1. Hagstad, David RN

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"It's not an American, so you don't have to donate." I was stunned. I had rushed to the blood bank when I'd heard my type was needed.


"Do you need A-positive or not?" I asked the lab tech, still a bit bewildered.


"There's an Iraqi EPW [enemy prisoner of war] in surgery right now, and he's bleeding out," the lab tech informed me. "We've got plenty of packed red cells, but he needs the clotting factors that only whole blood has."


In the newly constructed plywood room, I climbed onto the canvas stretcher used as the donor chair and offered my arm for prepping. I thought of my five-year-old son as I looked at the drawings by U.S. school children decorating the otherwise naked walls. "Why did you point out that the recipient is an Iraqi?" I asked.


"Some people don't want to donate unless it's for an American or coalition soldier," he replied matter-of-factly.


I felt a cold sting as the needle pierced my skin and then rested against my arm. As the tech secured the needle and tubing, I watched the dark, rust-colored blood race down the line and into the collection bag. It swirled into the anticoagulant, momentarily creating a two-tone mixture that rapidly melded into one. He placed the bag on a scale and told me to squeeze the ball he'd provided every 10 seconds.


"Would you like a drink or a snack?" he asked.


I don't know if I responded; I was thinking about the blood, my blood. I didn't feel any particular ownership of it. Not like my car or house, or even the warm soda I'd drunk before climbing into bed last night. It may be a tangible object, but one of only limited, nonenduring utility. Isn't my own body going to break it down in a few weeks anyway? I felt angry, and for a moment I was less than proud of my fellow airmen and other colleagues.


I had volunteered to come to Iraq and give whatever I could-shy of my own life or limb-to help those in need. I didn't quantify that decision by stipulating which people I thought deserved more help. It's just blood!! Other than a prick and a wince, my body wasn't really affected. It's not like I donated a kidney, or even that warm soda, and wouldn't I give at least a soda to save a life? American surgeons are awake in the middle of the night, frantically trying to save an Iraqi who tried to blow up a guard post. Should I decline to donate when they haven't chosen not to operate?


"You're all through," the tech announced and then removed the needle from my arm. "Hold pressure there, and lift your arm above your head."


Trying not to sound too high and mighty or condescending, I finally asked, "Do people actually refuse to donate blood based on nationality rather than life and death?"


He peered at me over his glasses, and I realized how naive I was.


"That's exactly what they're considering," he said. "If they give blood to an insurgent today, they may be unable to give it to an American tomorrow."


He taped the gauze to my arm and helped me off the stretcher and out of the room as I thought about what he'd said.


Later I stopped by the ICU. I asked the nurse how the patient was doing and mentioned that I'd given blood for him. I showed her my arm but was less proud than I thought I'd be. I was still glad I'd donated but not proud that I'd mistakenly believed my fellow airmen were deciding to donate based on the patient's nationality rather than on their ability to care for their own. I had assumed my colleagues had the worst of intentions rather than rational goals in a difficult situation.


She pointed to the two large, blood-filled drains on the floor by his stretcher. "Well, there it is," she said, and walked away.


He died before morning.