Blog of Bloodworks Northwest



"A Matter of Life & Death" - Dr. Jorge Reyes & Dr. Saman Arbabi (S2 E22)

We throw around the expression, “It’s a matter of life and death,” so frequently that the words can lose their impact. However, when you talk to trauma and transplant surgeons at the University of Washington Hospital and Seattle Children’s Hospital about the consequences of not having enough blood on hand for critical surgeries – that’s exactly what they’ll tell you. It’s literally a matter of life and death, especially with a summer holiday weekend like July 4th approaching, when emergency rooms typically see an increase in trauma cases rushing in. 

On this episode of Bloodworks 101, producer John Yeager spoke with two noted local surgeons, Dr. Jorge Reyes and Dr. Saman Arbabi about the importance of having an adequate blood supply for the life and death decisions they have to make every single day. Episode transcript below:

Dr. Reyes: If you find yourself in the operating room, and you don’t have blood, you know, it can be quite disastrous.

John: Hi, I’m John Yeager, and this is “Bloodworks 101,” the podcast designed to educate or inspire you to give you their time, money, or blood. That was Dr. Jorge Reyes, the Chief of Transplantation Surgery at the University of Washington and at Seattle Children’s Hospital. Dr. Reyes was talking about the prospect of not having enough blood on hand for the work he and his team of surgeons does.

Dr. Reyes: Operations will stop, will stop. We would not be able to proceed with a complex liver transplant unless we have the blood necessary because if you find yourself in the operating room, and you don’t have blood, you know, it could be quite disastrous. So this is quite serious. It’s a crisis.

John: We just had to declare a code red, which was less than a day’s supply of blood. You know, we say it could be a matter of life and death, but this is not theoretical. This really could be a matter of life and death.

Dr. Reyes: Absolutely.

John: A matter of life and death. It’s a common expression. I think sometimes so common that those words lose their impact. But sometimes, I need to hear them from those who hold the scalpel, and in whose hands are the lives of those admitted to hospitals all over the Pacific Northwest, the surgeons. Now, you rarely hear from them because, well, they’re pretty busy saving lives. But I was lucky enough recently to grab a few minutes with two of them, Dr. Jorge Reyes, who you just heard from, and now from Dr. Saman Arbabi, the Medical Director of the Surgical Intensive Care Unit at Harborview.

Dr. Arbabi: As you guys know, Harborview Medical Center is the level one trauma center in our region. By that region. I mean, not only our state but Alaska, Idaho, Montana. And we are the center where all the trauma patients that are seriously injured come. So I think one of the things for people to realize is injury and trauma, and having a major injury that require blood can happen at an instant to any of us. It can happen to my family, my son, my daughter, and it can happen to your family.

And the example was just few weeks ago when I was a trauma surgeon, there is a young man who was working, and he actually was the provider for his family. And while he was working at this industrial place, he got crushed. And they brought him here in shock, requiring CPR, and we had to take him to operating room. And the injury he had was major injury, tore most of his liver off. And he had about five liters of blood in his belly. The reason that gentleman survived even to get to the hospital is that our medics gave blood products beforehand. If they had given him fluid and they didn’t have blood products, he would get coagulopathy, as in, he won’t have any clotting factors for him to stop any bleeding. And he would have been dead even before getting to. So that was great.

The reason I was able to get him into operating room is because we started blood, that whole blood, and we started putting this blood into this gentleman, and we got him down to the operating room, and then anesthesia team continued to do so. If I did not have enough blood, there was no way that patient would survive. This was a difficult operation, a lot of people work, but the simple fact was, there is blood, when he’s losing it I can give it to him to keep him alive. That gentleman walked out of this hospital I think three weeks after multiple operations, but walked out of this hospital, and I think he can get back to his family and back to work. And all of this was, you know, I’m not saying blood is the only thing, but without it would have been completely fallen apart.

Having blood in major trauma, this is only one example of everyday blood and blood products that we use to save people’s lives. And it doesn’t matter how much of an expertise we have, if that blood is not here, the person will not survive. The great thing about the whole system is that when one of these patients survives and goes home, I think all of us have achieved something. When you ask, have I ever been in that situation? Somewhat, but our system has worked so well, but now there is threat. Because of events recently, and I understand, you know, that people are hesitant to go give blood, because, well, they have to get out of their home, but knowing that they are saving somebody’s life, knowing that it’s safe, they’ve got to put their mask on, they’re gonna be in a very safe environment to give blood, which save somebody else’s life, and that somebody else may, in fact, be your own family. This trauma, I’ve learned after all of these years, it can happen. A car crash is an instant, and it can happen to you, to me, to our family, to our neighbors, and you’re saving their life. I think, to think about it that way is the key part. And I truly would not know what to do without it. Every time I use, I always start thinking about, oh my god, I’m so thankful for people who donated.

John: It’s inspirational to hear of that particular one person who was saved. I think sometimes we need to be reminded that these are human beings that are saved. When you give blood it goes to somebody, and in this case, that man was able to walk out because you had enough blood on hand just to get him to the point where you could help him. And I guess what I’m saying is that we see that unit of blood, and it’s hard to envision that going to somebody else for somebody like you to use it in an operation. That really does get personal, in that sense, it really does become real, doesn’t it?

Dr. Arbabi: Oh, yeah. Especially, when you go and sit down and talk to his mother and his brother, that are waiting in their room. And, you know, telling them, it’s very sick, you can see their eyes, they’re like, the mom is ready to pass out, the brother is younger, doesn’t know what to do. And then you say, “But, things are going well. So far, we have kept him alive.” And then a week later say, “Oh my god, you know, I think we made it.” You have to look into their eyes. And then you see all family. You see another person. I think whenever you look at this blood that you donate, it’s more important than gold. I don’t know if you can put a price on life, but it is life itself that you give. I think that’s the only way to describe it in my book.

John: Wow, you really personalize this. I mean, one of the questions that, you know, I had down here was is this and can this be a matter of life and death? And I guess what you’re saying is yes.

Dr. Arbabi: It is a matter of life and death. It’s not can or could, it’s a matter of life and death. We these days don’t give blood to anybody unless they have to have it. And when they get it, it is the difference between I am going to be alive and I’m going to be dead. So it’s a major part of what we do.

John: You touched on it before just in that one sense with a car accident with trauma. And I think about we were down to code red, which we called it because we were critically low, you know, 24-hour supply of some types. And I was thinking, not that I wanna go to worst case scenario, but had there been a multiple car accident on I-5, and you bring five or six people in, what do you do? You…

Dr. Arbabi: I don’t wanna think about it. I mean, I know we have to think about all of these situations and strive to plan and we do. But, to be clear, planning means that we use the blood that we have judiciously, as in, somebody is going to die. And those decisions are very tough decisions, but not having enough blood when there is a major disaster going on. Unfortunately, there may be a multiple shooting which, you know, our region could have it. It could be a major car crash, it could be other events that can happen, and without the blood, keeping somebody alive would be impossible at times and extremely difficult at other times.

John: Doctor, is there anything I haven’t asked you?

Dr. Arbabi: No. The only thing I have to say is first of all thank you for donating your blood. It makes a big difference. It makes all the difference. Believe me when I say that. I would love it if you please continue. I understand the issues nowadays, but there’s safe environment. It’s safe to go to donate blood. It is life-saving. You will help others. It’s one of the easiest things to think about when you donate blood. Just go home and think that you’ve saved somebody’s life. And that’s my message.

John: For Dr. Jorge Reyes, getting that message out is everything. That’s why no matter how busy he is, he agreed to help Bloodwork spread the word on the importance of the simple act of donating blood.

Dr. Reyes: We have a very giving population, we want to help. So if you’re within the reach of this voice, please donate.

John: It’s so easy. Just go to bloodworksnw.org, and click the box that reads “Schedule a Donation.” Thanks. And that wraps it up for this edition of “Bloodworks 101.” I’m your host, John Yeager. See you next time.

November 9, 2021 5:09PM

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