The anesthesiologist, who had just given me the smile of approval, had taught us respect for blood. His belief was in the use of what he called “white blood,” Ringer’s lactate solution. It is a fluid that contains the salts, water and other ingredients necessary to replace body fluids, but it does not present the dangers of whole blood. He had repeatedly told us that if a patient did not need massive amounts of blood, then you were a fool to use anything but Ringer’s lactate to replace volume loss.

Shortly afterward, she gave me a list of blood replacement fluids that her Bible teacher had given her over the phone, and she asked me if I knew about these. It really exasperated me—to think that they thought I didn’t even know about plasma volume expanders. On the list was Ringer’s lactate, “white blood.”