This is the final installment in a three-part series on the physical properties of blood, and the spiritual truths those properties may illumine. In the article, which originally appeared in the March 18, 1983, issue of Christianity Today, Paul Brand reflects on the startling blood transfusion that inspired him to become a surgeon. Brand's provocative thoughts were gathered by writer Philip Yancey.
My entire career in medicine traces back to one dreary night at Connaught Hospital in East London. Until then I had stubbornly resisted all family pressures to enter medical school. Instead, I had entered the building trade, apprenticing as a carpenter, a mason, a painter, and a bricklayer.
My goal was to use these skills back in India. Evening classes in civil engineering had exposed me to the theories behind construction. One obstacle to my return to India remained: the mission required a one-year course in hygiene and tropical medicine at Livingstone College. I was assigned to a local hospital to do dressings in the wards and to learn basic principles of diagnosis and treatment.
It was during one evening of my stint at Connaught that my whole view of medicine—and of blood—permanently shifted. Hospital orderlies wheeled a beautiful young woman into my ward. She had lost much blood in an accident. It had drained from her skin, leaving her an unearthly pale color, and her oxygen-starved brain had shut down into an unconscious mode.
The hospital staff lurched into their controlled-panic response to any patient near death. A nurse dashed down a corridor for a blood transfusion bottle while a doctor fumbled with the apparatus to get the transfusion going. Another doctor, seeing my white coat, thrust a blood pressure cuff at me. Fortunately, I was trained to read pulse and blood pressure, but I could not detect the faintest flicker of a pulse on her cold, limp wrist.
She looked like a waxwork madonna or an alabaster saint in a cathedral. Her lips, too, were pallid, and as the doctor searched her chest with his stethoscope I noticed that even the nipple of her small breast was white. Only a few freckles stood out against her pallor. She did not seem to be breathing, having long before passed through the desperate phase of heaving breathing. I felt sure she was dead.
The nurse arrived with a bottle of blood, which she buckled into a high metal stand as the doctor punctured the woman's vein with a large needle. They had mounted the bottle high and were using an extra-long tube so that the increase in pressure would push the blood into her body faster. The staff told me to keep watch over the emptying bottle while they scurried off for more blood.
Nothing in my memory can compare to the excitement of what happened text. Certainly the precise details of that scene remain vividly with me to this lay. As I nervously held her wrist while the others were gone, suddenly I could teel the faintest press of a pulse. Or was it my own pulse? I searched again—it was there, barely perceptible but regular, at least. The next bottle of blood arrived and was quickly connected. A spot of pink appeared on her cheek, and spread into a beautiful flush. Her lips darkened pink, then red, and her body quivered in a kind of sighing breath.
Then her eyelids fluttered lightly and at last parted. She squinted at first, as her pupils adjusted to the bright lights of the room, and at last she looked directly at me. To my enormous surprise, in a very short time she spoke, asking for water. That young woman entered my life for only an hour or so, but the experience left me utterly changed. I had seen a miracle: the creation of Eve when breath entered into and animated her body, the raising of Lazarus. If medicine, if blood could do this . . .
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.
In most cases, a whole tribe of relatives would accompany a patient facing major surgery. There was never a lack of family to consult with, and conferences usually required translation into a local dialect.
I remember the case of one 12-year-old girl when Reeve informed the family that the patient had a very bad lung. To save her life it must be removed, he continued, as the family members nodded with appropriate gravity. The surgery required at least three pints of blood, and we had only one, so the family must donate two more. At that news, the family elders huddled together, then announced a willingness to pay for the additional pints.
I watched Reeve flush red at their response. The veins in his neck began to bulge, and his shining bald head was an excellent index of how much patience he had left. Working to control his voice, he explained that we had no other source of blood—it could not be purchased. They might as well take the girl home and let her die. Back to the conference. After more lively discussion the elders emerged with a great concession. They pushed forward a frail old woman weighing perhaps 95 pounds, the smallest and weakest of the tribe. The family has decided to offer her as a transfusion donor, they reported. We could bleed her.
Reeve fixed a stare on the sleek, well-fed men who had made the decision and then his anger took over. The bald spot atop his head turned blazing red. In halting but more-than-expressive Tamil he blasted the dozen or so cowering family members. Few could understand his American accent, but everyone nearby caught the force of his torrent of words as he jabbed his finger back and forth from the husky men to the frail woman.
Finally, with a melodramatic flourish, Reeve rolled up his own sleeves and called over to me, "Come on, Paul—I can't stand this! I won't let that poor girl die just because of these cowardly fellows. Bring the needle and bottle and take my blood." The family fell silent like birds before an eclipse, and watched in awe as I dutifully fastened a cuff around Reeve's upper arm, swabbed the skin, and plunged the needle into his vein. A rich red fountain spurted into the bottle and a great "Ahhh!" rustled through the family and spectators.
At once there was a great babel of voices. "Look, the sahib doctor is giving his own life!" Onlookers called out shame on the family for allowing the great doctor to give himself in the presence of so many kin. With a well-rehearsed tone I would reinforce dramas such as this one by warning Reeve that he had better not give too much this time because he had given blood last week and the week before. "You will be too weak to do the operation!" I cried.
Usually in such cases the family got the message. Before the bottle was half-full, two or three would come forward and I would stop Reeve's donation and take their trembling, outstretched arms. Ultimately I had to end the dramatic procedure Reeve had developed because, although he never donated much blood at one time, he gave with such regularity that his blood-forming cells strained to keep up. Nevertheless, his reputation spread: if the family refused blood, the great doctor himself would give his own.
As I ponderthe ancient symbolism behind the word blood in the Christian religion, especially as suggested in Jesus' statements, I keep returning to the relatively modern procedure of blood transfusion. Obviously, Jesus and the biblical authors did not envision a Red Cross blood supply depot when they used the term. And yet something about the image expresses for me the deep and sacred meaning behind. the Christian symbolism. The waxlike madonna in Connaught Hospital resurrecting before my eyes while elsewhere an Essex builder climbs another scaffold, oblivious; an Indian teenager, waiting with her chest heaving while family members debate who should spill their lives—these are the images of shared blood that hold most meaning for me today. It would not surprise me at all were Jesus, if born in the twentieth century rather than the first, to choose the image of transfusion rather than a parallel one of drinking blood.
When Jesus invited us to drink his blood, to take the cup that is the new covenant of his blood, he invited us to share in the rich resources of his ongoing life. While a blood transfusion procedure certainly does not describe the theological process of the Eucharist, it does help reveal the meaning behind the symbol. Indeed, who can describe the process by which his body and blood become a part of our own? Theologians have tried without agreement for centuries.
The Lord's Supper is a celebration of the new intimacy won for us by the blood of Christ. We are made near to him; we participate in him; he feeds us—any phrase only hints at the mystery. Jesus used the analogy of a branch attached to a vine; the image of blood transfusion speaks most forcefully to me. As a branch separated from a vine withers away, so also a limb severed from the blood supply quickly atrophies and becomes gangrenous.
Blood feeds life. The Lord's Supper loins together the diverse cells of his body with his river of life. Every cell is inked, unified, and bathed by the nutrients of a common source. Herbert Spencer expressed the scientific principle: Whatever amount of power an organism expends in any form equals the power that was taken into it from without. George Macdonald expressed the spiritual principle: "He requires of us what we cannot effect without Him."
Some have asked, "The meaning, yes; but why the ceremony? Why must we repeat this ritual?" Robert Farrar Capon answers such an objection against formality with his own questions. "Why go to a party, when you can drink by yourself? Why kiss your wife, when you both know you love her? Why tell great jokes to old friends who've heard them before? Why take your daughter to lunch on her birthday, when you're going to have supper together anyway?" The real question, Capon concludes, is, "Why be human?"
Sit down sometime and read through the Old Testament Books of Leviticus, Numbers, and Deuteronomy. Imagine yourself obligated to fulfill every requirement of the Law, with scrupulous attention to each rubric of worship. And then consider that Jesus left only two ordinances for us to follow: baptism, a one-time act, and the Lord's Supper, or Eucharist.
Each ordinance manifests a common theme of personal, intimate union with God. In one, a representative of God physically brings you in contact with water as a purifying symbol of new life. In the other, each person, one by one, pauses to ingest the bread and wine, the body and blood of Jesus. Under the old covenant, worshipers brought the sacrifice-they gave. In the new, believers receive tokens of the finished work of the risen Christ. "My body, which was broken for you . … My blood, which was shed for you . …" In that phrase, Jesus spans the distance from Jerusalem to our town, cuts across the years separating his time from ours.
When we come to the table we come pale, with light breath, a weakened pulse. We live in a world far from God, and we find ourselves doubting during the week. We muddle along with our weaknesses, our repeated failings, our unconquerable sins, our aches and pains. In that condition, bruised and pale, we are invited by Christ to his table to celebrate life. We experience the gracious flow of his forgiveness and love and healing—a murmur to us that we are accepted and made alive, transfused.
"I am the Living One," Christ said to the awestruck apostle John in a vision. "I was dead, and behold I am alive for ever and ever!" (Rev. 1:18). The Lord's Supper sums up all three tenses: the life that was and died for us, the life that is and lives in us, and the life that will be and will come for us. It offers a personal participation in the timelessness of God's provision for man. In the experience of Eucharist, I focus on transfused life, not on death.
Jesus Christ did not convey himself through writing. Nor did he convey himself genetically; if he had, his offspring would have been one-half Christ, one-fourth Christ, one-sixteenth Christ, until today when faint evidence of his bloodline would remain. Rather, he conveys himself personally, nutritiously, offering to each one of us the power of his own resurrected life. No other New Testament image—shepherd, building, bride—expresses the concept of "Christ in us" so well.
Recall the words that scandalized his followers: "Whoever eats my flesh and drinks my blood has eternal life, and I will raise him up at the last day. For my flesh is real food and my blood is real drink. Whoever eats my flesh and drinks my blood remains in me, and I in him. Just as the living Father sent me and I live because of the Father, so the one who feeds on me will live because of me" (John 6:54-57). He is real food, and real drink. The Anglican priest and poet George Herbert expressed this in "The Agonie":
Who know not Love, let him assay
And taste the juice, which on the cross a pike
Did set again abroach; then let him say
If ever he did taste the life.
Love is that liquor sweet and most divine,
Which my God feels as blood; but 1, as wine.
This article originally appeared in the March 18, 1983, issue of Christianity Today. At the time, Brand was the head of rehabilitation at the U.S. Public Health Service leprosy hospital in Carville, Louisiana. The article is adapted from the book In His Image.
Other stories appearing on our site today:
Noted Surgeon and Author Paul Brand Dies at Age 89 | Connected his pioneering work with leprosy and his missionary faith.
Blood, Part 1: The Miracle of Cleansing | We moderns are repelled by the thought of blood cleansing, but biologically and spiritually the precious liquid does exactly that. (February 18, 1983)
Blood, Part 2: The Miracle of Life | A well-known surgeon talks about that miraculous red river within us as an emblem of life. (March 4, 1983)
God's Astounding Laws of Nature | "I like to think of God as developing his skills," said Dr. Paul Brand. Interviewed by Philip Yancey (December 1, 1978)
A Surgeon's View of Divine Healing | Do doctors waste their time by doing slowly and painstakingly what could have been done in the twinkling of an eye? (November 25, 1983)
The Scars of Easter | He knows the wounds of humanity. His hands prove it. (April 5, 1985)
A Handful of Mud | Soil is life. Can we preserve it for future generations? (April 16, 1985)