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Sunday, January 20, 2008

A tale of two phlebotomists

I used to do my civic duty by giving blood at least once every 6 months. OK, there's a smidge of self-interest in this ritual since a donation of blood gives the donor, his/her spouse, kids, parents and in-laws, blood insurance for a whole year here in Israel. But still... in order to receive blood insurance coverage you only have to give once every twelve months, and I gave at least twice as often!

However, the previous time I'd tried to donate I was told I'd have to wait at least a year from the date of my last visit to India due to the risk of tainting the public blood supply with Malaria.

No big deal... I figured Zahava would step up and give a pint in order to keep the family insured. But alas, my slender wife weighs [value deleted by order of the management] soaking wet and has a blood iron level that would need to go up a few notches to qualify as anemic.

So once Zahava was laughed out of the blood bank, the treppenwitz family was officially left without blood insurance for a few months. Thank G-d, we didn't have any family medical emergencies requiring a transfusion (tfu, tfu, tfu), but still, I'd be lying if I said that it didn't weigh on me just a tad.

Anyway, this past Thursday I noticed that my blood was officially out of quarantine so I ran out to make a donation.

It must have been a slow day for blood donations because I had the place pretty much to myself. First I filled out the standard questionnaire with the general medical history and then submitted to a short interview with a bored clerk who went through a detailed list of personal questions as casually as if she were commenting on the weather:

"Are you an intravenous drug user?"

"Do you sleep with prostitutes?""

"Have you ever eaten a steak in London?"

Once I'd convinced her that I wasn't some sort of sexual deviant with a crank habit and poor taste in cuisine, I was handed a stamped form and told to go to one of the waiting vampires phlebotomists.

Here's where I made a serious strategic error.

You see, one of the phlebotomists was a pretty girl who looked to be fresh out of the army and who smiled expectantly at me ... and the other was a dour, middle aged matron who sat thumbing aimlessly through a newspaper.

Guess which one I picked? Oh grow up... of course I picked the young pretty one. Heck, the other one looked too much like the school nurse from Jr. High!

Well, in case you were wondering, my karmic punishment wasn't long in arriving.

This pretty young thing spent several excruciating minutes cheerfully digging around in the crook of my elbow with the needle before I let out my first involuntary exclamation. She seemed completely unfazed by her lack of success, and no amount of cringing or yelping on my part seemed to deter her from her aimless poking.

You know, if I hadn't been ready to pass out from the pain I might have found the way her tongue peeked out of the corner of her mouth to be charming... sort of like a pretty child trying to think of just the right word on pop vocabulary quiz. But after actually hearing her say, "Hmmm, that's not supposed to happen!", I shakily suggested that maybe she'd like to let her colleague have a try.

I guess she took my suggestion as some sort of personal insult because she put on a petulant pout and marched my paperwork over to my old school nurse's doppelganger. I'll be honest, by then I didn't care if I'd insulted her. I was just so delighted that she's stopped stabbing me that all I could do was sweat with relief.

The other phlebotomist came over to take a look at her young colleague's handiwork and barely covered her surprise with a sharp intake of breath. All she could offer was an even, "Maybe we'll have better luck with the other arm, dear".

A few painless minutes later my blood was packed away in a small ice chest and I was sitting by the cookies and juice trying to feed myself without bending my heavily bandaged left arm (the right one had just a small cotton ball held in place by a casual strip of surgical tape).

A few other men - car mechanics, judging by their greasy uniforms - had come in after me and I watched as the first one completed his interview and made a bee-line for the smiling young phlebotomist. It was like watching one of those nature shows where the gazelle takes a delicate sip from the Serengeti watering hole seconds before the lioness springs from the bushes and rips his throat out.

Within seconds a staccato stream of obscenities began pouring from across the room, and from my vantage point by the snack table I noticed something I couldn't have seen while I was on the couch: The older phlebotomist, who was making a pretty good show of having returned to her newspaper, wore a small grin on her face and was slowly shaking her head from side to side at the predictable silliness of middle aged men.

Posted by David Bogner on January 20, 2008 | Permalink


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מגיע לכם!

Posted by: a. | Jan 20, 2008 2:41:39 PM

A few years ago, I gave blood during a radio station's blood drive. They were giving away free tee shirts and it was for a good cause, so why not?

Why not.

About a week later, I received a phone call from the blood bank, wanting me to come in to talk to the doctor. "Er...why?" "We can't tell you over the phone." *gulp*

So I scurried on down there. The staff physician sat me down and explained that they used two tests for HIV in the blood. One was an antibody test that was reliable but only detected the virus once it had triggered (and apparently not yet destroyed) the immune system. That came back negative. The other was an antigen test that looked for the virus itself and was used to find the virus prior to the immune system taking notice. It was a new test and still needed to be tweaked a bit, colds and such would trigger a positive result....which is what I had, a positive result. For HIV.

"But I haven't done anything to get HIV!" No matter, they did the test and it was positive. They did it again, same result. Then they sent it out to a lab for a different test, which came back indeterminate. Come back and see us in eight weeks.

Eight weeks later, all the tests were negative. Despite that, I haven't given blood since. Scarred for life, I guess. As for the tee shirt, I finally threw it out a few weeks ago.

Posted by: Karl Newman | Jan 20, 2008 5:16:27 PM

Forget all that...I want to know how much Zahava weighs ;)

Posted by: cruisin-mom | Jan 20, 2008 5:25:04 PM

I love when you admit that men can be fools! :) hehehe!

Posted by: Val | Jan 20, 2008 5:25:29 PM

I love when you admit that men can be fools! :)

Men and Fools- I have never heard a more shocking combination of words. The dissonant clinkety-clank is far too loud to take on this fine morning. And you, the Yankee fan, have you no shame...

Without men the world would be a far darker and dangerous place. It is men like your brother who ensure that we can safely eat chopped liver, without fear of the schmaltz monster.

Ok, ok...One of these days I will find new material. I promise, I just don't promise when. :)

Posted by: Jack | Jan 20, 2008 5:59:56 PM

Wait - you only get blood insurance if you are healthy enough to give blood? That doesn't seem quite right.

Posted by: Ben | Jan 20, 2008 7:12:54 PM

Oh you big baby! Ask Zehava what it's like to give birth and then bitch and moan.
This reminds me of my medical school days. During the rotation in internal medicine the students' job in the morning was to take bloods. One of my school mates, a minor genius with two left hands was particularly adept:
We'd see him approach the patient's bed with all the vampire usual equipment and close the drapes around the bed to ensure the patient's privacy. Then we'd hear, ouch, ayyyyy, owwwwwww!. Our colleague would emerge with blood on his hands, on his shirt on his shoes, in fact blood everywhere except in the test tubes. Usually after that one of the other students would take the bloods with a patient who looks like a rabbit caught in the the strong beam of the headlights. After a few days of this repeat performance we suggested that he sit out the morning blood letting and let us do the work.

Posted by: QuietusLeo | Jan 20, 2008 8:06:04 PM

Last year when my daughter was in the hospital getting countless blood tests, a smiling intern came by to take blood. His name was, I swear, "Osama". My then 13-year-old daughter smiled sweetly at him and told him in no uncertain terms that he was not touching her with any needle and that he should please call the nurse.

She was not necessarily prejudiced (although she thought his name to be rather unfortunate), but felt that only nurses knew how to get the stick on the first try.

And what's this about blood insurance?? My blood is totally tainted. Can my husband donate if he has high cholestorel? What do I do if I need blood? NBN never told us this!!!

Posted by: Baila | Jan 20, 2008 8:32:54 PM

oh, yeah and sometimes you men really make us women laugh very hard!!

Posted by: Baila | Jan 20, 2008 8:34:52 PM

Oh my, this is hysterical. Since I just had blood siphoned away last week for a medical exam, I do feel sympathy --and extreme relief that I had the easiest vampire I've ever gotten and not an experience like yours! What's all this about needing to give blood in order to get insurance? Hrmmm maybe all the hummus I've been eating and related weight gain has upped my weight enough so they won't shoo me out if I want to donate...

Posted by: Yael | Jan 20, 2008 9:34:43 PM

a.... Yes, we deserve it. No argument from me on that.

Karl Newman... I had a similar scare in the states in the early days of testing for Hep C (non A non B) I got a false positive on one of my donations and even though a follow up test proved conclusively that I was fine I was permanently banned from the US blood supply.

cruisin-mom... Well, I can't really say, but if you find the guidelines for the minimum weight to donate... and added about three pounds (including clothing, shoes and jewelry) you'd be close. :-)

Val... Yeah, we're fools alright, but it's nice to have a fool around when you have a flat on a dark rainy night, no?

Jack... Is your goal really to make me the top Google search for glock chopped liver? :-)

Ben... Look, we have socialized medicine here, but that doesn't mean everything is free. Blood transfusions is something that are always in short supply and no amount of government financial assistance can change that. So they charge for blood transfusions... just enough that it hurts a little when the bill comes. his is an incentive to give, thus providing you, your spouse, kids parents and in-laws with a year's worth of blood insurance. You can also earmark your blood for someone specific or a particular family at the time of your donation. Since you can technically give every three months, this means that even if you and your spouse were both unable to donate, a friend could give you coverage by designating you on his donation form. Not a bad system if you ask me.

QuietusLeo... No offense, but docs are some of the worst sticks I've ever had. OK, maybe you gas passers have a bit more practice... but I'll still take a nurse if I have a choice. :-)

Baila... Read my reply to Ben. and one of the mechanics behind me told the interviewer he was taking lipator and asked if he could still donate. She checked her list and said no problem.

Yael... Se my responses to Ben an Baila for details. Oh, and my wife was a vegetarian when we met and had even lower blood iron than she does now (if that is possible). She also, like you, tips the scale very close to the cut off for donations. I imagine if you eat a big bowl of spinach the day before and then put a can of diet coke in your pocket before stepping on the scale they might let you give. :-)

Posted by: treppenwitz | Jan 20, 2008 10:02:04 PM

Has she done anything to get her iron levels up? Like take Blackstrap
molasses or something? (Not that I'm trying to make her donate blood,
but I thing being anemic is bad for other reasons.)

Posted by: Channah | Jan 20, 2008 10:21:26 PM

I wanted to get to 50 donations by age 50, but when I told them (after 40+ donations) that I had actually spent 7 consecutive months in Britain (Britain!!) in 1980-80, they stopped taking. Grossly unfair, and try talking to the management.

Posted by: asher | Jan 21, 2008 6:47:19 AM

Jack... Is your goal really to make me the top Google search for glock chopped liver? :-)

And Krokodil. ;)

Posted by: Jack | Jan 21, 2008 9:38:41 AM

donating blood in israel went pretty well. but i forgot to get my driver's license back (or as i saw it, they forgot to give it back to me) and by the time i realized i was back in america. they basically wanted me to fly back to israel to get it back.

Posted by: Lion of Zion | Jan 21, 2008 9:48:07 AM

Hey, kol hakavod to all you blood donors! I can't do it. I've been known to pass out during routine blood tests. My wife (a regular donor) considers me quite the wuss.

Posted by: psachya | Jan 21, 2008 10:33:41 AM

Jack... Is your goal really to make me the top Google search for glock chopped liver? :-)

And Krokodil. ;)

Schnappi?? Where? Where??

Posted by: a. | Jan 21, 2008 12:19:16 PM

What i don't understand about the "Mad Cow Disease" factor of not being able to be a blood donor, is how do the folk in the UK get blood for their bloodbanks? I am British, and can't give blood in New Zealand, even though I was a vegetarian when I lived in the UK in that period. Seems horribly random to me, and considering I have a rare blood group, a bit daft.

I nearly offered to give blood at the Jerusalem bus station two days ago, but realise after reading your post that I would have been rejected based on my "Mad Cow Disease" factor. Sigh!

Posted by: noa | Jan 21, 2008 6:21:05 PM

I donate blood and platelets here in the states. I've been to the center many times and know most of the phlebotomists at the center where I donate. I know which one to pick when she's available. I hardly ever feel the needle with her. There is one guy there who I never donate with. If I ever get him for the "interview" my pulse is always over 100 (reject range).

Posted by: JDMDad | Jan 21, 2008 6:32:20 PM

My daughter (24) has had a life-long thing about needles... "fear," or "phobia" are too tame (when she was 5, or 2, or something (I forget; the missus does not) it took 3 or 4 strong techs to hold her down to get blood samples from her before she had her tonsillectomy.

I'm just sayin'.

Flash forward. Now studying medicine at a local university, she figures out a good way to earn significant cash, with flexible hours, is to become -- a phlebotomist. And they practice on each other, and she (unlike myself) has no arm veins to speak of. Mine look like city sewer mains, and I've been timed at 4 min per pint when I'm in the zone.

She could tell you tales of the type of persons who train to be phlebotomists, but I will leave that to her. Suffice to say, I admire her solution to her phobia. It would be like me getting a job building high-rises to overcome my intense phobia of heights.

I get anxious just thinking about that.

P.S. -- you would pick my daughter, no doubt, to phlebotomize you; luckily for you, she's one of the tops in her class. Until you see her, though, PICK THE MATRON.

Lovely (and as usual) insightful post. And thanks for the tip, as I am going to England for holiday soon. No steaks? Or no meats at all?

Posted by: Wry Mouth | Jan 21, 2008 9:28:42 PM

Karl wrote: "But I haven't done anything to get HIV!"

Reminds me of my first well visit after graduating YU. The Nurse suggested that I get an HIV test just to be safe. I said that I didn't think that was necessary. She looks at me with a look of pity and says 'everyone could use one'. I said back - I've never had sex, never had a transfusion and I have never taken intravenous drugs. I REALLY don't think I need the test. Once she realized that I knew what I was talking about she relented and said - I guess you're right....

Posted by: Aharon | Jan 22, 2008 2:37:30 AM

I feel for Noa, as I'm O negative (had to be negative, didn't I?), in other words universal donor and now if I want to give it's a problem being British. That being said, there are cases where you mark yor blood as "not for transfusion" and get credited as having given which gets you a year's insurance and a nifty sticker to put on your bicycle helmet.
Remember there's no screening for mad cow so someone who's carrying it might live till 120 and not show any signs, but could pass a tainted transfusion to some poor sod with less resistance.
By the way Pete Townshend had a number called "give blood" on his White City concept album.

Posted by: asher | Jan 22, 2008 12:46:59 PM

I have never donated blood, but just last week I went in to get my cholesteral check and after poking in one arm with a needle, she switched and started on the other arm, when she finally found a supply. I guess if you dig around long enough you will hit a vein. Needless to say, I still have two very ugly (and sore) bruises on both arms. So I feel you pain.

Posted by: Jaime | Jan 22, 2008 9:09:42 PM

And all this time, the matronly phlebotemist is having a lovely, relaxing day with her newspaper....

Posted by: Gila | Jan 22, 2008 11:27:52 PM

I remember a blood test for a screening for something (what, I don't remember) when I was in college. I went with a friend of mine. There were two phlebotomists - a nice, sweet looking white lady in her 40s, and an African American man who looked like he'd played defensive lineman for a college football team, with dredlocks and multiple piercings. My friend got the lady, I got the football player. I was done in one stick with no pain, and my friend almost passed out. My rule is (if I have any choice in the matter) always pick the larger phlebotomist. Hasn't let me down yet. I also remember a time when it took three nurses, an anesthesiologist and a doctor to find a vein in my arm.

Posted by: Annie D | Jan 23, 2008 8:51:11 PM

impertinent, impudent and imprudent, but which newspaper was she reading?

Posted by: asher | Jan 24, 2008 11:26:16 AM

Pitch-perfect, David.

Posted by: ilan | Feb 3, 2008 11:57:14 AM

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