In the weeks before open-heart surgery, a quiet intervention — iron delivered through a vein — appears to tip the balance for patients who arrive already depleted. A large multinational trial published in The BMJ found that anemic cardiac surgery patients who received intravenous iron before their operations were measurably less likely to need a blood transfusion afterward, and spent one additional day recovering at home in the months that followed. The finding is modest in scale but meaningful in implication: in a domain where transfusions carry their own risks and blood is a finite resource,