Blood

Blood: From Vitalism to Vampires

Halloween has passed, and though it’s fun to see our friends’
and family’s children dressed in costumes on Facebook, there are plenty of
“shock” photos circulating on the internet of dummies smeared with blood—one
even prompted a 911 distress call, so realistic was it. Halloween conjures up
images of Friday the 13th movie characters as well as vampires.
Transfusion: Now that’s scary
Our business in hemophilia is blood. Blood at once attracts and horrifies; it is the stuff of legends
and tales, myths and medicine. I recently read the classic Dracula [read the book review below] and was amused to read how Dr.
Van Helsing wanted to help the young Lucy, a victim of a vampire, by giving her
a transfusion of blood. “Is it you or me?” he asks Dr. John Steward, about who will roll up their sleeve to donate; Steward who
replies, “I am younger and stronger, Professor. It must be me.”
Steward offered his blood based on the concept of vitalism, that blood contains the traits
of the being in which it flowed—a concept that was unchallenged for fifteen
hundred years. Later in the book, Van Helsing says to Lucy’s fiancé Arthur, “John was to give
his blood, as he is the more young and strong than me…. But now you are here,
you are more good than us, old or young, who toil much in the world of thought.
Our nerves are not so calm and our blood so bright than yours!”
Not so picky: Any old blood will do
So Arthur becomes the better blood donor because he is calm and not scholarly! Of course, this is nonsense, but author Bram Stoker fell for the widespread belief in vitalism when he wrote his book. Dracula isn’t so picky; he pretty much would drink anyone’s blood.
Douglas Starr tells us in his book Blood that the Egyptians saw blood as the carrier of the vital
human spirit, and would bathe in it to restore themselves. Roman gladiators
were said to have drunk the blood of their opponents to ingest their strength. “Our
own culture attaches great value to blood, with the blood of Christ as among
the holiest sacraments, blood libel as the most insidious slander, the blood-drinking
vampire as the most odious demon.”*
Vampires… which are repelled by
garlic and crucifixes (the two seemingly have nothing to do with one another).
Yet rather than secure eternal spiritual life by consuming wine that has been
transformed into Christ’s blood during Christian mass, Dracula drinks human
blood to extend his physical life. 
The only thing scarier than vampires is the
proliferation of teen movies about vampires!
*Starr, Douglas (2012-09-05). Blood: An Epic History of Medicine and Commerce (Kindle Locations
97-101). Knopf Doubleday Publishing Group.
Great Book I Just Read
Dracula  [Kindle]
By Bram Stoker
I haven’t read this book since high school, and forgot how
wonderful and visionary it is. A classic, as it has spawned an entire genre of
books and movies. Jonathan Harker, a young English lawyer, is summoned to Castle
Dracula in Transylvania to finalize a real estate transaction with the eerie Count
Dracula, who is purchasing property in London. Harker is warned by local
peasants, who give him crucifixes and other charms against evil. As a guest,
Harker soon notices strange things: the Count has no reflection, is never
present in daylight, and scales the castle walls downward, like a lizard.
Unable to escape, Harker is soon a prisoner, until the Count reaches London,
with 50 boxes of earth. The novel is told only through letters and diary entries
of the main characters, including: Harker’s fiancée, Mina Murray; her friend
Lucy Westenra, who is bitten by Dracula and slowly turns into a vampire; Dr.
John Seward, Lucy’s doctor and once beau. Harker reappears in Budapest and eventually
returns to London. Dr. Van Helsing, an expert on vampires, is called in from
Holland to help save Lucy. Everyone realizes Dracula’s scheme to populate
London with the “Undead”—vampires. When Mina is bitten, and begins to turn into
a vampire, the men sterilize the boxes of earth, set about London. Dracula,
having no haven to stay when dawn comes, flees back to Transylvania, while the
men pursue him. This is a fantastic story, though the language is not lofty or
even that clever, with memorable characters, and cleverly told in letters and
diaries. Perfect Halloween reading. Five/five stars.

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!

Those Very Special Inhibitor Families


Inhibitor families are a special lot and my admiration for them just continues to grow. For the past six months I’ve been interviewing parents and patients for my new book on inhibitors and I have learned what amazing hardships they face, and with such courage. Though I helped facilitate the Novo Nordisk Consumer Council for the past two years, I still didn’t have a full appreciation of their lives. This past week in New York City we inaugurated a new group of parents and patients for the Consumer Council, and I feel better able to represent their needs by knowing more about the medical care, parenting concerns and social issues they face.

We had a wonderful time on Friday. Meeting at the Westin Hotel Times Square for a full day, the marketing team at Novo Nordisk and I presented questions and listened to nine consumers share their experiences, thoughts, suggestions and concerns. None of them had ever met one another, as inhibitor patients are pretty rare and in a country as big as the US, it is hard for them to meet. The Novo Nordisk Inhibitor Summits brought inhibitor patients together for the first time two years ago, and yes–for all who are reading this–there are going to be two more this year.

We had breakout groups, exercises and ice breakers. One ice breaker–meant to help us get to know one another–asked each participant to identify themselves with an animal. Everyone chose different animals, from a kangaroo to a dog to a lion. But Schlander chose an ant–unusual because almost no one in these types of exercises ever chooses an insect. Why an ant? Because though small, they are strong in groups and can accomplish something that seems impossible, given their size. Given that this group will be together for two years, it was a perfect animal to choose to highlight what a small team of dedicated people might and will accomplish.

Great Book I Just Read: Blood, by Douglas Starr. Four stars! This book took me a while but it was well worth it. Fantastic overview of the history of blood. It starts with the story of a madman running naked through the streets of Paris… reads like a novel but is packed with information about the meaning of blood in society, medicine and business. Learn about its incredible importance during World War II, and how much we advanced our knowledge of blood because of the war. Fully half of the book is devoted to the hemophilia holocaust, and I read with sadness and pride about our community, and its fight to bring safer measures of blood treatment and justice to the victims. It was startling and impressive to read about the leadership and courage of people like Bruce Evatt of the CDC, and Corey Dubin and Dana Kuhn of COTT, true heroes in our midst even today. I had read the history of the HIV infection before, and even watched the HBO movie about it, and still see Corey and Dana at events. But.. time goes on, and being human, we all tend to forget the past. This book reminded me of how privileged we are to have these warriors; how lucky my son and anyone born after 1985 are because they benefited from their perseverance to get a settlement from the government and drug companies, and have safer measures. And they still persevere in protecting our blood supply even today. Blood is required reading for anyone involved in the hemophilia community on any level.

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