Doctor's Review: Medicine on the Move

October 20, 2017

Dr Charles Drew’s 1940 thesis spearheaded the first large-scale public collection of blood for transfusions.

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In the bag

McGill’s own Dr Charles Drew fought racism to create the world’s first blood bank

As every physician (and embalmer) can attest, blood is the liquid life force that sustains us all. It flows through the veins and arteries of all living vertebrates, transporting oxygen and nutrients throughout the body, feeding cells and shuttling away waste in what is literally a living organic river. And yet despite its ubiquity and efficiency, blood and its many mysteries remained a scientific secret until relatively recently.

It wasn’t until 1628 that Dr William Harvey correctly described the circulation of blood through the body - thanks to the pumping action of the heart - and at last displaced the erroneous albeit creative Galenic musings that held sway for centuries. From that point on, new generations of anatomists and physiologists slowly rewrote the book on blood. By the beginning of the 20th century, a clear picture had emerged as to what all that red stuff really was, courtesy of many important advances in hematology and microscopy.

But while the scientific world at last had some clue as to what blood was, where it came from and where it was going, nobody even dreamed of the true potential it held to heal.

All that changed when an American-born, Canadian-trained physician by the name of Charles Drew came along. Despite facing racism along the way, Drew would become one of the most appreciated minds in modern medicine for his work establishing the world’s first blood bank.

A doctor is born

Charles Richard Drew was born in Washington, D.C. on June 3, 1904, three years after Austrian physician and biologist Karl Landsteiner classified the four major blood groups, an accomplishment for which he would go on to the win the Nobel Prize in Physiology or Medicine, and one which would greatly influence the life and work of Drew.

As a child, Drew was bright and studious, though it was his athleticism for which he stood out. He attended Dunbar High School - D.C.’s first for African-American students - where he excelled in the classroom and on the field. He was awarded a scholarship to prestigious Amherst College in Massachusetts, where young Charles joined Omega Psi Phi, the first African-American fraternity, and became the captain of the football team.

From there, he found a job teaching chemistry and coaching football at Morgan State College in Baltimore - a job he took in order to save money for medical school, a dream he had held since a tragic event several years earlier. When he was 16 years old, his beloved sister Elsie died in the Spanish Influenza epidemic. From that point on, he had an inkling towards studying medicine, a feeling that only grew as the years passed. Eventually, he gave his notice at work and applied to medical school at McGill University.

Drew later said that he wanted to attend McGill because of its reputation for generally treating black students with fairness and because he anticipated more racism at the American schools. Although McGill was by no means perfect in the 1920s and ’30s - restrictive quotas were still in place for Jewish students and some hospitals prevented black students from hands-on work - Drew’s choice proved justified.

A standout student

Under the mentorship of anatomist Dr John Beattie, Drew excelled at McGill. He specialized in physiological anatomy, earned a slew of scholarships and graduated second in his class in 1933. During his internship and residency at the Royal Victoria Hospital and the Montreal General Hospital, Drew’s burgeoning interest in blood transfusions and plasma storage grew, as did his aptitude for the work he was doing.

After two more years in Montreal, his father died, and he returned home to Washington D.C. to accept a position teaching pathology at Howard University’s College of Medicine. He quickly rose through the ranks to become Assistant Professor of Surgery. His reputation had grown such that he was granted a Rockefeller fellowship to Columbia University to study advanced surgery, where he became the first African-American to do so. He graduated Doctor of Medicine from Columbia in 1940.

Banking on success

By this time, World War II was in full swing and Drew had earned a name for himself in the field of blood research, primarily because of his discovery that plasma’s longer shelf life made it more amenable to storage than whole blood; the fact that plasma transfusion was far less restricted by blood-type compatibility than whole blood didn’t hurt.

But separating the red blood cells from the plasma was indeed the key understanding that allowed the blood bank to be born. Drew’s groundbreaking thesis, entitled - Banked Blood: A Study on Preservation, - attracted the attention of British medical authorities, one of whom happened to be a former teacher of his who was working with the war effort and knew first-hand how desperately blood was needed to treat wounded soldiers and civilians.

Dr Drew was the clear choice to spearhead the newly conceived Blood for Britain project - the first large-scale public collection of blood for the purpose of transfusion. He ensured that donor blood was collected by well-trained medical professionals, that it was carefully tested for disease, and that it was handled according to a set of anti-contamination guidelines.

Straight from donors giving blood in the hospitals of NYC to the military hospitals and battlefield frontlines of Europe, the first test shipment was made up of two small orders of plasma. From then, it didn’t take long to declare the world’s first blood drive a huge success and the project went full-steam ahead. Through the enthusiasm of Dr Drew and his improvements in storage and refrigeration techniques, subsequent shipments grew, saving thousands of lives.

Separation anxiety

During Blood for Britain’s five months of operation before a similar blood drive began on British shores, the project collected blood from some 15,000 American donors and shipped over 5500 vials of precious plasma.

Back home, the American Red Cross took notice and started a similar initiative for American forces, also headed by Dr Drew. Millions of donations were collected. Dr Drew was also asked to undertake the new Red Cross Blood Bank. Having access to great quantities of healthy blood opened up a world of possibilities for patients, clinicians and surgeons everywhere. In the field of emergency medicine alone, the impact was felt immediately as patients suffering traumatic injuries were suddenly given a new chance at life.

It wasn’t long before racism reared its ugly head and, under pressure from various groups as well as from within, the Red Cross started segregating its blood supply allowing only white donors to supply the military. Outraged by the preposterousness of "black blood" and "white blood," Drew resigned in 1941 and returned to Howard University, where he was the Chair of Surgery. During these years, he was also elected the first African-American examiner to the American Board of Surgery.

On April 1, 1950, Drew was driving through South Carolina with three other African-American physicians on the way from working at free clinic in Tuskegee, Alabama. He had been in surgery late the night before and was extremely tired when he lost control of the car. Though the three other people in the vehicle weren’t badly hurt, Drew’s leg, chest and neck were broken. He began bleeding profusely and went into shock. Charles Richard Drew, age 46, died at the hospital an hour later.

A tall tale?

For years, rumors persisted not only that Drew had been turned away from a whites-only hospital, but also that the inventor of the blood bank was denied access to its precious, life-sustaining resource in his final hour of need because of his skin colour. His colleagues and friends, however, insist that Drew received the utmost of care at the hospital where he died.

Dr John Ford, who had been in the accident with Drew, tried to clear things up: "He had a superior vena cava syndrome - blood was blocked getting back to his heart from his brain and upper extremities. To give him a transfusion would have killed him sooner. Even the most heroic efforts couldn’t have saved him. I can truthfully say that no efforts were spared in the treatment of Drew."

Drew’s biographers point out that the tempting irony and injustice of this embellished story of Dr Drew’s death was used for many years by some Civil-Rights Movement leaders as a way to highlight the discrepancies between the quality of medical care available to black and white Americans.

Though the injustices of medical segregation were an undeniable fact in the US at the time, Drew himself would surely have been far more delighted in the other ways his name lives on. Blood banks, scholarships, academic honours - including a visiting professorship at McGill - a Navy ship, a university and at least 20 public schools in the US have been named in his honour.

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Comments

Showing 1 comments

  1. On September 29, 2010, Dr. Steve Choi said:
    Talent is blind to colour of the skin.

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