Sheep and Goats

Category: Blood Transfusions

  • Blood Transfusion, Oxygen, and Nitric Oxide

     

    As if offering a pinch of incense to the gods, the article begins: “Blood transfusions have saved millions of lives.” But doesn’t the very next phrase almost douse the flame?

    “yet stored red cells may be less effective than hoped for because they can quickly lose much of their ability to deliver oxygen.”

    They can? They do? If so, blood transfusions haven’t saved as many lives as they are credited with, perhaps not any more than simple saline solution or any other fluid that aims only to replace lost volume. Jehovah’s Witnesses have no objection to the latter. They do, however, for religious reasons, decline the former. They are well known for refusing blood transfusions. 

    If I had a nickel for every news article or web post lambasting us for our transfusion stand….some going so far as to call it tantamount to murder….I could buy myself a Maserati. And another, even fancier car for my wife, Mrs. Sheepandgoats. Blood substitutes are no good, they scream at us, because only the real thing, only real packed red cells, delivers the life-saving oxygen to the body. Yet according to this article, they don’t!

    The problem is that transfused blood needs nitric oxide to keep the blood vessels open, otherwise, the carried oxygen never reaches the tissues. But nitric oxide begins to break down within three hours of storage, and donated blood is presently stored up to 42 days. To be sure, researchers think they can remedy the problem. But that does nothing to improve the effectiveness of blood transfusions already given, each one of which was hailed as “life-saving,” yet few of them actually qualifying as such, at least not any more so than saline solution, which offers no danger of rejection. We all know that the body spots foreign tissue in an instant, and tries hard to get rid of it.

    Oddly, there are two versions of this AP story by Randolph E Schmid. One leads with the butt-kissing “blood transfusions have saved millions of lives” and one doesn’t. I suspect Mr. Schmid, who is a science writer, did not include it. But somewhere along the line, some pious editor unable to tolerate the blood transfusion idol besmirched, added the phrase. Versions that have the phrase are here, here, and here. Versions that do not are here, here, and here. (I’ve included so many because some sources don’t archive their stories very long….I hope some of them survive.)

    All this reminds me of Bruce Spiess, addressing the Australian and New Zealand College of Anesthetists a few months ago. He declares blood transfusions have hurt more people than they’ve helped. Transfusions, he observes, are “almost a religion” because physicians practice them without solid evidence that they help. “Blood transfusion has evolved as a medical therapy and it’s never been tested like a major drug,” he said. “A drug is tested for safety and efficacy, blood transfusion has never been tested for either one.”

    Meanwhile, Jehovah’s Witnesses steadfastly refuse blood transfusions (for religious reasons, not medical) and have created hundreds of Hospital Liaison Committees composed of members who interact with local hospitals and doctors. As a result, some in the medical field have pioneered bloodless techniques. By eliminating the risk of foreign tissue, human error, and blood-borne diseases, these new techniques offer a safety margin that conventional blood transfusions do not. The film Knocking states there are over 140 medical centers in North America that offer some form of bloodless surgical techniques. Might the day come, or is it even here already, when the number of lives saved through such medicine will outnumber those lost by a few members of a relatively tiny religious group that stuck to its principles amidst much opposition?

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  • Isaac Asimov and Ignaz Semmelweis

    I once worked with a girl named Casey who positively loved science fiction. In the context of other things, I mentioned the film I, Robot.

    Oh, that was terrible! she said.

    But as we kept talking, it turned out she had never seen it. Um…Casey, how do know it's terrible if you've never seen it? I asked. The answer was that she was a purist. She knew the movie did not follow Isaac Asimov's storyline, and that was enough for her!

    For an Asimov purist, the movie would indeed be blasphemy. Asimov, who wrote almost all the time, having 500 books (written or edited) and 90,000 letters to his credit, with works in nine of the ten major categories of the Dewey Decimal system, penned the Foundation trilogy and the I, Robot series, both pillars among science fiction. His plotting was ingenious, and had he been able to empathetically sketch people as well as ideas, he might have gone down as one of literature's true greats. Alas, his characters are cardboard, like those TV characters who are freely interchangeable save for one or two superficial features: this one is mean, this one likes to eat, that one is a geek, etc. Too bad – for every other aspect of Asimov's writing is extraordinary.

    Asimov was an atheist, but I always imagine that, if current atheists had been taught the Bible by Jehovah's Witnesses instead of the churches, they may not have turned atheist. It's probably not so but I dream it anyway. For example, in his last autobiographical book, Asimov observes that hell is "the drooling dream of a sadist" crudely affixed to an all-merciful God; if even human governments were willing to curtail cruel and unusual punishments, wondered Asimov, why would punishment in the afterlife not be restricted to a limited term.  [Wikipedia entry on Isaac Asimov] Yeah! Man, I wish he had heard first from Jehovah's Witnesses! Virtually alone among Christian faiths at the turn of the last century, Jehovah's Witnesses exposed hellfire for the vicious rubbish that it is. JW "founder" C. T. Russell was known in his lifetime as the man who "turned the hose on hell and put out the fire!"

    At any rate, had he been a Witness, it would have benefited him personally. He died in 1992, of AIDS contracted from a blood transfusion nine years prior.

    Still, I am grateful to Dr. Asimov, not only for the hours of intriguing science fiction he laid upon me, but also for his non-fiction works. Asimov's Guide to Science probably was my springboard to individual branches of science. If Asimov lacked in sketching fictional characters, he was gifted in sketching real ones. Not only the pillars, but also the buffoons, he succeeded in portraying the humanity of scientists. It is from him (Asimov's guide to Biology) that I first read of Ignaz Semmelweis, early advocate of antiseptic surgical practices and forerunner of germ theory.

    In the mid 1800's, Semmelweis got it in his head that fever and death following doctor-assisted childbirth could be curtailed by washing hands and equipment frequently. Doctors back then would deliver a baby, having just emerged from an autopsy, only wiping their hands on their smocks! There were some sort of tiny "particles" contaminating the women, Semmelweis proposed. Doctors howled with laughter at such nonsense. Asimov's book vividly portrays Semmelweis' presenting his ideas at seminars, with his esteemed audience mocking him, hurling catcalls! Doctors argued that, even if Semmeweis' findings were correct, washing one's hands each time before treating a pregnant woman would be too much work. Semmelweis enforced strict antiseptic practices at the hospital under his supervision, cutting deaths to under 1%, and it made no difference in their attitude! Colleagues ridiculed him his entire life, he suffered a nervous breakdown and, says Asimov, died in an insane asylum tormented by memories of women screaming in their death-agonies following hospital-acquired infections. With Semmelweis out of the way, his own hospital went back to familiar practices and the mortality rate climbed to 35%.

    You can read the bare facts in many places, but Asimov's account is the most vivid I have come across, remarkable in a book that purports only to be an outline, a "guide."

    Whenever those atheists start prattling on about how scientists graciously change their views at the first hint they may be off-base, whereas it's only the pig-headed religionists who "stay the course" come hell or high water, I play the 'Semmelweis' card.

    Athiest or not, I miss Isaac Asimov.

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  • Life Saving and Life Threatening Blood Transfusions

    In all history, there's never been a JW detractor who's used the noun blood transfusion uncoupled to the adjective life-saving. Thus, from time to time we hear of so-and-so, who's health is in jeopardy because he refuses a life saving blood transfusion. Always, the message is the same: what kind of a crackpot religion would persuade its members to decline a life saving blood transfusion?

    But we now know that life-saving is the wrong term. The correct term is life-threatening. Bloodless medicine, where available, is usually the treatment of choice. Largely due to Jehovah's Witnesses, scores of medical centers exclusively devoted to bloodless surgery have cropped up in North America and worldwide.

    Everybody knows that blood is a foreign tissue, even when types match, and they also know that the body tries to reject foreign tissue. Suppress the immune system, and that creates other problems. Bloodless medicine avoids the issue, and is thus safer.

    The latest authority to weigh in is cardiothoracic specialist Bruce Spiess, addressing the Australian and New Zealand College of Anesthetists. (May 28, 2007) He declares blood transfusions have hurt more people than they've helped. Transfusions, he observes, are "almost a religion" because physicians practice them without solid evidence that they help. "Blood transfusion has evolved as a medical therapy and it's never been tested like a major drug," he said. "A drug is tested for safety and efficacy, blood transfusion has never been tested for either one."

    Hurt more people than they've helped! That's an incredible statement, given that transfusions are always given to help and frequently given in the belief that they are absolutely essential, life saving!

    He cites a Swedish study of 499 Jehovah's Witnesses which shows their survival rate after declining transfusions is higher than that of patients who received them. Such studies are becoming commonplace.

    He told the conference: "If you come to surgery, we should ethically treat every patient as if they were a Jehovah's Witness…."

    This "almost a religion" description squares with my own experience. Through the years, I've personally known three people who were told point blank, curtly and without the slightest empathy, that they would die without a transfusion. None of them agreed to one. None of them died. Alright, one did die years later, but she was in her 80's. I've never personally known anyone who was told they'd die without a transfusion and who actually did die. Mind you, I don't doubt there have been such ones. I've just never known any, whereas I have known three with the other outcome.

    My point is that the life-giving blood transfusion mantra is overstated. Partly this happens because, if a person dies after refusing a transfusion, the added blood that never was is always reported as the cause! It does not matter if the person passed through a veg-a-matic beforehand. If nobody ever died after receiving a life-saving blood transfusion, I'd be more moved. But as observed above, they die in greater numbers than those who refuse.

    Old habits die hard, in medicine and most other areas, due to inertia. The words of Max Planke the physicist are applicable:

    People think new truths are accepted when the proponents are able to convince the opponents. Instead, the opponents of the truth gradually die, and a new generation comes along who is familiar with the idea. 

    Over time, and almost entirely born from the organized efforts of Jehovah's Witnesses, bloodless medicine will spread, to the benefit of JWs and non-JWs alike.

    Watchtower has produced documentaries on what's being done today and why bloodless is safer. This documentary has won a few "film festival" awards. In other words, it is well done and not schlocky.

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    Tom Irregardless and Me    No Fake News but Plenty of Hogwash

  • Rebecca Did Recover

    News update: Rebecca did recover. She was seen on other shows. And the actress that portrayed her mama really was one of Jehovah’s Witnesses.

    This, of course, is Rebecca from The Practice, the lawyer TV show of last decade. She got caught in a bomb blast, you’ll recall, and ended up in the hospital, where doctors insisted she needed a blood transfusion. Only she wasn’t about to have one, because she was one of Jehovah’s Witnesses, who take seriously the Bible command to abstain from blood.  The Mama character materialized to give her moral support. But I had imagined that this was the last episode of the season, after which Rebecca landed another role in some other TV show, so that we were left in suspense as to whether or not she would recover. It turns out that she did.

    Well, that’s indeed good news, Tom Sheepandgoats, but how do we know your update is accurate? Why didn’t you give us the straight scoop to begin with? Do you realize how close you are to being accused of being a false prophet?

    Hard hitting, but fair questions.  Readers deserve an honest answer, not the kind of hogwash they usual….readers deserve an honest answer.

    My source is Keith, who used to watch The Practice every week; it was one of his favorite shows. It was one of mine too, but I still rarely saw it. So I would give it a 92% probability that the Rebecca newsflash is accurate. The remaining 8% is to cover the possibility that my source got confused by summer reruns. It can happen to the best of us.

    As for the Mama aspect of the story, the accuracy probability here is lower, perhaps 80%. My excellent source notwithstanding, this story smells a bit of JW folklore. Until I receive corroborating evidence, I put it in the same category as the John Denver story, (unfavorable to us),  the John Wayne story (favorable to us), and the Johnny Carson story (very favorable to us, and payback to John Denver).

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    Tom Irregardless and Me     No Fake News but Plenty of Hogwash

  • The Practice Gets it Right on Blood Transfusion

    When TV writes Jehovah’s Witnesses into the plot, look out! We get clobbered. It not malicious, usually. They just don’t have a clue as to what we’re about. Nor are the hatchet jobs confined  to us. Religious folk never fare well on TV. There’s just not that many TV writers with religious backgrounds out there and they can’t picture the other side. Not that they toss and turn at night worrying about it. It’s much easier to use caricatures and stereotypes.

    So I was blown away when an episode of The Practice episode featured Jehovah’s Witnesses and they got it right, and even, amazingly, treated us with dignity.

    Do you remember Rebecca the receptionist? Well, it turns out she is one of Jehovah’s Witnesses, though nobody knew it until she got caught in a bomb blast. And who would plant a bomb in the Practice’s office? This creepy psycho fellow, wasn’t he a former client? who’s been up to no good the past few episodes.

    Anyway, they rush Rebecca to the hospital, where doctors decide only a blood transfusion will save her! But, lo and behold, Mama, a hitherto unknown character, shows up and declares that daughter is a Jehovah’s Witness who’s very serious about her faith. She has affidavits from the congregation to back her up. Head lawyer Bobby will have none of it. Rebecca needs blood, doctors say, and Bobby’s going to see that she gets it!

    And so the stage is set for a drama that, incredibly, gets it right….mostly. We don’t come across as right-to-die extremists, nor death-wish martyrs. We aren’t doctor wannabes, telling medical personnel how to do their job. Our blood stand is Bible-based. Someone in the writing staff did some research. (for a change) Not absolute accuracy, but that's allowable, since no case is ever "typical," there’s always individual variation. We all have quirks.

    Now, it should be pointed out that in the real world such situations shouldn’t pop up too often. You don’t just spring Surprise! No blood! on your doctor. Ideally, JW’s speak to their doctors beforehand, in good times. Not all doctors are comfortable with the added challenge of bloodless medicine. It’s not right to broadside them. Not to mention the anesthesiologist, who often frets more than the surgeon.

    However, as mentioned, this was an emergency, brought on by a unabomber. They never wait for you to ask your doctor if bloodless medicine is right for you (and them).

    In court, Bobby doesn’t believe Rebecca’s a Witness. Jehovah’s Witnesses talk about their faith, he says. Rebecca never did. That’s a good point, Bobby. They do. But Mama has an answer. Rebecca, who is black, is so worn down by facing prejudice that she has learned to keep her mouth shut. Well…… maybe. It’s not impossible. Especially if you’re the poor girl from the humble background working for hot-shot TV lawyers! (though she always seemed to hold her own pretty well)

    What about blood cards? Bobby wants to know. Jehovah’s Witnesses carry blood cards. Rebecca didn’t have one. Right again, Bobby. They do. They’re called Medical Directives. Baptized witnesses have them. It’s odd Rebecca did not.

    In fact, I’d almost side with Bobby around now: that Rebecca is not really a Witness, and Mama’s just an imposter. But what about those affidavits?

    Lots of courtroom drama follows; The Practice could keep you riveted with courtroom drama. Bobby works himself into a frenzy. Rebecca can be saved, he charges at the bench, but…but for this….Voodoo religion! Mama calls him on it, and she never loses her cool. Yes, Bobby, you tipped your hand. This is not about respect for Rebecca’s conscience. This is about your own religious prejudice, pure and simple.

    The judge rules for Mama. I couldn’t believe it!

    Afterwards, no hard feelings. Indeed, there is respect, for Mama proved herself dignified and sound of mind. As if admitted to the bar, she and all the lawyers close the show around Rebecca’s bed, praying for recovery.

    The Rebecca actress must have received a better job offer that year, for they wrote her out of the plot. The transfusion episode was her last. Thus we don't know how she made out!

    Three videos are available from Jehovah’s Witnesses with regard to bloodless medicine. Click here to view them: (the 3rd, 4th, and 5th listings)

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    Tom Irregardless and Me     No Fake News but Plenty of Hogwash