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I picked up the empty glass bottle, with traces of blood still smearing its side, and read the label. Who had given these pints of life? Later, I looked up its source in our registry. I discovered the donor lived in Seven Kings, Essex, a town where I had worked in a building construction firm. My eyes closed and I thought of a burly workman from that blue-collar neighborhood. As he climbed ladders or laid bricks, exuding strength and vigor, did he know about the trembling young woman being revived by his own blood cells miles away? How many others in Seven Kings and Ilford and Stratford would live because of this one man's donations?

In all of medicine, a blood transfusion is probably the purest example of shared health. Watching its effect transformed me. By the time I finished my year at Livingstone College I was incurably in love with medicine. With some shame at my vacillation, but drawn by a compelling inner sense, I entered medical school.

Twelve years later, with medical and surgical training behind me, I found myself back in India, in a culture that still reacted with fear and revulsion to the idea of mixing one person's blood with another's.

I arrived as an orthopedic surgeon at the Christian Medical College in Vellore just as the college was recruiting specialists from all over the world. Among these was Reeve Betts from the Lahey Clinic in Boston, who was to become the father of thoracic (chest) surgery for all of India. Betts immediately ran up against a roadblock: the lack of a blood bank. In our surgeries we had been relying on a ferry-rigged device that suctioned out and recycled the patient's own blood. But chest surgery required a prepared supply of 5 to 10 pints of blood, which in turn entailed an efficient collection and storage procedure. Reeve Betts had the experience and skill to save the lives of patients who began streaming to him from all over India, but he could do nothing without blood.

In 1949, a blood bank thus became my number-one priority. I had to learn the skills needed for typing, crossmatching, and screening donors for health problems. We had to develop ways to provide pyrogen-free water and to sterilize all our reusable equipment (India, wisely, did not know the word "disposable").

Time after time we suffered heartbreak when a transfusion intended to bring health instead damaged the patient; somewhere along the line the blood had become contaminated or was not a perfect match. Those accustomed to the smooth efficiency of blood banks today should pause and be thankful for the pioneers who tackled the many hazards of the transfusion process. In the hot, dusty atmosphere of Vellore, with so many people afflicted with parasites or a hidden virus of hepatitis, we had to struggle constantly to make our system foolproof.

Indian people themselves offered the biggest challenge. To them, blood is life, and who can tolerate the thought of giving up lifeblood, even to save someone else? I have vivid memories of a scene that transpired again and again in Vellore as Reeve collided with ancient prejudices. To begin with, Reeve had little sympathy for the endless questions and discussions involved in an Indian joint-family system. "How could anyone not give blood to save his own child?" he would mutter darkly after emerging from a lengthy family council called to discuss the need.

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July (Web-only) 2003, Vol. 47