MEDICAL SURFARI; ERYTHRON IS OUR LIFE BLOOD

Sluicing through our arteries and veins every moment we are alive, blood cells percolate through our tissues providing the obligatory oxygen to maintain the health of every cell in our body. The erythron (red blood cell) has been molded by evolutionary forces to effectively meet the demands for oxygen by the cells in our body. These cells are little more than boxcars carrying hemoglobin, the protein responsible for binding oxygen and transporting it to the tissues to meet their obligatory need for oxygen.

These little cells, all 4 million to 5 million per drop of blood, are the only cells in our body that sacrifice their own nucleus by extruding it so as to maximize their function. Their job is thankless, and most of us take them for granted until we bleed. Bleeding, like suffering, transcends all ages, races and socioeconomic groups.

As a neurosurgeon, I am especially mindful of controlling bleeding, as the nervous system cannot tolerate this. However, whenever a patient is injured in an accident and bleeding has been excessive, there are two things to do.

Stop it and, pray that there will be sufficient blood to effectively replace the loss. This causes me to think of a passage from "Mortal Lessons, Notes on the Art of Surgery" by Richard Selzer wherein he describes the struggle of a general surgeon desperately trying to dissect a common bile duct that is bricked up in scar. "The surgeon cuts. And all at once there leaps a mighty blood. As when from the hidden mountain ledge a pebble is dislodged, a pebble behind whose small slippage the whole of the avalanche is pulled.

Now the belly is a vast working lake in which it seems both patient and surgeon will drown. He speaks, 'Pump the blood in. Faster! Faster! Jesus! We are losing him.' And he stands there with his hands sunk in the body of his patient, leaning with his weight upon the packing he has placed there to occlude the torn vessel, and he watches the transfusion of new blood leaving the bottles one after the other and entering the tubing. He knows it is not enough, that the shedding out traces the donation. At last the surgeon feels the force of the hemorrhage slacken beneath his hand. Gently he teases the packing from the wound so as not to jar the bleeding alive. He squirts in saline to wash away the old stains. Gingerly he searches for the rent in the great vein. Then he hears, 'I do not have a heartbeat.' It is the man at the head of the table who speaks. 'The cardiogram is flat,' he says. Then, a moment later: 'this man is dead.' Now there is no more sorrowful man in the city, for this surgeon has discovered the surprise at the center of his work. It is death." It is death that we all face without our life blood.

Every three seconds someone needs a blood transfusion and that equals more than 32,000 pints of blood needed across America each day. January is National Volunteer Blood Donor month. Donating blood is fast, simple and safe, so if you have just one hour, you can help save lives one pint at a time by giving your erythron.

Contact you local Red Cross for donation dates and sites near you.

World Wide Web Resources American Red Cross www.redcross.org The American Red Cross receives nearly 6 million volunteer blood donations a year and serves more than 3,000 hospitals nationwide.

The American Association of Blood Banks www.aabb.org The American Association of Blood Banks, as well as the American Red Cross, coordinates the National Volunteer Blood Donor Month, which has the purpose of educating the public about blood donation.