Nine Pints: A Journey through the Mysterious, Miraculous World of Blood by Rose George

Reviewed by Rebecca Foster

Rose George is the author of three previous wide-ranging nonfiction books, about refugees, human waste and foreign shipping. In Nine Pints, she dives deep into the science and cultural history of blood. A human female body like hers contains about nine pints of blood, so she’s settled on a nine-chapter framework that provides plenty of latitude for travelling around the world and through history to record attitudes towards everything from blood-borne diseases to menstruation. Her own experience – she’s in early menopause and has also suffered from endometriosis – helps to fuel her curiosity, while her journalistic tenacity keeps her pushing through the statistics to find the human stories that animate the book.

In the first chapter we track the journey of a pint of blood that George donates in her hometown of Leeds. It’s taken to an NHS Blood and Transplant (NHSBT) centre in Filton. Here it’s tested, processed within 24 hours, and sent back out to its recipient. The UK’s blood donors get a text saying where their donation goes. It’s a simple thank-you gesture, but seems to be enough to keep 1–3% of citizens giving blood, which is a necessary baseline. Eighty percent of countries are at just 1%, George notes, but various international initiatives to recruit donors – even paying for blood – don’t seem to help. In India there is a kind of credit system in operation: as in a bank, you deposit blood now in the expectation that you or maybe a pregnant relative will need to take advantage of it later on.

I was particularly interested, if morbidly so, in the chapter on leeches and bloodletting. Biopharm, a company in southwest Wales, raises medicinal leeches. They are still frequently used after reattachment surgeries to drain excess blood and improve blood flow, which can keep body parts and/or skin flaps from becoming infected or being rejected. (Indeed, Glasgow maxillofacial surgeon Jim McCaul, author of the recent memoir Face to Face, mentions how he used leech therapy on a patient’s tongue after removing a large tumour.)

Other sections journey further afield, chiefly to South Africa and India, to explore AIDS and menstruation taboos. Over 7 million people are infected with HIV in South Africa, and the epidemic disproportionately affects young women. George is a guest of Médecins sans Frontières in Khayelitsha, a deprived Cape Town-area township, and is aghast to learn about the commonly accepted system of “blessers,” or sugar daddies, giving women gifts in exchange for sex. Although HIV is now treatable, not easily transmitted, and no longer leads to travel restrictions, it’s still a communicable disease with a serious effect on everyday life, as George learns from speaking with a group of HIV-positive youth.

In India it is not unknown for girls to drop out of school because there is no toilet or they have no menstrual supplies – around the world women have had to make do with everything from rags to sand. Arunachalam Muruganantham became known as “Menstrual Man” for his determination to make proper menstrual hygiene affordable. After eight and a half years of experimenting on sanitary pads during rented factory hours, he developed a machine to form cellulose pads. He now travels India with the machines, along with pregnancy tests and cervical cancer swabs. George rightly looks to him as a hero of feminine hygiene, but perhaps doesn’t go far enough to promote green alternatives to these landfill-bound sanitary products.

George’s style can be choppy and repetitive, given to short sentences and identical paragraph openers, and there are a couple of places where the nine-chapter structure shows its weaknesses: menstruation is split across two chapters that could have easily been combined into one, and a long, dry section on Janet Vaughan and Percy Lane Oliver, responsible for setting up the UK’s national blood banks at around the time of the Second World War, could forfeit its fascinating nuggets about the history of blood transfusion to Chapter 1 and then be binned completely. I wondered whether more strictly thematic chapters – shorter, and as numerous as necessary – would have proved more successful.

However, as a fellow book critic’s article reminded me the other day, it’s important to assess a book as it is and not as it might have been. And while Nine Pints is quite uneven, it does convey a lot of important information about the past, present and future of our relationship to blood. “Blood saves lives. It makes life better for millions of people. If you can, donate it,” George encourages. “But perhaps we can use it better. Or what if we could replace it entirely?” Synthetic blood, created from stem cells, is a holy grail but still the stuff of science fiction (TV’s True Blood) – at least for now. Who knows what medical science will accomplish in the years to come?

Rebecca Foster is a freelance proofreader and writer from Maryland, USA. Her book reviews appear in many print and online publications, including the Times Literary Supplement. She also blogs at Bookish Beck.

Rose George, Nine Pints: A Journey through the Mysterious, Miraculous World of Blood (Portobello Books, 2018). 978-1846276125, 384 pp., paperback.

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