Jacob Copeman's fascinating study, Veins of Devotion: Blood Donation and Religious Experience in North India, begins with a brief introduction to the modern medical process of blood donation, a topic that for many sits at the far edge of daily experience. Throughout the world, the success of modern health care depends on donated blood; yet because shortages are an unfortunate and predominant fact, getting blood into the system represents a central concern. There are three routes that move blood into the health care system: paid donation, replacement donation (whereby the family of the individual who uses the blood replaces it in the system), and voluntary donation. As Copeman reports, in recent years, the World Health Organization has promoted voluntary donation as the safest and most stable route. Paid donors, often from society's lowest socioeconomic rungs, tend to be disproportionately health compromised, while replacement donation lacks surety and tends to be a one-time only affair.

Critical to Copeman's study is the notion that voluntary donation is undergirded by an element of ethicization; that is, through the action of donating blood, individuals come to express a sense of altruism and selfless service to their communities, and these connotations can be used to compel individuals to donate blood. (According to Copeman, the relationship of utility to ethical value is a contentious subject in anthropology [p. 4], a shockingly naive position to those grounded in the study of ethics.) With this basic framework, Copeman finds in India that the culturally attuned factors of service (seva) and gift (dan), intertwined with ideas of “virtue, service, kinship, and the nation” (p. 2), center the discourse of voluntary blood donation. Along the way, Copeman looks to the broader elements of giving and exchange (as expressed in anthropological theory) to fill out the edges of his study.

As Copeman notes, Indians have not unambiguously embraced voluntary blood donation. Blood in India has long been viewed as a source of strength, and, equally, the loss of blood is understood to result in a state of long-lasting (if not permanent) weakness. In an attempt to change this perception, Copeman cites the work of donor recruiters who have reconceptualized blood donation to create a sense that giving blood leads not to blood loss but to blood gain. This has been achieved by representing blood donation as an opportunity to shed older, weaker blood cells, thereby opening the way for the production of fresh, younger blood cells.

In addition to the physical gain here, Copeman looks at how efforts to boost voluntary donation in India have benefited from an imagined spiritual component. This aspect of blood donation can be seen in the idiom developed by a number of guru-based (or satguru) reformist religious groups that have involved themselves in blood collection (Copeman attends in particular to the activities of the Sant Nirankarai Mission and the Dera Sacha Sauda [chapters 4 and 5], based on his field participation in the greater Delhi area). This idiom makes use of such conceptualizations of blood donation as that of the spreading of “spiritualized liquid love” (p. 97), as well as that of god returning what is given as a selfless gift (p. 87). Here, winning the approval of the guru for the selfless service of donation augments the spiritual element of the gift. Of course, this conceptualization is not without problems.

Copeman describes how, in their quest for service, these organizations generate a near-frenetic attitude to the gaining of voluntary blood donors; donor camps (often with more than 10,000 participants) become competitive events in which “world record” blood collections take precedent over safety and quality (pp. 89, 107). Additionally, as Copeman points out, by emphasizing the spiritual aspects of blood donation, potential donors may lose sight of the fact that voluntary blood donation is ultimately controlled by specific physical parameters; accordingly, those who are rejected from donating blood because of compromised health (and these individuals are disproportionately from the lower rungs of society) have effectively had a message of diminished spirituality delivered to them. Hence, rather than building a sense of a common spiritual bond regardless of caste (a key component of the satguru traditions), blood donation may very well reinforce India's traditional social demarcations.

This brief review hardly touches the surface of Copeman's richly conceptualized study, in which he nimbly moves from his underlying frame of the Indian notions of gift and service to touch on a range of related topics, from national integration (“The Nehruvian Gift,” chapter 7) to Indian notions of asceticism, sacrifice, sin, and caste. A few points, however, may be mentioned that detract from the overall high quality of this work: Copeman's discussion of Marriott's substance-code theory (pp. 24–25) is far too cursory given its significance for the topic of blood donation; additionally, Copeman has a tendency to use highfalutin language that in the end obfuscates rather than clarifies (e.g., “efflorescent biospritual medical creativity,” p. 147). However, these are small quibbles, and they should not deter readers from delving into Copeman's study, which lucidly connects a range of Indian spiritual idioms to the seemingly unlikely, mundane context of voluntary blood donation.