My Ngoc To
I had expected my first bike accident to be much more loud and drawn-out. But it happened in less than one second. There was no glory. There was no sound. I had simply ridden my bike and fallen off, landing twisted among the sand and metal juts.
I felt no pain, only a tingling in my left knee. I looked down and saw a large gash at the center of my knee. This porous stretch of skin contained little pink craters, each one containing a grain of sand, surrounded by multiple walls of flaking skin.
I stared at attention, fascinated at the transformation of my body, when something began to happen.A thick, bright red liquid seeped out from underneath, coming out from all the pores. Once it reached skin level, it bubbled out in the form of tiny flowers, which I intertwined until that hole in my knee turned red. It poured over the sides and trickled down my leg. The tingling turned into a sting.
I started to limp quietly towards the front door of my house, whimpering as I went, for I had just gone through the experience that every little girl must go through, of witnessing her own blood for the first time.
Since then, I have watched blood flow from my body countless times. I am consistently taken aback by its color, its silent movement across my skin, its slight saltiness against my tongue. Most of the time, I am not expecting it or the events causing it, unless I need to have it drawn. Even then, my own blood remains quarantined inside tubes and I am not called to interact with it.
But once I was, in my sophomore year in college, in a basic science class in which we studied the structure and nature of certain molecules essential to life. We often studied associated diseases, so when we reached insulin, we turned our heads to diabetes.
In a class lab, we had to measure our blood sugar levels before and after eating a glucose tablet. To do this we would have to prick our fingers with a tiny needle, wait for the blood to come out, and then insert that droplet onto the test strip of a machine for measurement. It was quite simple, really.
There were only a few pricking machines, so I had to wait my turn. I sat at my desk and watched ten other students play with their blood. The class, which generally stayed apathetically silent, had suddenly erupted into giggles and shouts of delight. I watched a tall lean boy next to me grin and stare cross-eyed at his finger as the blood came out. Another girl in the back yelled to the class that she had a lot of blood in her finger.
I prayed that I could get a lot of blood too.
The machine finally came to me. With the needle poised and ready to shoot, I counted to three and then pressed down hard on the release button. Before I could make sense of the pain, it was gone. I looked down, and to my delight, a small drop had already formed at the side of my finger. The drop swelled to twice its size and turned slightly darker in hue. I let it drip onto the testing strip of the machine, and once the machine was finished reading, I handed it to my friend.
Barely anything came out from his fingers. I watched him scrape the side of his finger against the plastic strip in order to get any few drops in, but it was not enough, and the machine showed a failed reading. He tried again, pricking himself from a different finger, but only a scant amount went out. The machine revealed the same result: FAIL.
I stared more than I should have—I found myself pitying him. Not because he couldn’t draw blood, but because it seemed as though his body did not hold any blood, as if his body had failed to keep itself running.
In the meantime, a giant drop of blood had already swelled on my skin and was threatening to slide down my finger. It wouldn’t stop coming out, and I continually wiped the drops away only to find them quickly replaced by another.
I was amazed at how much blood I had. More so, I was surprised at the vividness of its color. I stretched out my hands and imagined my hand without its cover, just a contained current of gushing blood. I felt pride.
Human skin is not very thick—just two to three millimeters—and yet it manages to hide the color of our bodies. If we peeled off our skins and threw them in the corner, all that would be left would be piles of meat and bone, complete with a set of eyeballs and spilling organs. And surrounding that would be blood, expanses of blood in all directions. Each human body contains up to five quarts of blood, enough to cover and stain the hardwood floor of any kitchen.
The next time I pricked a finger it was not my own. I’d taken up a part-time job as a research assistant in a geriatric clinic. I first started out dealing with just paperwork, but as I finished my trainings, I began to run the patient visits.
For a particular study about atrial fibrilation, we were required to measure the thickness of their blood by giving an INR, short for international normalized ratio, blood test.
A sweet old lady dressed in pastel floral patterns sat smiling at me from her chair. I fumbled around, gathering my necessary tools for my first real operation.
I slowly put on gloves and sat down on the stool in front of her. Everything happened very quickly. I sanitized her hands, took out the gauze and a Band-Aid in preparation, removed the stinger from its packet, and before I could think, I had already punctured a hole in her—the sweet red nectar was seeping out of her body.
My nervousness vanished the moment I saw the blood. It grew from her finger, forming a perfect round droplet. As I milked her finger for more, collecting it into the cup as I went, it began to spread to different parts of her finger, collecting in the small rivets of her skin, and it left behind the same familiar crimson stain. I no longer felt like I was dealing with a foreign object. Her skin became my skin, her blood my blood.
Once the cup was properly filled I inserted it into the cuvette, which drained the blood and simmered it inside the machine. The blood was boiling when I took it out.
I thought that her blood looked normal, but when the test results came back, we learned her INR had climbed up to almost five, while the normal range was two to three. I didn’t know what that meant at the time—her blood could have either been too thick or too thin. If it was too thin, I thought, there would be blood running like liquid through her body and seeping out of every little hole—through her eyes, her ears, her pores. If it was too thick, it would clot and stick to the vessels. Perhaps her high body temperature would have warmed up the blood, just like the machine did to the sample, and simmer it softly, just until it was cooked and brown like the coagulated pork blood that gets sold in Vietnamese grocery stores. I could not believe she was so close to death.
Whenever one of our patients had a bleed event or was hospitalized for any reason, we would receive pages and pages of lab results measuring almost every imaginable chemical in their blood. I had to enter each value into the computer: the time and date the blood was collected, the chemical being measured, and its normal range. This took hours and hours to finish. Once, when an event came up, I sat in front of the computer for two days entering almost three hundred labs.
That was my first time looking closely at any medical terms. Some terms I could understand, such as uric acid, glucose, or sodium, but I also encountered combinations of letters I had never seen before. Gradually, I came to understand that rbc stood for red blood cells, wbc for white blood cells, and hgb for hemoglobin. But there were still others that, even today, I do not know, only that the values recorded were almost all out of range.
One patient was in the hospital for one week, from December 28 to January 6. When I paid attention to the dates, I saw that his levels were mostly normal in December, but come January 2, almost half of his lymph%s and MCVs and MPVs were slightly abnormal, and then by January 6 his glucose levels had jumped to five times the normal amount.
But I was finally done, and I thought no more about it. I simply assumed that everyone was off in some way or another.
Later on, as I handed the paperwork back to my boss, I mentioned how a lot of this patient’s labs were abnormal. She paused for a second, and then explained that this patient had been in the hospital for quite some time for a serious bleeding event. She had been quietly watching him die.
I realized then what I had just done. I had documented the slow death of a man by watching his blood go berserk.
Blood holds within it the history of an entire life, and as long as we live, it flows through our bodies carrying evidence of our past, making us bleed and clot and cry until that history dissipates, and blood withers away with the life it once carried. Like how the lights on a switchboard go out one by one in a crashing plane with increasing speed until all the lights suddenly vanish, I was watching the levels of each vital fluid in his body shoot off in dangerous directions—until one day, when his entire blood system completely loses its balance, the last light will turn black, and he will have hit the end.
And I would sit in front of the computer with no more blood to enter. And a few days after, we would receive a safety notification letter from the International Review Board, saying that the cause of concern was, in cold, bold letters, DEATH. I would punch holes in that document and file it away in the binder used specifically for study correspondence, and then put that stark white paper away until it was time to move on to the next life.