Blood by Lawrence Hill

after operation in the hope of making herself beautiful.
    As I became transfixed by Truth and Beauty , I found myself rooting for Grealy in her early struggles to create a new face, but cringing when she appeared to indulge an increasingly dangerous vanity. I may have been too quick to weigh necessity and vanity, but I suspect that many others do the same. Perhaps this informs our own judgements about how we modify our own bodies — including our blood. Perhaps we are far too quick to qualify some interventions as right, and others as wrong.
    As Patchett implies in her memoir, when we adjust our outward appearance by means of surgeries and injections, we are generally aiming to enhance our beauty. We believe that this will put us on the path to personal or social gain. Although we don’t put it in the same category as plastic surgery, we also aim to enhance something about ourselves — our health, our strength, our endurance — when we change the nature of our blood. This reflects the notion of truth in Patchett’s title. The truth is very much at issue when we play with our blood, because many adjustments to our blood are secret, illicit, and violate laws or social rules.
    THE USE OF HUMAN EMBRYONIC STEM CELLS has generated years of controversy. Some consider it to be legitimate medical practice and scientific research; others say it violates human life or usurps a role best left to God. Like abortion, the creation of stem cells from human embryos — the early stirring of life after conception — incites heated debate about right and wrong. Before examining the issue, let’s consider what stem cells are and why they are useful.
    The bone marrow is the home of hematopoietic stem cells, immature cells that generate all other blood cells. If your stem cells don’t work, or if they have been damaged as a result of radiation or chemotherapy, you may need a bone marrow transplant — carried out by means of blood transfusions — to stay alive. According to the National Institutes of Health, some medical conditions that might require such a transplant are leukemia, lymphoma, sickle-cell anemia, and severe immunodeficiency syndromes. Leukemia, by way of example, is a cancer of the blood or bone marrow, accompanied by an overgrowth of white blood cells (leukocytes) that crowd the bone marrow and impede it from functioning properly.
    There are two ways to obtain donations for bone marrow transplants for people suffering from leukemia. The stem cells can be taken from the blood of another patient with a matching blood type. Or they can be harvested from the blood of the umbilical cord of a baby right after birth, and frozen until ready for use.
    The donated stem cells enter the body of the patient by moving into the blood through a venous catheter, much like an ordinary blood transfusion. Miraculously, donated stem cells know how to navigate through the bloodstream and find their way into the bone marrow. It is a complicated and risky procedure. The donor’s bone marrow, if not a good match, could perceive the body of the patient as foreign, and attack it. This is called graft-versus-host disease, and it can be fatal. Conversely, the patient’s body might attack and destroy the donated bone marrow. This is called graft rejection. Infections are another serious risk. If the transplant is to succeed, the patient is likely to require antibiotics and multiple blood transfusions. The patient can feel acutely ill for weeks, and a full recovery can take six or more months. But by the time the process is over, the patient has a new system of blood and marrow.
    Imagine a doctor going back in time and telling a bloodletter in 500 CE that one day, it would be possible to entirely replace a sick person’s blood, as well as the spongy material inside big bones that generates the blood cells. Imagine telling Hippocrates that if a person’s blood is failing, then it will be possible to replace