Five Quarts: A Personal and Natural History of Blood (24 page)

When he and I first got together, friends were dying of Kaposi’s sarcoma, Pneumocystis carinii pneumonia, and toxoplasmosis, all of which can now be prevented or treated. And while protease inhibitors certainly extend lives, they contribute to new health problems—heart disease, lipodystrophy, and kidney or liver dysfunction. Overtaxed organs may finally just give out. Should Steve ever get that sick, I would give my life for him, by which, in practical terms, I mean I’d donate spare parts of my living body—a kidney or half a liver, whatever he needed. And I could—there is no restriction against healthy, HIV-negative, gay men donating organs for transplant. The final irony is, were I to die today, I could literally give Steve my heart, yet when it comes to blood—such a simple, plentiful gift—I am not allowed.

T
WELVE

Blood Lust

BLOOD LIVES IN NEAR-TOTAL DARKNESS. WITHIN THE body it travels along the many thousands of miles of vessels under the deep shade of bone, flesh, and skin. Except during its jaunt across the eyes. These red threads in the whites of the eyes aren’t veins but arteries, it dawns on me early one morning. So obvious once you think about it, the color’s the giveaway, the blood so bright because its cells have just taken a deep breath. In the same way that the eyes gradually adjust when you enter a dark room, the closer I study my reflection, the more blood I begin to see just under the skin’s surface.

The hot water in the bathroom sink has once again fogged the mirror, and I give it another swipe of the hand. In the swath of me, I see the venous blood that purples the circles beneath my eyes, the blue earthworms of my temples. If I shut one tired eye—and oh, how the second wants to follow—I see the web of tiny capillaries on the outside of the lid. It’s as though I’ve showered in luminol, that blood-revealing solution used by crime scene investigators.

Shaving, I try too hard not to cut myself, and I do. Though minor, it’s enough to make me flash on a scene that’s stuck in my head since my last reread of Bram Stoker’s
Dracula:
It’s a little past sunrise, a few days into Jonathan Harker’s visit to the count’s Transylvania castle, and the young man is shaving in his room. He fairly jumps out of his skin as a cold hand settles on his shoulder and Dracula utters, “Good morning,” though nowhere in the mirror can the count be seen. Jonathan’s nicked himself and the sight of blood running down his chin seems to quicken Dracula’s. Only the crucifix hanging at his throat keeps the count from pouncing. “Take care,” Dracula purrs before retreating. “Take care how you cut yourself. It is more dangerous than you think in this country.”

Thinking about this exquisitely creepy scene makes me realize how differently it would play if it were set in the vampire world created by contemporary novelist Anne Rice. It wouldn’t take place during the daytime, for one thing, because Rice’s vampires can be injured or destroyed by sunlight. The crucifix, on the other hand, would cause no harm. Nor would the vampire be invisible in the mirror. In fact, since possessing great beauty is a prerequisite of being “turned”—so that the insult to God might be greater, as one vampire explains—Rice’s creations might even consider it cruel if denied their reflections for eternity. Also, unlike in
Dracula,
such a scene would never unfold from the mortal’s point of view. The reader would be placed inside the vampire’s head as he stalks the young man, lusting for his blood while also hating himself for the lust. Finally, while an Anne Rice vampire wouldn’t possess the power to slip through a keyhole, which is how Dracula magically snuck into Jonathan’s room, one could easily insinuate himself into a prospective victim’s bedroom in the more traditional way—through the art of seduction.

As Rice’s first vampire book opens, for instance, a mortal enters a vampire’s room, rather than the reverse. The young man has been enticed there for something illicit, thrilling: a story. The vampire promises it will be a good one. By all rights, the young man should be terrified. After all, he is alone in a room with an intense stranger he just met in a bar, a predator driven to drink human blood. But instead, the boy is utterly intrigued by this elegant, articulate character, the vampire Louis.

When I moved to San Francisco in 1985, the year the second book in the series came out, the fact that I hadn’t yet read the first earned me a joking reprimand from my new roommate, Rich: “Bad, bad homosexual!” as if I were a puppy who’d not been housebroken. He gave me a copy of Rice’s
Interview with the Vampire
along with another essential work I’d yet to read, Armistead Maupin’s
Tales of the City,
deeming this one of his cultural duties as a gay man who’d lived in the Castro for more than a decade. The two books were night-and-day versions of life in San Francisco.
Tales
was a delightful breeze, set in the 1970s, pre-AIDS, while the lush, dense, and tragic
Interview,
though it had been published in 1976, seemed to have been written expressly for San Francisco of the mid-1980s.

The story of
Interview,
with its brilliantly simple setup, struck a chord with me at age twenty-four. It read like a cautionary tale about dating during an epidemic. In Louis you meet a supernally attractive, urbane man who says he just wants you to know him. He wants to know you. He invites you back to his place. You go, though you know this guy is dangerous. But he is so irresistible. You spend the night together, locked in a profound intimacy. Oh, the things you talk about. Well, he does most of the talking, but that’s okay. You get to stare into those amazing eyes, all the while knowing that if you’re not careful, if you let your guard down, he can infect you with what infects him.

I could appreciate Daniel the interviewer’s risk-taking for the sake of an extraordinary story. But I also understood Louis’s motivation. Though the safety of all vampires lies in each one’s silence, for now he doesn’t care. A power beyond him has turned him into something he loathes, a monster, and he knows he can never change. He consents to the interview for a deeply human reason, to purge himself of his secrets. For myself, as a young man who had just horrified his parents by telling them I was gay and moving to San Francisco—“You might as well commit suicide” was my father’s bon voyage—I saw in
Interview
something instantly familiar. It was a vampire’s coming-out story.

Early on in the book, Louis tells Daniel of the anxious final moments of his first night as a vampire. As dawn approached with its killing rays, he’d accompanied Lestat, the vampire who’d “made” him, to a room in New Orleans. Accommodations were spare, so the two men would have to bed together. “I begged Lestat to let me stay in the closet,” Louis recalls, but the elder bloodsucker just laughed, exclaiming, “Don’t you know what you are?” Lestat slid into the narrow coffin first, then pulled Louis down on top of him and shut the lid. The two would sleep face-to-face. The following evening Louis would awaken and take his final step in crossing over. He’d hunt for the first time and drink the blood of another man.

THE DESIRE OF THE UNDEAD TO SUCK AND SWALLOW MOUTHFULS of liquid life has more to do with hunger than with thirst. The blood drive is the sex drive in the world of vampires. In ours, conversely, sex is driven by and dependent upon the blood, which works its own dramatic transformation on us humans. The change begins well before the clothes come off.

Naturally, the impetus for arousal varies from person to person, but regardless of the accelerant—a look, a smell, a touch—the biology is consistent. As ardor takes hold and heartbeats quicken, the brain green-lights the circulatory system to rush blood to certain sexually pleasing places as well as others less obvious. Capillaries in your earlobes and those lining the interior of your nostrils, for instance, will fill with freshly oxygenated blood, causing the skin to plump and become extra sensitive. Likewise, the tiny vessels in the lips and tongue fatten and warm, literally raising the temperature of your kisses.

Though it sure may feel like it, blood doesn’t increase in volume during arousal but gets redirected. In women, blood turns the pelvic area into a tropical zone, the labia and clitoris swelling, sensitivity building. The breasts, too, become fuller, the nipples stiffening from the blood-soaked spongy tissue within. Male nipples perform similarly, though, being of smaller stature generally, at a more modest scale. Of course, a grander transformation occurs in the groin, where arteries dilate to allow increased blood flow to the penis. Here, forming the length of the shaft, are three clustered cylinders that dangle like a soggy noodle when the penis is flaccid. (The urethra runs through the bottommost of these.) As these spongy tubes soak up blood, however, the organ bulges in all dimensions—on average, about two extra inches in length, more than half an inch in girth—raising the pressure within until it stands erect.

That it is called an erection merits a wee digression: How very male and grandiose the word sounds to my ear, bringing to mind such awe-inspiring feats of engineering as hoisting an ancient obelisk or raising a modern skyscraper. In point of fact, achieving an erection requires less blood to the penis than one might imagine, though don’t tell this to your typical size-sensitive male. About two ounces—or, one-eightieth of a 150-pound man’s total blood volume—is all it takes to make him hard.

Leonardo da Vinci

From the classical age to the Renaissance, it was believed that an erection was due to a breath-like substance brewed in the liver, Natural Spirits, which inflated the penis as, to use a modern analogy, air does a tire. The brilliant Leonardo da Vinci, a visionary in conceiving of such marvels as flying machines and diving gear, was also prescient in identifying the inner workings of male genitalia. More than a hundred years before blood’s role in erection was first correctly described in Western medical literature, Leonardo accurately summed it up in one of his illustrated notebooks. In 1477 he’d attended the public hanging of a criminal in Florence and, like others in the crowd, couldn’t help noticing that an erection was a consequence of this form of execution. During the subsequent dissection of the man’s body, Leonardo saw that it was in fact blood that had filled the organ, a result of the violent, downward jolt. (Incidentally, the phrase
well hung,
slang for “having large genitals,” does not derive from such observations. Rather, it dates back to an early-seventeenth-century description of a man’s jumbo ears, of all things, a usage that soon broadened to encompass any oversized body part. In any event, grammatically speaking, a noose and a fall lead to being well hanged, not well hung.) Following the dissection, Leonardo wrote, “If an adversary says wind caused this enlargement and hardness, as in a ball with which one plays, I say such wind gives neither weight nor density. Besides,” he added, referring now to the head of the phallus, “one sees that an erect penis has a red glans, which is the sign of the inflow of blood; and when it is not erect, this glans has a whitish surface.”

In his work
A Mind of Its Own
(2001), a “cultural history of the penis,” David M. Friedman writes with an implied wink that Leonardo, whom modern scholars agree was homosexual, “investigated the male member as no one before him ever had.” He filled page after page with detailed anatomical drawings along with quirky observations. Leonardo noted, for example, “The woman likes the penis as large as possible, while man desires the opposite of the woman’s womb. Neither gets his wish.” (I’ll assume Leonardo came to this conclusion anecdotally.) Further, the male reproductive organ, to his eye, was ideally situated on the firm base of the pubic bone. “If this bone did not exist,” Leonardo hypothesized, the penis during intercourse “would turn backwards and would often enter more into the body of the operator than into that of the operated.” In other words, one would end up screwing oneself.

Once blood was correctly implicated in erections, new discoveries were made and new misconceptions arose. Dutch scientist Reinier de Graaf, history’s next great investigator of the penis, correctly documented in 1668 that the penis does not, in fact, contain a single ounce of fat. What you see is lean flesh and blood. Its size will not change with weight gain or loss. De Graaf was also correct in declaring that the key to maintaining an erection is not getting blood into the penis but
keeping
it there. Alas, his theory that trapping blood in the penis depended on muscular constriction was interesting but wrong, as was the contention of subsequent scientists that valves in the blood vessels did the job.

Not until the early 1980s did the actual mechanism come to light. As it turns out, the process depends on what sounds like a physiological contradiction: A man gets hard because a crucial part of the penis softens. With the sudden influx of bright red arterial blood, the smooth-muscle tissue lining the three cylinders of the penis relaxes and, as a result, expands so fast that the veins through which blood normally returns to the heart get flattened against the shaft’s outer walls. In effect, a hematological flash flood has taken place, leaving all exits blocked. (A separate mechanism impedes urination, freeing the urethra to transport only semen.) With circulation cut off and the store of oxygen waning, the penis darkens in color, just like when you tighten a rubber band around a finger. The floodwaters typically will retreat soon after ejaculation. However, in the condition called priapism—named for the Greek god of virility and sexual prowess, Priapus, whose endowment, shall we say, was legendary—erection persists well beyond the point of enjoyment. Brought on by certain medications, injury, blood disorders such as sickle-cell anemia, or, in many cases, by reasons leaving doctors scratching their heads, priapism is painful and becomes dangerous if it lasts more than four hours. If the penis is not decompressed, the trapped blood starts to clot and must be extracted using a remedy that will make any man wince: A large needle is inserted into the shaft and the thickened, almost black blood is sucked out.