blood transfusion services

The Bloody Wars: When War Advanced Blood Transfusion

Dr. Norman Bethune

Scientists and physicians in
the warring nations during World War II struggled to save soldiers bleeding to
death on the battlefield. Dragging injured soldiers back to field hospitals resulted in too many lost lives. But what other alternative was there?
One of the early medical innovators of mobile blood
transfusions was Dr. Norman Bethune, a Canadian surgeon, who wondered: why risk
men’s lives by bringing them back to hospital when blood should travel to them?
Funded by an organization, he went to Madrid at the outset of the Spanish Civil War in 1936, where he developed a mobile blood transfusion service.
With charismatic enthusiasm and caring, he wrote:
“This is great! Isn’t it grand to be needed, to be wanted!” He had a high
proclivity to risk-taking and civil duty: he was involved in the war-time evacuation
of families and children. He was always concerned with the socioeconomic
consequences of medical services on the plight of the poor, and pushed for
socialized medicine.

In
Spain, he seized on this innovative idea: to take the blood donated by civilians in bottles
to wounded soldiers near the front lines. Being highly adaptable and effective,
Bethune’s service is regarded as one of the most significant military-medical
achievements of the Spanish Civil War. A benchmark in
the history of mobile medical achievements, his work later inspired MASH units.

This was not the first time this idea was proposed, but it was far
reaching. A similar service had been established in Barcelona by a Spanish hematologist,
Dr. Frederic Duran-Jorda, and had been functioning just months before.

The more precise and cautious
physician, Duran-Jorda ran a sophisticated operation in Barcelona. He collected only O blood; oxygenated the bottles; and ensured high standards of safety by testing rigorously. He had vehicles fitted with refrigerators to transport the blood to front line hospitals. In February 1939, Duran-Jorda fled to England, where he helped the British develop their blood banks for the front line.

And the Germans, who had practiced
the highest level of medical research in the world, regressed into medical myth
when the Nazis came to power. Blood now represented racial purity—with the
belief that only pure German blood could be used in German soldiers to save
their lives. This would cost the Germans thousands of lives. 

Fantastic Book I Just Read
Wind, Sand and Stars by Antoine de Saint-Exupery

I had long heard that this story was a classic in travel reading. The story of Saint-Exupery’s flights over Africa as a mail carrier for the French postal service, Aeropostale in the 1930s. Told in the first-person voice, Saint-Exupery shares his views from the airplane seat, and from his fertile mind. The text is lyrical, mesmerizing, fluid. An adventurer, he writes: “The call that stirred you must torment all men. Whether we dub it sacrifice, or poetry, or adventure, it is always the same voice that calls. But domestic security has succeeded in crushing out that part in us that is capable of heeding the call. We scarcely quiver; we beat our wings once or twice and fall back into our barnyard.” His crash and struggle to survive in the Sahara is riveting. A rousing five/five stars. Read it!

The Price of Blood


There is an ever constant debate throughout the worldwide blood community about whether blood donors should be paid or voluntary. There are all kinds of implications. I found the history of blood donation fascinating, as blood developed from a charitable service to a global industry. Here’s a snippet of what I read in Douglas Starr’s excellent and must read book Blood.

In the early 1900s, transfusion of blood was a clumsy, laborious process. No one stored blood in a blood bank. When a patient needed blood, he himself had to find a donor (this must still be the the case in some countries). One day in 1921, Percy Lane Oliver of the British Red Cross got an emergency call to find a donor. He realized this was stressful and inefficient, trying to find random donors when someone was already in trouble. So Oliver decided to create a registry of volunteers. More astonishingly, he ran it from his home! Oliver became a man on a mission, obsessed, and his idea was a stroke of genius. He worked seven days a week, recruiting, filing paperwork, and phoning people. Everything he did was free. His services were in so much demand, he could never get away even for a day. (You can imagine there was so much joy in being able to help when no one else could) Oliver even changed doctors’ practice of slicing open the arm and exposing the vein to insert a needle: all they needed to do was insert a needle now! Eventually, Oliver registered 2500 donors, all of whom were unremunerated. Britain led the way: soon donor panels were started in other countries. Dr. Arnault Tzanck established the Emergency Blood Transfusion Society in France. And he was also an energetic, tireless, and positive thinker. He wrote: “The man is truly poor who does not know how to give.”

Americans adopted the blood transfusion services, too, but were different: remuneration was ok. So paying for blood began in America. And Oliver? The man who created the idea of a registry of blood donors, who worked endlessly, helping to save countless lives, never received any recognition in his lifetime! Thanks to Starr, he is now recognized as revolutionizing blood transfusion services.

(I’m headed for England next week, a country with many medical firsts, especially in any fields related to blood. I’ll blog from there next Sunday)

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