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Essence and emblem of life—feared, revered, mythologized, and used in magic and medicine from earliest times—human blood is now the center of a huge, secretive, and often dangerous worldwide commerce. It is a commerce whose impact upon humanity rivals that of any other business—millions of lives have been saved by blood and its various derivatives, and tens of thousands of lives have been lost. Douglas Starr tells how this came to be, in a sweeping history that ranges through the centuries.
With the dawn of science, blood came to be seen as a component of human anatomy, capable of being isolated, studied, used. Starr describes the first documented transfusion: In the seventeenth century, one of Louis XIV's court physicians transfers the blood of a calf into a madman to "cure" him. At the turn of the twentieth century a young researcher in Vienna identifies the basic blood groups, taking the first step toward successful transfusion. Then a New York doctor finds a way to stop blood from clotting, thereby making all transfusion possible. In the 1930s, a Russian physician, in grisly improvisation, successfully uses cadaver blood to help living patients—and realizes that blood can be stored. The first blood bank is soon operating in Chicago.
During World War II, researchers, driven by battlefield needs, break down blood into usable components that are more easily stored and transported. This "fractionation" process—accomplished by a Harvard team—produces a host of pharmaceuticals, setting the stage for the global marketplace to come. Plasma, precisely because it can be made into long-lasting drugs, is shipped and traded for profit; today it is a $5 billion business.
The author recounts the tragic spread of AIDS through the distribution of contaminated blood products, and describes why and how related scandals have erupted around the world. Finally, he looks at the latest attempts to make artificial blood.
Douglas Starr has written a groundbreaking book that tackles a subject of universal and urgent importance and explores the perils and promises that lie ahead.
Essence and emblem of life—feared, revered, mythologized, and used in magic and medicine from earliest times—human blood is now the center of a huge, secretive, and often dangerous worldwide commerce. It is a commerce whose impact upon humanity rivals that of any other business—millions of lives have been saved by blood and its various derivatives, and tens of thousands of lives have been lost. Douglas Starr tells how this came to be, in a sweeping history that ranges through the centuries.
With the dawn of science, blood came to be seen as a component of human anatomy, capable of being isolated, studied, used. Starr describes the first documented transfusion: In the seventeenth century, one of Louis XIV's court physicians transfers the blood of a calf into a madman to "cure" him. At the turn of the twentieth century a young researcher in Vienna identifies the basic blood groups, taking the first step toward successful transfusion. Then a New York doctor finds a way to stop blood from clotting, thereby making all transfusion possible. In the 1930s, a Russian physician, in grisly improvisation, successfully uses cadaver blood to help living patients—and realizes that blood can be stored. The first blood bank is soon operating in Chicago.
During World War II, researchers, driven by battlefield needs, break down blood into usable components that are more easily stored and transported. This "fractionation" process—accomplished by a Harvard team—produces a host of pharmaceuticals, setting the stage for the global marketplace to come. Plasma, precisely because it can be made into long-lasting drugs, is shipped and traded for profit; today it is a $5 billion business.
The author recounts the tragic spread of AIDS through the distribution of contaminated blood products, and describes why and how related scandals have erupted around the world. Finally, he looks at the latest attempts to make artificial blood.
Douglas Starr has written a groundbreaking book that tackles a subject of universal and urgent importance and explores the perils and promises that lie ahead.
Due to publisher restrictions the library cannot purchase additional copies of this title, and we apologize if there is a long waiting list. Be sure to check for other copies, because there may be other editions available.
Due to publisher restrictions the library cannot purchase additional copies of this title, and we apologize if there is a long waiting list. Be sure to check for other copies, because there may be other editions available.
Excerpts-
Chapter One
The drama ended, as do so many these days, in a courtroom. This particular chamber was long and low-ceilinged, with a wide dais at its front for the eight black-robed judges. Each of the four defendants sat flanked by tall policemen who gazed impassively from under the brims of their trademark pillbox hats. In keeping with the formality of French courts, the prosecuting and defense attorneys wore flowing black robes, which would dramatically sweep behind them as they rose to make a point. The only visible flaw in the decorum appeared among the audience members, some of whom wore T-shirts bearing inflammatory slogans. There were audible exceptions to decorum as well, as people would moan or shout "Non!" at a defendant's response, or when one man, the most vocal of the plaintiffs, would, as his doctor walked past, loudly hiss "Assassin!"
The plaintiffs in this trial were dying of AIDS. They charged that they had been infected through the negligence of the defendants—high officials in the French national transfusion service. In France, where the government until recently held a monopoly on blood and its derivatives, these men were supposed to ensure the safety of blood products. Instead, they allowed thousands of the nation's hemophiliacs to inject blood-derived clotting factors they knew to be contaminated. The defendants had done so because of a complicated mixture of paternalism, economics, and to some extent the limits of science, but the victims saw the incident more starkly. To them the affair was a matter of betrayal. The doctors on trial in the summer of 1992 were supposed to have embodied all that was noble in the French transfusion tradition—altruism, medicine, business, and technology. Instead, during the years of the "contaminated-blood affair" they came to symbolize the cynicism and expediency of a money-driven age.
The sense of betrayal surfaced in many places beyond the courtroom in Paris. For more than a decade the theme has been sounded in one locale after another throughout the world. In America, patients have filed hundreds of civil suits against doctors, drug companies, and even their own patient organizations, for abandoning their health to the expediency of the marketplace. In England, AIDS-infected hemophilia patients castigated their national transfusion service with reacting too slowly to the threat of emerging viruses. In Japan, patients charged that the government and drug companies criminally concealed the contamination of blood products; as a result, some of the nation's most revered doctors have gone to jail. In Canada, the scandal of contamination spread so wide that the government held a series of hearings across the country that convulsed the nation with anger and shame.
Why those scandals erupted is one of the underlying questions of this book, a history of human blood as a resource and humanity's attempts to understand and exploit it. Blood is one of the world's most vital medical commodities: The liquid and its derivatives save millions of lives every year. Yet blood is a complex resource not completely understood, easily contaminated, and bearing more than its share of cultural baggage. Indeed, the mythic and moral symbolism of blood, which has been with us since ancient times, subtly endures. It clouded professional judgments and public perceptions in the AIDS scandals of France, Canada, and Japan, among others.
If one considers blood a natural resource, then it must certainly rank among the world's most precious liquids. A barrel of crude oil, for example, sells for about $13 at this writing. The same quantity of whole blood, in its "crude" state, would...
About the Author-
Douglas Starr is an associate professor of journalism and codirector of the Graduate Program in Science Journalism at Boston University. A former newspaper reporter and field biologist, he has written on the environment, medicine, and science for a variety of publications, including Smithsonian, Audubon, and Sports Illustrated. He was science editor of "Bodywatch," a health series that ran for three years on PBS. Mr. Starr lives near Boston with his wife and their two sons.
Reviews-
January 1, 1999 Starr, codirector of the graduate program in science journalism at Boston University, energetically plunges into the social, ethical, and economic history of one of the most mysterious and culturally pertinent resources in human history: our very blood. He starts with the first blood transfusion, from a calf to a man, in 1667 Paris and runs through the changing mythological landscape, medical advances, and the political (and certainly military) power associated with possessing a rich blood supply. He closes with a discussion of contemporary issues, such as the threat posed by regarding blood as a commodity. This is science writing at its best: well researched, socially relevant, and highly enjoyable. (LJ 8/98)
Starred review from August 1, 1998 From antiquity well into the nineteenth century, doctors frequently bled--extracted blood from--their patients. Indeed, Gutenberg's second publication was a calendar for bloodletting. During the early decades of the twentieth century, scientists started learning about blood types, collecting techniques, and processing methods. Karl Landsteiner, one of the great pioneers in the field, was, Starr relates, also an unusual scientist in that he was so modest that he asked Sinclair Lewis to respond for him when he received the Nobel Prize. Starr also describes the important work during World War II of Janet Vaughan, Charles Drew, and others who improved the supply of blood at home and at the front. One of "Blood"'s most fascinating episodes is about calm, perfectionist Edwin Cohn, who did so much for blood fractionation and for increasing the availability and usefulness of the parts of the life-giving substance. And then there is the quite recent story of AIDS. Starr uses humor and a knack for analogy to make many points; for example, he trenchantly notes both the Nazis' refusal to allow anything but Aryan blood into the veins of the master race and the American Red Cross' long insistence on keeping the blood of whites and blacks separate. The story of "Blood" is one of appalling greed, altruism at its best, and much in between; thoroughly documented and smoothly written, it deserves broad, continuing success. ((Reviewed August 1998))(Reprinted with permission of Booklist, copyright 1998, American Library Association.)
Starred review from August 1, 1998 At first glance, a lengthy book about blood might appear boring, even ghoulish. In reality, this book is totally fascinating. Using information gleaned from hundreds of interviews and extensive written documentation, Starr (science journalism, Boston Univ.) discusses how blood has evolved from a mystical force into a highly valuable commercial service. A significant portion of the book describes the impact of blood transfusion techniques learned during World War II. Also given considerable attention are the political and economic factors surrounding blood screening during the early years of AIDS and how the decisions surrounding these issues affected blood recipients, particularly hemophiliacs. The global aspect of the blood industry is considered throughout with lengthy comparisons on the status of blood research in other countries, particularly France, Japan and Britain. The lack of technical jargon makes the book easily understandable to nonscientific readers. Highly recommended for any public or academic health science collection.--Tina Neville, Univ. of South Florida, St. Petersburg Lib.
New York Times
"Fascinating...A rich story admirably told"
Science News
"Extraordinarily intriguing"
Atlanta Journal
"Definitive...an outstanding chronicle"
Boston Globe
"Illuminating...More than historical narrative...Starr also provokes a good deal of thought about the mismanagement of this 'precious and dangerous medicine'"
The Advocate
"'An exhaustive expose´ of the worldwide business of blood. Starr traces the links between the AIDS crisis and the distribution of contaminated blood products in the early 80's...An unnerving must-read on how the politics of blood affects us all"
Booklist
"A story of appalling greed...Thoroughly documented"
The New Yorker
"This rewarding book, filled with sharp science, has everything from a brief survey of bloodletting to the massive mobilization of donated blood for the invasion of Normandy. But its real subject is the postwar rise of the 'blood-services-complex,' which controls the global market for blood products."
Library Journal
"Totally fascinating"
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