July (Web-only) 2003

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My entire career in medicine traces back to one dreary night at Connaught Hospital in East London. Until then I had stubbornly resisted all family pressures to enter medical school. Instead, I had entered the building trade, apprenticing as a carpenter, a mason, a painter, and a bricklayer.

My goal was to use these skills back in India. Evening classes in civil engineering had exposed me to the theories behind construction. One obstacle to my return to India remained: the mission required a one-year course in hygiene and tropical medicine at Livingstone College. I was assigned to a local hospital to do dressings in the wards and to learn basic principles of diagnosis and treatment.

It was during one evening of my stint at Connaught that my whole view of medicine—and of blood—permanently shifted. Hospital orderlies wheeled a beautiful young woman into my ward. She had lost much blood in an accident. It had drained from her skin, leaving her an unearthly pale color, and her oxygen-starved brain had shut down into an unconscious mode.

The hospital staff lurched into their controlled-panic response to any patient near death. A nurse dashed down a corridor for a blood transfusion bottle while a doctor fumbled with the apparatus to get the transfusion going. Another doctor, seeing my white coat, thrust a blood pressure cuff at me. Fortunately, I was trained to read pulse and blood pressure, but I could not detect the faintest flicker of a pulse on her cold, limp wrist.

She looked like a waxwork madonna or an alabaster saint in a cathedral. Her lips, too, were pallid, and as the doctor searched her chest with his stethoscope I noticed that even the nipple of her small breast was white. Only a few freckles stood out against her pallor. ...