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A Piece of My Mind
September 21, 2021

It Is What It Is

Author Affiliations
  • 1Pulmonary, Allergy, and Critical Care Division and Palliative and Advanced Illness Research Center of the Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
JAMA. 2021;326(11):1007-1008. doi:10.1001/jama.2021.14917

“It is what it is.” This has become my sister’s battle cry.

I’ve heard her say it so many times during the past 25 years and in seemingly every conversation we have had the past 18 months. It is a statement that embodies her resilience, her ability to take things as they come, almost never complaining or expressing any resentment that I or any of her friends just plainly had it easier than she did.

At age 16, my sister began having episodes of flank pain, dysuria, and nausea, which were initially attributed to urinary tract infections. After the episodes continued, she saw a nephrologist and had multiple inconclusive biopsy results until she finally received a diagnosis of idiopathic glomerulonephritis—an illness without a clear course of treatment that landed her in the hospital many times for a variety of symptoms, including pain, uncontrolled hypertension, refractory headaches, and vomiting. She missed all sorts of teenage milestones—New Year’s Eve celebrations, her high school graduation party, and more. High-dose steroids introduced adverse effects of insomnia, increased appetite, and jitteriness. She had to take a semester off during college, staying home for a course of cyclophosphamide, during which she lost weight and some of her hair. Unfortunately, none of the treatments worked. She was 22 years old when she had her first kidney transplant in 1996; our father was her donor.

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    1 Comment for this article
    Beautifully Written Poignant Reminder of What the Pandemic Has Cost Us
    Darlene Moak, MD | St. Andrews Psychiatric Services, Charleston, SC
    Thank you for this beautifully written article. I work with transplant patients as a psychiatrist, and antibody sensitization is another layer of complexity in an already arduous and complicated journey to get a transplant. I hope your sister's secnd transplant is a complete success and she can go back to being the amazing strong mother, wife, & family member that she is. COVID-19 has cost us all so much and continues to ravage this country. Did it have to be this bad? No. Vaccination would have prevented a great deal of the damage of this unprecedented (in my lifetime, and I'm 66) pandemic. But "it is what it is". It could be better though. Again, thank you.