Good grief....
There is so much misinformation here, I hardly know where to start.
First: Underwood introduces the subject with a mention of a cut finger and the replacement of lost blood. While it's true that transfusions are often given to counter exsanguination, that is only one facet of the issue. Blood is given for many other reasons besides surgical blood loss.
Let's take just one example: Severe forms of leukemia, aplastic anemia, lymphoma and Hodgkins' disease were once thought to be incurable. A diagnosis was a death sentence. Via bone marrow transplant, thousands of lives are now saved every year and a great many people are alive today who would otherwise be dead.
However since chemotherapy intense enough to destroy the diseased marrow brings the production of erythrocytes to a halt and there is a period of weeks, sometimes even months before the grafted marrow is producing them again, transfusion remains an integral part of this procedure.
The simple fact is a leukemia patient can receive several hundred transfusions during the course of treatment even without bone marrow transplant. In 2002, an article appeared in The Oncologist entitled, "Faith Identity and Leukemia: When Blood Products Are Not An Option." The article was aimed at helping medical professionals deal with the feelings of guilt, frustration and anger associated with the routine loss of Witness leukemia patients. As the article pointed out, lasting remissions are extremely rare among Witnesses leukemia patients because of their refusal of transfusion.
Second: Underwood speaks of "2 million red blood cells dying per second." Yet circulating Erythrocytes are simply capsules of hemoglobin. --No nucleus, no DNA, no mitochondria or other organelles. Circulating Erythrocytes do not grow, they do not reproduce, they do not respond to external stimuli. In short, they do not exhibit the biological criteria which defines life.
Therefore, it is incorrect to speak of them "dying" and it is misleading, dishonest, and disingenuous to speak of them beginning to "Putrify." (Putrification is the bacterial breakdown of a dead organism.)
What actually happens is this: Since free hemoglobin is toxic in circulation, your body destroys erythrocytes at the first sign of damage to the outer membrane. This process is called erythrophagocytosis. Phagocytic cells in the liver and spleen attack and digest erythrocytes that exhibit signs of wearing out. The iron is stripped off the hemoglobin molecule and reused. The porphyrin, heme is converted through a series of steps into free bilirubin, which is released back into the blood stream and binds to the albumin protein. Free bilirubin is conjugated by heptacytes in the liver and secreted into the bile canaliculus as part of bile where it is delivered to the small intestine as a digestive fluid. It is an elegant process. Nothing dies, nothing "putrifies" and nothing is wasted.
Third: Underwood next speaks of dead leukocytes in a "Unit of stored blood." For reasons ranging from efficacy and safety to simple economics, blood is separated into components within hours after donation. Whole blood is not available except through special written request to a blood bank and leukocytes are not generally transfused, except in cutting edge treatments like peripheral stem cell autografting where a very specific precursor cell is involved. The components of blood that actually are transfused are processed so that things like cellular debris, heparin, fat, free hemoglobin are removed.
Fourth: By creating the mistaken impression that transfusion involves the transfer of unprocessed, unfiltered blood directly from one person to another similar in nature to the original artery to vein transfusions practiced by Crile and others at the very beginning of the 20th century, Underwood has set the stage for a nonexistent dilemma: What is going to happen when a "quart of rotting material" is routed into your arteries? As he so eloquently and scientifically puts it, "eeeew."
This transparent attempt to vilify transfusion medicine is incorrect at many levels.
It is true that the blood plasma acts as the vehicle for the soluable waste, urea. It's equally true that the plasma is removed from a unit of red cells and processed before it is frozen. A transfusion of red cells is one thing. A transfusion of plasma is something else entirely. Since Underwood himself (incorrectly) states that, "..transporting oxygen to your cells is kind of the whole point of transfusing blood" the reader has no other choice but to again conclude that the he has no concept of blood component therapy which has been the normative procedure for several decades now.
Like most Jehovah's Witnesses, and perhaps laypersons in general, Underwood seems to be confused at a very basic level over the differences between the digestive system and the immune system. Your blood does not transport solid waste to your intestine to become feces. Feces is the solid material left in your intestine after the soluable nutrients have been absorbed by the plasma. Your body simply takes what it wants and leaves the rest behind. (No pun intended)
The disposal of cellular components within the body is an entirely different process carried out by the immune system. With the exception of heme, which as I've described above, actually becomes bile, there is no waste because we're dealing with tissue whose components can be reused, not raw organic material taken in for digestion.
Fifth: While it is true that advances in bloodless medicine are greatly reducing the administration of red cells in scheduled surgery and that patients actually fair better with the less invasive procedures that have been developed along the way, it is equally true that bloodless medicine works primarily through blood conservation, which is limiting blood loss by controlling the bleeding. When bleeding is properly managed in the rigorously controlled environment of the operating room, the patient never gets to the point where doctors feel that a transfusion is necessary.
But bleeding cannot always be controlled. Trauma victims can experience catastrophic blood loss before emergency services even arrive. There was a DPS motorcycle officer here in Phoenix involved in a bad accident a few years ago. Multiple surgeries were required in a short period of time to put her back together and there was a Valley-wide blood drive in her behalf. Hundreds of units of blood were collected.
To apply the success of bloodless medicine to unscheduled surgery and other scenarios where blood conservation techniques are only marginally applicable is to deny in effect that it is possible to bleed to death, which is insane. The facts clearly contradict this idea. The Lancet reported that more than 60% of Witness patients whose preoperative hemoglobin had fallen below 6 g/dl died following the surgery. Multiple studies of maternal deaths have shown that mortality is many times higher among Jehovah's Witnesses than among the general population.
Underwood's treatment of this subject is incorrect to the point of being reprehensible. He should stick to religion
