Today Robert and I celebrated our 18th wedding anniversary, just under four months after our 18th transplant anniversary. I learned recently that timing—the surgery preceding the wedding—was very purposeful. At least on Robert’s part.   I remember in the weeks prior to surgery, I visited him at the dialysis unit as I often did. One of the dialysis technicians congratulated me on our upcoming surgery…and our engagement.   My brows furrowed a little in confusion because, “I don’t see any rings on these fingers,” I said, waving reverse jazz hands.   Not that Robert and I hadn’t ta ..read more

October 30, 2019 was my last day of clinical practice at UCSF. But it wasn’t until June 30, 2023, that the University of California, San Francisco (UCSF) no longer gets to claim my identifiers of being Black and a woman as a testament to their “commitment to diversity,” when the reality is that fewer than 1% of its faculty at the associate professor (my title when I left) are Black. The technical delay in complete separation was to allow me to spend down the remainder of my grant funding. Because I don’t believe in leaving my money on the table. Perhaps it’s my free school lunch background tha ..read more

Long before anyone asked the Make America Great Again crowd to pinpoint exactly when America was great if you were Black, I heard a White stand-up comedian joke about how he could pretty much go back to any time in history and be ok, and acknowledged a Black person would not be ok. Hell, we’re still not ok.   But when I think about medicine, no one could go back in time and expect to be better off. And not just from the discovery of antibiotics or anesthesia perspective—from all the perspectives!   For example, when I donated a kidney 18 years ago, I could have a laparoscopic procedu ..read more

After recording my latest YouTube video for the fifty-leventh time before getting a usable version, I realized I didn’t answer the question posed by the inspiration email. In the video, I talk about how to bring up the notion of stopping dialysis to the nephrologist, but the writer was asking how to bring it up to their sister on dialysis. Anyone familiar with the vernacular “fifty-leventh” knows that means I did not have it in me to do even one more take. But I can address their question here.   First, I’ll say, just like beauty, the perception that “life is horrible” is in the eye of t ..read more

I’ve written about my reasons for leaving UCSF. And while it was painful to feel unsupported, isolated, undervalued, and gaslighted—including by Black leadership within the institution—I was already a published author, recipient of multiple coveted grants and fellowships, and double board-certified in nephrology and internal medicine. I’ve since learned that my story pales in comparison to so many other young Black physicians who are being disproportionately pushed out of medicine at a time in their career when they have no license to practice independently but do have $240,000 of debt on aver ..read more

“My sister won’t let me have anything I want to eat,” said Mr. G during his primary care clinic visit. In his late fifties, Mr. G had suffered a stroke that had taken a toll on his memory. His sister had stepped in to help.   “Like what?” I asked. “Like burritos.”   “Why not?”   “Because of my kidney failure.”   I did a little what you talkin’ ‘bout Willis pout, as I didn’t remember him as having kidney failure.   I looked back at his labs and was reassured. His estimated glomerular filtration rate or eGFR was around 50, what I would call a smidge of chronic kidney di ..read more

Mr. Garcia was one of the lucky ones.   Not in the born-in-poverty or kidney-failure-by-30 sense. But lucky in the sense that by the time his kidneys failed completely, he was in California where Medicaid pays for undocumented folks get the same dialysis as the US-born and not in one of the 38 states that wait until undocumented people show up to their ERs damn near dead before they will give them a dialysis treatment or three before they send them back out to start the process again five or six days later—even though it is far more expensive than standard care. Because racism. But even ..read more

My latest installation of Real Kidney Talk with The People’s Nephrologist centers around a common refrain I heard in kidney specialty clinics: I pee fine, so my kidneys are fine. Or some similar iteration, to which my response always included: All pee ain’t good pee. Check out the video for why this is true.   Like much of the denial I’ve encountered in my role as physician, I understand it is usually rooted in fear and mistrust. That, and the general lack of appreciable symptoms for chronic kidney disease until one won’t survive much longer without dialysis or a transplant.    ..read more

It’s our 17th kidney transplant anniversary y’all! (Check out my latest video for “Real Kidney Talk with The People’s Nephrologist” where I talk about being a kidney donor.) If it’s not obvious from our picture, my husband and I are both Black. And don’t let the fair skin fool you: We are unapologetically and proudly Blackity-Black. The medical world, however, will have you thinking being Black is in and of itself a risk factor for disease. I actually heard somebody say this bullshit out loud on a UCSF panel about the use of race in medicine (fast forward to 39:05 to hear it for yourself and ..read more

I believe there is a way for kidney function to return. I believe the truth about that is held back from mainstream. These are lines from a recent email asking about treatment options for their loved one who has been miserable on dialysis for two years. This email served as fodder for my latest Real Kidney Talk with The People’s Nephrologist YouTube video. I hope you’ll check it out, like, subscribe, share, and let me know what you think. ? Because folks often wonder about treatment options for kidney failure and the likelihood their kidneys will come back, this is the focus of the video. B ..read more