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“The first five answers are true, the next three are false, and the last two are true.”
The nurse is taking no chances. It’s 7:45AM on a Wednesday, and I’ve spent the previous two-and-a-half hours going through the deeply tedious process of being approved to go back to selling my plasma. I’ve been weighed and I’ve been poked. I’ve peed in a cup. I’ve answered (and, as I was encouraged to do, lied upon) a long questionnaire about my sexual history. I lied on it the last time I took it three years ago, and at least I can say with small satisfaction that nothing in my private life has changed since. Now, I need to pass a true-false quiz about plasma donation. The quiz is an FDA requirement, and the questions are ridiculously easy – but clearly, the fail rate was once too high, and the staff are here to make sure that they don’t let any hopeful donors fall at this last small hurdle.
(There are three main international conglomerates that collect human plasma donations – all three have several facilities within an hour’s drive of my home. Since I’ve admitted I lied on my sexual history inventory, and that the nurse fed me the answers to the FDA quiz, you can see why I think it best not to name the particular one I visit!)
Human plasma is used in a variety of life-saving drugs, and it’s a lucrative business. A recent Business Insider article reported the industry is worth some $25 billion – and growing at a rate of 8% per year. Americans supply over 2/3rds of the world’s plasma, for the simple reason that we’re the only large industrialized country that permits these multinational drug conglomerates to pay people for donating up to ten times a month. While the European Union considers the process of plasma collection dangerous enough to donors to limit it to twice a month; the FDA permits Americans to sell plasma twice in any 7-day period:
Only 14% of US donors made over 50 donations in 2017. Still, without much research on the health effects of donating 104 times a year — the US legal limit — researchers worry that the American system could put donors at risk.
"Our concern is that people who are vulnerable are giving their plasma to make ends meet,"said one researcher. "And we don't actually know what the long-term repercussions of this is."
Plasma donation is harder on the body than giving blood, and takes considerably longer. I’ve learned tricks over the years to speed up my donation (be hydrated, and have an elevated heart rate from light exercise), but it still takes about 75 minutes to collect the 880 milliliters of precious fluid from my body.
Though some people have reported serious complications from donating over long periods of time, I’ve only experienced two side effects: lethargy (one has, after all, been rather literally drained) and tingling in my extremities as a result of the anticoagulant they use. Energy drinks help me cope with the former, and the latter always passes within a few hours.
I started donating in 2018 while I was homeless, saving up money for a down payment on an apartment with Victoria. Between September 2018 and July 2020 – when a big freelance gig landed with enough income to let me quit, I donated 157 times. The pay fluctuated: typically, I’d get just $35 on my first donation of the calendar month, and that would rise $5 for each subsequent donation until the 7th, when it would go up $10. If you could get 10 donations in a month, you’d net a cool $100 on your tenth visit.
The pandemic has increased the demand for plasma, just as enhanced unemployment benefits and the child tax credit reduced the number of interested donors. Reluctantly, plasma companies have raised the compensation; I came back this month when I learned that they’d be paying $100 each for your first 10 donations after your return, with additional bonuses that could push that fee even higher.
I need the money badly. But I’d be lying if I said money was the only reason I donate. I sell my body fluids in order to feel good at something.
I was a very good teacher. At least, I remember myself as one, and my evaluations – which, immodestly, were always the highest in the entire department – bore that out, or so I like to think. But I’m not a teacher anymore. I’m a grocery store clerk, and if my evaluations can be trusted, at best an average one. (I’m good enough to keep the job; far from good enough to be considered management material.)
I’m a writer, and though you are all very kind, you and I both know there are far more gifted and hardworking wordsmiths out there. (They don’t use nouns like “wordsmith,” for example, and might sneer that I just did so.)
I’m a father, and as any dad can tell you, if you generally feel you’re doing it right, you’re doing something very wrong. You are loved and appreciated despite your failures; at best, our children will judge us on our efforts and our intentions, not our myriad shortcomings as parents. Being a daddy is my most important job, and it is my favorite job, but I do not know if I will ever feel I do it well.
I remember what it was to feel I did something well. Selling plasma gives me a satisfying sense of usefulness. I can watch the blood leave my body; I can watch the machine separate the plasma and return my red cells to my body. When I am done, the attendant will carry away a bottle, filled with a pale pink liquid that carries my DNA; 880 milliliters of something I made that can do real, unmistakable, incontrovertible good. I can be irritable or depressed or tongue-tied; I can be giddy and hypo-manic, and still, every time, I can offer something useful to the world.
Is history useful? Did it help anyone to hear a ringing rendition of Charles I’s oration from the scaffold? It’s more useful to stick a can of refried beans in a paper bag with a smile and small talk, but my co-workers bag with greater skill and ease than I ever will.
No one can give plasma better than anyone else, so for once, my feelings of inadequacy vanish when I’m hooked to the plasmapheresis machine.
I can do this useful, precious thing, while politely chatting up the clinic staff, flirting with my favorite young gay phlebotomist who sings gospel songs while he connects us to and disconnects us from the machines. (Reynaldo takes requests, though he snorted with laughter when I once — naughtily —requested “Power in the Blood” as he slid the needle into my arm. Oh, Mr. Hugo, you’re too funny! Last week, Reynaldo was working – and acted as thrilled to see me as I genuinely was to see him.)
There is no shame in donating plasma. I certainly don’t think less of others who do it. I do, however, recognize that for me, it functions as a form of laudable self-harm. When I was regularly donating in 2018-20, I realized how similar it was to hurting myself with cigarettes or glass – except that the end result was ever so much more useful to others, and unlike any other form of self-injury save sex work, lucrative for myself. Just as the anorexic gets high on deprivation, and the self-harmer gasps with awe when the razor finds his inner thigh, I get a rush from pushing especially hard at work immediately after donating plasma. The saints had their hair shirts and their cilices; I have the mild intoxication of stacking case after case of bottled water when I feel particularly drained.
I am in blessedly good health physically. I won the genetic lottery when it comes to my body, just as I drew a tough hand when it comes to my mind. I can handle the lack of sleep; the jobs; the gym; the obligations and anxieties that every parent knows intimately – and I can handle selling plasma twice a week.
I do not write to encourage pity, or worry. I write in thanksgiving for the chance to make a little money doing something useful. Pastors and therapists love to quote the old Friedrich Buechner remark that a vocation is “the place where our deep gladness meets the world’s deep need.” For decades, I thought my vocation was the classroom. Now, my vocation is at the clinic, where for a blessed change, I can give something of myself that is incontrovertibly good. I have made such a mess of so many things -- but this plasma, this wonder-working substance that my body makes (and replaces) so efficiently -- this is the world’s deep need. It is my deep gladness that after so much ruin and wreck, I still have something so needed I can give.
-My favorite version of Power in the Blood belongs to the Oak Ridge Boys:
I confess, however, that the song I often sing to myself when I am donating is by AC/DC.