Tag Archives: blood

“A failure by the British state”

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Reading The Poison Line by Cara McGoogan for the Telegraph, 17 September 2023

Mayor Treloar College, founded in 1907 for the education and care of physically disabled children, was more than just a school for Ade Goodyear. The teaching and medical staff were more like an extended family. Dr Anthony Aronstam, director of the Treloar’s haemophilia centre, used to invite Ade and his schoolfriends over to his house where they drank lemonade and swam in the pool.

One afternoon in the summer of 1984 Ade found Aronstam bent over his desk, trembling. “‘We’ve fucked up,’ Aronstam said. ‘We’ve messed up, boys. I’ve messed up. It’s all gone wrong.’”

In the face of a gathering global calamity, Aronstam had been assessing Ade, without his knowledge, for signs of AIDS. Two of Ade’s schoolfriends were already diagnosed. One, Richard Campbell, had already died. By 1986 Aronstam had forty­-three patients who were HIV positive. He wrote in a report, “”There are gloomier predictions about, which suggest that up to 100 per cent of the infected haemo­philiac population will eventually succumb to the virus.”

The Poison Line is the first book by journalist Cara McGoogan. It began life as a couple of features written for this paper in the opening week of the Infected Blood Inquiry in 2019.
It may seem thin praise to single out the way McGoogan has arranged her material here, but truly the effort has been superhuman. This is the story of a global medical scandal, implicating health services, pharmaceutical companies and whole governments, and unfolding slowly enough, and meeting obstacles enough, that many of its victims died before they ever saw justice, never mind compensation. It is told, for the most part, through the recollections of the victims, their families, their doctors, their legal and political representatives. That so many individual stories here burn their way into the reader’s skull is testament to the strength of the source material, of course, but there were so many plates McGoogan could have dropped here and didn’t, so many stories to leave hanging and implications to leave unexplored, that there ought to be some sort of award for literary juggling established in her name.

Treloar College is just the most familiar domestic emblem of a crisis that played out across the US, UK, mainland Europe, and south-east Asia. It began when a new, much quicker, more convenient and more comfortable way was found of administering blood clotting factors to haemophiliacs. Factor VIII, a freeze-dried powder derived from blood, was infected with hepatitis B, but since this infection was common among haemophiliacs anyway, and went away in time, the issue was ignored. Consequently, other agents infecting Factor VIII went undetected, including HIV and hepatitis C.

Institution after institution doubled down on their original error in allowing and promoting a tainted product. In the UK, ministers themselves come out of this account surprisingly well, as McGoogan traces their appalled investigations into decades of deliberate cover-up. It was left to Jeremy Hunt, “the epitome of the establishment politician”, to sum up the disaster as “a failure by the British state. I don’t think there’s any other way to describe it.

The second half of Poison Line, about the victims’ courtroom battles, reveals the economic drivers of the scandal. By the 1990s plasma was more valuable than gold and oil. Most Factor VIII was produced in the US, and American blood bankers, who are allowed to pay donors for plasma, were gathering blood from wherever they could: outside nightclubs, from inside prisons, and from a centre in Nicaragua nicknamed the ‘House of Vampires’, which collected plasma from up to a thousand people a day. The there was the way Factor VIII was made: any one injection could contain the blood of twenty-​­five thousand people.

As McGoogan’s account gathers pace and scale, the more existential the issues become. At what point does a corporation countenance the death of its customers? In what institutional setting will a doctor think it reasonable to tell an AIDS-infected mother that “Women like you should be sterilized”? What level of conformism does it take for the mother of a seventeen year old, infected with HIV from a haemophilia treatment, to tell him that he’s brought shame on her, and throw him out the house?

By the closing pages, we seem to have left the news pages behind entirely, and be wrestling with something that looks very like the tragedy of the human condition.

The inside story of blood

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Visiting the Royal College of Physicians for New Scientist, 17 February 2018

AFFECTION and delight aren’t qualities you would immediately associate with an exhibition about blood flow. But Ceaseless Motion reaches beyond the science to celebrate the man – 17th-century physician William Harvey – who, the story goes, invented the tradition of doctors’ bad handwriting. He was also a benefactor: when founding a lecture series in his own name, he remembered to bequeath money for the provision of refreshments.

It is an exhibition conceived, organised and hosted by the UK’s Royal College of Physicians, whose 17th-century librarian Christopher Merrett described how to make champagne several years before the monk Dom Pérignon began his experiments. Less happily, Merrett went on a drinking binge in 1666, and let Harvey’s huge book collection burn in London’s Great Fire.

The documents, seals and signatures that survived the flames despite Merrett’s neglect take pride of place in an exhibition that, within a very little compass, tells the story of one of medicine’s more important revolutionaries through documents, portraits and some deceptively chatty wall information.

Before Harvey’s 10 years of intense, solitary study bore fruit, physicians thought blood was manufactured in the liver and then passed through the body under its own volumetric pressure. Heaven help you if you made too much of the stuff. Luckily, physicians were on hand to release this disease-inducing pressure through bloodletting.

It sounds daft now, but clues back then that something quite different was going on were sparse and controversial. The 16th-century physician Andreas Vesalius had puzzled over the heart. If, like every other organ, it fed on blood produced in the liver, why were its walls so impenetrably hard? But even this towering figure, the founder of modern anatomy, decided that his own observations had to be wrong.

It was Hieronymus Fabricius, Harvey’s teacher in Padua, Italy, who offered a new and fruitful tack when he mapped “the little doors in the veins” that, we know now, are valves maintaining the flow of blood back to the lungs.

Within 30 years, Harvey’s realisation that blood pressure is controlled by the heart, and that this organ actively pumps blood around the body in a continuous circuit, had overturned the teachings of the 2nd-century Graeco-Roman physician Claudius Galen in European centres of learning. The new thinking also put close clinical observation at the heart of a discipline that had traditionally spent more time on textual analysis than on examining patients.

The exhibition is housed in a building designed by Denys Lasdun. This celebrated modernist architect was so taken by Harvey’s achievements that he designed the interiors as a subtle homage to the human circulatory system.

With the royal college now celebrating its 500th birthday, its institutional pride is palpable, but never stuffy. As one staff member told me, “We only started talking about ourselves as a ‘Royal’ college after the Restoration, to suck up to the king.”

Those who can visit should be brave and explore. Upstairs, there are wooden panels from Padua with the dried and salted circulatory and nervous systems of executed criminals lacquered into them. They are rare survivors: when pickling methods improved and it was possible to provide medical students with three-dimensional teaching aids, such “anatomical plates” were discarded.

Downstairs, there are endless curiosities. The long sticks doctors carried in 18th-century caricatures were clinical instruments – latex gloves didn’t arrive until 1889. The sticks’ silver ferrules contained miasma-defeating herbs and, sometimes, phials of alcohol. None of them are as handsome as Harvey’s own demonstration rod.

But if a visit in person is out of the question, take a look at the royal college’s new website, launched to celebrate half a millennium of institutional conviviality and controversy. You will have to provide your own biscuits, though.

 

Bloody marvellous

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Visiting the exhibition Blood: Life Uncut at Copeland Gallery, London, for New Scientist, 20 October 2017

It caused a storm on social media when it was first shown in 2013, but Dan Glaser, director of Science Gallery London, has a deep and obvious affection for Casting Off My Womb, a scarf knitted over the course of a month by Australian artist Casey Jenkins using spools of yarn stored daily in her vagina. The scarf hangs across the gallery hosting Blood: Life uncut as a visceral and compellingly complex record of one woman’s menstrual cycle. “How else could you ever present that much data?” Glaser enthuses.

“Data” is one of Glaser’s watchwords. So is “visualisation”. He claims not to know much about art. It’s a pose, of course, but a useful one. After 15 years as a research neurologist, Glaser has reinvented himself as an impresario of science communication. His approach is bold: to wrest the gallery space off the art world and apply it to his own, very different ends.

This is the latest in a series of small, off-site exhibitions, and it’s in an out-of-the-way former industrial space in Peckham, south London, because the actual Science Gallery London building won’t be ready until next year.

Everything on show is meant to illustrate medical and scientific ideas. This is why they are here: they are only coincidentally works of performance art, or conceptual art, or what have you.

Normally, this approach encourages dull, derivative work. And if Glaser and his colleagues were as naive as they like to make out, that’s no doubt what we would have got. But the works here, including many new commissions, are often beautiful, and always visually arresting.

Inspired by research into sickle cell anaemia conducted at King’s College London (the gallery’s owner), Glaser and the show’s curator, Andy Franzkowiak, have assembled an exhibition that can be read both for its beauty and for its scientific pertinence.

Given the show quite literally drips with the red stuff, it is still capable of surprising subtlety. Turn from the mechanical behemoth perfusing a bucket’s worth of pigs’ blood in Peta Clancy and Helen Pynor’s installation The Body is a Big Place, and you confront a video filmed in the waters of a municipal swimming pool.

Those people clinging to the sides are organ donors, potential recipients and their families. They are each of them out of their depth in an alien environment, seen through a medium and at an angle that makes identities impossible to establish. If you want an image of what it is like to be caught at the end of your tether in the toils of a necessarily complex and bureaucratic system – well, this video is surely it.

Some of the best pieces here are the most direct. In a riposte to the usual cock-and-balls graffiti found in public toilets, the Hotham Street Ladies have decorated the walls of the gallery’s gents with menstruating uteruses made of icing sugar and sweets.

And then there’s Tough Blood by film-maker Stephen Rudder and choreographer Skylitz, a dance conveying, with brutal beauty, the excruciatingly painful episodes suffered by people with sickle cell anaemia.

The show ends with Jordan Eagles’ installation Blood Equality: a room full of overhead projectors displaying acetates smothered in the dried blood of sexually active gay, bisexual and transgender people.

It’s a campaigning piece, made to highlight the UK and US blood services’ refusal to accept donations from this cohort on the same basis as other groups. The eye is drawn first to the acetate sheets themselves, and naturally enough – given the associations between spilt blood and violence and pain – it’s not a pretty sight. It might not be until you turn to leave the room that it dawns on you that this blood is being projected. The walls and ceiling and floor are covered with it: rich, crackled, stained and impossibly beautiful.

In a strong show, it’s hard to think of a work that better expresses the intent of this queasy, seductive exploration of “the essential, expressive and visceral nature of blood”.

1908: The Island (work in progress)

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I’m writing some biographical sketches of Soviet scientists and academicians

Aleksandr Aleksandrovich Bogdanov, philosopher (1873–1928)

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The moment he stepped off the boat, Lenin went on the offensive: “I know, Aleksey Maximovich, you’re always wanting to reconcile me with those Machists. I told you in my letter it’s pointless, so don’t even try.”

For months, the writer and political activist Aleksey Maximovich Peshkov – better known as Maxim Gorky – had been trying to bring the twin stars of the Bolshevik movement back together. Aleksandr Bogdanov was already staying with Gorky at his residence on the mediterranean island of Capri, once the favourite resort of Roman emperors. Valdimir Lenin had a standing invitation tovisit. The men had once been the closest of friends. Bogdanov had helped Lenin through his split with Trotsky, and the consequent crisis in the party, and between 1906 and 1907, while hiding out in Finland, Bogdanov, Lenin and his family had lived practically out of each others’ pockets.

But as the forces of reaction dismantled the gains of the 1905 uprising, Bogdanov and Lenin had grown further and further apart. Lenin still held out hope that the Bolshevik cause might be furthered within the Duma – the constitutional parliament established in 1905. Bogdanov thought this was a waste of time. His radical politics had been acquired during his first Tsarist exile, while delivering lectures to factory workers; he wanted the Bolsheviks to align themselves much more strongly with the old underground workers’ organisations.

 The disagreement between Lenin and Bogdanov was a crucial one for the Party, and the men’s more or less equal standing only made things worse. Bogdanov – likeable, gentle, and a little bit full of himself – was also a loose cannon, preaching revolution for its own sake, as man’s only significant form of self-assertion. And he was extraordinarily good at getting hold of money. The Bolsheviks’ sometimes terroristic “expropriations” of funds from political opponents, and from the districts that harboured them, were Bogdanov’s idea. Bogdanov held the party’s purse-strings; since 1907, Lenin had found it harder and harder to fund his own projects.

Immediate and violent action might have drawn the two men together under the banner of a common cause – but there was no action to be had. With the decision to work within the Duma, 1905’s exciting world of barricades and mutinies had to be given up, and Bogdanov bitterly resented the fact.

The Bolsheviks seemed to be getting further and further away from any real action. In typical Chekhovian style, their factional arguments grew ever more rarefied. One contemporary memoirist wrote: “When Ilyich began to quarrel with Bogdanov on the issue of empiriomonism, we threw up our hands and decided Lenin had gone slightly out of his mind.”

Bogdanov, the son of a rural teacher, was an urbane thinker. He had read his Kant. He followed the theories of Ernst Mach and Richard Avenarius. He admired Marx, but he did not believe that Marx should have the last word on every topic. Above all, he understood that the sciences of mind lagged painfully far behind the physical sciences. So it was important to be as honest as possible about where one’s information about the world was coming from. The Austrian physicist Ernst Mach had pointed out that, real as the world may be, we can never apprehend it directly: our knowledge of it comes through our senses. Bogdanov’s “Machism” was an attempt to apply that honest admission consistently across all bodies of knowledge—    

Bogdanov knew far more than was good for him: that afternoon in May 1908, as he vainly tried to explain his position, he stumbled over his words.

“Drop it,” Lenin snapped.

Perhaps it was Gorky who suggested a friendly chess game to clear the air. At any rate, he is there in the photograph, looking on as Lenin, seated on a balcony with his back to the Tyrrhenian Sea, steadily loses control of the game, and himself. It astonished Gorky how angry and childish he became.

Lenin believed in Marx. He believed in the natural sciences. He believed that some things had been discovered once and for all. He was no philosopher, and he imagined that Bogdanov was a dangerous relativist. Bogdanov believed in nothing and so, whether he knew it or not, he was siding with the priests and the mystics. “Somebody or other – Juarez, I think – said, ‘It is better to speak the truth than be a minister.’ Or a Machist, I would add.”

Aleksandr Bogdanov had always revered Lenin, but the differences between the men were becoming unbridgeable. Bogdanov was the more intellectually adept of the two, but he lacked Lenin’s appetite for political infighting. Bogdanov was a novelist: his science fantasy Red Star was being published that year, and he hankered for more writing time.

Bogdanov and the others went out for a walk, and Lenin unburdened himself to his hostess, Gorky’s common-law wife, Maria Andreyeva. Of Bogdanov and his set, Lenin said, more in sorrow than in anger, “They are intelligent, talented people. They have done a great deal for the Party, they could do ten times more, but they won’t go with us! They can’t. Scores and hundreds like them are broken and crippled by this criminal system.”

With hindsight, it’s clear enough that Bogdanov’s philosophy foreshadows the greatest achievements of Soviet science in the first half of the twentieth century. Marxism’s greatest intellectual challenge was to to make room for human experience, while at the same time  doing away with God. It wasn’t enough to be crudely materialist, because Mind wasn’t a thing. You couldn’t point to it the way you could point to a chair or a table. And you couldn’t make mind a special case, either, because that led straight to mysticism. Mind, therefore, had to be an “emergent property” – something that arose, not from matter itself, but from the way matter was organised. 

Bogdanov’s breakthrough was to realise that this is true of everything. Everything is as it is because it is arranged in a certain way. If you understand how something is organised, then you understand its essence. If you can describe things in terms of their organisation, then you really can talk about human minds and even whole societies in the same breath as chairs and tables, since all these things are simply more or less complex arrangements of matter. Bogdanov envisaged a science which would embrace the biological and social worlds in the way that mathematics had described classical mechanics. In the West, we call this science “systems theory”: our entire digital culture is built upon it.

It has been said that Russian philosophy has a Messianic streak a mile wide, and Bogdanov’s writings certainly lend credence to the claim. Bogdanov attempted to apply what was essentially a scientist’s philosophy over the whole of human experience. He believed that the world’s “biological-organisational” tendencies could and should be mastered to control human society on an economic, political, psychic, and even sexual level. Bogdanov’s schemes were at once grander and vaguer than Marxism itself. They were – or seemed to be – wildly impractical. No wonder, then, that come the October Revolution, and the Bolshevik takeover of the State, Lenin was prepared to tolerate his old friend’s “infantile” social experiments.

Following his visit to Capri, Vladimir Lenin had split from Bogdanov and his followers. He had attacked Bogdanov’s work in print and in person, and had him expelled from the party. Bogdanov had responded by walking away with the Bolsheviks’ monies, and using them to set up an experimental revolutionary school on Capri with his brother-in-law, Anatoly Lunacharsky. The experiment had faltered. By 1917, Bogdanov’s ambition to manufacture and manage a truly proliterian culture must have seemed a harmless dream  – harmless enough that Lenin appointed Bogdanov’s co-experimenter Lunacharsky Commissar of Education, charged with the development of Soviet culture as well as its learning. Lunacharsky, in turn, made room for his brother-in-law’s ‘Proletkult’ experiment: an attempt to bootstrap an entire proliterian culture out of little more than a heap of good intentions.

Incredibly, it succeeded. At its height, Bogdanov’s cultural movement boasted 400,000 members, published twenty journals, and had won the public allegiance of virtually every significant artist, musician and writer in Russia. Experimental art, music and theatre flourished. The Tula Proletkult music section had a symphony orchestra, a brass band, an orchestra for folk instruments, and special classes in solo and operatic singing. Even tiny arctic Archangel, perched on the coast of the White Sea, boasted a choir. Lunacharsky greeted Proletkult’s meteoric rise with bemusement; Lenin’s reaction was one of barely-disguised horror. He insisted Lunacharsky’s Commissariat take over the running of the Proletkult: the Commissariat itself was closed down soon after. Now that the Bolsheviks were in power, Bogdanov’s anarchic inclinations could no longer be indulged.

Like many an intellectual who followed him into semi-obscurity, Bogdanov responded by devoting his time to his writings, and to science. In 1924, he began to investigate scientifically a folk idea about blood that had cropped up once or twice in his science fiction: the idea that transfusions might rejuvinate the body. His studies were perfectly serious: in 1925-1926, he founded the Institute for Haemotology and Blood Transfusions, which was later named after him. But here too, and critically, Bogdanov’s ambition got the better of him: on 7 April 1928 he died following a transfusion of infected blood.