How to stop the bleeding

The Wall Street Journal published Dr. David Shaywitz’s May 29 review of Charles Barber’s In the Blood: How Two Outsiders Solved a Centuries-Old Medical Mystery and Took On the US Army. Offhand, I can’t imagine a less inviting or more boring headline than the one the Journal slapped on the review: “How to Improve a First-Aid Kit.” It took me a while to get around to it, but I couldn’t stop reading it once I started:

In March 2000, at a Rand Corp. conference session on the medical support of urban military operations, John Holcomb ruefully acknowledged that the tools for controlling bleeding in battle had not advanced much since the Trojan War. Gauze and pressure—that was it. An Army trauma surgeon, Dr. Holcomb had served on the ill-fated mission in Mogadishu in October 1993, when 18 Army Rangers died, many from excessive blood loss.

Yet the most effective product—and the one that is now carried in the first-aid kit by every member of the American military—was discovered and commercialized by two unknown middle-aged men working at a nondescript gas-equipment company in New England. “In the Blood,” by Charles Barber, a writer in residence at Wesleyan University, tells the captivating, often cinematic story of how a medical innovation was improbably developed, fiercely resisted (by Dr. Holcomb, among others) and ultimately adopted.

Enter Frank Hursey:

Mr. Hursey, we learn, had grown up in an impoverished town in South Carolina. When his father died, he moved in with an uncle in Connecticut, finding work as an engineer’s assistant. After several failed attempts to start a business, he achieved a glimmer of success by developing an approach to purifying oxygen from air. A key ingredient in this process was zeolite, an “inexpensive and inert mineral,” Mr. Barber reports, “strip-mined by Union Carbide in the American South.” Mr. Hursey was “fascinated” by zeolite, which is composed of tiny caverns “in a series of endlessly repeating honeycomb patterns” that capture small molecules. Zeolite can help to separate nitrogen from oxygen since oxygen molecules pass through it more easily.

In 1983, as Mr. Hursey was thinking about those caverns, he found himself wondering if ground-up zeolite could treat an open wound by absorbing the liquid component of blood while leaving in place the components for clotting. After an encouraging experiment on a pet-store mouse, he collaborated with a local surgeon to conduct further studies on pigs. “The zeolite stopped the pigs’ bleeding every time, in a matter of seconds,” Mr. Barber writes. “It was miraculous.”

Mr. Hursey filed a patent and reached out to medical-product companies, receiving in response a single “withering sneer of a rejection letter,” in Mr. Barber’s words.

Disappointed but not dejected, Mr. Hursey threw his efforts into his oxygen-generator company, bringing [Bart] Gullong on board. Slowly, business took off; following the events of 9/11 and a surge in military spending, the company won a contract to develop an oxygen machine for battlefield surgical centers. Then, in 2003, Messrs. Hursey and Gullong learned of a competition in which bleeding-control products would be evaluated. They ground up some zeolite, vacuum-sealed it with a food-storage device they picked up at Target, and sent it off to the competition. The product—which they called “QuikClot”—would outperform all comers, including the shrimp-based product that Dr. Holcomb and the Army had been developing.

There is more to the story, of course. I am shortchanging the contribution of Bart Gullong to the venture.

This is how Dr. Shaywitz concludes the review:

The QuikClot story, so compellingly recounted by Mr. Barber, offers critical lessons about medical innovation: the importance of recognizing insights from nontraditional sources; the value of tinkering; the dismaying lengths to which incumbents often go to defend their turf; the fact that certitude, vital in some circumstances, can be detrimental in others. (A similar pattern can be seen in the determination of longitude in the 18th century, when a clockmaker figured it out ahead of resistant professional astronomers.) But the most powerful aspect of “In the Blood” is its deeply empathetic sketches of the key figures, typically men who grew up with limited resources, who endured hard times, and who somehow forged a life for themselves and persisted in the face of adversity.

I can’t remember the last time I heard the concept of “stopping the bleeding” used as anything other than a metaphor. This literal “stopping the bleeding” story presents an inspiring case study in the invaluable merits of persistence, free enterprise, and human creativity.

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