This is a gripping, informative, and well-researched book about human blood. An accomplished journalist, Rose George, covers a variety of topics, largely in the U.S., Britain, and Canada but also in Nepal, India, and South Africa. She describes many current issues, provides historical background, and speculates on future technologies, such as replacement of blood by other fluids. There are nine sections:

 “My Pint”  While the book’s title refers to the author's volume of blood, this chapter’s title refers to a single pint she is donating. We read about blood supply (donated and stored blood) in the U.S. and—by contrast—in India.

“The Most Singular and Valuable Reptile” refers to the leech. This arresting chapter describes both historical and  modern uses of leeches to gather blood from humans. She visits a company called Biopharm in Wales where leeches are raised and prepared for shipment to medical clinics and hospitals.  

 “Janet and Percy” is a historical chapter focusing on Dame Janet Maria Vaughan, a central figure in creating the Blood Transfusion Service in England during WWII and Percy Oliver, who guided its predecessor, the London Blood Transfusion Service.  

“Blood Borne.”  This chapter describes Khayelitsha, South Africa, “the ugly backside of Cape Town” (p. 100): a place of poverty, crime, rape, sexual predation, and HIV. While rich nations provide assessment and treatment for people with HIV, poor nations have many citizens infected with the virus and, over time, rising rates of infection. 

 “The Yellow Stuff” describes the plasma portion of blood; it can be frozen (as FFP) and used as a filler for bleeding or trauma patients. Unlike blood—which can only be given without payment—plasma can be collected from paid donors. It is a largely traded commodity, part of a multi-billion dollar industry worldwide. Plasma carries Factor VIII, a crucial protein for clotting blood; hemophiliacs lack this and are at risk for death by bleeding externally or internally. Some plasma has been tainted, for example by HIV.

“Rotting Pickles.”  In Western Nepal (and other places), menstruation is taboo. George writes, “We are in a minority among species, and among mammals, to bleed every month.” She reviews historical views of women’s periods, mostly negative. Worldwide, there are many taboos, but also some educational efforts for public health that are helpful in impoverished areas.  

 “Nasty Cloths.” This tells the unusual story of an Indian man named Muruga, “a poorly educated workshop helper” who became a leader in creating sanitary protection for menstruating women. Worldwide, the feminine hygiene industry is some $23 billion. George also reviews related history, including Toxic Shock Syndrome from tampons.  

 “Code Red.” Bleeding is often a fatal factor in trauma, even with the best efforts to transfuse blood into the patient, unit after unit. George observes open chest techniques at a resuscitation. She reviews breakthroughs in blood typing, component therapy, and “buddy transfusions.”  

“Blood like Guinness: The Future.” George starts with images from the past: vampires, human drinkers of blood, past and, even, present. She interviews a purveyor of the concept that “young blood” is healthier than older blood. Can there be, discovered or created, blood substitutes that also save lives? 


The dramatic cover on the book includes a photo displaying nine bags of donated blood. Stacked horizontally, they are emblematic of the book as a whole, nine chapters we read one at time. Since there is no introduction to the book nor a conclusion, we are left to make our own connections or evaluations from the large amount of information presented. The subjects of the subtitle (money, medicine, mysteries) are motifs throughout the text, but we don’t find interpretations of them. This is a journalist’s approach to her journey. George is an excellent researcher in her travels, in her interviews with a wide range of people, and in her scholarship; there are 42 pages of footnotes.

She writes directly about her feelings as she watches emergency surgery or as she receives a phone call warning that she might have been exposed to HIV. Her openness and honesty make her a voice we can trust. Her style shifts from levels of analysis to lively description of persons and places. Interviews with AIDS patients, the leech grower, and Muruga are fascinating; we feel that we are present and listening to them. Throughout, her prose is tight, intelligent, and inviting. 

George spends a large and important part of her book on menstruation and the lack of care society has provided for women…poor women…young women…women outcast from their homes during their periods. This focus in itself is important given that menstruation is largely taboo in many, many cultures, even the so-called first world. She calls for social justice for this topic; care for women working in factories in poor countries are often denied access to basic sanitary supplies as well as consideration for sick days. Further, many women die during (or soon after) childbirth, especially when transfusions with correct blood types are not available.

George also calls for education and other protections from HIV/AIDS, another threat to, especially, people without money, jobs, or chances for advancement.

Many readers will enjoy the pages about World War II that show how the early uses of blood storage and transfusion saved many lives, both military and civilian.             

Primary Source

Metropolitan Books


Henry Holt and Company

Place Published

New York



Page Count