Five Quarts: A Personal and Natural History of Blood

Five Quarts: A Personal and Natural History of Blood

by Bill B. Hayes

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“We’re born in blood. Our family histories are contained in it, our bodies nourished by it daily. Five quarts run through each of us, along some sixty thousand miles of arteries, veins, and capillaries.”
–from Five Quarts

In the national bestseller Sleep Demons, Bill Hayes took us on a trailblazing trip through the night country of insomnia. Now he is our guide on a whirlwind journey through history, literature, mythology, and science by means of the great red river that runs five quarts strong through our bodies.

Profusely illustrated, the journey stretches from ancient Rome, where gladiators drank the blood of vanquished foes to gain strength and courage, to modern-day laboratories, where high-tech machines test blood for diseases and dedicated scientists search for elusive cures. Along the way, there will be world-changing triumphs: William Harvey’s discovery of the circulation of the blood; Antoni van Leeuwenhoek’s advances in making the invisible world visible in the early days of the microscope; Dr. Paul Ehrlich’s Nobel-Prize-winning work in immunology; Dr. Jay Levy’s codiscovery of the virus that causes AIDS. Yet there will also be ignorance and tragedy: the widespread practice of bloodletting via incision and the use of leeches, which harmed more than it healed; the introduction of hemophilia into the genetic pool of nineteenth-century European royalty thanks to the dynastic ambitions of Queen Victoria; the alleged spread of contaminated blood through a phlebotomist’s negligence in modern-day California.

This is also a personal voyage, in which Hayes recounts the impact of the vital fluid in his daily life, from growing up in a household of five sisters and their monthly cycles, to coming out as a gay man during the explosive early days of the AIDS epidemic in San Francisco, to his enduring partnership with an HIV-positive man.

As much a biography of blood as it is a memoir of how this rich substance has shaped one man’s life, Five Quarts is by turns whimsical and provocative, informative and moving. It will get under your skin.

Product Details

ISBN-13: 9780345482150
Publisher: Random House Publishing Group
Publication date: 01/25/2005
Sold by: Random House
Format: NOOK Book
Pages: 304
File size: 1 MB

About the Author

The recipient of a Guggenheim Fellowship in nonfiction, Bill Hayes is a frequent contributor to The New York Times and the author of four books: Sleep Demons: An Insomniac’s Memoir, Five Quarts: A Personal and Natural History of Blood, The Anatomist: A True Story of Gray’s Anatomy, and Insomniac City: New York, Oliver, and Me (coming February 2017), and is currently at work on a new book Sweat: A History of Exercise.
A photographer as well as a writer, his photos have appeared in The New Yorker, Vanity Fair, Granta, The Wall Street Journal, and on CBS Evening News.  His portraits of his partner, the late Oliver Sacks, appear in the recent collection of Dr. Sacks’s suite of final essays Gratitude.
Hayes has been a visiting scholar at the American Academy in Rome, the recipient of a Leon Levy Foundation grant, and a Resident Writer at Blue Mountain Center. He has also served as a guest lecturer at Stanford, NYU, UCSF, University of Virginia, and the New York Academy of Medicine.

Read an Excerpt

Gorgon’s Blood

The first drop stains the pale, clammy flesh. It’s as if the skinned potato, not my sliced finger, is bleeding. Were the cut anywhere else on my body I’d have it under the faucet by now or washed with soap, yet I persist in sucking it. The blood is warm, warmer than saliva. This is what 98.6 degrees Fahrenheit feels like on the tongue.

There’s always a moment—less than a moment, actually; however long it takes an instinct to fire, as hand flies to mouth—when I think the blood will taste good (an expectation I’d never have, it strikes me, for other bodily fluids): as earthy as cooked beets or sweet as cassis. Wrong again.

Okay, so it doesn’t taste good, but it doesn’t taste bad, either. If it did, all creatures would be repulsed from licking clean their wounds. Blood’s no worse than a lick of sweat yet also not something to be savored. That it tastes faintly like metal, as some people say, is not an undeserved analogy; blood is iron-rich. Two-thirds of the body’s store of iron can be found there. Others say with great specificity that it tastes like a mouthful of change (have they tasted mouthfuls of change?), suggesting, too, that blood is currency, which it certainly is, a donated pint at a blood bank being valued at more than a hundred dollars, according to the FDA. Yet both of these analogies are imprecise, for pennies have a different flavor than quarters, don’t they? And there’s a world of difference between the lip of an aluminum beer can and a sterling silver teaspoon.

I’m reminded of my high school friend Melaine, now a mother of three, who has worked for twenty years as a technician in a hospital surgical unit and has, to her profound regret, acquired a fine nose for blood. Like body odor, she tells me, everyone’s smells different; some blood is pungent and sickening, some almost fruity. She sees blood as a constantly brewing stew, a mix of red blood cells, white blood cells, and platelets, all floating in plasma, the watery medium that carries nutrients to, and waste from, the body’s one hundred trillion cells. This basic recipe is then often spiced with medications, alcohol, nicotine, or other ingredients. Melaine thinks that each person’s blood is an olfactory signature, which leads me to think that no two samples would taste alike, either.

According to historians, Roman gladiators drank the blood of vanquished foes to acquire their strength and courage (a practice reputedly also followed by the nineteenth-century Indonesian headhunters, the Tolalaki, among other cannibals). But, if true, how exactly did the gladiators drink this blood: in bejeweled loving cups or straight from the jugular? Lapping it off a felled man’s chest, perhaps? In any event, why didn’t these victorious gladiators drink their own blood instead? They were the winners, after all.

Nitpicking about how it was drunk, whose blood was braver, and so forth, however, is missing a larger point. What makes the gladiator behavior truly arresting is this: They didn’t fear contact with blood. On the contrary, they gloried in it. Even the spectators were allowed, on occasion, to rush the arena to join blood-drinking free-for-alls. Sated, a gladiator or spectator may have even taken some to later sell. Gladiator’s blood, both a cure for certain diseases and a good-luck talisman for new brides, was a valuable commodity. Even so, in those days, the most prized blood of all was not that of a man but of a mythical creature, as found in the tale of Asclepius, god of medicine.

Asclepius, the illegitimate child of a beautiful maiden and the god of light, Apollo, has one of the juiciest backstories in classical mythology. He’d not even been born yet when his mother was slain by his father, who’d become enraged upon learning she had been unfaithful. Apollo snatched the baby from her womb and sent his son to be raised by a centaur named Chiron. From the half-man/half-horse, Asclepius received his medical training, learning to mix elixirs, use incantations, and perform surgeries. From his aunt Athena, the goddess of war and wisdom, he received his most powerful potion: blood from the veins of Medusa, the snake-haired Gorgon whose face turned beholders to stone. A single drop of her blood could either kill or cure a human. If drawn from the left side of the Gorgon’s body, the blood brought instant death; if from the right side, it miraculously restored life. This duality was an especially prescient invention of ancient mythmakers, for we now understand in cellular detail how blood can both bear disease with deadly efficiency and save a person’s life, as with vaccinations or transfusions. Indeed, Asclepius revived a man named Hippolytus by giving him the precious fluid, which may now be viewed as the earliest— albeit mythical—instance of a blood transfusion.

Asclepius—no fool he—realized there was profit to be made from Gorgon’s blood: gold, specifically, which he demanded in exchange for raising the dead. This unethical practice infuriated Zeus, king of the gods, who sent down a thunderbolt, killing the doctor. No matter. Zeus cooled down, realized the overall good Asclepius had brought to humankind, and raised him to godhood. Asclepius went on to father five daughters, all personifications of healing, including Panacea, the divine cure-all. She reigns to this day, in the private domain of my household at least, as the goddess of minor kitchen mishaps. I invoke her name as I wind a Band-Aid around my finger.

In practice, ancient physicians believed that blood was the dwelling place of the “Vital Spirit” that animated human beings—the stream in which emotion, character, and intelligence swam. This life force was thought to be circulated by the heart, which was falsely assumed to function as the body’s governing organ (what we now know as the role of the brain). The Roman poet Virgil offered a metaphysical slant. Noting that veins under the skin looked purple, a color lost when blood was shed and a person died, he concluded that the blood must therefore house the human soul—the purpurea anima, or “purple soul,” as he wrote in The Aeneid. It was a reverential perspective almost beyond imagination today, when blood is widely considered hazardous waste material.

I find Virgil’s conception marvelous, even though, truth be told, my own veins look aquamarine, not purple. The notion that blood is intricately linked with the soul has a deep resonance for me, above and beyond the fact of my strict Catholic upbringing. Blood, I’ve found, leaves mnemonic markers at each milestone or phase in life, a way to retrace one’s journey. Look back, you’ll see. The marks, whether literal or metaphorical, may not be visible at first, like fingerprints before they’re dusted, but then, upon second inspection, when the light is shone just so, your whole life looks spectacularly stained in red.

We’re born in blood. Our family histories are contained in it, our bodies nourished by it daily. Five quarts run through each of us, on average, along some sixty thousand miles of arteries, veins, and capillaries. Blood permeates religion, as it does the nightly news. Action films are bathed in it. Love songs and poems testify to its thunder. Modern medicines can thin it out, thicken it up, or redirect it to sexually interesting places. With the first shaving nick or menstrual period, blood initiates us into adulthood. It makes us blush, bruise, and go pale. It may leave a trace when a woman’s virginity is lost, and a drenching while giving birth. Blood is used to describe a range of emotions: It quickens, races, boils, curdles, runs cold, and sizzles, hot-blooded, under the skin. To say “I feel my blood” is to say one feels alive, vibrant, every cell pulsing.

And yet the mere mention of blood can induce a cringe. Reading about it makes some people squeamish. You can even taste blood without having it on your tongue. It’s a taste of, well, wrongness, I suppose—an emotional “taste” that things aren’t as they should be. At such moments one turns into a kind of temporary synesthete, a person whose senses are commingled. Synesthetes taste sights, see tastes, feel colors, hear shapes. An E-flat triggers a visual field of triangles, say, or pain manifests as a blue aura. For the Russian novelist Vladimir Nabokov, as idiosyncratic in his synesthesia as in his writing, every letter of the alphabet radiated a precise color; for example, O was the hue of an “ivory-backed hand-mirror.” His wife, Vera, who also had synesthesia, would likely have disagreed, for two synesthetes’ perceptions are almost never the same. An ivory O to one is black shoe polish to another.

This condition is rare—as few as ten people in a million have synesthesia, according to a recent American study, a figure that makes the pairing up of Vladimir and Vera even more extraordinary. Yet many of us, I believe, experience a similar phenomenon upon seeing blood. Blood is warmth to some; an overheated room. To others, blood is noise; a rabbit’s racing heartbeat. But I don’t see it that way. To me, blood is silence. It is slow motion, the pause between seconds. It is a sharpness, dry air, clarity.

Blood also marks the divide between me and my partner of fourteen years, Steve. He has HIV, a fact I’ve known since our first date. Steve’s always been extremely cautious about blood—overly so, I’ve thought at times. If he nicked himself shaving, for instance, he wouldn’t allow me within kissing range of his face. At those moments, I tended to act blithely unconcerned. Against his wishes, I might plant a kiss on his forehead—“See, no harm done.” I’ve never wanted Steve to think I was afraid of him.

I’ve seen him with a bloody nose before, but not with a serious, bleeding wound until a short time ago. While he was stocking food on the bottom shelf in our pantry, the iron toppled from the top shelf, a fall of about three feet, hitting Steve, tip-first, on the head. I heard his oophf! of pain and surprise and watched him stumble out of the pantry, trailing blood like beads of a broken necklace. My first impulse, Help him, was instantly followed by a second, seemingly contradictory one: Protect yourself. With blood dribbling down Steve’s face, mine went pale, I could tell, and I froze.

I stood there at least long enough for our eyes to meet. I looked stunned, no doubt, if not plain guilty; I’d been the last to use the iron and had left it too close to the edge. But concern for Steve broke through my self-absorption. I pivoted and grabbed paper towels as he said, calmly yet forcefully, “Put . . . on . . . gloves.” His extended hand established an invisible force field between us, a danger zone I could not enter. Though I didn’t have any obvious open cuts through which I could get infected, I knew it was better to be prudent. I dropped the towels and scrambled to the bathroom closet, returning with a pair of disposable latex gloves, gauze, and disinfectant.

Steve sank to the kitchen floor and sat there, eyes closed, gingerly assessing the damage with his fingertips, a slow spider’s crawl to feel if his skull was cracked. His hand came away sopped, but, he told me, there was no fracture, just a gash. Gloved, I blotted it with gauze and examined the scalp beneath his sticky flattop; the cut didn’t look deep enough to require stitches. It stopped actively bleeding in minutes, in fact. Steve was even able to joke that his Mega Hold hair gel must have blunted the impact.

Though this isn’t a pleasant admission, after Steve was cleaned up, I realized I’d found it thrilling to see his blood in such quantity—on his brow, staining paper towels, in a spattering on the floor. Its luminous red color was like molten lava, both terrible and beautiful. Until that day, it had been an abstraction to me, something drawn and analyzed behind a closed office door, mere numbers on a lab report, or a bluish fluid glimpsed through his veins. I was used to seeing Steve’s semen when we had sex; that didn’t scare me. But his HIV-positive blood was altogether different, seeming far more dangerous by being rarely seen. How well I knew its capacity to bring good or bad upon us—twin shades of the Gorgon. It made him sick. It helped him fight back. It kept him healthy. It could kill.

Returning to the myth I’d known so well as a kid, I of course remembered the basics: To free his captive mother, the hero Perseus had to deliver the severed head of the Gorgon Medusa, who was as deadly to look at as she was ugly. I was struck, though, by the myriad details I’d forgotten. The goddess Athena joined Perseus as his battle adviser, for instance, and others in the pantheon offered their aid. Winged sandals and a hel- met of invisibility were gifts of the Nymphs. A sword made of adamantine, a material as hard as diamond, was bestowed by Hermes.

With Athena by his side, Perseus flew to the Gorgon’s domain, landing amid a gruesome rock garden of men the monster had turned to stone. Each statue, a failed slayer forever frozen in horror, spoke to the utter hopelessness of Perseus’s task. A cold chill passed through him; for a moment he, too, was frozen, but he pressed on. Carefully, quietly, he made his way into Medusa’s lair. Fortune smiled upon him—the monster was sleeping! To protect Perseus should she awaken, Athena covered Medusa’s face with her shield. And with a single stroke of his blade, off came the snake-haired head.

A crimson puddle formed at Perseus’s feet. As Athena set to work collecting the magical blood she’d later give to her nephew, Asclepius, the pool spread. Laying down his sword and helmet, Perseus reached for the severed head, being careful not to look at it, and stuffed it into a magic satchel. In the blood below him, Perseus saw his own reflection, the face of a man who’d done the impossible and survived.

It is this conquering of one’s worst fears that I’ve always found satisfying, in tales spun on a grand scale and, more so, in those played out on the mortal plane. I’ve certainly known times when I’ve been paralyzed by fear or self-doubt but was still able to dig down and push through. These kinds of struggles almost always have unexpected results, as Perseus also discovered. Before his weary eyes, the thin layer of Gorgon’s blood began to ripple and, suddenly, an immaculate, white-and-gold creature leapt out, the winged horse Pegasus. It spread its magnificent wings and flew off to join the Muses, where it would come to serve as the spirit of poetic inspiration. But the pool of blood held one last surprise. Out crawled a foul giant brandishing a sword, the warrior Chrysaor, who’d go on to sire a three-headed monster and a man-eating daughter. The story of Perseus and the Gorgon has thus inspired mine, a personal odyssey through the history of hematology, from the classical age to the modern and, along the way, into my own past. With blood as the mirror, I look at my life and see what emerges.

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