Earlier this month I donated blood. Why now? Well, I saw the call for blood in my local library newsletter—this time run by the Connecticut Blood Center. After my last experience donating blood in February of 2023, it took me almost two years to donate again. Not because it was painful, though the memory of exhaustion that swept over me did deter me. But I’m happy to say I did not experience that this time. The main reason I dilly-dallied was because of my continuing ambivalence at the ecological side effects, the economic injustices, and frankly, the consumer nonsense I monitored over the past 22 months.
As I discussed in my 2023 reflection, American Red Cross executives make way too much money helping people, vampirically converting folks’ blood into fat salaries. Hence, this time around I went to its smaller, feistier competitor, the Connecticut Blood Center (CTBC). This organization, as the nurse noted, keeps all blood drawn for use in Connecticut, and is so small that they have to be efficient (for example, going only to locations where they can get more donations, such as schools rather than “Elk’s Clubs.”). On the one hand that suggests they both are valuable, filling two complementary niches. On the other hand, Red Cross with its brand, incessant advertising and perks (more on that later), and its larger budget, may be sucking up all the blood, making it harder for smaller, more just, banks to compete. (Not much different than the local burger joint struggling to compete with a nearby McDonalds….).
But I gleaned some interesting tidbits from this year’s experience to round out my earlier reflection.

On being small
Being the smaller organization seemed beneficial. Walking into the mobile blood van, it felt scrappy, and community-driven—and you had no choice but to be part of that tight-knit community. It was almost like being on a ship, and you could see the four nurses worked well together in those tight spaces.1
The downside was that it was a converted recreational vehicle. I honestly almost left before I even entered because the RV was running as I arrived and never stopped while I was there (my nurse said it’s always running). At first I thought that was to keep the blood cold (which would be excusable), but blood bags, I discovered, are simply packed in iced boxes. Instead, it was just to run the heat and lights—a problem easily solvable by parking near an outlet so the vehicle can be hooked into the grid (something developed years ago for tractor trailer operators).2
I also felt better than helping the multi-billion dollar Red Cross, knowing I was instead helping a community-based organization, whose CEO made just, oops, oh! Digging into the organizations’ 990 forms, it turns out that CTBC is operated by the Rhode Island Blood Center (RIBC), which was absorbed by New York Blood Center Enterprises (NYBCe) in 2019. In 2019, the CEO of RIBC was making $155,000. A good salary, but at least not the $860,000 the Red Cross CEO makes. But peeling the onion back further, it turns out the CEO of NYBCe made $2.7 million in 2023!!!3 That is nauseating, unethical, and even if he is a font of cutting edge research and business savvy, it’s simply too much.
So that was a confusing discovery, making it far less clear which organization I should donate to in the future.

Gamifying and Monetizing Blood Donations
But here’s where it gets more confusing.
Since I gave blood, I’ve continued to receive the emails from Red Cross: the invitations to donate, the warnings of blood shortages, the calls to be a hero. But more often, the emails focused on the consumer goods you get if you give: a new T-shirt, $20 Amazon gift cards, a raffle ticket to go to the Superbowl, or even to win a car (or specifically, a Ram Big Horn that gets 17 MPG in the city and 24 MPG on the high way). Many of the emails combined both messages into one weird hybrid like this one: “Be a Hero, Get Legendary Swag,” which warned of a blood shortage and co-branded with the new Godzilla-Kong movie and promised a T-shirt if one donated.

In some countries, donors are paid for donating. However, this can lead to dangerous results (for example if drug users donate in order to score a new hit). Red Cross’s constant offers of Amazon gift cards isn’t exactly the same, but it does monetize the blood donation process, and might skew one’s reasons to give.
Then again, considering the hour of time needed to donate, maybe it’s ok to give donors $20. It at least offsets the inconvenience of spending an hour to donate (though arguably it undermines the good feeling of doing an altruistic act). I’m sure Red Cross is conducting A/B tests all the time to see what brings folks in. Though for me, a more successful pitch would be offering to donate $20 per donation to the hosting institution. That’d certainly have been additional motivation in both cases—to my local YMCA and to my local library (both of which do lots of good things in my community).4
The point is: it’s not easy to come to any conclusions. Ideally, one can donate blood directly to a hospital (as discussed in the previous essay). That seems like the best way, but searching hospitals in my area and it turns out they all either contract with CTBC or Red Cross. In that case, one option is to simply ignore the BS and donate blood to save lives, to help others, and to share a renewable resource that your body can provide.
A better option is to still give blood, but to also write letters to these organizations questioning the large salaries they pay top executives, and pointing out that they should be greening their operations, and actively devoting some of their resources to traffic safety—from protected bike lanes to red light cameras—even lobbying for taxes on larger cars,5 all of which will lower the demand for blood (leading to less waste produced, less toxic plastic burned, fewer CO2 emissions, and fewer blood shortages).
But as with hospitals profiting from treating diseases rather than reducing ill-health, perhaps groups like NYBCe simply profit too much from serving as bloody middle men. Inevitably, organizations (whether non-profit or for-profit) take on lives of their own—wanting to perpetuate themselves (for those benefiting, like the CEOs). So while American Red Cross should be lobbying on climate action to reduce future disasters they need to provide relief for, instead they’re giving away trucks and normalizing the large-vechicle-centric transportation system in the U.S.
It’s all very confusing, as is the current moment of time more generally. Analysis paralysis shouldn’t be the stopping point though. Instead, one has to muddle through, rolling up their sleeves to do the work of making the least bad decision available, and in this case, to donate their blood.

Endnotes
1) It was also nice to see the team’s diversity—an older woman, a Muslim woman, and a Black man among the group. There might have been diversity at Red Cross too, but this was almost postcard perfect.
2) Here’s an example from 2017!
3) Not a fluke. He made $1.9 million in 2022; $2.0 million in 2021; and $1.7 million in 2020. Wrong, wrong, and wrong.
4) If you want to incentivize in a sustainable consumer way, there might be other ways. I noticed that a local inn in Middletown is going to host a blood drive. This inn has a nice restaurant. Imagine a $20 gift card to the restaurant as the incentive, instead of an Amazon gift card. This would support a local business, provide a meal instead of more stuff, and redirect donors away from eating low-quality snacks and juices that are more plastic than snack (heading to the restaurant instead). This could probably be done at churches too, which could have a good meal waiting for you after you give blood—even host a play area for kids while you donate—making it a community event, rather than a transactional one.
5) A great idea I learned about in this fantastic (but disheartening) article in The Economist.
ken ingham
As a retired scientist who researched blood proteins for 29 years with ARC, I recall many criticisms aimed at the blood program, many of which came from for-profit blood companies frustrated over having to compete with an organization that didn’t have to make a profit. But when I try to imagine myself as the CEO of that colossal organization, I wouldn’t do it for any salary. First of all, I don’t need that big of a salary. I don’t think anybody does. On the other hand, why would anybody take on the headaches of managing such a huge corporation? CEOUPDATE.com lists salaries paid in 2018 to over 400 top executives of other “nonprofit associations”. They range from 2.5 to 6 Million, with Christine Zambricki, CEO of America’s [non Red Cross] Blood Centers at 3.5M. That makes Gail McGovern’s salary of 694K that same year seem like volunteer work, which it should, given the role of volunteers in ARC.
Erik Assadourian
Thanks Ken! Great points.