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It's all in the blood

 An Epic History of Medicine and CommerceBlood: An Epic History of Medicine and Commerce by Douglas Starr
My rating: 3 of 5 stars

The first section of this book – the history of blood transfusion – was fascinating. Long before doctors attempted to infuse the blood from one human to the next, the blood of animals was used to fill the hungry veins of accident victims. Doctors hoped that by transfusing the blood of a gentle calf, they could calm the temper of a hotheaded recipient. Direct human transfusion was held up while public attitudes slowly changed: the practice was initially considered monstrous, no better than cannibalism.

As you remember from reading Dracula, Van Helsing grabs any donor that comes within reach to pour blood into Lucy Westenra’s empty veins. When medical statistics were first applied to the process in1873, 56% of blood transfusions ended in death. The discovery of blood types didn’t come until 1900, but it took 30 years for the concept to catch on. Then, of course, the Nazis tried to twist it to uphold their concept of “pure” blood types.

Once Starr dispenses with the science of blood, he’s on to the military uses. While I understand that WWII saw the first widespread use of blood transfusions and the collection and distribution systems set the course for our modern systems, the section goes on and on, long past the point where my eyes glazed over.

Things picked up when he began to cover the transmission of hepatitis via contaminated blood. Once it became clear to businessmen that there was money to be made collecting up free or inexpensive blood from donors, the almighty dollar trumped safety. (Starr likens the blood business to the petroleum industry and the American Blood Centers to OPEC.) Several studies showed that the odds of a hemophiliac receiving tainted blood and contracting hepatitis were 80% or greater, but that disease was considered less life-threatening than hemophilia. Patients’ questions were brushed aside even as the blood of 10,000 donors was pooled to create the medicine that treated their disease. If even one of those donors was infected, odds were that every dose of medicine from that pool was contaminated. Starr doesn’t draw the conclusion that these practices led to the spread of hepatitis today and the increasing number of drug-resistant strains.

He’s too busy jumping into the AIDS epidemic and the politics which condemned 80% of hemophiliacs worldwide to death. Because prison populations were a cheap source of blood, repeated indications that up to 90% of the blood gathered was toxic were ignored. Even after blood banks knew their products were contaminated, they continued to sell them to hemophiliacs they were certain were already infected – rather than destroy the bad stock and lose the income.

In the early 80s, I volunteered as a candy striper for the Red Cross blood program. There was no questionnaire for donors. I simply led them to a cot, stood by while their blood drained out, then helped them over to the cookies and juice. I thought I was helping to save lives. Starr’s book makes me wonder if I helped, however peripherally, to spread the disease that’s killed millions.

This review comes from Morbid Curiosity #8.

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