Second Wind: Oral Histories of Lung Transplant Survivors by Mary Jo Festle (review)

Second Wind explores a topic most people probably have not spent much time contemplating, unless they work in pulmonary medicine or are close to somebody with lung disease. Mary Jo Festle gets deep into her subject, giving readers a good understanding of the history of lung transplantation and the complex ethical, logistical, medical, and emotional issues surrounding this delicate operation.

Page one of the introduction dives head first into the question Festle was probably asked dozens of times: Why this subject? Despite a rising acceptance of organ donation, many people have an inherent revulsion about the idea of an organ being transplanted from one body to another—in fact, it conjures up images of Frankenstein, Dr. Moreau, and scores of mass market thrillers. But Festle had a very personal interest that originally had nothing to do with scholarly ambition: two of her brothers were born with cystic fibrosis (CF), a disease that causes thick, lung-clogging mucus and is usually fatal by young adulthood. John Festle died of CF in 1991, before he was able to get a transplant; Bob Festle, the younger brother, underwent lung transplant surgery and enjoyed about five years of quality living before chronic and fatal organ rejection set in.

Festle confines her personal story to the introduction and epilogue. The rest of the book chronicles the history of how lung transplantation developed from what seemed almost like a science-fiction procedure into a generally accepted surgery, and the personal experience of lung transplant patients. While Festle did lots of conventional research to understand the medical history, she relied on fifty-eight oral history interviews to delve into the personal side of lung transplantation; third- and fourth-year undergraduate students in Festle’s class, “Oral History of Lung Transplantation,” an interdisciplinary seminar she taught three times, conducted most of the interviews. Festle located many of the narrators by sending a request through the Second Wind Lung Transplant Association member e-mail list. The final list of narrators included seven patients waiting for a lung transplant, forty-six recipients (including Bob Festle), two surgeons, and four caretakers. The audio recordings and transcripts are housed in the Oral History Program archives at Elon University, a private liberal arts university in North Carolina.

The book gets uncomfortably intimate at times. Readers can imagine living a life where something as simple as getting dressed leaves them breathless, deciding whether or not to take their chances on an iffy operation that could either kill them or extend their lives a few years, and then waiting for a call that can come at any moment, letting them know that a suitable donor has just died. “One of the biggest challenges lung transplant candidates faced was how to cope with the two very different future possibilities: dying or undergoing a lifesaving transplant,” Festle writes (107). Should the person with lung disease travel to places she or he always wanted to see and eat all her or his favorite foods, or stay close to the transplant center and foster good diet and exercise habits? “It was difficult to contemplate and give equal energy to both possibilities, and people were often forced to make practical choices that tended to lean toward one more than the other” (108).

Festle and the narrators examine these complicated feelings. Transplant candidates are all too aware that somebody must die if they are going to have a chance to live. While the donor’s family is not given details about the recipient, many lung transplant survivors exercise their option to express their gratitude toward the donor family. In some cases, they even form an ongoing relationship.

Transplant candidates often look to each other for support, and to those who have successfully undergone the operation. At the same time, they are competing for scarce and precious resources. As Festle noted, “The greatest obstacle to community, however, may have been the fact that lung transplant candidates could have viewed one another as...