“I needed the money. I’m not ashamed of doing everything legal I can possibly do to avoid homelessness. The safety net is just gone right now, and it’s do or die for me — for millions of us. None of us has any reason to feel ashamed about needing help in this pandemic. But businesses like Octapharma — that exploit those of us with few or no options — rely on shame about our circumstances to keep us silent about injuries. I refuse to stand in that shame.” (The national effort to immediately extend pandemic unemployment assistance)
Donor has two dictionary definitions. The first common definition is “a person who donates something, especially money to a fund or charity.” The second medical definition of donor is “a person who provides blood for transfusion, semen for insemination, or an organ or tissue for transplantation.”
Even though donor is employed consistently in its in-store business practices, Octapharma’s use of donor does not conform to either definition. Payment is given in exchange for plasma and the plasma extracted is used for a variety of profit-making (and life-saving) Octapharma brand medical products, not for a specific medical procedure.
For Octapharma, donor is an invented business term intended to create the feeling of participation in an actual medical environment, while lending to the identity of donor an air of noble philanthropy.
It is also only one of many practices at Octapharma that function to construct artificial medical authority exercised by managers, phlebotimists, and support staff as they relate with the vulnerable humans they call donors. When something goes wrong during a plasma extraction procedure, the faux authority becomes a tool to shift accountability and responsibility from the professionals to the person lying on the table with a needle in her/his/their arm.
Power moves in our practices between one another. …Hoarding power means amassing concentrations of what fuels forward momentum: capital, bandwidth, credit, status, authority, weapons, position, and other resources. 10 Data-Based Relational Principles of Power
Wolfgang Marguerre is a German billionaire who owns, and acts as chairman for, the international Octapharma Group. Octapharma’s global leadership board is all white and all male. Octapharma’s corporate values statement includes zero language about the vulnerable humans they refer to as donors:
Our five values — Ownership, Integrity, Leadership, Sustainability and Entrepreneurship — guide our patient-oriented corporate culture. We aspire to embody these values in everything we do.
The claim that Octapharma, Inc. is a “patient-oriented corporate culture” is not supported by any reference to specific practices in which those values are embodied and actualized in their stores. According to the statement, patients who pay in their hospital bills for Octapharma medical products — made from extracted plasma — are central in Octapharma’s considerations.
Not considered in those corporate values is the user experience for the vulnerable humans in Octapharma stores whose extracted plasma is crucial for the medicines that make all those white men and their families rich.
The Twisted Business of Donating Plasma
Since 2008, plasma pharmaceuticals have leapt from $4 billion to a more than $11 billion annual market. Donors…
No one is donating anything in Octapharma stores. Instead, those who sell their plasma use Octapharma’s marketplace, which is often conveniently located in a shopping center next to check cashing, payday loan businesses, and deep discount stores. Users are thoroughly medically screened before they are allowed to join the Octapharma market to sell plasma, and they are not allowed to sell elsewhere. Before each procedure, users’ vitals are also checked, and a series of questions about sexual activity, tattoos, prison time, and pregnancy (among many others) thoroughly screens out any potential user health issues.
Extracting plasma from healthy humans is important for end-product safety and quality, both very lucrative aspects of the plasma-selling sphere. Equally important is reducing the potential liability risk for a business that employs phlebotomists to perform an invasive medical procedure to extract a product for profit from a living human being.
Pharmaceutical Companies Are Luring Mexicans Across the U.S. Border to Donate Blood Plasma
Leer en español. Every week, thousands of Mexicans cross the border into the U.S. on temporary visas to sell their…
Octapharma’s misleading use of language in its corporate and in-store business practices is another in a long list of examples where capitalist language practices steal power from human beings in order to empower corporate profit-making:
[T]he regime of late-capitalist language [is] a set of ubiquitous modern terms, drawn from the corporate world and the business press, that…promulgate values friendly to corporations (hierarchy, competitiveness, the unquestioning embrace of new technologies) over those friendly to human beings (democracy, solidarity, and scrutiny of new technologies’ impact on people and the planet).
Octapharma’s capitalist language choice to call users of their marketplaces donors who exist in a “patient-oriented corporate culture” functions in the same way that gaslighting propaganda works in an authoritarian culture: the language choice intentionally mixes terms across realms to conflate meaning and confuse fact with fiction.
A current example on the platform LinkedIn is the effort of for-profit concerns like Octapharma to partner with — and borrow the giving halo from — organizations like the American Red Cross. Cross-promotions for collection standard quality — under cover of plasma donations for COVID-19 medications — simply blur the line between the for-profit and the non-profit, lending further credibility to the faux medical authority of employees in Octapharma stores.
FDA, under pressure, authorizes blood plasma as Covid-19 treatment
WASHINGTON - The Food and Drug Administration announced Sunday that it has authorized the use of blood plasma from…
In current COVID-19 pandemic conditions, the most economically vulnerable and exploitable — poor and working class users of plasma-buying marketplaces — are supplying the bulk of the world’s plasma. At the same time, for-profits like Octapharma siphon off supply, stealing and hoarding power in a global plasma marketplace owned mostly by white men and their families:
Currently, 5% of the world’s population provides more than half of the world’s plasma, with just five countries — the U.S. and four European countries that allow plasma donors to receive payment — accounting for 90% of the world’s plasma.
Jaworski and others believe this is not a sustainable model, pointing to COVID-19 as an example of a supply chain disruption that has reduced the amount of plasma available as the need has continued to increase.
Profit-making practices that exploit the most vulnerable are covered over with medical language, which focuses attention on the patients receiving life-saving medicines while those humans whose plasma made the medicines possible are erased from view, dropped from consideration, and exist in an aggressive Octapharma marketplace with little protection.
Indeed, as Dr. Lucy Reynolds, a research fellow at the London School of Hygiene and Tropical Medicine told The Atlantic:
Certain governments are people- and people’s rights-centered. In those places they make the plasma corporations play by the rules; sometimes they just choose to have as little as possible to do with them.
But the United States is a corporate country, and maintains the least restrictive plasma donation regulations in the world.
In “Blood Money” Mark LaRocque reminds us that the professional organization supporting the plasma industry also aspires to protect the health of the plasma, not the health of the user selling plasma:
The Plasma Protein Therapeutics Association, which represents companies like Octapharma Plasma, states that the industry is proud of its leadership in establishing collection standards, ensuring that plasma is only collected from “healthy, committed individuals and is used to manufacture the replacement therapies that enable patients worldwide to lead healthier, productive and fulfilling lives.”
Although challenges to the plasma buying business model are not unusual, what has not been addressed in any comprehensive way is what the experience looks and feels like — how it functions — for the user of Octapharma’s plasma-buying marketplace.
A Narrative User Experience of one Octapharma Marketplace
Power moves in our practices between one another. …Stealing power means engaging in practices that functionally create barriers to slow, stagger, and/or stop others’ forward momentum.” 10 Data-Based Relational Principles of Power
[Based on field notes collected July, October-November 2020. User experience data have also been published on Yelp. Other data have been published on a private blog where individuals have been documenting experiences with plasma extraction processes since 2017. Full case study descriptions and recommended democratic practices will be available at The Relational Democracy Project. This business joins other case studies of democratic and non-democratic U.S. business cultures and practices. All names are pseudonyms.]
July 2020: The circumstances. The first time I visit, I’m nervous, but everyone is so nice and welcoming, I feel at ease. This can’t be that hard, I think. At $50 per visit twice a week, that’ll put $400 toward rent each month until I have an income. I am terrified of running out of money, of being homeless with no one to help. I’ve been working without a paycheck toward a market in the Bay that 4 years of interpersonal churn and COVID have decimated. And teaching isn’t possible until the spring. The gut-stress and full-body anxiety stalk me, and the feeling in my bowels — of falling from a very high ledge — visits often, sometimes for a whole day at a time. I learned lots of processing tricks the past few years to push through, but the feeling of falling makes it really hard sometimes to keep moving forward.
The store. It’s a relatively new store, which is reassuring. As one of the phlebotomists will tell me later, it’s like a spa compared to the other store in the area. Everything is spotlessly clean and organized. Lots of white lab coats and blue nurses’ uniforms make it feel like a mobile mall hospital. The whole medical screening takes a little more than an hour and the process definitely moves this into the serious category, into medical territory. Like I’m under someone’s care. Someone’s authority.
Reclining chairs next to extraction machines fill the center of the room. A man in the back behind glass is working on plasma stuff and it gives the place the feel of a laboratory. Phlebotomists and other techs move between machines, between the humans attached to them, talking, adjusting, extracting. The television sets play together in the background.
The Phlebotomists: Mistakes, and Injuries. Mitchell is my first phlebotomist, and he’s new. He’s very friendly, and I can tell he’s also a little nervous. He makes a mistake as he inserts the needle, and I immediately feel a burning sensation around the site. (Mitchell has since left Octapharma. As one of the phlebotomists tells me later, he’s off making mistakes for someone else.)
I didn’t complain. It was an accident. Everyone makes mistakes, and the last thing any of us needs is someone piling more on top of someone new who probably really needs the job. I’m sure he’ll get better at it. Another phlebotomist takes over, puts lots of pressure on the site, and adds an ice pack, but the bruising is epic: huge, very colorful, and a little painful. I have to wait two weeks before I can use that arm again.
After the first two visits, I stop going to the plasma store because I’m able to manage for a few months on unemployment insurance. I apply for job after job after job, while authoritarians terrorize vulnerable humans and the planet. Dozens of custom cover letters, resumes, and cvs, all sent into a void where no light and no response ever seem to escape. It’s like I don’t exist. Summer moves into fall, and I return to the plasma store in October when the unemployment insurance drops to 167 per week. I have no choice.
The phlebotomists have injured me with needles causing infiltration three times so far. I’ve sold my plasma roughly a dozen times in the Octapharma store, in July, then October-November 2020. This time, the phlebotomist who inserted the needle incorrectly once previously does so again and the machine to which I’m attached appears to malfunction.
The machine gets stuck on “high pressure return,” and the phlebotomist is flicking the machine with his FINGER trying to fix it. My legs are crossed, so he says it’s that. I uncross. It’s 3 minutes or so and the machine is just cycling, not working. It’s stuck.
My arm is beginning to hurt: where the end of the needle is placed my arm is starting to darken and feel stretched. The blood is backing up in my arm. I try to get someone’s attention, and the phlebotomist saunters over. I show him and tell him my arm hurts and the machine seems to still be stuck. He flicks it again, looks at my arm, and I ask what it might be since my legs are uncrossed.
He says it could be anything: “dehydration, a greasy dinner last night, your arm was moving when it shouldn’t have been.” The site is burning and hurting and the machine is still stuck, so I offer: “I’m fully hydrated as you can see from the flow, I don’t eat grease in my diet, and my arm has been still the whole time while I squeezed with my fist. And I’ve uncrossed my legs. Why isn’t the machine working?”
He goes back to the same list of reasons that I AM CAUSING THE MALFUNCTION IN THE MACHINE. (I have noticed that different machines draw differently. This particular machine made more noise than the rest.) I say, “I don’t want to argue, but I know my body and right now my arm is in pain and the blood is infiltrating my tissues because the needle is in the wrong place and the machine is stuck.” I say these words just to him without raising my voice. I am direct, but not angry. I am clearly concerned.
He begins unwrapping things without telling me what he’s doing. I ask, and he says he’s ending the procedure. He goes very quickly, without going through the standard protocol of telling me what he’s doing as he does it: no offer of an ice bag (the bruising was going to be very bad, you could already see). No making sure the pressure was good at the site, and he neglects to tell me the compensation for the procedure. I ask on the way out, as he snidely tells me to “have a nice day.”
The management. After processing the difficult experience, I write a review on Yelp with no names and with recommendations for improving communication between phlebotomists and donors. I return 4 days later to do the second donation of the week. The assistant manager, Earl, calls me into the back office after I check in. I thought he was going to offer an apology. Instead, he insists that if I don’t agree to “listen to the phlebotomist,” I won’t be allowed to donate again. He has not read my review and is advocating for the phlebotomist. I agree to get this second extraction over with — the second is necessary to make medicines, I’m told. A different phlebotomist misplaces the needle this time, without puncturing the vein, but the bruising is very bad again after I leave.
My last visit is an experiment to observe and document the response by management to the two bruised arms caused by Octapharma’s phlebotomists. Esther, the screening tech, notes that the bruising on both arms is bad enough that she is required to deny access to the marketplace. I ask her to confirm for me that it’s because of the injuries caused by the phlebotomists’ needle placement mistakes, and she retrieves the assistant manager.
Earl comes out and I tell him I’m recording to keep everything transparent and accurate. He says “that’s fine.”
I ask him to confirm that the reason they are denying access to their marketplace to sell my plasma is because Octapharma’s phlebotomists have injured both my arms with misplaced needles to such an extent that the infiltration (the internal bleeding causing severe bruising) have made my arms unusable in this context. He would not confirm that.
Then the assistant manager insinuates that the bruising wasn’t caused in this store by saying, “Maybe the bruising is from here, we don’t know that.” He makes the claim in front of staff and “donors” after acknowledging to me just days earlier that the very same injuries were caused by phlebotomist needle misplacement in his store.
When I get home, there are 6 new reviews on Yelp for this store, all 5-star, and all within the week I wrote my 2-star review recommending improvements. Three are from out of town, and one uses my name and calls me mentally ill. [Yelp has since removed the latter review.] All new reviews have been liked in the same way.
Finally, I try the online OctaPass check-in system as an experiment to see if I have access to the marketplace after my questions and concerns, but I have been blocked.
What Is the Blood of a Poor Person Worth? (Published 2019)
Desperate people can make $30 donating plasma, up to 104 times a year, in this $20 billion industry. By Ms. Greenberg…
What it All Means
In a recent global survey, Pew found that, among respondents in 27 countries, 51% are dissatisfied with how democracy is working. Further, Millennials and Gen Zs are increasingly disinterested in capitalism, with only half of them viewing it positively in the United States. — Harvard Business Review, 11 March 2020
U.S. businesses functionally compete with the most vulnerable humans in America. Capitalist interests use democracy’s structures to craft policies that strip millions of protections in the marketplace creating easy human prey for aggressive profit-seeking. In effect, state-level U.S. democracy has become a structural and policy handmaiden for capitalists’ ambitions, while also standing in as the sole safety net when epic capitalist failures occur. It is no wonder that most Americans can’t distinguish the cultural difference between a democratic norm and a capitalist one.
Ironically, predatory capitalist practices are driven by the same imbalanced power relations that constitute authoritarian practices. For instance, the faux medical “authority” created in Octapharma stores is employed by the phlebotomist in relation with a user.
The fake medical frame compels compliance, and staff are empowered in the relation while the user’s power is stolen. As a result, the phlebotomist-user relation is severely imbalanced: it functions, by definition, as authoritarian. More, Earl’s instructions to “listen to the phlebotomist” functionally meant, “Comply with the phlebotomist.” Even when the information being offered is inaccurate and even when it means silently submitting to injury after injury because a user has no other choice.
Employees conducting medical screenings are trained by Octapharma, as are phlebotimists and managers. (They are also often vulnerable professionals who are under pressure to adhere to policies set by corporate to keep their job.) When safely performed by a trustworthy and accountable phlebotomist under the supervision of trustworthy and accountable management, the experience of selling plasma feels safe and comfortable, seems relatively painless, and appears to be a “win-win” for everyone. Power is shared through professional practices that center the user’s experience.
When capitalist power-stealing norms bleed into a democratic (power-sharing) culture, however, they orient humans in adversarial and competitive frames. Gaining the competitive advantage often means stealing and hoarding power from the most vulnerable in the marketplace. The injuries are not just physical: they damage dignity, violate autonomy, and silence the voices of users. Sowing doubt about a user’s credibility and trustworthiness, drowning out a public record of injuries, and silencing a user’s self-advocacy all function to steal the power necessary to generate and maintain forward momentum.
On the other hand, the momentum — of power-stealing and hoarding practices in U.S. businesses — has grown in size and fury during the last four years. That aggressive, predatory power stands on one side of millions of vulnerable humans in the U.S., who are also flanked on the other side by the end of an “administration” that has stolen the power of security from millions trapped in a pandemic economic hell.
Now that more than 80 million Americans have voted to block authoritarian access to our democratic systems and processes, it’s time to focus on repairing and rebuilding our relational democratic practices and norms to strengthen their ability to resist power-stealing and hoarding business practices.
A Final Note
The words quoted in the beginning of this article are mine. I am the user in this story. My unpaid ethnographic research and cultural work in Rural American Cultures since 11.8.2016 inadvertently put me on a socioeconomic level of experience right near the “bottom.” Kind of like Nickle and Dimed, except for real, and solo, for an extended period of time. (Or like Hillbilly Elegy without the self-hatred. Or Deliverance without the “redneck nightmare.") I’ve documented it all, and what I’ve learned about power, culture, and change I’ve found nowhere else. It’s my life’s purpose to share what I learned, and continue to learn.
Cathy B. Glenn, Ph.D. is an independent critical researcher, creative, and cultural worker whose areas of expertise are power, culture, and change. Formerly Private Principal Investigator for The Center for U.S. Rural Cultures Studies, she is now Educational Content Director and Developer for The Relational Democracy Project. She spent 5 years functionally outside capitalist demands, documenting the experience, and it changed her fundamentally as a human being.
Feel free to use this content, with attribution.
Cathy B. Glenn, Ph.D. is an independent critical researcher, creative, and cultural worker whose areas of expertise are power, culture, and change. Formerly Private Principal Investigator for The Center for U.S. Rural Cultures Studies, she is now Educational Content Director and Developer for The Relational Democracy Project. She spent 5 years functionally outside capitalist demands, and it changed her fundamentally as a human being.