Jimmy Akin

In my life, I think I’ve read three vampire stories: The Vampyre, Interview with the Vampire, and Dracula.

Each is a major landmark in vampire fiction (which is why I read them; the genre doesn’t have a lot of native appeal to me, but I’m not opposed to reading the classics in it). Yesterday I was listening to an audiobook that I made out of Dracula, and it got me to thinking about the medical aspects of vampirism, which led me to do a pair of posts on the subject.

I must say that I’m impressed with the way Bram Stoker wrote Dracula. Though, from what I can tell, Stoker was an Irish Protestant, his novel is remarkably Catholic-friendly and spends a great deal of time discussing spiritual matters.

It’s also quite cosmopolitan culturally. Though the main characters are British, there are not only representatives from different English social classes but also a lot of characters from and portraits of other cultures. As he goes to visit Count Dracula in Transylvania, Jonathan Harker describes various eastern European cultures in significant detail. Dracula himself is Transylvanian. Dracula’s nemesis–Dr. Van Helsing–is Dutch. And there’s even a major character who is a cowboy from Texas.

A special treat for me is the way that different languages and dialects bleed through into the language of the novel–as when Van Helsing speaks of things that in English are neuter using the masculine or feminine genders they would have in Dutch. (E.g., referring to "corn" [i.e., wheat] as "he" instead of "it.")

The novel is told in semi-epistolary form. An epistolary novel (in the strict sense) is one told exclusively through the use of letters written by characters in the novel, though in Dracula not only letters are used but also diary entries, telegrams, and newspaper articles. (I’m sure one day soon someone will write an e-pistolary novel told entirely through e-mails.)

So it’s a cool read.

But there are still flaws.

Some of these occurred to me when Stoker got to a particular point in the plot in which a character named Lucy had become the object of Dracula’s predations and her health was suffering. Dr. Van Helsing determines (I presume correctly) that her blood loss is sufficient that she needed transfusions in order to survive. He then sets about arranging these.

At the time, this would have been REALLY cool. I don’t know of ANY prior vampire story in which they tried to bring (then) modern science to bear on the problem of vampirism by giving blood transfusions. So megakudos to Stoker for that!

But there are some oddities for the modern reader.

One of the first things that struck me about the way the novel treated them was how DRAMATIC the transfusions were held to be. I mean, the characters were making a WAY bigger deal over transfusions than we would today.

Some of that may be natural for the time period, though, since I assume transfusions weren’t done as regularly as they are now.

One of the ways that a bigger deal is made of transfusions is that there is a big hullaballoo over who can be a donor for the procedure. Van Helsing is willing to do it himself, but his student–the English Dr. John Seward–points out that he is younger and ought to do it. Better yet is Lucy’s fiance, an even younger lord who is simple and healthy and uncomplicated–unlike the two doctors who, being engaged in intellectual pursuits by their profession, have higher strung "nerves" and are less suitable donors.

This sounds very suspicious. Old people give blood all the time today. In fact, blood banks rely HEAVILY on the generosity of older people; the young frequently being unable to be bothered with giving blood. And having an intellectual career has NOTHING to do with the ability to give blood.

Still, this may have been the 19th century understanding of things.

Another way a bigger deal is made of the transfusions than we would make of them is that discussion is made of giving the donors an opiate in order to knock them out during the procedure. I guess maybe folks back then were so horrified at the thought of giving blood that they wanted to be knocked out for it, though today people give blood all the time without any sedation at all. (I’d also have a hesitancy of giving the donor a sedative as anything that goes into his bloodstream is, of necessity, going to go into the recipient’s bloodstream in short order as the transfusion progresses–see below.)

After the transfusions are over, Van Helsing orders that the donors "eat and drink much," which is fine by modern medical science. They should do that to help their bodies replenish their blood supply.

I’m less sanguine (pun intended) regarding his advice that one of the donors should be given port wine to drink after a transfusion. I’m not sure about the effects of alcohol on a person who has just given blood (won’t that at least make him EXTRA woozy?), but I can let that pass.

What really set off alarm bells was Van Helsing administering to LUCY (the blood recpient) an opiate BEFORE the transfusion in order to knock her out.

WAIT A MINUTE! Lucy is suffering from acute posthemorrhagic anemia! She’s lost so much blood that she’s going to DIE if you don’t get more blood into her. Her blood pressure is DOWN and her heart is STRUGGLING ot beat fast enough to keep her blood pressure up and her cells oxygenated. Is giving her a sedative that will depress her system REALLY the thing to do at this moment?

"Please, Jim! Don’t leave her in the clutches of 19th-century medicine!"

Where Dracula really loses it, though, is in the fact that Van Helsing administers the blood transfusions with NO ATTEMPT WHATSOEVER to establish whether the donors have blood types that are compatible with Lucy’s blood type or not.

I’m sorry, but Dracula came out in 1897, and blood typing began (in a rudimentary form) almost a hundred years earlier. Doctors had realized that far back that the reason that people often died from blood transfusions was that they had different types of blood than the donors. It was the discovery of blood typing that ALLOWED transfusions to begin to become commonplace. Previously it was too dangerous.

Now, I’m not an expert on the history of medicine, and it could be that a doctor in 1897 would have made no attempt to type the blood of a donor and a recipient, but it seems to me that almost a century after this discovery–when it was this discovery that really allowed blood transfusions to take off–that a supergenius such as Dr. Van Helsing should have been on top of this one.

So, like later authors of vampire stories, I think that Stoker could have done with a little more medical research amidst his admirable cultural and historical researches.

That doesn’t stop the book from being a really cool read, though.

GET THE STORY (FROM PROJECT GUTENBERG).

UPDATE: Further investigation reveals that Van Helsing did just fine by not checking for blood typing. The original criticism was based on a Wikipedia statement that blood typing was discovered in the first decade of the 19th century, but whoever wrote that was wrong. It now appears that blood typing was not described in medical literature until three years after Dracula appeared.

I admit it: I nitpick the science in novels I read.

Take Anne Rice’s Interview With A Vampire–those best-known vampire novel of the last few decades. When I read this novel, I couldn’t help being distracted by the fact that, when the vampires in it are draining blood from someone they can hear the person’s heartbeat (okay, I can buy that part; Rice’s vampires have supersensitive senses, including hearing) and the person’s heartbeat is getting slower and slower until the vampire drains so much blood that the person dies.

"This is not what would happen," I said to myself.

A person about to die from vampire predation would be suffering from acute posthemorrhagic anemia, whose symptoms are known, though in the real world they are more commonly caused by accidents than vampire predation. The symptioms include faintness, dizziness, thirst, and sweating. Gradually slowing heartbeat AIN’T one of them, though.

In fact, you get just the opposite.

If you suddenly lose a whole bunch of blood then there is a mechanical process that takes place which is relatively easy to understand. With the sudden subtraction of a bunch of your blood volume that means you’ve got LESS blood in your circulatory system. That means that your blood pressure goes DOWN. That means that your heart will pump FASTER to try to keep your blood pressure up so that oxygen can keep getting to your cells, and you will go into TACHYCARDIA.

Eventually, the amount of blood loss will overtax the heart’s ability to pump fast so that it can’t push through enough blood because the chambers don’t have the chance to fill completely and the heartbeat will be rapid and weak. The heart itself will also start suffering oxygen deprivation and you’ll have a myocardial infarction or "heart attack." Eventually you get things like uncontrollable falling blood pressure and fatal cardiac arrythmias.

Not quite so romantic–eh?

But in Interview with the Vampire it’s such a seductive experience that the vampires have to STOP themselves from draining a victim so that they don’t get drug down into death with him.

Why that is, I’m not sure. If all you’re doing is moving blood from the victim to yourself then (assuming you can metabolize blood), you’d be STRONGER as the victim gets closer to death.

What’s more, the process of killing a victim by vampirism would be so revolting that it would have built-in factors that would cause you to want to let go at a certain point.

Unless vampires do something that allows them to bypass the normal rules of cardiology, their victims’ hearts won’t just slow gently down as they drop into the sleep of death. It’ll be a much more traumatic thing than that with the victims’ hearts speeding up, getting faster and weaker and more irregular until the victim dies, possibly amid classic heart attack symptoms like chest pain and numbness in the left arm and nausea and vomiting and dizziness and things like that.

ICK!

What vampire wouldn’t want to pull away before THAT happens!

Reading the novel, I also found myself wondering: "Just how long do these vampire predations go on? Wouldn’t it take quite a long time to get enough blood out of a person to kill him?"

It turns out that the amount of blood you can lose without dying depends on how fast you lose it. If you lose it rapidly, you can only stand to lose about 1/3rd of your blood volume (3-4 pints). But if you lose it slowly–say, over a 24 hour period–you can lose up to 2/3rds of your blood volume (6-8 pints). If a vampire sucked you dry slowly, over the course of a day, he could get a lot more out of you before you died, but that isn’t the way vampire predations are typically depicted. They’re much faster things.

So in a classic vampire attack, the vampire would only be able to pull 3-4 pints of blood out of a person before the person died.

That’s still a LOT of blood–especially if it’s being taken from two little holes in the blood vessels of the neck. I mean, I assume from the way that vampire attacks on the neck are classically depicted that they’re either going after the carotid artery or the jugular vein, but even though these are large blood vessels, it seems to me that it would take a significant amount of time to suck 3-4 pints out of one of these, especially (in the case of the carotid artery) without starving the brain of oxygen and causing the victim to go unconscious for that reason (as opposed to hypnotism or something).

Such long predations might be possible in the seclusion of a house, but not in a darkened alley in London with lots of people walking around and stuff.

Now, I know that vampires are supposed to be supernatural beings who may have ways of circumventing what would normally happen in the real world in such situations (like their ability to hypnotize the victim into staying still for all of this), but I still think that the authors of vampire stories could do with some medical research as part of all the other research (e.g., of a historical nature) that they do for their stories.