In 2001, several years after his doctors advised him that he would eventually need dialysis, my brother Joel's renal consultant decided that that time was imminent.  Although we knew that Joel had terminal kidney failure, i.e. one day they would pack up, he was now in end stage kidney failure i.e. they're about to pack up soon.  I think it was July that Joel and my mum went to look around a dialysis unit.  Up until then I had assumed that dialysis was a wonderful, non‑invasive solution to the problem of kidney failure… not.

I remember when she called me to tell me about it.  She was very upset.  Joel had a choice between two types of dialysis.  The first one, is called haemodialysis and is the one you normally think of, when a person goes into a unit every three or four days, and their blood is pumped around a cleaning unit.  In order to do this you have to have an operation to make what's called a fistular, which is a reinforced vein in your arm.  This has to be done some months before dialysis begins, to allow it to be healed.  The major problem with this for Joel was that he has partial (mostly) paralysis of his right arm, so if the operation was done on his left arm and went wrong, he would basically be stuffed.  (He eventually had it on his right arm.)

The other type of dialysis is peritoneal dialysis, where a bag is inserted (a different operation that needs to take place months before), in the abdomen near (or it might be in) the peritoneum, and the blood is cleaned by means of diffusion with the contents of that bag.  This is continual, so it requires the kidney patient or their carer to do some actual nursing.  With Joel's physical disability this again was a pretty poor solution. 

When Joel had a stroke at the age of fourteen he lost a lot.  He had to learn to walk again, to talk again, and has permanent disabilities as a result of the damage to the areas of his brain that deal with speech and movement on his right side.  He was on constant blood pressure medication, and developed epilepsy and had to take drugs for that too.  He has had electrotherapy on his right leg and arm, and botox injections to prevent muscle spasms and help him with his movement.  He has speech therapy and had to learn to use his left arm to do everything, even though he was previously right handed.  He never took G.C.S.E.s, but through sheer bloody mindedness he went back to college, and did a BTEC (which took three years because after the first year they changed the rules and he had to start from scratch), a Foundation in Art, and finally a BA in Fine Art.  He's shit hot too.  But the point is that Joel has had to go through a lot, it would be horrible to see him go through any more.

I told my mum that I wanted to find out about giving a kidney. 

I remember coming home that night feeling really depressed, partly for Joel, partly for myself.  When Joel was 14 and I was 15 he had a stroke.  Writing about the kidney transplant, and even Joel's eventual dialysis (the kidney failed after 7 and a half years) is very emotional, but I can't even begin to tell you about the stroke.  I could sit here and tell you about the details, but I am not sure if I will ever be able to describe the sheer tornado of a serious stroke, especially on a young family, and having to watch one of the people you most love in the world become as helpless as a baby.  For months we visited, watched, prayed, cried, hoped, put on brave faces and did that thing that is less than living, called surviving.  When I spoke to mum about dialysis I felt like it was all starting again.  As I was sitting, feeling sorry for myself at home, an acquaintance of mine rang out of the blue.  She wanted to know why I felt so down, I told her and, as she tried to be sympathetic, I felt like saying that she couldn't possibly understand what was happening.  Then she told me that her sister had died in a car accident before she was twenty.  She understand it all, the guilt that you feel as a sibling that it didn't happen to you, and all the confusion.  But she made me realise how lucky I was.  To still have my brother, and maybe to be able to help him.