Confessions of a Donor

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Why Why do I do this? Stop! Breathe deeply deeply. Savor that that scent. It is the smell of life! I forget how how honored honored I am To stand stand so close to it. Reprint no. 47/1/53855

Address for reprints: Major Lee ABMT Lee EPayne, E Payne,MD, MD, ABMT Division Acute Care/PSA Division of Acute Care/PSA Wilford Wilferd Hall Hall Medical Medical Center Center

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Confessions Confessions of of a Donor Donor [Wrenn Ann Emerg April [Wrenn K: K: Confessions Confessions of adonor. a donor. Ann EmergMed MedApril 1994;23:895-896.] 1994;23:895-896.] The overhead bright as I lie here on a overhead lights are a little too bright stretcher. Nevertheless, it's restful. People are speaking stretcher. Nevertheless, speaking quietly in the background, background, and and I hear hear the rustling, rustling, clicksporadic activity just ing noises of sporadic just outside my visual field, which portion of the ceiling which encompasses encompasses a portion ceiling of an auditoauditorium. pleasant interlude rium. It's a pleasant interlude in a hectic day day. Blood is draining draining from my right right arm. I grip a wad wad of paper rhythmically paper rhythmically every five to ten seconds seconds as instructed, instructed, presumably to increase the flow. I don't presumably don't want want to look. The nurse periodically checks nurse periodically checks and and tells me it's going OK with with a and that's pleasant Other people are lying in smile, and pleasant too. Other fairly close proximity, so I'm not alone. I hope hope my feet don't pretty close to another don't smell because they're pretty another fellow's head. head. When When I arrived arrived 30 30 minutes minutes ago, late and and harassed, harassed, the volunteer volunteer at the front made made me sit down down and and answer answer lots of bureaucratic bureaucratic questions birth date, social secuquestions about my birth number, and and so on, not not unlike unlike taking taking a deep breath breath rity number, basketball game. It before shooting shooting a free throw throw in a basketball slowed the pace and and set a more more leisurely tone. nurse who who took my blood pressure and Back to a nurse pressure and pulse. A prick and I watched watched a drop of blood prick on the finger and bottom of the blue liquid. sink lazily to the bottom liquid. A moment moment of anxiety anxiety. Was it too fast or slow? My hemoglobin hemoglobin must must personal have been been OK because she started started to ask very personal questions questions in the most most serious tone and and very quietly quietly. I had had

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to force myself to listen and and not not to giggle. She had had no trouble keeping keeping a straight straight face. I suspect suspect I blushed blushed even though though I've heard heard these questions questions before. Then Then more time to ponder ponder whether whether I really wanted wanted to go through through with with this. The final heavy question question had had been been broached: broached: Had Had I been truthful? truthful? Finally, I was allowed up onto onto a stretcher, stretcher, and and the nurse nurse with with the smile had had inspected inspected and and disinfected disinfected my right right antecubital antecubital fossa before I was fully settled in. with only slightly more more Frankly, I'm afraid of needles, but but with pain than prick," the needle was in pain than the advertised advertised "little prick," the vein. Now I'm lying here staring staring at the ceiling in a sort of trance, what meditation trance, very relaxed. This must must be what meditation is all about. I'm struck struck suddenly suddenly by the fact that that over the last few years, this act of giving blood has become my way of getting getting routine routine medical medical checkups. checkups. I've subconsciously increased but almost to increased my visits recently recently. I'm 42, not not old, but prostate the age where I'll need need sigmoidoscopy sigmoidoscopy and and prostate checks. Does the Red Cross do this? seemingly I am a physician, physician, but but I have no physician. physician. In seemingly good health pleasant denial, health or at least in a state of pleasant denial, I've not n o t seen the need need to find a regular regular doctor. Stupid? Stupid? Maybe, but I would unwilling to but would guess many many doctors are like me, unwilling subject ourselves to the regular probing we recommend regular probing recommend so blithely, especially by someone someone we know know (I mean mean really know). Some of us may be embarrassed to take up embarrassed up a colleague's time for less than than full compensation. compensation. On On the other other hand, patients, in my hand, while doctors may not not be very good patients, experience experience they don't don't get great care either. either. PhysicianPhysicianpatients are often the victims of assumptions. patients assumptions. In truth, truth, on one level, if I harbor harbor a really serious illness, I don't don't want want to know know about about it. Between reading reading about lead-time lead-time bias and and the side effects of medications, medications, taking taking a chance Nature doesn't seem so bad chance with with Mother Mother Nature bad to me. After all, there's always a subspecialist subspecialist at curbside curbside or the emergency emergency department department should should disaster disaster occur. Yet, I am beginning beginning to have niggling pains. niggling aches and and pains. Every time I see someone person someone with with a heart heart attack, that that person doesn't look that that different from me. Some are actually younger! On On the other other hand, hand, my genes are good, I don't smoke, I buckle up, up beef for fish or smoke, up, I occasionally pass up chicken, bladder haven't chicken, and and my my bowels and and bladder haven't failed me yet. How bad bad off could could I be? Well, I could have contracted contracted AIDS or hepatitis hepatitis unknowingly, since I work unknowingly, work in an ED. I know know the odds are but I still worry a bit that small, but that my my hepatocytes hepatocytes or lymbeing destroyed faster than phocytes are being than my neurons, neurons, which which seem recently to have accelerated accelerated their their drop-off. Also, there's my family to think think of.

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I'm ashamed ashamed to say that that I've used used the Red Cross. I don't don't give blood blood for purely purely benevolent benevolent or charitable charitable reasons. primary care provider provider by proxy. I The Red Cross is my primary pressure, pulse, and hemoglobin hemoglobin like to have my blood pressure, pulse, and checked checked every three to six months. months. I don't don't mind mind answeranswering the personal personal questions; questions; as a test, it's somehow somehow lifeaffirming juice. How affirming if you "pass." I even get cookies and and juice. many many doctors do this at an appointment? appointment? My family treats me a little nicer than than usual usual for 12 hours hours or so because I'm a little tired from giving blood. How different than than being being tired from work, which is never an excuse for anything. which anything. I who exercise religiously that that my love telling my friends who blood pressure and pulse were on the low side of normal normal pressure and despite my my more more sedentary sedentary lifestyle. It makes makes them them exermore zealously. cise even more I'm secretly relieved when not notified notified that when I'm not that I failed my HIV test or hepatitis hepatitis screen. I do get called occasionaloccasionally, ly, when when supplies supplies are low, to ask if I'd consider consider donating donating again. This makes makes me feel desirable or at least that that my blood is. It makes blood makes me feel good to help help someone someone in so tangible a way. Those of us who who are not not surgeons surgeons rarely get the chance chance to have an immediate immediate measurable measurable effect. There There it is, right right there in that that plump plump plastic bag. I'm even lowering lowering my ferritin and and possibly improving improving coronary odds, without without giving up up ice cream. cream. All this, my coronary and and it's essentially free. What What a deal! My only major major fear is that I might be embarrassed by fainting before I get to the that might embarrassed fainting cookie table. This hasn't hasn't happened happened yet. hope the Red Cross will forgive me, but but maybe by I hope publicizing the side benefits of giving blood a few more publicizing physicians, who physicians, who are otherwise otherwise too busy or hassled, hassled, will be drawn drawn in as donors. donors. I think think I'll leave the sigmoidoscopy question question alone for now. Maybe in a few more more years.... years . . . .

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Address for reprints: Keith KeithWrenn, Wrenn,MD MD Room Room1368. 1368,Emergency EmergencyDepartment Department Vanderbilt VanderbiltUniversity UniversityHospital Hospital Nashville, Nashville,TN TN 37232 37232 615-936-1157 615-936-1157 Fax Fax615-322-0138 616-322-0138

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