Narrator: On a busy London morning, a woman cycling to work goes under the wheels of a bus. Her pelvis is crushed, and major blood vessels are severed. The call goes out: "Code Red." This alerts the hospital's Major Trauma Centre that a patient is arriving with catastrophic bleeding. At the scene, the Helicopter Emergency Medical Service (HEMS) team finds her conscious and talking, a deceptive state medics call "talk-and-die," where the body has not yet shut down despite horrific internal injuries. They know they have only minutes. This life-or-death struggle, centered entirely on the loss and replacement of blood, is the dramatic entry point into the world explored in Joanna Ebenstein’s book, My Body, Your Body: How Blood Connects Us. The book reveals that this vital fluid is not just a biological substance but a complex symbol, a global commodity, and a carrier of our deepest histories and fears.

Narrator: The journey of blood often begins with a simple, quiet act. The author describes her own experience donating at a center in Leeds, a soothing and mundane process that takes just ten minutes. That single pint, however, is the start of an immense industrial journey. At facilities like the Filton blood processing center in England—the largest in Europe—donations are transformed. Here, blood is no longer a personal gift but a product. It is spun in centrifuges, separated into red cells, plasma, and platelets, and rigorously tested for infections. This high-tech process reveals the dual nature of blood: it is both a banal, everyday substance and a wondrous, life-saving resource. Globally, over 110 million donations are collected each year, feeding a system that turns a simple bodily fluid into a critical medical and economic commodity, with the United States alone earning $19 billion from blood fraction exports in 2016, earning it the nickname "the OPEC of plasma."

Narrator: While countries like the UK pride themselves on a voluntary, non-remunerated blood donation system—considered the gold standard for safety by the World Health Organization—this model is not universal. In many parts of the world, a desperate need for blood creates vastly different and more dangerous systems. In India, the system officially relies on voluntary donations, but the reality is a heavy dependence on family replacement donors and informal networks. This can be a force for good, as seen in the story of Baba-ji, a volunteer at a Delhi hospital who organizes a group of friends to donate blood every Sunday for strangers who have no local family to help them.

However, this same system creates opportunities for horrific exploitation. The book recounts the 2008 police raid on a dairy farm in Madhya Pradesh, where seventeen men were found imprisoned in tin sheds. They were kept as "blood slaves," bled twice a week to the point of near-death, their blood sold on the black market. This stark contrast illustrates the global divide, where blood can be a symbol of altruism in one context and a driver of human trafficking in another, with dire consequences for safety and human rights.

Narrator: Perhaps no story illustrates the dark side of the blood industry more than the tainted blood scandal of the 1970s and 80s. For hemophiliacs, the development of Factor VIII—a concentrate of a crucial clotting protein—was a miracle. It allowed them to manage their condition at home and live relatively normal lives. But this miracle came at a terrible cost. To meet demand, pharmaceutical companies created Factor VIII from massive pools of plasma, with a single batch containing contributions from up to 60,000 donors.

Much of this plasma was sourced from the United States, which, unlike many other countries, paid its donors. This created a high-risk supply chain, with collection centers targeting impoverished communities and even prisons, where rates of hepatitis and HIV were ten times higher than in the general population. Warnings were ignored. As a result, thousands of hemophiliacs worldwide, including children at specialized schools like Treloar College in the UK, were infected with HIV and hepatitis C. The book tells the story of Ade Goodyear, who was informed of his HIV-positive status at age fifteen and told he might have two years to live. He was the only survivor out of the five boys in that room. The scandal revealed a catastrophic failure where profit was prioritized over patient safety, leaving a legacy of death and suffering that continues to this day.

Narrator: Long before transfusions, the primary medical intervention involving blood was its removal. For centuries, bloodletting was a common treatment for a vast range of ailments, based on the theory of balancing the body's humors. This led to the "leech mania" of the 19th century, where millions of leeches were used annually. While the practice fell out of favor with the rise of modern medicine, the leech has made a surprising comeback.

The book takes us to Biopharm in Wales, a modern-day leech farm. Here, leeches are bred not for balancing humors but for their saliva, which Roy Sawyer, the company's founder, calls a "living pharmacy." Leech saliva contains powerful anticoagulants, like hirudin, and anti-platelet agents that are more effective than synthetic alternatives. Today, these creatures are used in delicate microsurgery. For example, when surgeons reattach a severed ear, the tiny veins can become congested with blood. Leeches are applied to the area, where they gently draw out the pooled blood and secrete their anti-clotting compounds, allowing the tissue to heal and survive. It’s a remarkable example of an ancient remedy finding a new, highly specific purpose in cutting-edge medicine.

Narrator: Blood that leaves the body voluntarily through menstruation carries its own profound and often negative cultural weight. The book explores this global taboo, from the horrifying practice of chaupadi in western Nepal to the marketing of feminine hygiene products in the West. In Nepal, the author meets Radha, a sixteen-year-old girl who, during her period, is considered impure and banished to a small, unlit shed, where she lives in fear of the cold and snakes. This practice, rooted in ancient beliefs about pollution, persists despite being outlawed.

In stark contrast, the book introduces Arunachalam Muruganantham, an Indian man from a poor village who became a social entrepreneur. After discovering his wife was using "nasty cloths" because she couldn't afford sanitary pads, he embarked on a mission to create a low-cost alternative. His journey was fraught with social ostracism; he was shunned for his unconventional research, which included wearing a "uterus" made from a football filled with goat blood to test his prototypes. Ultimately, he succeeded in creating a simple, affordable machine that allows women in self-help groups to manufacture and sell their own pads. Known as "Pad Man," Muruganantham's story is a powerful testament to how innovation and empathy can challenge deep-seated taboos and empower women.

Narrator: The book returns to the high-pressure world of emergency medicine to explore the science of trauma. When a patient suffers massive blood loss, they risk entering the "lethal triad": hypothermia (getting cold), acidosis (blood becoming too acidic), and coagulopathy (the blood's inability to clot). This creates a vicious, self-perpetuating cycle that is incredibly difficult to stop.

The approach to treating such patients has evolved dramatically. For decades, the standard practice was to pump patients full of saline to restore volume. However, this dilutes the blood's oxygen-carrying cells and clotting factors, often making the situation worse. Military experience, particularly in conflicts in Afghanistan and Somalia, has driven a shift back towards using blood itself. Surgeons like John Holcomb, during the Battle of Mogadishu, used fresh whole blood from volunteers when their supply of components ran out, with remarkable results. This has led to a reevaluation of component therapy versus whole blood in trauma settings. Today, London's trauma network, which rushes blood directly to accident scenes, has seen death rates from hemorrhage drop from 34% to 18%, a testament to how learning to use blood better continues to save lives.

Narrator: The single most important takeaway from My Body, Your Body is that blood is never just a substance; it is a story. It tells a story of scientific discovery, of cultural belief, of economic power, and of human connection and disconnection. From the altruistic gift of a donor to the life-saving work of a trauma surgeon, and from the exploitation of a "blood slave" to the stigma faced by a menstruating girl, blood flows through every aspect of our world, revealing our best and worst impulses.

Ultimately, the book leaves us with a profound challenge. As we stand on the cusp of creating lab-grown blood and developing even more sophisticated medical technologies, we are forced to confront the complex human systems that govern this life-giving fluid. Will we use our growing power to build more equitable and safer systems, or will the historical patterns of profit, prejudice, and fear continue to shape blood's journey? The answer will define not only the future of medicine but the very nature of our connection to one another.