"You should think it over - you'd feel so much better if you took a transfusion."
My patient lay in her hospital bed, head at the proper thirty degrees of comfort, staring at some private point on the wall across the room. Her anemia had worsened and I couldn't tell if it was from the effects of cancer or of chemotherapy. It didn't really matter since the treatment was the same: two half-liter units of merlot-colored blood, courtesy of a pair of anonymous angels of mercy, also known as donors.
"I really don't want to do that."
"You don't have to, but getting two bags of blood will help your fatigue and tiredness."
"Yes, but how do I know I've got good blood?"
"How do you know you've got good blood? You mean is the blood safe?"
Her eyes met mine. "I mean, have I got the right kind of blood for this?"
I recalled what she had shared with me during our first visit, about how she had spent forty years working with school children while raising her daughters. She possessed an aura that reminded me of walking through summer meadows, but until today its source was unclear. As she fussed with her blanket I suddenly seemed to see behind her hardened voice. Here was a woman who had spent her life giving to others, who never showed up late nor petulant, a wife and a mother, an independent soul who now was forced to ask for mercy from a disease that harvested the living like a scythe. I still wasn't sure what she meant but answered her with a smile.
"You've got great blood - you worked your whole life to earn it. You know, you're my role model on how to live courageously. I can see the strength flowing through those veins.
"You've got the right kind of blood all right, and I'll remember that whenever I think that mine is faltering."
That could be (but isn't) my mom; first it was the chemo that knocked off her RBCs... this go-around, it's the damned disease itself. My mother, the woman who wouldn't eat a medium-well steak if she were starving to death ("It's *BLOODY!*"), who makes meatloaf wearing rubber dishwashing gloves ("It's *BLOODY*!") and who would let her only child exsanguinate before so much as looking at the spillage from a battle with recurrent epistaxis ("It's *BLOODY*!") finds herself in a hospital bed, hooked up to a bag of something a lot rarer than my last steak. The last time, the nurse offered a kind of knitted HemeCozy to hide the gore. Mom demurred, saying she didn't mind. I know better.
I wish I could just give her some of mine. It's rich in fats and glucose, loaded with more iron than Detroit's finest. But we don't match; never have, on so many levels, not the least of which being antibodies. Nobody else wants it. I can't be that angel for anybody.
What I can do is be thankful - for those angels who do bear the brunt of getting poked by needles and dripping like so many pounds of defrosting hamburger, in exchange for a thank-you, some Tang and a cookie.
I hated the blood. Of everything, it is still the thing that I shudder most at when I remember. I hated that I felt bad and that I needed it. I hated to take it in the summer when the supply was low, and there might be someone who was otherwise healthy but needed it because of an accident. I hated that I could taste it for days and days afterward when it flowed through my port. I hated the feeling of having someone else's cells flowing through the center of me, as if it were some sort of violation of the core of my being. And still, reading your account, I can't imagine what your patient was talking about.