The needle used in plasma donation is bigger than the needle used in regular blood donation. It’s a bore needle, which is aptly named because they bore it into your arm. It’s like drilling for oil, or gold! They’re drilling for liquid gold—plasma—the fluid part of your blood.
Plasma is not necessarily more precious than platelet-laden whole blood, but it is more easily replenished. And more lucrative. In the U.S., blood donated for transfusion is required to come from volunteers, according to the Red Cross, who will amply supply you with cheery nurses, post-donation cookies and lemonade, and an all-around feeling of do-goodery for your trouble. Plasma will net you an extra forty or fifty bucks a week, and a warm thrum of altruism if you think of all the medical treatments it’s enabling—I guess. If you’re that kind of person. I wasn’t. If you’re me, it will leave you with a knot of conflicted feelings dotted with spasms of guilt about “Wrong Reasons for doing Good Things,” and tiny permanent scars in each inner elbow.
The Lutheran Church-Missouri Synod does not believe in transubstantiation. That’s a Catholic piece of theology, the idea that the wine and bread of Eucharist, or communion, are transformed by the sacrament into the actual, literal flesh and blood of Jesus Christ. You can imagine the squirming this induced among the 12-year-olds in my confirmation class. This was one of many boggling concepts explained to us during my years of Lutheran parochial education, that Jesus’ blood—freely given, through no merit of our own, it was always emphasized—was in, with, and under the bread and wine, but not actually it, a concept a bit obtuse for our pre-teen brains. I went home and told my mother I wanted to name one of our kittens Eucharist. She disapprovingly explained the meaning of the word “sacriligious.”
I donated blood in high school and beyond, when drives were set up in student lounges or school lobbies, but I stopped once I realized I could make some money donating plasma. Unlike donating my eggs (I’d have to go off birth control) or participating in drug testing (same, plus didn’t work with my class schedule), giving up my plasma seemed relatively easy. I was in college, and my friends gave me the rundown about the plasma clinic a 15-minute walk from campus, would roll their eyes when you mentioned you didn’t think you could do it because you got a new tattoo/piercing/were just getting over pneumonia.
“You don’t need to tell them that,” they scoffed.
But those white-coated phlebotomists radiated authority! They looked so knowing when they asked when I had gotten my ears pierced, my eyes darting around the exam room. But I learned quickly that they have no idea if you’ve been sick recently, or if you drink a Colt forty after your donation session rather than a bottle of water, or sit on the curb and smoke a cigarette for the highly effective buzz, rather than, per official recommendation, eat a sandwich. Hydration is the thing, though. If you’re well-hydrated, you can pump out a few more cubic centimeters, and make yourself an extra five bucks.
If you’re a first-timer, you’ll wait for hours in the cramped lobby, rich in people-watching potential (no one does this unless they have to, you’ll determine). On my maiden voyage, I was fine, I was a rock star, I was 19 years old, luridly awaiting the day when I’d see one of the blood bags accidentally disconnected, as one of my friends had witnessed. He said it looked like a murder scene.
“You’ve got some roly-poly veins, don’t you?” the phlebotomist said as I looked away from the insertion site. I pumped the little foam ball in my hand as the tube on my arm filled, watched my whole blood separate: platelets in the bag, liquid in the bottle, extracted through a whirling, centrifugal device. Like urine, which it resembles, plasma from a healthy and hydrated donor will be clear and light. If it’s from, say, a hungover college student, it’s cloudy and darker. If they eat at lot of fat you can see it in the bottle, in foamy streaks.
Mixed with anticoagulant, the platelets flowed back into my arm. The machine clicked off and the saline came and I was shivering, teeth chattering. It is a very specific set of sensations, having saline pumped into your veins. A chemical, metallic tang grips the back of your throat, and your body starts at feeling an icy foreign substance flush into its veins. Months of a twice-a-week donation routine took a toll on my veins, which started squirming away from the poke, and it took a lot of kneading and coaxing of flesh on the phlebotomists’ part to get that needle in place.
Home for the holidays, my parents eyed me suspiciously when I asked for gas money. “What happened to your plasma money?” they asked. I was pale and wan, with dark circles under my eyes, always getting sick. My mother insisted that I wasn’t getting enough rest, a lifelong refrain. “Your body is the Lord’s temple,” she told me, lips pursed. “You need to treat it like a temple.”
Lutherans lump first communion in with confirmation, around the age of 14. That much of the theology was easy enough to process: that I would not be tasting wine until the 8th grade. I had a lot of expectations of that day in May, kneeling at the altar with my classmates, all of us in white robes, listening as the pastor intoned the liturgy, “take, drink, this is my blood which is shed for you for the remission of your sins.” I ate my Styrofoam wafer. I took my sip of Mogen David. I stared at the pale statue of Christ at the front of the church and waited for the transformation to take hold, washed in the blood of the lamb.
Instead it was panic that set in, that maybe this was what redemption felt like: nothing special, no different at all, no glow, no ecstasy, not even a head rush from the teaspoon of weak wine. Or that maybe that this freely given blood was not actually free, not for the likes of me.
Several years after that first plasma donation, far removed from declaring never again, never, ever again, I was back. Same town, same clinic. I was two or three jobs beyond my college degree, and settling into my dream profession, newspaper journalism, nursing the realization that my dedication to the craft was rendering me akin to a whaling ship captain circa 1861. The reporting job paid next to nothing and I was trying to fund my first ever Thanksgiving dinner as a host. I was 23, and there I was with another hole in my arm, but at least unlike the John Prine song that always got in my head every time there was a needle in my line of sight, money was coming out, not going in.
I don’t remember being embarrassed the first time around, years earlier, or having the phlebotomists treat me differently, but this time I was. They did. No longer an obvious student in scruffy thrifted pants and old-man sweaters, I stuck out. The lab-coated employees joked loudly with the donors placed next to me, but then turned and quietly asked me if I felt alright. I was miserable. The new ID photo shot for my file was all sad eyes and defeated forehead. Because I hadn’t done it in years, I had to go through the agonizing first-time process all over again, urine test and all. This being the start of the recession in a town already economically depressed, the lobby was packed from open to close. Four hours of waiting for 45 minutes of a fat needle stuck in the crook of my elbow, a tube taped to my arm running hot with blood then cold with anti-coagulant, for $40—just to put gas in my car and pay my electric bill. It was agonizing, I suppose, because it was a choice: I could just not do it.
I could just not have a strange woman with a mustache listen to your heart, massage your arm for veins, swab you with iodine, stick you. Back at my apartment I crawled into bed, alternately humiliated and annoyed with myself for being humiliated by this completely optional income supplement. In the shower, everything went hot and blurry, so I yanked off the water and sat in the tub shivering until the nausea passed. I could still smell the antiseptic clinic in my hair after I toweled off. This was all incentive enough to spend more frugally. But accidents happen—or accidentals, in my case—like a car repair that would’ve been manageable had I been in possession of a savings account.
I went back several times through the first months of that new year, always avoiding a beautiful woman named Graciella, and her enviable cheekbones. I had met her and her younger brother when we all waited tables for the same restaurateur, back in my college days. I needed a third roommate, and her brother, Joe, had needed a place to live.
He stayed for a few months, while he was 17, until he ran into some trouble and couldn’t pay rent. There was a fight, a mutual decision for him to move out. We’d called each other little brother and big sister but there was no blood between us, and so with the money gone there was nothing to sustain all that familial warmth. I avoided her until I couldn’t, worried she’d be annoyed that I had ditched her brother once upon a time. Graciella checked my knuckles and elbows for tracks and marked the nail of my left ring-finger with a black-light marker and asked my name, address, date of birth and phone number and took my weight. As I plucked an AIDS bulletin from the stack she asked, “Did you used to work at that restaurant?” “Yes!” I said.
“I knew I knew your face!” she said, smiling. Joe had had no accent, even though they both grew up in Venezuela, but hers was still there, only adding to her loveliness. “And Joe was my roommate for a little while,” I chirped, hoping to preempt the awkwardness. Her face did not change. “Joe is dead,” she said.
”It was an accident,” she said, and I was called away, back to a booth to have my finger pricked and my blood pressure checked. She came back to talk to me when I was hooked on the line. There was no way to avoid her. By “accident,” I had thought she meant a car crash, but what she meant was that he’d been running with troublemakers in Venezuela (I didn’t even know he’d gone back), and had been in the wrong place in the wrong time and caught some fire, a bullet that was not meant for him but it killed him anyway. ”I am so, so sorry,” I said. It was months ago, she told me. I had never known someone who was killed. Not dead, but killed. She asked me if I had anything of his, any pictures, her eyes pleading.
“It’s been almost two years since I lived in that house,” I told her, lamely. She was disappointed. I told her instead how he’d dreamed of managing a club, of driving flashy cars and showing off for VIPs, how he had such a crush on Lindsay Lohan. It was all I had to give to her. She hadn’t known, she said, and smiled. When I was finished, they pulled the needle out of my arm and I trudged home through snow drifts, knowing I would never go back. It wasn’t worth it. The rising tide of resolution in my chest made me feel lighter, somehow.
But I certainly felt far from sacred.
Lynn Vollbrecht is a writer and editor living the dream in flyover country. Photo: Shutterstock/sfam_photo