It Takes a Village

Too complicated — Maybe I should just buy the blood instead and store it? That would require spending something like $2K a week. That and the equipment would be a serious expense. And it would only help me: it would keep me ‘alive’ without giving me any reason to be. I can only truly live by enabling others to live.

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LANA

The US Army — accidentally provided a major part of the ‘ cave dialysis’ solution. Blood transfusion kits are not available at the local CVS, so even after getting the tubes, needles, pump, and bandages that seem to be required to make this work, you need someone that knows how a non-hospital transfusion setup would function. And would trust it enough to try it out. On themselves.

That person was Lana: a combat medic for the US Army discharged about a decade ago. And now homeless. Our country has a serious problem with taking care of people we put in harm’ s way after we are ‘done’ with their service.

Lana would sporadically visit my clinic instead of the VA (or nothing at all I assume), and I started driving her home shortly after she showed up. She happened to arrive very late, so I was always done for the day at about the same time as she was. During the drives I started bringing up her in-field medical activities. Recounting this was traumatic for her, but I believe it was also cathartic, and she did it because she wanted to and not because I influenced her.

Over the next couple weeks, I learned she had done many field blood transfusions and although not thrilled by them, was certainly comfortable with them. Venipuncture (putting a needle into a vein) and cannulation (creating a ‘canal’ for the blood to flow through) are simply skills with a high-degree of risk associated with them. Lana was good at them from a war-time of experience.

In theory I should have been good also, but that was both not true and irrelevant. Not true because I never had to do it myself and had not picked up the skill. And irrelevant because Lana had to trust the process, and she was always going to trust herself as a skilled medic than almost anyone else.

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We use ‘El Toro’ — as the first medical bay for our first transfusion attempt. It may seem strange to do a transfusion in a car, but this was a very large and comfortable vehicle. It also has extensive power supplies due to several Goal Zero lithium batteries and inverters within its trunk. Further, I made custom sanitary flooring, seat, and window covers. Finally, we parked the vehicle in the Stanford Hospital parking garage in case anything went terribly wrong. Calling 911 might provide a gurney to wheeled directly to our vehicle. We hoped it would be unnecessary or in record time if it was.

We happen to luck-out with our first attempt logistics because she uses her right arm for dialysis and I use my left: we can just connect the tubes between our two ‘biceps’ right-to-left. After getting the four 15-gauge needles in place, we unclamped the flow from her to me, and a few minutes (and a half-liter) later from me back to her. The flow meter measures about 100mL per minute through this diversion without the pump turned on. That means we will be sitting here for about 16 hours.

Lana can handle 400mL/m from her normal dialysis sessions, so we try that. Higher rates can be hard on a living heart and also cause a ‘dry zone’ between the two needles, and we were both used to 4 hour down time.

For the next four hours — we talk about the war, family, and life in general. She never asks what blood type I am or why ‘trading blood’ will help her and me. Somehow she has faith, but I am suspicious this is actually an influence side effect. I do not think I am steering her wrong, so I don’t offer any vampiric information.

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