Remembering the Indomitable Chris Blagg
When Chris Blagg passed away on March 31, nephrology lost a brilliant mind, and the world lost a good, unfailingly kind, funny man who was passionate about life and travel and helping people with kidney disease to live their best lives. Born and trained in the UK, Chris was caring for people with acute kidney failure when the shunt developed by Belding Scribner and Wayne Quinton first made chronic dialysis possible—drawing him to a new life in Seattle. His book about those early days is available on Amazon.
I was fortunate to first meet Chris in 1993, when MEI started the Life Options Rehabilitation Program, which aimed to help people with kidney disease to live as long and as well as possible, through the “5 E's”—Encouragement, Education, Exercise, Employment, and Evaluation. Edith Oberley recruited him to be on the first Life Options Rehabilitation Advisory Council (LORAC). Already a huge international name by that point, he did not have an ego to match, and was always both humble and gracious. I ran into him at the doorway to an ASN exhibit hall, and exclaimed, “Hi, Dr. Blagg!” He was clearly discomfited, admitting (in his lovely, cultured British accent), “I am so sorry, but I don't remember your name.” At all of 33 at the time, and having met him just once or twice at that point, I honestly didn't expect him to. “Dori Schatell,” I reminded him. “With MEI and Life Options.” He nodded. “Call me Chris,” he replied. And, he never forgot my name again.
You wouldn't think such a little thing could change a life—but it really did. Being asked to call the great Chris Blagg “Chris,” knocked down a status wall and gave me the courage to call other doctors by their first names—which has allowed me to develop stronger relationships with many wonderful nephrologists around the world who became my mentors.
Chris brought his delightful wife Jean to LORAC meetings, and she and Joan Sadler would spend days exploring and shopping while Chris and John Sadler (Chair of the MEI Board of Directors) who were longtime friends, attended the working sessions. Chris loved to travel the world, especially to exotic locales, like India, Singapore, and Malaysia. Jean…not so much. But, she went because he loved it, and was rewarded with memories and beautiful jewelry that she treasured. It was always fun to see what jewels she was wearing.
Chris was a passionate advocate for home dialysis, having been there at the forefront of the practice in Seattle. Today's Transitional Care Units—now resurging across the nation as a way to onboard new patients, educate them, and give them a more gentle and less-scary dialysis start—owe their origins to the Orientation Unit he started with Joe Eschbach (another wonderful man) and others to bring back home hemodialysis, which ran for many years.
We launched Home Dialysis Central in 2004, and he was involved even before the start, with advice and a letter writing campaign to help us secure funding. He and several others, including Bob Lockridge, met with legislators for years to urge support for the Kidney Patients Daily Dialysis Quality Act—urging funding for more frequent HD than just three treatments per week.
In 2006, Chris agreed to be filmed in Seattle in 2007 for a patient video about PD, daily home HD, and nocturnal home HD, Home Dialysis: Your Life, Your Choice. The video can be shown in its entirety or broken into segments by modality. He was terrific, and we still offer the video on our site.
Over the years I knew him, Chris sent me almost 300 emails about a variety of things, mainly related to the battle to increase access to and use of home dialysis and the International Society for Hemodialysis, where he was the editor of the Hemodialysis International journal for a number of years. So, I had a bit of insight into his thought processes and intriguing bits of history:
-
He agreed with John Agar that “In fact the whole nomenclature [for home HD] is a mess. They are all "more frequent hemodialysis", "daily dialysis" is used indiscriminately for both daily and nightly dialysis, "nocturnal" is misused rather than "nightly", and "quotidian" means daily and is again used for both daily and nightly dialysis and I think is an ugly and somewhat pretentious term anyway. And to make things worse "daily" and "nightly" generally mean only 5 or 6, rarely 7, times a week.” (He was right, but I suspect that this ship has sailed and we will never fix the nomenclature.)
-
[Re: increasing use of home HD in the US] I think we have at least three concerns:
1: increasing home hemodialysis generally - this will require major efforts in terms of education of patients, nephrologists, nurses and other staff, facilities, corporations, insurers and the government. This will require much effort and some time;
2: seeing that reimbursement for conventional home hemodialysis (and PD) is not reduced; and
3: getting reimbursement for more frequent hemodialysis.” -
[Re: Design of the FHN trial] At the NIH Task Force on Daily Dialysis in April 2001, in the discussion on Trial Design Issues, Tom Green from the Cleveland Clinic estimated that such a study, assuming a 10% difference in event rate (which he thought realistic for mortality) and 3 years of accrual and 2 further years of follow up would require an N of 1,622 (Note: the final N for the daily HD study was 245; the final N for the nocturnal HD study was just 87). This was for more frequent hemodialysis versus conventional in-center dialysis but there would seem no reason for it to be much different for home hemodialysis. These numbers are not realistic when there are so few home hemodialysis programs in the US.”
-
“Tassin is not unique - we were doing this [Nocturnal HD] in Seattle with our overnight 3 x weekly dialysis in the 60s and 70s when Bernard Charra was a fellow here. Scrib always used to say more is better and I think this is true. What matters to patients is how they feel and many US patients have problems during and after dialysis on the presently used regimens and in my experience, these usually disappear with more frequent dialysis.”
-
“In my view, I believe home dialysis (including PD) is better than center dialysis for many more patients. I also believe strongly that more frequent home hemodialysis, especially long nightly dialysis is the best of all treatments at this time other than transplantation. Consequently, I believe it is only ethical that I should urge these therapies on all patients who I feel can do them. It is still the patient's choice, but the physician has to advise the patient what he believes is best for the patient.”
The service for Chris will be held on Saturday, April 30, at 2 pm, at Emmanual Episcopal Church, 4400 86th Avenue SE, Mercer Island, WA, 98040.
Cards may be sent to:
the Christopher R Blagg Family
c/o Covenant Shores
9115 Fortuna Drive, Apt 6301
Mercer Island, WA 98040
United States
You can read Chris' obituary and write any note or remembrance you have in the guestbook at https://obituaries.seattletimes.com/obituary/christopher-blagg-1084984696.
Comments
George E Harper
May 13, 2022 1:41 AM
He told me about the giant baked potatoes he was served in the dining car of the Great Northern Railway.
It is very hard to see our physicians that we look up to pass away. Rest in peace Dr. Blagg.
Sharon Parker Burbage
May 04, 2022 9:26 PM
Dr Joe Lee
May 03, 2022 7:57 PM
Beth Witten
May 01, 2022 4:54 PM
Colonel James A Manning
Apr 30, 2022 4:24 AM
john agar
Apr 28, 2022 9:52 PM