Strange Harvest: Organ Transplants, Denatured Bodies, and the Transformed Self (review)

In Strange Harvest: Organ Transplants, Denatured Bodies, and the Transformed Self, Lesley Sharp engages her readers in an exploration of organ transplantation. Her leadership guides the reader on both a philosophical and a sociological journey into Organ Transfer, the term she prefers for her long-standing field studies. This is not light reading for the simple passage of time, but rather a challenging study of a field imbued with emotion, religion, spirituality, and personal acceptance of very difficult problems. How individuals deal with the issues addressed forms the structure of the discussion, from the vivid descriptions of the heartbreaking realization that a loved one has died, to the all-too-real problem that donor families may be directed how to grieve their losses and recipients celebrate their gains. Sharp deals with the topics in four chapters, with detail gathered from interviews with recipients, donor families and especially donor mothers, organ procurement organization representatives, and transplant professionals. Each chapter deals with a different issue and its subissues in a scholarly way. Sharp has produced a treatise that reflects unique insight into provocative areas, grounded in sound research. This is a timely and highly educational text suited for graduate and undergraduate students, as well as those involved in transplantation. It is thoroughly engaging and provides new views into some murky areas of transplantation.

The first chapter,"We Are the Dead Men," deals with the never-ending controversy surrounding brain death. Among the questions addressed are the definition of brain death, the possibility of the twice or even thrice dead, and, if donors are dead, why anesthesia is a part of the donor operation. As a transplant physician, I find these topics engaging, challenging, highly stimulating, and sometimes bothersome, each begging for ongoing and thorough exploration of the unknown or unknowable. From the viewpoint of the non-medical public (especially donor kin), each issue accentuates the emotion of the donor situation and the fragile understanding we have about the process of death, and certainly its timing.

Chapter 2,"Memory Work," details the feelings and communications of transplant recipients and donor relations, as well as perceptions from the outside world of the non-transplanted. Central to this chapter are the memories of the recipients of their prior lives and of their donors; of donor families for their loved ones; and of the uninitiated into the touchy struggles of transplant recipients. Rare is the individual recipient who suffers no buyer's remorse over the receipt of an organ and has no challenges in ongoing life. Rare is the donor family (especially mother) who feels that their loved one has received all the recognition deserved. And rarer still are the non-involved who can understand the trials of either the recipient or the donor family. Particularly difficult is the perception of censoring felt by the donor family who wish to publicly memorialize the dead but are directed to stick with a scripted and palatable formula for public discussion. Sharp describes both the emotions felt in this circumstance and the hostility that may result, and how transplant public policy is evolving due to the efforts of those who see the control as unwarranted and overly sanitized. The result is that Sharp captures the sense of denial of grieving that many donor families feel and the complex sensations of the recipients, who are sometimes asked to suffer silently because they have been given a gift and are thus expected to just be grateful.This chapter provides a clear view into these several problems.

Chapter 3, "Public Encounters as Subversive Acts," addresses the issues surrounding the discovery and identification of anonymous donors or recipients of their organs. It is only relatively recently that much attention has been paid to donors and their families by the transplant community or that various fetes have been held in honor of the recipients. Based on the old premise that organ donation ought to be anonymous, the hide-and-seek of a recipient's search for donor information was...