Blood (5 page)

Traditions and superstitions around bleeding women have seeped deeply into our culture, from myths surrounding the death of plants touched by a menstruating woman to sailors' stories about the dangers of having a “bleeding wench” on board. They are behind one of the most common slang phrases for menstruation: the Curse.

Still today, the notion of the Curse is tattooed on the collective psyche. In 2012, for example, a man named Richard Neill posted a message on the Facebook page of U.K. maxi-pad maker Bodyform, complaining that happy advertisements about managing menstruation misled him as he stepped into a sexual relationship with his girlfriend.

He wrote, and I am excerpting just the core of his message: “As a man, I must ask why you have lied to us for all these years. As a child I watched your advertisements [about] how at this wonderful time of the month the female gets to enjoy so many things. I felt a little jealous. I mean, bike riding, rollercoasters, dancing, parachuting, why couldn't I get to enjoy this time of the month. Dam [
sic
] my penis! Then I got a girlfriend . . . and couldn't wait for this joyous, adventurous time of the month to happen . . . you lied! My lady changed from the loving, gentle, normal skin-coloured lady to the little girl from
The Exorcist
with added venom and extra 360 degree head spin. Thanks for setting me up for a fall, Bodyform, you crafty bugger.”

Bodyform responded by posting an online clip featuring a fictional
CEO
named Caroline Williams who replied directly, and playfully, to Richard Neill. In the video, the fictional
CEO
pours herself a glass of liquid tinted blue, looks straight into the camera, and says, “Hello, Richard . . . we read your Facebook post with interest, but also a sense of foreboding, and I think it's time to come clean. We lied to you, Richard, and I want to say ‘sorry'. . . . You're right. The flagrant use of visualization [in our advertisements] such as skydiving, rollerblading, and mountain biking — you forgot horse riding, Richard — are actually metaphors. They're not real. I'm sorry to be the one to tell you this, but there's no such thing as a happy period. The reality is, some people simply can't handle the truth.”

At this point in the video, we see images of men in maxi-pad focus groups reacting in horror as they are presented with details that the
CEO
enumerates. She says: “The cramps, the mood swings, the insatiable hunger, and yes, Richard, the blood coursing from our uteri like a crimson landslide. So we knew we'd have to change our strategy . . . We have managed to maintain this illusion. But you, Richard, have torn down that veil and exposed this myth, thereby exposing every man to a reality we hoped they would never have to face. You did that, Richard. You. Well done. I just hope you can find it in your heart to forgive us.” The actor sips from a glass of tinted blue water — the same sanitized stuff used countless times in advertisements about the absorbency of pads and tampons (blue, of course, appearing cleaner and less offensive than the colour of blood) — raises it as if to toast Richard, and lets out an unmistakable fart. She says, “Oh, sorry, Richard. You did know that we do that too. Didn't you?”

Culturally there has always been a taboo around bleeding women. An argument could be made that because women have been socialized to think of their own menstruations as unclean, it suits them to keep men in the dark about what they might be going through, or that they might be having a period, or what that might involve.

The
Globe and Mail
reporter Stephanie Nolen caught the essence of this strange dynamic in an article that she wrote last year about a man in India who discovered that his wife was forced to use unsanitary and makeshift means to catch the flow of blood during her period. Arunachalam Muruganantham found his new wife sneaking around the house one day carrying old rags and newspaper. He asked her what was going on, and she brushed him off. When he insisted, she admitted that she was menstruating. He asked her why she wasn't using sanitary napkins and she said that they couldn't afford them. Muruganantham embarked on a long quest to develop an affordable sanitary napkin for Indian women, a process which included parking himself outside a medical school and asking female students about their periods, and walking around with a blood-filled goatskin strapped to his body, which was connected by means of a tube to his underwear. From time to time, he would squeeze the goatskin and force it to release blood, to see if the napkin he had made — and was wearing — would absorb the flow.

Muruganantham's efforts to invent the perfect — and affordable — sanitary pad were judged sufficiently insane to prompt his wife, mother, and sisters to move out. They came back after he won a prize from the Indian Institute of Technology for his invention of a tabletop machine capable of shredding cellulose fibre and shaping it into sanitary pads with a hydraulic press. Instead of trying to make a bundle of money by selling his invention to a company, he sold it at barely above cost to some rural Indian women who started production in a rented garage. The women who purchased the equipment now make the pad and go door to door explaining its use and sanitary qualities, and Muruganantham also delivers the machines to isolated mountain villages so that girls in schools can make their own pads and make some money in the process. As Nolen said, miraculously, in a country where men are not known for meddling in the monthly affairs of their women, Muruganantham has become known as the sanitary-napkin man.

The American feminist and activist Gloria Steinem jokes about how different the world would look if it were men, instead of women, with menstrual cycles, in “If Men Could Menstruate,” an essay in her book
Outrageous Acts and Everyday Rebellions
. To begin with, she says, “Men would brag about how long and how much.” In addition, she predicts, “Generals, right-wing politicians, and religious fundamentalists would cite menstruation (‘
men
-struation') as proof that only men could serve God and country in combat (‘You have to give blood to take blood'), occupy high political office (‘Can women be properly fierce without a monthly cycle governed by the planet Mars?'), be priests, ministers, God Himself (‘He gave this blood for our sins'), or rabbis (‘Without a monthly purge of impurities, women are unclean').”

These are but a few examples of how the bleeding that differentiates the genders gave rise to negative social stereotypes that still permeate our societal beliefs and values today. But sadly the divisive nature of blood does not end there.

The necessity of access to safe and affordable methods of dealing with menstrual blood is not limited to developing nations. In 1980, epidemiologists began reporting cases of toxic shock syndrome related to the use of a super-absorbent Rely tampon that Procter & Gamble had manufactured for use in the United States. The tampon had been designed to contain a woman's entire menstrual flow without leakage or replacement. The Rely tampon was meant to contain nearly twenty times its weight in blood, and to expand into the shape of a cup as it filled. The company recalled the product, but later it was demonstrated that the super-absorbent tampons of any manufacturer were linked to increased risk of menstrual toxic shock syndrome.
TSS
, as it is known, results from bacterial infection. Although it can present in otherwise healthy individuals, it can lead to stupor, coma, organ failure, and death.

Men just don't have to think about these things. Many are proud to shed their blood in sport or war as a badge of courage and proof of devotion to a noble cause. But men do not have to consider how to deal with regular, healthy monthly bleedings. Jerry Seinfeld thought it was funny enough to crack this joke: “TV commercials now show you how detergents take out bloodstains, a pretty violent image there. I think if you've got a T-shirt with a bloodstain all over it, maybe laundry isn't your biggest problem.”

The joke is custom-made for men, for whom blood in clothing often results from sport or war. But blood in clothing and laundry, for women, is a fact of life.

WE HAVE TRAVELLED A
LONG JOURNEY
in coming to understand the way that blood works in bodies. The things we can do with blood seem nothing short of miraculous. We know how to withdraw it, how to break it into its main parts (red blood cells, white blood cells, platelets, and plasma) in a centrifuge. We store it safely and transport it around the world. We treat and analyze it to ensure that it is free of diseases. We carry out millions of transfusions each year around the planet. We employ dialysis to clean the blood of a person whose kidneys don't work. We manufacture insulin and a variety of pills to help diabetics maintain acceptable levels of sugar in their blood. We have developed artificial blood-clotting products designed to prevent people from dying of bleeding disorders.

But there are still countless ways that our blood can betray us. As much as our blood works to regulate itself and help repair or maintain the health of our bodies, it can also circumvent its own rules, turning on us in potentially lethal ways. We have bleeding problems such as hemophilia and von Willebrand disease, cancers of the blood or bone marrow such as leukemia and lymphomas, and disorders such as anemia and sickle-cell disease, in which blood fails to carry oxygen properly from the lungs to the rest of the body. Blood disorders affect millions of North Americans each year, straddling all boundaries of age, race, sex, and socio-economic status. In addition, we are facing an epidemic of diabetes, a disease manifested by a surplus of sugar in the blood. When sugar (or glucose) levels remain too high — either because the pancreas is not producing insulin or because the insulin is unable to do its proper job in controlling blood sugar levels — the body begins to break down. In the worst-case scenario, nerve endings fray, body extremities have to be amputated, organs begin to fail, and the patient dies.

An exogenous agent can also corrupt blood. Your body doesn't choose to break down, but a foreign visitor forces it to do so. This can take place through a variety of means, such as sex, blood transfusions, the use of infected needles, and mosquitoes.

In 1989, I was working as a volunteer with Crossroads International in the landlocked country of Mali, in West Africa, when I became aware that I was sick, and nauseated, and feverish, and that my bones were aching terribly. How to describe the symptoms: it felt like the worst flu I've ever had. I had been faithfully taking Aralen, an anti-malarial prophylactic — the most awful-tasting pill I have ever put in my mouth, by the way — but it did not prevent me from acquiring malaria. It is possible, however, that it kept the disease from becoming fatal. I took refuge in the house of my good friends Francine and Pierre Baril in Bamako. I let them take care of me, and I believe I took some quinine. Other than that, I lay under a ceiling fan and drank lots of water and waited out the flu-like symptoms. They held me in their grip for about a week, and then they let go, and I recovered.

Not every person is so lucky. The World Health Organization estimates that there were more than two hundred million cases of malaria in the world in 2010, and that more than six hundred thousand people died from it. Most deaths occur in Africa, where, according to the
WHO
, a child dies of the disease every minute. People commonly assume that malaria is restricted to tropical climates such as sub-Saharan Africa, but we find instances of it all over the world — in Asia and in the Americas too, for example, with cases showing up annually in the United States and travellers returning to Canada with the disease in their blood. Some face the misfortune of periodic new bouts of malaria over the course of a lifetime. Malaria is not as much geographically specific as it is climate-related, and if global warming continues, the disease could present itself more often in northern climates.

It took scientists a long time to figure out that mosquitoes are the vectors of malaria. In the eighteenth century, for example, malaria raged in the sea islands off the coast of South Carolina. It was so bad that the spring and summer were known as the “sick season” on slave plantations, and some Southern whites left their plantations entirely to be run by African slaves until the season passed. It was thought at the time that noxious airs were responsible for the fatal illness.

It was not until medical breakthroughs in 1898, when the Scottish physician Sir Ronald Ross proved the complete life cycle of malaria in mosquitoes — for which he was awarded the Nobel Prize for medicine — that we came to understand that the disease is passed from one human being to another by means of the mosquito. Malaria is caused by any of four different plasmodium parasites, transmitted by the female anopheles mosquito, of which there are about twenty key species around the world.

You don't have to touch the person who is infected. You don't have to meet the person, or even be in the same room. Presumably, the infected person could die after having been bitten by the mosquito, and it wouldn't matter to you. All that matters is that a female mosquito bearing sporozoites
in its saliva glands chooses to bite you, and to spit into your bloodstream while it extracts a tiny hit of your blood. The disease usually shows up ten to fifteen days after the infective mosquito bite.

It is disturbing to stop and think about how malaria works, because the mosquito links the blood systems of people who don't even know each other. It doesn't stop with malaria. From human to human, mosquitoes can also transmit West Nile virus, dengue fever, yellow fever, and Japanese encephalitis. We are more connected than we think, and sometimes in dangerous ways. The more we learn about blood, the more we understand how all blood is hopelessly and forever intermingled, just like humanity itself, across culture, across gender, across age and race, and even across time.

SOMETIMES, THE VERY PERSON
who is trying to keep you healthy can be the one who infects your blood and causes your demise. In the mid-nineteenth century, while working as an obstetrician in the Vienna General Hospital, the Hungarian physician Ignaz Semmelweis discovered that new mothers died from puerperal fever (a form of blood poisoning also known as childbed fever) at a far higher rate in a maternity ward in which doctors worked, than in a second maternity ward in which midwives worked. The problem was publicly known to such a degree that some pregnant women begged not to be admitted to the ward supervised by doctors and preferred to give birth in the streets. This was in the 1840s, about two decades before the British surgeon Joseph Lister built on the work of the French chemist Louis Pasteur and began to require — with great success — doctors to wash their hands and medical instruments between patients, to reduce the spread of germs.