MARILYN STAKER: IRON LADY, GOLDEN HEART – CBC’S CALM & PERSISTENT VOICE FOR LIFE

ImageMarilyn Staker has been with Community Blood Center from the ground up. She graduated from nursing school in 1966 and went to work at the newly formed CBC, housed in the basement of the Fidelity Building.  In her 38 years at CBC she has seen the organization, grow, change, reinvent and thrive.  Marilyn retires April 26.  Her story is our story.

Born to be a nurse

Why did Marilyn choose to become a nurse?  “My parents decided it for me!” she said. “I had aunts, and eight cousins that were nurses. It kind of ran in the family.”  However, she is the middle child and only nurse of three sisters that grew up in rural Farmersville. (Her siblings are Carolyn and Doris; Carolyn is the CBC Middletown account representative).  She went from Farmersville High School to the Dayton School of Practical Nursing.  In September of 1964 CBC had just established itself with a handful of employees in the Fidelity Building, where many doctors and Medical Society specialists worked.  When she graduated in 1966, she heard “They might be hiring nurses.”

Getting in on the ground floor

“I talked to Mike Barlow, the director at that time,” said Marilyn.  “It was on a Wednesday and he hired me right away.”  She started the next day and worked a 12-hour shift.  “I thought, ‘Oh my goodness, what am I getting myself into?’”

She was helping build the vision of CBC co-founders Dr. Ludolph van der Hoeven and Dr. James Funkhouser.  “The reason they started CBC,” she said, “is they had different hospitals with donors going from hospital to hospital.  They were trying to keep track of them, which hospitals would hoard blood for traumas, and which blood was expiring.  A central blood center could keep track of blood and prevent ‘out dating’ from occurring.  At the time it was 21 days for whole blood.  I’ve seen it go from 21 days to 35, to 47 and down to 42.”

“Back then we were giving a whole unit of blood, that was the standard care,” she recalled. “That’s because we were not separating components.  Mainly because we were using glass bottles and couldn’t separate it.”

The plastic bag for blood drawing was introduced in 1948 and revolutionized blood banking.  But it was a slow transition to all hospitals and centers.  “We drew in glass bottles the first couple of years I was here,” she said.  “They switched over to single unit bags, but still couldn’t separate it.  Many were used for open heart surgery.  We would draw 10 to 16 units of fresh blood for them.  Kettering hospital in 1966 was the first to do open heart surgery.”

CBC began with four employees and was still a tiny organization when Marilyn came on board. “When I started, there were five nurses: the director of nursing and four of us. We would drive in the director’s car to the mobiles up in Darke County.  The first mobile was at St. Denis Catholic Church in Versailles.”

“I remember bringing the blood home in the trunk of the car,” she continued. “Listen, we were busy! We would draw 100 to 200 units.  I can’t remember how we did it, but we’d try to get it all back in the trunk of the car.”

A different time, a different approach to donor screening

“Our biggest mobile was when we went to the Lebanon prison, once a month,” she said. “They would take us through the cells and we would draw in a big room.  Back in the ‘60’s, we didn’t wear pant suits, we wore dresses.  We would cover our legs up.  The security guards would stand there with clubs.  Half of those guys were in there for sex offenses.  They could say ‘Yes ma’am’ or No ma’am’ to us and that was all, and we would draw several units.  The crazy things I remember!”

(Compare that experience to today’s restrictions against anyone who has been an inmate at a correctional institution.  And then there’s the thought of drawing blood from a convicted sex offense).

A different time, a different version of juice and cookies 

Marilyn will never forget one uncommon approach to fluid replacement at those early mobile drives at St. Denis Church in Darke County.  “I had never been around Catholic parishes that much, being from Farmersville,” she said.  “They would finish the blood drive and they would have a keg of beer mounted in the wall, and they’d get a beer and drink it.  In Dayton, the Shriners would have hard liquor at blood drives and they would put it in a punch bowl.”

“The Shriners and Mason were big supporters of the blood center,” said Marilyn, recalling the long history of productive blood drives and giant donor dinner parties.  “I remember going to the Masonic Temple for the dinners,” she said.  “Over the years, they dwindled down.  Once a year I would speak at a big evening event.  We had meals with them for 20 years, all the chair people from the Masonic lodges that sponsored blood drives.”

Changes in training

“We had only nurses for my first 15, 20 years,” Marilyn said. “Then it went to donor room techs. There have been so many changes.  Back then it was so simple to register a donor. They’d say their name and spell it, their birthday – that was it. They didn’t have to show an ID.  We just typed the information on a little card. We asked about 25 questions.  When we were finished, we’d file it in a secretary’s office. We kept attaching cards every time they donated.  We had donor cards everywhere!  When you think back at how simple it was when I first started…”

“I started on a Thursday. I watched nurses screening donors. The next day – Friday – I was screening donors – a day later!  I didn’t have any SOP’s.  It was the same with sticking. I watched for a day and the next day I started sticking.  They’d help me with it – and I needed help! Back then there were no sterile swabs.  They would sterilize cotton balls in a steel bin in an autoclave in the back.”

“We would cut off needle points and put them in a Styrofoam cup.  At the end of the day the needles would go into a coffee can, then the autoclave, and then put out in the trash.”

Different advice for donors

“Back then, we didn’t want them to eat much,” Marilyn said about the common pre-donation advice of the day.  “And we’d have some severe reactions. They wouldn’t have eaten six to eight hours before donating. Some really got sick.”

By today’s standards, some of the old procedures may seem barbaric.  But no one ever died.

“No,” said Marilyn. “We’ve been very blessed here.  All the miles we’ve traveled. I was screening someone once and they said, ‘I’m not feeling very good.’  I called the squad and sent him to the Valley. He was having a heart attack. He survived, and he came back to thank me.”

There have been times when screening brought unexpected news to the donor. “I can remember three or four that were diagnosed with leukemia during platelet donations,” she said.  There also remembers an older woman, attempting to donate for the first time.  She broke down in tears in the screening room and admitted to Marilyn her husband had been diagnosed with AIDS, she was worried about her own health and didn’t know where to turn.  Marilyn explained that she must get testing… but not by trying to donate.

Journey to the desert

Marilyn left CBC when she married Steve, her high school sweetheart, in 1969.  “It’s true that opposites attract,” she said, comparing his quiet, stay-at-home personality with her outgoing, social butterfly nature.  Steve was in the US Air Force and they were soon on their way to Nellis Air Force Base near Las Vegas, which became their home for the next four years.

She got a job at a blood center in Las Vegas, and that’s where she says, “I saw it all.  And that was because we paid them.”

“We paid $5.00 (per donation),” remembers Marilyn. “Most had lost all their money gambling. When they wound up in jail, they sent them to us. They had 24 hours to get across state lines.  We had some really sad situations.”

United Blood Services operated the Las Vegas blood center, and that provided another opportunity for Marilyn to develop her nursing career.  “They sent me to school in Rapid City, ND to start doing apheresis to make Rhogam.  (The drug was being developed to treat Rh incompatibility between mothers and their newborns).  I came back and started that program,” she said.  “I was just starting it when we left.”

Back to Dayton

Steve and Marilyn returned to Dayton in 1973.  She went back to work at CBC, but only for a few months. She gave birth to son Matt in 1975 and was a stay-at-home mom for four years. She came back to CBC in 1979 “and has been here ever since,” even after the birth of her second son Mark in 1980.  She worked part time, and every Saturday, so that she could be home with her young family in the evening.

The advent of apheresis

“Apheresis, from the Latin for ‘a taking away,” Marilyn explained to me once.  You can only wonder how many conversations she has begun that way over the many years of recruiting apheresis donors.

“I went up to apheresis in the late 80’s,” she said. “We were still not drawing many, maybe two to six a day. What was big here in the apheresis department, we went out and worked on patients.  Auto immune deficiencies, leukemia patients, full blow crisis – all blood related diseases.  We would take a machine in and take off their plasma (removing antibodies) and replace it with saline and albumin.  It was basically a blood exchange. It was the two-arm procedure back then and it was that way for years.”

The bone marrow program

In July 1994 Marilyn entered one of the most rewarding periods of her career.  CBC joined the national bone marrow program and Marilyn became coordinator, working with the program for 15 years.

Larry Lapuh was the first bone marrow donor and went on to become one of CBC’s top apheresis donors. “Don’t thank me,” he said, “Thank Marilyn. If it wasn’t for her, I wouldn’t be coming down here.”

“It was unreal,” she recalls. ‘It was hard work.  I got to use my nursing, physicals, working so closely with the Miami Valley Transplant Center.  I learned so much, seeing what transplant patients go through and what their families go through.

She remembered when former Miami Valley Congressman Tony Hall’s son developed leukemia and how the public awareness resulted in 2,000 donors added to the bone marrow registry. “I remember one (bone marrow registration) drive on Far Hills, there were 100 people lined up,” she said. “I called Dr. Woll (former CBC CEO Dr. Judith Woll) and said everybody from the blood center needs to come.”

Marilyn said the program produced perhaps six or seven matches a year.  She said the cases were “quite involved.”   They would begin with an “information session” with the donor. “We would sit down and tell them what lies ahead,” she said. “Only a couple declined. But all had to be handled differently. It was very interesting.”

“Surgery was always in the morning, 5 a.m. We would do the harvest at 7 a.m. and leave by 11 or 12. The flight would be at 3 p.m. to the transplant center.  We traveled many places in the U.S. and internationally.  They would be waiting for you.  Everything was timed.  If I missed the first flight we had a back-up ticket to catch the next one, or bump somebody off it if I had to.”

“The stem cells or bone marrow had to be transferred in 24 hours.  If it was out of the country, it had to be in 48 hours.  We would work all day and travel all night.  We would carry a lunch cooler (containing the transplant) and you would keep it under your seat and take it with you to the rest room.  I can remember a passenger on a plane refusing to sit next to me when he figured out what was in the cooler.”

The travel overseas sometimes felt like a James Bond mission. “We went all over. We flew out of the country to Italy, Australia, Spain to hand deliver bone marrow.” She remembers traveling to Venice with co-worker Carolyn Conner and being mistaken by the hotel workers as “two rich ladies from America.”  They were escorted by gondola to factories and showrooms, presumably to purchase beautiful hand-blown glass.  “We said no, we didn’t want any, that we couldn’t afford any,” she said. “The guy took us back and I thought he was going to throw us out of the boat!”

The program performed 55 bone marrow harvests over 15 years, and 16 stem cell collections. Stem cell donors received injections to stimulate white blood cell production which caused aching as the cells pushed against their large bones.  “I’m very surprised, only a few turned me down,” she said. “I’m amazed really.  You had to build their trust and become very close to them.”

CBC’s was a small bone marrow center and Marilyn could see the end of the program coming as the talk at national training sessions turned toward consolidation.  The program ended in 2009 and all CBC records moved to Cleveland, now home of the only bone marrow center in Ohio.  By that time Marilyn had already begun splitting her time with apheresis recruiting.

Telerecruiting was important for increasing the donor base, but she said at times it also seemed “We kept calling the same donors.” Recent focus has been on recruiting whole blood donors to apheresis and reaching out to potential automated donors with more apheresis opportunities on mobile drives.  She also recruited her most dedicated donors to be part of an “A Team,” committed to responding to immediate blood needs.

“We need someone out at the mobiles,” she said. “Things can fall apart quickly, donors calling in, machines down, re-routing donors.  You have to have someone there to work the crowd and get the donor’s ear. We only have so much time to get donors on the machine and keep on schedule.”

Her last mobile

Marilyn’s final mobile blood drive was April 16 at St. Remy’s Hall in Russia.  “It’s hitting home, my last drive, my last time to see people,” she said.

She said farewell to dairy farmer Patrick Busher, who she got to know when he donated stem cells for his brother Mike when he was battling leukemia. “She’s a neat lady,” said Patrick. “She’s got a great personality.  That’s what makes you want to keep coming back.”

Jo Heitmeyer has been donating platelets for about 15 years. The St. Remy drive was the last chance to have a long chat with Marilyn. “She’s so nice,” said Jo. “She just makes you want to donate.  We like talking about our dogs. Once, my husband was waiting for me with our Golden Doodle ‘Ollie.’ Marilyn went out to the car to say hi to him!”

“Whenever Marilyn calls, I kid her and give her a hard time,” said Henry Barhorst . “She’s a real sweet gal. I’m always glad to have her around and I hate to see her go.”

 

A wonderful career

“It’s been a wonderful career,” she said. “Phenominal.  The people I worked with over the years and became good friends with, still good friends.  We really had to work as a team and we worked very hard to be a team at CBC.

“I’ve been blessed to run the bone marrow program and apheresis.  I met so many people, sat with them and conversed with them and got to know them. It’s been a wonderful career.  I wouldn’t change anything.”

“I’ve seen so many changes.  All the automated, leukopoor, Cryo, Factor VIII.  We didn’t have FDA inspections for years. No SOP’s.  Just show and tell you, and you’re on your own, which you had to learn pretty quick.  If you weren’t busy as a nurse, we had a little call room and you’d go in there and call people.”

“Just so many changes over the years.  In the 70’s when AIDS came out.  That was a challenge to our testing and it had a big impact on blood.  It was a battle for a few years. It was a real fright.  More and more people came in and wanted to donate their own blood, a really big increase in autologous donations and the number of donors dropped down.”

Final thoughts

The bone marrow program will remain Marilyn’s most satisfying achievement.  “I really felt blessed to have that job,” she said. “I was really busy all the time. For me it was the most rewarding.”

“Apheresis recruiting has been wonderful too.  Working with these donors, growing up with a lot of them when I was a nurse in apheresis. We go back 25 years.  I’ve had several donors say, ‘You are some sales person!’”

What was her secret?  “I would tell them how important it is to donate platelets.  How you can help a cancer patient who has received a lot of chemo and their bone marrow has been repressed.  Nine out of 10 will do it.  It has shocked me over the years. It’s that one-to-one approach.  Just handing out the brochure isn’t going to do it.”

“I’ve seen what it means to patients.  I’ve had to be careful. You could get really attached to the bone marrow families.  They believe you’re going to find the match.

She remembers an eight year old boy who kept refusing a transplant.  “The family was from my hometown.  I went out and talked to him at his house and he decided he would do it. He’s still living today.”

 

What will she miss most about CBC?

“The people.  Definitely the people, the donors.  I’m a people person. I will definitely be missing that.”

That’s because each life has been part of this nurse’s journey, her 38-year CBC history, a shared life story.

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