HOW I FOUND MY RHYTHM WHEN THE MUSIC STOPPED

At a time in everyone’s life, we come to find ourselves in a situation where the music stops, and we must go on.  The unfortunate truth about life is that the unexpected will happen. Some of us learn from it, some of us change because of it and some of us find our life’s calling because of it. The latter was the case for me.  After our dad picked us up from middle school, we spent that afternoon like we had every afternoon that month. We went to the oncology unit at the hospital, where my brother was admitted.

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THE MAN IN A BLUE SARONG

I remember him. I remember the man in the dark blue sarong the same way I remember the lines on back of my own hand. He was hunched over next to a column on a dirty platform at a railway station in Calcutta, India in the middle of the harsh summer sun. His hands were withered, his fingers and toes looked like tiny nubs, and he was completely malnourished and alone. He had opaque blue eyes, as if fog had taken place of his irises and pupils.

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PATIENT “OWNERSHIP”

I studied insects in college; my favorite insects were the bees (I found them diligent and so helpful to humankind).  One of my favorite classes was about medical diseases caused by insects. My professors noticed my interest in the medical side of things and connected me with a professor who did clinical research. Our work focused on a clinical trial for children with intractable epilepsy and exposed me early on to patient care and patients.

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training of local surgeons and transplant team members thereby making the program more self-sufficient. Since then, and with close contact and ongoing discussion between UK and the Honduran team, living related donor kidney transplantations have been performed independently and without donor or recipient complications.


In September 2017, Dr. Analia Castellanos travelled to Honduras as an invited speaker participating in the first transplant symposium ever held in Honduras.  In addition to participating in that symposium, she helped to provide education and training to nurses and ancillary personnel caring for patients with chronic kidney disease, end stage renal failure and kidney transplantations.


Compassion and altruism are borne out of love and respect for ones fellow man, and such is the origin of the effort described above. However, this effort has gone several steps beyond by providing training and self-sufficiency to those involved.  In so doing it improved the lives and wellbeing of the patients who received care and also enhanced the skills and confidence of those practitioners who rendered the service.   Compassion and altruism have thus become beneficence, and the collaboration has taken a major step toward sustainability.  

Compassion does not know city limits or county lines. Neither state nor international  borders can contain such acts of altruism. For the last four years two surgeons and one nephrologist have travelled to Honduras to perform living donor kidney transplantation thereby expanding the art and science of transplant surgery and medicine in Central America.


In August 2006 a young Honduran woman arrived in Lexington accompanied by her mother and brother. She was referred by her nephrologists, Plutarco and Prospero Castellanos, to be evaluated for kidney transplantation. Although kidney transplantation had been performed in Honduras since 1986, the program was not active at that time. Because of medical coverage issues the transplant couldn’t be done expeditiously, so the UK Transplant center’s social workers arranged accommodations in Lexington until a suitable contract could be negotiated with the insurance company. Eventually the patient was able to undergo live donor transplantation from her mother prior to starting dialysis and travelled home to Honduras four weeks later to be followed by her nephrologist, Dr. Prospero Castellanos.  Eleven years later she is still doing well with excellent kidney function.


Why was UK chosen to transplant this patient when centers in Mexico or Florida were closer? Indeed, it was because of our nephrologist Analia Castellanos MD, daughter and niece of Plutarco and Prospero respectively.  However, the story doesn’t end with one patient encounter. The Social Security Hospital in Honduras had accomplished living donor kidney transplantation in the past with members of the team

BY THOMAS WAID, MD

being trained in different countries and with affiliated efforts afforded by the Social Security Hospital in Mexico.  More recently transplant surgeons and a nephrologist from Toledo Hospital in Spain also participated in the transplant activities from 2008 to 2010.  The program often stalled because of inconsistent staffing and support.


In 2013, the UK Transplantation program sent a team of three surgeons and physicians to Honduras to rekindle the program.  The team consisted of Dr. Steve Strup, Chairman of Urology and laparoscopic donor surgeon, Dr. Roberto Gedaly, Chief of Abdominal Transplantation and Dr. Analia Castellanos, transplant nephrologist.  Laparoscopic live donor kidney donation had not been done in Central America and the first procedure of its kind in Honduras was performed by Dr. Strup.  The donors and recipients all did well and were cared for by nephrologists, Plutarco and Prospero Castellanos. These clinical efforts established a Central  American teleconference to provide transplant education and to discuss difficult cases with other transplantation programs.


Then, in 2015, Drs. Gedaly, Strup and Castellanos travelled for a second time to Honduras to perform more live donor kidney transplantations and to continue the

THOMAS WAID, MD

Thomas Waid, MD, MS, is a professor of internal medicine specializing in nephrology at the University of Kentucky College of Medicine. He graduated with a Bachelor of Science degree in pharmacy from the University of Cincinnati in 1972. He received his master’s degree and medical degree from the University of Kentucky in 1980.