#hematology

Okay, alright, so to start with, we have to establish a few things we know about the blood ocean:

The floor of the blood ocean is made of coagulated blood that routinely shifts due to the release of gas bubbles. These clots are large and stable enough that they can form and hold hills at a significant angle as well as forming caves.

The floor of the blood ocean also has massive skeletal remains of creatures we can't identify.

The blood ocean is identifiable as human blood, which means it must also contain plasma.

The red blood cells of the ocean hold and transport oxygen. They are functioning at least somewhat normally.

I operate under the assumption that the blood in the blood ocean comes from the humans taken during the quiet rapture. I don't know how or why, maybe its the universes way of making sense of the quiet gods understanding of the universe when it looked through its pinhole, but that blood is human. So I assume it comes from humans.

BACKGROUND INFORMATION

Because the blood is confirmed to be human there are a few things we can assume about it. The first is that the lifespan of mature red blood cells is approximately 120 days. In the human body, that is how long a red blood cell survives in the peripheral blood before they become senescent (nonfunctional). This is because red blood cells lack mitochondria and exclusively use anaerobic glycolysis to produce ATP. When a red blood cell becomes senescent it is removed from circulation by macrophages via phagocytosis (kupffer cells in the kidneys splenic macrophages in the spleen).

We can ALSO assume that red blood cells follow normal maturation pathways. All blood cells mature from hematopoietic stem cells in red bone marrow (as opposed to yellow bone marrow, which contains adipose cells that function as energy storage) (don't be scared by the big word 'hematopoiesis' it just means production of blood cells).

RED CELL PRODUCTION AND CLOT FORMATION

SO HERES THE DEAL. The quiet rapture happened at least a decade ago, but all these red blood cells are still functioning. If we assume the blood ocean has been here since the quiet rapture first happened, that means that these are NEW, FUNCTIONING red blood cells.

WHERE ARE THEY COMING FROM??

Something has to be synthesizing these red blood cells (unless they're all just immortal for some reason?) and that usually happens in the bone marrow. So heres my theory, I think its possible that the skeletons in the blood ocean aren't made of dead material, I think its possible that they could be PRODUCING those red blood cells.

Furthermore, what happens when those red blood cells become senescent and can no longer function? Well, senescent red blood cells deform from their biconcave shape and actually play a role in coagulation. This process is mediated by thrombocytes (platelets). It's possible that the reason there is so much clotted blood at the bottom of the blood ocean is just because the senescent red blood cells are gathering there. With a seemingly endless supply of blood and no pitting process to remove deformed red cells, the potential for forming a clotted bottom is endless.

And just for reference, this is what all that clotted blood looks like down there. Normal blood clots are about the consistency of jello, but high concentrations of of the clotting factor fibrin, a structural protein, results in more firm formations. High concentrations of fibrin also mean it is more resistant to the process of fibrinolysis (fibrin breakdown). Because there are literal MASSIVE CAVES made of this stuff that the big eel cant just break out of, I assume there are areas that are more and less fibrin dense (ignore the eel please I know she's very pretty but I need you to focus on the hemo-bathymetry happening here)

WHERE IS THE OXYGEN COMING FROM

Okay so. We know the blood is oxygenated. Not only because of the color (bright red) but also because it released oxygen into the Iron Lung. Fun fact! Hemoglobin in red blood cells can become oxidized in a way that requires a special shunt to reverse (methemoglobin reductase pathway)! This process turns the iron stored in hemoglobin from a Fe2+ ion to Fe3+ ion. This oxidized red blood cell is called methemoglobin and has a specific shade that will be immediately recognizable!

That is supposed to be blood. Blood is not supposed to look like that. Thank you for entertaining this sidenote.

So, where is that oxygen coming from? I DON'T KNOW. We DO know that the moon, AT-5, does not seem to have an atmosphere, at least, not a breathable one. I assume that means there isn't a whole lot of oxygen for the blood ocean to absorb.

Wait no okay rant prematurely interrupted, time for another side-quest. If AT-5 has no atmosphere how is the blood ocean not boiling from the lack of air pressure and then freezing from the cold? Maybe there IS some kind of atmosphere but it isn't breathable? Titan, one of Jupiters moons, has a substantial atmosphere made mostly of nitrogen. It has plenty of surface pressure but its still really REALLY cold. Blood functions optimally at human body temperature (97 Fahrenheit 37 Celsius don't get on my ass about using the degree symbol I don't feel like copy pasting it from somewhere) WHERE IS THAT FUCKING HEAT COMING FROM? We can rule out starlight (lol. lmao. fuck.). Ohhh shit I've gone full circle lads I've gone full circle.

It leads back to a few options there could be for oxygen production. Option one that I thought of is that maybe there are just large oxygen deposits below the surface of the moon that the blood ocean is taking advantage of at the moment? The other option that I thought of could be massive sections of something like lung tissue that are somehow adapting whatever the atmosphere of the moon is made out of into oxygen. Body heat is generated by METABOLIC ACTIVITY. All those chemical reactions are EXOTHERMIC, they generate WARMTH, thats why you get hot when you work out it's because of increased chemical reaction activity.

Are there unseen metabolic processes happening on AT-5 that are generating warmth? Maybe something related to harvesting oxygen from the atmosphere or underground stores. Maybe something related to how the FUCK theres any glucose to fuel red blood cell activity. I'm getting in the weeds now man I'm getting in the weeds I need to move on to a different topic before I lose my shit.

BLOOD TYPES AND RED BLOOD CELL ANTIGENS

IF the blood ocean comes from people taken from the quiet rapture that is then continued in production by skeletons spread across the ocean floor... are there still blood types?

The reason we have to do blood typing in transfusion medicine is because of the antibodies contained in blood plasma. Your blood cells are covered in glycoproteins that serve as antigens, some of which are more immunogenic (immune system triggering) than others. For example, people with type A blood have the A antigen on their red cells. This must mean that they have anti-B immunoglobulins (antibodies) in their plasma. You cant give someone with type B blood a transfusion of type A plasma because it will literally KILL them. The anti-B antibodies in plasma will recognize the B antigens on the red blood cells and form an antibody-antigen complex, which causes noticeable agglutination (clots). We mix patient red blood cells with reagents containing these antibodies (forwards typing) and then test patient plasma with commercial red blood cells that we can confirm have a specific antigen (reverse typing). Heres an example of what those agglutination reactions look like.

My point is YOU CANT JUST MIX A BUNCH OF BLOOD TYPES TOGETHER AND EXPECT THINGS TO BE FINE. YOU ARE GIVING THE BLOOD OCEAN AN ACUTE HEMOLYTIC TRANSFUSION REACTION. Surely this will effect the trout population.

ANYWAY.

Maybe there are sections of the blood ocean for each blood type? I said in an earlier post that it would be interesting to see if that created any kind of currents. In the start screen for the game we can see that the blood ocean isn't staying still, it has waves, that implies some kind of current or tide or MOVEMENT happening that probably isn't related to wind? Probably? Fucking hell I can not escape the atmosphere problem in my weird biology post ASTROPHYSICS LEAVE ME ALONE. WRONG SCIENCE. GO BOTHER SOMEONE ELSE.

Either that or maybe the skeletons DON'T produce different blood types. Its all one blood type. Let me type the blood ocean. I just want to run a CBC. Just a little one. Please. Let me see what happens if you attempt a transfusion with the blood ocean. Give me a container with EDTA anticoagulant I can be trusted.