Summary of Nine Pints by Rose George

BookSummaryClub Blog Summary of Nine Pints by Rose George

Are you ready for a blood-filled summary? Most of us don’t really think about blood unless we see it. However, it is what sustains our body, carrying oxygen, nutrients and specialized cells. The average adult has between nine and eleven pints of blood but even before this number was determined, its importance as our lifeforce was known. 

So, how much do you know about the history of blood? From the development of blood banks to medications derived from blood – this fluid continues to be integral to our lives. It is therefore important that you have some idea of the many marvels of blood. 

In this book summary, readers will discover:

  • The basics of blood
  • The story of leeches
  • Dame Janet Vaughan
  • Plasma – the money maker of blood
  • Treatment of HIV and AIDS have improved by improved understanding of blood
  • Blood transfusions remain vital in trauma patients

Key lesson one: The basics of blood

Everyone thinks that the heart is one of the most important organs in the body but what would a heart be without blood? Every organ works in conjunction with the blood in our bodies. The lungs get oxygen into the blood, but the blood transports it to the rest of the body. The same goes for nutrients, water and even medication. 

Blood gets its typical red colour from the 30 trillion red blood cells it contains. These red blood cells carry oxygen and conduct waste disposal throughout our bodies. In just 24 hours, red blood cells can travel a total of 12000 miles! However, your blood contains more than just red blood cells. There are platelets that help your blood clot when you are bleeding and white blood cells that are an important part of our bodies immunity. Whenever our immune system detects a threat, white blood cells will attack the foreign particles. It is because of these important factors that blood plays a vital role in saving lives. It is given to cancer patients to elevate their platelet numbers and blood transfusions also help trauma patients when they have lost too much of their own. A blood transfusion is done every three seconds around the world. 

However, blood transfusions are a bit more complicated than your think. Patients can’t receive just any blood – it has to be the correct type. Blood type is determined by antigens. These antigens are attached to the surface of red blood cells and come in different types. Blood type is determined by A and B antigens. Blood with only A antigens is Type A, only B antigens in Type B, both antigens in Type AB and none in Type O. Also contributing to blood type is the Rhesus factor. This factor is what determines whether blood is positive or negative. This is why recipients can only receive the correct blood. Therefore a patient that is B negative cannot receive a transfusion of A positive blood.     

Key lesson two: The story of leeches

Leeches have been a part of medicinal practices for centuries. These little parasites feed off of blood and back in the day, they were considered lifesavers. Early medicine deemed most ailments as too much blood in the body and what better way to get rid of it than using leeches? Leeches were used to cure everything from a headache to a fever. They were also used across the globe by different cultures. They were so popular that at one point in the nineteenth century, the bloodsuckers almost went extinct! 

Even though modern medical science has said goodbye to bloodletting, leeches have found a new place in medicine. They secrete anticoagulants when attached to a host that is a complex mix of chemicals. It is so complex that scientists haven’t quite mastered its production just yet. Anticoagulants come in handy when surgeons need the blood to keep flowing during tissue transplants and to prevent clotting. The anticoagulants produced by leeches are still the most effective blood-thinning agent available. This is why they still remain a popular tool in many surgeons’ medical artilleries. 

Key lesson three: Dame Janet Vaughan

Do you know the name, Dame Janet Vaughan? You should for a variety of reasons. Firstly, she fought for her place to receive an education when women were thought not to need one. She pursued her right to an education and studied medical sciences at the University of Oxford graduating with distinction. She thereafter received a Rockefeller Scholarship to study at Harvard being the only female student there at that time. Being female, they did not allow her to study human blood and instead gave her pigeon blood. 

Despite this, Vaughan persevered and began her research on vitamin B12 deficiencies in blood. She became an expert on blood diseases and published a textbook called The Anaemias in 1934. Vaughan continued to be a force to be reckoned with in her chosen field of study and this culminated during the war. She had learned about a Catalan doctor who, during the Spanish Civil War, developed a system for the collection, storage and transportation of blood. Vaughan knew that Britain would need a similar system during the war so she set up the Emergency Blood Transfusion Service or EBTS. It consisted of four depots outside London that donors could go to donate blood that would be later transported to the hospitals in the city. Donated blood was stored in milk bottles and transported in specially converted ice cream trucks. 

The EBTS was able to save countless lives during World War II and continued to function after the war. The war had made people realise just how important blood donation was and it still remains crucial today. This would have not been the case if it were not for Dame Janet Vaughan.

Key lesson four: Plasma – the money maker of blood

The plasma portion of our blood accounts for more than 50 per cent of its volume. Plasma contains fat, water, salt, proteins, antibodies and coagulants. For medicinal purposes, plasma is harvested from the blood after donation. The product is called fresh frozen plasma or FFP. It is possible to also get source plasma using an apheresis machine that is connected directly to the donor. The plasma is removed from the blood and plasma-less blood is returned to the donor. FFP is normally used as transfusions to encourage blood clotting while source plasma is refined to increase the concentration of the ingredients it contains. 

Source plasma contains immunoglobulins that are important for immune system deficiencies as well as albumin, a protein that aids in sustaining blood volume and pressure. Then there’s something called Factor VIII that is also found in source plasma albeit in small quantities. Factor VII is used to treat haemophilia, a disease that prevents blood from clotting and leads to serious bleeding. Factor VIII became a product that could be sold for the treatment of haemophilia patients but because source plasma contains so little, huge amounts of plasma were needed to concentrate it. This is why some countries pay people for source plasma. The world’s largest supply of plasma comes from the US. As much as it is helpful, it also comes with major disadvantages. Since people are being paid for the plasma donations, it is often the poorest people in society that sell their plasma. These people are likely to be in poor health as well and could potentially pass bloodborne diseases on to recipients. In addition, if they give plasma often, it will put an additional strain on their bodies causing side effects. However, they still endure them for the money they receive. 

Key lesson five: Treatment of HIV and AIDS have improved by improved understanding of blood

In order for researchers to understand HIV and AIDS, they had to first understand CD4 white blood cells. CD4 cells are an integral part of the body’s immune system – they recognize threats and release chemicals that attract other white blood cells to the problem. HIV attacks CD4 cells and uses its DNA to start manufacturing more of its own. This is how HIV spreads to infect other cells, eliminating all the body’s healthy CD4 cells. This is what causes a person to develop AIDS. 

When a person had AIDS they are vulnerable to any disease and illness due to the lack of CD4 cells. For years, HIV and AIDS  were thought to be a death sentence but this changed when antiretroviral therapy or ART was developed. ART entails the use of different drugs to prevent infected cells from manufacturing the HIV virus and to stop the virus from penetrating healthy cells. The treatment is highly effective and has changed the lives of millions of people across the world. Prevention is still the best treatment for HIV and AIDS but researchers continue with the hopes of one day eliminating the disease completely.

Key lesson six: Blood transfusions remain vital in trauma patients

Globally, 40 per cent of trauma patients die from severe bleeding. Although is blood is supposed to clot when we suffer an injury, in extreme trauma cases, the body halts blood’s ability to clot to prevent clots from forming in organs and arteries. This can lead to quick blood loss and with less blood circulating in the body, all our organs become deprived of oxygen. In cases of internal bleeding, blood cells produce lactic acid and potassium that have the potential to stop the heart. 

This is why blood transfusions are so important to trauma patients. Their survival basically depends on receiving a blood transfusion. Component Therapy or CT entails isolating the components of blood and transfusing them accordingly. This means that a trauma patient can get exactly what is needed. However, CT takes time and using fresh, whole blood is possibly more effective. Researchers continue to look for new ways to make transfusions and transfusion techniques more effective. We have come so far, there is no doubt that the future of blood research will be equally exciting.

The key takeaway from Nine Pints is:

Blood is a key component of life. However, for the most part, it is overlooked. People tend to focus more on human organs like the heart and brain. The simple truth is that none of our organs would function without the oxygen and nutrients supplied by the blood. Blood has always been considered as our life force. Ancient civilizations realized its importance and history has detailed our understanding of it. As our knowledge continues to expand, it is only a matter of time before researchers unlock more potential of this important liquid that we require to exist. 

How can I implement the lessons learned in Nine Pints:

Being a blood donor means that you have the ability to save lives. A transfusion is given every three seconds somewhere in the world. This means that blood is needed in unfathomable quantities. Be a part of the solution, donate blood and help save a life!

🤙 Your Next Step… 🤙

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