Catalogue


Blood : an epic history of medicine and commerce /
Douglas Starr.
edition
1st ed.
imprint
New York : Alfred A. Knopf, 1998.
description
xv, 441 p. : ill. ; 24 cm.
ISBN
067941875X (alk. paper)
format(s)
Book
Holdings
Subjects
More Details
imprint
New York : Alfred A. Knopf, 1998.
isbn
067941875X (alk. paper)
catalogue key
2287398
 
Includes bibliographical references (p. [357]-414) and index.
A Look Inside
About the Author
Author Affiliation
Douglas Starr is an associate professor of Journalism and codirector of the Graduate Program in Science Journalism at Boston University.
Awards
This item was nominated for the following awards:
Excerpts
Excerpt from Book
The drama ended, as do so many these days, in a courtroom. This particular chamber was long and low-ceilinged, with a wide dais at its front for the eight black-robed judges. Each of the four defendants sat flanked by tall policemen who gazed impassively from under the brims of their trademark pillbox hats. In keeping with the formality of French courts, the prosecuting and defense attorneys wore flowing black robes, which would dramatically sweep behind them as they rose to make a point. The only visible flaw in the decorum appeared among the audience members, some of whom wore T-shirts bearing inflammatory slogans. There were audible exceptions to decorum as well, as people would moan or shout "Non!" at a defendant's response, or when one man, the most vocal of the plaintiffs, would, as his doctor walked past, loudly hiss "Assassin!" The plaintiffs in this trial were dying of AIDS. They charged that they had been infected through the negligence of the defendants--high officials in the French national transfusion service. In France, where the government until recently held a monopoly on blood and its derivatives, these men were supposed to ensure the safety of blood products. Instead, they allowed thousands of the nation's hemophiliacs to inject blood-derived clotting factors they knew to be contaminated. The defendants had done so because of a complicated mixture of paternalism, economics, and to some extent the limits of science, but the victims saw the incident more starkly. To them the affair was a matter of betrayal. The doctors on trial in the summer of 1992 were supposed to have embodied all that was noble in the French transfusion tradition--altruism, medicine, business, and technology. Instead, during the years of the "contaminated-blood affair" they came to symbolize the cynicism and expediency of a money-driven age. The sense of betrayal surfaced in many places beyond the courtroom in Paris. For more than a decade the theme has been sounded in one locale after another throughout the world. In America, patients have filed hundreds of civil suits against doctors, drug companies, and even their own patient organizations, for abandoning their health to the expediency of the marketplace. In England, AIDS-infected hemophilia patients castigated their national transfusion service with reacting too slowly to the threat of emerging viruses. In Japan, patients charged that the government and drug companies criminally concealed the contamination of blood products; as a result, some of the nation's most revered doctors have gone to jail. In Canada, the scandal of contamination spread so wide that the government held a series of hearings across the country that convulsed the nation with anger and shame. Why those scandals erupted is one of the underlying questions of this book, a history of human blood as a resource and humanity's attempts to understand and exploit it. Blood is one of the world's most vital medical commodities: The liquid and its derivatives save millions of lives every year. Yet blood is a complex resource not completely understood, easily contaminated, and bearing more than its share of cultural baggage. Indeed, the mythic and moral symbolism of blood, which has been with us since ancient times, subtly endures. It clouded professional judgments and public perceptions in the AIDS scandals of France, Canada, and Japan, among others. If one considers blood a natural resource, then it must certainly rank among the world's most precious liquids. A barrel of crude oil, for example, sells for about $13 at this writing. The same quantity of whole blood, in its "crude" state, would sell for more than $20,000. Crude oil, as we know, can be broken down into several derivatives, including gasoline, distillates such as diesel, and petrochemicals. Blood can be separated into derivatives as well. Spun in a centrifuge, it divides into layer
First Chapter
The drama ended, as do so many these days, in a courtroom. This particular chamber was long and low-ceilinged, with a wide dais at its front for the eight black-robed judges. Each of the four defendants sat flanked by tall policemen who gazed impassively from under the brims of their trademark pillbox hats. In keeping with the formality of French courts, the prosecuting and defense attorneys wore flowing black robes, which would dramatically sweep behind them as they rose to make a point. The only visible flaw in the decorum appeared among the audience members, some of whom wore T-shirts bearing inflammatory slogans. There were audible exceptions to decorum as well, as people would moan or shout "Non!" at a defendant's response, or when one man, the most vocal of the plaintiffs, would, as his doctor walked past, loudly hiss "Assassin!" The plaintiffs in this trial were dying of AIDS. They charged that they had been infected through the negligence of the defendants--high officials in the French national transfusion service. In France, where the government until recently held a monopoly on blood and its derivatives, these men were supposed to ensure the safety of blood products. Instead, they allowed thousands of the nation's hemophiliacs to inject blood-derived clotting factors they knew to be contaminated. The defendants had done so because of a complicated mixture of paternalism, economics, and to some extent the limits of science, but the victims saw the incident more starkly. To them the affair was a matter of betrayal. The doctors on trial in the summer of 1992 were supposed to have embodied all that was noble in the French transfusion tradition--altruism, medicine, business, and technology. Instead, during the years of the "contaminated-blood affair" they came to symbolize the cynicism and expediency of a money-driven age. The sense of betrayal surfaced in many places beyond the courtroom in Paris. For more than a decade the theme has been sounded in one locale after another throughout the world. In America, patients have filed hundreds of civil suits against doctors, drug companies, and even their own patient organizations, for abandoning their health to the expediency of the marketplace. In England, AIDS-infected hemophilia patients castigated their national transfusion service with reacting too slowly to the threat of emerging viruses. In Japan, patients charged that the government and drug companies criminally concealed the contamination of blood products; as a result, some of the nation's most revered doctors have gone to jail. In Canada, the scandal of contamination spread so wide that the government held a series of hearings across the country that convulsed the nation with anger and shame. Why those scandals erupted is one of the underlying questions of this book, a history of human blood as a resource and humanity's attempts to understand and exploit it. Blood is one of the world's most vital medical commodities: The liquid and its derivatives save millions of lives every year. Yet blood is a complex resource not completely understood, easily contaminated, and bearing more than its share of cultural baggage. Indeed, the mythic and moral symbolism of blood, which has been with us since ancient times, subtly endures. It clouded professional judgments and public perceptions in the AIDS scandals of France, Canada, and Japan, among others. If one considers blood a natural resource, then it must certainly rank among the world's most precious liquids. A barrel of crude oil, for example, sells for about $13 at this writing. The same quantity of whole blood, in its "crude" state, would sell for more than $20,000. Crude oil, as we know, can be broken down into several derivatives, including gasoline, distillates such as diesel, and petrochemicals. Blood can be separated into derivatives as well. Spun in a centrifuge, it divides into layer
Full Text Reviews
Appeared in Library Journal on 1998-08:
At first glance, a lengthy book about blood might appear boring, even ghoulish. In reality, this book is totally fascinating. Using information gleaned from hundreds of interviews and extensive written documentation, Starr (science journalism, Boston Univ.) discusses how blood has evolved from a mystical force into a highly valuable commercial service. A significant portion of the book describes the impact of blood transfusion techniques learned during World War II. Also given considerable attention are the political and economic factors surrounding blood screening during the early years of AIDS and how the decisions surrounding these issues affected blood recipients, particularly hemophiliacs. The global aspect of the blood industry is considered throughout with lengthy comparisons on the status of blood research in other countries, particularly France, Japan and Britain. The lack of technical jargon makes the book easily understandable to nonscientific readers. Highly recommended for any public or academic health science collection.‘Tina Neville, Univ. of South Florida, St. Petersburg Lib. (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Appeared in Publishers Weekly on 1998-07-31:
The codirector of Boston University's graduate program in science journalism shows how it's done in this exemplary study of the role that blood has played in human affairs. Although Starr begins the story centuries ago, he concentrates on modern times. Throughout his coverage, information about advances in biology and physiology is introduced as needed, often enabling the reader to share in the excitement of scientific discovery. But this book is about much more than just biology. The politics of blood play a central role, from our race with the Germans during the Second World War to develop a system to enable battlefield transfusions to the squabbling and animosity present among the various blood collection agencies in the U.S. As Starr makes clear, as the global traffic in blood and blood products has expanded into a multibillion-dollar operation, the financial bottom line has begun to outweigh the importance of medical benefits. In riveting fashion, Starr explains how business practices enabled the AIDS virus to permeate the world's blood supply, leading to thousands of unnecessary deaths, particularly among hemophiliacs. Truly frightening are tales of the harvesting of blood and plasma from indigent and unhealthy third-world natives and the unwillingness of governments, third- and first-world alike, to take action to protect their citizens. Clear-eyed and wrought with superb attention to detail, this is first-class science writing, with a striking message. 16 pages of photos, not seen by PW. (Sept.) (c) Copyright PWxyz, LLC. All rights reserved
Appeared in Choice on 1999-03-01:
Starr's thoroughly absorbing and original tale, written in lively, accessible prose, traces the story of blood from ancient times--when it carried symbolic and magical connotations--to the 20th century, when blood, now recognized as a biological constituent, became "one of the world's most vital medical commodities." Always a part of the human conceptualization of health and vitality, from the early Greeks through the 19th century, blood was regarded as an essential component of salubrious balance. Bloodletting, a practice for 2,500 years, was common in Western, Arabic, and Indian medicine as treatment for illness and psychic malaise. Yet, not until the start of the 20th century did blood became the focus of medical research, regarded as an element of human anatomy, and only then did its life-saving attributes become therapeutically available. Starr describes the evolution of blood transfusion technology and the recognition of blood types, plasma, and gamma globulin; blood preservation, the development of blood banks, and how blood became a critical determinant of the Allied victory in WW II; the corruption of the blood supply in the 1970s and '80s as blood, traded on an international free market, became a source of hepatitis and AIDS, and how these diseases ravaged the hemophiliac community, dependent on frequent blood transfusions for life-saving blood clotting. All levels. J. P. Brickman; United States Merchant Marine Academy
Reviews
This item was reviewed in:
Publishers Weekly, July 1998
Booklist, August 1998
Kirkus Reviews, August 1998
Library Journal, August 1998
New York Times Book Review, December 1998
Library Journal, January 1999
Choice, March 1999
To find out how to look for other reviews, please see our guides to finding book reviews in the Sciences or Social Sciences and Humanities.
Summaries
Main Description
Essence and emblem of life--feared, revered, mythologized, and used in magic and medicine from earliest times--human blood is now the center of a huge, secretive, and often dangerous worldwide commerce. It is a commerce whose impact upon humanity rivals that of any other business--millions of lives have been saved by blood and its various derivatives, and tens of thousands of lives have been lost. Douglas Starr tells how this came to be, in a sweeping history that ranges through the centuries. With the dawn of science, blood came to be seen as a component of human anatomy, capable of being isolated, studied, used. Starr describes the first documented transfusion: In the seventeenth century, one of Louis XIV's court physicians transfers the blood of a calf into a madman to "cure" him. At the turn of the twentieth century a young researcher in Vienna identifies the basic blood groups, taking the first step toward successful transfusion. Then a New York doctor finds a way to stop blood from clotting, thereby making all transfusion possible. In the 1930s, a Russian physician, in grisly improvisation, successfully uses cadaver blood to help living patients--and realizes that blood can be stored. The first blood bank is soon operating in Chicago. During World War II, researchers, driven by battlefield needs, break down blood into usable components that are more easily stored and transported. This "fractionation" process--accomplished by a Harvard team--produces a host of pharmaceuticals, setting the stage for the global marketplace to come. Plasma, precisely because it can be made into long-lasting drugs, is shipped and traded for profit; today it is a $5 billion business. The author recounts the tragic spread of AIDS through the distribution of contaminated blood products, and describes why and how related scandals have erupted around the world. Finally, he looks at the latest attempts to make artificial blood. Douglas Starr has written a groundbreaking book that tackles a subject of universal and urgent importance and explores the perils and promises that lie ahead.
Table of Contents
Prefacep. xi
Blood Magic
The Blood of a Gentle Calfp. 3
"There Is No Remedy As Miraculous As Bleeding"p. 17
A Strange Agglutinationp. 31
Blood Wars
Blood on the Hoofp. 53
Prelude to a Blood Bathp. 72
War Beginsp. 88
Blood Cracks like Oilp. 101
Blood at the Frontp. 122
Blood Money
Dr. Naitop. 147
Dr. Cohnp. 163
The Blood Boomp. 186
Bad Bloodp. 207
Wildcat Daysp. 231
The Blood-Services Complexp. 250
Outbreakp. 266
"All Our Lots Are Contaminated"p. 299
Judgmentp. 322
Epilogue: Blood in a Post-AIDS Societyp. 345
Notesp. 357
Acknowledgmentsp. 415
Indexp. 419
Table of Contents provided by Syndetics. All Rights Reserved.

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