Thursday, October 22, 2009

Mutiny against an Ancient Grudge

So colorful and exact in quality, so fluid in its flow, so functional in its capacity and yet so turbulent in its history, this blood, the humor of our humor, this life behind our living is the touchstone of being.
It provides the first blush of a fair teenage girl on seeing her heartthrob. The color of cheeks suffused with the pink and redness of a rose or the color of the flame and warmth of the ill-gotten infection that rises to the face and disassembles the beauty by the invisible hands of the infecting agent. It is also the color of bodily response around a sustained wound. This color is the projection of this body humor called blood.

From Galen’s concepts of the origins of where blood is formed based on the “dark’ from the liver and the “bright red” from the heart to the circulating anatomical description by William Harvey, blood has been mentioned as a source for purity of the soul and as the scourge of plagues. In disease the oft-practiced venesection and bloodletting became a therapeutic endeavor for most illnesses. Many an intellect has fallen prey to the seductive powers of blood, proclaiming it to be the be-all, end-all of life and it is, for no substitute has yet to be discovered to take the burden of it’s claim. Blood therefore has endured this fame and its share of infamy over millennia.

Blood has always been as it now is, the transporter, messenger, supplier and mobilizer of cells and cellular products. It accounts for 7% body weight and the heart pumps 80 pounds of it every hour to keep the milieu in harmony. Attempts at transfusing from different species met with failure as equally also between humans, until the early 20th century when an Austrian physician in 1901 figured out the cause of death after blood transfusion was due to a mismatch. He received a Nobel Prize in 1930 for his work in Blood Typing.

                                                        Sir Frank Dicksee 1884 painting

From two households close in proximity, modest in civility but silent in their anger towards each other, there blossomed an infatuation that proclaimed into undying love between the boy and the girl. The anger between the households stemmed from a silence, created by introversion and lack of neighborliness, which evolved into an unsaid but slow boiling dislike finally blossoming into hysteria of unexpressed anger. The children however drawn to each other by invisible tugs of unexpressed emotions found refuge in hidden pleasures of subterfuge and clandestine meetings. Love thrived under the canopy of darkness and shadows.

                                                      Casa di Giulietta in Verona, Italy

It was a winter’s night when she was awakened with a fast heartbeat. She was shivering with fever and soaked through her nightclothes that the alarm was sounded through the house. The following morning and the weeks beyond the family became familiar with the environs of the hospital and its doctors.
After repeated attempts at communications with his love, the sixteen-year-old finally found out the cause of the silence. In a fearful desperation late that night under the cover of darkness he approached her hospital bed. The family had just left and his love lay there quietly, eyes closed, breathing lightly, barely enough to register. The only external reference to life was the loose dark blonde hair billowing to the rhythm of her breath.

“Hi.” He said as he approached her. She looked up and the clarity of vision and her desire all rose into her face with a sudden blush, the same he had seen many months before when they had met.
“What’s wrong?”
“I am sick and they can’t fix it.”
“That is not possible.” His voice rose in defiance. “My father tells me everything is possible all the time and I believe that.” He stuck his right fist into the palm of his left hand. Tears just lurking at the corners of his eyes. His dreams and desires were lying there in front of him. At sixteen there was a tomorrow and beyond but without her there was nothing.  “What did they say is wrong with you?”
“It is a bone marrow problem. They say they cannot find a match for mine. They have tested all my family and everyone is a partial match which is not good.”
“Can I be tested?”
“I think only family is allowed.” She answered doubtfully, her eyes seeking his and nothing else. A heart once fulfilled now crying of emptiness and hearing echoes of a lost future.
They fell silent for a while as their dreams and desires were held in the palms of their hands each clutching the other for safety and security. The nurses looked through the window periodically but did not interfere. They all knew the plight of the invisible embrace of the two. No words could describe their togetherness better than their proximity. After an hour when fatigue overwhelmed her into a deep sleep he rose from her side and went home.

“Okay genius, tell me again what this HLA stuff is all about.”
“MHC stands for Major Histocompatibility Complex region of the genome. It is located on Chromosome 6 and carries 3.673 million base pairs. This region determines who we are and so differentiates between “self” and “non-self”. His friends voice over the cell phone was tinny and detached. “What makes you so interested in biology suddenly? I thought math was your subject?” he asked.
“Try me another piece of BS.”
“So how much of a match between two people is required?”
‘There are nine of these HLA genes within the MHC. The best matches need the HLA-A,B and DR subtypes. Always, the more the merrier.”
“But why so much difference within humans. It makes us so different.”
“Well, half the truth is that the first HLA-A,B,C carry between 800 to a 1000 differing alleles so having two people completely matching is next to impossible.”
“Its plain dumb. Nature is stupid as shit, isn’t it?”
“Not really. There is a special region in the MHC that deals with your sense of smell. It appears that women prefer the diverse smell of their future mates. That particular gene encodes the proteins for that aroma. It is nature’s way of saying “variety is the spice of life.”  There was a brief hesitation and then he concluded, “That is why you don’t want to marry your cousins. You get monsters for children!”
“If two people can’t be matched perfectly, how do transplants work then?”
“Immune suppressive drugs.”
“For the rest of one’s life?”

The chirpy broken response and the cloudy hiss of lost signal ended that conversation. He tried the number again but the network was overwhelmed with other teenager calls. He gave up and sighed.

Weakness tortured the heavy eyelids and forced them shut to the outside world. She could hear the lingering echoes of words of endearment and then of encouragement. They were all mixed together, jumbled beyond recognition. From whom they came and where they seemed to disappear she could not decipher. The weight of the fatigued mind crushed all physical abilities. She wafted through the walls of the building like an ethereal being, saw nothing yet heard words she could not fathom. They seemed to call to her, but from where she could not make out. This disguise of fictional reality played in her mind’s eye until the first glimmer of understanding. She felt the hand she had come to hold and love. She felt it, firm and comforting, holding hers in its warm embrace. It was his and without opening her eyes she felt him near her and all was well.

Two week later the two families looked on through the window into the sterile laminar flow room where the two sixteen year-olds laid side by side in their beds with hands clutched across the divide. His bone marrow was a near perfect match and the transplant was an unqualified success. The cells from the two clandestine lovers were perfect among eight of the nine HLA loci. Karl Landsteiner, the Austrian Nobel Laureate, would be proud of this equanimity of cellular fortune. Both also had the rarest type blood O grouping, less than 1000 years old in evolution versus the others A and B, which were 25000 and 10000 years old. Rare creatures that life sometimes smiles upon to uphold the virtues of love over anger and misplaced venom are gifted with the simplest of reasons and strongest of desires.

Her marrow purged from its predecessor vile and villainous cells was now host to those that belonged to her young love. His marrow gifted with strength and love prevailed against all odds. A bond that could be broken in life from circumstance, a wronged stare or a flippant word was now laid permanent in deed. The shared blood now strengthened the unity of love. Love had triumphed over hardship, disease and consummated the desires of the future.

Two meager lights shown from disparate homes where ancient grudge once existed now dissolved into a bond of friendship, one that would seal civil fates of these two families in happy union for generations. From the conspired mutiny of ancient grudge to the inspired design of lasting friendship, the two households joined together in harmony.

At twenty-two they married each other and at twenty-four they were blessed with a child. Sometimes it takes the innocence of children to see through the profanity of misconceived ideas of adults. This is a tale of two young hearts beating with common blood. A single strand of simplified reason can untangle the most chaotic of knots built from least reasonable of ancient grudges.

The brevity of life like a string of melody is a poised potential for a beautiful symphony.

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