Blood

Castle of stone and glass, light and dark, echo chamber.  For thousands of years men built churches to resemble stands of trees, high and huge, the eye drawn upward to gather men closer to God.  Then the lovers of books and learning stole the stucture of the church and built it into libraries.  Here I am in the echo chamber of the reading room of the Suzzalo library, silence accentuated by the occasional cough, the shifting of a wooden chair.  There are rosettes in the stained glass and even crosses.  What would have been chapels are lined in books.  There's even a wooden gated apse, a sacristy.

A boy walks by who looks like my friend Henry looked when we first started medical school.   More hair than Henry has now, his face less lined.  There was a chapel like this one in the library at my medical school, above the famous corridor with the murals.  I rarely studied there; when I was in the library it was the small, warm attic reading room I favored, soft leather armchairs and heavy tables in dark, carved wood.  The last arched dome I sat in often was in my undergraduate college, a library whose satanic symbols were the subject of some graduate student's dissertation.  I was younger then than the boy who just walked by me, as young as the girl to my left who is flipping through an anatomy textbook, highlighting pages and labelling drawings.  How long ago all that was!  And how pleasant the silence now, more pleasant even than then.  I'm quieter inside now—I couldn't have spent a truly peaceful hour at Sterling, my mind was ablaze then, pulsing with fear and desire and crushing uncertainty, the relentless adolescent preoccupation with sex and identity, the self and other.  How exhausting it all was.

My arm pulses now where the needle pierced it, but my heart rate and blood pressure are back to normal; I can feel it, the passing of the dizziness, the softening of the post-phlebotomy tension.  My head was fuzzy for an hour and is now clear.  Push fluids for three days, they said today as always.  No heavy lifting for the first twelve hours.  I think it takes three days, maybe only two, to resynthesize the lost pint; I knew those numbers exactly once, in that warm low-ceilinged library.  My first blood drive was in high school—I was in charge, too young to donate, and spent weeks cajoling and bullying my classmates into giving up their blood.  It's odd to remember now that once I was quite the organizer.  A talent I may or may not still have but a taste I've certainly lost.  I worked the drive as well as recruiting; there were volunteers in a half dozen areas - greeters who signed the students in, ones who helped with their forms and led them to the nurses who pricked their fingers for anemia and took their temperatures, and asked the screening questions.  I don't think the questions were quite as complicated then, I think it was a year or two later that the more complicated AIDS questionnaires were added, which always made me giggle: have you had sex with a man who's had sex with another man since 1977?  Even now I'm amused and want the ricochet to go on: have you had sex with a woman whose had sex with a man who's had sex with another man who's had sex with....since 1977?  Pre-1977, the questionnaire seemed to imply, you could have sex with pigs or with men who had sex with pigs, anything goes—which from the epidemiologic standpoint of AIDS, of course, is perfectly true.  But I think in the days of the blood drive in my Catholic girl's school, those questionnaires had not yet been developed.

We had volunteers in the canteen, handing out juice and cookies and checking when enough time had passed that the student could go, get her thank you sticker and go back to class.  Someone's mother worked for a fast-food chicken chain and we had chicken nuggets to give out as well as juice and crackers, the only time I've encountered blood-draw snacks that could double as a meal.  The school gymnasium where we held the drive smelled of alcohol swabs and chicken nuggets.

The best job, the one I usually claimed, was attending during the actual donation.  The bags had to be brought over to the cot and a dozen labels from the donor's form transferred to each of the bag's many components—three main parts, plus each segment of tubing.  Labeling required careful focus and lives could be at risk if there was an error—or so we thought.  Probably if there were an error the unit would have simply been discarded, but we thought of it as lives at risk.  There was fluid in the bags to prevent coagulation so they were intriguingly squishy, the consistency of water under silicone, a texture I would later associate with breast implants.  After the blood was drawn and the bag sealed we had to roll it gently back and forth so the anticoagulant would mix, then carry it to—here my memory, or imagination, fails—was there some kind of special box, or refrigerator?  I remember the carrying but not the endpoint, so shocked I was by the jarring reality of the blood's heat.  I wasn't stupid, I could have told you blood should emerge from the body at 98.6 degrees, but it was an entirely different matter to feel it through the silicone, the heat warming my ever-chilly fingers.  From the arm of Catholic-school girl after girl, this hot red blood.

I promised all those girls with their pink, virgin veins that I would have donated my own blood if I could, that I would do it religiously as soon as I was able, and I did, through college and into medical school.  I have a red two-gallon pin somewhere, dusty and rusting in a drawer with other unusable and undiscardable treasures.  The college blood drives were in a dusty, cold performance space, something or another Hall, and I remember the sight of the needle sliding into my arm, the cold of the iodine swab beforehand and the pressure of the tourniquet band on my upper arm, the unexpected pain of the needle—huge, it seemed at the time, and now I realize again from past the perspective of many needles: yes, huge—parting my skin, insinuating itself, how deeply it moved into my arm, burning all the way.  I watched with fascination and growing nausea, my heart pounding across my eardrums, the world wavy before my eyes.  The room was cold and I sweated and shivered, and afterward got lightheaded and had to sit with my head between my legs, a nervous attendant fussing over me.  After that I learned that it was better not to watch, to look the other way.  I still got dizzy afterward but at least I didn't feel so bad.

In medical school the drives were in the student center, the same room I waited in for hours to be in the front row listening to Hillary Clinton, and shake her hand.  I have a copy of a picture somewhere, taken by the student news photographer, the back of Hillary's head obscuring the front of mine as she leaned politely toward me.  The blood drive experience was warmer there, and the juice was better, real juice from concentrate rather than the fake orange-flavored water we had in college.  I was still in my blood donor fanatic phase, still repaying the pale ghosts of all those high school girls.  I missed a drive once and learned where the blood bank was, an unassuming white and green building off the drive to the hospital.  Struck with my eagerness they asked if I would become a platelet donor.  I recall that there was a great deal of testing involved in this and that I was told it was also the first step in joining the bone marrow registry.  In retrospect I suppose my HLA type is out there somewhere in a Red Cross computer, though I had not considered that between now and then, even in the paranoid-resident moments of backache wondering if I might be HLA-B27 positive, or otherwise wishing to peer into my own genetic code.  Some things it's better not to know.  I didn't sign up as a bone marrow donor but I did do the platelet donation a handful of times, sat for two hours with a truly monstrous needle in each antecubital fossa, my blood gushing out of my left arm, spinning through a filter and gliding back in through the right.  I watched bad movies and studied the tree whose branches scraped across the window, unable to read because I couldn't bend my arms.  Then I hit third year and that was it.  Many, many needles were part of my life, but I stayed away from the working end.  In the beginning of residency I was too tired and later I had the excuse of having been too recently to a malarial region of Africa, which was on the long list, along with having sex with men who had sex with men, that disqualified one's blood from recirculation.

So today is the first time I've donated in all the years I've lived here.  I wasn't planning it; I had the day off and thought I would come explore the undergraduate library, which rumor held was beautiful.  Climbing the hill to campus I passed an unassuming white van parked in front of the engineering department, with pink signs scattered around: Give Blood Today!  And I could think of no good reason not to.

So now I sit in the library's reading room, admiring its novel yet familiar stained-glass windows and the echoes off its high stone walls.  My bone marrow churning out new cells, my fluids reequlibrating.  I sit in this adapted cathedral and reminisce and gather strength; tomorrow I will be ready to return to the professional end of the needle.  Not far away, a red sac sits cooling in a brushed-silver refrigerator, my blood slowly giving up its heat, beginning its steady journey toward another vein.