Tuesday, December 06, 2005

Reflections of a blood eater

Updated: 16 May 2015 
December 1 is World AIDS Day and every year, despite the advances, HIV and AIDS continue to be major challenges for mankind:
Since its appearance in 1978, AIDS has had a profound effect on the blood industry, requiring screening questions and new expensive tests. Transfusion-associated HIV infection is now rare in the West but continues to occur in developing countries. The aftermath of the so-called "tainted blood scandals" occurred in all countries and continues today in some countries

As a blood banker I worked on the bench ("in the trenches") in the pre-AIDS days when syphilis and hepatitis B were the main concerns. We performed risky practices in those days and never gave safety a thought.
Here's a few memories from my past that I call "Reflections of a Blood Eater."

From the mid-60s to 1977 I worked as a medical laboratory technologist (aka clinical lab scientist) for the Canadian Red Cross in Winnipeg, which was a combination blood center and transfusion service along the lines of Puget Sound Blood Center in Seattle. Yes, mid-60s! We are definitely in the realm of old-geezers here. 

One of my most fond memories from that time was how we used to "shuck" (pour out) blood clots from 100s of donor specimens into kidney dishes before preparing 5% saline suspensions for red cell testing. All the while smoking and drinking coffee, of course. Time was a factor and those clots got tossed with wild abandon - it was the start of what could be a very long day depending on the clinic size. 

We worked until all blood was tested and sorted (put into inventory), no matter how long that took. For the 1000+ donor clinics after New Year's Day that could be from 07:00 to 23:00 hrs. No union to influence working hours in those days, either.

But I digress. To start each day we would shuck like crazy until the kidney dishes were full. Blood would splatter everywhere, including all over us, our smokes and coffee cups. No gloves, of course, only white lab coats that we wore everywhere including into the lunch room.

My most vivid memory from those days is the taste of blood on my cigarette filter. It tasted awful, probably more so as I'm a vegetarian. The second most vivid memory is of bloody finger streaks on the back of everyone's lab coat (after all, techs need to keep their hands clean and the buttocks was as good a wipe as any).

When hepatitis B testing was instituted (during my years there we went through counterimmunoelectropheresis, reverse passive hemagglutination, and radioimmune diffusion, now considered prehistoric), one year all lab staff were tested for both HBsAg and anti-HBs. 

Of the 20 or so technologists none were positive for HBsAg and only one (a good friend of mine still working there) was anti-HBs positive.
So, what does this contribute to the issue, i.e., the risk of disease transmission via drinking, eating, smoking in the lab? Probably not much. 

We were testing healthy blood donors for hepatitis and Canada had a relatively low prevalence rate, even given immigrants from higher prevalence countries. Mind you, some of the specimens tested were positive, and perhaps some of those made their way to my cigarette filters. Also, in the 1960s we bled donors from Manitoba's two penitentiaries. Indeed, once the rate of HBsAg in jails became known, prisoners were dropped as donor sources.

In retrospect, based on my experience working at the Red Cross in the pre-AIDS days, I suppose that I view the risk of contracting hepatitis and other blood-borne agents from activities such as drinking as being quite low. Certainly not zero, however. Consider that there were two technologists in Saskatchewan who contracted hepatitis B and died from mouth pipetting positive controls chemistry lab. We in the blood centres had luck on our side.

Also, Baruch Blumberg, awarded a Nobel Prize in 1976 for his discovery of HBsAg (initially called Australian antigen), tells the story of how his laboratory technologist came down with hepatitis B before they knew what the Australian antigen was (Source: ISI Current Contents).

Personally, I would not want to play Russian roulette with a million-bullet gun cartridge containing only one bullet. Sooner or later, someone gets the bullet. This scenario likely applies to all the rarer risks that we try to prevent by using universal precautions.

Today's students and younger lab professionals are astounded at these practices. In retrospect, even this vegetarian, once blood eater, finds them surreal.

"The Eagle has landed" (Jamaica 1969)

On 2 Dec. 2005 NASA in collaboration with California space organizations announced two $250,000 prize competitions to develop technologies needed for exploring the moon and beyond. After the shuttle disasters, Challenger in 1986 and Columbia in 2003, the value of manned space travel has been questioned.

This got me thinking again about the moon and where I was on 20 July, 1969 when we heard those thrilling words, "Houston, Tranquility Base here. The Eagle has landed."

In July 1969 I was in the midst of a 6-month holiday in Jamaica.

My father, an Air Canada mechanic and inspector, had taken a posting to Jamaica when the Air Canada base in Winnipeg closed. Air Canada had been contracted to get Air Jamaica up and running and my Dad was one of the staff assigned to the airport in Kingston. I was lucky enough to be able to quit my job at Canadian Red Cross Blood Transfusion Services in Winnipeg and spend six fabulous months essentially bumming around Jamaica.

When Apollo 11 LEM landed on the moon, we got it on Jamaican television but it was really blurry with much static. However, I distinctly remember going outside and looking up at a cloudless sky with a perfect full moon - whether it was or not I do not know but that's the memory.

Must admit it was magical - something to treasure forever. My other memory of the event is of the ads on Jamaican TV. One for "Creamo" was on all the time (milk, I think), as was the one for Red Stripe beer.

Living in Kingston, we got to see more of the real Jamaica than visitors to the north shore resorts in Montego Bay (Mo' Bay) and Ocho Rios. Kingston, the capital, had much poverty and squalor, banks guarded by men with machine guns, crime and violence, yet so many kind and friendly people going about their daily lives. The political scene was energetic, with heated debates from the right and left on how to create a prosperous country.

While we resided in an expatriate compound with gardener, maids, and swimming pool, many, if not most, Jamaicans lived in shanty towns with houses that reminded me of my grandmother's chicken sheds. My parents were encouraged to hire a maid and a cook in order to give employment to the locals, which they did.

As it turned out my parents got to be friends with Mrs. Harley (cook), Rema (maid) and Eric (gardener), which created a bit of a trouble with the East Indian Jamaicans that managed the compound. My Mom started to have lunch with Mrs. Harley and Rema, with us all sitting at the kitchen table, which apparently was "not on" - the "reprimand" did not stop my Mom, though. Similarly, my Dad would occasionally allow Eric to sleep overnight in our car, a "dangerous" practice according to the managers, but like my Mom, this disapproval did not deter my Dad.

It was the first time that I saw what looked like prejudice in people who were not white Caucasians. Jamaica has a real mix of cultures and races and its own class divide.

Besides the local beach in Kingston (great rollers!) and weekend trips to Ochos Rios, one of our favorite trips was from Morgan's Harbour Resort near the airport in Kingston to Lime Cay. Just a short trip by motor boat, we would go over for the entire day and be picked up before sunset. Lime Cay is about as close to heaven as there is. White sand beaches, pale green water, sea shells galore, and shaded areas for picnics. If you are ever in Kingston, take this trip!
Some vibrant memories of this time:
  • Dreadlocked Rastafarians sitting by the roadsides in a ganja haze
  • Beachcombing on Lime Cay
  • Playing scrabble with our American neighbor's 12 year old son Felix for hours by the pool (the kid was a genius!)
  • Eating paw paw fruit and mangoes. With paw-paws all I could think of was the enzyme papain and its use in blood bank serology!
  • Climbing Dunn's River Falls on the north shore
  • Reading everything I could about Jamaica's history;
  • Eric killing a lizard who had taken up residence in our bathroom with a machete (my Mom only wanted him out, not dead)
  • Listening to tales spun by neighbors Hamish and Myra from Scotland (he with Lloyd's Bank)
  • Trips through Fern Gully on the way to Ochos Rios
  • Upon entering a resort at Ochos Rios, my young cousin Wendy exclaiming, "Pat - it's just like the movies!"
  • Seeing the red bauxite red mines that blight the landscape (and offer jobs)
  • How many families were headed by women, with mothers working and grandmothers taking care of the children
  • Giant flying cockroaches (sometimes hiding in kleenex boxes) and the odd scorpion
  • My cousin Wendy and I lying in bed at night with the lights on scanning the walls and ceiling for the dreaded cockroaches or harmless geckoes
  • Blue Mountain coffee with a chaser of Tia Maria
  • Political figures such as Norman Manley, Michael Manley, and Edward Seaga
  • Reggae music (once heard, the soft chucka-chuka" beat stays forever)
  • "Houston, Tranquility Base here. The Eagle has landed."
Most of all, my brief 6 months in Jamaica were memorable for seeing another culture up close, one with a history of exploitation and extreme poverty, pockmarked by tourist resorts of great wealth.

I have never forgotten what Jamaicans would say if the mail was late or the electricity was off: "Soon come, mon." All in all, a pretty good philosophy.

Red Cross emblem to be neutered?

The headline reads "Red Cross mulls 'neutral' emblem".

They're calling the proposed new emblem a red crystal but it looks like a diamond with a hole in the middle. Apparently, the only two emblems currently recognised under the Geneva Conventions are the red cross and red crescent. Relief workers and ambulances bearing these symbols are protected under international law.

It turns out that Israel uses a red Star of David (also its national symbol) and therein lies the rub:
  • Israel uses the red star for its relief organization, therefore
  • Israel is not allowed to be part of the Red Cross movement
  • Arab states will not accept the red star of David
  • They see the third emblem as an unnecessary accommodation of Israel

The issue seems artificial since the crescent is a universal symbol of Islam.

Doesn't arguing over emblems whose purpose is to protect humanitarian aid workers seem a bit nuts? The Asian tsunami and Pakistan earthquake with hundreds of thousands of people killed ... who gives a flying fig about what emblems are used by relief workers?