David and Goliath: Underdogs, Misfits, and the Art of Battling Giants

by Malcolm Gladwell

Freireich went out and recruited blood donors. The father of one of his patients was a minister, and he brought in twenty members of his congregation. Standard procedure in blood transfusions in the mid-1950s was steel needles, rubber tubes, and glass bottles. But it turned out that platelets stuck to those surfaces. So Freireich had the idea of switching to the brand-new technology of silicon needles and plastic bags. The bags were called sausages. They were enormous. “They were this big,” said Vince DeVita, who was one of Freireich’s medical fellows in those years. He held his hands far apart. “And you have this kid, who is only this big.” He held his hands much closer together. “It was like watering a flowerpot with a fire hose. If you don’t do it right, you put the kids into heart failure. The clinical director of NCI at the time was a guy named Berlin. He saw the [sausage] and said to Jay, ‘You’re insane.’ He told Jay he was going to fire him if he kept doing platelet transfusions.”