Survival by Machine: The Psychological Stress of Chronic Hemodialysis

  • Harry S. Abram
Part of the Current Topics in Mental Health book series (CTMH)


Chronic hemodialysis for terminal renal failure is an example of medical progress in which the patient faces new, and at times overwhelming, psychological stresses. Dependence upon machines for survival is a recurrent theme of man’s response to artificial organs. In cardiac surgical patients, the patient experiences this dependence in the Intensive Care Unit with its mechanical respirators, electrocardiograms, and computerized monitoring devices. In postcardiotomy deliria, patients often project their feelings upon these devices and have illusory experiences in which they perceive the machines as menacing. Usually the ICU stay and this type of dependence on machines is of short duration. However, with dialysis it is chronic and lifelong in nature. Put in one form or another the patient must learn to “live with the machine.” Through patients’ thoughts and fantasies we can learn a great deal about this relationship with an inanimate object which becomes an essential part of the patient’s life.


Chronic Renal Failure Dialysis Patient Psychological Stress Chronic Hemodialysis Artificial Organ 
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Copyright information

© Plenum Publishing Corporation 1977

Authors and Affiliations

  • Harry S. Abram
    • 1
  1. 1.Vanderbilt University Medical CenterNashvilleUSA

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