Tuesday, August 5, 2014

Medical Science in a Dystopian Light

The first human organ transplant was a kidney transplant performed in 1954. The donor of the kidney was the identical twin of the recipient and therefore there was no immune rejection of the organ.
The recipient lived for eight years following the transplant and the surgeon who performed the transplant, Dr. Joseph Murray, went on to win the Nobel Prize for this work. The recipient of the first heart transplant, performed in 1967 by Dr. Christian Barnard, lived only 18 days. The patient did not die because the new heart failed, but because of pneumonia that the patient acquired due to the patient’s immune system being compromised by the anti-rejection drugs that he had to take.
These two cases illustrate both the promise and the challenges of organ transplantation: donor organs can greatly extend life, but there is a critical shortage of donors and, unless the donor is the identical twin of the recipient, the recipient’s body will always reject the donor organ.
In order to combat this rejection, the patient must take lifelong anti-rejection drugs which compromise the immune system and greatly increase the risk of the patient dying from infections.
In the 1960s, anti-rejection drugs were very poor; hence very few organ transplants took place. In the 1970s, better anti-rejection drugs, particularly cyclosporine, were developed and by the late 1970s many heart transplant patients were living up to five years with their donor hearts.
In 1983, the FDA approved cyclosporine for use in organ transplantation, and the first lung transplant patient survived more than six years. Although the improved anti-rejection drugs increased the life expectancy for patients receiving organ transplants, they came with harmful side effects that shortened the recipient’s natural life span. In addition to the side effects, the anti-rejection drugs are also very expensive and must be taken for as long as the patient lives.
Such is the historical fact behind British dystopian (from “dystopia” which is an undesirable society, even terrifying as opposed to “utopia” which is a desirable, perfect society) science film (2010), Never Let Me Go, based on Kazuo Ishiguro’s novel of the same title (2005). Available from online book and film stores like Amazon.com and Barnes & Noble.com.
Parable of human mortality
The film begins in a British boarding school where the children are special, extreme care is taken concerning their health. They are genetically engineered to provide human spare parts when they mature. Most of them “complete” (die) after their third donation.
Many would want to complete earlier and nobody wants to live beyond fourth donation, because life would be very hard— no more ‘carer’ and they just wait and watch until they are switched off. They have no parents, they cannot have babies, but they can have sex. Their last chance at happiness is to have a “deferral,” meaning, two people in love can live together for three years before they start donating their organs. But this proves untrue, as the authorities said there is no such thing.
The story is narrated by Kathy H., in a love triangle with Tommy and her best friend Ruth. Both Ruth and Tommy “complete” before Kathy does, as she volunteers to be a carer for donors. She serves as carer of both Ruth and Tommy, briefly at different times, after 10 years they have been apart. When Tommy dies, Kathy is tired of being a carer and wants to start at becoming a donor soon.
Although the film is a profound parable of human mortality, the medical backdrop wherein surgeons harvest organs from clones to save lives of wealthy privileged patients, is deeply disturbing; and even more horrifying is the implied power of bio engineers who play god, creating sub humans meant for destruction after fourth donation when the clones “complete.”
Why four donations and not just harvest all the organs at once? In the Amazon online forum, a reader discusses:
“We all know that these organs are taken from a living donor—liver or portion of it, one of two kidneys, one of two lungs, intestine, ligament, femoral arteries, cornea, intestine, skin, etc. Organs are harvested in whatever order they are demanded, not a ‘’this first, this second’’ type of thing.
“The heart and lungs are not the fourth donation. It would be a waste not to use the rest of the body, and the heart is required to be pumping blood to keep organs viable. Organs are donated on an “as needed” basis. So, “completion” means brain death, though other viable organs are harvested momentarily from the donor-clone while the heart is still pumping. This is where the fear comes into play that consciousness would continue past brain death.”
Parable of medical ethics
The film is also a parable of medical ethics. How far can medical practitioners go in the name of science? Apparently, organ transplantation is intended to save lives. But whose lives (the privileged class of society), and at the expense of whose lives (the poor and marginalized like criminals, prostitutes, orphans)?
Like a great work of art, Ishiguro’s novel rendered cinematically with great success, (excellent direction and cinematography; powerful but restrained performance by the lead actresses and actor) reveals several layers of meaning and continues to provoke questions. It is all at once local (British) and international (people of various nationalities can relate with its fundamental theme and message).
All of us want to live a full life, to be married to someone we love and spend the rest of our life with, have children of our own; and we all fear death, but we all accept it, we do not run away from it when we know it is coming soon inevitably.
Terminal cancer patients do not go on a safari adventure or world tour. They just want to continue living each new day as long as possible, witness the sunrise and sunset, take a bath, enjoy sizzling coffee and buttered toast, nothing more, and yes, deaden the pain with a dose of morphine, as the doctor prescribes.
Both book and film are valuable for what they communicate but even more precious for what is left unsaid— especially for those of the Christian faith. Life on earth is just a transition. Eternal life awaits those who believe in the saving power of Christ’s resurrection.
We all want to give our best shots in whatever profession we are in, because this is the only way to live, so that at the end of the day we have no regrets. As the film narrator Kathy H. philosophizes, “We all complete.” In more ways than one.
July 2014 Health and Lifestyle

1 comment:

  1. My source for intro is Harvard Apparatus Regenerative Technology at www.harvardapparatusregen.com . My apologies for failure to paraphrase.