It’s the summer of 2003. She and Joe are starting to get serious after a long on-again, off-again friendship. They are curled up on a sofa at her apartment and she is in a melancholy mood, having just learned that the kidney donated to her by her eldest sister three years earlier is failing.
Bernardine, or Dine, as friends call her, confides to Joe: “I’m scared to be sick and not able to take care of myself.” She is working as an independent social policy consultant and her health insurance premiums are astronomical.
Joe says, “I have insurance.”
Whoa. Dine wonders if that’s Joe’s way of proposing … marriage? Joe grins and shrugs, “Sure.”
A few months later, in April 2004, Joe and Dine are married at Lake Tahoe under a big tree, “just the two of us, a minister he’d found in our hotel services directory, a kindly gentleman from the hotel groundskeeping staff who agreed to be our witness and two wild geese quacking happily in the background,” Dine writes.
Way to go, Joe. If you only know about love stories from watching Lifetime and Hallmark, you’ve probably never met a man like Joe. You won’t find him in “Waiting to Exhale” or any of the Tyler Perry fare. This is the real deal, not fiction or fake. Not the kind that bails on a sick wife. He doesn’t even have to make a vow to stick by Dine “through sickness and in health.” That’s just who he is. That’s what he does.
Soon after they started dating, it became clear that Dine would eventually need another kidney transplant. Problem was, Joe’s blood and tissue types were not compatible with hers.
While considering their options, they learned about the Incompatible Kidney Transplant Program at Johns Hopkins Hospital. The way it worked: If Joe donated a kidney, doctors would find a compatible recipient, and in return, a matching kidney would be found for Dine.
The two were in bed, in a darkened room, when Joe agreed to the kidney swap.
“I had known deep down that Joe would respond that way,” Dine writes. “Still, hearing him say it was such a relief. I closed my eyes. How do I respond to such goodness? Joe always came through for me. As someone who had taken care of herself for as long as I had, I sometimes struggled to accept Joe’s goodness. But it just kept coming.”
Dine had been diagnosed with a type of kidney disease called focal segmental glomerulosclerosis, or FSGS, in 1984. There is no known cause or cure. She was 33. Born to working-class parents in South Philadelphia, she had graduated from the Philadelphia School for Girls in 1969, left home at age 19, pregnant. She stayed awhile with her then-boyfriend’s parents, then set about raising a son while working her way through Temple University, where she received bachelor’s and master’s degrees. She got a good job with opportunities for advancement, then discovered she had life-threatening kidney disease with a name she could hardly pronounce.
For nearly a decade, the condition remained stable. By 1994, signs of kidney failure began showing up on her medical tests, and by 1999 she needed a kidney transplant. Fortunately, her eldest sister, Alice, was a match and agreed to the procedure.
Three and a half years later, however, the transplanted kidney developed FSGS. Before the kidney swap deal involving Joe’s kidney materialized, Dines began dialysis at Fresenius Kidney Care Dupont Circle. The function of a kidney is to remove waste products from the blood and produce urine. Dialysis removes waste from the blood and excess fluid when the kidneys aren’t functioning properly.
Joe would bring Dine to her appointments — which lasted four hours — three times a week.
At every dialysis center she visited — whether in D.C., Philadelphia, Detroit or even on Martha’s Vineyard — the patients were usually Black. Just like her — although many were poor, some homeless, some addicted to drugs or alcohol, some blind, some amputees, all were weary and often in pain. High blood pressure and diabetes are the two most common causes of kidney disease.
In the book, Dine explains how at first she resented being among the dialysis patients because they reminded her of the poverty she had worked hard to escape. But then she came to see them as “her people” — how race had linked them in a struggle against racially disparate outcomes in health-related matters.
At a book reading Saturday at Politics and Prose, a White woman in the audience rose to comment.
“I just want you to know I’m your people, too,” she said. Dine knew the woman and introduced her. She was Judy Payne — donor of the kidney that Dine had received in the swap for one of Joe’s. The audience gasped.
Kidney recipients have the option of contacting donors to say thanks. Dine had done that immediately after her transplant, and she and Judy have been close friends ever since. Payne, who lives in New Hampshire, told me later: “I just wanted to help somebody. What I got in return was the gift of friendship.”
The recipient of Joe’s kidney remains anonymous. And Joe is okay with that. “I just wanted to help Dine,” he told me.
In the book, Dine describes a trip she and Joe took to Paris, Nice, Madrid and London to take their minds off the upcoming surgeries. One day she asked him, “Why does croissant and Perrier taste better in France than they do in the United States?”
Joe replied, “Because we’re in France, baby.”
Who knew the Federal Insider could be so suave?
Dine had come to the right conclusion about the Black dialysis patients: They were her people. But she was also aware that she had advantages that many of them would die for want of — including adequate health insurance, the means to make lifestyle changes, access to the best doctors and altruistic organ donors like her sister, Alice, and Judy.
Not to mention a support system anchored by someone as steadfast as Joe.
Dine says she wrote the book in part to raise awareness about kidney disease and the needs of the less fortunate among us. That and the love story make it well worth the read.