Five Quarts_ A Personal and Natural History of Blood - Bill Hayes [61]
I’d hastily dialed the number stamped atop the lab request form Steve takes to the phlebotomist and hadn’t quite formulated the nature of my request, nor to whom I wished to speak. The Chief Blood Tester? Blood Docent? “I’m wondering,” I stammered, “could I come out and just take a look around?”
“A look around what?” she returned pleasantly.
“Well, at the lab. Get a sense of the process involved with testing blood. Maybe, if it’s not too much trouble, take a tour of the facility.”
Long pause. “A tour?” I pictured her scanning the room, thinking, Heavens, what guidebook does he have? “Um, well, we don’t give tours. Are you sure you have the right phone number?”
Oh, yeah, yeah, yeah, I explained, I didn’t need any blood tests myself but was interested in seeing how they’re done. The more I spoke, the odder it must’ve sounded. As if she’d finally caught on, the receptionist said, “Oh, are you with the FDA or something?”
Before I could deny anything, she’d transferred me to IDL’s medical director, the head honcho, Edward Winger. He, thankfully, understood my desire to see what happens to blood in the in-between, after it’s drawn but before the results are sent on. Sure, he could show me how it all works. “How about ten-thirty Friday?”
Before hanging up, I thought, Oh, go ahead, just ask: “My partner just had his blood drawn,” I began, “and I assume you’ll have it by the time we meet. Would it be naÏve of me to think that I could actually see his blood being tested?”
His burst of laughter supplied a thorough answer, but, lest I had any doubts, Dr. Winger added, “Yes, it would be naÏve of you. We don’t track the blood by a person’s name.”
“Oh, for confidentiality purposes, you mean,” I said. “That makes sense.”
“But also,” Dr. Winger added, “almost all of the testing is done late at night.”
Night? So the workers come out to count the blood only after sundown. How vampiric. Well, no wonder parking was so easy.
Dr. Winger enters the reception area. He’s a tall, thin man in his fifties. He has silver-blue eyes behind delicate wire-rimmed frames. Shaking his hand, I find it cool and powdery-dry, as if he has just pulled off a latex glove.
Without further delay, Dr. Winger begins the walk-and-talk, ushering me into the laboratory he founded in 1982. I can see right away that the word laboratory doesn’t quite fit, associated as it is in my head with beakers, bottles, and burners. Immunodiagnostic’s lab is a facility about the size of a basketball court—brightly lit, with white walls and shiny floors. But chilly. Now I understand why Dr. Winger wears a heavy flannel shirt on this Indian summer day. I spot a total of three people in work areas scattered about the floor. In lieu of introducing me to his staff, however, over the next hour Dr. Winger will introduce me to his machines.
The first pair handle what is called viral load testing, which provides a measurement of the amount of HIV in a person’s blood. A decade ago, the best test of this kind was the p24 antigen, which only gave a Yes or No answer to the question, Is the virus actively replicating? It worked by searching the blood for a discarded part of HIV, a method akin to determining if a McDonald’s burger has been eaten by rummaging for the tossed wrapper. By contrast, today’s viral load tests zero in on the Big Mac itself, the genetic material in HIV. They quantify how virulent your virus is as well as whether or not the pills you’re taking are having an effect. The two machines before me aren’t large or imposing, but their power to change a person’s life is enormous. How the tests work, though, is complicated, and I pay a price for my momentary lapse in attention. Dr. Winger is in the midst of describing the most sensitive of the three types of viral load tests, the Q-PCR:
“. . . so we have a single-stranded molecule and another single-stranded molecule here”—Dr. Winger is now also drawing—“and what happens is, we end up having only this region here being copied, and then, well, then we get a double-stranded molecule.”
He makes a new addition