I have often thought about the day my fistula would stop working. Its inception was a hellish nightmare, a messy operation in which my arm was clamped down, veins were repositioned, scarlet ribbons snipped apart and tied together into a beating, throbbing mass. A second heart weighing down on my elbow.

Frankenarm. That’s how it felt.

During the procedure, I suffered electric shocks, had a fountain of my own blood splatter on my face, and was asked asinine questions about my university lectures and time in Russia. For two hours. It was never ending torture. At the end of it all, I had a throbbing, aching *thing* there, complete with scars and an infinite itch I could never scratch.

It buzzed. Like a bumblebee. Sometimes, at 3am when I lay awake reading for essays, I thought I could hear it. It boomed. It fucking hurt.

Yet, when it was needed for dialysis, it kept me alive. My lifeline.

The first time it was needled, blood rushed out like newly-corked champagne. By the end, it had bled so much under the skin that I looked like I had been beaten black and blue, but only on one side. I could barely move, it hurt so much.

For those who don’t know, haemodialysis is a bloody, but effective business. Your kidneys don’t work. You need to filter the rubbish out of your blood, and take off the excess fluid. So the doctors make a fistula, an enlarged artery and vein to give access to an adequate blood flow. Then, big needles are put into your arm 3 times a week for four hours at a time. Blood flows through a filter that works exactly like a kidney, filtering out the excess toxins, electrolytes and removing excess fluid from the body. Like a fast, grisly detox.

It feels weird as fuck. It feels terrible at first. After every session, your body has gone through the equivalent physical effort to running a 10K race. The closest I can come to describing it, is being put through a washing machine, while having the worst hangover of your life. As a healthy person, you take for granted that you feel okay on a regular basis. As a dialysis patient, *okay* is a godsend. You learn to make the best of *okay* days. You learn to love them.

You really learn to live your life like there’s no tomorrow. Because there is no guarantee that there is.

Day by day, I accustomed mysef to its incessant hum. It meant I was okay. It meant the next dialysis session would be okay. It meant I would stay alive.

I have seen dialysis patients lose their fistulas. I have seen fistulas blow on dialysis. That means a clot forms in the artery during dialysis, but blood is still pumping in and out through the machine. It leads to a bottle neck in the vein, and things get messy very quickly. It’s not a pretty sight. Patients scream in pain then faint, blood bursts from the fistula in a frothing, scarlet eruption. The unit transforms into a murder scene. Nurses follow emergency proceedings, doctors suddenly run in from nowhere. Curtains close around the patient like a shroud. You hear mutterings, whispers, groans. After an age, the patient is wheeled out, covered in bloody sheets, transported to another fate on another ward. Removed from our world. We would never see them again.

All the while, we can taste the iodine in the air. We can smell the metallic stench of blood. Because we’re all confined to our machines, like humans plugged into a vampiric matrix, all we could do is watch, and hope it wasn’t our turn next. Sometimes, we felt like the lounging dead.

In between sessions, I would check the thrill of my fistula. Whirring away like bloody clockwork. We’re still okay. I’ll live another day. I think.

Even after I had my transplant, I still checked to make sure my fistula was buzzing away. First, it was daily. I was on a ward with four other women who had just had transplants. Theirs all failed. I assumed mine would too. My kidney thrived.

Then it was weekly. I was on daily visits to the hospital. You could never be sure what would happen in the first six months. Levels of toxins rose and fall like the tides. Drugs chopped and changed. Side effects would sneak up unexpectedly, then gradually wash over you. It was expected. Everything was going well.

Gradually, I stopped checking. Then one day, I woke up, and I felt so ill I could barely remain conscious. I remember hearing my phone through a black fog, hearing people speak around me, lights moving, my body being rushed around a hospital. I could barely hold onto the light, barely follow the conversation. Life was slipping away from my grasp.

Sepsis. It almost got me. I came within hours of losing my kidney and my life. My fistula hummed with life, the one part of my body that throbbed with pain. I pushed through.