ANCORA IMPARO 

RICK RADER, MD ■  EDITOR-IN-CHIEF

Blood Red

Blood Red Parents of children with special needs have gotten used to red ink. They've gotten used to seeing red ink circling abnormal lab values on reports, seeing the words "denied" or "ineligible" underlined in red from insurance companies, and seeing maps with redlines indicating where group homes could be built and operated.

On most weekends I head for my garage to recharge my batteries, both mine and the vintage cars I collect. It's my outlet and my favorite diversion. So, last Saturday, I worked on an old race car, trying to convince it that after 90 years of slumber it was time to get up, growl, and spit fire. Of course, success in the garage is labor intensive. While I was coaxing life back into the speedster, I committed one of the fundamental rules of mechanics – never push on a wrench. It's okay to pull on a wrench, but not to push on a wrench. This was made very clear to me when I was pushing down on a ¾ inch wrench against a bolt that was last touched when a gallon of gas was ten cents, a loaf of bread was nine cents, and the average price of a new house was $590.

The bolt was frozen with rust and was humored by my efforts. I gave it my all and pushed down hard and the wrench slipped and my knuckles went flying into the engine block. The reluctant bolt now wore a coat of red, courtesy of the fresh cut on my hand, which to no surprise came in second to the engine in the new guessing game, which thing is more fragile than the other. I was bleeding, not gushing, but enough to get my attention. Red blood can certainly get your attention, especially when it's your own. The red color of blood is among one of nature's most outstanding features.

Linda Crampton, writing in Owlcation, provides an explanation, "In humans, oxygenated blood is bright red and deoxygenated blood is dark red or maroon. The color is due to the presence of hemoglobin molecules in the red blood cells. Hemoglobin is a respiratory pigment. It transports oxygen to the tissue cells, which need the chemical to produce energy. Blood that is not red may indicate a health problem. Human blood may become brown or green due to the buildup of an abnormal form of hemoglobin." It was obvious that my blood was well oxygenated, it was as healthy as blood could be, it just was now residing outside my body.

As medical students, my classmates and I were made aware of the importance of recognizing the different colors of different body fluids. There are approximately 26 body fluids and they all (in both health and disease) have distinct variations in color.

RED SCARE: The mark of death was seeing the following words in red ink on the tests, compositions, assignments, and reports that were returned to me by my teachers: "See me after class."

Stool, urine, sweat, mucus, phlegm, menstrual blood, amniotic fluid, semen, nipple discharge, saliva, tears, cerebrospinal fluid, and others can be identified by their colors. Shakespeare referenced black bile, yellow bile, green phlegm and red blood as the "four humours" of the human body. It's noteworthy that during a man's midlife crisis, they typically are found ordering a new sports car and insisting it be "blood red." There are not many orders for a new Ferrari or Corvette in "yellow bile" or "phlegm green."

What is it about red that Mother Nature insisted her blood had to come in that color? Alice Hoffman, the American novelist and children's writer (Practical Magic) provides some provocative insight. "How could I have been so stupid to ignore everything I'd had in my life? The color red alone was worth kingdoms."

Besides the 120 colors in the largest box of Crayola crayons, there are colors that are only known to the most elite Scrabble players. When was the last time you heard someone at the make-up counter at Saks Fifth Avenue or Henri Bendel's asking for cosmetics in the colors of sarcoline, coquelicot, wenge, fulvous or falu?

There are nearly 10 million unique colors, and while not all of them are distinguishable by the human eye, the color red provokes the strongest emotion of any color. Kendra Chery in "The Color Psychology of Red" suggests that "while cool colors like green and blue are generally considered peaceful and calming, red is considered the warmest and most contradictory of the colors. In fact, this fiery hue has more opposing emotional associations than any other color. Red is linked to passion and love as well as power and anger."

It's no wonder that during all the years of my education, the most feared symbol were the comments in red ink on the tests, compositions, assignments, and reports that were returned to me by my teachers. The mark of death was seeing the following words in red, "See me after class."

Sociologists Richard Dukes and Heath Albanesi of the University of Colorado claim in a paper they've published in the Social Science Journal that when teachers use a red pen to add comments to student papers, students perceive them more negatively than if they use another color pen. They found that the red ink did not have any impact on them if they agreed with the teacher's comments. But, if there was a disagreement between the teacher and the student, the red ink was considered to be very harsh and the students directed their dismay to the teacher and not to their comments.

With so many courses being conducted online, what has happened to the red pen remarks? The modern technological equivalent of red ink for grading appears to be the equivalent of using all caps when writing e-mail or text messages; it's like shouting at a person and causing them to feel abused or being excessively critical.

Parents of children with special needs have gotten used to red ink. They've gotten used to seeing red ink circling abnormal lab values on reports, seeing the words "denied" or "ineligible" underlined in red from insurance companies, and seeing maps with redlines indicating where group homes could be built and operated.

The one sign in red they have worked so hard to find and see is the sign that has eluded them for decades; the sign that says "All are welcome." The one in blood red. •

ANCORA IMPARO

In his 87th year, the artist Michelangelo (1475 -1564) is believed to have said "Ancora imparo" (I am still learning). Hence, the name for my monthly observations and comments. – Rick Rader, MD, Editor-in-Chief, EP Magazine Director, Morton J. Kent Habilitation Center Orange Grove Center, Chattanooga, TN