better living through phlebotomy

Non-fiction, 2/17/11

It was the summer between my freshman and sophomore year at college. Just before vacating the dorms that June, my buddy Jason and I saw an advertisement on TV—I don’t remember the channel, but it was at some ungodly hour of the morning and we were drunk again—for a clinical research center in Tacoma. The commercial spoke of breakthrough studies, backed by sterling safety records, carried out by professional, highly-trained staff in their state-of-the-art facility. It all seemed very trustworthy and legit, and the two of us were rapt. There was no real action to the ad; it just showed bullet-pointed text narrated by a youngish, nursey-sounding woman, accompanied by a phone number and Web address. It concluded by mentioning the long stays with free accommodation, cable TV, and the fat checks available upon completion of each trial. We were buying this, sight unseen. Compromised though our judgment was at the time, Jason and I both knew we had hit upon college-slacker gold.

The study we signed up for was a test-run for some sort of kidney medication. Apparently this drug was designed to help prevent renal failure, and our job as voluntary lab rats was to ingest said drug and submit to numerous blood draws—sometimes up to 20 in a day—to monitor its presence in the bloodstream. There were to be two study groups: those who would consume a high-fat breakfast each day before taking the drug, and those who ate a low-fat breakfast before taking it. Our diets would be strictly regimented, to ensure that the drug’s absorption be as closely controlled as possible. Every meal needed to be finished to the best of our ability—no saving food, no unauthorized snacking. And certainly no food from outside. Nearly every last calorie would be accounted for, or at least that was their aim. In all it was a four-week ordeal, split into two two-week sessions that would be spent at the Tacoma facility. Between these sessions, there would be a week in which we could go home, but we were to adhere to the rather limiting parameters of the trial: no smoking, no drinking, no exercise, no sex. The powers that were conducting the trial didn’t want any build-up of lactic acid in our blood—hence the moratorium on physical activity—and any nicotine or alcohol would just sully the results. For our labors (or lack thereof, actually), we would be recompensed $3,200 after the final blood tests ran through.

Before Jason and I could participate, we had to pass a rigorous in-person examination at the facility. It was sort of like a physical, a drug test, and a psychiatric evaluation all rolled into one. They didn’t want any drugged-out weirdos hanging out with the patients, apparently. Because that’s what we would become: not weirdos (we hoped), but patients confined to the halls of a pseudo-hospital (which, we later learned, had been a retirement home in a previous life). The requirements for our study: males only, between 18-30 years old, with “healthy” body-mass indices and no history of smoking or heavy drinking. The examiners poked and prodded us, asked probing questions about our mental proclivities, asked about our drug use, and of course tested our urine. Jason and I had anticipated this, and had spent the last three weeks chugging cranberry juice in a desperate attempt to flush any tetrahydrocannabinol (that’s THC, natch) from our systems. Our efforts paid off, and we were summarily admitted into the fine tradition of guinea-piggery for pay.

That first day felt sort of like move-in day at the dorms. We were all standing in lines, the two dozen of us in the kidney trial, holding our duffel bags of belongings and scoping out the premises, trying to determine what, exactly, we had gotten ourselves into. There were lines to get checked in, lines for the preliminary blood draws, lines for the bathroom to pee into Dixie cups for testing. The building was essentially square-shaped, with long hallways down each side that were flanked by the patient’s rooms. The halls were thinly carpeted, and along the walls—which were adorned with uninspired still lifes of potted plants and bowls of fruit—ran a sturdy, geriatric-grade handrail (a vestige of nursing homes past). In the middle was a mess hall where we would take meals and receive our daily dosages. To the right of the front entrance was a “medical wing” where the biweekly checkups took place, basically to ensure that nobody expired mid-trial. Taken as a whole, the place had sort of a walk-in clinic-meets-halfway house vibe to it. I would come to know every square inch of it in the weeks to come. Our trial was one of two being conducted at the two-tiered facility; the other was an all-female study involving birth control of some sort, and they were staying upstairs. Round-the-clock security guards and a closed-circuit surveillance system kept funny business to a minimum: lights out at nine, wake-up knock at 6:30 a.m., no exceptions.

For the first two-week stint, Jason and I were placed in a room with another college kid named Harry. That wasn’t actually his name, but that’s what we called him—Harry as in “Harry Potter”—because that’s what he read for the entire duration of the trial. Harry rarely spoke to us, except to tell us to quiet down at night when he was trying to read. We slept in bunk beds, and for the first couple nights Harry’s bunk was only half-filled. Then Chris showed up. Chris was in his mid-twenties, lived in Gig Harbor, and drove a black scooter. His voice was the epitome of stoner deadpan, and we eventually learned there was good reason for this. It seemed Chris had what might be called an entrepreneurial spirit—he fixed scooters and bikes out of his garage back home—but when it came to selling drugs, the product itself was simply too hard to resist. He sampled a little here, a little there, and before long, Chris had taken the concept of “quality control” to new heights. “I’ve sold weed, pills, mushrooms—but I don’t really make money from it,” he told us rather candidly, the second day we knew him. “It’s mostly because I end up using a lot of it myself. Once I had three pounds of mushrooms that I bought to sell, but I ate every single one myself before I found any buyers.”

Jason and Chris hit it off immediately. And not because Jason was a stoner—he rarely did drugs of any sort, in fact. (For context, Jason was a self-described redneck, car enthusiast, and chauvinistic beer-drinking Republican who was fond of saying things like “Get ’er done!” and “Holy shit, Batman!”, apropos of nothing.) Neither was it their shared affinity for all things mechanical. No, their mutual interest was porn. Both were unabashed skin-flick aficionados, and each came amply prepared for the sexual drought ahead. Jason had his external hard drive filled entirely with prurient downloadings; Chris brought a veritable smut-library of DVDs, all neatly labeled and stored away in a black CD booklet. Sometimes I would come back to the room to find the two of them (Harry was conspicuously absent at these moments) sitting up in their respective beds, dispassionately watching porn on the muted TV, or on Jason’s laptop, or occasionally on both screens at the same time. They looked almost bored, as if they had spent the previous hour flipping through channels, finally deciding on porno for lack of anything better to watch. During one such session, I stepped in to grab my shower supplies and made the foolish mistake of glancing up at the TV. On it, someone’s asshole was being toggled with a dildo in an alarmingly close-up shot. “Hey, whose asshole is that?” Chris asked, with perhaps a hint of genuine interest. As if in response, the camera zoomed out, revealing two naked women and a man…with a dildo sticking out of his ass! “Augh! What the hell?!” The DVD was yanked in favor of another. From one glimpse, I had seen enough, and that was nothing. During our second two-week installment, just the three of us shared a room, meaning no Harry around to curtail the obscenity. Needless to say, I spent a lot of time outside of the room after that.

Perhaps the hardest part was finding stuff to do. We weren’t allowed outside, where we could potentially exert ourselves physically or hitchhike to McDonald’s or hit up a corner store for some smokes and a six-pack, so that narrowed things down a bit. I read nonstop, quickly exhausting my own supply of books and moving on to the hand-me-downs shelved in the mess hall. I paced the carpeted corridors aimlessly, sometimes with my nose buried in a book, sometimes while chatting on the phone with my girlfriend at the time. I watched many terrible movies (none of which were rated X, though it was always an option) and surfed the internet whenever a slot opened up—the three computers in the mess hall operated on a first-come, first-serve basis, and there was almost always a queue. Every once in a while, if it was an especially gorgeous summer day, one of the security guards would take us on a chaperoned walk through the neighborhood surrounding the facility. There we were, twenty-odd pasty males squinting fiercely in the sunshine as our scrub-clad orderly led us through Tacoman suburbia. People stared, dogs barked, cops mumbled into walkie-talkies as we passed. Those walks were the best.

Meals offered a welcome distraction from the tedium. The food wasn’t bad—though I may have been alone in that opinion—and the staff clearly made an effort to diversify our menu throughout the trial. It was stereotypical hospital fare, I suppose. Every meal was pre-portioned and we were strongly encouraged by the staff to clear our plates—“for the sake of the trial,” they’d say. Some found this to be a particularly onerous burden; others did as they were told and promptly asked for more, to no avail. I simply ingested my food as slowly as possible, drawing out the tactile experience of ferrying morsels from the plate to my mouth. All the patients ate together in the mess, including the women from upstairs, and the conversation flowed freely across the cafeteria-style tables. Cliques quickly formed. I dined alongside Jason and Chris and we amused ourselves by rating the female patients based on physical appearance, nicknaming each in turn. It was like junior high all over again. There was even a vending machine—for lunch and dinner everyday each patient received two drink tokens to “buy” sugar-free diet sodas. I never used mine, so they went straight to Jason and Chris, who amassed quite the cache by the end of our stay.

As we fought tooth and nail to stave off complete stupefaction, our blood was being drawn with an almost comforting regularity. This was a clinical trial, after all. The little prick in the arm was like being pinched: it reminded us that we were awake, alive, not just sleepwalking in some banal netherworld. Usually it was just once in the morning, once in the evening, but there was one hellish period in which our veins were jabbed no less than 45 times over the course of three days. For a little while, we were being woken up in the middle of the night to relinquish blood. The preferred access point was the inside crook of the elbow, but some people got so sore toward the end that they begged for different spots, and wound up with holes down their forearms, near their wrists, around their knuckles, even. With all our minute punctures and subcutaneous bleeding, we looked like track mark-riddled heroin junkies. Because there were only a handful of nurses on-site, and because the draws occurred so frequently, we naturally picked favorites among the blood-letters and raved incessantly about them. Jason and Chris liked Tina, who was by far the most attractive of the nurses (there were five in all, I think). Tina was definitely a fox—what with her coy demeanor and vaguely Asian looks—but her phlebotomy was nothing to write home about. She was alright, I acceded, but Lamar was better. With him I was never shanked repeatedly because my “vein bounced”; I never had to worry about him lancing my muscle tissue in an overzealous plunge. Lamar was calm and competent, and he looked kind of like Tiger Woods.

After the four weeks were up, after the last vial of blood was drawn and packed away, we were given a final check-up before being cleared to go. There was little fanfare from the staff: we were just the guinea pigs passing through, scarcely more than walking blood bags, no different than the last group that showed up, offered their veins and took home the compensatory checks. I continued getting emails from the clinic about new trials to join, but I never went back. In both a literal and figurative sense, the experience drained me. I lost almost 10 pounds of muscle and perhaps a small portion of my sanity, as well. Do I regret it? No. But I would never do it again.


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