Bodies Into Other Bodies | MedPage Today

On December 23, 1954 — about 70 years ago — at the Peter Bent Brigham Hospital in Boston, the American surgeon Joseph Murray, MD, removed the kidney of Ronald Herrick and planted it into the right pelvis of his ailing twin brother Richard. Once the clamps were removed on the transplanted kidney, it turned pink and urine flowed. This counts as the first successful living transplant in history. It gave Richard the chance to live 8 more years, marry his nurse, and father two children.

A year later, in 1955, Murray wrote with barely a tremor of excitement in JAMA that “Tissue transplantation…appears to be a feasible procedure in identical twins, but to date, successful permanently functioning homografts appear to be limited to such individuals.”

Things have changed since then, and many more organs and body parts can now be recycled: skin, faces, legs, larynxes, uteruses, penises, and more. The transplanted body has also entered the cultural bloodstream, in part because it lends itself so well to narrative. It can horrify (Mary Shelley’s Frankenstein), sentimentalize (the movie “Return to Me”), and philosophize (French philosopher Jean-Luc Nancy’s essay “The Intruder”).

Most modern transplants follow the structure of what ethnographer Arnold van Gennep calls a rite of passage in his book of the same name. A rite of passage, such as a birth or marriage, transports participants to a time outside of time. It has three stages: separation, transformation, and incorporation. Transplantation begins with separation from the world and the self as they knew themselves, through illness or accident for the recipient, and through surgery for the living donor (or death for the cadaveric donor). Then comes transformation in the operating theater, as part of one body becomes part of another body. Finally, recipient and donor (if alive) are re-incorporated, gingerly stepping back into the lives they’d left.

I received a kidney transplant 26 years ago at New York-Presbyterian Hospital in Upper Manhattan. An organ transplant, like anniversaries, sits like a rock in the stream of time, splitting it into different currents. Perhaps we could call it “transplant time.” This form of temporality, like its sibling “crip time,” in the words of disability scholar Ellen Samuels, “extract(s) us from linear, progressive time,” and casts us “into a wormhole of backward and forward acceleration.” An organ transplant warps time and creates different time zones, just as it transforms the body.

Though I’d been abroad for 15 years, I returned to New York like a salmon returning to its gravel nest to spawn. For over a year, my blood had slowly turned to urine, bringing me so close to death I could feel its mass. I was about to be released from its orbit into a new body. Two days after my birthday, which was spent watching my blood travel from my body and through a dialyzer, I would celebrate my rebirth-day.

Following surgery, things were — to borrow from Sara Wasson, PhD, a scholar of the transplanted body at Lancaster University in England — “temporally ambiguous,” certainly not chrononormative. The New York minutes ticked down Broadway, past my first nursery school at Riverside Church and Columbia University where I’d gone to graduate school; but in my room, different time zones and histories intersected. A raw scar over my pelvis showed where I ended and someone else began, a slightly bulging oasis of otherness. Most of my body was 29, but the kidney my aunt Ingeborg had given me was 54.

Unlike recipients of a cadaveric kidney, I knew some things about this kidney. I knew it had spent most of its life in wilds of the American Midwest; but also that when Ingeborg was an infant in 1944 her mother dodged advancing Russians and their bullets to ferry her — and her kidneys — out of Poland to Germany before migrating to the U.S.

After a couple days, I shuffled with a precarious gait down the hall to a large-windowed lounge overlooking the Hudson, the river that flows both ways, to New Jersey, where I’d been born. We, the “reborn,” hovered there, like ships waiting for the tide to change, our bodies dosed on the immunosuppressant cyclosporine (Neoral), derived from a soil sample collected in Norway in 1969.

Deceiving the immune system into accepting the Trojan Organ is still the great challenge of transplantation. This is perhaps why Jean-Luc Nancy, who received a heart transplant, calls his heart a “trespasser” and transplantation a “metaphysical adventure” that challenges the concept of selfhood. A 2024 study in the journal Transplantology of 47 organ recipients revealed that 89% reported changes in their personalities after surgery. One of the authors raises the possibility that non-neurological “cellular memory” in the donor organ may be responsible.

I still take immunosuppressants, a daily reminder of the kidney’s guest-worker status. Transplant recipients may be reborn, but we are not cured. There’s a good chance I will outlive my aunt’s kidney and need another. Every 3 months I visit my nephrologist to discuss the health of my organ, as though it were a fetus. Each time I hear the kidney is doing well, I am as relieved as a prospective mother.

There’s my life and the life of the kidney. If it is true, as writer Susan Sontag says, that we all hold dual citizenship in the “kingdom of the well” and the “kingdom of the sick,” transplant recipients are detained at the border between the two, moving on a double track of “cured” time and sick time.

But borders can be exciting places, where you are neither citizen nor foreigner. I am grateful to be here. When I shake my 26-year-old pillbox and hear the clatter of tablets inside the frosted plastic, I am grateful. When I touch the slight rise in my abdomen where I bear Ingeborg’s kidney, I am grateful. Tante Niere (Auntie Kidney), as we call Ingeborg in her native German, is 80 now and glad her/my/our kidney is performing the alchemy of converting blood to urine in New Zealand, where I now live.

When I first learned I needed a different kidney, my nephrologist at the time told me, “It’s time we transplanted you,” as though I were to be spirited away to some wild shore of existence. In retrospect, I suppose he was right. Since that time, however, I’ve come to believe the transplanted body is not unique to me at all. I’ll give van Gennep the last word: “Life itself means to separate and to be reunited, to change form and condition, to die and to be reborn. It is to act and to cease, to wait and to rest, and then to begin acting again, but in a different way. And there are always new thresholds to cross.”

Eric Trump, MS, is a writer and a professor of medical humanities at the University of Otago Medical School in Dunedin in the South Island, New Zealand.

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