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There is nothing like blood to grab the attention, as anyone who has found some in their urine will testify. The estimable British journalist Rose George has now written an entire, very good book about what Goethe called this 'amiable juice.' Its title, 'Nine Pints,' refers to how much blood the typical human body contains. If you give blood, which she highly recommends you do, you will still have eight, until your body self-replenishes.
I will read anything George writes. I decided this a decade ago, after avidly consuming her book 'The Big Necessity: The Unmentionable World of Human Waste and Why it Matters.' It's among the best nonfiction books of this still newish century.
'The Big Necessity' demonstrated the qualities George brings to everything she writes: a no-nonsense briskness on the page; a forensic zeal; a potent moral sensibility. She's a nimble writer, one who walks in fear of euphemism or pretension. There are no peacock displays of pointless erudition in her work; no recondite allusions are dragged in. She rips open her topics as if they were bags of chips.
'Nine Pints' is her fourth book - her previous, 'Ninety Percent of Everything,' was about container ships - and her most personal. It begins with her giving blood. Along the way it pauses to discuss, if briefly, her painful endometriosis, a uterine disorder, her menopausal depression and hormone replacement therapy to fight her symptoms. It is among this book's angrier contentions that there has never been enough research about women's health, and there still is not.
This book does not have a memoirish feel, however. As if George were pinching and expanding an image on a screen,'Nine Pints' expands to open up a world. She covers many thousands of miles in pursuit of the intricacies of her subject.
She visits the largest blood-processing facility in Europe. (It's in Filton, a small town in southwest England.) She travels to Delhi, where there is no anonymous volunteer system for giving blood and where, if you stand outside a hospital, you will be offered blood for sale.
She visits a leech farm in Wales, because these parasites (she describes them as useful and polite and almost jaunty) are still needed by doctors for skin grafts, among other things; the leeches help remove blood that pools under the graft. She goes to a South African township, to unpack the reasons why too many young women are still being exposed to H.I.V.
In rural Canada she investigates the morally suspect trade in plasma. It's among this book's most consistently underscored points that it should be illegal everywhere to buy or sell blood or plasma.
Sellers, unlike donors, have reasons to lie about their health. Plasma-buying companies tend to set up shop around prisons and skid rows. They prey upon the weak and the destitute. This segment of the population, because of drug use, poor diet and other problems that fall under the collective heading of 'lack of money,' tends to have blood that can play host to more impurities.
In Nepal, George describes with something close to horror the tradition of making women sleep outside in shacks during their periods. After flying into Delhi, she profiles a man who designed a simple machine to make inexpensive sanitary pads. And in a bravura penultimate chapter, she lingers in the resuscitation room at the Royal London Hospital Major Trauma Center.
This book has many heroic figures in it. Among them is Janet Vaughan, who overcame an extraordinary amount of sexism to become a pioneer figure in the development of blood transfusions.
Vaughan attended the same Oxford College, Somerville, that George did. She was a Bloomsbury figure. In 'A Room of One's Own,' Virginia Woolf described her intensely chopping liver with mincers. She had been working on a concentrated liver extract, using Woolf's mincing machine, to help people with anemia.
Among this book's most vivid scenes are of Vaughn, during World War II, helping devise and then operate a system that delivered blood, in ice cream vans on blacked-out streets, to city hospitals that needed it. There's a harrowing moment when Vaughan is forced to inject blood directly into a badly wounded girl's breastbone because her legs and arms were too burned to have locatable veins. We discover that this girl not only lived but grew up to attend Oxford.
'Nine Pints' is dedicated to England's National Health Service. George wishes Vaughan were still here to fulminate against the sly dismantling of our welfare state and the National Health Service. She wouldn't stand for it, as we should not.
George has always been a forceful writer about language. In The Big Necessity she pointed out that there is no neutral word for what humans produce at least once a day, usually unfailingly. There is no defecatory equivalent of the inoffensive, neutral sex.
The wrong words make things harder to talk about. In this book she makes a tally: 'Uterus. Yuck. What a horrible word. Vagina: even worse. Menstruation sounds like a disease. Menarche, endometrium: what do they even mean?'
She dislikes the euphemism 'the change' for menopause because it is a bland word that holds none of the distress and despair of endless hot flashes, depression, brain fog and eradication of libido.
When she wishes to, she has her own way with words. A tampon is described as 'a hands-free, longitudinally stitched little plug of freedom.' Watching the H.I.V. virus attack a cell, she writes, is 'no streamlined moon landing but an incessant jostling and tussling, like a cat pushing its face at you again and again, a sinister nuzzle.'
This book was clearly a trial for the author to write; she was frequently ill with dire symptoms caused by hormonal fluctuations during its composition. These facts add a bass note of mortality to the discussion. At the same time, at one or two moments, George's prose is not as utterly sharp as we've come to expect from her.
'There's so much goop inside of us, man, and it all wants to get out,' Denis Johnson wrote in 'Jesus' Son.' George covers the planet and considers many aspects of blood and its spillage, and her English phlegm never falters.
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