By every standard medical and logical, Henry Jackson, lying unconscious in a New Jersey hospital on his 32nd birthday, was finished. Massive internal hemorrhaging had drained him of 90% of his blood. His level of hemoglobin--the vital, oxygen-carrying compound in his red cells--had plummeted from a normal reading of 13 to an ominous 1.7, a number that one of his doctors characterized as "incompatible with survival." A blood transfusion could save him, but his wife, torn between her husband's life and their beliefs as Jehovah's Witnesses--a religious community that prohibits transfusions because of biblical references to the sacredness of blood--had refused. Eventually, at the urging of members of her community, and in the face of a hospital threat of a court order to thwart her, Claudette Jackson had Henry transferred to nearby Englewood Hospital's New Jersey Institute for the Advancement of Bloodless Medicine and Surgery.
It was an understandable choice. The institute is the leader among more than 50 in the U.S. that now practice bloodless surgery. Without using any donor blood at all, they offer a wide range of surgical procedures that would ordinarily include transfusions, along with techniques that dramatically reduce, or virtually eliminate, blood loss.
When Jackson was wheeled into the institute, Dr. Aryeh Shander, chief of anesthesiology and critical-care medicine, and his team moved swiftly. First, they essentially paralyzed the patient with drugs to reduce the demand for oxygen by his muscles, brain, lungs and other organs. Next, they gave him high-potency formulations of iron supplements and vitamins, plus "industrial doses" of a blood-building drug, synthetic erythropoietin, that stimulates the bone marrow to produce red blood cells. Finally, intravenous fluids were administered to goad what little circulation he had left.
Breathing on a ventilator, and without a drop of transfused blood flowing in his veins, Jackson gradually began to respond to the treatment. Within four days his blood count had risen significantly. Soon after, he was shaking his head in disbelief and telling his doctors, "If it wasn't for this, I wouldn't be here." It was around then that the first hospital called to ask whether Jackson was dead. With undisguised satisfaction, Shander told them, "He's not only not dead, but he's well and ready for discharge, and he'll soon be about his usual business."
If Shander, 49, an Israeli-born physician who majored in Asian languages as an undergraduate, is passionate about anything, it is blood. Not only because it is, as Goethe observed, "a very special juice," the fluid pumped by our hearts through arteries, veins and capillaries, and without which the body's cells would be starved of oxygen and nutrients; nor only because he knows blood transfusions save lives; nor simply because 70% of those transfusions are administered by anesthesiologists.