Like Taking Blood from a Baby

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[NONFICTION]

Like Taking Blood from a Baby

“We’ll have to take blood from a vein in the baby’s head,” Eugene said. He frowned when Tina and I hesitated.

“Babies don’t feel pain there,” he insisted.

The preemie nursery was a swamp. To reach the clear plastic enclosures where babies lay immobilized in webs of tubing, we picked our way gingerly through thick wires braided into the backs of the beeping and buzzing life support equipment. But Baby O wasn’t with the rest of this plastic hatchery; he was in the preemie isolation room where it was even damper and hotter. Although he was wearing a long-sleeved shirt and wrinkled lab coat, Eugene, our new pediatrician, didn’t seem to be sweating like the rest of us. Tina had come down from the lab without her coat, her short red hair already plastered to her head from hours of processing blood samples under the isolation hood. This was the last blood draw of the day for the maternal transmission of HIV study and she wanted to get her hands on the tubes as quickly as possible so she could go home at a normal time and see her husband.

I never wore a lab coat, just a blouse and skirt with pockets big enough to conceal the tools of my trade: blood tubes, butterfly needles small enough for tiny veins, sterile gauze, band-aids, and latex gloves. In 1986, I talked my way into a job at Bellevue Hospital working as a researcher at the Pediatric AIDS Clinic, which was easy at the time, because no one wanted to touch anyone with AIDS. In the past year, a school in Brooklyn had been closed down by frantic parents when an eleven-year-old boy infected with HIV during a transfusion tried to enroll. Angry residents of a town in Florida burned down the home of three HIV-infected hemophiliac brothers to force the family to move away and not send their kids to the local schools. My husband’s coworkers, meeting me for the first time at a cocktail party but already knowing what I did for a living, refused to shake my hand.

My part in this particular vascular drama, besides sweating profusely, was to have the correct glass tubes ready for the blood draw, to code and date each tube, and to complete the paperwork that identified the specimens and tracked them to the appropriate abbreviated destination, CDC, NYCDOH, BELLEVUE PEDS ID. The sterile glass tubes, known by their brand name, Vacutainers, averaged four inches long and a half-inch wide but some were bigger or smaller; there were various colored rubber tops signifying their eventual use for testing and analysis.

I spent the last six months asking squeamish, skeptical, and very scared pregnant women if they would consent to having their blood drawn using the new HIV antibody test. The majority of the pregnant women at the Bellevue prenatal clinic ignored me or said no. Baby O’s mother had just barely survived a bout with pneumocystis carinii pneumonia. Though there was a formal consent procedure, taking her blood sealed the deal between us.

At two days old, her baby was jaundiced and shriveled, though he was born near term and bigger than the other preemies.

Locating a viable vein was a matter of art and experience. No amount of book learning could teach you how a good vein feels to the finger, how it yielded under the skin when palpated. Eugene, energized by the confidence that accompanied inexperience, jabbed the tip of the 25 gauge butterfly needle into the vein he had chosen, just above the forehead over the baby’s right eye. Baby O, unimpressed with Eugene’s technique, sprung into action, crying, kicking, thrashing.

“Help me out,” Eugene demanded. I grabbed the baby from above and held his soft, tiny head as steady as I could. Tina fainted dead away behind the bassinet. The baby squirmed and screamed lustily, threatening to knock over the tubes I positioned close by. I strained to hold the baby’s head still without crushing him, while Eugene was forced to jab another vein behind the right ear. This time, he struck blood. As the thin trickle began, Eugene and I struggled to insert the other end of the needle into one of the Vacutainers. Usually, it would be just a matter of puncturing the rubber top, filling the tube, and quickly puncturing the next tube top while the blood was flowing, a crude but effective procedure that allowed many tubes to be filled with one tremulous jab.

Eugene was as agitated as the baby: “Hold tighter…where’s the damn red top…Is she pregnant? Keep the baby still…He’s moving too much…Gimme that red top first…keep his feet down…Hand me the green top HURRY UP…Where’s the purple top?”

There wasn’t more than a squirt in each tube but he saved the best squirt for last, so that the purple top, which was used for lymphocyte analysis, had an actual measurable quantity in it. The chief of Pediatric Infectious Diseases, Bill, alerted by the charge nurse, appeared with smelling salts. “Is she pregnant?”

By the time I had gathered up Vacutainers, sharps, and used gloves, Tina was sitting up, gasping: “I’m not pregnant.” I left the doctors bending over Tina.

My last specimen delivery of the day was the 23rd Street post office where I had to send the red tops and green tops, securely packaged in a heavy-duty cardboard tube stuffed with plastic bubble wrap to the CDC labs by overnight express. CDC had given me a number code so that Bellevue Hospital Pediatrics did not have to absorb the cost of shipping the specimens. But the postal clerk behind the counter decided that I looked suspicious or stupid or nutty enough to defraud the government of the seven bucks mailing fee.

“What is this?” he asked.

Specimens of babies’ blood from Bellevue Hospital for the CDC.”

“Where are you sending this?”

“C—D—C, ATLANTA, GEORGIA.”

“Wait a minute.” He thumbed through a thick book, and with a grim purse of his lips, looked up at me. “This code is for the Federal Reserve Bank.”

The image of a mailroom clerk at the Federal Reserve Bank opening this package, handling the Vacutainer tubes, and reading the accompanying lab slip, clearly marked CDC HIV LABS: PEDIATRIC AIDS, alarmed me. What would happen if the hundreds of bureaucrats running the economy fled the Federal Reserve building, panicking because someone they worked with had touched a package with HIV blood in it?

I leaned over the counter and got very close to the postal clerk’s face. “If you send this to the Federal Reserve Bank, I guarantee that the economy will come to a standstill.”

Rather than annoy a demented customer in an area populated with ambulatory outpatients from Bellevue’s mental health clinics, the clerk admitted that he was using an old code book, and well, since the words CDC ATLANTA were clearly written on the package, he would send it there.

Because we were desperate to understand this mysterious and deadly disease, every specimen from every HIV infected person was important, but none more precious to us than Baby O’s.

—Terry M. Dugan

Terry M. Dugan worked as a researcher at the pediatric AIDS clinic at Bellevue Hospital in the 1980s and continued to work on HIV/AIDS research at other sites until funding became scarce. She has won awards for poetry and fiction examining the lives of people with HIV/AIDS and those who care for them. She has lectured on human rights and AIDS in Africa at Oxford and was invited to read her poetry at the United Nations. She is currently completing an MFA at Manhattanville College.

Award 3Brent Calderwood, A&U’s literary editor, on our Summer Reading feature, “A Growing Legacy”: A&U’s Summer Reading Issue has become an annual tradition, an opportunity for us to showcase new work by both established authors and emerging talents. This year, we’re thrilled to share work by the winners of A&U’s newly established Christopher Hewitt Award. (Poet Christopher Hewitt, now deceased, was a founding board member of A&U and served as its literary editor for many years.) Given each year to the best unpublished poetry, fiction, creative nonfiction, and drama that addresses HIV/AIDS, it’s our chance to recognize and encourage quality work that not only builds upon the legacy of thirty years of literature about our community, but also helps to enrich and expand our ideas of what “literature” and “community” mean when we speak about AIDS in the new millennium.

This month, we introduce you to the First Place winners in each genre. Terry M. Dugan’s nonfiction piece “Like Taking Blood from a Baby,” an excerpt from her memoir in progress, uses startling details to capture the heady urgency of the early days of AIDS research. In “Greyhound, 1984,” fiction winner Lisa Sandlin grabs and holds onto the reader with terse, rhythmic language, unique imagery, and a story that’s both unsentimental and poignant. Evan Guilford-Blake, meanwhile, gracefully blends monologue, dialogue, and dance in “Cowboy Nocturne,” his short play about love, loss, and remembrance. And Oklahoma poet Dorothy Alexander’s “Trip to Wyuka” is remarkable for its specificity of character and place, and a last line that cuts right to the bone.