My experience related to this is that of a health care practitioner, as an anesthesiologist.
One 21-year old male sustained a cardiac tamponade from a stab wound in the chest (ice-pick used). I practice in a 100-bed hospital in central Philippines and we don't have the luxury of sophisticated medical equipment. The patient was the son of a Jehovah's Witness but he himself was not baptized. Postoperative hemoglobin was 4 grams. The surgeon gave me the prerogative to manage the patients anemia. Crystalloids and dextran was given to maintain BP and hemodynamic stability. He was not extubated and since we did not have a ventilator that time (early 1990s) his breathing was assisted with the use of an Ambu bag, with the relatives taking turns squeezing the bag. We call it "relative ventilator." Oxygen was administered through a port at the bottom of the bag. Iron sorbitol was given IM (the only one we had) once a day.On the second hospital day, patient extubated himself and refused re-intubation. He insisted on eating his meal as he claimed he was hungry and not in pain. The surgeon resumed his diet and we placed him on oral iron twice a day. On the 7th day his hemoglobin was 6 gms and he went home. After a month he was alredy working in Manila and he sent word that he was fine.

Second case was a 67 yr old male who underwent excision of multiple gouty tophi but developed GI bleeding due to use of pain relievers (NSAIDS). He was not a Jehovah's Witness but children were. Hb dropped to 6 and he developed chest pain. I gave him nitroglycerine patch and oxygen and he was put on complete bed rest while IM and oral iron were administered. His attending physician scolded him and told him that in a week's time he will die if he doesn't get a transfusion. His chest pain ceased and on the 7th day his Hb increased so he told his MD , " See Doctor? I'm still here!"

These are only 2 among several patients , JW and non- Witnesses, who refused blood and who who have been treated in our hospital without a transfusion. I am one of only 2 Jehovah's Witness doctors practising in our small city and other medical practitioners have already been convinced that a Hb lower than 10 gm is not really scary in some patients, and even more beneficial.

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Angelina A. Gapay, MD