Bad Blood

I hate to admit this but a lot of what I do in life is driven by a sense of responsibility, aka guilt.  At some point in my early pharmacy career, probably during my residency, I participated in an in-hospital blood drive and word got out that I’m O-Pos blood type, the very common• but also very useful ‘universal donor’.  Since that time, I basically have led the life of a small-time celebrity, dogged by the paparazzi-esque blood center employees week after week.  They are relentless in their pursuit of my plasma.  I finally got them to stop calling my home, but that only resulted in more emails.  Also, if you donate at different locations, it just sets another pack of hounds on you.  So now, when the requisite 8 weeks has gone by since my last donation, the emails start flooding my inbox, pleading with me, begging me, guilting me into giving blood.  And I am powerless to stop them because I know it is for a good cause.  I mean, why shouldn’t I give blood?  Why not save a life?  So you can imagine how painful this has been for me as we traveled.  Helplessly deleting dozens of these emails, a frustrated donor, unable to bleed.  Well, I decided to do my civic duty yesterday, and having made an appointment online, I showed up at my appointed time to go through the motions that would inevitably result in me donating a pint (or 10%) of my total blood volume.  For whatever reason, I prefer the traveling donor trucks, or blood mobiles.  Maybe I feel that the quirky employees are like me, always seeking adventure, even if it is within the confines of King County.  Wedged beside the guy next to me, who was carefully shielding the screen of his electronic tablet as he answered each question, I began my survey.  In the last 12 months have you engaged in unsafe sex, had a tattoo, used drugs, etc. I clicked through the questions, hesitating at the one that asks about traveling outside the country in the last 12 months.  I said ‘yes’ and moved on.  There was a question about cumulative travel in the UK adding up to more than 5 months in the past 5 years, and I said no, feeling that I had aced the exam.  The next step of the intake process is that you are taken into a very small room (a refurbished RV toilet, basically) where you are further interrogated about your answers on the questionnaire, before they check your hematocrit to ensure that you aren’t anemic and also retype your blood by fingerstick.

Jess asked me what country I had been to in the past year and I said that there had been over 30.  After a beat, where she struggled with her emotions, she looked at me, exasperated and snapped that I would need to write them all down for her.  She sighed heavily as she bent down to search for a blank piece of paper and pencil.  I wasn’t sure why she was upset.  I guessed that I was going to mess up the lunch schedule, or perhaps she felt I should have known better than to try to donate blood after cavorting carelessly around in the far reaches of earth’s dark corners.  After a moment’s hesitation, she suggested I just tell her the countries out loud and she would write down any that she recognized as ‘bad’.  Feeling instantly protective of the places I had traveled to, I briefly thought of leaving out the ones I know are the malarial culprits, but in the end, I admitted to whoring about in such awful places as Tanzanzia and Indonesia, among many many others that were written down on the doomed list and underlined for emphasis.  When we had finished flogging my itinerary, she started from the end and we worked backwards, inspecting a color coded map for each place to see if I had ventured into some of the more high-risk areas.  Costa Rica, Nicaragua, Peru, and Chile, all passed, even though some regions are ‘questionable’ and the zones of travel that we may or may not have crossed are not an exact science when gazing at a world map that covers a 8.5 x 11 inch page.  But then we looked at Indonesia, which on her map was entirely darkened in purple.  I tried to wiggle around the rejection, by telling her that we really hadn’t been on land, only on the water, too far for the mosquitoes to reach us but she had reached the limits of her comfort with me and my sketchy travel history.  I knew it was pointless and that she would have stopped me in Cambodia anyhow, just 2-3 more countries prior to Indonesia.

Long list of hazardous regions we traveled through. Who knew we were so hard core?

A mucher nicer person than I have probably given her credit for here (or perhaps she had misjudged my intentions altogether), Jess sweetly offered me juice and cookies even though I was ineligible to donate.  She then flagged my chart, made a notation on a piece of paper, and handed me my rejection notice. I quickly scanned the form, which stated that my medical history evaluation indicated that to donate may pose a risk to the patient receiving my blood because I have traveled or lived in a malarial risk area.  As a exited the tiny interrogation closet and caught eyes with other potential donors, I relished the little bit of excitement that my ‘rejection’ must be conjuring in their minds.  I had been unsafe, but probably not in the way they were imagining, wondering where my new tattoo was hidden under my conservative cardigan sweater.  I suddenly felt alive, like the trip was real, and it was mine, and it had happened.  It was impacting my life in a very small but real way.  I had been deferred, temporarily, until 3/1/2015.  If after that date I had not expired from malaria or some other mysterious viral or vector illness, I was free to take one more step back into US society by once again establishing myself as a donor of life-saving O positive blood.

Although my inbox will likely grow quiet as I drop off the paparazzi’s list, and I’ll admit that brings me a little pleasure, I can’t shake the feeling that there is a person out there who will soon be in a very horrible situation and they will be missing my blood.  So I thought I would turn this rejection into triumph and ask those of you who only traveled from afar, from the screens of your computers, to consider giving in my stead.  How many pints of good blood can we make from one pint of bad blood?  Although I have missed the chance to donate my blood and spread the ‘travel bug’ to some unsuspecting recipient, maybe those of you who are willingly affected by and sharing my wanderlust would consider saving a life today?

Imagine Saving a Life

*varies a little by ethnicity but anywhere from 37-53% of the population is O-positive, and they can donate blood to all other blood types.