A TRANSPLANT OF REAL-LIFE

A case of steroid-resistant nephrotic syndrome with focal segmental gl omerulosclerosis leading to renal failure in a 4-year-old girl is desc ribed by her mother, with special emphasis on the problems resulting f rom recurrence of this disease, with graft loss in three successive ki dney transplants. This report chronicles the gradual evolution from a family's initial heavy dependence upon medical solutions to their ulti mate primary emphasis upon spiritual values, with medicine seen as the support toward achieving the child's psychological well-being and spi ritual growth. The physician's role in balancing medical decision maki ng, non-medical alternatives, and demands on limited and precious reso urces in such difficult cases is discussed.