Kathleen McLaughlin's BLOOD MONEY: THE STORY OF LIFE, DEATH AND PROFIT INSIDE AMERICA'S BLOOD INDUSTRY

"We've built an entire segment of global medicine upon the certainty that a certain number of Americans simply can't live on a regular income alone." - Kathleen McLaughlin in Blood Money

I've had just enough good fortune in my life to have been the kind of person who could hear a phrase like "plasma economy" and think it was some of that charming combination of actual scientific terminology and gobbledygook that we call "technobabble" or more specifically "Treknobabble" - in which the meaning of "plasma" concerns a superheated state of matter used to make things go pew-pew-pew on a starship. Had I gone to a public university instead of the groovy private college that gave me a huge scholarship because it wanted more geographic diversity in its student body, I might have found out about the exchange of human plasma -- as in that straw colored fluid that separates out from red and white blood cells when blood goes through a centrifuge -- for money a lot sooner than I did. And, to be honest, coming from a vastly different socioeconomic background from my classmates at my swanky private college as I did, I might have been tempted into that industry back then too. Concert tickets, beer money, spontaneous train rides into The City to go shopping or clubbing or to the opera -- the cost of these things meant nothing to most of my peers but I had to think long and hard before saying yes to opportunities. Had my college been located in a less privileged area, where a plasma "donation" center might actually be located, well, I might have said yes a lot more often than I did, and never mind that I might have been too fatigued to properly enjoy it.

I've donated buckets of whole blood over the years, hitting the one gallon club too long ago to remember, and I was a regular platelet donor, too, once a random test of my donated whole blood revealed that I had never been exposed to a common virus that is very dangerous to premature babies and cancer patients, meaning my platelets were safe to give such patients in a way that most other people's weren't. I kept on donating platelets until I had to go on a medication that meant I couldn't donate anymore and felt horrible about it. But, only dimly aware via, of all things, a college guide by Lisa "Preppy Handbook" Birnbach that some folks out in the world sold their plasma for beer money, I never thought of selling my plasma.*

Like I said, I was fortunate. And really dumb with a credit card, but it could have been worse. But anyway, I only learned what the true, real-world meaning of the "plasma economy" was this year, when Kathleen McLaughlin made the political podcast rounds promoting her latest book.

As I learned when I read Blood Money: The Story of Life, Death and Profit Inside America's Blood Industry, the plasma economy was only really becoming a thing over in China while I was learning Chinese at my private college in the late 80s and early 90s. China built plasma donation centers all over its poorest regions like the province of Henan, and persuaded its poorest citizens that it was safe and altruistic and patriotic and slightly profitable to roll up a sleeve and let an already-big-but-not-yet-quite-global industry treat them like lodes of metal in a gold mine (plasma gets described as "liquid gold" a lot in this book). Only it wasn't quite as safe as advertised; cutting corners to meet demand and save costs led to unsanitary practices like reusing needles and tubing or not sterilizing phoresis machines... just in time for the HIV/AIDS crisis (which China ignored about as assiduously as the U.S.A. did for as long as possible/until some heroic women whom McLaughlin profiles called out the problem and were exiled for their pains) to kill or permanently impair countless citizens for (shortened) life and ruin China's blood supply for years and years to come.

Fortunately for the global trade in human plasma, which is made into a whole host of long-known and newly-developed pharmaceutical products that are pretty much all insanely expensive by the time they're administered to patients whose mobility, functionality, even lives depend on them, the same ghoul who retarded the U.S.A.'s response -- even acknowledgement -- of the HIV/AIDS crisis had also so accelerated our country's descent into gross economic inequality that conditions were perfect to start up a bigger, better, badder version of the plasma economy right here.

The trick, the industry had learned by the time a building boom of plasma centers started in earnest here, was not to rely on the seriously destitute/homeless, who among other things are less likely to be healthy enough to provide the staggering volumes of body parts the industry needs to satisfy global demand for the stuff (because only a tiny handful of countries allow this trade). But the people who are just a paycheck or a family crisis away from being that undesirably desperate can and have been incentivized not only into selling their plasma on the regular but also selling it as often as they possibly can, by paying them enough to supplement the kind of shitty jobs that in addition to not paying a living wage also tend not to allow workers to hit that magic 40 hours a week that would  qualify them to receive shitty health insurance and helpless 401k exposure to the stock market they offer instead of pensions -- but not paying plasma sellers enough for the supplementary income they get to actually help them beyond a tank of gas or sack of groceries or Christmas gifts for the kids.

And speaking of how most countries have prohibited this trade, you won't believe where another huge pool of donors comes from. Hint: that flow stopped abruptly when COVID-19 closed our land borders for a while, and still hasn't really recovered since a follow-up debacle in which Homeland Security suddenly decided that crossing into the U.S. to sell body parts counted as labor and violated the terms under which most plasma sellers were permitted to come in for a day. 

And speaking of COVID-19, I couldn't stop wondering as I read: given that the people whose veins are tapped the most to meet the global demand for plasma are the same people who were hardest hit and mostly likely to have died from the virus before they even had the chance for cynical and manipulative blowhards to persuade them not to get the vaccine, to the tune of some 800,000+ souls lost forever, how many plasma sellers did we lose to COVID-19? And did their habits of selling their valuable plasma for pittances twice a week increase their susceptibility to dying of COVID-19 if they caught it? We might never know, because even before the pandemic, nobody seemed interested in studying the long-term effects on plasma sellers of the practice. There's too much money at stake for gigantic multinational corporations and too little concern for the human motherlode they mine, very few of whose members are treating Senators or Supreme Court Justices to lavish yachting vacations if you know what I mean.

Adding to the inherent (and aggravating) interest of her subject is McLaughlin's own connection to the plasma economy: she suffers from a rare autoimmune condition that leaves her dependent on regular infusions of an insanely expensive medication made from human plasma. Several times a year, the combined plasma of dozens, if not hundreds or maybe even thousands (it's kind of hard to know because the industry isn't exactly bragging about this in prime time) of people is slowly infused into her body over the course of five boring hours at a high but fluctuating cost to her medical insurance provider and to McLaughlin herself. A journalist with a history of covering things like what HIV/AIDS did to China (and herself living in China on and off over many years), it was surely inevitable that she would come to write a book like this, and from a compelling personal perspective. 

It also gave her a conversational inroads with the many plasma sellers she interviewed in places like Rexberg, ID, Flint, MI and El Paso, TX that few journalists could match. Her combination of gratitude and ever increasing discomfort with the whole subject color every line. 

And, as we demand more and more from nosy journalists who call attention to problems we've been happy to go on ignoring, McLaughlin has given considerable thought to what we might, as a civilization and as a nation, do to make this system less exploitative and safer. Compensate plasma sellers fairly and on a consistent basis. Do basic research on how frequent extraction of this fundamental body part affects the short- and long-term health of the extractees. And, of course, restore the social safety net so people don't get trapped in this system in the first place. 

Blood Money is a captivating and infuriating read, despite its tendency to repeat points and even whole sentences - like pretty much every other major non-fiction book in this age of publishing consolidation, this text could have used a bit more attention from an editor or two, but of course that would cut into the bottom line and, who knows, the poor overworked editor now having to do the equivalent of five people's jobs might also have been a little weak and exhausted from a lunch hour passed in a crappy recliner with a fat needle stuck in the crook of her arm, sucking out her blood and forcing an anticoagulant into her vein. 

I learned a lot and was made to think a lot about a system I've only been dimly aware of, out of what seems more and more like plain old luck. I might yet find myself in the position of the people McLaughlin interviewed, though given my own personal constellation of obnoxious health issues, if our society ever reaches the point where it's depending on the plasma of people like me, we're pretty much screwed all the way.

Here's hoping...

*There have been times when I was in desperate enough financial straits to have done it, but such times have only ever come upon me when I lived and worked (on a salary basis for pay that I learned years later would have qualified me for food stamps and Medicaid even though I had the words "executive" and "director" in my job title) in regions too isolated and remote to participate in the plasma economy; any money I'd have been paid would have just burned up in the gas tank of my shitty car driving some 300+ miles round trip to be tapped.