Strange Harvest. Lesley A. Sharp
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and so only Nick's corneas could be retrieved; Greenberg 2003.) This procedure is moving rapidly from the experimental to the routine. As noted by Renee Fox, this unsettling approach to organ retrieval can transform the dying patient prematurely into a source of transplantable parts (Fox 1993; Fox, DeVita, and Ritchie 1998; cf. Lynn 1993). This new protocol also raises serious questions about the role that health care providers should play in facilitating death versus prolonging a patient's life (not to mention the ethical problems associated with slotting minors to NHBD status). Ultimately, this new protocol runs great risk of eroding an already shaky public trust in hospital care in this country.
Final examples of responses to scarcity anxiety involve new forms of medical research and experimentation. These ultimately rely on new hybrids of the human body that extend well beyond allotransplantation, or the melding of human-to-human bodies and parts. Briefly, these sorts of hybrids include the development of mechanical and organic alternatives, which could either help bridge the gap while patients await organs of human origin or sidestep the human organ donor entirely. Among the most celebrated examples is the development of several models of mechanical heart, including the Jarvik-7 in the 1980s and, currently, the AbioCor and other recent total artificial heart (TAH) prototypes (ABC 1996; Gil 1989; Hamilton 2001; Plough 1986; Rowland 2001). Currently such devices ensure only very short-term success rates for patients who, as little more than human guinea pigs, inevitably die from a cascading set of serious medical complications. In short, at present medical science is unable to duplicate the long-term workings of our sophisticated organs. Implantable devices that help drive a failing heart, most notably left ventricular assist devices (LVADs) currently bear more promise. Yet another highly experimental domain of research is the realm of xenotransplantation, or the creation of hybrid animal species (especially simian and porcine) that bear human genetic material and might one day define a source of organs for human use. The obstacles to creating such viable designer creatures are immense, and the research is plagued by the immunological dangers associated with cross-species infection. Such dangers have defined a focus for heated debates within this country and even more so in England (Bach, Ivinson, and Weeramantry 2001; Birmingham 1999; Butler 1999a, 1999b; Clark 1999; Vanderpool 1999). Nevertheless, within the transplant community, experimental mechanical and organic alternatives are imagined as potentially viable—and highly profitable—solutions to the current scarcity of organs (Maeder and Ross 2002). The desire for alternatives that would eliminate the problem of organ scarcity is so strong in some professional quarters that discussions may skirt ethical and other inherent dangers associated with radical proposals.
Natural and Denatured Bodies
As noted earlier, the miracle of organ transfer rests largely on surgical prowess and technological sophistication. In this sense, the range of medical expertise associated with the retrieval, preservation, and replacement of human organs represents the zenith of biomedical accomplishment in a nation that celebrates biotechnological solutions to human health problems. When framed by this dominant cultural ethos, the transfer of human parts between disparate bodies is conceived of as a natural progression within medicine. A new, experimental procedure may quickly become routine, spreading in practice from one surgeon or hospital unit to others throughout the country (and beyond) once described in published form or demonstrated with slides and videos at professional conferences.
If innovation defines a natural progression of knowledge and technique in transplant medicine, then the bodies of organ donors and transplant recipients become naturalized through this process, too. Much is made over this phenomenon within the realm of organ transfer, and this understanding is expressed through several rhetorical forms. Common assertions are that there is nothing odd, strange, or unnatural about organ transfer as a sociomedical process; nor in the ways that organs are retrieved from the dead; nor even in the fact that a surgeon can remove a patient's heart, support the body temporarily on a bypass device, and then restart a new heart once it has been properly implanted in the patient's chest (and all this without killing the patient in the process).
From the point of view of a range of lay parties—and even among recipients—the medical miracle of organ transfer is a strange act indeed. The strange and unnatural qualities of organ transfer together define a troublesome and seemingly unstoppable undercurrent. Most pronounced is the sense that the recipient body is a hybrid one because its viability as a living organism relies on its being made up of parts from at least two human beings. In contrast, a widespread understanding within anthropology and other social sciences is that hybridization is part and parcel of human existence, especially within postindustrial contexts. As Van Wolputte explains, “We are all Creoles of sorts: hybrid, divided, polyphonic, and parodic—a pastiche of our Selves. The contemporary body-self is fragmentary, often incoherent and inconsistent, precisely because it arises from contradictory and paradoxical experiences, social tensions, and conflicts” (2004: 263; cf. Haraway 1989, 1991; Latour 1993). Within the highly medicalized realm of organ transfer, however, talk of a multiple, disparate, or fragmented self is evidence of pathological thinking and requires therapeutic intervention. Lurking in the darker corners, it seems, is the specter of Frankenstein's monster (J. Cohen 1996; Shildrick 2002). Transplant recipients who openly express the sense that another person dwells within them may well acquire medical labels that draw on monstrous imagery, such as “Frankenstein syndrome” (Beidel 1987; Rollin 1995). In an effort to quell the potential unease associated with the hybrid body, transplant professionals regularly describe body parts as inert objects. In this way, the surgeon's craft centers on the repair of a complex and fragile machine. Further, when members of the lay public express unease or more blatant distaste for organ transfer, such sentiments are considered evidence of superstitious or misguided religious thoughts that can be redirected especially by procurement staff through aggressive public education campaigns.
Regardless of this professional stance, both organ recipients and donor kin regularly consider and even embrace the idea that the recipient body is a hybrid one. Although their opinions are generally voiced out of earshot of professionals, many recipients understand their new lives as dependent on the workings of parts derived from others. In this sense, both the dead donor and once ailing recipient are rejuvenated through the melding of their bodies. Donor kin may similarly embrace this idea, understanding the deceased donor as living on in the bodies of recipients. At work here, then, is an altogether different idea of the composite human form, now redefined as a gestalt composed of once disparate human parts. Such responses, rather than being pathological, naturalize the recipient body in an altogether different sense. In essence, by “embodying the monster” (Shildrick 2002), an action so feared in professional circles, organ recipients naturalize hybridity.
A key component of this process of naturalization is the manner in which numerous donor kin and recipients seek out each other, transforming one another from anonymous strangers to intimate friends and even kin. Socialization in this sense similarly defies dominant professional premises that assert that transplanted organs are inert and, thus, denaturalized parts incapable of harboring traces of their once human origins. This resocialization of the deceased donor (now understood as an integral part of the living recipient) also flies in the face of the seemingly inevitable commodification of bodies-as-parts within the transplant industry. Transplanted organs are perceived instead as fragments of beloved individuals who live on within and grant new life to others.
The Corporate Body
A final premise crucial to this study involves professional concerns over the corporate restructuring of organ transfer. This shift characterizes medicine more generally in the United States, yet, as described earlier, in the realm of organ transfer it is driven especially by anxieties over organ scarcity. Amid this shift, involved professionals may express distress over changing labor requirements and the restructuring of the workplace itself. As one longtime procurement professional lamented, her agency began twenty years ago as a mere “shoe box operation,” where a small collective of employees worked elbow to elbow in a cramped, one-room office, sharing all duties. Today this same agency is housed in an impressive suite with a large and highly specialized staff who are divided into a range of divisions. Such developments are hardly confined to the transplant industry: Lorna Rhodes (1991), for instance, recorded similar sentiments among mental health care specialists who began as community activists working the streets on foot or from the back of a van.
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