POISON

WHAT HAPPENS WHEN YOUR IMMUNE SYSTEM TRIES TO DESTROY YOUR NERVOUS SYSTEM WHEN YOU’RE IN COLLEGE?

by Sarah Manguso

1. BAD BLOOD

I was brought upstairs from Emergency to Intensive Care and given a treatment called apheresis.

From the Greek: aphairein, to take away.

In the hematological context, apheresis is the process of separating blood into its components (red cells, white cells, platelets, plasma), removing the component that’s sick, and reinfusing the rest of it, along with a suitable replacement for the sick part. The sick part of my blood was the plasma.

My nurse told me about a man she treated whose body manufactured too many platelets, enough to clot his blood right in his blood vessels. And so when his blood was separated, the extra platelets were removed and thrown away, and replaced with saline to make up the lost blood volume.

I thought his platelet-producing powers might have been made useful—if his extra platelets could flow out of him, through an apheresis centrifuge, and right into a hemophiliac.

But of course the man’s genes might have been diseased, or he might have been infected by a secret virus, and his platelets might have given someone his disease, or worse. So they were just collected in a bag and thrown away.

My plasma was filled with an antibody that destroyed peripheral nerve cells, so it was thrown away, too.

We hope you enjoy this excerpt.

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Sarah Manguso’s fourth book, The Two Kinds of Decay (Farrar, Straus & Giroux), is out now. She lives in Rome.

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