The Body's Keepers

This originally appeared at The Irresponsible Reader.

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What’s The Body’s Keepers About?

I feel underqualified to try to describe this book, and you’ll see why here in a sentence or two. So, I’m just going to paste what the Publisher’s Site says: (yes, I typically would cite the audiobook publisher here, but the print edition’s publisher gives more details)

A remarkable account of the kidney and the scientific, medical, and health evolution tied to our understanding of it.

The kidney is an extraordinary organ – in many ways the regulator, the metronome, the keeper of the human body’s delicate equilibrium. On a given day, minute by minute, it purifies the body of toxins it encounters from diet, climate, activity, and injury. It allows us to be and to move in the world. And yet most of us know so very little about these extraordinary vessels nestled in our bodies – and indeed millions of us only really learn about them when they stop working. Nearly a million Americans every year have end stage kidney disease, about 37 million have some form of chronic kidney disease. And it is an incredibly common universe of challenge and ailment that, until relatively recently, would simply kill those afflicted with it.

Renowned nephrologist Dr. Paul Kimmel takes us on an eye-opening journey through the history of kidney disease, dialysis, and transplantation. Drawing on both his extensive research and decades of experience in the field, he explains the development of treatments, technologies, and medical practices that have advanced the care of patients with kidney disease. Kimmel illuminates the impact of medical advances on the lives of those suffering from this debilitating disease and offers a clear understanding of the challenges that remain.

The Body’s Keepers also reveals the inequities and injustices at the heart of America’s healthcare system. Filled with case studies, personal histories, and first-hand accounts, the book reveals the shocking truth about the exploitation of vulnerable populations in the pursuit of profit. Kimmel examines how disparities in access to care have led to life-threatening consequences for many Americans. He also looks at the ways in which the medical industry has profited from the suffering of others, and how the path to health equity is still far from being realized. With unflinching honesty and a passionate commitment to social justice, his book is an essential read for anyone looking to understand the complexities of modern healthcare.

What Did I Think About the Narration?

With all due respect to Dr. Kimmel, this could very easily have been a dry-as-dust book. Yes, there’s occasionally some wit and some passion in the text–Kimmel’s personality does come through. Lane Hakel makes sure that shines through. He maintains the appropriate tone and seriousness to the subject, but with simple and subtle changes in inflection and so on to help maintain the listener’s engagement.

If nothing else, Hakel helped me pronounce a few terms and medication names that I’ve always stumbled on (or heard multiple ways).

I’m not saying that Hakel made this a joy to listen to, or that it was entertaining in the same way that, say, Luke Daniels makes a book–nor should it have been. But he keeps the listening experience accessible and interesting–even when the text seems just to be a list of names and acronyms. (which doesn’t happen often, but, occasionally it seems like it).

My Interest in the Book

So, I saw this on Netgalley the day after my son’s first dialysis treatment. And I clicked the request button as quickly as I could. I’ve talked in this space a little about his kidney transplant a few years ago. But what I know about kidney disease and the treatment of it doesn’t amount to much–and it’s very focused. So the opportunity to learn more–particularly in a history, was more than appealing.

Sure, I was discouraged a bit right off when one of the first things that Kimmel says is that he won’t be discussing the kidney disease my son had. But, he spent a lot of time talking about End Stage Renal Disease and transplants. So that more than made up for the skipped subject. And even the topics that didn’t directly have anything to do with my son were interesting to listen to. Because really, at the end of the day, the more medicine learns about various treatments for one area of kidney disease/treatment, the better off all patients are.

So, what did I think about The Body’s Keepers?

Can a non-medical professional read/listen to this and profit from this book? Absolutely. Are we the target audience? I don’t think so–well, those interested in the overlap of politics/economics/prejudices and medical treatments are definitely part of the target audience. So it’s not just the kind of book for M.D. after their name. But it’s not written for the person browsing a bookstore/library shelf for their weekend read, either.

This is an 18-hour listen, and it’s not the easiest listen, either–both because of the subject matter and the thoroughness with which Kimmel discusses things. Folks who are just idly curious are probably not going to make it through this book. But those who have a connection to the topic–because of their profession or professional interests, because (like me) they are or know someone going through these things, or because they’re invested in the social aspects and things like equitable access to care, or some other connection–will make it through this book and be glad for it.

For those who are interested in this subject, this is a fascinating book and a good audiobook experience. I do think I may end up getting the print edition just to make looking up a point or two easier. But for non-reference use? The audiobook is a good way to go.

I learned a lot, I have to say. The historical development of nephrology is fascinating. For such a young science the advances made are truly astounding (for example, when you hear how they made the first “artificial kidney”–the precursor to a dialysis machine, your mind will be boggled). The origins of the treatment of kidney diseases and injuries really start because of the World Wars and now kidney transplants happen all the time (not often enough for those on a transplant list for years), dialysis is routine, and the medical research is very promising to improve and innovate both.

Yes, the impacts of race, sex, income, and so on when it comes to access to and varieties of treatment are dismaying and befuddling (and on those providing the treatment). But the book suggests there’s every reason to be hopeful for the future, and that progress has been made. Easy for this white guy to say, but that was my takeaway from Kimmel. And, as in this post, I’m talking about this as a listening experience rather than commenting on the society that is depicted–the shortcomings of the system (especially in the U.S.) contrasted to the successes make for a more engaging narrative.

I should add that in the early chapters while doctors and researchers were still figuring out how to treat various kidney ailments, the symptoms and treatments (and failure rates), were strong reminders of how correct I was in choosing academic and career paths that took me far away from medicine. Some of that was rough for me (and no, I will not watch any documentary Dr. Kimmel decides to make in the future). People of stronger constitutions will not be bothered.

I’m really glad I listened to this, and encourage those interested to give it a try. It’s not a book for everyone, but for the right people will appreciate this.