, in the hearing room for the House Ways and Means Committee. Yeah, they'll all be there. Just ignore the national press. And the TV cameras. Then I need you to give dialysis to this guy who's flying in to testify. After that, come on back and we'll finish rounds. Okay?"

The fellow was James Carey who had this to say about the event:

Several years later, Carey disclosed to Schreiner that Glazer had gone into ventricular tachycardia during the dialysis session before the committee. Carey had immediately clamped the lines. The "treatment" was very short, perhaps five minutes in all, long enough to open the blood lines but hardly a dialysis session. Nevertheless, the few members of the committee who were present characterized the episode as "excellent testimony."

That was when being a nephrology fellow was really cool.

As recounted in Biomedical Politics and Christopher Blagg in AJKD.