An Interview with a Living Vampire

Kathleen McLaughlin on her participation in and reporting on the blood industry

The line to donate plasma, including hundreds who’ve crossed the border specifically to donate, in Brownsville, Texas in May 2021 (Sergio Flores via Getty)

I apologize for the punny headline, but I couldn’t resist (and I didn’t make up the language to be cute, you can find it in the interview below). Plus, I would do pretty much anything to draw more attention to the work of my great friend Kathleen McLaughlin, whose new book, Blood Money: The Story of Life, Death, and Profit Inside America’s Blood Industry, comes out later this month.

The first time I read Kathleen, it was in a profile of a Montana politician that I knew I couldn’t top. She’d recently moved back to Montana after decades living in China, and she’d shown up at Crow Fair to write about the congressional race between Greg Gianforte (who’d previously won the seat after assaulting a reporter) and Kathleen Williams, the surprise winner of Democratic primary, for The Guardian.

It was the perfect journalistic scene (the Native vote is hugely important in Montana) for both (very white) candidates to be awkward, and they both were, in different ways that were at once very much them and also incredibly illustrative of Montana politics in general. Kathleen captured it with such concision, such sleight of hand. She was showing, showing, showing in a way you couldn’t ignore — never telling.

I’d only recently moved to Montana, and I DM’ed her on Twitter, effusive with praise. She could’ve ignored me or deflected me. But we had the shared, weird experience of trying to report nationally, even internationally, from Montana — how to make the specificity of the place make sense without fetishizing it. She lived in Missoula then, but she was a Butte girl through and through — and if you know what that means, well, you know. Barbara Ehrenreich was a Butte girl too.

People from Butte, they don’t forget, and they don’t forgive. Not insults, not slights, not anyone from Bozeman, and certainly not the deep, deep scars incurred in the interest of capital. (If you want to know more about Butte, once The Richest Hill on Earth, I mostly recommend talking to someone from Butte and/or Kathleen, but I’d also recommend Michael Punke’s Fire and Brimstone).

Walking and talking and texting with Kathleen meant talking and learning so much about the history of Butte, the violence in the air on the playground in the ‘80s as kids internalized the collapse of the copper industry, the beauty and toxicity of the Berkeley Pit — but also what it meant to go to college in the ‘90s without enough money to cover books, what it felt like to learn from the best in Montana journalism, and what became of it all.

Kathleen has that coveted thing from coming up in the print newspaper world: concision. And as I learned reading her in various online outlets, she can wield it like a weapon. When I read her book earlier this year on a long plane ride, I was enraptured and shot through. I needed to stare into space afterwards. You’ll see why below — it is at once deeply personal and an incredible feat of reporting — but the book is also an essential continuation of our ongoing conversations, whose recurring refrain comes never leaves me.

The problem with journalism, Kathleen would say, is that so few journalists know anything about what it actually means, what it actually feels like, what is and is not possible, when you don’t have money.

You can find Kathleen on Twitter here and pre-order Blood Money (out here.

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On the first page of the book, you write: 

“It was 2004 in Shanghai, and I had just told the first of many lies to come about the contents of my luggage. I concealed in my suitcases a dozen glass vials of medication made from human blood, extracted from people living elsewhere in the world.” 

Kathleen, this is an opening. Truly, what a hook — and one that immediately establishes that this story (which is ultimately a story of macro-level wealth inequality) is also deeply, deeply personal. This is going to be a whopper of a question, but for readers that are unfamiliar with your own story — can you talk about the twists and turns in your own life that led you to thinking and reporting about the blood industry? 

It's funny but because this is just my life, I don’t often think of it as bizarre or weird. But yes, I know that it’s unusual and what I’ve done isn’t the norm. My life has been lived a little bit on the edge at times.

My interest in the global blood trade began in the late 1990s, when I was still in my 20s. I started getting sick in weird ways, and sometimes disabled, with what was for about five years a mystery illness. Basically, my hands and feet would go numb, and it got progressively more difficult to walk or to use my hands over a period of months. It would go away and come back and I go to another doctor, who’d tell me it was all in my head, until eventually I found one who took me seriously and took the time to figure it out. I was diagnosed with a rare disorder in which my immune system attacks healthy parts of my body. The treatment that works, which has always felt extremely bizarre to me, is periodic infusions of a drug made from isolated parts of other peoples’ blood. 

I’ve joked about it for years that I’m a living vampire. Existing as a kind of real-life vampire, dependent on other people’s blood, is actually a lot more boring and tedious than it’s made out to be in popular lore.

My curiosity about the drug itself began in two ways. First, all of the literature about the drug says each dose may contain the immune system particles of as many as 10,000 people. It’s made from a whole lot of people’s parts. The infusions take a long time – around six hours – so I have lots of very boring minutes to sit and think about the particles of other humans, thousands of them, entering my veins. I wanted to know, who ARE all these people?

Secondly, I spent more than half my adult life in China, which had a deadly AIDS disaster in the 1990s that was almost entirely sparked through the blood trade. So I knew that China had attempted to build a profit-making system off the blood of poor people, who sold their plasma for cash. I lived under this very shaky, naive belief that the United States would never be so callous as to build an entire economy on people’s blood. You get a little bit over-confident about the morals of your home country when you live overseas, or at least I did. But the truth is, we did it. It’s bigger, more complex and more hidden than what China attempted to do, and undoubtedly safer. But the US actually went ahead and built a sub-economy around the blood of economically disadvantaged people. We created the thing I thought China was crazy and possibly cruel for trying. As more and more people are at the losing end of things with rising economic inequality, the system keeps extracting more of their blood parts.

As you were doing the early reporting for what would become this book, I learned so much from our conversations — and also learned just how much I didn’t know, or rather, how much of the infrastructure industry is RIGHT FUCKING THERE but also very adept at making itself invisible to those who don’t know what to look for.

It strikes me that the blood industry is one of so many (for-profit colleges, payday lending, bail bonds) whose entire profit structure is rooted in exploiting the desperation of those hovering below or just above the poverty line, people without family wealth of any kind, people without a safety net. These industries are so egregiously gross, but there’s no public uproar, in part because poor people problems are not often conceived of as “public” problems, at least not until they’re directly affecting rich people. Do you have a name for this sort of industry?

I tend to think of these kinds of industries as economic vampires. It’s not even a metaphor or subtle in this case. But probably a better way of phrasing it is simply extractive. These kinds of businesses build up in the fissures of society to extract from people in society who have the least in terms of money and power – pawn shops, payday lenders, Dollar Stores that overcharge for simple items. We extract from people who are not wealthy and not powerful. The blood plasma industry does so literally, in a way that’s so obvious it’s kind of ridiculous.

What’s so interesting to me is how hidden the plasma economy is. There are more than 1,000 paid plasma extraction centers across the country, and we’re talking about millions of liters of plasma extracted from potentially millions of people in the United States every year. It doesn’t take much asking around to find a friend or family member who sells plasma or has sold it, but we’ve been so thoroughly conditioned to stigmatize poverty and to believe that only poor people sell their blood. It just isn’t true, but it helps sustain the myth.

When I tell people what this book is about, I generally get two responses. One is “I’ve never heard of that.” The other is “I’ve done that,” or “My brother/daughter/cousin does that.” This all tracks around lines of region, race, income and age. Someone in New York, where this practice does not exist, will think I’m talking about something obscure and rare, someone in Texas will know exactly what it is and maybe have the scar to prove it.

I guess what I’m trying to say is one of our primary obstacles is that our society is so stratified and people from the working class so rarely have a large platform that we don’t “see” these parts of society as anything more than a curiosity. That needs to change. This is who we are.

Giving blood plasma, a part of your body, when you’re broke is the very definition of altruism. You might not have money to give but you’re giving up a piece of yourself. Because of the ways we view wealth and poverty and class, we have chosen instead to see this act as something to be hidden or whispered about. And we uplift as generous so many people with immense wealth who are later revealed to be straight-up frauds or tax dodgers. I can’t make sense of it, but I can help tell the stories of people who might otherwise not be heard.

You are an old school newspaper reporter at heart, someone trained in the fine and essential art of *going to a place* and *talking to people* (for a long time). I know that a lot of your reporting plans were derailed and/or delayed by Covid, but there’s still so much rich reporting in the book. You can “see” it in the various scenes, but you can also feel all the reporting below the surface, the stuff that doesn’t show up, per se, but just undergirds your understanding of the industry itself. Can you share one of your favorite reporting stories — and what made it into the book, and what didn’t? 

Can I just say, it was an incredible gift to finally be able to go out and talk to people in person, even though the reporting was delayed for months because of covid? Most of my reporting took place standing outside plasma centers, in Rexburg (Idaho), Flint (Michigan) and El Paso (Texas), and just being able to use all of my senses in reporting and to look people in the eye when they speak, it was amazing (and allowed thanks to vaccines).

Probably the most eye-opening experience was interviewing for a job I didn’t want at a plasma center in Flint. It was the only way to get an unfettered look at how the operation works and it was very revealing.

The place was clean, organized and well run by people who clearly cared about their work. But they were interviewing me, a random person with no medical experience, as a potential hire who would stick donors with a huge needle. My hands are so unsteady! But what I learned is they want experts in customer service who can keep people coming back in the door. That was the most important thing, and to me, that’s very revealing. Keeping the donors happy was more critical than knowing how to wield a very large needle that gets stuck in someone’s vein.

It was interesting and kind of exciting to play a role to get glimpse of something I wouldn’t have been able to see otherwise. It was also totally bizarre and I understand why plasma donors had told me they sometimes felt like dairy cows. It’s so *mechanized* inside those places. People are being mined for their parts, but in the most orderly, sanitary fashion.

How did you figure out how to balance the personal narrative with the reporting itself? I know in my previous books, my editors have always pushed to really amp up/expand/front load the personal narrative, because it makes it easier for readers to connect or identify with the story. But knowing you like I do, I also know that you probably shared some of my reticence: like, yes, your personal experience is how you got interested in this story, but you are also a character, for lack of a better word, with so much more situational privilege than so many others caught within the larger web of the blood industry.

How did you work through this tension as 1) a reporter but also 2) an author trying to write a book that people will pay attention to? 

You know I hate writing about myself. Call it a Gen-X reticence or whatever, but I do not like it, not one bit. This was the hardest, most personal thing to write about. I hid for years from most people I know that I have a weird illness so revealing that in a book project is terrifying on many levels. But I have a brilliant and extremely patient editor who convinced me, and it did take some convincing, that this story works because it’s my story. I think that’s true. You get to see both sides of the equation - the vampire (me) and the people who give up their blood parts to keep me functioning and to make their own lives possible financially. 

There’s also this connection that I don’t think most people would make. I learned about the plasma industry in China, but later came to realize it was so much bigger and woven into the fabric of society in the United States. As someone who spent a huge part of my life living outside the US, I wanted to be sure to tell this story of discovering that my home country is deeply flawed in ways that are easy for a lot of people to overlook.

Besides that, my own relationship with blood plasma gives me an unusual perspective on the whole thing. I am the direct beneficiary of exploitation. I really believe that and it makes me deeply uncomfortable.

Plasma companies encourage donors by calling on people to “save a life,” which makes it a difficult thing to challenge because you’re challenging the saving of lives. Well, here I am, a beneficiary of the system, and I’m telling you the way things are set up is exploitative, our society is broken, and we are failing people. Not just the poorest of the poor, but so many others as well.

Besides that, in all honesty, I didn’t want to be more of a vampire than necessary and telling the story around myself helped alleviate that. There is something in journalism where you’re always taking from other people and using them to tell the truths of the world that you already know, from your own experience. We are forever extracting things and walking away. I didn’t want to do that. This was a chance for me to tell my own story rather than just pretending to be an observer with no stake in the matter. 

It is scary to write about myself, especially about something I’ve kept deliberately hidden. But if I’m asking people to talk to me about something personal, their economic situation, some of the hardest things they’ve gone through, I owe it to them to do the same. In some ways it allowed me to be less of a vampire. I’m not just sharing their stories, I’m telling you why I give a shit – which journalists aren’t often allowed to reveal. So in that way it’s kind of a gift. At the same time, this is always presented by plasma companies as “save a life!” Well, here I am and I think the system is unfair. I think people deserve better and we need to look at our economic structures and what we expect of people who are not wealthy. I’ve come to believe that I actually owe it to people who sell their plasma to give them my story, too.

I really tried to be deliberate in this writing about not further stigmatizing people or the process, or poverty and economic hardship. We do enough of that. 

The book is about blood and plasma donation but it’s also asking readers to think about the much higher stakes of body extraction — like, deeply dystopian shit. How have other societies understood how this process can and would escalate, and what controls have they put in place to protect against it? Put otherwise, how have other countries worked to protect the body from the forces of extractive, unregulated, high-growth capitalism? 

I was talking to a filmmaker about the book a few months back and they asked me if there was a developing country somewhere in the world that was the largest single source of the blood plasma in the world, a place that wasn't strictly regulated, a place that is kind of a representation of how Dystopian this system is. Well, it's us. It is the United States. We are that country.

I kind of hate to say this, but I think a lot of the rest of the world – Europe at least – is simply content to depend on the United States for its plasma supplies right now. If you examine the numbers it’s hard to draw a different conclusion. I don’t think this is necessarily deliberate, but the system has developed and grown in such a hidden manner that America  became the plasma provider without much notice. More than half of the blood plasma used in the EU comes from the United States. And the “most productive” plasma centers in the United States, according to industry documents, are on the US-Mexico border, where thousands of Mexican citizens cross over to sell plasma in the US.

We are not good at protecting people from economic exploitation and the rest of the world relies upon that fact. Paid plasma donation is banned by most countries and the US fills up the tank.

We are such a massive supplier of blood plasma, the world’s largest extractor and collector, that a lot of other countries with high demand don’t even have to think about it. They just ban paid plasma extraction and buy it from us instead. We have a huge population and a lot of people who need extra cash. Why are we willing to have a system where people sell their plasma twice a week as long as they are physically able, when most countries ban the practice? Why don’t we want to examine this in a serious way?

In 2021, American blood products accounted for more than $24 billion in worldwide sales and were 2.69 percent of the United States’ total exports. That’s a higher percentage than several of our common farm crops that are sold overseas. A substantial portion of the blood plasma used all around the world comes from the veins of people in the United States. Other countries, in large part, are able to ban the practice of paying people for their blood plasma because the US is willing to allow it to exist and grow.

To me, the answer lies in paying people more, giving them more choice, offering better protections and potentially encouraging scientific research in other directions so we are so reliant on people feeling like they have to sell blood. I went into this project thinking I’d come out with ideas about science and health as solutions, but I realized pretty quickly this all about the United States’ failed financial safety net. The world depends on it. Full stop.

Whose work are you reading today — on China, on medicine, on the future of the blood industry, on Montana — that’s pushing you forward and forcing you to ask new, even more complicated questions? 

This book has really launched me even deeper into questions about class and inequality in America and our ongoing, frustratingly stubborn refusal to admit they define everything about our society. After talking with more than 100 people, with so many different reasons for needing to sell their blood plasma, it’s impossible for me to pretend we’re anything but a deeply class-based and flawed society. Ouch. Someone told me recently this is all Dystopian and I’m like, no it’s just us. I’m trying to read some things that are a bit more optimistic and more broad about these big questions.

I’ve been re-reading Barbara Ehrenreich, fellow Gal From Butte and genius on these issues. Her work is so essential and it’s such a loss that she’s gone.  I’ve also been reading a whole lot of labor history, in light of our current moment. Two of the best I’ve read are Fight Like Hell by Kim Kelly (AHP note: read the Culture Study interview with Kim here!) and Midnight in Vehicle City, Edward McLellan’s account of the Flint Sit-Down Strike in 1936. People have been disadvantaged and fought back for the entire history of this country, which is heartening. 

While reporting this book, I read and re-read several books by Yan Lianke, who is absolutely essential if you want to understand China. In the Mountain West, I’m super excited about Betsy Quammen’s new book coming up on Western identity, it’s going to be great. 

You can find Kathleen on Twitter here and pre-order Blood Money here.

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