Five Quarts_ A Personal and Natural History of Blood - Bill Hayes [95]
To underscore the machine’s efficiency, Richard had me imagine the typical pouch of whole blood that’s collected in a standard donation, from which only a tiny squirt of platelets is derived. In a single apheresis session, he stressed, five times the number of platelets can be withdrawn without removing a single red cell.
One aspect of the e-chair setup that’s consistent with the traditional method is that the blood collection bags are not in the donor’s direct line of sight. This, I am certain, is for the best. No matter how soothing the phlebotomist’s manner or how frequently the donor donates, I don’t believe a person could stare directly at that transparent pouch as he or she drains into it without having a visceral reaction. I suppose this could be considered the most primal form of separation anxiety: a person from his or her own blood.
At this moment the young donor was being separated from both platelets and plasma. Richard pointed out the two corresponding pouches hanging behind his shoulders. The technology is cost-efficient in so many ways, Richard enthused, allowing his inner accountant to romp—lower labor costs, less lab time, fewer blood tests, the ability to maximize the contribution of a single donor. It’s also safer for patients who receive the products. He used the example of someone being treated for severe leukemia. Such a person would likely need an infusion of platelets every other day for five months. As I’d already learned, one infusion is typically a pooling of five people’s platelets. With apheresis, however, the product comes from just one donor. Thus the potential for a bad transfusion reaction is slashed 80 percent.
The only drawback, he conceded, is the time commitment required of the donor—ninety minutes as opposed to the usual half hour it takes to give a pint of blood. That’s where the e in e-chair comes in. A mounted computer screen and keyboard let you access the Internet, listen to CDs, or watch TV or movies. A five-foot-tall, fully stocked DVD carousel stood off to the side. Conceivably, you can catch up on office work and e-mail while giving blood (though it helps if you’re a good one-handed typist, since one arm is locked down with tubing).
The current donor, wearing earphones, was about an hour into watching the movie X-Men and looked completely absorbed. Of course, I wouldn’t have wanted to disturb him—Mystique was just about to sabotage the mutant-detecting device Cerebro—but I was curious to know his story. One of the technicians had mentioned to us that he was a first-time donor, and Richard had quietly noted that he was much younger than their typical volunteer. In order to earn a seat in this e-chair, I knew, he’d had to pass an extensive donor screening centered on a medical history survey with forty-three yes-or-no questions. In the strictest sense, these questions are designed to eliminate groups of people. The first fifteen, asked during a brief one-on-one interview, are intimate in nature but clinical in wording. The questionnaire is also ever-evolving. As there is not yet a blood test for the human variant of mad cow disease, for example, questions regarding past travel to the United Kingdom were added to disqualify the possibly exposed. However, there’s no space provided for elaboration—no room for the Well, yes, buts, as in, Yes, I did stay in England for a summer, but I’m a strict vegan, so beef never crossed my lips. . . . The screening doesn’t bend. Nor does it address a broader field of inquiry, the prospective donor’s character and intent, which, granted, has no bearing on the quality of the blood itself and, in any case, would be hard to assess through simple yeses or nos. Even so, this eliminates the first question I would ask of a person, one that’s far too open-ended to be practical but whose answer I’d still like to hear: So tell me, why do you want to give your blood?
Someone needs help, you do what you can. Call 911. Stop at the scene of an accident. Or help