Five Quarts: A Personal and Natural History of Blood

by Bill Hayes

  NINE

  Exsanguinate

  Blood makes noise

  It’s a ringing in my ear

  And I can’t really hear you

  In the thickening of fear

  Blood makes noise

  —SUZANNE VEGA, 1992

  FOR A PERIOD OF SEVERAL HUNDRED YEARS UP THROUGH the nineteenth century, the earthly punishment meted out to British criminals sentenced to death did not end with execution. Worse than imagining the tightening of the noose or the plunge of the guillotine’s blade, according to writings of the time, was a felon’s fear of ending up on the wrong side of an anatomist’s knife. The idea of your body being sliced apart piece by piece—regardless that this was done to instruct medical students or in the name of science—could tap into every private horror, whether humiliation or desecration or something grislier. For this, the condemned had England’s Henry VIII to thank. In 1542, by royal decree, the Guild of Barbers and Surgeons—the bloodletting specialists who sidelined in haircuts and minor surgeries—was granted a maximum of four executed “malefactors” per annum for use in public dissections. This was the only legal source of cadavers. By no miracle of accounting did four per year come close to meeting demand, however, and the shortage led to a thriving black market in stolen bodies.

  The Reward of Cruelty by William Hogarth, 1751

  In 1752 the king’s law was amended to allow a judge to send any executed convict’s body to the Surgeons’ Hall. A felon had just cause to worry. An engraving titled The Reward of Cruelty (1751), by the British artist William Hogarth, depicts a dissection-in-progress at Surgeons’ Hall. The naked body of a freshly executed murderer is splayed in a crowded auditorium of onlookers, and the lead anatomist directs the activity with a long stick: Cut here and gouge there, if you please. One surgeon pries loose an eyeball, another slices open the foot, while a third man seems to have slid his entire hand up into the deceased’s chest cavity, perhaps reaching for the heart. A final man kneels to the side collecting in a bucket the long sausage of the intestines. While Hogarth’s engraving is a work of satire—the noose is still affixed to the felon’s neck, for instance, and a small dog is about to make off with what looks like the liver—it nevertheless captures the graphic nature of the butchering.

  More gruesome still were twin dissections performed the following century, as recounted by medical historian Gustav Eckstein in his book The Body Has a Head (1970). Eckstein’s tale is thin on personal details but rich in methodology. Two criminals, sentenced to decapitation, would be used to answer once and for all the nagging question, How much blood does the human body contain? Of course, many times throughout history best guesses had been made, but this latest effort would be as exacting as humanly possible. First, each man had blood drawn—a predetermined amount, which was diluted precisely one hundred times. These samples were set aside to serve later as a color standard. With no further ceremony, the two men were relieved of their heads, and all spillage was collected. The heads and trunks were drained, then squeezed. Once no more color would bleed, the bodies were carved into smaller and smaller pieces, eventually down to human chum, and washed, soaked, and wrung. All excess water added to the process was tallied and saved. Finally, in a process that to me seems fraught with the potential for error, the total liquid remains of each criminal were color-compared to his original sample, dilutions were made until they matched, mathematics were applied, and both weight and volume proportions were calculated. The results, consistent in both men, were presumed representative of all people—not inaccurately, as it turned out. The exsanguinations “proved our blood to be one-thirteenth of us,” to borrow Gustav Eckstein’s summation. This is roughly 7.5 percent of our total body weight. Likewise, every thirty pounds of us has about a quart of blood. For the average 150-pound man such as myself, that’s 11.25 pounds of blood in circulation, or, echoing Eckstein, “Five quarts go the round-and-round.”

  Now, trading horror for horror, the coolness of science for the seduction of literature: Set in the same century, this next story revolves around the same unsavory deed—the taking of blood—yet to an altogether different end and employing a more sensual methodology. The basic plot should be familiar, even if you’ve yet to read the tale in its original form. Within a handful of pages, our protagonist stands in the gloom of a desolate night, in a foreign land, on the doorstep of an enormous stone castle. He finds no bell or knocker and is unsure how to signal his arrival after the arduous journey from London. Just then, a noise from within: rattling chains followed by the clanking of massive bolts, a key thrust into the lock. At last the door swings open. Centered in the entryway stands a tall older gentleman dressed in black, clean-shaven but for a long white mustache. His pale, pale skin picks up none of the warmth cast by the flickering lamp he carries. “Welcome to my house!” he says in peculiarly inflected English. “Enter freely and of your own will!”

  The weary traveler shakes an ice-cold hand, and the elder man makes it official: “I am Dracula.”

  If you, too, are still puzzling over that long white mustache, I’m right there with you. The Dracula in Bram Stoker’s Dracula, the template for bloodsucking horror since its publication in 1897, does not resemble Bela Lugosi; nor does sunlight destroy him. The story of the Transylvanian vampire has been retold and reimagined in such varied contexts—from early Hollywood flicks to adult films, a soap opera to video games, and a breakfast cereal to the number-obsessed Count von Count from Sesame Street—that it’s fascinating to discover elements in the original source that, more than a century later, feel new. How creepy, for instance, is Dracula’s lizard-like way of scaling walls. And how clever is his strategy of concealing fifty coffins throughout the greater London area so that, after prowling, he has a wide variety of places to rest during the daytime. And, oh yes, the way the heroes use Communion wafers to render these coffins unsleepable. At the same time, it’s great to find all those familiar trappings of vampire lore: the mirrors that don’t reflect, the fangs, the turning into a bat, the garlic, the stake through the heart. And sure enough, the greedy mouthfuls of blood. Save for the Bible, no other work in the English language has had, I’d wager, a stronger impact on how people of the modern Western world think and feel about blood. Blood as dangerous and profane as opposed to sacred and profound.

  Stoker’s novel, originally titled The Un-Dead, a term the Dubliner coined, is more ambitious than I had remembered, technically as well as psychologically. But Dracula is also very much a dusty product of its era. Abraham (Bram) Stoker (1847–1912) wrote a conventional Gothic novel, the type of romantic fiction that first appeared in England in the mid-eighteenth century, a forerunner of the bodice ripper and the modern mystery novel. True to the form, Dracula features a damsel in distress (two, actually); a good guy (in this case, a quintet of good guys); and a tall, dark villain, although here, obviously, Stoker created a new standard of darkness. As was typical of Gothic fiction, the action takes place in ominous locations, shadowy and perilous, the most archetypal of which is the count’s home, Castle Dracula.

  Stoker wrote the novel during a seven-year period that neatly falls between two major advances in the understanding of blood: the identification in the 1880s of platelets, the circulating blood cells that aid in clotting, and the discovery of human blood groups in 1901. This precarious in-between stage is reflected in the scene describing the character Lucy’s blood transfusion, a procedure necessitated by Dracula’s secret nightly feedings. When choosing a compatible blood donor, the two doctors treating Lucy never mention blood type. A, B, and O are a few years off. This being Gothic fiction, the desired sex of the donor is also never questioned. “It is a man we want,” Dr. Van Helsing states, implying in these six syllables all sorts of manly virtues, such as vigor. A spirited game of scissors-paper-rock, I imagine, is waylaid by the arrival of the ideal donor, Arthur. The youngest, strongest, and “calmest” of the three men, Arthur is also madly in love with Lucy, a quality that seals the deal.

 
; Next, Stoker makes a little stumble. He has Van Helsing happily point out that Arthur is “of blood so pure that we need not defibrinate it.” Only in a work of fiction would this be considered an advantage. Blood that does not produce fibrin is blood that doesn’t clot. A real-life Arthur would’ve been suffering from a disorder analogous to hemophilia and clearly would not have been a doctor’s first choice when selecting whose vein to slice open. In the story, however, the physicians are glad to avoid the sticky problem of coagulation, which I can certainly appreciate. Upon exposure to air, blood at the site of an injury immediately begins to clot, or congeal. The body is trying to self-seal. Platelets (so named for looking like tiny plates) converge on the site, clumping together and simultaneously secreting chemicals that turn the blood-borne protein fibrinogen into long, sticky threads. Red and white cells get caught in the webbing, and the clump becomes a clot. At a wound site, clots are lifesaving. But within the circulatory system, a clot may lodge in a blood vessel (this is called an embolism) and cause stroke or death. While anticoagulants prevent clots from forming during transfusions today, such agents did not exist during the era portrayed in Dracula—hence the need to defibrinate.

  Defibrination was a crude but clever process developed in the 1820s and used up through the introduction of anticoagulants in the 1920s. Wildly varying methods arose, but each took time, so I can see why Bram Stoker, if only to keep the scene moving, had Dr. Van Helsing skip this step. One method involved collecting the donor’s blood in a bowl, whipping it with a wire eggbeater, then filtering out the clots through a stretch of gauze. Even simpler was allowing the collected blood to settle for several minutes and then scooping out what congealed. Sometimes, too, the blood was twirled in a flask containing glass beads around which clots would form. These methods were not foolproof—bacteria entered the process, and clots slipped through—but transfusions had become safer, if only just. (To be fair, they did represent a vast improvement over the previous treatment for blood loss, bloodletting. Up until the 1820s, for example, a woman with uterine hemorrhaging following childbirth was commonly bled. Now, there’s a horror story.)

  Once Lucy is drugged up, Van Helsing proceeds. Arthur lies next to his fiancée while the doctor removes from his bag the necessary instruments—what he calls the “ghastly paraphernalia of our beneficial trade.” Although Stoker doesn’t linger long on the procedure, details suggest that his fictional doctor may be performing an actual type of transfusion that, at the time Dracula was written, would have been highly experimental, a direct artery-to-vein transfer. This method, considered promising in animals, made a short-lived leap into human use in the late 1890s. You’ll soon see why it so quickly came and went. Typically, the blood donor’s radial artery (one of the two main arteries in the forearm) was exposed, distended, tied off or clamped, sliced open, and then either sewn directly to the recipient’s similarly exposed vein or connected to it via a small metal pipe. Bodies had to be aligned just so. Once the clamps were removed, the donor’s heart literally served as a blood pump. But, like gassing up the SUV without benefit of a meter, the transfer was difficult to measure. Too much blood? Too little? In some cases, the blood donor was simply weighed before and after “the operation,” to borrow Stoker’s apt phrase, and the difference used to estimate the volume taken. (A bit late, no?) In Dracula, Van Helsing demonstrates an alternate method. For several tense minutes, his gaze darts among Lucy, Arthur, and his pocket watch, used to time the flow. Once some unexplained threshold is reached, he announces, “It is enough.”

  It is enough. A bloom returns to Lucy’s cheek, and the possibility of her heart being overwhelmed by too much blood has passed. Arthur, who could’ve suffered excessive blood loss, is shaky but also fine. While the medical dangers have been avoided, however, a supernatural one remains. Dracula, unbeknownst to all, continues to feed on Lucy. Over the next ten days she receives three more transfusions, each helping her less. The heroic efforts fail to save Lucy’s life. Dracula drinks her to death, and Arthur’s dream of marrying the beautiful young woman is dashed. Heartbroken, he consoles himself with the fact that a consummation of sorts had taken place: “The transfusion of his blood to her veins had made her truly his bride.”

  Performing “the operation” of transfusing blood

  But alas, Dracula’s bride as well.

  Dr. Van Helsing, demonstrating a knack for good guesses, concludes that poor dead Lucy is now one of the Un-Dead. A trip to the cemetery later confirms his hypothesis. Lucy lurks among the tombstones, feeding off a child. Transformed by Dracula’s blood, she is “like a nightmare of Lucy,” her sweetness “turned to adamantine,” her purity to “voluptuous wantonness.” She approaches Arthur, who has joined the doctor: “My arms are hungry for you,” she purrs. A brandished crucifix forces her retreat.

  In the scene set the night thereafter, Stoker was clearly intent on steaming his audience’s reading glasses. The lid of Lucy’s coffin is lifted and her sultry form is revealed. With meaty stake in hand, Arthur awakens her with a great thrust. Lucy writhes, moaning behind deep red lips. Her “body shook and quivered and twisted in wild contortions.” Arthur plunges again, drawing blood. “He looked like a figure of Thor,” hammering, “driving deeper and deeper.” But for the reality of the stake that finally pierces her heart, she seems to be enjoying this. Lucy gives a final shudder, then is still. If Dracula is even aware of her demise, he doesn’t give a damn. Once he’s “turned” a woman, he loses all interest in her and moves on.

  JUST BENEATH THE SURFACE, BARELY, DRACULA IS A CAUTIONARY TALE about the evils of submitting to one’s darkest desires. This reflects Bram Stoker’s Victorian and Christian sense of morality. At the same time, the writer was savvy enough to know that excessive finger-wagging does not a bestseller make. By making the sex metaphorical, he was able to push against the edge of propriety, just this side of objectionable, without sullying either his own or his upstanding characters’ reputations. Lucy, for instance, dies a virgin, despite her having been, forgive the inelegance, penetrated countless times in various ways—fanged by Dracula, poked by doctors, infused with donor blood, staked by her fiancé. In the end, as death releases the vampirism from her body, Lucy returns to a picture of purity, her original self. What Stoker accomplished with words reminds me some of Alfred Hitchcock’s approach to horror while shooting his 1960 film Psycho. When asked after its release why he hadn’t used color film, which was, of course, available at the time, Hitchcock replied, “Because of the blood. That was the only reason.” Had he shot the infamous shower stabbing scene in Technicolor, the studio censors would’ve done their own slashing. “I knew very well I’d have the whole sequence cut out,” he said. In black and white, though, he could get away with, well, murder.

  With Dracula, Bram Stoker was determined to create a substantial work of literature that would make his name. In the dozen years before he started his first draft, he’d dashed off ten pieces of fiction, including another novel. As to their reception, a phrase comes to mind: It’s a good thing he kept his day job. As the secretary and business manager for Henry Irving, the foremost Shakespearean actor of the time and a world-class prima donna, Stoker had to squeeze writing into moments snatched between beck and call. He slowly built the character of Dracula, who, though he would become literature’s most enduring vampire, was not in fact the first. Three had come before, and Stoker culled important elements from their tales. Dracula’s seductive ways, for example, owed a debt to the lusty female vampire of Carmilla (1872), a Gothic novella written by fellow Irishman J. Sheridan Le Fanu. (Le Fanu was Stoker’s boss at a Dublin newspaper at the time of Carmilla’s release.) Dracula’s black cape, the wooden stake, and the notion that vampirism could be passed to others through blood exchange were details borrowed from James Malcolm Rymer’s Varney the Vampire, or The Feast of Blood (1847), a 750,000-word saga that had originally appeared as a “penny dreadful” serial. Finally, the delicious casting of Dracula as a nobleman, a count, living in t
he midst of and feeding on members of high society descends from fiction’s very first vampire, Lord Ruthven, who appeared in John Polidori’s short story “The Vampyre” (1819).

  The story behind Polidori’s story is far better than his final product. Twenty-year-old Dr. John Polidori, a British physician with literary aspirations, was sharing a lakeside villa near Geneva, Switzerland, with the poet Lord Byron, who’d fled London due to debt and allegations of an extramarital affair between him and his half sister. This was the summer of 1816. The two men had what one might call a give-and-take relationship: Byron freely took the opiates Polidori could legally obtain and, in return, gave the doctor the opportunity to orbit in literary circles. During several weeks in June, the gentlemen were joined by three invited guests: England’s leading poet, Percy Shelley, his young lover Mary Godwin, and her stepsister, Claire. Claire, as had and would several other women, was carrying Byron’s illegitimate child. The two immediately had a tiff, and Byron from then on would speak to Claire only in the presence of the others. Perhaps the pets in residence picked up on the tension. Percy recalled that “eight enormous dogs, three monkeys, five cats, an eagle, a crow, and a falcon” all moved freely about the house, “which every now and then resound[ed] with their unarbitrated quarrels.” Bad weather further tested everyone’s nerves. A series of fierce rainstorms kept the group housebound for days. One night Byron and company, desperate to fill time, resorted to reading aloud from a collection of French translations of old German horror stories, perhaps left behind by a previous renter. (As a contemporary analogy, I imagine a klatsch of socialites reading to each other from the lyric sheet of a rap CD.) The stories were horrifically bad. Byron felt that he and the others could surely do much better, and, as an amusement, issued a challenge: “We will each write a ghost story.” Now, the two people one would think most likely to produce something magnificent didn’t get very far: Byron and Shelley both had ideas, but quickly abandoned their efforts. But not eighteen-year-old Mary Godwin. An idea came to her in a dream, and she began working feverishly on what would two years later be published under her married name, Mary Shelley’s Frankenstein (1818). As for the doctor in the group: “Poor Polidori,” Mary would later recall, “had some terrible idea about a skull-headed lady.” It seems that Polidori fizzled not just creatively but socially, too. By summer’s end he and Byron had severed their relationship, igniting an enmity they would both carry through the rest of their lives. Polidori, still hoping to be a writer, took the idea that Byron had discarded—the skeleton of a vampire tale—and began adding meat to the bones. Out of spite, Polidori fashioned the villain of the reworked piece after Byron. Enter the bloodsucking aristocratic fiend “Lord Ruthven.” Even in this name, though, Polidori wasn’t original. He’d borrowed it from a roman à clef written by one of Byron’s ex-lovers. Thus, in an exhalation of venom, “The Vampyre” was born.