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Care
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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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Article
Art
Culture
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War & peace
5 min read

Forgotten soldiers and new narratives are shaping how we mark our wars

Writing our history of conflict is as much a war of images as of words.

Susan is a writer specialising in visual arts and contributes to Art Quarterly, The Tablet, Church Times and Discover Britain.

An actor reads a speech at a commemoration
Timothy Spall recites Churchill.
Sky News.

Heading into an intense summer of World War Two remembrance, with May’s commemoration of the 80th anniversary of VE Day followed by marking the end of war in the Far East in August, it is remarkable how well the essentially Edwardian model of honouring the war dead has stood the test of time. 

In The Edwardians Age of Elegance exhibition, at the King Gallery’s, a room is devoted to the passing of the extravagant turn-of-the-century era into the sombre age of war memorialisation, following World War One. George V commissioned traditional English artist Frank O Sullivan to paint the inaugural service for the Unknown Warrior in Westminster Abbey. The long canvas, with a domed frame at the centre to accommodate Edwin Lutyens’ freshly unveiled, lofty Cenotaph, captures the solitary King walking behind a flag draped coffin, mounted on a gun garage, as the parade passes the war memorial. Initially a temporary wood and plaster structure, Lutyens’ Portland stone monument commemorated over a million soldiers lost in the Great War, some buried near the battlefields near where they fell, and nameless others whose remains had been obliterated by mechanised warfare. 

Attended by widows, ex-servicemen and armed forces personnel, the 1920 Armistice Day ceremony marked a shift away from solely glorifying commanders and officers, placing the sacrifice of ordinary combatants centre stage. The monarch symbolised his gratitude to his people, rather the other way around. 

Ceremonial Great War gun carriages featured in the London VE Day parade on 5th May. And the King’s Troop, Royal Horse Artillery provides gun carriages and teams of six black horses for state funerals. Following World War Two, and complete mechanisation of artillery, George VI instituted a troop of horse artillery for ceremonial occasions, enshrining the continuation of practices from a previous era’s warfare. 

Layering memorialisation upon memorialisation was also evident in the 5th May ceremonies when actor Timothy Spall read an extract of Churchill’s Whitehall speech, given to the crowds when European hostilities ended.  

“In the long years to come, not only will the people of this isle, but of the world wherever the bird of freedom chirps in human hearts, will look back on what we have done and they will say do not despair, do not yield to violence and tyranny, march straight forward and if needs be, die unconquered.”  

Narratives around the present and recent past are codified with a focus on forecasting how future generations will view events when looking back.  

While Europe celebrated in early May 1945, the one million troops of the Fourteenth Army continued fighting the Japanese Army through Burma and the Pacific. Dubbed the Forgotten Army and the Forgotten War, their campaigns were underplayed in the Allies’ wartime narrative. Singapore’s fall to Japanese forces in February 1942 was seen as a shameful defeat. Remoteness from London of the Far East campaign, and the vastness of the theatre of war, made it near impossible to report on by radio and print journalists. Letters to and from the Fourteenth Army took months to reach their destinations.  Soldiers and civilians held as prisoners of war by Japanese forces were forbidden to make images or create records of their captivity, making contemporaneous images of their incarceration rare. But drawings of camps and hospitals by Jack Chalker hidden in hollowed out bamboo sticks, acted as preparatory works the artist to later make paintings such as his painting Medical Inspection, Chungkai Hospital Camp 1943, created in 1946, and now held by the Royal Army Museum. 

As traditions of commemorating the war dead evolve, new grey areas come to light, demanding space in the official narrative 

Contrasting the paucity of images of the war in the Far East, with the array of works depicting the Blitz in London - created with  American audiences in mind, in the hope of winning support for the Allied cause - together with photographic images of North African and Middle East operations, it is little wonder the Forgotten War struggles to be remembered. Veterans of the Far East campaign and POWs were far more likely to join ex services organisations such as the British Legion and Burma Star, than those who served in Europe. Marginalised from victory and peacetimes narratives, the Forgotten Army chose to remember together. 

Before Victory over Japan’s 80th anniversary is commemorated on 15 August, with the famous cover photo of an American sailor dramatically embracing a woman in a white dress showing on repeat, the 80 years since the dropping of atomic bomb on Hiroshima and Nagasaki will have to be faced. Mainly civilians died as a result of impact and sickness from the bombing of Hiroshima on 6 August and Nagasaki on 9 August, with estimates of between150,000 -246,000 deaths. Whether the only use of nuclear weapons in warfare was justified, as it prevented loss of life from not having to wage a military campaign to occupy mainland Japan, or the horrific sacrifice of so many civilians was a war crime, remains a morally grey area. 

As traditions of commemorating the war dead evolve, new grey areas come to light, demanding space in the official narrative. Actress Sheila Hancock wrote recently about the trauma and fear of being an evacuee, sent away from her London family as a small child, to an emotionally neglectful home in the ‘safer’ countryside. Forced adoption of children born to lone mothers, and the stigmatising treatment expectant women received at the hands of Christian denomination- ran mother and baby homes, is a wartime and postwar story now demanding to be heard. 

Lesser documented stories of marginalised civilians, and combatants in faraway places take time to emerge, fighting to be heard above familiar images of plucky cockneys in bombed out buildings and amorously celebratory sailors. Shaping a multifaceted history of conflict is as much a war of images as of words. And as families become more transnational, the search for a shared narrative can replace clinging to the right or official story. 

The idea of army chaplain, the Reverend David Railton, to commemorate an Unknown Warrior with honour, still resonates over a century later. Railton’s battlefield altar cloth, known as the Padre’s or Ypres Flag, covered the coffin on its journey from Boulogne to Westminster Abbey. 

Stretching and fraying to include the stories of groups previously overlooked, the Edwardian fabric of military remembrance is proving remarkably strong. 

 

The Edwardians: Age of Elegance, the King’s Gallery, until 23 November.

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