CBS's Undercover Boss includes TV's best portrayal of dialyzor

By Bill Peckham

After the Super Bowl, CBS premiered a new show - Undercover Boss. It's a new reality show where corporate leaders take entry level jobs at their companies. The premier shows Waste Management President Larry O'Donnell going undercover as Randy and working a range of jobs, from cleaning porta-potties to running residential garbage pick-up routes. One of the jobs was policing blowing garbage at a landfill (UPDATED video - CBS has made a clip with Walter available):

The dialyzor, Walter Settles, is the supervisor who fires Randy - he fires his company's COO.

Watch the full episode, the segment with Walter starts at the 11:44 mark. At 13:47 there's this bit of dialogue:

Walter: I'm on dialysis and that take up three days .. three nights anyway. I lost the functions in my kidneys
Randy: I would have never guessed that you have that kinda health issue. I've been marching up and down those hills picking up trash - you come marching up there. How do you do all that?
Walter: I let my spirit tell my body what's going to happen what I'm going to do what I'm not going to do, because if I let the body tell me what I'm going to do I'm not going to do very much.
Randy: You have such a positive attitude do you work with other people on dialysis?
Walter: I would like to but as long as I can work and I'm able to work I'm going to work ... when I see a perfectly healthy person dragging around, and I can go out there and work circles around them, and he can't do this and can't ... that really pisses me off there, because I wish I was healthy ... you should be able to do more than I do. If I can get out there and fill two bags in 10 minutes, I'm expecting you to do three bags in ten minutes

It's was good television. And it really could have only happened on a reality show. If the show was written we would have never seen someone on dialysis in a physical job.

At the end of the show Larry/Randy's real identity is revealed. When Larry reveals himself to Walter he mentions Walter has been on dialysis 19 or 20 years and promises Walter the opportunity to volunteer on the company clock. 

I think outside of news pieces this marks two television firsts - showing someone who has been on dialysis a long time and showing someone on dialysis working a job that is physically hard. Undercover boss showed a long time dialyzor who has to shower after work. We're out there; it was a pleasant surprise to see this accurate, positive portrayal.

Comments

[Zach]

Three cheers for Walter!

[Erich Ditschman]

very nice. Erich

[Simon Prince]

Nice find.. thanks. As you already have seen, I added this to my blog as well to further publicize the show.

Keep up the great work Bill.

SP

[Bill Peckham]

Thanks Simon. Paris on IHD posted that in a future show a dialyzor at 7-11 is shown working circles around another corporate type.

If Undercover Boss keeps this up it might get me watching TV on Sunday nights.

[Miriam Lippel Blum]

That was a terrific show. I ended up watching the whole thing. Now, if only we could get a few corporate dialysis types to go undercover to really improve life for both their employees and dialyzors...now that would really be something.

[Bill Peckham]

I'm not sure I'd want Fresenius CEO Ben Lipps canulating me but it would be good TV.

[somerville]

You characterize this as an "accurate, positive portrayal," but I ask, what is it an accurate, positive portrayal of? It may be an accurate picture of one exceptional person, Walter Settles, but it is a profoundly misleading picture of the typical dialysis patient, who is not only too exhausted to do physical work, but who is in the overwhelming majority of cases inacapable of any work. According to one study of hemodialysis patients aged 18 to 60 in a country where they had no medical insurance disincentives to work, only 22% of working age dialysis patients were employed. See S. Molsted, et al, "Self-Rated Health and Employment Status in Chronic Haemodialysis Patients," Scandinavian Journal of Urology and Nephrology, vol. 38, no. 2, p. 174 (2004).

[Bill Peckham]

It must be hard when reality bites you in the butt huh "somerville". I'm working swing shift today out of the carpenter's union, I think it's time for you to stop trying to prove I and Walter and Zach and Erich and Miriam and ... should be spending our days in bed.

YOU had trouble on dialysis. The problem wasn't the dialysis, it was you. When you can face that you'll be a better man.

[Jenny Patterson]

Go, Walter! Go, Bill! Great things are in the air for the *typical* person on dialysis - when "somerville", some doctors and other professionals get that the times they are a changing, we will get the *typical* patient representation is a person with a capacity for doing many things - And by the way, the study cited is almost 6 years old. Ancient history concerning the new/old technology in dialysis.
That is something to consider though - victimization by dialysis. Mentality or mentality brought on by how professionals can speak to new dialyzers?

[Jeff]

Great; we need more people like Walter to set an example to strive for!

[Zach]

It's good to hear from my old nemesis, "stauffenberg" err, I mean"somerville."

Yes, I'm still producing documentaries -- a career which began about four years after I started incenter hemodialysis. The only thing that slows me down is the fundraising, not dialysis.

Part of the problem is the low expectations nephrologists and others have towards those on dialysis.

[roberta mikles]

I, too, watched 'undercover boss'. Fantastic. I wonder if Walter knows about home dialysis. I believe he said he does dialysis three times a week, therefore, probably assuming he does incenter. What a remarkable model for others. I was truly touched.

Also, indeed touched by the sensitivity of this corporate person who showed a real interest. Perhaps dialysis corporate persons should do same.

Of importance also is a reminder to all about Patient Safety Day in rememberance of those who were injured or lost their life to a preventable error. Larry shared about his daughter the victim of a preventable error and this is why he is so intuned to procedure adherence he stated.
www.patientsafetyday.com

[Susan]

Well, as usual, any comment like Somerville's is bashed. What a site.

[Bhanu]

I have not posted before ...but looking at the exchange in the comments, I wanted to think aloud. I guess the truth is somewhere in between. I somehow get the impression that historically dialysis was for very old patients who were almost retired ...and increasingly lot of younger folks are ending up in Dialysis. And hence the old perceptions need to change. There might be lot of folks for who dialysis might not be good...but the moral of this story is that for those who would otherwise be working full time...let there not be low expectations to start with. So, I think more power to such shows. However, I can see quite a few who may not do well on Dialysis due to other co-conditions and guess incidents such as the one in this show are not that helpful.

[Bill Peckham]

I'd say that studying the SF36 scores of a Danish dialysis unit tells you how well the Danish dialysis unit is doing, it doesn't tell you anything about what it's like to use dialysis to treat CKD. Current data from the USRD show the high levels of unemployment and under employment among people who use dialysis to treat CKD. That's not news.

The issue is, does every portrayal of someone using dialysis have to be negative? Must dialysis always be portrayed as a living death? In the stauffenberg/somerville world the answer must be yes. Just as the answer must be yes for many who advocate for an organ market. What I object to, what DSEN objects to, is this fetishistic insistence that dialyzors be portrayed as incapable of any work.

After the hundreds and hundreds of "this life saving transplant" stories the TV World was overdue for a more accurate portrayal of the complex world of people who need dialysis. We still haven't seen a 'Walter' character written into a TV show or movie. We still have a distance to travel.

[somerville]

By saying that under-employment and unemployment among dialysis patients is "not news," it now seems that you agree with me when I said that the positive image presented by the case of Walter Settles represented a misleading picture of the typical hemodialysis patient. I agree that there are some few people who do quite well on dialysis, and that the common understanding of dialysis might be usefully rounded out by providing information about those exceptional cases, but the fact remains that the true character of any phenomenon is determined by the statistical average, not by the extraordinary or the anecdotal.

As long as what Professors Jeremy Levy, et al, 'Oxford Handbook of Dialysis' (Oxford: Oxford University Press, 2001) p. 534 say remains true, that "It is not uncommon for patients or family to feel that the quality of life on dialysis is so poor that they would rather die," then renal transplant remains an absolute necessity for most dialysis patients.

[CJ]

It was an exceptional show Bill - you did a great job. As those that have CKD know hemodialysis can be hard on a body (as can all types of CKD treatments) - but I do agree with Walter here, the mindset has a lot to do with how well we handle our condition.

[Bill Peckham]

DSEN has made the point on many occasions and in many ways that dose of dialysis determines the experience of living with CKD, but to the idea that 13% is a trivial number. Hispanics and African Americans each comprise about 13% of the US population.

Walter is as an appropriate representation of people who need dialysis, just as he is an appropriate representation of a working American. He is typical of someone of his age and flavor of CKD and he is an 'n' of one. There is no other example, that I know of, that has been presented on TV or in a movie - aside from news stories.

Walter is the only television example of someone who is successfully treating their CKD with dialysis. The previous complete absence of Walters is what is misleading about the historic portrayal of "typical" dialyzors.

[Angie of KidneyKorner.com]

I can't watch the video in Canada. Is there a version of it on YouTube at all?

[Bill Peckham]

Try this Angie. Being in the US I can't tell if this is the whole episode or not because I think you have to be above the 49th parallel to watch it on CTV.CA
http://watch.ctv.ca/undercover-boss/season-1/undercover-boss-ep-101-waste-management/

[Zach]

While it was a good show, we must remember that one of the first casualties of "Reality Television" is the truth.

[Bill Peckham]

Someone should make a documentary or something.

[Zach]

:)

[Delaney]

Just saw this episode and googled walter's name. Unfortunetely at the end of the episode, it said that walter passed away. Such a tragedy, but at the same time, he obviously was able to touch the lives of many people.

[A]

Sadly, it appears that walter sellers passed away. It was displayed on the rerun of the show tonight.

[Big Joe]

so sad! I couldn't find in his obit what the cause of death was....probably kidney related, but how exactly?

[J]

I saw the show and noticed they used Walter's name in the past tense (end of show). I googled Walter and to me it appears he passed away August 30, 2010. RIP Walter.

[Bill Peckham]

I did hear from a family member on 9/1 that Walter passed "Monday August 30th, 2010 due to complications from an operation".

The family would like everyone to know that they: "appreciate all the caring people who took the time to cheer him on. He was a very proud man and I would just like to thank everyone on his behalf. God bless!!!"

RIP Walter Settles.

[SM]

R.I.P. Walter Settles

[Betty Boop]

I just saw that too...sorry to see that he was the most positive person on that show, and obviously worked until he passed. RIP Walter!

[noah]

RIP Walter Settles

Your spirit will live on forever.

[Kathy]

I was sad to see at the end of the show that Walter Settles had passed away. My ex was a dialysis patient but he let his body dictate his life not his spirit as Walter did. Many people could learn from Mr. Settles, what a positive individual. RIP Walter

[Daniel Wright]

R.I.P. Walter Settles, 1957-2010. Walter passed away on August 30th 2010 from complications during a back surgery. However during surgery Walter unfortunately went into cardiac arrest and was unable to be resuscitated. Walter was my stepfather and a well respected man. It was sad to see him leave, but at the same time a relief to know that he's no longer suffering. He is a true inspiration to me, there will never be another Walter Settles, take care.

[Zach]

RIP
Walter Settles

[Bill Peckham]

My condolences to you Daniel and to your family. I'm glad CBS gave me the opportunity to know Walter a little bit. I hope that you can find some comfort knowing that Walter was able to touch the lives and be a positive inspiration to so many people because of his willingness to share his story.

Thank you for taking the time to write. Please let us know if an obituary become available so that I can post it too. Take care.

[ss]

I just saw the Undercover Boss repeat with Walter. He truly touched me. I was crushed to hear of his passing - just as his life's hard work was being recognized - and so sad for his family. But I know this extraordinary man's memory will live on through the joy he gave to those around him -- a joy they will continue to pass on...

[CM]

I enjoyed the episode tremendously and was especially touched by Walter's great attitude and positive outlook.
RIP Walter... Prayers for his family...
cm

[Amy Lindley]

Today if September 6th, 2011. I saw the rerun of Undercover Boss with Walter in it the other day. I had never watched the show before.

His words moved me and struck at my heart. I hope he knows, wherever his spirit is now, that over a year after he passed he is still motivating people with health issues.

Thank you Walter, where ever you are.