By Victor Walker, Contributing Writer
If you look at me, you wouldn’t be able to see my illnesses. At least, that’s what several people have told me. They say, “You don’t look sick,” as if they expect me to cough up blood, look gaunt, or fragile. They don’t seem to know it’s not a compliment to tell someone they don’t look sick. It’s an invitation to be invisible in their world where illness needs to be visible to be validated.
My kidneys have failed me. I also struggle with diabetes, high blood pressure, and survived a stroke in 2022. I’ve known for several years that I would eventually need dialysis and a kidney transplant. I dreaded the thought because, though I had heard of dialysis, I didn’t really understand what it was. Most people don’t. Thus, they don’t understand what I go through just to make it through a day.
Dialysis is a ritual of borrowed time. It’s a process that filters toxins from my blood because my kidneys no longer can. Three times a week, for four hours at a time, I sit tethered to a machine that keeps me alive, for now. If I miss a treatment, toxins build up quickly, and I risk heart failure, coma, or death. Without a kidney transplant, this routine will continue indefinitely, each session buying me just enough time to make it to the next. Dialysis isn’t a cure. It’s survival on a strict schedule.
Even with a kidney transplant, the challenges are not over. A transplant isn’t a finish line. It’s another beginning. The body doesn’t always accept a new organ willingly. I would have to take antirejection medications daily to prevent my immune system from attacking the new kidney, and those medications come with their own risks.
There is increased vulnerability to infections, higher chances of developing certain cancers, and side effects that can affect everything from my mood to my metabolism. There are frequent lab tests, more doctor visits, and the anxiety that the new kidney might fail too. Not to mention the guilt that could arise from knowing the possibility that someone might have to die for me to get their kidney. A transplant offers freedom from the dialysis machine, but not freedom from illness.
I began dialysis in November 2024. I’ve also been active on the kidney transplant list for roughly a year. Though I’m grateful for the life-saving treatment, I’m tired of dialysis interrupting my life. Tired of the cold chairs, painful needles, blood spilling everywhere, and a system where Black people die waiting to procure an organ donation.
According to the Centers for Disease Control and Prevention, Black Americans develop end-stage kidney disease at rates nearly four times higher than white Americans, largely due to higher prevalence of diabetes and hypertension, the leading causes of kidney failure. Although Black people make up about 13% of the U.S. population but represent approximately 35% of those receiving dialysis treatment.
Additionally, the United States Renal Data System and the Organ Procurement and Transplantation Network, report that Black patients often face significantly longer wait times for kidney transplants compared to white patients, reflecting systemic inequities in access to care and organ donation. These disparities highlight a persistent crisis in both healthcare and social justice. I experience this firsthand every time I get in the dialysis chair.
Sometimes, when I’m sitting there, I stare at the ceiling and try not to feel anything. The machine beeps every few minutes and pulsates like a second heartbeat. I’ve learned to tell time by the rhythm of the machine. Cold saline enters my arm as warm blood leaves it. The technician tapes the needles in place with the same casual firmness you’d use to tie a shoelace. I try not to watch, but the writer in me wants to document the whole process. However, watching doesn’t make it less terrifying.
There’s a moment, just after the machine starts, when I feel like a part of me disappears. It feels like I’m no longer entirely human, like in the film The Matrix, where the humans are in the pods connected to the power plant. Dialysis zaps my energy and leaves me depleted and it takes everything within me to not cry or scream. Something in me breaks every time I have to go for treatment. Then, I think about the people in my life that need me to be strong and endure.
Through dialysis, I’ve learned that strength isn’t always what people think it is. It’s not smiling through the pain, so others feel more comfortable. Some days, strength is just getting in the car and showing up. Some days, it’s letting myself feel the weight of it all without going home and burying my head under my blankets. I don’t always tell people how much it hurts, or how there are mornings when I sit on the edge of my bed, trying to convince myself to go to treatment. I go anyway because I want to be brave, and I feel I have no other choice. That, too, is a kind of strength.
The hours I spend in the chair each week are exhausting, but they’ve also become a type of classroom. Instead of watching my blood go through the tubes, I’ve used the time to learn more about dialysis itself. Not only have I learned what dialysis does to my body, I’ve learned how the system is structured. I’ve learned about the racial disparities that shape who gets sick, who gets treated, and who gets saved.
Black people are disproportionately affected by kidney failure and overrepresented among those on dialysis. When it comes to organ procurement, registering as donors, or being prioritized for transplants, we are underrepresented and underserved. That contradiction isn’t simply unjust, it’s deadly. It means Black people are more likely to wait longer, suffer more, and die sooner in a system that wasn’t designed with us in mind.
Add to that, Black people seem afraid to be living donors. When the nurse from my transplant team asked me if there was anyone in my family or friend group who would sign up to donate a kidney to me, I wanted to laugh and tell her, “Black people don’t do that.” Despite the humor in that, it seemed to me that some Black people would be more willing to donate their organs after they died, than to be a living donor. It speaks to a deeper history of mistrust, of scarcity, of always needing to hold on to what little we have, our bodies included.
I keep showing up to be tethered to machines, as I try to outlive statistics. I fight, I educate myself, and I encourage because no one else is going to do it for me. Survival isn’t passive. It’s daily labor, laced with fear, frustration, and the quiet hope that maybe, someday, something might shift. I’ve lost time, strength, and parts of myself in this process, but I’ve also gained clarity. This isn’t just about me. It’s about all the Black and brown bodies filtered through a machine while the system refuses to change the conditions that put us here.
However, I still believe in possibility. I believe in science, in policy, in people who are willing to act, to care, to see us. I believe in the idea that one day, we won’t have to fight so hard just to stay alive. Until then, I will keep showing up, tired, aching, and human, because I am more than a list of illnesses and I don’t want to die! I will be 50 years old in September. With all of my conditions, I was certain I wouldn’t make it to be 50.
If you’re reading this and you’re Black, please consider becoming a living donor. Get on the donor registry. Get tested early. Take care of your kidneys. Know the risks and the signs, and most of all, talk about this with your family and friends. Start the conversation that too many avoid. Our survival depends on it.
Living donation matters because it can dramatically reduce wait times and improve transplant success, offering hope where dialysis offers only survival on borrowed time. I understand the hesitation due to centuries of medical neglect. Exploitation has harvested mistrust that runs deep in our communities. This history is real and painful, but so is the urgent need to protect our health right now.
Early testing and managing conditions like diabetes and high blood pressure are critical steps we can take to prevent kidney failure. Beyond personal care, we must also raise our voices and advocate for equitable healthcare policies, supporting Black-led health organizations, and sharing our stories to reshape how the system sees and serves us. Our survival depends not just on medicine, but on collective care and action.
Despite many not seeing my illnesses, or expecting me to look a particular way, I’m here, visible, and resilient. I claim my story beyond the shadows of what’s unseen, and I ask each of you to do what you can to make sure people like me can continue living.
A Detroit native, Victor L. Walker is a singer, poet, and self-published writer whose work addresses issues related to race and equality, men and masculinity, and queer experiences.
