Behind The Scenes

I've had a small insight. Us "labbies" (term used to describe one whose life work revolves around a laboratory - yes, I made that up) don't get enough credit. Just saying. I mean, I'm not officially one (yet?) but being one on placement counts. It's actually pretty surreal how critical their/our work is.

I started 'work' on Tuesday at KCH and following my meeting with Henry (who for the record is less scary than first impressions made out), I was placed in the Blood Bank. He let me choose the departments I wanted to see so I thought why not jump into the deep end. I should point out that all the labs are under one roof; it's literally one corridor with labs for Biochemistry, Microbiology, Haematology, Parasitology, Serology and PCR (Polymerase Chain Reaction). I could be working on DNA in one lab and casually wander next door to look at some disease causing specimen wriggling under the microscope. I'll be honest, I'm not too sure how hospital labs are arranged in the UK but I assume that unlike here, they're split into faculties or departments.

So I'm in the Blood Bank till Friday. It's basically the department where we deal with blood transfusions; it's THE busiest department because of the sheer demand Malawi has for them. Any number of transfusions ranging from 50-100 on average occur a day. So as you can imagine, demand exceeds supply meaning we have to prioritise requests; paediatrics, those suffering from a rupture or have just had an operation, and those women who have just given birth or are undergoing complications regarding a pregnancy.

We receive the blood sample of the patient and then the first step is to determine the blood group because if the same blood type isn't transfused, the blood is rejected, and the whole process is deemed pointless. In the West, advanced technologies allow sophisticated machinery to simply take in a blood sample and indicate the blood type.

Here, it takes a more manual approach; blood type is determined by the surface antigens one's red blood cells display, so blood type A displays A-antigens, B displays B-antigens, and AB displays both. So we test the blood sample against monoclonal antibodies where agglutination with their respective antigen tells us the blood type. The next step is to confirm the blood type by cross-matching with a blood donor and observing its compatibility. If it all falls into place, it's given the go ahead and sent off for the patient.

It's quite sad that the majority of the emergency cases are children...from six days old, to one-year olds, to seven-year olds, all suffering from severe anaemia or chronic organ failure. We get women suffering from incomplete abortions whereby they take pills to terminate the pregnancy rather than taking clinical control. Ultimately, the baby is only partially lost, so the mother loses an insane amount of blood in a short space of time.

Today we had a critical emergency where a woman was on the verge of death and a blood transfusion was a lifeline. It's pretty crazy having a first-hand experience of real-life situations where screwing up (which I do more often than I'd like) could lose a life. It seems like a lengthy process, but we have to do it there and then, whilst a patient in a ward somewhere is rapidly losing blood. The weight of responsibility is heavy. It's one thing doing an experiment at uni, where it can be repeated till it's done right (if at all). It's another to be in a hospital lab, handing over the correct blood bag, in order to save someone's life.

It's also super exciting. I mean, studying the theory is all well and good, but having the opportunity to see it all in practice and tackling a reality that depends on techniques and knowledge that is taken for granted, is amazing.

I went from only ever seeing blood bags on The Vampire Diaries, to handling them on a daily basis where I'm independently left with the task of meeting blood transfusion requests. And I'm loving every minute of it.