The Gift of Death: Confronting Canada's Tainted Blood Tragedy

Dedication

This book is dedicated to the AIDS care-givers — the parents, children,

spouses, lovers, siblings and nurses — who do not allow a disease

that robs so many of life to steal away their dignity in dying.

Epigraph

. . . and bless’d are those

whose blood and judgment are so well co-mingled

That they are not a pipe for fortune’s finger

To sound what stop she pleases.

Shakespeare

Hamlet, Act III ii 72

Contents

Cover

Title Page

Dedication

Epigraph

Preface

1Gift of Life: Kiss of Death: Mr. L. and Mr. P.

2Blood Ties: Red Cross and Connaught

3Boys Who Bleed: Hemophilia and Transfusion

4Death Touches Down: AIDS in Canada

5Lethal Indifference: How Many Deaths Do We Need?

6Blood Money: The Fractionation Débâcle

7Consensus for Inaction: Heat-Treated Concentrate

8One in a Million: AIDS Testing Begins

9Through the Looking-Glass: Look-Back and Trace-Back

10Money Can’t Buy Me Life: The Fight for Compensation

11Under the Microscope: Inquiries, Lawsuits and Justice

12Global Connections: Tainted Blood Around the World

13Call to Action: Rebuilding the System

Epilogue

Acknowledgments

Appendix

Glossary

Chronology

Endnotes

Sources

Index

About the Author

Copyright

About the Publisher

Preface

IN APRIL 1994 I WAS INVITED to address a conference of the Canadian Association of Journalists on the topic Could the media have done a better job covering the tainted-blood tragedy?

I began my speech with this very harsh assessment: We journalists are guilty of the same ‘crime’ as the main players in the blood system — the Red Cross, Health Canada, the Canadian Blood Committee, the provinces, the politicians, medical officers of health, doctors — a failure to inform the public. Like them, we have excuses . . . but, collectively, our mistakes have cost hundreds of people their lives. There can be no excuse for that. We cannot be forgiven. But we can make amends by learning from our failures, by never again repeating them.

More than 1.5 million Canadians who received blood transfusions between 1980 and 1985 were unwitting participants in a lottery of death, and the odds grew worse with each passing month of inaction. The country’s 2,300 hemophiliacs, whose blood products are manufactured with the plasma of thousands of donors, were even more at risk: 43 per cent of them contracted the AIDS* virus from the products that were supposed to keep them healthy. Even after public health authorities finally reacted to AIDS, another menace, hepatitis C, continued to infect thousands of transfusion patients and hemophiliacs until testing was introduced in 1990.

Despite the enormity of the tragedy, tainted blood did not become front-page news in Canada until late 1992. In an age when the media examine, in minute detail, everything from murder cases to the deliberately vague pronouncements of politicians, it is unbelievable that the infection of more than 1,200 Canadians with a deadly virus went virtually unnoticed for almost a decade after the first victims started dying.

Yet there were real barriers to getting to the bottom of the story, among them lack of accurate information. As journalists and members of the public, we are too trusting of the so-called experts; we all too often accept their views, however speculative or self-interested, as the unvarnished truth. When, at the outset of the AIDS epidemic, Red Cross officials said the risks of contracting AIDS from blood were one in a million — coded language for don’t worry — we took them at their word. The media, in covering health-related issues, remain far too much in awe of institutions and people with fancy titles, and not nearly respectful enough of the needs of patients and their families.

Adding to the problem, perhaps central to it, is the structure of Canada’s blood system. It is daunting and impenetrable in its bureaucracy, administered by a combination of the Red Cross and thirteen federal and provincial governments. This overblown and inefficient administration allowed virtually endless buck-passing while a fatal virus spread unchecked. Though countless people, from hemophiliacs through to epidemiologists, expressed concern about the transmission of AIDS via blood, their worries were summarily dismissed because they were mere individuals. Users of blood products, when they raised red flags, were considered hysterical. Transfusion recipients and hemophiliacs were lied to repeatedly by experts, and the checks and balances that should have been there to protect them failed.

Above all, the full extent of the disaster went unexplored for a decade because of the stigma of AIDS. Ignored as a disease of minorities on the margins of society — homosexuals, drug addicts, prostitutes, Haitians, hemophiliacs — the epidemic wasn’t taken seriously by the mainstream media. Many journalists, like the public health officials and politicians, didn’t allow themselves to see beyond their prejudices, notably homophobia. In turn, many of the victims were ashamed to speak out, because we treated their disease as shameful.

With scorn as a backdrop, it has not been easy for people with AIDS to step forward. The gay community, where the disease hit first and hardest, responded to the epidemic by building support networks. Their activism changed the health system for the better, though not nearly enough. But the victims of tainted blood didn’t have self-help groups, and they were further isolated by the lack of information in the media. Those who did come forward to explain the ravages of blood-borne AIDS were particularly brave.

* * *

It’s a very special person who, in the midst of his or her own suffering, can reach out to help others. Yet during the four years I’ve been working on the tainted-blood story, I have met many, many such generous souls. For most of them it was too late but, rather than die silently, they spoke out in the hope that they would help others. Marc Dagenais was typical of these altruists. In March 1993, just days before the federal compensation plan for victims of tainted blood expired, he welcomed me into his Montreal home to make a case for an extension of government assistance. He was suffering from a case of oral thrush so severe that he could barely speak; I could tell that each word cut his throat like a razor blade. But the pain didn’t matter to him. Right now, I’m living on borrowed time, Marc said, as he showed off pictures of his daughters, Carolyne, ten, Tammy, eleven, and Tina, twelve. The girls probably won’t have a dad in a year. All they’ll have left is a wonderful mom and the money the province gives them. Right now, that looks like nothing. And it doesn’t seem fair. Marc Dagenais died a couple of months later, at age thirty-six. His girls won’t benefit from the provincial compensation plan, but hundreds of others will, in part because of his refusal to be silenced.

In recent years, the news stories about the tainted-blood tragedy have had a tremendous impact. The steady stream of revelations about the failings of healthcare officials, and their utter contempt for hundreds of people infected with AIDS, forced the provincial ministers of health to cobble together a $151-million assistance package, and the lingering questions about misdeeds prompted the federal government to order a judicial inquiry into the decisions, and non-decisions, of the administrators of the blood system. The Commission of Inquiry on the Blood System in Canada, headed by Mr. Justice Horace Krever, has provided an important forum for the victims of tainted blood to air their grievances, and an unprecedented opportunity to get to the bottom of this complex story. The commission will also make recommendations on the changes required to ensure that a similar tragedy never happens.

* * *

I wish I could have told the story of each of the 1,200-plus victims individually. The hardest part of the editing process has been choosing whose horror story to leave untold. I have tried to present a cross-section: children, women and men from every region of Canada and every walk of life. No community from Newfoundland to British Columbia, and no age group from newborn to senior citizen, has been untouched by the epidemic. Yet too many of us remain smug, convinced that the disease only affects others.

Many victims have asked for anonymity because the stigma of AIDS is still so pervasive. They fear being pointed out in the supermarket, seated apart in restaurants, patronized by physicians and pitied by journalists. In all my professional dealings with people with AIDS, I have attempted to treat them not as lepers, but as people with a story to tell, and I have been rewarded with candour and intimacy. I am convinced that we must make a greater effort to ensure that people with HIV-AIDS be permitted to be full members of society. There can’t be diseases of good people, like cancer, and diseases of bad people, like AIDS. It is abhorrent, for example, that provincial healthcare plans provide free drug therapy to people with cancer but not to those with AIDS. Regardless of the origin of their illness, all Canadians afflicted by fatal disease should be treated with the utmost care and compassion.

It has been difficult to see these new friends die, knowing that many more will die in the months and years to come. But many have said they have two wishes before death: to know why this tragedy really happened, and to have someone apologize for the wrongdoing.

Writing is an often solitary pursuit, and the complexity of the tainted-blood story made my task all the more difficult. When I was struggling, I always tried to remind myself that behind the statistics, the science and the institutions, there were people like Billie Jo Decarie, a little girl who turned six in June — Canada’s youngest victim of tainted blood.

For inspiration I turned not only to my memories of Billie Jo swallowing her AZT pills as she coloured, but to a binder I labelled Krever’s List, in which I kept a summary of the testimony of every witness who appeared at the commission of inquiry. (Excerpts from the testimony at the Krever Commission can be found, in italics, at the beginning of each chapter.) The words of Ronald Mitchell, a plain-talking man of few words from Hagersville, Ontario, often popped out at me, because I had heard the feelings expressed so many times, though rarely so poignantly: I feared death at one time, but I don’t fear that no more. But I would really like to see a few answers before I do pass away.

I hope this book helps answer the why? for Ronald Mitchell and for thousands of Canadians who have been touched, directly or indirectly, by the tainted-blood tragedy. If my work can bring even a modicum of dignity to those who are dying of AIDS, then it will have been worth the effort.

Yet, as I said in concluding my speech to the Canadian Association of Journalists, we cannot content ourselves with burying the dead. What the media are doing today, rehashing the past failings of the blood system and reporting bland assurances that things are different now, is no better than the days when, blind to crisis, we routinely reported the blood shortages at the Red Cross every Christmas and summer. Nor can we continue to give fawning coverage to every small breakthrough in the molecular biology of AIDS while giving short shrift to the broader legal, ethical, political and social issues at the heart of the epidemic. With the next blood-borne catastrophe possibly just around the corner, we need to add foresight and leadership to our public health arsenal. We cannot content ourselves with writing the obituary for Canada’s failed blood system; we must help draft the blueprints for a new, more responsive, more democratic system.

* * *

In the final chapter, I make a series of recommendations for change — proposals that are radical and hard-hitting, designed not only to be thought-provoking but to reflect the fact that the response to an unparalleled tragedy cannot be half-hearted.

In offering these conclusions, I don’t mean to compete with the findings of the Krever Commission. On the contrary, I hope that my account of the enormity of the tragedy will help convince Canada’s health ministers that change can no longer wait, and inspire them to act swiftly and decisively on Judge Krever’s recommendations. Letting his report gather dust on a shelf would be the ultimate insult to the victims of tainted blood.

At the same time, we must not allow ourselves to be so disillusioned by the tragedy that we forget all the benefits of blood and blood products, life-savers for more than 300,000 Canadians each year. Nor should we ignore the more than 1.1 million Canadians who give blood each year. Giving a pint is one of the purest acts of charity; it is truly giving of oneself to a stranger. Donors like Jean-Guy Duclos, a retired firefighter from L’Assomption, Quebec, who has donated blood and plasma almost five hundred times since he started in 1961, are truly heroes.

I have learned from people like Jean-Guy Duclos that giving blood may hurt a little, but it helps a lot; and I have learned from tainted-blood victims like Marc Dagenais that speaking up for change may hurt a lot, but it too is necessary. More than anything else, it is the undying spirit of caring, the unselfish desire to help fellow citizens in need, exhibited by people like Marc and Jean-Guy, that has inspired me to write this book.

I hope no matter how the blood system changes, how ugly the turf battles get, and how outraged Canadians may be by the news out of the inquiry, that no one will stop giving blood. The soundest part of the structure of our muddled, bureaucratic blood system, the one element that must be retained, is its foundation, the selfless generosity of those who give the Gift of Life.

1

Gift of Life: Kiss of Death

Mr. L. and Mr. P.

When desperate ills demand a speedy cure, Distrust is cowardice, and prudence folly.

Samuel Johnson

Irene

Rose Marie Gillis, New Waterford, Nova Scotia

A coal miner’s wife with three young boys, Rose Marie was devastated when her eldest, Everett, was diagnosed with leukemia in 1982, at age five. On Christmas Eve 1985, the family doctor phoned to say Everett was in remission, but a week later called back to say the boy had likely contracted AIDS from tainted blood. As part of his leukemia treatment, Everett had been injected with about two tablespoons of platelets. The boy died in 1988, just days after his eleventh birthday. Before going to the hospital for the last time, Everett insisted on a party and invited singing star Rita MacNeil, whom he had befriended when he was a cancer patient.

"Everett was very, very sick. He was sicker with AIDS than he was when he had cancer. . . . He wanted a birthday party, but I was kind of hesitant. I was saying, I should wait until he comes home again. It’s a good job I didn’t because he didn’t come home.

I had a party for him, and [MacNeil] came. She bought him a stereo, and she just made his day. She was fantastic to Everett, and I often thanked her for that because she’s a busy lady and she took the time out of her busy schedule to spend a little time with Everett, and that made him very happy. . . .

Her Christmas album says: ‘This album is dedicated to the memory of Everett Gillis who at the young age of 11 taught me the meaning of the words strength and courage.’"

(August 2, 1994)

THE BOYS ON THE CHRYSLER ASSEMBLY LINE were in a good mood; not only were they cutting out of work early, with the boss’s permission, but they were off to do a good deed. As the thirteen of them scrambled aboard the minibus, they joked that the blood would flow not only that afternoon at the clinic in Ajax but at the hockey game in Oshawa later in the evening. When they bounded up the steps to the second floor of the Royal Canadian Legion Hall on November 13, 1984, Mr. L.* and his co-workers were welcomed by a smiling Red Cross volunteer still sporting a Remembrance Day poppy. With the greeting came an offer of juice and a pamphlet entitled An Important Message to Blood Donors, the first step of the bureaucratic shuffle that is blood donation. First-time donors were shown to the registration table, asked a few stock questions and given donor cards. At the next table, technician Dolores Beaven pricked Mr. L.’s finger to type his blood and test his hemoglobin level. She also handed him a questionnaire and asked some follow-up medical questions, including whether he had read the pamphlet. Mr. L. nodded, even though he could barely read. The veterans, those who had already earned their stripes as donors, were by now lying back on the bleeding beds with needles in their arms, flirting with the nurses. Mr. L., a strapping 32-year-old who had recently emigrated from Montreal, joined them. After giving 450 millilitres of blood, he moved to a recovery bed and, after a few minutes, into the refreshment area for Peek Freans and orange juice. The blood donor clinic operated according to a finely honed system: the donors moved in clockwise fashion, with military precision.

By evening, when Mr. L. and his buddies had knocked back a few beers — one of the unspoken benefits of giving blood, the assembly-line workers knew, was that it was a lot easier to get drunk after giving a pint — and laced up their skates for the weekly hockey game, their blood was safely on ice in the freezer at the Toronto headquarters of the Canadian Red Cross Society, ready to save lives during the busy holiday season.

Voluntary blood donation is as archetypically Canadian as the pick-up hockey game, and the red cross has been as enduring a symbol as the maple leaf since Canadians were first asked to make a date with a wounded soldier during the Second World War. The annual drive by Chrysler workers was just one of hundreds of corporate blood challenges held every month across Canada — feel-good competitions in which everyone from students to factory workers to company presidents willingly rolled up their sleeves and gave a pint to save a stranger.

Kenneth Pittman, a 53-year-old manager at The Bay and self-described best hardware man in Canada, would have loved to share a few beers with the Chrysler workers that cold November day, but his health didn’t allow it. Since his triple bypass in October 1982 he had curtailed his smoking and drinking, but his heart problems had persisted. In September of 1984 he had gone under the knife for another bypass, but months of illness had followed, so the doctors decided to open him up again in December 1984. The surgery was a disaster; Mr. Pittman suffered a heart attack on the operating table, and bleeding that threatened his life. The next morning he was infused with cryoprecipitate,* a fluffy white protein mass that is extracted from blood and helps clotting.

One week after the cryo injection, Kenneth Pittman sat up in his hospital bed and looked at the clock grumpily. Rochelle, his wife, couldn’t help but laugh. After all he had been through, Ken was scolding her and the children for being a few minutes late for Christmas dinner. It was strange to be having dinner in the intensive care unit of the Toronto General Hospital instead of at home, but the family was ecstatic to see Ken Pittman looking and sounding so good. They knew he was feeling better because he had mentioned, more than once, how a stiff drink and a smoke would round off the meal nicely. But he would have to settle for singing Christmas carols and telling stories about the holiday fun he had had as a boy in Nova Scotia.

For decades, blood transfusions have been instrumental in bringing people back from the edge of death. That’s why they’re called the Gift of Life. That Ken Pittman’s life-saving operation took place just days before Christmas made it all the more special.

Unfortunately for Mr. Pittman, Mr. L.’s blood was infected with the AIDS virus. This gift of life was a kiss of death.

* * *

The single unit of blood Mr. L. donated at the Legion Hall was broken down into three parts. Mr. Pittman received component number A96490, the cryoprecipitate. Two other surgery patients also received parts of Mr. L.’s blood during the busy holiday season, the red cells and the platelets. By the time the Chrysler crew boarded the minibus to attend the same Ajax blood clinic in November 1985, two recipients of Mr. L.’s first donation had already died. Mr. Pittman’s fate was to suffer a slower death.

Once again the illiterate auto worker breezed through the screening procedure, despite a new pamphlet and questioning about specific symptoms. Luckily for others awaiting surgery, universal testing of blood for the AIDS virus had finally begun two weeks earlier — after lengthy delays — on November 1, 1985. Mr. L. would be one of the first blood donors who tested positive for HIV.

Mr. L. seemed physically quite healthy, just as he had a year earlier. Right before his first donation, in November 1984, he had been discharged from hospital after a hernia operation with a clean bill of health. He had also received high marks on the company physical. His emotional health, however, was wanting. Far away from his hometown of Montreal and his girlfriend, he was lonely and often drowned his sorrows in alcohol and anonymous sex, with prostitutes or women — and men — he met in local strip clubs. Like most Canadians, Mr. L. was unaware that the AIDS era had begun. The Red Cross had done little to warn him; its medical experts insisted that the odds of blood being infected with the AIDS virus were about one in a million, about the same as getting cancer after smoking a single cigarette.

Kenneth Pittman wasn’t a gambling man, but his odds were nowhere near as good as the Red Cross scientists predicted. Of the one million blood donations the Red Cross had in 1984, Mr. L.’s was far from the only one infected with the AIDS virus. During a lawsuit many years later, it would be advanced by one of the world’s foremost experts on infectious disease that Mr. Pittman’s odds of being transfused with AIDS-tainted blood when he lay down on the operating table that day might have been as high as one in four¹ — worse than a game of Russian roulette.

Ironically, on the first roll of the dice during surgery, Kenneth Pittman beat the odds. But the next day, when an intern prescribed the cryoprecipitate to help stem the bleeding in his battered heart, a nurse injected unit A96490.

About two months after Mr. L.’s second blood donation, he received a letter from the Red Cross urging him to see his doctor. He and his common-law wife were tested for the human immunodeficiency virus on January 12, 1986. Mr. L. tested positive; his partner was negative.

Mr. and Mrs. Pittman were not so lucky. It took the Red Cross another eighteen months to contact Toronto General Hospital — now called the Toronto Hospital — to tell them that Mr. L.’s blood had been infected. The hospital, in turn, took from June 12, 1987, until February 24, 1989, to link Mr. Pittman’s name to the cryoprecipitate unit number A96490. Mr. L. had actually made the donation forty months earlier.

Sometime in April 1989, Dr. William Francombe, the hematologist in charge of the blood transfusion laboratory at Toronto General, phoned Dr. Stanley Bain to inform him that his patient Kenneth Pittman had received a transfusion that was likely contaminated with AIDS. The North York family physician took note of the information on a Post-it note that he placed on the inside cover of Mr. Pittman’s voluminous medical file, and awaited a letter of confirmation. None ever came, nor did he receive any information on how important it was to have his patient tested. Meanwhile, Dr. Francombe wrote to the Red Cross, telling them that the recipient’s physician had been contacted. The agency that had collected the tainted blood took no more follow-up action than the hospital that had transfused it.

Dr. Bain had been treating Kenneth Pittman for more than twenty-five years. He had seen him transformed from a healthy bon vivant to someone incapacitated by chronic heart disease and depressed about his fate. The doctor decided his patient was too emotionally fragile to be told of his transfusion of bad blood, so he simply kept him in the dark. Dr. Bain says he examined Mr. Pittman during a routine physical and saw no obvious signs of infection — just as Mr. L. had had no signs of infection when he had donated the poisoned blood. Given that the incubation period of the AIDS virus was known at the time to be as long as a decade, dismissing the possibility because of a lack of symptoms was a dangerously erroneous assumption for a physician to make. General practitioners can’t be expected to be up to date on every disease — even one of epidemic proportions — but failure to consult specialists is, at best, sheer arrogance. Dr. Bain not only violated basic ethics by withholding the news from Mr. Pittman, he was also in clear violation of his professional code of conduct. A second violation was failing to report the patient’s possible infection to the Medical Officer of Health.

There is no doubt that Mr. Pittman’s quality of life would have been improved by a swift diagnosis of AIDS, even though many treatments were still in the experimental stage: he never had the benefit of drugs like zidovudine (AZT); he wasn’t given the opportunity to make lifestyle changes that would reduce the chance of contracting an infection; and when he contracted Pneumocystis carinii pneumonia (PCP), often a sign that a person with AIDS is on his last legs, he didn’t get the chance to say his final goodbyes.

His three weeks in North York Hospital in March 1990 were excruciating. His body, deprived of all immune responses, was racked by infections, including the pneumonia that was ultimately listed as his cause of death. As inexplicable as his own doctor’s paternalism was the ignorance of the hospital staff. By then more than four hundred Canadians had contracted AIDS and half of them had died. The symptoms were widely known even to casual readers of newspapers. Months earlier, the federal government had announced a humanitarian assistance package for transfusion patients infected with HIV — hundreds of whom had already been identified and twenty of whom were already known to have died of AIDS. Yet a man with an obvious history of multiple transfusions, who was suffering total collapse of his immune system in a major metropolitan hospital, wasn’t diagnosed until his daughter, a nurse, insisted that he be tested for HIV.

Kenneth Pittman was tested for AIDS just days before he died of the disease, although it had taken more than five years to kill him. Rochelle Pittman, his wife and sexual partner of thirty-two years, didn’t learn of the diagnosis until three weeks after the funeral.

Her immediate reaction was, How long do I have to live?

Dr. Bain responded, You weren’t having sexual relations with him, were you?

The question, like so many in the tainted-blood saga, came years too late. Dr. Bain had assumed that Mr. Pittman wasn’t having sex because he was a cardiac patient (some heart medications dampen sexual drive, but the drug he was taking didn’t interfere with erection) married for more than three decades, and depressed. Governments were asking doctors to promote safe sex, but Dr. Bain was too embarrassed even to ask his long-time patient if he was having sex. He just assumed he wasn’t.

In fact, the Pittmans had made love just two weeks before Kenneth entered hospital for the last time, in March 1990, by which time he had full-blown AIDS. There is no way of knowing exactly when Mrs. Pittman was infected, but it was almost certainly during this period. Research has shown that HIV carriers are most likely to transmit the disease to their sexual partners when their CD4² count is low (an indication of high immunodeficiency); this indicator reaches its lowest levels in the first six weeks after infection, and again just before opportunistic infections develop. It was well known at the time that using a condom would dramatically reduce the risk of transmission of the virus, but the family doctor never broached the topic. As a result, Rochelle Pittman, mother of four and grandmother of six, died of AIDS.

For failing to tell Mr. Pittman that he was infected with a deadly disease, and for failing to refer him to a specialist who could have treated and counselled him, conduct judged by the Ontario College of Physicians and Surgeons to be disgraceful, dishonourable and unprofessional, on March 11, 1993, Dr. Stanley Bain was handed down a two-month suspension — a meaningless penalty to a man who had already retired — and ordered to complete a course in bioethics. This slap on the wrist is typical of the medical profession’s lack of self-criticism concerning tainted blood and AIDS. At the very time he committed the offences against his patient and his profession, Dr. Bain was president of the Ontario College of Physicians and Surgeons. At the height of his profession he was, sadly, leading by example.

Later, in a lawsuit, Dr. Bain would be found negligent for failing to tell Mr. Pittman that he was likely HIV-positive, and assessed 40 per cent liability, while the Toronto Hospital and the Red Cross would share a 60 per cent liability for failing to notify him promptly of the infection. (But the judge found the Red Cross not negligent in its efforts to screen blood and the hospital not negligent in administering it to a patient in need.) The court judged that the lack of diagnosis had cost Mr. Pittman two years of his life.

No amount of money can ever compensate me and my family for the loss of a husband and father, Rochelle Pittman said the day the landmark judgment was handed down. Nor will it change the fact that I will likely experience a similar fate.

Mrs. Pittman had sued for $2.085 million — less than the average award in U.S. cases. She was awarded $469,317, while the couple’s four adult children shared $45,758. With interest, the total award rose to almost $630,000. The court also ruled that the defendants should pay 60 per cent of Mrs. Pittman’s legal costs, about $370,000. Dr. Bain, who was deemed to have been most at fault, didn’t have to pay a penny out of his own pocket. His legal costs and the settlement were paid by the Canadian Medical Protective Association, which provides liability insurance to 90 per cent of Canadian physicians.

Madam Justice Susan Lang, of the Ontario Court of Justice General Division, was conscious that, as the first-ever Canadian ruling on a civil suit involving tainted blood, Mrs. Pittman’s case was a cause célèbre. For that reason, she stressed that the courts were not the appropriate venue for such cases. It will compound the tragedy of transfusion-associated AIDS if more cases must be decided by the litigation process, Judge Lang wrote in her 312-page judgment. Litigation is a fault-driven process where each case must be decided on its own merits. It is ill-suited to an expeditious resolution of such tragic situations.

Judge Lang had been under tremendous pressure to write a definitive judgment within a strict deadline, and it was a burden she resented. Guided as much by her social conscience as by legal responsibility — in stark contrast to many of those who dealt with Mr. Pittman’s case over the years — she worked day and night to be able to release her ruling on March 14, 1994.

The reason for the haste was that provincial and territorial ministers of health, after years of stonewalling, had offered a compensation package to the victims of tainted blood, but it came with a March 15 deadline. The hundreds of other victims had less than twenty-four hours to digest the Pittman judgment and decide if they would continue fighting or take the settlement.

Throughout the civil suit launched by the Pittman family, Red Cross lawyers repeatedly referred to Mr. L. as an irresponsible donor and argued that the organization’s efforts to ensure the safety of the blood supply had to be balanced against its duty to ensure an adequate supply, which included not alienating responsible donors. Mr. L. was precisely the kind of donor they targeted: young, healthy and pushed by workplace peer pressure to give again and again. The agency assumed such people would not carry AIDS. Yet Mr. L. had had sex with at least fifteen different men, and many more prostitutes, making him a high-risk donor. The approach required those at risk not to give blood, but Mr. L., for one, bristled at the thought that someone might consider him homosexual; the failure was that the Red Cross eschewed members of high-risk groups, rather than individuals who practised high-risk activities.

Mr. L.’s Gift of Life was no less charitable than that of the other guys on the assembly line, yet he was being vilified, even after his death.³ The real culprit was a charitable agency that had a virtual monopoly on information about blood-borne infection, but didn’t propagate it so that individuals could make informed decisions.

We have to ensure that something of this magnitude never happens again, Mrs. Pittman told the public hearings of the Commission of Inquiry on the Blood System in Canada. She spoke of the devastation not only of losing a life-long companion, but of living the horror of a disease that would soon claim her own life. The former People’s Jewellers clerk, dressed in a smart suit, stood stoically and told a rapt audience that her husband’s death-bed agony was so imprinted in her mind that she couldn’t bear to suffer in the same way. She pleaded that the law be changed so people in the advanced stages of AIDS could opt for assisted suicide.

I’ll never forget what his dying was like, the horror of it is etched in my mind . . . When my time comes, when my major organs shut down, I hope someone will help me die with dignity, she said on March 11, 1994. It was four years earlier, almost to the day, that her husband had died — without dignity, and without answers.

Just weeks before her appearance at the public inquiry, Rochelle Pittman had travelled to her hometown, Lunenberg, Nova Scotia, where, thirty-five years earlier, she and her husband had spent their honeymoon. Along the wintry ocean shore, she caught a chill, and developed flu — something HIV sufferers dread. Before long she developed PCP. Unlike her husband, Rochelle was aware of her underlying condition and was treated. Still, the chills that summer reminded her of the way Kenneth shivered during the last year of his life — always cold, always tired, always taking refuge in his blue flannel pyjamas. He had been wearing them at Christmas dinner at the Toronto General, and he was wearing them on that cold March day in 1990 when the family bid him a final farewell. When the doctor disconnected the life support system, a shiver shot up Rochelle’s spine. It remained there through her years as an activist, as the public face and voice of HIV-positive women. Rochelle’s shivers only dissipated on that warm day in June 1995, when the children gathered around her bed to kiss her goodbye.

2

Blood Ties

Red Cross and Connaught

You must begin with an