Tools
Students filter into the class with looks of curiosity mixed with disgust. Artificial arms lay limp on nicely folded towels at lab desks throughout the room. Surgical tubes emerge from the severed ends of the arms, connecting them to hanging IV bags, like cables from the VCR to the TV. The limp bags hold fake blood, various shades of red food coloring and water. It looks like someone is trying to bring mannequins to life piece by piece: a madman's rubber morgue. We eye one another nervously. We're all here for one reason: to learn how to bleed.
One of my reasons for taking this phlebotomy class was to cure my small fear of needles. I also thought working at blood drives might be a good way to meet people--looking savvy in a stained lab coat, begging healthy folks to show me their arms, and being asked my phone number in return. Long shot. But mainly I was bored and in need of a job. I thought it'd be fun to drive a huge donor van around the city in search of blood. I was told the Puget Sound Blood Center was looking for people, and the pay was rumored to be good. (Plus, I figured I could make off with all the latex gloves I wanted.)
Stranger Personals
During the week, this classroom at North Seattle Community College is used to train nurses and medical assistants. Public health signs dot the walls. What do you do if your best friend has AIDS? asks a somber-looking woman on a poster. Another wall holds brightly colored placards illustrating the functioning of the heart, the workings of the sinuses, and the consequences of high blood pressure. And there's a skeleton hanging limply on a rolling stand near the door, grotesquely suspended from a swivel-hook in its head. Its hollow eye-sockets watch us the whole time, warning us of our fates should we somehow botch this bloodletting business. For the next five Saturdays, four and a half hours each day, this room is ours.
"George Washington was killed by a phlebotomist," our instructor, Tim Guirl, announces. Tim has been teaching this, the longest running phlebotomy class in Washington state, for all of its 12 years. During the week Tim works as a medical technologist, supervising a major hospital lab. A small man, Tim carries himself with an air of calm, in stark contrast to the students' nervousness. As the weeks progress, Tim smiles more as the students begin enjoying themselves, becoming more comfortable with the idea of poking each other with needles.
We are shown proper techniques with overhead projections and demonstrations on the fake arms. We take turns poking the rubber arms with needles to see if we can extract their watery blood. Some of the arms are so stained with puncture marks we call them "junkies."
"You're all going to be drawing blood from each other next week," Tim says, "so be prepared." I make mental notes of which of my peers have been blurting out "Damn!" or "I was so close!" and vow to steer clear when it comes time to choose a partner.
WEEK TWO: FIRST BLOOD
The class is split into two groups, morning and afternoon. Eleven people are in my afternoon group. Tim and I are the only guys. "A majority of the students are female," says Tim. "Usually three to six guys out of 20." A giddy female energy soon dominates the room. Even the rubber ball we use for squeezing has an ad for progesterone on it. Tim takes this into consideration in his lectures by frequently referring to doctors as "she" or "her."
Exiting the room, the morning group seems ecstatic. They all have little wads of cotton taped to their arms. They took blood from each other and seem to be okay. I notice one girl wearing full early-morning gothic regalia: dark clothes, black/white/red makeup, and jet black hair. Going outside for a break, she pulls up the hood of her sweatshirt, revealing little horns sewn on top, right about where they ought to go. She seemed to be avoiding the sunlight. I'm sort of glad she's not in my group.
Most students take this class to fulfill entry-level requirements for jobs in health care, or to add to skills they already have. Misty, 21, is the most energetic (and nervous, and fun) person in the
group. She works at a nursing home and is taking phlebotomy and pre-nursing classes to advance from her current position. "Basically, I wipe asses," she says. She is eager and contributes a great deal of levity to the class. She was good at extracting blood from the dummies, but she is thin, and so are her veins. I reject her as a partner.
I had gone to the gym before class to lift weights, concentrating on my upper body--I wanted my veins to bulge. Bruising and pain come from needles missing the veins, going too far or not far enough. We work on the fake arms to warm up. I look around the tables at how people are doing: Misty keeps cursing her bad luck, two older Russian women don't seem to be getting it at all, and Amy was having a great time but not getting any blood-water into the test tube. Amy has proudly told us that she is going to be a doctor. A stocky blonde, Amy is bossy and confident--a drama queen--well on her way to becoming a professional. And just like a doctor, she is doing horribly at drawing blood. I steer clear.
Cristi, on the other hand, is a quiet woman, calmly concentrating on what she is doing. Each time I look over, fake blood rushes to fill her test tube. I talk with her briefly. She notices the large veins on my arm. It's a match made in heaven.
After warming up, we start doing actual supervised blood draws on each other. When it's our turn, Cristi flops down into the donor chair and extends her arm for me. I wash my hands and put on gloves with a loud snap, just like on TV. I tie the truncate (the strip of rubber we were issued the first day) around her upper arm. One finger of my glove gets tied in the fold of the truncate. I start over, untying the glove. I feel for a vein. She has a nice one right down the center.
Tim and the textbook ($12, and black and white and red all over) both tell us to have strategic bedside manners. The book has an appendix for common Spanish phrases: Le va a doler un poquito ("It will hurt a little"). One pointer is not to ask people if they faint--you don't want to inspire anyone.
Tim has us pretend this is a real situation: "Hello, my name is Jake. I'm here from the lab to take a blood sample. Can you tell me your full name?" I place all the things I need within reach. I wipe her arm with an alcohol swab. As a child, this is when I would scream--when I felt the cotton dabbing my bottom.
I prep the test tube by inserting it into the back of a special holder, which has an inch-long needle protruding from the front of it. I take a deep breath. "I hope you're okay, because I'm about to faint," I say. Then to ease my "patient's" concern, I offer the musty bedside jest, "Don't worry, I've never done this before," and swiftly slam the needle into what I hope is Cristi's vein. She doesn't even flinch. I push the tube forward, breaking the seal. If my aim is right, the vacuum in the tube should force blood to rush in. It starts filling with REAL blood, darker and thicker than the fake stuff. I hit the vein perfectly. My peers cheer on.
I don't feel a thing when we switch and Cristi takes my blood. It's a lot harder taking someone else's blood. I even look down and offer compliments as she works. Unflinching, I watch my own blood fill the test tube.
WEEK THREE: THE BRUISE
Cristi asks to see my arm, curious as to whether I had a bruise. Nothing. Just a little yellow spot. I ask to see hers. She turns bashful and says no. I persist. She shows me her arm--and a huge bruise. It looks like a pit bull got hold of her and didn't let go. The area of puncture is fine, but butterfly bruises radiate outward. I feel bad. She consoles me by saying she bruises easily.
Out of guilt, I volunteer to be stuck as many times as possible. I sit in the chair and let my classmates have at me--except the Russian women, who were busy hurting each other and Amy. I knew she was having problems getting blood, and I have my limits. Tim volunteers.
"They told me not to do this anymore because my veins have become so bruised over the years. I used to let students practice on me." Tim coaches Amy through the procedure, and she finally gets blood. Amy's ecstatic, waving the warm tube around in victory. Tim gets up and starts behaving woozy and faint.
"Ohmygawd! Are you, like, okay?" asks a truly horrified Amy.
"Yes, I'm just kidding."
"Ohmygawd! I thought you were, like, totally serious!" exclaims our future doctor.
"Don't worry, you'll learn not to have so much compassion later," observes the wise instructor with a smile.
WEEK FOUR: STICK ME!
Week four is syringes and other techniques. When we finally get to use syringes, I feel like we're novice cops getting issued our guns. My fear of needles vanishes when they are not pointed at me. I think of all the doctors and nurses who stuck me as a child--and how I've finally wrestled the weapon away. I feel professional stabbing Cristi and pulling the plunger back with one hand. I could be good at this. Her bruises are more yellow than red this week.
We learn how to do capillary sticks too. That's when you squeeze a person's finger and strike it with a tiny lancet, then use a tiny pipette to collect blood from the drop that forms when you squeeze. Though diabetics do this every day, there is no way I am going to. Sticks hurt way more than needles. Meanwhile, Misty is feeling confident for having successfully drawn blood earlier, and is eager to strike at somebody's finger. I hear her argue with another girl in the class:
"I want to poke your finger!"
"No way!"
"I wanna poke somebody!"
I don't even look. I've been in the donor's seat most of the class, still feeling bad about the bruising from week two.
WEEK FIVE: THE FINAL
"If a person fails," Tim says, "it's usually on the basis of academic performance. You might know how to draw blood, but if you don't know the reasons why, it's difficult. Most who don't pass--one out of 25, maybe--have ESL [English as a second language] problems."
The Russian women are not doing any better this week. They don't use number-two pencils with their Scan-Tron tests, so Tim has to grade them by hand. Both Tim and I are afraid to be stuck by them. They work on each other instead, cringing the whole time. Everyone (except the Russians) does well on their practical final. I get a 3.1 in the class.
Weeks later I go to the Puget Sound Blood Center to see about getting a job. They aren't hiring, but after pattering about on their computers, they see that I am 0 negative--the universal donor. The Puget Sound Blood Center exists for only one reason: to get blood. The needle they use is huge, much larger than any we had in class.
I can't watch.
North Seattle Community College offers phlebotomy classes each quarter. Call 206-527-3790 for more information.
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