Larissa Roy

To Your Health

It starts with a cough. Nothing but a small, tickling, wondering-why-it-won’t-just-go-away cough, then a fever deep enough to conjure images of dancing hippos and elephants, even though Fantasia hasn’t been played in the household for years. And still that cough is there, no matter how much one may wish to ignore it or drown it in water, orange juice, or a foul-tasting syrup that tests the gag reflexes better than a wooden tongue depressor. Perhaps it starts with a small pain in the ankle, never mind that unfortunate moment on the basketball court, or realizing that maybe those heels were a little too daring. Maybe it’s just a stomachache with nausea that will rise and build until anxious swallowing and deep breaths don’t seem to help much or maybe it’s a nasty new parasite. A flood of questions follows regardless. Should I go to the doctor? Is he going to say it’s only a virus and demand a hundred dollars though he did nothing? He’s only had years of schooling and seen millions of patients; what does he know? Is this something to walk off or sit down and let it rest?

The doctor’s office is seldom a desired place to spend one’s afternoon (psychological issues aside). The pale blue walls are wrapped in a border of purples and deeper blues, setting off the purple specks in the stubby carpet. Chairs cluster too close around the short, wooden table. The stale magazines are not interesting the first time around, let alone on the second flipping. She doesn’t even look sick. He could have coughed up a lung with that hack. That woman’s face should not be that shade of grey and my hands should not be shaking. Why does everyone have to go in front of me? I can’t take this much longer. Time crawls when there is nothing to focus on but how lousy you feel, and oh how we envy the well.

The hospital is a common focal ground for harsh reality, moments when individuals face life-altering decisions and changes and the white noise of other thoughts crushed by the magnitude. Our bodies were simply not meant to last forever. The realization of our own mortality is a taboo subject in many circles; anyone who spends too much time thinking about death is evidently a morbid person and probably suffering from some other issues. But whether it was the tragic incident with Fluffy or Rover that started this train of thought or a death in the family, eventually the concept of the temporary nature of this existence (religion aside for the moment) begins to dawn on us all. Walking down the hallway in any given hospital can be a terrifying experience—listening to the assorted beeps from one room to Mr. Smith retching loudly down the hallway and perhaps a crying young child who cannot fully fathom why the pain does not go away with a band-aid and a kiss like Mommy usually does. People move in and out of the sterilized white rooms week by week, some nearly regular in their stays and others the victim of a freak occurrence. They all have one thing in common, at least the conscious folk: they all want to return to their lives before the pain and discomfort as though it had never happened. Unfortunately, science has yet to produce a giant rewind button. Health is not always so easily restored as it is lost.

The most potent means to transfer medicine to the body is intravenously, directly into the bloodstream. This network of vessels is far more efficient than the postal service could ever boast and often taken for granted unless it is brought to our attention by somehow becoming blatantly obvious, i.e. a paper cut, accidental run-in with a particularly vengeful piece of furniture, or rampant chainsaw psychos. But from a biological standpoint, blood is fascinating, complex, and certainly pertinent in good health. In one drop of blood, there are about fifty two million red blood cells, four hundred thousand neutrophils (these are leukocytes or white blood cells and part of the immune response, destroying invaders along with themselves), two hundred and fifty thousand B and T cells (again, important for immune response), forty thousand macrophages (which essentially eat the invaders and report on them), along with plasma and platelets. All in a single drop of blood.

Most folk don’t take much time to consider how much is happening on the cellular level—to fully comprehend the complexity in one cell (let alone one body) is somewhere between mind-numbing and mind-exploding. However, many folk are faced with drastic or ongoing circumstances with a transfusion, as a result of a nasty traffic accident or a disease that eats at tissues until they break and bleed. Emaciated by whatever reason, factors such as blood type become vital lest the body attack the donated materials, organs or blood. Blood is categorized as positive or negative then as either A, B, AB, or O. There are a few theories surrounding why mankind has developed different types, but the most logical answer for the purposes here rests in that it is another layer of protection from our marvelous immune system. O+ is the most common blood type, convenient for its illustrious status as universal donor, with A+ behind it. AB as the rarest, particularly negative, because of how blood types are inherited (but this is a point for another day). These letters refer to carbohydrate chains that form antigens that identify the cells. Essentially, these antigens are like a photo ID resting on the outside of various cells, in this case red blood cells. Individuals with type A blood have A antigen sites, “A” being more or less just a name for that specific marker. People with B blood form B antigens, and those with AB have both sorts on the same red blood cell. Type O individuals have neither one of these markers. NK cells, or natural killer cells, wander around the body, so to say, looking for “missing self.” In other words, these cells are like the passport checkers at the airport, making sure that only those with the proper passports and citizenship are allowed in (those with the same antigens as the rest of the body) and detaining those without citizenship to Ellis Island (based on whether they have the wrong antigens and, with a darker twist, destroying them rather than shipping them back to the former country). These and other cells are part of the immune system’s stellar response to regulating the body’s health—the immune system kills about ten thousand cancer cells daily.

Unfortunately, the immune system is the subject of a lot of aggression for “the one that got away” and, in the case of allergies and poor reactions to blood transfusions, simply for trying to do its job. If person number one has type A, they produce antibodies to bind to the B antigens in an effort to mark them for destruction and vice versa. Should a random accident victim—say type A—need a transfusion and through a lax in hospital policy they are given the wrong blood type—say type B—the immune system will recognize something is amiss, and through the lysis of the donated blood, no matter how desperately it is needed, the recipient soon feels symptoms of chills, fever, shock, and kidney malfunctions. AB is everybody’s friend and produces no antibodies against A or B, as these would ultimately do more harm than good; generally the body works better if it doesn’t naturally produce antibodies that attack itself. This type is known as the universal recipient because the receiver of this type is least likely to reject the donation since it would not recognize A or B as foreign or note that O was wrong. Type O is a sneaky undercover agent and simply has no distinguishing characteristics, or rather antigen markers, to attack. It’s known as the universal donor because it is least likely to be rejected in situations when the blood type is unknown, such as emergency hospital procedures. The Rhesus (Rh) factor, where the + or – comes from, is much more common to be positive than negative, as if blood wasn’t picky enough. This matter comes up occasionally with pregnant women, when the mother and child have different Rh factors. The mother’s immune system does not recognize the fetus as part of itself and takes subsequent action against what it “thinks” is a parasite, with any personal views of children aside. There are current therapies to deal with the dilemma.


Careful; this knowledge is a dangerous thing. Excuses of ignorance no longer hold any standing with blame and guilt marking a new place to settle with a strong, dead weight; perhaps that should have been mentioned first. The problem with knowledge and understanding is that an inclination to act can follow. Kindergarten teachers get us started on the alphabet so that we can read and one day figure this out for ourselves. Recent campaigns against cigarettes promise truth. Political activists educate others on their cause to garner support. Doctors are called upon to answer questions (placing as much jargon aside as possible) so that the patient can listen to his advice and be well. Doctors are counted on to know the answers and tell us what’s wrong so we don’t have to bother spending hours studying and critiquing our own signs and symptoms (a very difficult process if say the patient is suffering delusions or impaired vision as a result). Being human, doctors are fallible and he or she had to start in the same place, chucked into high school biology. Even a small grounding of information can grow into a larger, complex world. No one else in the world shares your DNA (excluding identical twins) but millions of people share your blood type, more depending on your type and the region (some countries have more of one sort than another). What is stopping those who can from donating?

Issues arise when blood comes into contact with other blood. For each donation of blood three lives are saved but, according to America’s Blood Centers, although sixty percent of Americans are eligible to donate blood, only five percent do. It would be easy to veer off on a tangent and the cliché, albeit true, statement that chances are someone you know is going to need blood at some point in his or her lifetime. Numbers are much easier to cast aside as less than human. Those moments probably happen in every cafeteria where the local blood drive is advertising, discussing who is going to actually spend an hour of his or her time to donate. Many fear that the whole situation just isn’t safe; aside from the diseases that are rumored to stem from donating blood (with no grounding), there’s the possibility that if you receive blood from a madman, you’ll adopt his personality and his mind will take over and force your body to do inhuman acts and…this is still better left to the comic books. I had a friend who was so petrified of needles that she told the doctor in a slew of fast excuses that she was pregnant (while her mother was in the room) to avoid a shot; he asked if it was true and she confessed otherwise, still eyeing the needle warily all the same, I imagine. Many folk have a disease or condition that renders his or her blood ineligible. There remains a worse, subtle infection that can affect everyone, commonly known as human apathy. This nervous disorder starts in the brain and works first to the hands, stopping them from reaching out, then eventually to the feet where the victim feels inclined to shake the dust off and take a comfortable seat. Certain religious sects place a high value on blood, finding no reason why it should leave the body when it seems to be quite content and functioning where it is. Jehovah’s Witnesses, for example, harken back to a verse in Leviticus but make an exception in some cases to a machine called the cell saver as it is on a closed system (the patients’ own cells are rinsed and returned).

What of evolution? Blood itself is not likely to up and leave on all of mankind, having proven useful in evolution thus far, but health does have a habit of fluctuating through actions of our own or otherwise (“was that chicken supposed to be pink?”). All the same, are we, as cold as it is to say this, damning ourselves by keeping weaker genes floating around, like dead bugs, hair, and algae, in our pristine, chlorinated gene pool? Maybe it would just be best to let young Wendy be a sacrifice instead of chancing her diabetes to be spread to another generation. Timmy doesn’t need a transfusion because he really should have stopped that semi full of chickens from running that red light and slamming into his bicycle; obviously since he cannot watch where he is going, we don’t want his “stupid genes” to infect our future. It’s Jenny’s fault she was raped and her attacker didn’t use a condom. Eugenics—selective breeding with aims for specific traits within the human population—is not typically a favored idea, especially when this could swiftly pass from cruel to science fiction, but it’s best for mankind in the evolutionary scale.

There are still some factors to consider in that some traits may have effects that we are unaware of until they are eradicated. Take the quintessential example of sickle cell anemia—where red blood cells are shaped more like a crescent than a full moon—as a case of what’s called the heterozygote advantage, evidence encouraging why some harmful genes still float around. This disease is caused by having two recessive genes (homozygous, having the same) with those who have either one dominant and one recessive (heterozygous, having different) or two dominant genes (homozygous) not with sickle cell anemia. However, the heterozygous individual has immunity to malaria that the homozygous dominant individual lacks and without the adverse effects of sickle cell anemia of the homozygous recessive. Destroying this gene could prove quite detrimental and would involve killing off many healthy individuals; two healthy heterozygotes could still produce progeny with sickle cell anemia. Should carriers of the disease be eradicated as well as those showing signs of the disease? To deliver the death sentence is easier when it applies to nameless masses, but many healthy individuals carry all sorts of genes that combine in just the wrong manner have severe consequences; the more genetics are considered, it truly is a miracle to form one healthy baby. With many diseases strained from our gene pool, something new would inevitably rise up—bacteria has always been more clever and significantly faster at evolving than we are. All the same, the average Tom, Dick or Harry that’s rolled into the ER needing blood for whatever reason is never as important as a beloved family member carted in with a brave but weary smile. The first is easily sacrificed for the good of humanity and as a species. But the latter, in this unfortunate situation blood is demanded.

Who owns your blood? Obviously, you do, this concept of ownership evolving after blood along the evolutionary timeline. You were born with it, and it will continue to be yours until you lose it (not as easy to misplace as car keys, at least) or die. But we still have Timmy who was just at the wrong place at the wrong time. Perhaps the neurologist should be paged so he can assess the latest case of human apathy. Timmy’s too young to have donated blood for himself, which some adults do, so his family hopes that someone has. I have money of my own but Timmy needs just a little to get through this rough patch in his life; in a week, interest will have made up the difference (the red blood cells have been replaced) and in another seven it’s not worth it to keep the receipt (since the iron count has returned to normal). Ownership of land is commonly up for dispute, ranging back from the first settlers who set foot on shore, much like shouting for “Shotgun” before the other siblings could steal the prized seat. And the big brother can amble up and easily push little sister out of the way with a rough claim that it’s his turn; little sister can cry but if the new law does not recognize shouting “Shotgun,” then her ownership is void. Should the government rule that blood is an open resource to everyone like a community well, where would those opposed to the bill stand? On first thought, it seems like common sense but what precedents can be cited? From there, it would likely be unlawful to do anything that would taint the water supply; anyone who spreads HIV or Hepatitis or spends too much time in a foreign country where CJD (mad cow disease) has recently broken out or does not simply take care of his or her health could be punishable by law. Eugenics may be the least of our worries if every stuffy nose would mean jail time (there are probably better uses for our penal system). All the same, blood is a resource and just as claims for land or the front seat, it will be disputed.

Since the Bill of Rights does limit the tireless soldiers of the American Red Cross from veritable vampirism, with a rubber tourniquet and a needle instead of seduction and fangs, the question of filling the ever emptying blood banks rests highly in the hope of donation. Asking people to donate time or money has an instant reaction of a hesitant ‘um’ or at least a drop in enthusiasm that may not be visible so much as audible in the tone of voice. The word has a stigma. Making the issue personal is a difficult process when those who would donate blood never see or understand it being put into use. I could easily go on about how a blood transfusion saved my life in the middle of a flare up from Crohn’s disease, but chances are, you’ve heard it all before; I was already convinced, having donated several times prior to that whole mess. The only way to understand fully is to see someone you know in that situation, even if that someone is yourself. There will, at this rate, ultimately fall a time of desperation, and desperate people are dangerous. The urban legends following the story of innocent folk lured and drugged to wake up missing an organ would turn into a frightening eventuality of real blood hustling. Blood is thicker than water and probably worth considerably more when sold on the black market—a transfusion of water would ultimately do more harm than good anyway whereby through simple osmosis, the red blood cells would burst trying to take in too much water (that’s why hospitals use saline). There is no monetary gain in donating unless karma and the black market are factored into this equation. But donation takes time which is far too valuable to be spent on ways that are not immediately beneficial. Again, the neurology department bemoans that there is no definite cure for human apathy—regardless of how many lobotomies they perform and what experimental drugs they prescribe—and can only pray that its victims find his or her own way to escape its cold clutches. Receiving a donation is more dangerous than giving one, but that terrible bruise resting in the crook of the arm is far from fetching. If they hit an artery with the needle instead of a vein, some obese nurse will all but sit on the arm until it stops. Some people are just going to keep needing blood and we’d rather not be enablers. One the plus side, a unit of blood is approximately a pound so an hour and a half guarantees that you lose weight.

The statistics still stand that one in five people entering the hospital will need blood. The average adult has about ten pints. As vital as it is to you, it could be immediately crucial to someone else. It’s like a white elephant gift; the body was going to destroy it in a few days anyway (red blood cells don’t hang around for very long). So much is going on in your body to prevent the tragedy of falling ill, just as there are those trying to prevent the environment from crumbling before it becomes a nostalgic memory. The human body is a universe all to itself from the amazing cooperation of the cells that form each individual piece. The subject of blood isn’t left to the morbid or pop songs screeching on broken hearts and love pounding through their veins because it belongs to all of us but uniquely to oneself. What it is used for, that’s the interesting question. Eat vegetables, drink water, and appreciate a good string of health while it’s here.