The science & fiction of organ transplantation
A transplant surgeon once asked me why people have so many doubts about becoming an organ donor. Why do they think organs transplantation is dangerous or immoral? I believe the main reason is that what they see on television and read on the Internet raises so many philosophical questions. For example, when I think of organ transplantation the first image that comes into my mind, is that of COMA. I saw this movie in the late 1970s as a young girl. It was the first thriller I saw, very exciting. The movie tells the story of healthy people who go into a COMA after undergoing a relatively simple surgical procedure. These COMA patients are moved to a special clinic where they are to receive ‘proper medical care’. But, as the heroin of the story discovers, the Jefferson Institute is not a hospital, it is a repository of fresh, healthy human bodies whose organs are collected and traded on the black market.
The story, written in 1977 by Robin Cook, is a reflection of the developments in medical science at the time. A number of successful first organ transplants were performed in the late 1960s. One breakthrough followed another. The first successful heart transplant was performed in 1967 by the charismatic South African heart surgeon Christiaan Barnard. His patient, Louis Washansky, lived another 18 days after the procedure. He died of pneumonia. This medical breakthrough fueled fiction and wild fantasies.
“One need not be a science fiction writer to envision the possibility of future murder rings supplying healthy organs for black-market surgeons whose patients are unwilling to wait until natural sources have supplied the heart or liver or pancreas they need. More prosaically, shall people near death be allowed to sell their heart or liver to the highest bidder or shall the future use of such vital ‘spare parts’ be decided by some agency set up by society,” wrote a New York Times commentator about Barnard’s revolutionary transplant.
In the years that followed, the techniques improved and with the discovery of cyclosporine in the early 1970s, organ transplantation became a more and more a common medical procedure. It radically changed the way we perceive the human body, and therefore human beings.
Transplant medicine, forced us to replace a holistic image of the body with a mechanistic image. The body changed from a unique entity into a body made up of interchangeable parts. The body became a machine and the organs become a commodity.
The fact that we can so easily replace body parts also raises a another philosophical question. How is the body related to the ‘I’, or the soul? Can you just take part of a body and transplant it to another body without affecting the identity of the recipient of the organ?
This question is older than transplant surgery. Take for example the silent movie Les Mains du Orlac from 1924. This movie narrates the story of a successful pianist who loses both his hands in an accident. His girlfriend cannot accept his loss and urges the doctor for a transplant. Coincidentally, a violent criminal was executed the same day so his hands are used. You can guess it, those hands lead a life of their own. These were the hands of a murderer. Orlac cannot control the hands (with which he cannot play the piano) and starts killing.
A more comical and absurd variation on this story is the halloween episode of The Simpsons Halloween Special IX, Hell Toupee. The story is similar to Mains du Orlac: serial killer Snake is executed and Homer Simpson gets a hair transplant that same day. The hair looks great, only the nerves from the hair transplant grow under his skull into his brain and take control take control of Homer who suddenly behaves like a serial killer. It is bizarre. It is funny. What do these fantasies, these horror stories tell us about how people feel about, and think of organ transplantation?
Bruce Hood, professor of cognitive neuroscience at the University of Bristol, studied the effects of information about the donor’s moral character on the potential heart recipient. It made a huge difference. Most of the respondents did not want the heart of a rapist or serial killer. I fully understand this. It’s just not a nice idea that you walk around with the heart of a rapist beating in your chest. According to Hood, we feel that way because we deep down believe that after a transplant we become a little bit like the other person.
“Essentially they believe, that somehow they will take on those characteristics of the donor.”
I will give you another example. Not fiction this time, but a true story: Gary Gilmore. Gilmore was a serious criminal, convicted for multiple rape and murder. He was sentenced to life for his actions. He did not want want to spend the rest of his live in prison, and therefore asked the American state to execute him. He wished to die in front of a firing squad. But he had one more wish. He also wanted to donate his organs. This happened in 1977. Someone got a kidney (the other was damaged by a bullet). Two others got his corneas. Strange thought? That’s also what Timothy Smith, songwriter and singer of the punk band the Adverts, thought. He wrote a song about is:
I’m lying in a hospital,
I’m pinned against the bed.
A stethoscope upon my heart,
A hand against my head.
They’re peeling off the bandages.
I’m wincing in the light.
The nurse is looking anxious,
And she’s quivering in fright
I’m looking through Gary Gilmore’s eyes.
The doctors are avoiding me.
My vision is confused.
I listen to my earphones,
And I catch the evening news.
A murderer’s been killed,
And he donates his sight to science.
I’m locked into a private ward.
I realise that I must be
Looking through Gary Gilmore’s eyes.
Looking through Gary Gilmore’s eyes.
I smash the light in anger.
Push my bed against the door.
I close my lids across my eyes,
And wish to see no more.
The eye receives the messages,
And sends them to the brain.
No guarantee the stimuli must be perceived the same
When looking through Gary Gilmore’s eyes.
Gary don’t need his eyes to see.
Gary and his eyes have parted company.
These kinds of reflections go beyond biology. It’s about the relationship between body and personality. Body and identity. Organ transplant enables people to fuse. That simply must have an effect on the recipient. At least, that’s what some people, with no medical expertise think. There are plenty of high-profile cases of people claiming to have changed character after a transplant. Their stories are weird, amazing and very entertaining!
Take for example, the remarkable story of Sonny Graham. Too good to be true, one might say. He married the 20 years younger widow of his heart donor. (When he got the heart he was married to another woman, the mother of children!) Several years after his second marriage to his hearts donors’ wife, he commits suicide with a firearm. Just like his heart donor did.
Would you like to hear more stories like this? Then watch Mindshock transplanting memories, a channel 4 documentary. The main message of this documentary is that the heart is also a carrier of memories. You hear two scientists, who come up with very plausible explanations.
The Daily Mail, is always a source of good stories. The one about a woman who started reading Dostoevsky after her kidney transplant is my favourite. Other stories are about fast food, green peppers and sports. All of these articles tell more or less the same story: it is difficult for the recipient of an organ to let go of the thought of the other. The other persons’ heart is pumping your blood through your body.
That is exactly what the film 21 grams is about.
The movie begins with the following image: Sean Penn lying in an hospital bed, holding a heart in glass jar in his hand. His own heart. Someone elses’ beats in his chest. Even if you do not have a medical background, you can see clearly his heart was in dire need of replacement. It does not look good.
Anyway, with that new heart his life becomes an emotional roller coaster. He argues with his wife after finding out she once had an abortion, and he becomes obsessed with his new heart. He must know who the previous owner of his new heart was. He hires a private investigator to find out. He learns that the heart belonged to happily married man with children. Killed in a car accident.
As soon as he discovers this, he starts chasing the widow. She is a beautiful woman. He makes contact with her. The rest is easy to guess. I find the most dramatic scene is when she lies with her head on his chest and listens to the beats of her deceased husband’s heart. The film does not have a happy ending. But I can recommend it. It is very relatable.
This I cannot say about Heart of a stranger that is based on a true story. This story is about a female piano player, who receives the heart from a young brash drunkard. After her operation she turns into a ruthless woman. With a lust for beer. The story on which the film is based is that of Claire Sylvia, allegedly her first words after the successful heart transplant were: “I am dying for a beer.”
She had never drunk beer in her life.
Science fiction and medical fantasies taught me 3 lessons about our thoughts and emotions on the subject of organ transplantation.
Firstly, some may find it unappealing that the body consists of spare parts, and the body can be seen as a commodity. It is in stark contrast to the body as a sacred spiritual unit.
Secondly, I think people have legitimate fears about harming the donor’s interests. His or her interests always inferior to the interests of the recipient. We have to deal with that carefully.
Finally, not everyone can let go of the idea that part of donor continues to live on in the recipient. They fear that memories of the donor will be transplanted with the organ.