Schwab: Imagine if blood transfusions were illegal for all

By Sid Schwab / Herald columnist

For reasons I’ll explain further down the page, blood has been on my mind.

My career involved a lot of it, leaking out, pouring in. Surgical residency produced lots of memories; many colored red.

On the heart surgery service, an abundant source of excellent stories, the chief resident once scrubbed out of a case to donate his own blood to the patient on whom he was operating, who wouldn’t stop bleeding after finishing the pump run. Fresh blood — his was a match, of course — has magical powers, in some circumstances, to stop bleeding. It worked. Joe scrubbed back in and finished the case.

Another time, when another patient wasn’t responding to routine post-pump coagulants, the attending cardiologist left the room, returned wearing a feathered headdress and carrying a ceremonial rattle, which he shook, chanting, over the patient. The bleeding stopped.

Before moving here, 40-plus years ago, I began my surgical practice in Salem, Ore. Not long after setting up shop, I was called to the ICU to see a woman in her early 40s, bleeding relentlessly from a duodenal ulcer. Other surgeons had been consulted before me, the last-choice new guy of whom few had heard. They had all declined to operate, despite her obvious need for life-saving surgery. The reason: A devout Jehovah’s Witness, she refused to receive blood. Her husband was equally adamant. Those surgeons wouldn’t agree not to use blood, or to face a potential lawsuit for “wrongful life” if they did. Already a tough situation, that makes it tougher.

But I didn’t hesitate to operate on the exsanguinating young woman; she’d die if I didn’t try. She needed me and I was there. I did, however, make clear to her husband (she was no longer able to concur) that it was possible she wouldn’t survive the surgery if I was prohibited from giving her blood. He understood. Still, I told him, if we’re at that point, I’m going to come to the waiting room to ask one more time if you’re willing to have her die. So don’t go away. He nodded.

Disaster avoided, I was able rapidly to control the bleeding and do a couple of things to minimize the chance of it happening again. I don’t know what I’d have done, had it come to “do or die.” Amusingly, after word got around the community that I was a surgeon willing to operate on Witnesses, I saw many more in my practice. Continued to do so, here, too. (Side note: In training and for a while after, I operated on many emergency ulcer patients. They’re uncommon nowadays, as new understanding of the origins of peptic ulcer and better prevention have made such operations much less frequent.)

So, why have these patients been on my mind?

Imagine if our government was fully controlled by people whose particular interpretation of the Bible demanded refusing blood transfusions. What if they made giving and receiving it illegal? What if state legislators passed laws to imprison doctors who gave transfusions and their patients? What if citizens were rewarded for reporting people who received blood? What if a single federal judge, appointed by a “president” who lost the popular vote by millions, narrowly confirmed by a Senate majority representing 40 million fewer Americans than those who voted against him, single-handedly made transfusions illegal in all states under all circumstances, for all people, of all or no religions, no matter their personal beliefs, or the fact that it had been legal for decades?

What if “the system” allowed zealously pro-life-without-transfusions people to sue in a state where it’s possible to hand-pick the court and the judge who’d hear the case? What if that judge had had no judicial experience prior to his appointment to the federal bench, but was chosen for his extreme, anti-blood-transfusion religious views? Added together, would those what-ifs be more consistent with properly functioning democracy or theocratic oligarchy?

It’s unlikely to happen with blood transfusions. For one thing, judges might need one someday. But it’s exactly what may happen regarding medical abortion pills (effective only prior to ten weeks, by the way), even in states where it’s been legal for decades, which is most of them. The case will be decided in Texas, where nearly all those what-ifs apply. In Amarillo, you’re practically guaranteed to get the “right” guy (which they did), who, in addition to rabid anti-choice views, is known for his vehement anti-LGBTQ rhetoric (Vox: tinyurl.com/2pickjudge and Washington Post: tinyurl.com/noFDA4u).

Remember when warnings of President Obama establishing “Sharia Law” were sliming their way through right-wing media? How crazy it was to think that one set of extreme religious views could be imposed on us all, here in the U.S. Oh, how innocent we were.

Also: “Woke” doesn’t break banks. Deregulation does. (New York Times: tinyurl.com/nowokebank).

Email Sid Schwab at columnsid@gmail.com.