Easy accessibility of blood encourages unnecessary surgery

patient facing a blood transfusion ask his doctor whether he will receive volunteer blood or "bought" blood.

Another problem is the large amount of blood which must be thrown out for a variety of reasons, such as too much collected for use within the time limits. Added to this are the internal political squabbles in the blood bank industry. Finally, there is the basic question of how much blood is used for unnecessary operations. I still am waiting for the first blood bank which will provide an honest report to blood donors stating the types of surgery for which their blood was used.

In your particular case, I presume you wrote for my advice because you do not trust the people in the blood bank who try to reassure you.

I can understand your concern, since blood bank personnel obviously have a vested interest. I hope you will discuss this incident with your own doctor so that he may contact the blood bank to find out exactly what happened. You should return only after careful investigation reveals sufficient evidence to convince your husband that it is safe for you to again set foot inside the blood bank.

Blood banks across the country took offense after I answered this elderly Florida woman's question about donating blood.

Among the flurry of negative letters I received was one from Edward O. Carr, executive director of the Central Florida blood bank in Orlando, who objected to my statement that paid—for blood, with its high incidence of hepatitis, represents a major source of transfusions in the United States. Carr points out that volunteer donors now "provide more than 95 per cent of the blood used for human transfusions," and he assures me that the blood banks which still are paying their donors are "rapidly diminishing."

I will not argue whether five per cent represents a major or a minor potential source of hepatitis, since everyone knows doctors use statistics differently than do patients. Thus, an operation which may be minor to the physician can be major to the patient. Complica- tions from blood transfusions may be of low incidence to the physician, but for the patient who becomes jaundiced from hepatitis—carrying blood, the incidence of complications is 100 per cent. That's why my Newsletter is not called "The Doctor's Doctor," but rather "The People's Doctor."

Bill T. Teague (whose name is followed by the letters BS, MT(ASCP) SBB), president of the American Association of Blood Banks, makes the same point as does Mr. Carr. But, just to show you how carefully you have to watch the use of words, Teague speaks of 95 per cent of the "whole blood" collected. Yet another correspondent, Delores McGuire Mallory, MT(ASCP)SBB, of Dayton, Ohio, adds a further piece of informa- tion in her statement that while only a few blood banks use paid "red cell donors, many commercial plasma banks exist." Ms. Mallory adds that single unit transfusions, properly condemned by practically all medical educators, "are still given." Like her colleagues, she objects to my statement that blood banks have a vested interest, and she insists that the only vested interest blood banks have is "to develop repeat blood donors who feel good about donating blood." I can't help thinking that this kind of statement would have greater credibility if it came from someone whose livelihood and career were not dependent on the number of gallons of blood collected.

Jacqueline D. Miller, M.D., medical director of Eugene, Oregon's Lane Memorial Blood Banks, informs me, as does Bill Teague, that a new chemical——CPD—Adenine-—now is being added to extend the shelf life of whole blood from 21 to 35 days. This means patients have a whole new