Illustration by Angelica Alzona/GMG

A flustered, stuttering phlebotomist once pointed out to me that men, left to nature, would never get a glimpse of their own blood except for in instances of trauma, and that this probably explains why men are notoriously squeamish about having their blood drawn. He told me this while I was leaning over and grabbing my knees and taking deep recovery breaths, before he even drew any blood.

That was years ago. I’m happy to report I survived the procedure, though it was dicey there for a few moments. I’m less happy to report it was not the last time I ever had blood drawn, and even less happy to acknowledge that I am certain to have blood drawn many more times before I die. Assuming, of course, that I don’t keel over dead the next time someone ties a strap around my bicep, from terminal anxiety.

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Men! You are wrong to fear the phlebotomist, but you are also mostly powerless against the fear. Nothing short of a near-lethal dose of some narcotic is going to erase all your queasy anxiety about blood-work, and such a dose would be counterproductive, because it would render your blood useless, except possibly as an artisanal psychedelic among certain Goth subcultures. It’s gonna be bad, the blood-letting. There will be blood. Here are some tips for surviving your appointment with death.

Make it a morning appointment

Depending upon the type of blood work being done, they’re gonna want you to refrain from eating prior to your procedure, and this will be a lot easier between midnight and 9 a.m. than it will be between 9 a.m. and 6 p.m. Also, if you’re super hungry at the time of your appointment, there’s a chance you will be primed for light-headedness, via the magic properties of blood sugar. Now is not the time for that! Make your appointment for the morning, and plan on eating a late breakfast, after you’re free.

Forget your insurance card or ID or something

I had a 9:45 a.m. appointment to have blood drawn on Monday. Via some combination of the doctor’s admin people assuming I am not a complete chucklehead (totally their fault), and me actually being a complete chucklehead (still feel like this one is on them), I arrived on time but didn’t bother bringing my insurance card. Nuts! Can’t draw blood without an insurance card! Guess we’ll have to reschedule!

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Gotta say, though this turn of events was an accident (or was it????), it helped tremendously. I did all the panicking and all the quiet self-reassuring and marched into the office and met the phlebotomist, and then I got to go home with all my blood. It was practice! A rehearsal! I’m sure this aborted session was every bit as reassuring for the staff as it was for me.

Since you are slightly less of a chucklehead than I am, you will probably not forget to bring any important things. That’s OK, I guess—some might even say it’s “normal” and “not dysfunctional” and “not in keeping with a life-long pattern of humiliating self-sabotage.” Maybe another way of easing into this thing gently that doesn’t involve wasting everyone’s time would be to call the office in advance and ask to speak to the phlebotomist. Why?

Alert the phlebotomist to your troubles with blood

Maybe you’re like me and even the word “blood” makes the insides of your elbows and knees feel tingly and weak—this is the kind of thing the person in charge of actually taking real blood out of an actual real vein in your ar—

[passes out cold]

Ahem. As I was saying, your phlebotomist is gonna want to know that you may not be able to stay upright during the procedure. Sure, you could wait until you’re seated in the chair with the little arm-rest and the phlebotomist is arranging six—SIX! oh god there is no way I’m gonna survive this—vials in a little plastic bin right there in your line of sight, when you are already green and sweaty and seeing stars, and blurt out I think I should lay down. Your clammy, washed-out skin and failing posture will really drive home the point, I bet.

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The problem, here, is we are trying to avoid altogether those moments of spinning terror. When you make the appointment to have blood drawn, tell whoever schedules the thing that you aren’t comfortable with blood and would welcome whatever advice the phlebotomist might have for avoiding passing out or puking (or both) during your procedure. Then, just in case, call a day beforehand to “confirm” the appointment time, and either speak directly to the phlebotomist, or once again relay the message that you are a big fucking wuss-bag and require extra special care. You aren’t the first, buddy! They’ve got protocols for this kind of thing.

Lie down horizontally during the procedure

If you tell the phlebotomist you’re going to be trouble, and if you convey it such that he or she fully appreciates the likelihood that they will be carrying you around like a sack of dirt if things go poorly, they will probably move you to a bed or reclining chair.

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If they don’t have a bed or reclining chair and aren’t willing to let you lie on the ground, seriously, get your blood drawn elsewhere. I once went for blood-work at a tiny, dingy little lab in an office complex after work one afternoon, and was reassured by the plucky house phlebotomist that it would be quick and I shouldn’t worry about anything. She did not move me to a bed, and I trusted her and didn’t press the issue. I am fidgeting and dizzy and sweaty even thinking about what happened next.

She jabbed the thing into the vein and no blood came out. So, she withdrew the thing and swabbed the area again and slapped my elbow again and tightened the strap and jabbed the thing into the vein again and no fucking blood came out. By this time I was swooning, badly: stars, blurred vision, flop sweat, failing motor skills, unnatural complexion—the works. Incidentally, I am going to go walk a lap around my house right now. Be right back.

So, I summoned my very last reserves of consciousness and muttered something like we have to stop this right now or I’m going to pass out. And then I lurched forward out of the chair and stumbled to the door and held onto the doorknob for 15 or 20 seconds. And then, like that, she found me a bed! After a full half-hour of laying on it in absolute silence, we were able to complete the procedure.

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The thing about the bed/recliner trick is, because you are horizontal, you will not experience all the blood (there’s that word again) draining out of your head and the light-headedness that follows. Crucially, you will also not have to look away to avoid seeing the phlebotomist doing all the awful things to your arm. You will just lay there and clench your jaw and stare up at the ceiling, and when you feel woozy you will say friendly, endearing, self-deprecating things like man I am so bad at this, to let the phlebotomist know you’re struggling but also awake.

Drink lots of water before you go in

If they tell you to fast the night before your appointment, you should definitely do that. They might also tell you to drink plenty of water before your appointment, and you should definitely do that, too.

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See, the reason the plucky phlebotomist couldn’t make my veins work was probably because I was dehydrated (although it’s possible my veins were recoiling in terror and she lacked the hunting instincts of your apex phlebotomists). Don’t think about this, because it will make you seasick as hell. Just drink a lot of water the night before your appointment, and start your morning with two big glasses of water. This will make your appointment go faster and more smoothly, and will prevent the dreaded second effort.

Don’t sit through multiple efforts if the terror is too much

This would be bold advice from an internet person, except that this advice came to me directly from the mouth of a phlebotomist, before he drew my blood. Blood-work is done by professionals, and it shouldn’t be a goddamn scavenger hunt.

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In ideal circumstances, a phlebotomist who knows what they’re doing will not need a second attempt. In less than ideal circumstances—dehydration, tricky veins, you trembling so bad they need a team of techs to come in and pin you in place—it might take more than one try. But if you’re already having a hard time, having someone repeatedly jab at your throbbing veins with a goddamn needle is only going to make things worse. You should try to sit tight for a second attempt, but if the second attempt fails, you should feel free to abort the entire procedure. Your phlebotomist will understand if you simply say something like I’m sorry, I really don’t think I can sit through another attempt. Could we possibly reschedule this?

This is a vastly more socially acceptable way of conveying your state of discomfort than, say, blasting puke all over the walls and sobbing and passing out spread-eagle on the floor. You and the phlebotomist have a shared interest in keeping you a few steps short of maximum anxiety.

Close your eyes, breathe deeply, think about something else

This most recent phlebotomist was alert enough to notice that I wasn’t really breathing much, and reminded me to inhale. Passing along his wisdom, here!

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This really helped: I closed my eyes but didn’t clench them shut; I took slow, deep breaths in through my nose and out through my mouth; and I made a mental list of the names of all the create-a-players I’ve made over the years in NBA 2K. Alphonse Joppy...[inhale]...Otis Pukemeyer...[exhale]...Blake St. Putz...[inhale]...Bromite Charles...[exhale]. And on and on.

Who can say whether I would have been just fine otherwise? Point is, my mind was sufficiently occupied, and I was relatively calm, and when it was over a nice woman said hey you look great! You did fine! Which made me feel like a five-year-old and got me thinking about stickers and lollipops, but also is the complete opposite of what the flustered, stuttering phlebotomist told me all those years ago: I think you should stay lying down for a few minutes until your color returns.

Stay horizontal until your color returns 

This shouldn’t take more than a minute or two. Just lay back and continue taking deep breaths until that awful tingly feeling in your joints starts to fade, then rise slowly and sit for a few moments.

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Or, hey, wanna get crazy-ass vertigo all at once? Rocket up quickly and try to stand. Bitchin’! Like surfing on reality itself.

You will notice, we have not cured you of blood anxiety. Sorry, man. If you’re anything like me, having blood drawn is always going to be a touch-and-go experience. You are probably not going to suddenly become the kind of person who can give whole bags of blood (BAAAAAAAAAAARF) to the Red Cross.

Advocate for yourself, on this one. This is one of those times when being the strong, silent type is bad, and will lead to you being the catastrophically nauseated, falling-out type, taking a fucking header on the floor of some office somewhere. Not worth it! Take these steps and survive. And share your horrifying blood stories down in the comments.