Five Quarts: A Personal and Natural History of Blood (11 page)

Leeuwenhoek returned over and over to studying blood, constantly refining his understanding. He compared human blood to that of different animal species and noted, correctly, that the “globules” are the same size in all red-blooded creatures regardless of total blood volume, whether in a minnow’s thimbleful, say, or a whale’s many gallons. In addition to discovering red cells, Leeuwenhoek described the coagulant properties of blood and made preliminary observations of the colorless corpuscles now known as white cells, or leukocytes. None of which is to suggest that Leeuwenhoek didn’t make errors. Sometimes when you go out on a limb, the branch snaps. For instance, for the remainder of his life, Leeuwenhoek insisted that red blood cells were spherical when, in fact, they’re more like pinched balls of Play-Doh or, if you will, like sunken jelly doughnuts. Further, in attempting to explain where in the body blood cells originate, he theorized that they formed from minute particles of food that were built up then rounded in the steady rush of the bloodstream, like pebbles polished by the tumble of waves.

He never hesitated to share the smallest details of his findings, and at times, in his nearly four hundred letters to the Royal Society, Leeuwenhoek was forthcoming almost to a fault. “Whenever I found out anything remarkable,” he explained in 1716, “I have thought it my duty to put down my discovery on paper, so that all ingenious people might be informed thereof.” A noble credo, but he did make exceptions. He never divulged exactly how he ground and polished his amazing lenses, for instance, or, as important, how he so successfully illuminated his specimens. He even admitted to having a couple of microscopes with lenses of superior magnification, a private cache he showed no one. This last bit of withholding, I believe, is a forgivable indulgence. I’d like to think that, at least for a short while, before the next generation of microscopists brought forth their own innovations, Antoni van Leeuwenhoek had the best eyes in the world.

“Whaddya see?” I asked Al. “See any red?”

Silence for a minute as he fiddled with the focus, and then, with a sense of ceremony, he handed his microscope to me.

I was surprised by what I saw, which pleased me most. My first impression was not of color, as I’d expected, but of translucent shapes: countless clear granules where I thought I’d see brilliant scarlet beads. They had a slushy appearance, as if I were looking at ice-frosted glass. At the edges, however, where cells were piled up, there was an unmistakable rosy tinge.

I was completely satisfied with the demonstration. Al wasn’t. “Can you spare another drop?” he asked.

Al then disappeared with a new slide, freshly smeared with a touch of my blood. A few minutes later, he hollered from his back porch: “Come take a look! We’ve got a better microscope!”

Al had dug up a modern-day compound microscope, which he’d positioned atop his washing machine in the sun-drenched room. “This light is so perfect,” he exclaimed.

With magnification set at about five hundred times—more than twice that of his Leeuwenhoek model—I could now see hundreds of my red blood cells, sharp and delineated. Most were stuck together, huddled as if for protection from my huge peering eye. But a few lay flat, perfect specimens. And if I wasn’t mistaken, I also spied a couple of cells near the top of the slide with a different profile—white blood cells.

“Pretty cool, huh?” Al said.

“Very cool.”

“It’s just too bad that there wasn’t anything crawling around in that water drop. But we can try that again, too—have a better look with this ’scope.” Al surveyed his overgrown property through the back screen door. “There’s got to be some scummy old water back here someplace,” he said. “Let’s see now . . .” With that, he set forth, blazing a trail through the wilds of his Berkeley backyard, in search of his own very little animals.

That our blood absorbs fresh air within the lungs and then circulates it throughout the body was first proved during Antoni van Leeuwenhoek’s lifetime. Exactly how the blood carries out this task of transporting and discharging oxygen remained a mystery, however, for another two centuries. In studies conducted in the mid-1860s, a German pathologist discovered that the main component of the red blood cell is a complex protein he named hemoglobin, which gives blood its characteristic color. If you stop and think about it, the concept is counterintuitive: Blood is bright red
because
it is fully oxygenated, yet oxygen is, by definition, colorless. But this scientist proved that hemoglobin is actually a functioning pigment, the precise shade of which is determined by how much breath, so to speak, the cell is holding. To picture how it works, think of a balloon not yet inflated. It’s deep burgundy in color. Now blow. As it fills with air, its color is stretched and the burgundy brightens to cherry red. This is hemoglobin in action.

Over the past hundred years a series of scientists have unveiled further clues as to the workings of the red cell (also known as an erythrocyte,
i-RITH-row-site,
from the Greek for “red,”
erythrós
). With its supple disk shape, the erythrocyte can dock next to other cells in tissue throughout the body to perform the equivalent of mouth-to-mouth resuscitation. It not only breathes oxygen into these cells but also sucks up carbon dioxide and carries it back to the lungs. Its compact shape, together with its elasticity, allows the erythrocyte to squeeze through the narrowest of capillaries and then spring back to normal size. (When red cells have the wrong shape, as in people who have the hereditary disease sickle-cell anemia, the elongated and curved—sickle-like—cells cannot pass through capillaries; the resulting blockages cause intense pain and serious deficiencies of oxygen to tissue.)

A healthy erythrocyte will continue its nonstop travel, cycle after cycle after cycle, for about 120 days until, too exhausted and battered to go on, it drops off the circuit. Scavenger cells in the spleen gobble it up and strip it of iron and other components, which are then sent for recycling to the body’s blood incubator: the bone marrow. Here, in these hot, spongy, fat- and vascular-rich tunnels, reside the ancestral cells from which erythrocytes, as well as all other cells of the body, are derived: the stem cells. Those that are specially programmed to become red cells divide and multiply; three million form per second. But these proto-red-cells, technically called erythroblasts, are not yet ready to enter the bloodstream. They must first mature and acquire ample hemoglobin. When they are finally ready to squeeze through tiny blood vessels and enter into circulation, a defining event occurs: They lose their nuclei, the cellular “brains” in which DNA is encased. Structurally, this sets erythrocytes apart from most other cells. Without a nucleus, there’s more room for hemoglobin and, therefore, for more oxygen. But its absence also guarantees each individual red cell’s demise, for without a nucleus it cannot reproduce. What’s more, stripped of DNA, the body’s biological signature, it has no identity. In this regard the formation of an erythrocyte is the antithesis of a classic origin story.

In the comic-book definition, the origin encapsulates a character’s pivotal moment of transformation, telling in orderly panels and with pithy phrasing how he or she came to be. Ordinary human beings have such tales, too. But we don’t call them origin stories, we call them ordeals—those life-changing episodes that, assembled in hindsight, tell us who we are. Coming out in my early twenties was mine. For my sister Shannon, leaving both the church and her training with the Carmelite nuns back in 1984 was but a prelude to hers. The events that would truly transform her life began unfolding a few years later.

She was twenty-nine, living by herself in Seattle, and working as a department-store shoe salesperson. I’d moved to San Francisco three years earlier and was living in the Castro district. In many ways Shannon and I were on similar paths—both lapsed Catholics, both dodging our disapproving parents at every turn, both trying to figure out who we were at the core—but going in different directions and at very different speeds. I had chased down a life I’d desired for years, whereas she, partly out of loyalty to me, had relinquished hers. While I’d found my community, Shannon was now without one. The farther she’d gotten from Catholicism, the greater her disenchantment with its dogma. On the one hand, distance had made things clearer—she’d lost her religion but not her faith—and yet, stripped of her long-held identity and without a new passion, she struck me as being a little aimless.

During our regular phone calls, I always dominated the conversation with stories of my friends and my jobs—first at a small theater company, then at the modern art museum—and of my first serious relationship. That dynamic changed with a phone call in the spring of 1988. “I’m pregnant,” Shannon told me.

I hugged the refrigerator. What came to my lips was not
Congratulations!
or
How wonderful!
but: “Are you sure?”

She was not only sure, she was more than six months along.

It hit me that I knew next to nothing about my sister’s social life—aside from the girlfriend with whom she went to movies and out dancing—let alone her love life. “So, who is he?” I ventured.

A man she’d met at a club, Shannon answered. Someone she’d really connected with, at first. He was beautiful and Cuban and mysterious. And secretive and insistent and controlling. And scary and—more than anything else—dead set on getting a green card. He’d disappeared, who knows where.

My heart sank. “I am so sorry, Shannon, so sorry. Is there something I can do?” I was offering both consolation and an apology. I felt terrible that before now she hadn’t been able to share all this with me, that I probably had not ever given her an opening. Regardless, I was the first in our family to hear that she was expecting. She’d just gotten the news herself earlier that week, Shannon said. Okay, now I was just plain confused. Didn’t she say six months?

“I thought I was off again,” she started to explain. “You know I’ve never had regular periods. It wouldn’t have been the first time I’d gone a while without having one.” This sounded like a bad rough draft of an answer, one she wasn’t convinced of herself.

As for her swelling belly, she added, fumbling, “I thought I was gaining weight again. I thought I was having more stomach problems. I—” She stopped herself. “The truth is, I couldn’t face the reality. I couldn’t go through that door.”

I was glad we were separated by hundreds of miles of phone line because the look of horror on my face would’ve killed her. Shannon had always been at odds with her physical self, but this was on a whole different level. With a calm I did not feel, I quietly asked, “Are you dealing with it now? You’ve seen a doctor, right?”

“Yes, I’m all checked out. I had a sonogram,
amnio-
whatever, everything. They say the baby seems to be fine.”

“That is great. And you? How are you doing?”

“I’m doing . . . okay.”

“Good, good.” I sighed relief. “So, you’re . . . You’re keeping the baby, right?”

Shannon stated evenly, “I’m having the baby, but I’m not keeping it. I’m going to give it up for adoption.”

Evidently, once her denial had been punctured, absolute clarity had kicked in. Shannon had already made arrangements for the adoption through a private agency recommended by her doctor.
Are you really sure about this?
I was tempted to ask again, but I kept quiet. Her voice was firm; she was not calling for advice, I could tell, but to let me know how everything was settled. The prospective mother, who had just written Shannon a warm, earnest letter introducing herself, was a family-practice physician, a single Caucasian woman who spoke fluent Spanish. Shannon chose not to meet her in person or to maintain any contact after the birth—feeling this would make it easier to separate from her baby—but she knew what she most needed to know, that this woman would provide a loving home. Plus, Shannon’s child would have an older brother, for the mother already had an adopted little boy of mixed race. This woman had also offered to defray the costs of my sister’s medical care, counseling, and other expenses, which lifted a burden since Shannon made little money and had no savings.

Despite the spinning in my head, I found myself saying reassuring things: She’d made the right decision; it sounded like a perfect match. But I held back what I most felt: Was there really no other way?

After speaking with me and my other sisters, Shannon broke the news to our parents. If she’d written a list in advance of all the things
not
to demand of her, it would have consisted of my father’s three commands: She must return to Spokane and stay with them. The adoption must go through a Catholic agency. And the baby must be baptized.

Sorry, but no, no, and no. In so answering, Shannon was cutting her ties with Mom and Dad. My sister had never before exhibited such grit. White-knuckled at the wheel, she saw her destination eighty days ahead and wasn’t allowing any obstacles to get in her way. Distancing herself from family members was crucial. At the time, two of our older sisters each had infant sons, the family’s first grandkids; for Shannon, seeing them was too painful. She also insisted I not come up to Seattle.

“I went into hiding,” she admitted to me recently, the first time we’d sat down together and spoken of this at length. She gave a sigh and a look that said,
I cannot believe how much I’ve changed.
“I did not want to see or be seen by anyone, including you.” Among all her siblings, Shannon told me, my opinion had always mattered most, and she couldn’t bear to have me witness her shame. But I think she was also protecting herself and her baby, in an almost primal way. It was as if she had physically grabbed the walls around her and pulled them closer in, forming a space she could manage, a place in which her tiny flame of strength could glow.

Two weeks after she’d first called with her news, my good friend Peter died. This was not unexpected. This wonderful, witty man—a diminutive and Deutsch Oscar Wilde, if you can imagine—had been sick with AIDS and bedridden for weeks at his home, where I and a corps of friends helped nurse him. Even so, I was stunned. This was my first experience of profound loss—something my sister was preparing for, too, I realized in the following days. Shannon, who’d met Peter during a visit to San Francisco, sent a note after she’d heard of his passing. Her words conveyed loads of sisterly love. “As it came time for him to let go of his life,” she wrote, “it is my honor to give birth to a new one,” a sentiment I found genuinely comforting. That she had pulled herself up to a place of such pride buoyed me at a moment when I was sinking. And the idea that her child, girl or boy, might become someone’s joy, as Peter had been to so many, gave me peace.