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Doctor sees both side of dialysis treatment

by CINDY LANGE-KUBICK Lincoln (Neb.) Journal Star on June 11, 2013 11:00 AM

LINCOLN, Neb. — The two patients were in renal failure, and the doctors at the hospital on the hill had no way to treat them.

Some of the bigger Veterans Administration hospitals had artificial kidneys, big tubs that looked like smokers, with coils and pumps and tubes that cleaned the blood of patients with kidney disease.

But in the 1950s, Lincoln’s wasn’t one of them.

So doctors put the sick veterans on a plane to Minneapolis.

“They both died on the airplane,” Frank Neumayer told the Lincoln Journal Star. “And that ended up bothering me a great deal.”

Neumayer was assistant chief of surgery at the VA then, and when a colleague told him about an article he’d read about a promising — and affordable — new dialysis machine, Neumayer went to his boss.

Soon, Lincoln had dialysis, too.

After the $1,500 contraption arrived, the hospital sent the young, dark-haired doctor to Cleveland for two weeks to train with the machine’s inventor, Dr. Willem Kolff.

By the time he came back, a patient was waiting.

“City’s Only Artificial Kidney Used 1st Time,” read the headline in the Nebraska State Journal on March 13, 1957.

“The machine, called a “hemodialyzer,” takes over for the injured kidney until the organ is sufficiently healed to resume function,” the story said.

In the photograph, medical staff from the hospital posed with that patient, Dr. Francis Neumayer of Philadelphia on the right.

The World War II veteran survived.

“He lived for quite some time. He eventually died of liver disease, but his kidneys were working.”

The young, dark-haired doctor is 90 now, white-haired and reluctantly retired.

And he tells his story from a blue recliner at the Dialysis Center of Lincoln, where he’ll come three times a week for life, tubes running from his arm, his blood flowing into the 21st century version of Kolff’s machine.

o o o

Francis “Frank” Neumayer wasn’t going to be a doctor. And when he became a doctor, he wasn’t going to be a surgeon.

He’d joined the service, and in 1942, the government decided the war probably was going to go on for a long time, and they’d better have college graduates when it was over.

Before he enlisted, he’d started night school in accounting, but an aptitude test later pointed toward pre-med.

So that was his path. He wanted to be a family practice doctor, and a surgery rotation was part of this training.

When a surgical residency opened up at the VA in Lincoln, he applied.

He liked it here. And he ended up liking surgery, too.

“He was one of the busiest, most popular surgeons,” said Frank Marple, Neumayer’s kidney doctor.

He was thorough, technically perfect and compassionate, the kind of doctor who sat at a bedside with tears on his face to tell a woman the biopsy said cancer.

For 25 years, Neumayer took out gallbladders, repaired knees, removed varicose veins and diseased breasts during the day — and helped run a dialysis clinic at night.

He moved the machine from hospital to hospital in the back of a pickup, Neumayer said. “Like a huckster hauling fruit.”

Early on, it was a stopgap measure, the machine effective for only short-term repair.

Then that machine was replaced with something more modern. And with something more modern after that.

And the doctor got older.

Even after his surgical practice prevented him from continuing to run the dialysis clinic, Neumayer used his surgical skills to splice veins into arteries to create fistulas — larger openings that kept the bad blood flowing out and the blood cleaned by the dialysis machine flowing back into patients’ bodies.

“He worked well into his 80s assisting people because he just had all this experience,” said Dr. Les Spry, medical director of the Lincoln Dialysis Center.

His colleague would have loved to work forever, said Stephen Nagengast, who began sharing an office with Neumayer in 1993.

“He’s been like a second father to me. I wish I had been younger when I met him.”

o o o

Ten years ago, the surgeon had a slight stroke and doctors were doing tests. Neumayer watched as the ultrasound image showed up on the screen.

“Oh, my god,” he said. “Look at that.”

Polycystic kidney disease.

He kept it under control for eight years, avoiding dialysis by taking medication, watching his diet and monitoring his fluid intake.

Then, after a family reunion with his seven grown children and grandchildren in Colorado a few years ago, he overdid it.

He went to see his kidney doctor.

“I think it’s time.”

o o o

Last Sunday, the dialysis center held a reception for its patient — the man who brought dialysis to Lincoln. They put a plaque on the wall honoring his contribution.

“He’s kind of gone around in the circle,” said Larry Emerson, chief executive officer. “He’s just a wonderful gentleman.”

That first artificial kidney didn’t come to town just because of him, Neumayer said.

“The thing that I think is important is how many people helped me. This was a group effort.”

There were few patients those first years, their numbers in the dozens across the country. By 2010, nearly 400,000 people in the United States were receiving dialysis.

The 21st century machines, about $18,000 each, keep people alive until they get new kidneys.

Those not eligible for transplants — like Neumayer — are lifers. There are worse things, he said from his blue recliner in the room he visits three times a week.

“I’ve been very lucky in my life.”

PHOTO: In this May 28, 2013 photo,  90-year-old retired doctor Francis Neumayer, who helped bring dialysis to Lincoln in the late 1950's, undergoes dialysis treatment at the Dialysis Center of Lincoln, Neb. (AP Photo/The Journal-Star, Francis Gardler)

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