Five Quarts_ A Personal and Natural History of Blood - Bill Hayes [64]
Dr. Winger and I stand before the Flow Cytometer, the state-of-the-art cell tabulator, a machine that, to me, would not look out of place at a Kinko’s. He introduces Mark, the technician who operates it, but then backtracks a bit to remind me of a basic fact of hematology: White cells look a lot alike. While it’s easy to tell the difference in a blood smear between, say, a red and a white cell, the distinctions among the types and subtypes of lymphocytes are subtle. “You can’t tell a helper T from a suppressor T cell under a conventional microscope,” he explains. But there’s a way around this. By introducing into the blood sample what’s called a monoclonal antibody, the specific white cell you’re trying to count will be “tagged.” Next, a dye is added that stains the tagged cells.
“How very Paul-Ehrlichean,” I comment.
“Exactly. It was his idea to couple antibodies to dyes and use them to identify cells.”
“But today this is all done by computer.”
Dr. Winger nods. The dyes used are fluorescent, which makes them recognizable by laser. He next points to a rectangular black contraption, the contents of which aren’t visible. “We put a test tube of blood in a carousel down there, and Mark here tells the computer we want to ‘interrogate’ certain stained cells. So, for example, it allows us to look at T helper cells only.”
“You say look at them, but you’re never looking at the cells directly.”
Well, no, he concedes, but the computer is. “Every single cell passes by a sensor head that inspects it.” At the same time, the flow of cells is shown on a computer screen. Sure enough, Dr. Winger points to a monitor where a meteor shower of gold pixels is shooting across a black field, left to right. These are T cells. I have no reason to believe they’re some of Steve’s, but then again, who knows? Either way, I find myself transfixed, rooting for a high count. I wait until I’m sure several hundred have flown by. Now it’s safe to move on.
EIGHT
Blood Criminal
THE CRIMINAL TRIAL OF THE SMITHKLINE BEECHAM phlebotomist accused of deliberately reusing blood-draw needles was scheduled to commence in mid-August 2001, more than two years after Steve and thousands of other patients had first been notified of this woman’s dangerous actions. How often she’d reused the butterfly needles and with which patients remained unknown or, at least, unreported. Either way, the math didn’t look good. She had been employed by the lab off and on over six years, during which she’d had contact with up to twelve thousand people. (In a sickening coincidence, the last of the eighteen times Steve used a SmithKline lab resulted in the blood work that gave him his AIDS diagnosis.) He and I had never seen a photo or news footage of the “renegade phlebotomist,” as she was called in some early media reports, and we didn’t learn her name until a May 2001 newspaper story provided details of her upcoming jury trial. Elaine Giorgi faced six felony charges, including assault with a deadly weapon—dirty needles. Though she’d worked at SmithKline labs throughout the Bay Area, the charges had been filed in Santa Clara County. The trial, in which she’d be represented by court-appointed attorney Brian Matthews, was to take place at the San Jose Hall of Justice.
I wasn’t surprised to learn that the first session served as an opportunity for her lawyer to request a delay, which was granted. But I never expected that, over the next year, her trial would be postponed ten times due to assorted legal matters. I was anxious to get a good look at Elaine Giorgi and to hear how she justified what she herself had admitted to doing “occasionally.” And then, in July 2002, the prosecutor dropped the most serious assault charge and Giorgi pleaded guilty to separate felony violations of illegally disposing of medical waste. There would be no jury trial after all, only a sentencing. She faced a slew of fines and a maximum of five years in state prison.
The picture I had in