Article
Care
Creed
Easter
Trauma
1 min read

Understanding the power of blood

From hospitals to hymn books, it's significant for a reason.

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A bag of blood connected to a drip.
Give blood.
Aman Chaturvedi on Unsplash.

With one billion molecules of oxygen packed into each of your 30 trillion red blood cells, blood is sometimes known as the red river of life. Countless lives have been saved through blood transfusion, but why, throughout history, across continents and cultures, has there been a special interest in the blood of one man crucified 2,000 years ago, believing it alone to have “wonder-working power”?  

Whether you are a newborn baby with half a pint of blood, or an adult with nearer nine pints, “what is certain is that you are suffused with the stuff”, writes author Bill Bryson in his book, The Body.  

Once thought to ebb and flow in waves like the sea, from the liver to other organs, having been heated in the heart, blood in fact flows in a network of vessels measuring some 60,000 miles, with the heart acting as pump, not heater. Cleverly conserved through a complex system of blood-clotting in the case of injury, blood is a precious resource that needs replacing if lost in large amounts. Victims of road traffic accidents can require up to fifty units of blood; significant amounts are needed for organ transplantation, severe burns or heart surgery. 

The first human blood transfusion in Britain, using blood from a lamb, was performed by Dr Richard Lower in 1667, given not to replace blood loss but to change character: could the old be made young, the shy be made sociable through blood transfusion? Apparently not.  

Safe transfusion awaited the discovery of blood types by Dr Karl Landsteiner in the early 20th century. Today, NHS Blood and Transplant deliver 1.4 million units of red cells to 260 hospitals each year for transfusion; about 85 million units are transfused worldwide, given to replace blood loss after accident, surgery, ulcer, ectopic pregnancy or for anaemia in cancer. Also used to boost blood cell numbers in malaria, sepsis, HIV, leukaemia and sickle cell anaemia, blood transfusion is now amazingly safe. Fatal reactions are extremely rare, “occurring only in one out of nearly two million transfusions”, writes physician Dr Seth Lotterman. “For comparison, the lifetime odds of dying from a lightning strike are about 1 in 161,000,” he adds. The risk of HIV infection has dropped dramatically, to less than one in seven million. 

History tells though of the danger of transmitting disease from the blood donor during transfusion. The World Health Organization recognises risk of infection with HIV, hepatitis, syphilis, malaria, and Chagas disease. The Contaminated Blood Scandal saw an estimated 30,000 people in the UK given blood transfusions and blood products infected with hepatitis C, hepatitis B and HIV. More than 3,000 people died as a result, and thousands more live with on-going health complications. For my final Christmas article for Readers Digest, I wrote on Stephen Christmas, a tireless campaigner for blood safety who lived with haemophilia and died in 1993, having contracted HIV through contaminated blood. 

I was a blood donor. However, I am now unable to donate blood or organs for the rest of my life since there is a possibility that my blood is ‘stained’, possibly with prion disease, after adopting embryos. The Blood Transfusion Service will not accept donations from women who have had various fertility treatments. 

And there’s another uncomfortable truth about blood donation – the NHS does not have enough blood, organs, tissues, platelets, plasma or stem cells to treat everyone who needs it. As a nurse, I remember caring for a man dying of liver cancer. Suffering from sudden, massive melaena (blood loss in black, tarry stools as a result of internal bleeding), he received emergency blood transfusion, with bag after bag of blood being infused, until the consultant called for the treatment to stop, because the bleed was too big – and blood supplies too scarce.  

Struggling to accept the stark reality of stained blood and dangerous shortages, I kept coming back to an old Sunday School song about blood, where absolute abundance and ultimate cleansing are instead promised. 

There is a fountain filled with blood 
   Drawn from Immanuel’s veins; 
And sinners, plunged beneath that flood, 
   Lose all their guilty stains. 

Gruesome and graphic in its imagery, but full of deeper meaning. And as a nurse, I’m accustomed to blood, sometimes lots of it. I’ve seen that man bleed out on the ward that night; I’ve attended a road accident, where a boy lost his leg – but not his life, because towels stemmed the massive flow of blood. I’ve raced a patient to the operating theatre after her aortic aneurysm burst within; I’ve stemmed arterial bleeding from the groin by applying prolonged pressure to the site punctured by a catheter during cardiac stenting. According to the World Health Organization, severe bleeding after childbirth is the leading cause of maternal mortality world-wide. Each year, about 14 million women experience postpartum haemorrhage resulting in about 70,000 maternal deaths globally.  

In the Bible, and in hymns of praise like this one, there is also no getting away from blood. “Like it or not, the Bible is a bloody book,” writes  Kyle Winkler. It runs through the book like a crimson thread. There’s a story of a woman bleeding for twelve years, until she touched the hem of Jesus’ garment and was healed.    

Elsewhere the Bible keeps returning to the idea of blood, shed in sacrifice, used to cleanse, save, and heal in a spiritual sense. In the Old Testament, animal blood was painted on doorposts at Passover as a sign of protection from judgment, and sprinkled ritually on the altar as a sacrifice for human sin, restoring relationship with God.  

On Good Friday, Jesus himself shed (and sweat) his blood, sacrificing his life on the cross to “wash our souls” once and for all. Millions of Christians across the world take a sip of communion wine each Sunday in commemoration of this act. It’s a beautiful gift, coming with a promise that the shed blood will “preserve thy body and soul unto everlasting life”, through the forgiveness of sins. It’s no wonder then that churches love to sing about this blood. “Would you be free from the burden of sin? There's pow'r in the blood, pow'r in the blood,” goes one hymn, while another simply says, “Your blood has washed away my sin, Jesus, thank you”.  

“God’s intention for blood isn’t gory—it’s beautiful! And I’m certainly not offended or scared by it,” writes Kyle. “Rather than question how little blood I can get by with, I’d rather stand under the cross to be covered in all that I can get!” Thank God for the fountain of forgiveness that flows from Good Friday. 

  

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Column
Books
Culture
Music
Space
6 min read

Magnificent or mundane: how do you react to the overview effect?

Creators of a book, an album and a game, can’t agree.
A small white space capsule orbits around the earth.
A SpaceX Dragon capsule orbits above Earth.
NASA.

As I write this, two Nasa astronauts – Suni Williams and Butch Wilmore (possibly the most USA-sounding name imaginable) – are preparing to leave the International Space Station to return to Earth. They were supposed to stay on the space station for eight days, but a technical problem with their spacecraft meant they’ve been stranded in space for nine months.  

Nine. Months.  

It sounds like the premise for a horror film. Two stranded astronauts slowly descend into madness as they become increasingly isolated and cut off from humanity. Written and directed by M. Night Shyamalan, probably. 

That’s a lot of time to be stuck orbiting Earth, gazing at the pale blue dot, contemplating our little corner of the universe. There’s a phenomenon called the overview effect: a shift in thinking astronauts go through when they see Earth from space. Putting the planet into the wider context of the entire cosmos leads observers to rethink humanity’s place in the universe, and what it means to be human.  I imagine Suni and Butch have had quite a bit of time to do just that in recent months.  

And the overview effect is currently having a bit of a moment in wider culture, too.  

If you went into any bookshop in the weeks before Christmas, you likely saw stacks of Samantha Harvey’s novel Orbital. It tells the story – although there’s not much by way of traditional ‘story’ in Orbital – of six astronauts on the International Space Station, pondering the nature of humanity from their lofty vantage point. 

Having won the booker prize, booksellers were keen to encourage readers to buy Oribtal. Praised by the Booker Prize judges for its “beauty and ambition”, I was looking forward to reading it, when I could. (And, let’s be honest, it’s a short book, which probably helped sales. Who has the time to read Ulysses or Infinite Jest in between school runs and weekly shops?) 

When I finally read it in January, I was left disappointed. I found a surprising lack of humanity in Orbital. With the exception of one astronaut – who spends her time mourning her recently deceased mother some 250 miles up in the sky – the characters feel somewhat paper thin; barely human. As the story meanders from person to person, never really settling on one character long enough to really develop them, it feels a bit … insubstantial?  

Maybe it’s a victim of its own hype. Maybe the not-quite-humanness of the astronauts and the listless quality of the narrative are intentional, designed to capture the ungrounded nature of life in space in both form and content. Maybe that’s being generous. Either way, I was left closing the book and shrugging my shoulders. If Orbital was supposed to offer a glimpse into that overview effect, it left me nonplussed. 

By coincidence, Steven Wilson has just released his eighth solo album: The Overview. Who is Steven Wilson, you ask? Only “probably the most successful British artist you've never heard of” according to The Daily Telegraph. With Wilson’s album currently sitting at #1 in the UK album charts, it doesn’t seem an unwarranted title.  

In The Overview, Wilson explores the overview effect across just two lengthy pieces of music. In the first, Wilson contrasts the mundanities of life on Earth with the chaos of space, calling us to attend to miracle that is humanity, thanks to lyrics written by the annoyingly talented Andy Partridge of XTC: 

“And there in an ordinary street  

A car isn't where it would normally be  

The driver in tears, about his payment arrears 

 Still, nobody hears whеn a sun disappears in a galaxy afar.” 

With Partridge’s help, Wilson manages to capture that humanity so sorely lacking in Orbital. Amid a sea of seemingly barren space, there is life here on this small, pokey planet, and the dramas and stresses of a man fretting about his debts don’t seem out of place, even when compared to the implosion of a star on the other side of the universe.  

All this makes a recent interview with Wilson all the more odd.  

When speaking about the overview effect, Wilson says “Your life is futile, it’s meaningless – and isn’t that a wonderful thing?” before doubling down: “And I do mean that. We spend so much of our time anxious, stressed, worried about things that sometimes we just need an injection of perspective.” 

For Wilson, this perspective – this overview effect – is liberating. It allows to stop navel-gazing, to pick our heads up and to realise our freedom to do whatever we want. After all, everything’s just matter in varying different arrangements:  

“The clouds have no history 

And the sea feels no sorrow 

The oxygen recycled 

And the atoms are just borrowed,”  

At the climax of the album’s second epic, Wilson sings – with more glee than it warrants –  

“There's no reason for anything  

 Just a beautiful infinity 

 No design and no onе at the wheel.” 

 Cheery stuff. 

It's easy to see why, in the same interview, Wilson rails against the concept of religion: “Religion is a classic manifestation of cosmic vertigo … To even understand even the very simplest, most basic facts about space, should be enough to disabuse anyone of the notion of God. But apparently it doesn’t.” 

It all sounds a bit like an angsty teenager encountering the New Atheists for the first time. And this edge to Wilson’s work jars uncomfortably with the humanitarian streak that runs through his music. Wilson wants (rightly) to celebrate the mundane, the ordinary, and the human. And simultaneously wants to tell us that we’re just … stuff. Just atoms arranged in one way or another. Wilson pays lip-service to the humanity missing from Orbital, but it’s superficial.  

And all this reminds me of my favourite video game ever: 2019’s The Outer Wilds. (Not to be confused with 2019’s also-space-based-but-decidedly-mediocre The Outer Worlds). In The Outer Wilds, you play as an alien with a ramshackle spaceship who sets off to explore their solar system. Except every 22 minutes, the sun explodes. When it does, you wake up on your home planet and start again. 

You use these 22-minute loops to explore the solar system, flying manually from planet to planet, and exploring every nook and cranny of them in the process. You see awe-inspiring sights and are confronting with the absolute otherness and horror of the vastness of space.  

And yet. As you explore, you come across notes left by long-forgotten civilizations. Mundane lists and frustrated exchanges between colleagues. You come across life, in other words, even if you don’t meet many other actual people. I can’t say much more than this without ruining the game: The Outer Wilds depends on your real-world knowledge to progress, and so, the more I tell you, the more I ruin.  

But, suffice it to say that this is exactly what is missing from Harvey and Wilson’s work. While they both ostensibly want to remind us of the value and the miracle of humanity, both leave me feeling cold. Both leave me with the impression that life is little more than atoms arranged one way and not the other. Just stuff.  

But in The Outer Wilds, the sun’s implosion – and all that is lost with it – is a genuine heartbreak every single time. I think about all the stories I’ve read, and the people I’ve met, and how it’s all about to be lost as a bright supernova washes over me. And then I wake up again at the start of the cycle, relieved that all is not lost.  

If you can, you should play The Outer Wilds. It’s beautiful. Really, really beautiful. More so than Orbital or The Overview. Our place in the universe can be overwhelming; we’re small, and the universe is strange and scary. But we’re not just insignificant stuff. Our stories and the people we share them with matter. And Outer Wilds captures this tension impeccably. Only it captures life’s miraculous nature in the way it deserves. 

Celebrate our 2nd birthday!

Since March 2023, our readers have enjoyed over 1,000 articles. All for free. This is made possible through the generosity of our amazing community of supporters.

If you’re enjoying Seen & Unseen, would you consider making a gift towards our work?

Do so by joining Behind The Seen. Alongside other benefits, you’ll receive an extra fortnightly email from me sharing my reading and reflections on the ideas that are shaping our times.

Graham Tomlin

Editor-in-Chief