I am at least as sweet and cuddly as a leprous armadillo...
I don't really want to talk about armadillos, or leprosy, though. Fascinating as both subjects no doubt are, they just aren't my thing. Instead, I want to discuss an impression that some of you may have of me. Specifically, a number of you may think that I'm an asshole. It appears that dorotha, at least, was of that impression judging by her comments in response to this post. Well, if you think I'm an asshole, it just so happens that you're right. I am an asshole, a huge asshole in fact. I find that everyone needs an asshole in their lives, and I just happen to be rather good at filling that niche. What can I say? We all have a role to play in this world, and mine just happens to be a great deal of fun.
Despite this, however, I do from time to time give in to my better impulses and, regardless of the way it may seem from my blog, do something that doesn't imply disdain for my fellow man. A significant portion of humanity, I'll grant, earns my ire, but not all. Today we're going to talk about one thing that doesn't annoy me- one small chink, if you will, in my Asshole-Armor.
That thing is blood, blood-products, and tissue donation. Bet you weren't expecting that one, eh?
Back in the days of yore when I was just a wee Drek I became very ill. It isn't important why I was ill, I'm not sure you'd believe it if I told you anyway. You can content yourself with knowing that it was quite serious, quite mysterious, and had the doctors preparing my family and I for a diagnosis of cancer. It did not, ultimately, turn out to be cancer (for which I am grateful) but I did spend several months in the hospital and lost a great deal of weight.
Now during this time two very useful things happened to me. You know... aside from my getting better, which was damn nice. The first thing is that I developed an appreciation for the limitations of modern medicine. This is not to say that I'm going to launch into some diatribe in favor of herbal remedies. No, what I mean is that I realized that our technology, procedures, and trained professionals are quite imperfect. There are no guarantees that a given professional will have the training, and skill, and equipment to diagnose and treat a given disorder when you need them to. In my case, were it not for the fact that my doctor was married to another doctor who happened to have read a medical journal describing a patient with symptoms similar to mine, I might have died. The second thing that happened is that I lost all fear of needles. No, really. In one incident it took three different nurses about 12 tries to get an IV line in place. I need not go into detail about the number of times I had blood drawn, often early in the morning. It got to the point where I could wake up just enough to thrust the arm with the fewest recent needle holes at the tech when they came for their daily offering.
So, after this experience, when I at last matured enough to give blood I found myself strangely compelled to do so. Partly this was a result of my understanding that successful medicine relies on a variety of tools, one of which is blood. Partly also this was a result of my comfort with needles. Given the number of people who are so afraid of them, it seemed a sin not to take advantage of my own relative ease. So, on the first occasion when the local blood bank visited my high school, after I had at last grown old enough, I presented myself as a fresh young blood donor.
Of course, getting out of Pre-Calc was also a nice bonus. I don't want you to think I was being TOO noble.
Little did I know, as I waited outside the blood mobile, that my first experience was going to be quite memorable. As I waited for my turn, a young female donor inside was just finishing up. The phlebotomist told her to elevate her arm (the young woman was lying down to donate) and press the gause against the needle site with her free hand. Our heroine was having an animated conversation with a companion across the aisle, however, and took her hand away to emphasize a point. Of course, her wound hadn't closed yet and thick jets of blood began pumping out over her prone body. The girl screamed, and neglected to simply reapply pressure. The phlebotomists responded, and got the pressure back on, but by this point the girl was in a full-on panic.
Yes, ladies and gentlemen, immediately before my first blood donation I witnessed a young woman with a blood-soaked shirt and a glassy look being helped from the blood bus by two anxious technicians. A less auspicious start to donating could not have been had without the assistance of explosives or, perhaps, the ebola virus. Despite this unfortunate start, my own time with the needle went smoothly.
When I went to college I became a regular whole blood donor, carefully monitoring the time since my last donation so that I could give whenever I was eligible. I discovered that, in addition to my comfort with needles, I had no tendency to pass out while donating, or get light-headed. This made donating quite a bit easier, and made the nutter-butters afterwards all that much more tasty.
Later when I was a sophmore, my university was having a bone marrow drive in the hopes of finding a donor for a faculty member with cancer. After carefully considering the matter (and deciding that, if asked, I would be willing to donate) I went down to the church hosting the drive and signed up for the National Marrow Donor Program. I was poked, prodded, asked a lot of rude questions, and then sent home.
On my way out of the church basement, however, I was stopped by a man from the American Red Cross. He asked me if I knew anything about platelet donation. I responded that I was a regular blood donor, and tried to keep going, but he stopped me again and insisted on telling me about what platelet donation was. I don't know why he decided to be so insistent with me, and I'll admit to being a tad annoyed at the time, but when I returned to my dorm I took a look at the material he forced into my hand.
What many people don't know is that the blood you donate at most blood drives (called "whole blood") is rarely used in that form. In most cases it is separated into four components: red cells, white cells, platelets, and plasma. Red cells, of course, carry oxygen, and are relatively long-lived cells. After donating a pint of whole blood, your body requires approximately 45 days to replace the red cells lost. White cells are a part of your immune system and are replaced more rapidly than red cells. Platelets allow your blood to clot, and thus help you to stop bleeding, and are replaced in 24-48 hours. Finally, plasma is the liquid that transports your blood cells, and can be replaced in 12 hours.
As it happens, platelets are an extremely useful blood product, used most commonly in the treatment of cancer and organ transplantation. They also play a significant role in the treatment of burns. Because of their many uses, the Red Cross and other organizations have developed a way to harvest only the platelets, and often plasma, but allow the donor to retain their red cells. This technique is called Apheresis.
In apheresis the donor is connected not to a bag, but to a machine. This machine may use either one needle, or two (one in each arm). Blood is withdrawn from the donor and centrifuged to separate out the various blood components. The platelets and plasma are then harvested, and the remaining components are returned to the donor's body. The process does have some unfortunate drawbacks, as you probably suspected. One is that a donation can take anywhere from 50 minutes to 2.5 hours, depending on the equipment and the donor. Another is that an anti-coagulant must be used that has been known, in very rare instances, to cause dizziness, muscle cramps, and seizures. Finally, because the blood cools somewhat towards room temperature while outside the donor's body, most donors become cold while connected to the machines, and must be covered in blankets and heating pads. The benefit is that a single apheresis donation yields 8 times as many platelets as one whole blood donation. Even better, some individuals have naturally high platelet counts and, once their platelet production is stimulated (something that is a natural byproduct of being a regular donor), they may be capable of donating twice as many platelets per session as an average donor. As it happens, I'm one of those individuals, so every time I donate the Red Cross gets an amount of platelets equal to 16 whole blood donations. Needless to say, I get a lot of phonecalls from the Red Cross, and as a result go in two to three times a month. I tried to donate last Friday, as you can see in my post from that day. Having had problems that day, I returned on Monday, and donated two units of plasma and two units of platelets without incident. As it happens, I even ended up working with nurse Stabby again. She did marvelously. Hell, I have the easy part- I just have to let them stick a needle in my arm, squeeze a ball every now and then, and watch a video tape. Not such a bad way to spend an hour or two.
So am I telling you this to emphasize how wonderful a human being I am? Oh, hell no! This is my excuse to be self-righteous. We all have one: for some of us it's our veganism and belief in animal rights, for others it's our commitment to abolishing child-labor, for still others it's a dedication to some religious tenets. We all have things we feel self-righteous about, and I'm no different. This is my excuse and, as much as I'd like you to believe that I do it all out of the goodness of my heart, I do enjoy the free t-shirts, the raffles, the chance to go to work with a big bandage on my arm and lord it over my colleagues and, of course, the nutter-butters.
Still, platelet donation is a crucial bit of public service. Blood is one of the cheapest, and most effective, medical products available. The timely application of blood products can mean the difference between life and death. Unlike many other medical products, however, there is only one place to get platelets and other blood products: live, healthy, human donors. No artificial blood substitutes have yet been developed that can stand in for what can be drawn from a healthy donor's veins. What makes platelets even scarcer is that, with all the extra hassle of participating in an apheresis donation, few of those who donate whole blood ever try platelet donation.
Unfortunately, not everyone who is willing to donate CAN donate. Some have had sicknesses or diseases that prohibit it. Others have engaged in behavior, or travelled to locations, that put them at an unacceptable risk of passing on an illness to a recipient. These individuals must, to our collective loss, be barred from donating.
In some cases these prohibitions are useful, such as in the case of individuals with HIV. In other cases they may not be so useful, as in the case of gay males. Yet, regardless, they are prohibitions, and they make an already small pool of willing donors even smaller.
[As a side note, I have met several people who refrain from donating to protest the ban on gay male donors. This ban was imposed during the early period of the AIDS epidemic when rates of HIV infection were significantly higher in the homosexual population than among other demographic groups, and no test for the virus yet existed. Today, this ban makes no sense, and should by all rights be abolished. However, the Red Cross and the other blood banks did not make up this rule, nor do they maintain it. Such rules are imposed by the FDA and must be adhered to by organizations dealing in blood under pain of federal prosecution. If you want to change this, write to your congressman. In the meantime, if you CAN give, refraining from doing so doesn't hurt the blood banks, it just deprives needy patients of an irreplacable resource. For more on the reasons for the gay ban and the early days of the AIDS epidemic, see Randy Shilts' excellent book.]
Ultimately I donate because, through an intersection of events, I can do so with ease. I am not afraid of needles, I am not alergic to iodine or betadine, I tolerate the anti-coagulant very well, and I have a horkin ton of platelets in my veins. To my way of thinking, it would be criminal of me NOT to donate.
You can find your own reasons to donate, but I would like to make an impassioned plea that you try to donate. There are never enough donors, particularly in the summers when people travel. It is difficult, in the best of times, to fill orders for blood products, and there are simply no alternatives. Maybe this isn't what you will feel self-righteous about, but regardless you will be giving a priceless gift to someone else. We social scientists often complain about the rarity of generalized exchange. Now, here's your chance to do something about it.
That's what this post is about. No tricks, I'm not being sarcastic, this is no joke. Call the Red Cross or call you local blood bank, and give things a try. If you don't know where to find one, try the Red Cross's donation homepage, or look up a blood bank on the website of the American Association of Blood Banks. Ask about platelet donation if you think you can stand it, but please donate somewhere. The life you end up saving might not belong to someone you love, but it will belong to someone who is loved.
Isn't that enough of a reason, even for an asshole?